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If mother-to-be needs prenatal care, she'll get it

Few ideas in medicine are clearer than this one: Pregnant women need to get early prenatal care.

Women who get that care have much less chance of giving birth to premature and low-birthweight babies, who often suffer serious medical complications.

"We don't need to do a pilot study," said Dr. Claude Dharamraj, assistant director of the Pinellas County Public Health Department. "We know that."

But an organization studying the issue has found that many Pinellas County women still aren't getting the help they need.

In some neighborhoods, nearly half the pregnant women did not get any prenatal care until the second trimester or later, according to data compiled by the Healthy Start Coalition.

In other neighborhoods, more than 20 percent of the babies weighed less than 5{ pounds at birth.

"This was worse than I expected," said Connie Smith, project director for the coalition, after reviewing data on about 40 census tracts that are considered to need increased prenatal services the most. The mission of the coalition, made up of representatives of social service agencies, the medical profession and the public, is to ensure that more women get proper prenatal care and more babies are born healthy. Similar organizations have been set up elsewhere in the state.

Smith said Pinellas County's statistics compare favorably with state and national averages, but it is clear that Pinellas County still needs to make some changes to make sure more expectant mothers get prenatal care.

Using the survey information and other data, the coalition board has come up with reasons that some women don't get prenatal care, and strategies for encouraging them to do so.

A survey of women who received prenatal care later than recommended showed that the most frequent explanation for not going to the doctor was an inability to pay.

Many women probably didn't make the first trip to the doctor because they had no insurance and felt, "If I have no money, why should I call the doctor?" said Gwendolyn Claxton, chairwoman of the Healthy Start Board.

Actually, more people are now eligible for help because Medicaid benefits recently have been expanded to include anyone who earns up to 185 percent of the federal poverty level. That means that a pregnant woman who is in a family of four could have Medicaid pay for the cost of birth as long as the total household income is under about $23,000.

A high number of women also said they didn't receive the care because they didn't have transportation and because of long waits at doctors' offices.

The county needs to focus more on education and awareness, Smith said.

She would like the coalition to increase publicity about the need for prenatal care so that, "if you're pregnant and you're not in care, people will say, "Why not? Why not?'

" Smith said.

Teen parents are considered more likely to fail to get proper care, and that's one reason the coalition hopes to encourage expanding health clinics at Pinellas schools.

While acknowledging that it will be a controversial suggestion, Smith said the clinics should provide information on birth control.

Another possibility is to get pregnant teenagers to talk to other teenagers.

"A teen that's been through it and that's going through it will often be heard in a different way than an adult," Smith said.

Now that the coalition has analyzed the data and come up with some strategies for improving the level of care, members hope to draw up a list of specific goals within the next 60 days.

PRENATAL CARE

Pregnant women in Pinellas County who want to receive care and are unsure if they qualify for medical benefits should come to the health department, Dr. Claude Dharamraj said. She said the department will provide health care for at least 45 days while determining if they qualify. Pregnant women can call first, or just go to the health department without an appointment. Health department offices are at 500 Seventh Ave. S in St. Petersburg; 6350 76th Ave. N in Pinellas Park, 547-7780; 310 N Myrtle St. in Clearwater; and 301 S Disston Ave. in Tarpon Springs.

Keeping babies healthy

Here are some characteristics of 10 Pinellas County census tracts that will be getting special emphasis from Healthy Start, a program designed to improve the health of pregnant women and their babies.

201.01: In this area, 73.2 percent of the recent births were to unwed mothers and 22.7 percent were to mothers age 18 or younger. About 9.3 percent of the babies were 5.5 pounds or less when born.

205.00: The median household income was $13,224. About 11.4 percent of the babies weighed 5.5 pounds or less at birth.

206.00: About 77 percent of births were to unwed mothers and 30 percent were to mothers who were 18 years old or younger. About 12 percent of the babies were 5.5 pounds or less when born.

208.00: This census tract has 461 households headed by women, more than any other in Pinellas County. Nearly 14 percent of the babies were 5.5 pounds or less when born, and 85.3 percent of the recent births were to unwed mothers.

209.95: This is the fourth-most densely populated census tract in Pinellas, which is the most densely populated county in Florida. About 86 percent of the families were headed by women. The median household income was $7,308.

212.00: This is the third-most densely populated tract in the county. About 17.7 percent of the babies were under 5.5 pounds at birth.

246.00: About 29.8 percent of the families were headed by women, a lower percentage than some of the other census tracts in this group. Nonetheless, the total number of households headed by women was 268, the 12th-highest in the county.

249.04: About 30.9 percent of the recent births were to single mothers. About 8.3 percent of the babies were 5.5 pounds or less at birth.

250.08: About 24.5 percent of the recent births were to single mothers. About 20.3 percent of the mothers entered into prenatal care after the first trimester.

253.01: About half the recent births were to single mothers, and 33.3 percent entered prenatal care after the first trimester.

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