The Du Page County Health Department has cut by half the number of poor women admitted to its free prenatal care program because it can`t find enough doctors willing to treat them.
As a result, hundreds of women a year who otherwise would have received free medical treatment during pregnancy will have to look elsewhere. And health officials say those women might not be able to find that help.
``We`re giving out suggestions saying where these women can go,`` said Millie Sweeten, the program coordinator, ``but we have to tell them, `We don`t know if they can help you.` ``
The program refers poor women to physicians for care and delivery at local hospitals. Health officials say prenatal care is strongly related to infant health and can help prevent premature birth.
Premature babies can require tens of thousands of dollars` worth of treatment, health officials say.
The county program began in September 1987 and initially enrolled about 15 patients each month. That has since risen to more than 60 new patients a month. Effective immediately, however, the program will take and refer only 30 new women each month-eliminating an estimated 360 women a year or more from participating.
``We profoundly regret having to take this action, but the number of women who need the program has risen more rapidly than the number of local physicians who will accept them for care,`` said Dr. James Paulissen, executive director of the Health Department.
``When you`re talking about turning away as many women as we need to turn away, you`re talking about a crisis situation,`` he said.
When the program was begun, Loyola University Medical Center in Maywood agreed to handle all high-risk patients in the program as well as the low-risk patients who could not be placed with local obstetricians.
But Dr. John G. Gianopoulos, acting director of maternal and fetal medicine at Loyola, said Monday that the caseload has just been too much.
``We were winding up having to ask people from our neighboring communities to get on a wait list because we were getting so many people from Du Page,`` Gianopoulos said. ``They had to wait five or six weeks to get treated because we just couldn`t handle them.``
In a sense, the program is a victim of its own success. Gianopoulous said that when Loyola signed onto the program, officials expected to help about 200 women a year. But that number has multiplied fourfold.
Only 54 of the 113 obstetricians who practice in Du Page participate in the program, along with 12 family practitioners. They each treat up to 12 people every year.
The Health Department estimates that if all the Du Page doctors who deliver babies would participate in the program, each would need to take only six patients a year.
The head of the Du Page County Medical Society said the county`s physicians were inundated by women in the program.
``The demand for services has exceeded anyone`s estimate,`` said Kirk McMurray, medical society executive director.
Paulissen said the decision to cut back the program was difficult because ``we have an ethical and moral responsibility to take care of these women.`` But, he added, the cutback was the department`s only choice.
The Du Page program is financed with state grants and county funds. The Health Department pays doctors $550 for regular deliveries, $700 for Caesareans and $28 for each office visit. Those rates are the same as are paid by the Illinois Department of Public Aid. However, the county patients are responsible for their own hospital bills.
Advocates of the Du Page program point out that some poor people who don`t qualify for public aid do meet the county`s requirements. And the county program provides a doctor to patients, while public aid recipients have to find their own.
Even so, Paulissen said it is difficult to persuade doctors to help.
``Some of them want to treat poor women on a case-by-case basis, rather than in the program. And they are very busy people,`` he said.
Other doctors are wary of taking public-aid recipients, he said. And still others see that fewer and fewer people have medical insurance to help pay for the care.
``But this really isn`t the doctors` problem,`` Paulissen said. ``It`s the community`s problem.``
Loyola will continue to handle high-risk patients, which Sweeten and Paulissen described as women with severe health problems, including drug abuse, high blood pressure and diabetes, or a combination of problems. It also will treat a few low-risk women each month, Gianopoulos said.
Sweeten said high-risk patients account for about 10 percent of the total. ``You`re more likely to see high risks in patients that have a combination of factors, living in cars, doing drugs and the like,`` she said. But Paulissen and Sweeten both fear that many high-risk mothers-the ones who need care most-will be lost in the shuffle because of the program cuts. The expectant mothers will be accepted on a first-come, first-served basis.
To qualify, applicants` income must be no more than 133 percent of the so-called poverty level. For a family of three with another baby on the way, the cutoff is $18,000 a year.
Of the 677 women in the program last year, 9 percent were between ages 14 and 17, 18 percent were 18 or 19 years old, 62 percent were between 20 and 29, 9 percent were between 30 and 34 and 2 percent were 35 or older.
About 55 percent of the women were Caucasian, 28 percent Hispanic, 12 percent black and 4 percent Asian.