Natasha M. Tracy is more than eight months pregnant and hasnt seen a doctor yet.
She insisted its not for a lack of trying. The 22-year-old Ogdensburg resident is a Medicaid recipient who said recently she cant 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.
Its frustrating. Im 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 Centers Maternal Care Center, a clinic that provides prenatal care to Medicaid patients, remains closed.
It was supposed to reopen in January, but it didnt, 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. Were 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 cant do that without policy and procedures in place.
Mrs. Shea agreed there is a lack of services, but said the hospitals hands are tied.
Were dealing with private physicians, she said. They dictate what patients they take. Unfortunately, were ready to open, with staff waiting and improved facilities, but one doctor cant do it alone. Were 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 were not obligated to offer, but we recognize the need, she said. Were not happy with the difficulties moms are having finding care, but it isnt really a new challenge. Its 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, were 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 hospitals obstetricians are all accepting new patients. They have been seeing patients from Ogdensburg.
We have several from the Ogdensburg area that cant 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 cant 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 havent 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.