Natasha M. Tracy is more than eight months pregnant and hasn’t seen a doctor yet.

She insisted it’s not for a lack of trying. The 22-year-old Ogdensburg resident is a Medicaid recipient who said recently she can’t find a doctor willing to accept the publicly funded health coverage for prenatal care. She said she has been turned down in Ogdensburg by three obstetricians who either are unable to take new patients or do not accept Medicaid.

“It’s frustrating. I’m scared that the first doctor I see will be when I deliver,” Ms. Tracy said.

She said part of the problem is that Claxton-Hepburn Medical Center’s Maternal Care Center, a clinic that provides prenatal care to Medicaid patients, remains closed.

“It was supposed to reopen in January, but it didn’t,” she said.

Claxton-Hepburn spokeswoman Laura C. Shea said the medical center remains in negotiations with private physicians to provide the coverage for the maternity center.

“The Maternal Care Center is expected to reopen, but we have no definitive date,” she said. “We’re working out the position coverage, which is a major component. We have to be able to provide the full book of services, from prenatal care to delivery and beyond, for these mothers. We can’t do that without policy and procedures in place.”

Mrs. Shea agreed there is a lack of services, but said the hospital’s hands are tied.

“We’re dealing with private physicians,” she said. “They dictate what patients they take. Unfortunately, we’re ready to open, with staff waiting and improved facilities, but one doctor can’t do it alone. We’re working with all three of them on a situation where we can open again.”

According to Mrs. Shea, the Maternal Care Center has been serving low-income pregnant women for more than a decade, and the hospital works with obstetricians to ensure that Medicaid patients receive proper care.

“These are services we’re not obligated to offer, but we recognize the need,” she said. “We’re not happy with the difficulties moms are having finding care, but it isn’t really a new challenge. It’s been there.”

Penny A. Ingham, executive director of the North Country Prenatal/Perinatal Council, Watertown, said the situation is creating a gap in services in St. Lawrence County.

“With Medicaid women in particular, we’re hearing from people here at our office that need assistance in finding a doctor,” she said.

The council coordinates a response to prenatal issues in the north country, including access to care.

“She will have to look more broadly for care, like Canton or Gouverneur,” Mrs. Ingham said of Ms. Tracy and other pregnant woman in her situation. “The access to care in the last couple of years has become more critical. There is a lack of prenatal providers accepting Medicaid.”

Representatives of three other hospitals in St. Lawrence County — Canton-Potsdam Hospital in Potsdam, Massena Memorial Hospital and E.J. Noble Hospital in Gouverneur — said Medicaid patients are being accepted.

Monica M. Haynes, a licensed practical nurse at E.J. Noble Hospital, said the hospital’s obstetricians are all accepting new patients. They have been seeing patients from Ogdensburg.

“We have several from the Ogdensburg area that can’t get in there,” she said. “A couple a month, usually Medicaid.”

The gap in services being experienced in the Ogdensburg area, according to Mrs. Ingham, means expectant mothers may not receive care important for a safe delivery.

“Prenatal care is critical in ensuring a healthy birth outcome — appropriate weight, gestation length, assistance with pregnancy with chronic illness — these issues are best dealt with by a health care provider,” she said. “If they can’t find it in Ogdensburg, they may have to look geographically elsewhere. Instead of the Maternal Care Center, their first professional visit may be weeks later, and transportation can be an issue, especially for women on Medicaid.”

Without prenatal care, Mrs. Ingham said, an emergency room visit is likely for delivery, which also poses less than desirable circumstances.

“Because they haven’t been registered with the maternity department through a health-care professional means the hospital is not prepared for that person. They may have no information on mom — all the things they need to know to serve her and the baby in the best way possible when she comes in to deliver,” she said. “The loss of the Maternal Care Center is hurting the Ogdensburg community because people are used to it being there.”

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