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Delivering a healthier baby

Raechelle Bellamy was 18, four months pregnant and without health insurance.

Her options were to pay out-of-pocket for prenatal care or turn a blind eye to preventative care and hope her baby was delivered to term without any complications.

Fortunately for Bellamy, and thousands of other pregnant women without the means to pay full costs for prenatal care and the delivery of their babies, there are options in Clark County, even with the state’s economic troubles.

Area health care facilities such as Sunrise Children’s, North Vista, University Medical Center and St. Rose Dominican and Valley Health hospitals offer programs that arrange for obstetrician/gynecologists to accept payment plans or provide services at a discount to pregnant women.

The programs go by different names, such as Baby Your Baby, Baby Steps, Babies Are Beautiful, or Healthy Beginnings, but operate under the same concept.

“We’re providing the care up front so as to avoid even more expensive costs in the future,” said Dr. Kord Strebel, one of a dozen OB/GYNs who works with Sunrise Children’s Hospital to deliver babies under its program.

The programs, which originally started in the late 1990s, have resulted in lower infant mortality and fewer premature babies as well as decreases in medical complications during delivery, Strebel said.

Studies show that women who utilize early and continuous prenatal care tend to have fewer problems during pregnancy.

Babies born more than three months early often suffer from long-term lung diseases and brain and heart problems. These conditions often cost hundreds of thousands of dollars to treat, sometimes millions, officials say.

When a pregnant woman delivers a baby prematurely or with medical problems those costs often trickle down to the taxpayer, Strebel said.

“This is a huge deal for us because the alternative would be someone running through our emergency room doors ready to push when the baby hasn’t completely developed,” Strebel said. “Still births. Gestational diabetes. Heart problems. These can all be prevented with early access to care.”

When he first joined Sunrise’s Baby Your Baby program three years ago, Strebel said the majority of the pregnant women he was seeing “were coming in at 28 weeks or greater.”

“That’s kind of too little too late, but not too bad to spot complications. Now, with more outreach, we’re getting women in as early as 15 weeks gestation. Coming in early significantly increases the chances I will be able to help them deliver a healthy baby.”

Mary Lou Haslach, director of women’s services at Valley Hospital Medical Center, said some patients come into the emergency room with contractions and have never seen a doctor for prenatal care.

Because of Nevada’s current economy, in particular the 7.6 percent unemployment rate, hospitals anticipate an even greater need for these kinds of services. Already, North Vista Hospital is seeing people who have recently lost jobs come in needing assistance with their pregnancies, said Janice Smith, director of its Healthy Beginnings program.

In some cases there are couples who can’t pay the $200 to $300 deductible for doctor visits, said Melissa Flores, a Healthy Beginnings’ intake clerk.

“We’re seeing people who had insurance yesterday that no longer have it today. We are seeing a lot of women whose insurance plans no longer provide maternity benefits,” said Lisa Pacheco, a registered nurse and assistant clinical manager of UMC’s Baby Steps program. “People are coming to us from all walks of life.”

Pacheco said between 1,700 and 2,000 babies are delivered through the Baby Steps program each year. Roughly 250 pregnant women are registered for the program each month, though not all of them remain in it throughout pregnancy.

About 60 to 80 women are signed up for North Vista’s program each month, Flores said.

Flores and Pacheco said once a family has made the decision to use the program, their eligibility for state and local assistance is determined. For example, in Bellamy’s case, Sunrise Children’s Hospital determined she was eligible for Medicaid and WIC, the Women, Infants and Children food and nutrition service program.

She was signed up for the two programs and when her Medicaid status was pending, Bellamy was matched with Strebel as her OB/GYN.

Roughly 30 to 50 percent of those signing up for the programs qualify for Nevada Medicaid, officials said.

If a family doesn’t qualify for Medicaid the hospital then works out payment with them. The physicians do the same, though most will treat first and work on the payment schedule later.

“We actually have them sit down with a financial person and go over what their payments would be,” Pecheco said. “Some, meaning the clientele we’re dealing with, just need some hand-holding. They need some guidance.”

Families are also assisted with finding pediatricians and family care doctors as well as obtaining simple necessities such as clothing and food. Some of the families in UMC’s program need help with transportation to and from doctor visits, Pacheco said.

In those cases UMC will send bus passes to the family.

“Whatever we can do to ensure that a healthy baby is delivered we are willing to do,” she said.

Fewer than 1 percent of the babies whose mothers participate in UMC’s Baby Steps program end up in the Neonatal Intensive Care Unit, officials say. And because of its family resource center case management approach, about 97 percent of the mothers have a pay source at the time of delivery.

The other programs experience similar results, officials say.

Bellamy, who gave birth to daughter Raeanna Marie Sims earlier this month, says without Baby Your Baby her pregnancy could have been a lot different.

Although her pregnancy, and delivery, was considered smooth compared to others, Bellamy did experience high amniotic fluid — polyhydramnios. That can lead to congenital defects, intestinal tract blockage or neurological abnormalities.

Strebel said this is the type of complication that a physician needs to monitor during pregnancy. Had Bellamy not been taking part in prenatal care, this could have been manifested into something more serious, including her having a stillborn.

“These pregnancies do become a little more riskier when prenatal care has been lacking and the physician does have to increase the level of care being provided,” Strebel said.

Contact reporter Annette Wells at awells @reviewjournal.com or 702-383-0283.

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