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July 25, 2013
KANSAS CITY, Kan. On Tuesday morning, Dr. Sharon Lee bent down and gently placed her hand on the tummy of 7-week-old Daniel Marquez.
The boy’s stomach issues had led his mother, Nolberta Marquez, to bring him into Southwest Boulevard Family Health Care. Lee, chief executive of the safety-net clinic, determined that some tweaking of the boy’s feeding regimen would likely solve the problem.
“Oh my God, I love these people,” said Marquez when asked about Family Health Care. “It is very, very good.”
It was families like hers that Lee and officials at the University of Kansas Medical Center had in mind when they started what is called the Maternal Options that Matter (MOM) clinic inside Family Health Care.
Initiated quietly in January, the clinic was officially opened on Mother’s Day. It now has more than 100 women enrolled in a comprehensive program aimed at getting infants through their first year.
“This isn’t just a typical prenatal clinic,” Lee said.
MOM, she said, includes services such as career counseling for young mothers and screenings for domestic abuse and depression.
The Tuesday morning MOM clinic also provides an additional obstetrics training opportunity for residents from KU Med’s Department of Family Medicine (residents have long helped provide prenatal care on Thursday evenings at Family Health Care).
Another feature of MOM is the inclusion of students in the Certified Nurse-Midwife program at the KU School of Nursing.
According to data issued in January by the National Center for Health Statistics, Kansas ranked 16th among states and the District of Columbia in infant mortality in 2009.
Kansas’ infant mortality rate was 7.49 deaths per 1,000 live births while the national average was 6.59 deaths per 1,000 live births.
Lee said MOM was born of necessity.
Within the last several years, she said, the number of physicians available for prenatal care and obstetrics in Wyandotte County had dwindled to three.
That made access especially difficult for low-income clients, Lee said, since the city-county health department relied on those community physicians for some referrals. And Family Health Care, Lee said, was increasingly seeing women late in their pregnancies that had received no prenatal care.
Under Lee’s long-term plan, MOM would grow to serve 500 women a year on a $1.8 million budget, though much of that total would come as in-kind contributions of staff and facilities from the partners, including KU Hospital.
Lee has also built in about $300,000 a year in philanthropic support. She got a boost this week with a $100,000 grant from the William T. Kemper Foundation in Kansas City, Mo.
But the overall funding response has been disappointing, Lee said.
Foundation leaders have told her they consider it a state responsibility to provide these types of services to low-income women. But, Lee said, state support is decreasing.
Dr. Kelsie Kelly is medical director of MOM and is fresh off completing her family medicine residency at KU Med last month.
As a family medicine physician with a special interest in obstetrics, Kelly said the Tuesday morning clinic provided her more opportunities to learn by doing.
Moreover, she said, if she could help an at-risk mother have healthy baby, “I feel like I have done a service.”
As chair of the Department of Family Medicine at KU Med, Dr. Joshua Freeman was instrumental in helping establish MOM.
Making family medicine doctors more familiar with obstetrics, Freeman said, hopefully will help buck the trend toward treating a normal delivery as a medical procedure requiring all sorts of specialists on standby.
Freeman said he’d like for KU Hospital to shed its reputation as one of those facilities where machines and staff surround women.
“I think that sometimes people are actually seeking a more simple, natural, normal delivery with fewer tubes in their various orifices and more family members around,” Freeman said.
It’s also important, he said, for rural areas to have family medicine doctors well-schooled in obstetrics.
“If they learn to deliver babies better,” Freeman said, “then they can be of more use to your cousin George who lives somewhere in Kansas where they don’t have any doctors to deliver babies — or your cousin, Georgina, even more.”
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