NEW SMYRNA BEACH ... Getting women ready both physically and emotionally to welcome new life into their lives ... is what Tyus, a certified midwife, does.
... It means women from Southeast Volusia, where there are no private-practice obstetricians who deliver, won't have far to travel for prenatal care, a crucial weapon in the fight to keep infants alive beyond their first birthday.
It's a battlefield on which some ground has been lost in recent years. Between 2003 and 2007, the rate at which women received prenatal care in the first trimester of pregnancy dropped nearly 17 percent in Volusia County, so more than a quarter of all pregnant women did not get it. In Flagler, it dropped 10 percent, so nearly one-fifth of pregnant women did not receive first-trimester prenatal care, according to state Health Department numbers.
Those drops are likely to be a factor in a grim statistic: The number of Volusia County children dying before their first birthday has increased 12 percent in three-year rolling averages between 2001 and 2007 ...
Because the majority of Volusia County births occur under Medicaid, the state's health insurance for people with low income, a new automated system for enrolling in that system has been blamed as a possible culprit for why pregnant women are not getting to the doctor sooner.
... "Karen is the only one who would take me without insurance," Reddy said. "She was so nice. I just kept going to her."
Tyus' policy is that she sees everyone who thinks she's pregnant and worries about Medicaid reimbursement later. She uses a Doppler and the results of laboratory blood work that's paid for through funding from the Healthy Start Coalition to determine whether the patient needs more than her high-touch, low-tech services.
"Midwifery clinics are easy -- they aren't expensive," Tyus said.
If a pregnant woman needs more help than what Tyus can provide -- such as when a positive screen for gestation diabetes comes up -- she collaborates with a network of doctors willing to provide back-up.
... "She is so passionate with the support she gives, the follow-up -- it's way beyond a 15-minute visit and a lot of women need that, especially a woman who has social (risk) factors," Morgese said, recounting how Tyus has visited a homeless shelter to administer her care ...