January 26, 2014

Dr. Louis M. Viamonte: A risk identified

By Dr. Louis M. Viamonte

— The Dalton-Whitfield Archway Executive Committee set a community goal for all children to read on grade level by the third grade. A child’s intellectual development, however, does not begin in kindergarten or even pre-K. The brain develops early in the mother’s womb, and may be affected by whether or not a mother receives proper prenatal care.

After discussions with local citizens, social workers and health care providers, the Archway First Five Coalition discovered that many women in our community do not receive full-term prenatal care. The First Five Coalition is a community committee dedicated to success of all young children.

According to hospital representatives, despite the national trend in lower birthrates, the number of women presenting at the Hamilton Medical Center delivery room without prenatal care has increased from 1.3 percent in 2009 to 4.6 percent in 2013. Because the interpretations of prenatal care vary by patients, the number of women without adequate care is probably higher.

Prenatal care is a program of care to promote the birth of a healthy baby with minimal risk to the mother. The U.S. Department of Health and Human Services noted that women who do not receive prenatal care are three times more likely to give birth to a low weight baby and their baby is five times more likely to die. Further, studies show that the cost of post-natal care of women and children lacking prenatal care is three times more expensive on local communities than if women received proper prenatal care.

Despite challenging economic times and extensive budget cuts, our health department has distinguished itself as one of only two in the state of Georgia that provides partial prenatal care. The Whitfield County Health Department does a very commendable job providing prenatal care to women who do not qualify for insurance or Medicaid for the first two trimesters of a woman’s pregnancy for $500. The expecting woman is then referred to a private OB-GYN for the final trimester. Some women cannot afford the third trimester care at a private OB-GYN office and thus do not complete their prenatal care.  

Medicaid pays for prenatal care, but not for those with an income above a certain level and not for those who are undocumented. Our local hospital and obstetricians take care of all deliveries, including those without prenatal care, while shouldering lower reimbursements, and higher overheads and malpractice premiums.

It is our belief that we are presented with an opportunity for improvement. Our future citizens are more likely to reach their full productive potential if they are born healthy. The First Five Coalition recently convened our major community health care entities to discuss the current state of prenatal care in our community, and future possibilities of providing access to quality prenatal care for women who are underinsured. The coalition is currently exploring those possible avenues with the assistance of local physicians, health care entities and funding organizations.

What can we collectively do to improve prenatal care rates in our area without bankrupting our providers?


Dr. Louis M. Viamonte is a retired pediatrician and a member of the Archway Partnership First Five Coalition.