Commonsense Childbirth Inc. (CSC) is a non-profit organization that was formed in 1998 to enhance women’s experience of childbirth and improve perinatal outcomes using a midwifery model of care. Low birth weight, prematurity and infant mortality rates remain particularly high in Central Florida’s minority and indigent population and so CSC has focused efforts on removing and reducing the barriers to health care that have impacted these statistics. Our vision is that all women have a healthy baby.
Mission
Commonsense Childbirth’s mission is to ensure access to timely maternity healthcare particularly for minority, low-income, uninsured, and underinsured women; and to provide practical, social, educational and emotional support, resources and referrals as a means to improving the chances for a positive pregnancy outcome.
Target Population
CSC currently operates a community-based midwifery clinic and birthing center, known as The Birth Place in Winter Garden in the west Orange County zip code 34787. Although once considered rural, the area has rapidly expanded and is encroaching on the west side of Orlando and its urban population. Patients come from a tri-county area but increasingly from neighboring zip codes 32808, 32810 and 32818 which have a large African American population. We have consistently targeted the women in these areas who are at risk for late-entry into prenatal care due to lack of resources or support and have traditionally had poorer perinatal outcomes.
Need for Project
There is an over-all shortage of obstetrical providers currently and no midwives at all in the targeted areas. Patients often have transportation difficulties and may need to take a minimum of three buses to reach our clinic from certain areas. Additionally all local DCF offices have been closed causing major delays in pregnant women being able to apply for Medicaid. Subsequently women have been presenting for care later than usual, if at all, and are often unable to secure a provider due to their advanced stage of pregnancy. Newly relocated pregnant women are also experiencing difficulties accessing obstetric care, even if they bring prenatal records with them, due to being in their second or third trimester.
Activities and Services
CSC provides an on-site outreach clinic day once a week. Midwifery care is provided utilizing Jennie Joseph's JJ Way MCH healthcare system, as well as help with Medicaid applications and referrals to social services as needed. We see all women, regardless of race, creed, sexual orientation or ability to pay, for full new-patient exams, repeat prenatal visits and postpartum care as needed. Education services encompass nutrition, childbirth preparation, breast feeding and parenting support groups. Referrals are made to our regional perinatal service at Winnie Palmer Hospital, Orlando for any high-risk patients that we identify. Healthy, low-risk women who are motivated to deliver naturally are offered the opportunity to deliver at our birth center, all others proceed to the hospital for delivery and return to our care for postpartum follow-up.
Outcomes and Desired Changes
We have found that perinatal outcomes have consistently improved in the women who are currently being served by The Birth Place/CSC program. Women in this practice tend to reach full-term, have babies over six pounds and are more likely to initiate breast feeding than similar populations. By providing easier access to the midwifery model of care in the targeted areas we anticipate being able to continue this positive trend.
Objective
A priority focus for this project is to increase the number of women who receive medical care, education and referrals in their first trimester.
