Efforts To Expand Prenatal Care In Northern Virginia Counties Halted

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Recent efforts to expand prenatal care for low-income or uninsured women in Loudoun and Prince William counties in Virginia have halted, and community leaders are working to ensure pregnant women receive prenatal care, the Washington Post reports.

The Prince William County Health Department restricted eligibility for prenatal care at its clinic to women in the lowest income bracket of the federal poverty guidelines because of limited staffing and a lack of funding, according to Alison Ansher, the department's director. On Aug. 1, the clinic increased the eligibility threshold to 180% of the federal poverty level, but many pregnant women still are ineligible for care, Ansher said.

Health leaders in Loudoun County had planned to provide prenatal care through the Loudoun County Community Health Center when the center opened in May, but Debra Dever, the center's director, found that the center's malpractice insurance did not cover prenatal care. Dever added that it was too expensive to purchase additional insurance for the center, which is funded through grants and donations.

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David Goodfriend, director of the Loudoun County Health Department, has been working for six years to create a center that would provide prenatal care. Goodfriend and a team of nurse practitioners see about 300 pregnant women annually during the first and second trimesters of pregnancy before referring them to a physician at a local hospital. He said that the care he provides is "not the best care because it's disjointed," adding that he is unable to offer specialized care for high-risk patients, such as women who are pregnant with twins or who have diabetes.

For many uninsured and low-income women who do not have access to prenatal care, their "only option is to deliver the baby as an emergency," Nora Lobos -- a case manager at MotherNet/Healthy Families Loudoun, a not-for-profit group that provides support to low-income families in Loudoun County -- said. According to the Post, some women in the area move or lie about their residency to obtain prenatal care. In addition, many low-income and uninsured pregnant women often face language barriers or other problems, such as domestic abuse, that hinder their ability to seek prenatal care, the Post reports.

Community health centers in Loudoun and Prince William counties are planning to apply for a federal grant to cover malpractice insurance costs for prenatal care, but Dever said competition for the grants is high. The Loudoun health department earlier this month received a $54,000 grant from Kaiser Permanente, which will be used to increase access to prenatal care, Goodfriend said (Schrank, Washington Post, 8/28).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Weekly Health Disparities Report, search the archives. The Kaiser Weekly Health Disparities Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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