Grant Aims to Improve Health of Area's Likely Future Mothers; Five Counties Will Split Money to Give Better "Preconception Care."

Article excerpt

Byline: ANNE MARIE APOLLO

When the U.S. Centers for Disease Control and Prevention came out with a list of recommendations for women to take before they ever conceive, the people behind Jacksonville's Magnolia Project weren't surprised.

Faced with a fight against the region's higher than average infant mortality rates, the group suspected years ago that the general health of the mother might have something to do with how well the baby fares and set out to help women without health insurance or with other risks that could impact a future pregnancy.

Now, as interest in what's known as "preconception care" grows, the Northeast Florida Healthy Start Coalition is taking its show on the road. A $148,000 grant from the state aimed at improving the health of women likely to become future mothers will be split between the five-county area but spent largely in Clay and St. Johns counties on spinoffs of the Magnolia Project called Camellia and Wildflower.

The idea is to take aspects of what has already worked in Jacksonville - like preventive screenings and case management for women in the riskiest situations - and apply to women in similar situations in different areas, said Carol Brady, executive director at Northeast Florida Healthy Start Coalition.

She thinks the Magnolia Project already is onto something.

NO ACCESS BEFOREHAND

When it started, following a study of the disparity of infant mortality rates between black and white babies in Jacksonville, organizers realized there were plenty of services for women once they were already pregnant. The problem was that many women, even those who were working, had no access to health care beforehand. Some had untreated chronic conditions that could affect the health of a pregnancy. Others may have had poor nutrition, or were at risk for having two pregnancies too close to one another.

While many of the women said they weren't expecting to have a baby, a good portion weren't doing anything to prevent it, either.

Unplanned pregnancies can be high-risk pregnancies, Brady said.

By the fourth week of gestation, before some women are even suspicious about a missed period, groundwork is being laid for the neural tube that will eventually make up a brain and spinal cord, among other things.

According to the Mayo Clinic, by that time the heart is also forming, and begins to beat a week later.

A campaign started by the Centers for Disease Control last year that focuses on the preconception care emphasizes the importance of those first few weeks, along with the overall health of the woman.

So do the local programs.

After seven years operating in Jacksonville, the Magnolia Project has had good results, Brady said. There have been promising results with birth weight of the babies of women who had participated in the program compared with those with similar backgrounds who did not, she added.

The challenge is to do the same thing in other counties, which don't have the same federal grant the Magnolia Project enjoys.

Camellia starts in Clay County next week.

In Clay County, screeners at the Health Department will examine 50 women a month. About 20 to 25 determined to be high-risk will get ongoing case management to help them with issues that could put a future pregnancy at risk.

Rashel Klein, Healthy Start program manager in Clay County, said information will be distributed at the family planning clinic, where many uninsured women come for their annual exams, birth control or care after a miscarriage.

Though Clay County's infant mortality rate is not as high as Duval County's, Klein said there are women there who might not realize things like obesity, high blood pressure and diabetes, as well as their general health, all play into pregnancy. …