COUNTYWIDE : Clinic Takes Its Prenatal Aid on Road

Josefina Jaracuaro started getting prenatal care in October when she was seven months pregnant. Fear brought the mother of four to see a doctor.

Without a physician, she worried that a hospital emergency room might turn her away when she went into labor. So last month, Jaracuaro visited the St. Jude’s mobile clinic for pregnant women, where she received her first prenatal examination.

“That to me is the saddest part,” said nurse Cathy Hruby, who was a midwife in Ireland before coming to the United States and joining the hospital. “We don’t see them until they are already 20 to 30 weeks pregnant. It is difficult to imagine.”

It was a year ago this week that St. Jude Hospital and Rehabilitation Center in Fullerton opened its prenatal program so women such as Jaracuaro could get help. Working out of a tiny room in the hospital, there were only four patients at the time.

Today, a team of doctors and nurses, along with a social worker, educator and nutritionist take turns traveling around in an $87,000 mobile “mommy clinic,” the only one of its kind in Orange County. On a typical day as many as 15 patients are examined, and there is a monthlong waiting list for future appointments.

“The need is unbelievable,” said Joan Furman, executive director of the hospital’s Care for the Poor Program, which runs the clinic. “It is really frustrating. For every woman we take care of, probably five are turned away.”

Sitting in the parking lot of St. Angela’s Church on South Walnut Street in Brea on Thursday, the van’s generator, which provides power for lights, water and air conditioning, quietly purred. Four women crowded inside the tiny waiting area between the two examining rooms.

Although only six appointments were scheduled, the van quickly filled up with children, patients and their relatives. About 70% of the women who come to the mommy clinic are Latino, with their ages ranging from 14 to 42.

Most of the moms-to-be who visited the clinic Thursday are scheduled to give birth in December and have begun the weekly ritual of going to the clinic for pre-delivery checkups. One exception was 15-year-old Guenevere, who is four weeks pregnant and made her first visit to the van Thursday. It is her second pregnancy--the first ended with a miscarriage last year.

Guenevere’s appointment marked the end of a long day for Hruby. All in all it had been a good day, she said before seeing her last patient. “It has been nice today. No complications, thank God.”

The idea for the program started after a hospital study revealed that poor women have little to no chance of getting any prenatal medical assistance. Few doctors accept Medi-Cal reimbursements, and those that do have offices that are overflowing with patients, the study showed.

Clinics set up to take Medi-Cal recipients are so overwhelmed that Orange County Health Care Agency reports that it turns away 2,500 pregnant women a year, Furman said. “The lack of access to prenatal care in Orange County is horrendous,” she said.

After some political finagling to persuade federal officials to allow the clinic to take Medi-Cal, the van was off the ground and rolling.

On its weekly tour, the mobile clinic stops in Placentia, Brea and Fullerton. About 200 women are currently enrolled, receiving not only medical exams but also education in everything from how to bathe a child to proper nutrition. The goal of the program is to prevent low birth weight babies who need costly care.

The $160,000 operating cost of the mobile clinic is covered by a grant from the hospital and private donors.