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Alicia Lurry, 404/616-6389 ~~
Assistant Director of Media Relations
for Emory University Physicians at Grady Memorial Hospital
[The Emory Grady Partnership]


December 6, 2000 

Emory University OB/GYNs Addressing Growing Number of Hispanic Births at Grady Memorial Hospital

More poor and disadvantaged Hispanic women in Fulton and Dekalb counties are giving birth at Grady Hospital, a growing trend that many Emory University OB/GYN doctors at Grady Hospital believe will continue for years to come.

Of the live births at Grady since 1995, 64 percent are black, 33 percent Hispanic, and 3 percent white. In 1992, the number of Hispanic births at Grady was estimated at only 10 percent.

The number of Hispanic births is up largely because of increased labor opportunities in the metropolitan Atlanta area. As many Hispanics find work here, many of them settle here and start families, doctors say. Yet, the problem is many of the women, like their male counterparts, are illegal or undocumented aliens without medical insurance.

The growth has also brought its share of challenges. Many the Hispanic women who come to Grady are not in the best health. Take one Hispanic woman, who prior to giving birth at Grady Hospital last summer, was diagnosed with Rh disease, a serious blood disorder that causes severe anemia, and sometimes death, in infants. To save the unborn child's life, doctors performed seven intra-uterine fetal blood transfusions, which is a technical and tedious procedure. Each transfusion began by inserting a needle through the mother's abdomen into the womb, and then through the umbilical cord for direct transfusion of blood to the fetus. As a result, the baby was born healthy, and is in good health.

But Dr. Hugh Randall, an Emory University School of Medicine professor who heads the department of gynecology and obstetrics at Grady Hospital, says so many other Hispanic women who come to the hospital also lack proper prenatal care.

"It's going to be a challenge, in terms of how we're going to care for this growing population," Randall says. "Finding a way to pay for their health care and health insurance is one of the biggest challenges. Hispanics play a vital role in our economy, and they're going to need health care and support services."

What often leads to improper prenatal care is the women's inability to pay. So rather than come in for regular prenatal visits, many of the Hispanic women who come to Grady limit the number of prenatal visits or come for only a few.

Claire Westdahl, a certified nurse-midwife at Grady, says the nurse-midwives, nurse practitioners and physicians' assistants who care for the majority of pregnant Hispanic women in the Grady neighborhood clinics of Fulton and DeKalb counties are sensitive to the cultural and social issues of monolingual, immigrant women.

"We need to invest our time and energy in culturally appropriate prenatal care because these babies are our future Americans," she says.

Many of the health care providers at Grady, for example, are able to provide pregnancy care in Spanish. When needed, translators are available to assure that health care needs are met. An effort is also made to assure that support staff in the clinics, such as medical clerks, financial counselors and medical assistants is not only bilingual, but bi-cultural, as well.

Quarterly, Grady sponsors a "Celebration of Motherhood" program inviting all pregnant women from the neighborhood clinics to tour Grady's Family Birth Center and nursery. Classes in Spanish are provided on breastfeeding and childbirth. Women and their families are especially interested in information about the Medicaid and birth certificate application process. This one-day celebration offers an opportunity to meet the Spanish translators who are available when women and their families come to Grady for the birth.

To address even more needs, group prenatal care has been offered in Spanish at one Grady neighborhood clinic. Women due the same month have their prenatal appointments at the same time of their care.

Through the group, women are able to develop social relationships and receive their prenatal education and prenatal care at one time and in their native language. A Spanish-speaking nurse-midwife, social worker and clinic assistant lead the group, providing care in Spanish and addressing the specific needs of each group of women.

Beginning January 2001, the Grady Health System, in partnership with Emory University and Morehouse schools of medicine, will introduce a "package price" for prenatal care. The program will allow Hispanic women and others to come in for care earlier in pregnancy and receive the full content of prenatal care. For $1,000, women will be eligible for 13 prenatal visits, routine prenatal lab work, and one ultrasound. Women are able to pay for the services within eight months.

Westdahl hopes the program will also cause more women to choose the health services provided by Emory University.


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