ARRA:Health Center Integrated Services Development

The women and children in rural eastern KY have suffered for too long with inadequate prenatal care (only 3O% of Knott County women and 40% of Perry County women receive adequate prenatal care I), appallingly high rates of smoking during pregnancy (at 45% in Perry County ii), breastfeeding percentages that are among the lowest in the state (at 19°/o in Knott County and 21% in Perry County iii), as well as excessive preterm births (at 14 % in Perry County and 17% in Knott County iv) and unacceptably high infant mortality rates (at 12 per 1,000 live births in Knott County v). These distressing health disparities attest to the need for obstetric and gynecological services within our service area. Incorporating educational sessions with obstetric visits utilizing an interdisciplinary approach such as the centering pregnancy model would permit an educational focus on issues of importance to our population, such as smoking cessation, domestic violence, oral health care, nutrition and breastfeeding, and the impact of drug use on the developing fetus. Such sessions would allow the development of supportive networks among expectant mothers, and could provide an additional impetus for mothers to comply with follow up care