Pregnancy is different for women without access to health care.
For poor women, single mothers and non-English speakers, it can be bewildering and even terrifying. Lack of adequate prenatal care affects both mothers and their infants, who are more likely to suffer from low birth weights or are born prematurely.
Enter Healthy Start, a program offered by the Maternal and Child Health Consortium of Chester County, which helps low-income pregnant women gain access to prenatal and postpartum services.
"Honestly, I really don't know what I would have done without Healthy Start," said single mother Mary Wimberly, 18, as she repositioned her 14-month-old son, Marquez, on her lap during a visit to Healthy Start's Phoenixville office.
"They helped me find out how to get all the things that I need, what programs could help me; they just made it a lot easier. From getting insurance to day care to getting jobs to getting housing. . .they really help me a lot."
Healthy Start's family health advocatesrefer women to prenatal care providers, get health insurance for them and their children, offer free transportation to and from appointments, help them fill out applications (for food stamps, housing, etc.) and provide medical interpreting. They also screen for depression, offer emotional support and provide health education services in both English and Spanish.
"There's such a wide range of what we provide," said family health advocate Winona Patterson, 29. "If they need something, we try our best to find it and get it. If they need emotional support, we're always here to talk to."
In 2007, Healthy Start served about 1,200 women, a majority being Latina and African American. It helped enroll about 1,400 women and children in health insurance, and, according to its web site, 98 percent of infants were born at a healthy birth weight.
"Usually I come here any time I need help filling out applications for things like housing or food stamps," said Cynthia Olmo, 19, who is expecting a boy in July. "A lot of times I just come here when I need to talk, or when I have questions about something, or if I'm feeling sad or nervous."
The consortium's 30-person staff is all women. About half the employees work for Healthy Start's five offices, which are in West Chester, Coatesville, Oxford, Phoenixville and Kennett Square.
Most advocates are bilingual and bicultural. "Health care [and social service] systems are not easily accessible or understood, especially when there are language and culture barriers," said Neydary Zambrano, 36, Healthy Start's program director. "We try to serve as a link between these women and the community."
A big problem for Healthy Start, however, is ensuring that women are aware of their services. To that end, family health advocates do extensive outreach, handing out leaflets and making contact with community leaders who they hope will refer women to Healthy Start. Wimberly, for example, heard about Healthy Start from a doctor at a hospital.
Healthy Start doesn't stop at childbirth. Advocates continue to work with the women for up to two years after the child is born, often paying home visits, to monitor the mother's health and her baby's development.
"We're advocates, but we teach them how to advocate for themselves as well," said Patterson. "We don't just give them things, we give them skills and knowledge to prepare them for the future."
If they need more help, the consortium also has a family center serving families whose children are ages 2-5. It also provides a Health Insurance Enrollment Program, Professional Training Program (helping to educate health care and human service providers in Chester County about cross-cultural health issues), Provider Services Program (helping to train and provide access to interpreters) and a Prenatal and Parenting Education Program. The last is the only bilingual parental education program in the county.
"One of the things I love about the work that we do is that women really feel empowered and supported," Zambrano said. "A lot of women are isolated in the community because of financial, cultural or language barriers, among other things. So we offer them our support."
For those who lack support from their families or friends, Healthy Start is a surrogate support system.
"It really did feel like I was talking to my family," said Wimberly. "A lot of places judge you when you're a teen mom. . . .When I came here it was different. No one passes judgment on you for the things that you've done or for the things that you're saying. They understand what you're going through."
The main office of the Maternal and Child Health Consortium of Chester County is at 30 W. Barnard St., Suite 1, West Chester, Pa. 19382.
The consortium's phone number is 610-344-5370 and its Web site is