Program helps pregnant teens with prenatal careWritten by Caitlin McGlade | | firstname.lastname@example.org
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Editor’s Note: Toledo Free Press, United Way of greater Toledo and 13abc’s “Bridges” with Doni Miller are profiling 12 education initiative programs in Northwest Ohio.
Danea Pittman is a 16-year-old single mother, but raising her son Damarion has been anything but a solo task.
She knows that help is there when she needs to travel to and from the doctor, or if she needs diapers or toys. She knows how to gauge whether her 18-month-old child is up to speed with average childhood development.
And she knows that yelling back at him when he yells at her won’t stop his temper tantrums.
Pittman credits much of her teen-mom success to a cutting-edge county program aimed at reducing the number of babies born below healthy birth weight, or less than 5.5 pounds.
“If I wouldn’t have come here, there would be a lot of things wrong with my motherhood,” Pittman said.
Called the Lucas County Initiative to Improve Birth Outcomes, informally known as Pathways, aligns major health care agencies that offer medical and social aid to high-risk pregnant women. ZIP codes 43604, 43607 and 43610 are targeted because low birth weight rates reach 18 percent in Central Toledo.
Pittman attends Polly Fox Academy, a school for parenting and pregnant girls in Toledo. Polly Fox refers girls to the Pathways program.
The 4-year-old program is the answer to The Toledo Community Foundation’s 2005 request for a solution to fight local low birth weight rates.
Lucas County has hovered consistently above state averages of low birth weight births from at least 1997 to 2007, reaching as high as 9.8 percent in 2004, compared to the 8.5 percent state average. Only eight other counties had higher average percentages of babies born underweight when the initiative started, according to March of Dimes data.
About one in 14 infants in Toledo were born to mothers who received late or no prenatal care around that same time, according to the data.
The initiative faces an upcoming year with promising numbers. About 600 women have enrolled since the program’s inception and each has averaged about eight prenatal visits. In 2010, 6 percent births resulted in low birth weight, down from 15 percent in 2009, according to initiative data.
Coordinators take a proactive approach to finding clients.
Rather than waiting for women to come in for help, outreach workers hit the streets to recruit them.
Some go door-to-door, ask neighbors or talk to local pimps to find out who is pregnant, said Jan Ruma, project director of the initiative and vice president for the Hospital Council of Northwest Ohio, which organizes the program.
“The health care system services those who seek it but those who seek it aren’t those who often need it the most,” Ruma said.
Some studies suggest that individuals who were born with low birthweight may be at increased risk for certain chronic conditions in adulthood. These conditions include high blood pressure, type 2 (adult-onset) diabetes and heart disease. When these conditions occur together, they are called metabolic syndrome. One study found that men who weighed less than 6 .5 pounds at birth were 10 times more likely to have metabolic syndrome than the men who weighed more than 9.5 pounds at birth.
It is not yet known how low birthweight contributes to these adult conditions. However, it is possible that growth restriction before birth may cause lasting changes in certain insulin-sensitive organs like the liver, skeletal muscles and pancreas. Before birth, these changes may help the malnourished fetus use all available nutrients. However, after birth these changes may contribute to health problems. The cost of a low birth weight baby in the first year is $40,000.
“That’s a very expensive way to come into the world. You are at risk for a lot more issues when you start out small,” Ruma said.
Once women are inducted, they become connected to an outreach worker who ensures they have transportation to and from doctor visits, have enough food and other products. Workers also aid mothers after they give birth, Ruma said.
In Pittman’s case, she and Damarion will receive help from the Neighborhood Health Association until he is 2 years old. Some of the perks also involve parenting education.
“Danea’s case is one of our success stories,” said Michelle Smith-Wojnowski, supervisor of the association’s perinatal outreach services.
The association has had a low-birth weight program for 10 years and, like the other agencies involved, offers incentives such as gift cards and baby supplies to stick with it. The county initiative program has helped the association target women in the specific ZIP codes at highest risk, Smith-Wojnowski said.
The Toledo Children’s Hospital has also operated a program to reduce the number of underweight babies, but Pathways provided funding to drum up incentives to participate, like gift cards or bus tokens to get to doctor appointments, said Christy Colony, who is a clinical supervisor of Help Me Grow with the ProMedica Health System.
Colony said the only problem is that the initiative limits eligibility to those three ZIP.
Across the country, the percentage of babies born underweight rose more than 9 percent between 1997 and 2007. Ohio’s average rate has steadily risen as well, according to the March of Dimes.
Programs like the local county initiative are modeled off an idea called the Pathways Model, which started in Mansfield, Ohio. Pathways, an increasing trend in the state, has become somewhat of a “buzzword” lately, said Lisa Holloway, program director for the Ohio chapter of March of Dimes.
Toledo is one of a few that have started up statewide, Ruma said.
The Toledo Community Foundation sees the program as a success thus far, said Christine Dziad, the program officer.
The foundation is one of the major contributors that has helped bring the annual budget to about $240,000.
“We’re a community that has a lot of poverty,” she said. “There are issues around access to service, or lack of nutrition, or whether or not people have housing that is unstable. Being pregnant becomes sort of a side activity.”