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,
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
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.