Pregnancy ‘Crisis’ Conference Urged

Declaring that thousands of poor women in Orange County face “substandard” maternity care, local March of Dimes officials on Wednesday called for a community meeting to resolve what they termed “the present crisis.”

March of Dimes leaders Fred Owens and Dr. Ralph W. Rucker also warned that unless more hospitals agree to treat the indigent pregnant women, “we face the prospect of reverting to a two-tiered level in the standard of medical care--substandard for the poor and excellent for the rest of us.”

They invited hospital administrators, the Board of Supervisors, state legislators and advocates for the poor to attend an open forum July 13 at the Westin South Coast Plaza hotel on “Access to Maternity Care in Orange County.”

The March of Dimes’ call for a meeting is at least the fifth such request by various groups since June 2, when UCI Medical Center in Orange announced a controversial policy to turn away some women in labor because its obstetrics ward is overcrowded and conditions are “unsafe.” The medical center cares for most of the county’s indigent pregnant women, many of them Latinas who have had no prenatal care.

UCI officials have hoped that other hospitals would sign Medi-Cal contracts, sharing some of the indigent-patient load, but some hospitals have expressed concern about Medi-Cal’s low reimbursement rate. Also, some had wanted “obstetrics-only” contracts that state Medi-Cal officials have not been willing to allow.

Earlier this week, state Health Services Director Kenneth W. Kizer invited hospital administrators and others concerned about maternity care in Orange County to meet with him. Depending on what that meeting--or series of meetings--produces, Kizer and his officials “may or may not carry a particular message” to the commission that sets Medi-Cal rates, Kizer told The Times Orange County Edition this week.

Also in separate discussions, officials from the Hospital Council of Southern California, the county’s Obstetrics and Gynecology Society and United Way of Orange County have reacted to UCI Medical Center’s “obstetrical diversion” policy, expressing concern about improving access to maternity care. Owens, the March of Dimes board chairman, said he was aware of the other meetings or requests for meetings. But, he said, “it seems that a lot of people are talking, but nobody’s talking together.”

Owens said he would like to get lawmakers--particularly county supervisors--”to realize there is a problem. . . . When women are denied access to maternity care, that seems to be a pretty serious problem.”

Added March of Dimes Community Service Director Dorothy Andrews: “We’re seeing a community denial that there are problems in Orange County affecting poor women and children. . . . We thought it was time we acted as a neutral party to call all the other factions and organizations together at least as a first step” toward improving maternity care for the poor.

The March of Dimes letter was sent to about 100 individuals and organizations, including all five county supervisors, Orange County representatives in the state Legislature, UCI’s Medical School dean and vice chancellor of health sciences Walter Henry, the administrators of 15 hospitals, several prominent obstetricians as well as advocates for the indigent.

Henry could not be reached for comment Wednesday, but Wade Rose, an assistant dean at the medical school, applauded the idea of the March of Dimes’ forum.

“It’s a very positive sign to have people in the community reaching out to solve this very serious problem,” Rose said.

What various organizations describe as a crisis has been building for some time as more hospitals in Orange County dropped their Medi-Cal contracts and most of the county’s obstetricians have declined to treat Medi-Cal patients because the reimbursement rate was so poor.

The situation peaked in early June when UCI Medical Center officials said that their obstetrics ward was crowded and “unsafe,” with fetal monitors in short supply, infections frequent among women having Cesarean deliveries and some mothers forced to deliver in the hall.

Since the medical center’s “obstetrical diversion” policy was announced, the hospital--whenever it was full--has turned away pregnant non-patients at curb-side and handed them a map to other area hospitals.

So far, the hospital has announced four “diversions” and turned away two pregnant women, hospital spokeswoman Elaine Beno said Wednesday.

Ironically the maternity ward, designed to handle 250 deliveries a month, may handle more than 600 births this month since women who have had prenatal care at UCI clinics have continued to be admitted during “diversions.”