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Women Urged to Seek Prenatal Care: Experts Say Diabetes, Obesity and Hypertension in Valley Putting Pregnant Women at Higher Complication Risks

Posted on: Sunday, 25 December 2005, 15:00 CST

By Melissa Mcever

ight Ridder/Tribune Business News

Dec. 24--Considering the Rio Grande Valley's skyrocketing rates of diabetes, obesity and hypertension, many pregnant women here could be at high risk of complications, experts say.

That's why health-care providers and officials, like Sister Angela Murdaugh of Holy Family Birth Center in Weslaco, want more Valley women to seek prenatal care.

"It's kind of like a Russian roulette -- most pregnancies are normal, but there are those few we need to pick up," said Murdaugh, one of the nonprofit birthing center's founders.

Prenatal care, which includes examinations, lab tests, nutritional counseling and regular checkups, can help detect pre-existing conditions and possible complications, as well as helping women know what to expect during their pregnancy, health-care providers said.

"It's a chance to keep (the woman) healthy, to answer questions and offer advice," Murdaugh said.

Yet many Valley women receive insufficient care or no care during pregnancy, according to the Texas Department of State Health Services.

In Cameron County, about 43 percent of pregnant women received inadequate prenatal care between 2000 and 2003, meaning their care has not met certain state-specified guidelines, the department has reported.

In Hidalgo County, about 30 percent of women received inadequate care. In both counties, about 5 percent received no care at all.

"We have much lower rates of women getting care in the first trimester," said Dr. Brian Smith, regional director of the Texas Department of State Health Services' Region 11. The region includes Hidalgo and Cameron counties.

Providers and experts cite several possible reasons why many Valley women aren't seeking prenatal care or are receiving insufficient care.

Smith speculated that many women, especially the uninsured, are unaware of their options and face bureaucracy and backlogs when they seek care.

"When a person's new to the country, for instance, they don't know where to go (for care)," he said. "And then, when they go to the county health department, there's a long wait."

County health department officials, however, denied there was a backlog of patients and said many patients can see a doctor or nurse practitioner within a week or two.

"I think the Valley has a lot of services available," said Eduardo Olivarez, chief administrative officer for the Hidalgo County Health Department.

Olivarez said he thinks some women opt not to seek prenatal care out of fear of being reported to U.S. Customs and Border Protection if they are undocumented immigrants.

"I can understand their tentativeness," he said.

The counties' health departments require only proof of residency, not proof of citizenship, from patients. That's the case at most clinics, Olivarez said. Still, some patients are nervous, he said.

Cost is another obstacle.

Several of the Valley's federally funded indigent clinics offer comprehensive obstetrics services, including prenatal care, but usually for at least a small fee.

At Su Clinica Familiar, patients with no insurance typically pay about $400 for prenatal care, exams and delivery, said Dr. Elena Marin, director.

At Holy Family Birth Center, prenatal care and delivery cost about $3,000, but patients who can't pay can contribute volunteer hours toward the cost.

Still, for the poorest of the poor, even scraping together a small fee is a challenge, Murdaugh said.

"Some of them can't even afford gas for their car," she said.

Lack of transportation to the clinic or hospital also is an issue, Marin said. And some women just don't think prenatal care is necessary, she said.

"They just go to the ER for delivery, and they see it all as natural," Marin said. "But it's important to identify risk factors early."

Those risk factors include pre-existing diseases like diabetes and hypertension, as well as conditions that can appear during pregnancy, like toxemia. Pregnant women with poorly controlled diabetes, for example, are three to four times more likely to have a baby with birth defects, according to the March of Dimes.

Murdaugh said she thought more women would seek prenatal care if emergency Medicaid covered the cost, like it covers labor and delivery costs.

Smith agreed.

"We should put money into prenatal care instead of into disease," he said.

Meanwhile, local providers said they hope to increase awareness on the importance of prenatal care.

"It's extremely important for the health of the child," Marin said. "And it's a good way to ensure a healthy delivery."

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Copyright (c) 2005, Valley Morning Star, Harlingen, Texas

Distributed by Knight Ridder/Tribune Business News.

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Source: Valley Morning Star (Harlingen, Texas)

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