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Having a baby? Not in Grand County

Tonya Bina
The Sky-Hi Daily News
Tonya Bina/Sky-Hi Daily NewsCharisse Eaton holds 7-month-old Kim at her home in Kremmling. Eaton, mother of two, knows well the lack of obstetric care in Grand County.
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In an effort to hide from an estranged husband, Sylvia Tellez, 24, moved to Grand County from California with her young son. In Granby, she took refuge at her sister’s.

Then life took an unexpected turn.

Tellez met someone, then confirmed she was pregnant during a visit to the Grand County Public Health and Nursing Services office in Hot Sulphur Springs.

She also found out that her new someone wasn’t ready to take on the responsibility of a baby.

“I was sad, scared. I was afraid to tell anybody,” she said.

But Tellez soon learned she would not have to go through her pregnancy on her own.

Maternal Child Health Coordinator and Prenatal Nurse Ellen Stone would be there for her, from counseling to by her side during the delivery ” a service that in Tellez’s situation became invaluable.

In Grand County in situations like Tellez’, people such as Stone and volunteers at the Pregnancy Resource Connection often become beacons of support as they break surprising news to expectant mothers and newcomers to the area.

“You should see people’s eyes when I tell them, ‘You’re not having a baby in Grand County ” not unless it’s an accident,’ ” Stone said.

It’s an inconvenient truth that forces mothers to decide between the least harrowing of routes when planning their prenatal care and delivery. Grand County is an isolated island lacking in women’s health with no easy way out, particularly in the winter.

Even with all the planning, there is still an occasional baby born at home or on the way to the hospital, or at a Grand County hospital not equipped for neonatal intensive care.

In a 2005 survey to assess health care needs and issues in Grand County, conducted by The National Association of Counties and the federal Office of Rural Health Policy, in conjunction with the Grand County Rural Health Network (GCRHN), the question was posed: “What additional health care services do you feel are needed in Grand County?”

The response cited most frequently was “specialty services,” according to the Rural Health Network, followed closely by “OB-GYN services.”

“The majority of persons interviewed indicated they currently utilize OB-GYN providers in the Denver area,” said Dorri Penny, executive director of GCRHN.

“My biggest concern was that I wouldn’t be having the baby in the hospital, but in the car,” said Tellez, who gave birth to a healthy 7 pound, 3 ounce boy at Yampa Valley Medical Center in Steamboat last month.

She named him Angel.

Public Health a source of support

Like all parents who have spent prenatal months in Grand County, David and Charisse Eaton of Kremmling know all too well the shortage of pregnancy care and delivery options.

Charisse’s eldest, David, 3, was born after Charisse was evacuated by helicopter from Kremmling Memorial Hospital following two incidents of premature labor triggered by a fall that resulted in a broken femur. Because there is no facility in the area for high-risk or C-section deliveries ” or any deliveries for that matter ” she was rushed to Denver where David eventually was born.

During the pregnancy of her second child, 7-month old Kim, the Eatons traveled to Summit County for Charisse’s prenatal appointments, toting young David along and scheduling appointments around hectic work schedules.

They did so during winter months when weather was unpredictable.

“Going over mountain passes to prenatal appointments when they’re eight months pregnant is pretty daunting and intimidating to some people,” Stone said. “I have some intrepid mothers who drive themselves, even when their pregnancy is far along.”

Stone, through Public Health and Nursing, has become a source of trusting and caring support to the Eaton family. As part of her rounds, she visited the family Wednesday.

When she entered their home, young David bounced toward Stone to hug the lady who has helped his parents through two challenging pregnancies. She remains their friend and health mentor.

Choices few and far between

There are too few choices in local health care for expectant mothers, Stone said, but there is support.

If a young mother is undocumented without insurance, her choices are narrowed to a single option for hospital care.

For such mothers, Grand County Public Health provides them an Emergency Medicaid application and refers them to a University Hospital program in Denver, where mothers can feel safe in applying to the program. This program costs $40 per prenatal visit. A condition of the program is that the mother must deliver her baby at University Hospital.

If a mother is documented but has no health insurance, she may have presumptive eligibility for emergency Medicaid if she meets income and citizenship requirements. This covers labor and delivery only. For prenatal care, the mother must be within a certain percentage of the poverty level. Or, the mother could qualify for the Colorado Health Program, designed for children and pregnant women.

For a citizen who is insured, the Grand County Public Health and Nursing Services is still available for whatever an expectant mother needs, such as nutrition information, social and emotional counseling, information about breast feeding and postnatal care.

“The most important part is listening,” Stone said.

Mothers choose between long distances

Mothers in Grand County have just a smattering of prenatal care options in the county, with doctors and midwives visiting periodically.

An OB-GYN as well as a nurse practitioner see patients at St. Anthony’s Granby Medical Center twice a month. Another OB-GYN visits Kremmling Memorial Hospital monthly, with a possible scheduling of more frequent visits in the works, according to the hospital.

At Planned Parenthood in Granby, nurse midwives see prenatal patients on Tuesdays.

Regarding appointments closer to the birth date and actual deliveries, however, mothers must travel to Summit County, Steamboat Springs or Denver. Kremmling Memorial Hospital District has not delivered babies since the mid-1980s.

The topic remains sensitive, according to Ellen Parri, chief of nursing at the Kremmling Memorial Hospital District.

Parri served 11 years in prenatal education counseling at Grand County’s Public Health office, and understands, like Stone, the void in prenatal and delivery care in the area.

Although she remains optimistic that someday Grand County will attract a full-time OB-GYN and anesthesiologist, at this time, the present amount of expectant mothers in Grand County discourages it.

“An increase in child bearing-aged residents” is what is needed to eventually have baby deliveries return to Grand County, she said, as well as the recruitment of specialty doctors to fill the void.

With an average 150 pregnancies in the county per year, and no guarantee that all of them would choose care in Grand County, “it’s a matter of numbers,” Parri said.

Only seven possible births in Grand County per month is just not enough to keep the highly specialized staff that would be needed to ensure the health of both baby and mother. And it doesn’t help that the practice of obstetrics has among the highest malpractice insurance premiums.

Yet, practitioners and women, especially, keep hoping.

With 21 years experience in delivering babies, Nursing Supervisor Valerie Lind at St. Anthony’s Granby Medical Center said she would “love to be able to deliver babies in Grand County,” and thinks it may be possible as the population of the area increases.

She is encouraged by the increasing number of couples who fill up the prenatal five-week-course she teaches at the Pregnancy Resource Connection in Granby, the only such class available in the county.

Support available at home

Meanwhile, there remain a few places where expectant mothers unsure about their options can comfortably seek help.

At the Pregnancy Resource Connection in Granby, June Matson and staff stand by pregnant mothers as they make one of the most important decisions in their lives.

Then, they shower them with information to make the next nine months easier.

“We’re not ashamed that we’re a Christian ministry,” Matson said, “But we don’t want people to think they’re not welcome if they are not Christian.”

The resource center is volunteer- and charity-based, and provides childbirth and parenting classes, adoption information, post-abortion counseling and an Earn-While-You-Learn program that rewards clients with free prenatal vitamins, maternity clothes and baby items as young couples learn what it takes to be parents of a newborn. The course can even earn young parents credit in their high school health class.

The Resource Connection is six months away from expanding its medical pregnancy care by providing limited ultra-sounds to verify viable pregnancies.

The center works closely with Stone and the Grand County Public Health office in steering women of any age to the care they need and the information on how to pay for that care. They also help to coordinate rides for pregnant women who need transportation to their long-distance prenatal appointments.

At her public health office, Stone’s door remains open for mothers in need and cares for them no matter the distance.

“I’ve worked in mental health, trauma nursing and hospital nursing,” she said, “and the thing about being a part of a woman’s pregnancy is when you connect with a mom through the relationship that develops. It opens the doors for a child and the family, and from that point on, they are connected to health care, education and to the community. Especially for those families that don’t have the skills. It’s an open door for the rest of that kid’s life.”

Of course, her job has other perks ” involving chubby cheeks and bright eyes open to a bold new world.

She added, “And I get to hold lots of babies. That’s the best part. I melt at those puppy noises.”

– Tonya Bina can be reached at 887-3334 ext 19603 or e-mail tbina@grandcountynews.com.


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