2 weeks Ago By Chrissy Booker
Clark County Public Health highlighted disparities in prenatal care access across the county, particularly for those with Medicaid, during a Wednesday presentation at the Board of Health meeting. The Clark County Council, which also serves as the county Board of Health, heard from three Public Health employees, who also spoke about the high cost of postpartum care and how to improve access to maternal health services across the state. “We continue to hear from pregnant individuals and those that provide services to the community that accessing prenatal care with Apple Health coverage is difficult and sometimes impossible,” Public Health Family Initiatives Coordinator Hayley Pickus said.
“This can be extremely harmful to both the fetus and pregnant person and will require a concerted effort to solve the problem in the short and long term.” Prenatal care, offered during a pregnancy, may be delivered by a primary care provider, midwife or OB-GYN. Routine prenatal care is a valuable opportunity to identify and treat pregnancy complications, infection or diseases — and offer health counseling, Pickus said.
But even individuals with comprehensive pregnancy coverage through Apple Health, Washington’s Medicaid program, are struggling to access care, Pickus said. “Investments early in life reap benefits into adulthood,” Pickus said. “Early and regular prenatal care promotes healthy pregnancies, while inadequate prenatal care increases risk for pregnancy complications.
” Public Health Epidemiologist Adiba Ali said each year about 5,500 children are born in Clark County, according to the most recent data available from Public Health . In 2023, 38 percent of all births in Clark County were covered by Apple Health, while 57 percent of births were covered by private insurance, Ali said. The highest rate of Apple Health births were among Pacific Islander, Hispanic, Native American and Black populations.
That same year, overall about 27 percent of people who gave birth in Clark County received inadequate prenatal care. This rate nearly doubled for the county’s Pacific Islander community, with 56 percent receiving inadequate prenatal care between 2018 and 2022, according to Public Health. “This is really alarming and informative, and I think highlights your important role in analyzing and collecting the data and transforming all of that into actionable items,” Council Chair Sue Marshall said to the team from Public Health at the meeting.
Emma Burghardt, a nurse with Public Health’s Nurse-Family Partnership program, provided anecdotal insight into the countywide issue. A couple of months ago, Burghardt received a referral from a young, first-time mom whose second language was English. Burghardt recounted how she and her client struggled to find a provider who accepted Medicaid and offered prenatal care.
The two contacted multiple clinics, trying to confirm whether Medicaid was accepted, but did not find a suitable option in Vancouver. The closest option for was a clinic in Longview. “I tried to learn more about her pregnancy.
She was growing anxious with how hard it had been to find a doctor,” Burghardt said. “When we were finally able to connect with the staff, they asked her a series of questions, some of which she didn’t know how to answer. As I put myself in her shoes, I couldn’t help but feel her sadness and discouragement.
” The key takeaway is that there are levers — at the federal and state levels — to improve the way Medicaid is managed, funded and delivered, Pickus said. The agency hopes to eliminate barriers to care through community initiatives, such as the Nurse-Family Partnership and Raising Clark County . Yasmina Aknin, program coordinator for Public Health, previously said the agency is working to improve referral pathways and increase existing prenatal and postpartum support resources, which includes conversations around mental health and continuity of care.
“Our culturally specific community-based organizations share examples of biased clinical care, a provider population that does not reflect the county’s diversity, transportation barriers and social cultural norms that are not reflected in the American health care system,” Pickus said. “We cannot discount these drivers.” This story was made possible by Community Funded Journalism , a project from The Columbian and the Local Media Foundation .
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