‘They can be heard.’ Latina moms beating the odds at this prenatal clinic in Houston County
Some mothers in Houston County are beating the odds in a state with one of the highest death rates for mothers and babies.
Latina women in the United States have better birth outcomes than their counterparts. Researchers refer to the phenomenon as the “Hispanic Paradox.”
The paradox is playing out at the Houston County Health Department, and through a new partnership between the North Central Health District and Mercer University School of Medicine, a community health professor and an undergraduate student are working with the health department to examine the inner-workings of the clinic for a research report they plan to publish later this year.
‘They can feel that they can be heard’
Cultural sensitivity plays a fundamental role in the success of the Houston County Health Department’s prenatal clinic, said nurse manager Chris Sikes. OB-GYN Eva Martin is fluent in Spanish, as is the clinic’s case manager, Diva Bourlakas. An interpreter is also available for patients who don’t speak English.
It’s important to be able to communicate with patients in the language that’s most comfortable for them, Martin said.
The OB-GYN can’t imagine how difficult it must be for her patients to navigate a country where they don’t know the language, even on a healthy day. Dealing with doctors and medical jargon in a foreign language adds even more barriers to access.
“It takes a huge amount of effort and bravery to do that, and I don’t think we understand or appreciate as much as our patients do just to get to our doors,” Martin said.
The clinic staff works hard to establish trust with its patients, Bourlakas said.
“They can feel that they can be heard, they can be respected, accepted and loved,” she said.
Bourlakas has worked for the health department for over a dozen years and has known many of her current patients since they were children. She remembers giving flu shots to the women who now come to the clinic for ultrasounds.
They’re more than just patients, Bourlakas said. “It’s more like friendships that we have built over the years.”
Patients can tell that the clinic staff cares about them, Martin said.
“We ask them about their entire family. They bring in their kids. We know our patients one on one, and patients hug us,” she said. “How often do you see that?”
Once that trust is built, the clinic staff strives to empower patients to make the best decisions for their own health, and for the well being of their baby. Expectant mothers receive information about family planning, child care and potential pregnancy risks, all in their native language.
Sikes knows she’s done her job when a mother comes to visit with her newborn strapped into a car seat and immunized.
“She knows more about her health when she comes out of our care than she did when she came into our health (department). She’s smiling. The family is together and smiling,” Sikes said. “To me, that’s the most rewarding thing, is just to see the little impacts that public health and their time with us has made along the way.”
All babies should have the best hope for a healthy start, Sikes said.
“It shouldn’t matter where you come from. It shouldn’t matter how much money you have or how much money you don’t have. All babies should get a good start in life,” she said. “And all moms that are bringing these babies into the world should have the option to have health care that’s safe and that’s equal.”
Testing the Hispanic Paradox theory
The health department opened its prenatal clinic in 2016 to provide affordable prenatal care to uninsured women who might otherwise fall through the cracks. The clinic has since served over 150 patients, with great success.
“They do such wonderful work and such vital work, but it’s understudied. So the academic health department helps facilitate the study of that work,” said Jennifer Barkin, the professor leading the investigation. “We can start to quantify what’s going right and even feed it back to the agency.”
Studies show Latina women tend to have better birth outcomes than the general population, especially among first-generation immigrants. Though they often face higher poverty rates, uncertain immigration status and language barriers, Hispanic women are more likely to deliver healthy babies and to survive childbirth than the average American woman, data suggests.
The Houston County prenatal clinic’s success shows in its numbers. Of the 151 patients served between May 2016 and November 2018, only two mothers’ infants were hospitalized for an extended stay after birth. Patients rarely miss their appointments, and the majority of those who stayed with the program through delivery had healthy vaginal births.
Martin, the clinic’s OB-GYN, attributes the positive outcome partially to biology. Her patients are mostly non-smokers, of healthy weight and have low rates of pregnancy-threatening conditions like hypertension, she said. Most also follow a healthy diet and stay active through jobs that keep them on their feet, Martin said.
Researchers think cultural factors may play a role in Latina women’s positive birth outcomes as well. Some credit strong family ties and support networks. Others argue migrants who survive the journey to America are more likely to be in good physical shape and therefore more biologically fit to give birth.
Barkin and her student researcher, Mercer University senior Kelby Flournoy, hope to test the theory of the Hispanic Paradox in Houston County. In the coming weeks, they’ll interview Hispanic patients before their appointments to learn about their support systems, employment status, length of time in the U.S. and other factors that might play a role in their health outcomes.
Latinos are the largest ethnic minority in the country, and their population is rapidly growing in Houston County. Flournoy hopes to better understand the role their culture plays in their health outcomes and to educate other women, as well as clinicians, about how to better care for pregnant patients.
“What is it that these people are doing right and how can we be able to help others do those things?” she wants to know. “And just how can they better serve that community in learning more about their culture?”
Samantha Max is a Report for America corps member and reports for The Telegraph with support from the News/CoLab at Arizona State University. Follow her on Facebook at https://www.facebook.com/smax1996 and on Twitter @samanthaellimax. You can also join her Facebook group. Learn more about Report for America at www.reportforamerica.org.
This story was originally published March 29, 2019 at 12:00 AM with the headline "‘They can be heard.’ Latina moms beating the odds at this prenatal clinic in Houston County."
