A state Department of Health Services report that touts Berkeley’s high rate of pre-natal care is being greeted with cautious optimism by the city’s public health officials.
The 90.1 percent of pregnant women who seek care in Berkeley is the highest rate among the state’s 61 reporting agencies, according to a DHS publication, “Atlas of Prenatal Care Utilization, California 1998,” issued Wednesday. Berkeley’s rate is up from 83.1 percent in 1989.
“That’s reflective of the efforts of the health care community,” said DHS spokesperson Lea Brooks.
Dr. Vicki Alexander, the city’s director of maternal, child and adolescent health agreed that Berkeley’s efforts are paying off – it is one of three cities in California which has its own health department – but she underscored that the numbers tell only part of the story.
“There’s nothing new about the pre-natal part of it,” Alexander said. “We’ve met the goal for the last three years.” Berkeley’s overall rates of prenatal care have exceeded both state and national rates since 1996.
It’s important to look at the break down of who is getting the care, said Alexander, pointing to statistics that show that 96 percent of Caucasian women in Berkeley get adequate prenatal care, 95 percent of Hispanic women get the care, but only 83 percent of pregnant African American women get adequate care.
In addition to looking at prenatal care, one has to look at the outcome – at the babies – to evaluate a pregnant woman’s health care.
A recent study by the city’s health department showed a great disparity in the health of African Americans living in the flatlands and Caucasians living in the hills. Berkeley ranked third highest in cities of similar size across the United States in the proportion of low-birth-wieght babies born to African American women between 1993 and 1995.
An important, and often neglected, piece of the prenatal care puzzle is looking at a doctor’s understanding of the expectant mother’s needs. “If you look at access to pre-natal care alone, that is not going to solve the disparity,” Alexander says.
In particular, black women are generally under a tremendous amount of stress, said Alexander, who is African American.
Alexander said she will be working with physicians at Alta Bates Medical Center to make them aware of the particular stress factors in black women’s lives.
The basis for the stress is racism, she said. Following a teaching model already in place at Children’s Hospital, Alexander said her goal is to teach doctors about the value of public health and about the stressors that affect the lives of people of color.
Those who administer health care to black people need to understand what it is like to be the only black person in an elevator, to be seated at a restaurant but not served, to be stopped “driving while black,” Alexander said. “You add all that up. It is constant.”
A doctor who is conscious of his patients’ needs will not only treat her with greater understanding, but recommend her for support services, such as the Black Infant Health Project, a new initiative of the city’s health department which focuses on mothers and mothers-to-be self-esteem and offers them support.