GRAND JUNCTION — Loud, rhythmic thumps fill a cramped medical exam room — a good sign that a 15-week-old fetus will not become another Colorado statistic.
“Wow. It’s really fast. It’s so exciting,” Krystal Archuleta says as her baby’s heartbeat is magnified through a fetal heart monitor.
The fact that Krystal and her husband, Salomon, are here for prenatal care is encouraging to health care professionals who know only too well how early care can circumvent later problems.
It also highlights an important cost-saving measure used by a Grand Junction-based program called B4 Babies & Beyond that physicians say should be a model part of the debate over health-insurance reform.
Colorado ranks poorly nationally on its rate of babies with low birth weight. And intensive hospital care for those babies in this state can add up to about $10,000 a day.
The March of Dimes has tallied the average cost nationally for the first year of life for low-birth- weight babies beyond intensive care at $49,000.
Prenatal care and education that helps expectant mothers stop risky behaviors is vastly cheaper than paying for the care of babies with problems.
Krystal has insurance through her husband’s job at a recycling center, but the co-payments are too much for their budget.
Working with Krystal to provide her with the services that will help her deliver a healthy baby costs B4 Babies about $168.
“This gets women into care and real ly helps navigate them through care. It’s done at a really low cost for a really high benefit,” said Chris Wiant, executive director of the Caring for Colorado Foundation that has been funding B4 Babies for six years.
The B4 Babies program has given Mesa County the best ranking in a state with one of the worst numbers for low-birth-weight babies — newborns of less than 5.8 pounds.
Working with a mostly high-risk population of mothers-to-be, B4 Babies has held low-birth-weight babies in Mesa County to 7.3 percent.
That compares with 8.9 percent statewide. The national average is 8.3 percent. Some of the top-rated states in the country are as low as 6 percent.
Other programs
Why Colorado has so many low- birth-weight babies isn’t clear. Factors that have been associated with the problem include smoking, low weight gain during pregnancy and, some health care professionals think, altitude.
There are other programs for uninsured pregnant women in the state, but none is as comprehensive as B4 Babies, say those who help fund the program.
The Nurse-Family Partnership in Denver gives home visits to first-time expectant parents throughout pregnancy and through the first year of a baby’s life.
The Colorado Department of Public Health and Environment sponsors programs that target at-risk women and counsel them about smoking. The Aurora/Arapahoe Healthy Start Initiative targets areas of high mortality rates and tries to lower those rates through prenatal, postpartum and child care.
B4 Babies is recognized as a model because it offers every type of care an expectant mother could need.
Pregnant women get help filling out daunting 12-page applications for financial assistance through Medicaid or Child Health Plans Plus.
Rather than waiting weeks for approval, their applications are whisked through a process that determines “presumptive eligibility” in as short a time as it takes to watch a video about healthy pregnancies.
A client specialist then helps the mother-to-be make a medical appointment. Ninety-eight percent of the obstetrician-gynecologists and midwives in Mesa County see patients through the program.
A specialist also goes over everything from a “training camp” for new dads to stop-smoking advice and a list of dangers such as drinking and eating unpasteurized dairy products.
“Have either of you ever heard of baby blues or postpartum depression,” client specialist Diana Cato asks a pair of expectant mothers.
They shake their heads.
Are they taking prenatal vitamins?
Another negative head shake.
By the time they leave, these nervous women are loaded with information and breathing easier.
“We’d be like nowhere right now. We had no idea what to do,” Krystal said when asked what her options were without B4 Babies.
Translation, transportation
For non-English-speaking clients, an interpreter can go along on doctor visits. Lenna Sadler also doubles as a driver for clients without transportation. She is currently helping to shepherd 57 mothers-to-be through medical care.
As they waited in an exam room at St. Mary’s Family Practice Center, Sad ler asked one of those mothers, Lourdes Bautista Perez, what she would have done without B4 Babies.
“No se,” Bautista Perez answered. She didn’t know.
B4 Babies was started by Hilltop Community Services 19 years ago.
In the same way that medical professionals have collaborated on so many other health care initiatives in Mesa County, Hilltop, physicians, midwives, Rocky Mountain Health Plans, St. Mary’s Hospital, the Marillac Clinic for the uninsured, and the state Department of Health and Human Services came together to make the program work.
Funding comes from grants and donations. No state or federal funds are involved.
The U.S. Department of Health and Human Services recognized B4 Babies in 1998 as a “Model That Works.”
Many who are close to the program also sing its praises.
“It’s an amazing resource. It has so many positive effects,” said Dr. Elvi Whiteford, who oversees the obstetrics portion of St. Mary’s residency program.
Midwife Anita Sheetz called it “a huge service.”
But the biggest endorsement might be the Archuletas’ grins — and their determination to be good parents even before their baby is born.
“We want everything to be right,” Krystal said.
Nancy Lofholm: 970-256-1957 or nlofholm@denverpost.com
This article has been corrected in this online archive. Originally, due to a reporting error, the low-birth-weight figures for
Mesa County and the state of Colorado were incorrect.
