Commonsense Childbirth Inc. (CSC) is a 501(c) 3 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 pregnancy, birth and baby and our key principle is that no one is turned away.
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 outcome.
A priority focus for this project is to increase the number of women who receive medical care, education and referrals from their first trimester onwards, carry their babies to full-term (37 weeks), have babies weighing greater than 5lbs 8ozs, and for women to have low-intervention and empowered births, bond well to their babies and start and succeed at breastfeeding.
Commonsense Childbirth currently operates a birthing center, known as The Birth Place in Winter Garden, Florida which incorporates a new concept, a community-based midwifery clinic called the Easy Access Prenatal Care Clinic. 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. Additionally in these hard economic times we have seen an increase in the number of women of all races who are newly uninsured or underinsured, have become indigent or who are undocumented.
As our program has expanded we have added sites in Volusia county, another Central Florida County. Our goal is to provide Easy Access Prenatal Care Clinics wherever we can partner with supportive agencies and/or practitioners. In Volusia county two existing midwifery practices were willing to host a one-day-per-week clinic which has opened the doors for many more women to gain access to care for a healthier baby.
Need for Program
There is an over-all shortage of obstetrical providers currently and there were 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 clinics from certain areas. Recently all local DCF offices have been closed causing major delays in pregnant women being able to apply for Medicaid. The current system of applying for coverage online is difficult, cumbersome and sometimes all but impossible to negotiate. 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
Commonsense Childbirth provides an on-site outreach clinic day once a week. Maternity care is provided utilizing Jennie Joseph's JJ Way® MCH health care 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 post-partum 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 our practice tend to reach full-term, have babies over six pounds and are more likely to initiate breast feeding than similar populations. (See our 2007 Study results). By providing easier access to this model of care in the targeted areas we anticipate being able to continue this positive trend.
Jennie Joseph, Executive Director explains the impact of the program during an Issue Briefing in Washington DC, April 2009