Progress Made in Helping Poor Pregnant Women

Orange County hospitals are making progress in coping with overcrowded maternity wards and a severe lack of prenatal care for poor women, but grave problems persist, health-care officials said Thursday at a conference on maternity care.

Two new birthing centers, one at UCI Medical Center and the other at Western Medical Center-Anaheim, have finally been approved by the state board that contracts with hospitals to provide indigent care.

UCI Medical Center is negotiating a lease and hopes to begin construction in two months on a site two miles from the hospital, said Dr. Thomas Garite, chairman of the obstetrics department. The birthing center could open by next summer and deliver 1,700 babies in its first year, Garite said.

West-Med Anaheim is preparing to take not just obstetrical patients but all indigent patients on Aug. 1, after having quit the Medi-Cal system last year, officials said.

And overcrowding has lessened at UCI Medical Center, which last June began a controversial policy of discouraging women from delivering there during times of peak crowding. Garite said the number of births there have dropped from more than 500 per month in June, 1989, to between 300 and 350 a month today.

Despite these pockets of progress, there are still too few hospitals and physicians who will treat pregnant women on Medi-Cal, officials said.

As many as 10,000 of the 50,000 women who deliver babies each year in Orange County receive prenatal care very late in pregnancy or not at all. About 3,000 to 4,000 of these women “drop in” to emergency rooms to deliver their babies, according to a recent survey of 190 obstetricians.

Lack of prenatal care vastly increases the risk of premature delivery and birth defects--and vastly increases the costs to taxpayers, who end up underwriting public hospitals’ red ink.

“If you can prevent one premature birth at 28 weeks, the cost of that baby going home . . . is equal to providing prenatal and delivery and postpartum care for 100 women and 100 children,” said Dr. Manuel Porto, director of maternal and fetal medicine at UCI Medical Center. “I don’t think this message is getting out.”

“We’re paying through the nose for those premature babies and birth defects,” Porto said.

As of Jan. 1, all pregnant women with incomes of up to double the poverty level are eligible for Medi-Cal coverage regardless of their immigration status. But the word has not yet spread, and some still believe that they will be deported if they apply for Medi-Cal, doctors said.

In addition, Orange County is in the throes of a baby boom. The number of births jumped 12% last year and is expected to increase another 12% this year, while the number of hospital beds and doctors who will accept Medi-Cal patients has not kept pace, officials said.