Grant helps prenatal clinic expand care

BANGOR – Delores “Dee Dee” Bryant lay down on an examination table in a room at the Mabel Wadsworth Women’s Health Center recently. The 19-year-old woman uncovered her expanding abdomen for Melissa Berky. The nurse practitioner placed some gel on Bryant’s belly, then pressed on it with a hand-held fetal monitor.

Almost immediately the “whoosh whoosh” of a healthy fetal heartbeat filled the room. Bryant’s toddler stopped exploring the examination room to listen. A broad grin spread across Bryant’s freckled face as she listened.

The Newport woman’s recent visit to MWWHC was pretty typical of the prenatal care offered by the center to low-income women. This month, the Harlow Street center received a $30,000 grant from the Penobscot Valley Health Association to expand its prenatal care to women who qualify for Medicaid.

An earlier grant of $35,000 helped MWHHC conduct a strategic plan, identify unmet needs and take steps toward filling those needs.

The $30,000 grant has allowed the center to hire a second nurse practitioner part-time, and to purchase equipment needed to serve low-income pregnant women.

Normally the agency serves 100 women a year; the extra money will allow the center to serve 130, said executive director Ruth Lockhart recently.

“They’re really nice here and they treat me good,” said Bryant, whose husband, Aaron, was unable to accompany her on this particular visit. She was referred to MWWHC during her first pregnancy by Carmel Health Care.

Bryant’s due date is April 25. So far, her pregnancy has progressed quite normally, except for heartburn and some cramping, said Terry Marley-DeRosier, a women’s health care nurse practitioner and co-founder of the center.

“The people who work here have nice personalities and they’re here when I need them,” said Bryant of the staff at MWWHC. “I always call whenever I feel I need to. Terry was very comforting when my daughter was very sick shortly after she was born.”

When she was 9 days old, Courtney contracted a respiratory infection that was life-threatening. The infant spent 31/2 weeks in the hospital. Although she sometimes needs to use a nebulizer now, doctors expect Courtney to outgrow any lingering effects of the infection, according to her mother. The illness was unrelated to the prenatal care Bryant received.

Bryant said she’s very pleased that she hasn’t gained as much weight with her second pregnancy as she did with Courtney. She said most likely that is because her daughter keeps her so active.

“It seems like most of the day I clean and she comes along behind me to mess things up,” said the expectant mother with a laugh.

The need to expand services arose last year, explained Lockhart, when Dr. Parker Harris, a Bangor-based OB-GYN, retired. Harris was one of the few obstetrician-gynecologists in Greater Bangor who accepted Medicaid as a primary care physician without a referral.

MWWHC partnered with Harris to provide prenatal care to low-income women. Patients received care there during the first 36 weeks of their pregnancies, then saw Harris for the final couple of weeks and the delivery.

When Harris retired, a few other specialists in the Bangor area began accepting a limited number of Medicaid patients, according to Lockhart. Reimbursement from Medicaid covers only about 40 percent of costs for delivery care, she said.

Realistically, most low-income women who live in and around Bangor have only two options for prenatal care – the Family Practice Residency Center at Eastern Maine Medical Center, which is staffed by doctors-in-training and overseen by EMMC staff physicians, and MWWHC.

The grant money from PVHC will allow MWWHC to provide care through a client’s entire pregnancy as well as follow-up care. The center now works with the Family Practice doctors, who usually don’t meet patients until they are in active labor.

Lockhart added that if anything indicates a client’s pregnancy might fall into a high-risk category, such as diabetes or a multiple birth, a referral is made to Family Practice and EMMC staff physicians.

“Even though clients usually first meet their doctors in the labor room,” said Lockhart, “we’ve gotten excellent feedback about the treatment they’ve received. Our clients tell us that the Family Practice doctors are compassionate and caring.”

Some of the $30,000 grant was used to purchase a fetal monitor that allows nurse practitioners at MWWHC to administer a nonstress test to determine fetal distress. Lockhart said it will be used most often toward the end of pregnancy, and often is reassuring to an expectant mother who hasn’t felt the nearly full-term baby move as frequently as it did previously.

While 130 pregnant patients is a small part of the 2,000 clients MWWHC sees on annual basis, they account for about 40 percent of the yearly visits made to the center. During the average full-term pregnancy, a client will visit the center between 12 and 15 times, according to Lockhart, while most other clients come in once a year for a pap smear and breast exam.

“That many visits with us allows for greater continuity of care,” observed Lockhart. “Some of that time is spent in educating the client about what’s happening to her body and what she can expect during pregnancy, labor and delivery. We also offer prepared childbirth classes and assist clients in connecting with other agencies that might be helpful like the Women Infants and Children Program, the Department of Human Services and public health nurses who can help with infant care education.”

Lockhart said that most women who come to the center find out about its programs through word of mouth. Bryant said that she had recommended MWWHC to a couple of her friends who also recently became clients.

“I feel comfortable here,” said Bryant. “I’m not sure what I would have done without them. And, they treat my daughter really well too.”

MWWHC opened its doors in 1992 with a volunteer staff and gradually added paid staff and increased services. It began offering prenatal care in 1997. Lockhart said that the need for prenatal care is expected to increase over the next two years, and the center expects to employ another nurse practitioner full-time by 2004.

“We are seeing more and more women who are not insured or are underinsured,” said Lockhart. “We are here for women of all ages, but this grant allows us to target uninsured low-income women who need OB-GYN services. No one else does that.”

For information on Mabel Wadsworth Women’s Health Center and its services, call 947-5337 or (800) 948-5337.