By Toni Garrard Clay
|Certified Nurse Midwife Robin Fincher and OB Clinic Coordinator Marie Taylor serve at the ETMC Athens OB Clinic.
Several years ago, the staff in the ETMC Athens OB department became aware of a growing problem. More and more women were coming to the hospital to deliver babies without having seen a doctor beforehand.
The result was too many premature deliveries and too many moms and babies with compromised health - conditions that often could have been prevented with routine prenatal care. Something had to be done, and that something was the opening of a free ETMC Athens OB Clinic in August 2003.
Word was sent to health departments around the area, and women began to show up for eligibility screening.
"When we first opened, it was just two hours every Monday morning, with six or seven patients," said OB Director Heidi Cantrell. "Then we moved into the clinic behind the main building and made it all day Monday. Now we've expanded to Mondays and Fridays, and we see 20 to 24 patients a day. That's pretty good growth."
The clinic is run by OB Clinic Coordinator Marie Taylor, herself a nurse at ETMC Athens, and Robin Fincher, a certified nurse midwife who also works at a local private practice. Taylor and Fincher manage the pregnancies of the women who come to the clinic up until the last three weeks before delivery.
Those last three weeks, the women are seen by one of five doctors who volunteer their time at the clinic: family doctors Ted Mettetal, Norm Jennings, Jon Rich and Doug Curran, and obstetrician/gynecologist Dr. Gregory Mondini.
Curran said the impact of the clinic on the overall health of the community has been enormous. "Our community hospital a few years ago was recording high numbers of premature births. Now, we have some of the lowest numbers in the state of Texas for premature births," said Curran, "and I attribute a lot of that to the success of the OB Clinic. "We're able to manage expecting mothers and keep their pregnancies going so they can deliver healthy babies. The clinic is good for mom, and it's good for baby."
The clinic regularly has about 55 women enrolled in the program, and with the recent expansion to two days a week, those numbers will likely go up.
"We're expecting to see more women," said Taylor. "Thanks to the new program offered by CHIP, we'll now be seeing the patients after they deliver, for their two-week and six-week check-ups. That will give continuity of care for our patients."
CHIP is the Children's Health Insurance Program provided by the state of Texas. Starting this year, CHIP offers prenatal care for the unborn children of Texas residents who are uninsured and not eligible for Medicaid due to income or immigration status. Judy Carlisle, a financial consultant at ETMC Athens, screens potential OB Clinic patients.
She explained that up until the CHIP program, the prenatal care has been provided at no charge by the hospital, though there was reimbursement through Medicaid for the actual deliveries.
"We've been offering the prenatal care for free for years, but now we'll get a little reimbursement through CHIP," said Carlisle. While the majority of the clinic's patients are Hispanic women who do not qualify for Medicaid because of their citizenship status, Cantrell points out the clinic is open to any pregnant woman whose income level is below a certain percentage and who does not qualify for Medicaid.
"It doesn't matter what the nationality is," she said. "The OB Clinic catches those people who don't qualify for Medicaid -- and that might be because they make too much money for Medicaid but still can't afford medical care."
Gestational diabetes care
"There's no doubt this clinic causes better outcomes for mom and baby," said Taylor. "At 28 weeks, we check for gestational diabetes, and we're able to help those moms who otherwise wouldn't have known. Many of them, when told they have gestational diabetes, are shocked."
Since the Hispanic population is more susceptible to diabetes, such diagnoses aren't uncommon at the clinic. Fincher also noted that when patients at the clinic are recognized as being at high risk, they are transferred to one of the private care offices in the area. "Those are patients who otherwise wouldn't have received any care," she said.
Cantrell is straightforward in her assessment of the clinic's practical application: "If we don't provide these services, they will still come to our labor and delivery unit, with no prenatal care, and they'll often end up costing more because you might have a sick baby or momma who has to be taken care of, probably at a higher level of care."
Taylor and Fincher said the women who utilize the clinic are aware of their good fortune and the hospital's generosity.
"These women are very gracious and thankful for anything we do for them," said Fincher. "So that really makes it all worthwhile."
The number for the OB Clinic (open on Mondays and Fridays only) is 903-676-5480. To discuss qualifications for the clinic, Judy Carlisle may be reached at 903-676-1111 (Monday-Friday).
Originally posted June 4 2007