Prenatal Program Delivers a Message of Caring and Concern : Pregnancy: Counseling, education and incentives are offered on a personal basis, helping black women understand the importance of medical care and a healthy lifestyle.

Thea Singleton was six months pregnant when pain in her rib cage and back became so intense that she feared her swollen womb had snapped a rib.

“I was hurting, and I didn’t know if the baby had something wrong with it,” said the 25-year-old Singleton, a first-time mother. Finally, she sought help at the emergency room at Daniel Freeman Memorial Hospital.

Medical workers traced the pain to a pulled muscle and prescribed a few simple remedies--Tylenol, sleeping on her side, propping her head up with pillows. The pain faded within days.

But the medical staff also referred Singleton to Inglewood Healthy Mothers and Babies, a new program aimed at improving prenatal care among African-American women in the Inglewood area.

“Now, I’m not as worried as I was. I’m not as stressed out,” said Singleton, whose baby is due three days before Christmas. She praises the support she has received from the program, noting that she can “pick up the phone and call, and someone’s going to be there.”

Program organizers know that some problems will not be overcome so easily. They rattle off a litany of statistics showing that African-American babies are more prone to health problems, that their birth weight is often below average, and their mortality rate roughly twice that of the general population.

In 1990, 349 black babies in Los Angeles County died before age 1. That translates to an infant mortality rate of 16 deaths per 1,000 live black births, double the Anglo rate of 7.8 deaths.

It is that kind of statistic that spawned Great Beginnings for Black Babies, a campaign geared to educate black women about the importance of prenatal care and a healthy lifestyle. Launched by the county Department of Health Services in early 1990, the campaign has employed graphic billboards and radio announcements to deliver the message that expectant mothers should avoid drugs and alcohol and seek regular medical checkups.

The campaign’s second stage is to work with pregnant women on a personal basis. That stage began in September with the launching of the Inglewood Healthy Mothers program, funded by the James Irvine Foundation.

It offers women counseling, education and incentives, such as bus tickets and diaper bags, to encourage them to keep returning for prenatal care. The project may be repeated elsewhere in Los Angeles County, depending on funding and results in Inglewood.

If the Inglewood project succeeds, “We should be able to go into any city and implement a program,” said Zola Jones, project director and a nursing consultant for family planning at the county Department of Health Services.

So far, the fledgling project consists of 11 pregnant women, the project staff and offices in a medical complex on Prairie Avenue near Daniel Freeman Memorial Hospital. But in coming months, the staff expects to assist at least 125 women from Inglewood and other South Bay cities.

Most of them will receive prenatal care at the new Daniel Freeman maternity center and deliver their babies at the nonprofit Catholic hospital’s newly remodeled obstetrics unit.

The Healthy Mothers program hopes to give those women counseling and support to maintain a healthy pregnancy.

One woman receiving care is seven months into what health workers describe as a problem-plagued pregnancy.

Although she was being seen at a clinic, she did not divulge some potential health problems until she spoke to a community health worker at the Healthy Mothers program. That was when she acknowledged her use of crack cocaine and hard liquor while she was pregnant; she also said her partner was physically abusing her.

“She is truly a case study of high-risk pregnancy,” said project administrator Clara Love. Program workers say they will refer the woman to a drug rehabilitation program and provide other help.

Use of drugs or alcohol during pregnancy is just one factor that can injure a baby. Experts blame the high mortality rate for black babies on a range of other causes too, such as smoking, poor nutrition, teen pregnancy and a delay or lack of good prenatal care.

Those factors can produce a “low birth weight baby” of less than 5 1/2 pounds, a problem related to more than 60% of all infant deaths, health officials say.

Officials with Great Beginnings for Black Babies are honing in on prenatal care as a way of helping the mother and her unborn baby.

“One aspect of the campaign is to go to the doctor early, even if you don’t think there’s something wrong with you,” said Dr. Nelson El Amin, a public health physician and administrator with the county Department of Health Services, who is on the Great Beginnings task force.

Any problem pregnancy should be identified early, El Amin said.

For instance, a baby can be damaged if its mother is suffering from undetected syphilis during pregnancy, El Amin said. But those problems may be lessened if the syphilis is detected during the first three months of pregnancy.

County health officials were encouraged by newly compiled figures showing a sharp drop in 1990 in the county’s infant mortality figures, especially among black babies, where the rate dropped from 21.2 deaths to 16 deaths per 1,000 live births. The officials hope the decrease may be a result of a range of programs, including improved access to prenatal care.

In addition to the incentives program, which provides RTD bus tickets or parking-ticket validation to make it easier for women to keep their appointments, the staff of the Healthy Mothers program helps women with Medi-Cal paperwork.

Different gifts are also offered at each trimester for women participating in the program: a prenatal calendar, a plastic tote bag, a measuring tape, a drinking cup, and--at the third trimester--a custom-made diaper bag with diapers, receiving blanket, T-shirt and baby toiletries.

The Healthy Mothers program won praise from Brenda Bradford of Hawthorne, a 32-year-old nursing student at Los Angeles Southwest College whose child is due in December.

“This program shows women there are ways to get prenatal care,” said Bradford, who says she personally received regular care during her pregnancies but knows some women who have not. She said they may be hampered by a lack of money or simply may not be familiar with prenatal programs.

“If you don’t know, you’re not going to go after it,” Bradford said.

Another woman, who is 22 and five months pregnant with her second child, singled out Great Beginnings’ pink-and-blue prenatal calendar, which shows pictures of an unborn baby at different stages of growth and describes the mother’s symptoms.

“I think that would motivate people to come in, because you’re getting all these special things, and they’re showing you pictures of the baby,” she said. “Looking at how the baby grows inside you--that would encourage me to go.”

Race and Infant Mortality

Percent of babies born with low birth weight in 1990 in Los Angeles County, by race/ethnicity of mother: All groups: 6.0% Asian/Pacific Islander: 5.6% Black: 12.9% Hispanic: 5.1% White: 5.2% Infant mortality rate, Los Angeles County, 1989 and 1990 by race (deaths per 1,000 live births):

1989 1990 All groups 9.2 8.0 Asian/Pacific Islander 5.9 4.7 Black 21.2 16.0 Hispanic 7.6 7.0 White 8.3 7.8

Source: California birth and death files, state Department of Health Services