A Promising Passport to Obstetrical Care : Health: Free booklet offers pregnancy information and provides doctors with medical data on the expecting woman and her child.

The small aqua notebook looks like a miniature baby book, with a special place for baby’s first photograph and a tiny footprint.

But along with a brief text on problems and questions about pregnancy, there are spaces inside for detailed medical information, such as the mother’s blood type, her weight, her baby’s gestational age and mother and baby’s condition at each prenatal visit.

Dubbed “My Baby and Me,” this 4 1/2-by-7-inch booklet is the latest armament in the March of Dimes’ battle to improve access to prenatal care.

Each year more than 3,000 Orange County women get little or no prenatal care, many delivering their babies in emergency rooms with the help of doctors who have never seen them before.

March of Dimes officials are hoping the free booklet, written in English and Spanish, will be a “passport” to obstetrical care, providing doctors with the medical information they need to properly care for patients they’ve never treated.

They are also betting that this 14-page booklet--meant to be carried in a purse as a “keepsake” of pregnancy--will persuade the mothers to take an active role in their own medical care. They hope that they will become familiar with such terms as fetal heart rate and estimated date of confinement and, primed by the booklet’s list of questions, will ask their doctors about proper nutrition or the effects of smoking during pregnancy.

“My Baby and Me” is not expected to solve Orange County’s crisis in prenatal care, but this pilot project is “one small step” toward that goal, said March of Dimes community affairs director Dottie Andrews.

The booklet is “a little nice thing (for a pregnant woman) to have,” Andrews added. “Beyond that, I hope it sends a message to women that their pregnancy is important to us.”

Andrews and Diana DeVane, the agency’s consultant for the project, began distributing 40,000 copies of the booklet to community clinics on Friday, as well as all 385 of Orange County’s obstetricians and any woman who requested a copy.

The first reactions to “My Baby and Me” were enthusiastic. Several women who studied a preview copy last week at the county’s prenatal clinic said they would like to take it home.

“It is interesting,” said Yolanda Peralta, a petite 18-year-old Santa Ana woman whose smocked dress billowed out, suggesting a belly large with child. “The questions and answers you can ask the doctor would be helpful.”

Peralta said that this is her first pregnancy and that she did not begin her prenatal care until she had been pregnant for six months.

Local obstetricians, including Dr. Phillip Chiu, president of the Orange County Obstetrics and Gynecological Society, lauded the booklet’s educational value for their patients.

More than that, “My Baby and Me” could prove to be a lifesaver for some babies and pregnant women who receive treatment in an emergency, said Fullerton obstetrician Dennis Buchanan, one of the March of Dimes’ medical advisers on the project. Buchanan, who works at St. Jude Hospital, said an average of six to eight pregnant women a month arrive at the hospital’s emergency room in labor with little or no history of medical care.

“The most help (from the booklet) is the establishment of an accurate date of the pregnancy,” Buchanan said. “In a high-risk situation, where a woman comes in in premature labor, it may be critical to know if she is 30 weeks pregnant or 34 weeks, to know whether to deliver her or hold off.”

He said the information is crucial because a baby delivered too early may not survive.

With the booklet, doctors should feel more comfortable treating a “drop-in.” Information from one prenatal visit alone would include data on the baby’s development, the woman’s blood pressure, whether she tests negative for hepatitis, so “you’re not treating them as blindly as you otherwise would,” Buchanan said.

Experts say that a prenatal record book has long been customary in Europe, some African countries and Japan but is relatively new in the United States.

In Japan, where such a booklet has been given to all pregnant women for 50 years, its use--along with a national maternal health campaign--has contributed to that country’s record for the world’s lowest infant mortality rate, said William E. SteslickeQ, an associate professor of public health at the University of South Florida in Tampa who studied Japanese health care on a Fulbright scholarship last year.

But Steslicke cautioned other health officials not to assume such a prenatal record book will be “a magic bullet. . . . In Japan, it’s been used for 50 years, and that experience cannot be discounted. It’s very different in the U.S.”

Still, the idea has caught fire recently in Washington where the Department of Health and Human Services is now pilot-testing a prenatal record book to be filled out by mothers. The Health Department’s book would also contain educational tips on pregnancy and a child’s health through age 2.

“My Baby and Me” was launched last June when March of Dimes volunteers were brainstorming about what could be done to improve prenatal care for Orange County women. About 20% of pregnant women in Orange County don’t receive any care until after the first trimester of pregnancy.

Andrews sent a formal proposal of the idea to several prominent doctors--among them Buchanan; UCI chief of obstetrics, Thomas Garite, and UCI director of maternal and fetal medicine, Dr. Manuel Porto--and received strong support.

Andrews then sought funding for the pilot project--$20,000 from the Pacific Mutual Foundation of Newport Beach--to produce small prenatal record books at just 40 cents apiece. Foundation director Patricia Kosky said she and everyone she spoke to liked the idea for a booklet that would go “not just to Medi-Cal women but all women in Orange County, encouraging them to be partners in their own health care.”

Of course, how “My Baby and Me” will be received by Orange County obstetricians and their pregnant patients remains to be seen. Will pregnant women want to carry it everywhere in their purses? Will doctors--or, more likely, their assistants--take the time to fill out the medical data in the book’s entry spaces?

“That’s our challenge,” said consultant DeVane. “The real challenge is what happens when we send it out to the 385 obstetricians.”

But already March of Dimes activists are taking steps to see that obstetricians take notice. UCI has a prenatal program for physicians and other health professionals that covers 17 hospitals in Orange County. “We’ll be making that (the prenatal booklet) a topic of discussion at outreach meetings over the next year,” Porto said.

Meanwhile, late this week local health agencies were snapping up copies of the booklet. The county’s Coalition of Community Clinics ordered 2,500. And the county Health Care Agency ordered 2,500 for its four prenatal clinics.