So, let me tell you about the very best part of my week.
The Marillac Clinic is a clinic for the uninsured in Mesa County with
a satellite clinic in Palisade, Colorado. The Palisade site had it's
origins as a clinic for migrant and seasonal farmworkers, but now serves
the uninsured east valley community at large. The clinic is still a
medical home to a largely monolingual, agricultural Spanish community.
Included in this community are a group of pregnant women who do not have
access to any public assistance for their prenatal care other than
emergency Medicaid at the time of delivery.
Historically, the Marillac Clinic has not provided prenatal care
given the availability of such services in the private sector. However,
changing funding streams created a need to provide these services, as
many of these women did not participate in any prenatal care before
presenting to the hospital at the time of delivery. In Colorado, 32.4
% of Hispanic women either present late for or have no prenatal care in
comparison to 13.8% of white women.
Despite my perception that I should try to provide this service, I
was thwarted by my knowledge that even when financial barriers are
lessened or removed, disparities of utilization exist in access to
prenatal care. I was also concerned about my abilities to efficiently
provide care to this community of women when I only attend this clinic
one day per week.
I decided to start a group prenatal visit for these women knowing
that there are models and literature to support this. I easily
convinced my behavioral health colleague at the clinic and our cultural
diversity coordinator to join this endeavor. I have to admit we have
been rather spontaneous about the project, but have been rewarded with
unexpected enthusiasm and participation by our patients.
We usually cannot even get through introductions without the women
laughing and "taking off" onto topics which interest them. The group
has grown in number and the women bring their friends, mothers, and
children. We had hoped during these group visits to provide education
concurrently with their prenatal care, which I think has happened.
However, more importantly what has happened is that these women have
become less isolated, have shared their stories, their experiences,
their sadness and their joy. They have shared with us their "creencias"
and have taught us how best to help them with their health care.