McLeod Medical Center Dillon - Latina Perinatal Outreach Project

Overview

The Latino population in South Carolina's Pee Dee region is growing rapidly. In South Carolina, Hispanic mothers have had the highest rates of late or no prenatal care compared with other maternal race and ethnicity categories. In 2007, the March of Dimes funded the Latina Perinatal Outreach Project, a collaborative initiative between McLeod Medical Center Dillon and the Coastal Plain Rural Health Network, to improve birth outcomes of Latina women. This project provides prenatal education in Spanish for pregnant Latina patients of the McLeod OB/GYN Dillon practice, and provides cultural competency training to staff.

Impact

When the program began in fall 2007, pregnant Latina women and their spouses participated in prenatal classes taught on the hospital campus. Nearly 400 women benefitted from these classes; however, due to transportation challenges, many women and their spouses were not able to attend. Now, the program has incorporated the education component into the pre-natal visits at the hospital-owned OB/GYN physician's office. Based on feedback, these women have increased their knowledge of the signs and symptoms of pre-term labor and how to navigate the American health care system, which has resulted in the birth of healthy babies. The program provides bilingual assistance to participants in completing Emergency Medicaid applications, resulting in increased payment to the hospital and physician. Cultural competency training for staff has improved patient/physician relationships and patient satisfaction.

Challenges/success factors

The majority of rural hospitals and physician practices have neither an adequate number of bilingual staff nor an adequate understanding of cultural differences. In Mexican culture, the predominant group in South Carolina, adults do not traditionally have family physicians or seek medical care. Shame is associated with inability to pay for services, so if individuals are unable to pay, they often do not seek treatment. Although pregnant women seek prenatal care from a physician, it often is not until late in their second or third trimester.

Another challenge has been insufficient staff capacity to provide outreach and follow-up services. Crucial to the program is that the care coordinator is a native of a Central American country and has a strong health care background. He understands the Latino culture and effectively communicates appropriate childbirth education to the patient, the needs of the patient to the physicians, and cultural competency to office staff. The OB/GYN physicians speak some Spanish and make a concerted effort to communicate with their Latina patients.

Future direction/sustainability

To alleviate some of the transportation barriers, providing the education during the pre-natal visit allows expecting moms the opportunity to receive both the health care attention they require as well as the appropriate education needed for a healthy pregnancy. Expecting moms are also encouraged to enroll the baby with a pediatrician and enroll the family with a primary care provider. Program sustainability following the March of Dimes funding is expected from McLeod Medical Center and/or Healthy Families.

Advice to others

This program can have a very positive impact on Latino patients by encouraging early prenatal care, payment for services rendered, and culturally competent health care services.

Contact: Rachel Turner Gainey, MHA
Associate Administrator, Public Information and Communication
Telephone: 843-487-1397
E-mail: rgainey@mcleodhealth.org