County 1st in State in Early Prenatal Care

Ventura County is more successful at providing prenatal care during the first trimester of pregnancy than any of the state’s 57 other counties, according to a state report made public Wednesday.

Local health officials attribute this to a network of public and private clinics that eases the way for poor and hard-to-reach women--who may lack transportation, education or baby-sitters--to get early help.

“A lot of our patients walk [to the clinics],” said Dr. Robert Lefkowitz, director of obstetrics for the county. “We just try to make it easy and seamless to be seen at clinics. It’s word of mouth.”

According to the report by the California Department of Health Services, 88.4% of all Ventura County women who gave birth got care during the first three months of their pregnancies in 1998, the last year tracked. That was enough to move the county up from third in 1997.

Los Angeles County--No. 17--had an 83.6% rate, and Orange County--at No. 9--had an 83.5% rate.

Ventura County also fared well in teen birth rate for those under 15, third-lowest in the state, and was ninth-lowest for very low birth weight. However, it had a large number of caesarean births, ranking ninth highest.

Prenatal care is an important indicator of the overall health of a community and a chance for doctors to treat women early in their maternity and care for them throughout the lives of their children, doctors said.

“It’s been proven in the literature: Women who get good prenatal care have less of a tendency to poor outcomes,” said Dr. Don Taylor, chief of the office of epidemiology at the state Health Department. “Rural populations that are poorly educated have a tendency to have poor indicators on prenatal care.”

The county’s clinics--about 25--record about 300,000 total patient visits a year.

That translates to 20 to 25 visits a day for Dr. Lynn Rockney, who practices at Oxnard’s Magnolia clinic, a small, spare office that opened five years ago. Rockney sees a steady flow of women, many of them poor and with few English skills.

On Wednesday, Rockney talked to a woman, in for a regular checkup, in Spanish. She listened for the baby’s heartbeat, measured how the baby was growing and asked about the mother’s worries.

Socorro Villicana, 33, a mother of four, said her back and leg hurt. She has been working in the fields, and it will be awhile before she quits, she said.

Each of her pregnancies has been different, Villicana said. She said she comes to this clinic because it’s close and she likes her doctor. She will continue coming, she said, as her child grows.

“We have whole families,” Rockney said. “We see a 5-year-old here we took care of” before he was born.

The county began the clinic program in 1993, and since then the number of women seeking early prenatal care has risen 4%. In 1994 the private, nonprofit Community Memorial Hospital also began treating Medi-Cal patients.

“The intent was to provide better access to the low-income--and get more patients,” said Dr. Richard Reisman, director of Community Memorial Hospital’s five clinics, which he said have 70,000 to 80,000 total patient visits a year.

“I think the patients have been the beneficiaries of this competition,” Reisman said. “Before, the [county] centers were really busy; it was a week to get an appointment at the county clinic.”

Roberto Juarez, director of Clinicas del Camino Real, a nonprofit group of clinics for farm workers and their children, said he was surprised and happy to see how well Ventura County came out in the rankings. He said it’s taken his clinics some time to bounce back from the fallout of Proposition 187, a 1994 initiative that would have denied care to undocumented immigrants if it hadn’t been block by the courts.

“They were scared,” Juarez said. “We saw them coming in in the second and third trimester. We were getting calls from women who were seven or eight months pregnant. It’s been very nice to see this turnaround.”

And it’s been a chance for the county to boast about a program that officials say is envied throughout the state.

“It used to be, ‘If you want care, you get yourself there,’ ” Lefkowitz said. Now, “around the state, it’s called the Ventura model. The state statistics have shown we’ve succeeded.”