March 1, 2000

In an average month, the staff at the Oakdale Women's Health and Prenatal Clinic will see 550 women and teen-age girls.

They'll attend to the medical needs of a 12-year-old girl, who has just learned she is pregnant and has decided to keep her baby. They'll provide access to reliable birth control for a mother of four whose husband's income cannot support more children. They'll detect the beginning stages of cervical cancer in a woman who exhibited no symptoms.

"It's a great service to these people," said clinic manager Marjory Hillier, a Registered Nurse who got her start in medicine as a nurse midwife in rural eastern Kentucky. "They are given assistance in every way."

Founded a decade ago by Oakdalen Sharon Ordelheide - a Registered nurse who still works at the clinic once a month - the clinic today is experiencing labor pains of its own.

The 12 chairs in the waiting room and the two tiny exam rooms here are almost always full. Nearly every inch of this 1,700 square foot medical clinic that serves women who would otherwise not have access to medical care is occupied with something.

There is no wasted space. There is no room at the inn.

But an upcoming move to larger quarters will change all that. After an operational agreement is finalized between the county and Oak Valley District Hospital and final inspection by the state, the clinic will be relocated to an over 2,000 square foot suite in the same medical complex off Oak Avenue.

"We desperately need more space", Hillier said in her cramped office that doubles as a Medi-Cal satellite center once a week. "There are times where the waiting room is so full, people standing and people sitting, that you can barely breathe in there."

Hillier attributes the maxed-out patient load to an increased demand for family planning services.

"It has gone from about 350 to about 550 purely because of the increase in family planning (patients)," said Hillier, who has been with the clinic for two years. "That's where our numbers are now.

"And that's wonderful, because that way we can avoid the unplanned pregnancies that change young girl's and women's lives forever."

Staff like Maria Hernandez, a medical assistant with the clinic for six years, have seen it all.

Teen pregnancies too numerous to count. Couples barely able to feed the children they have learning one more is on the way.

Drug- or alcohol-addicted women unwilling or unable to get clean or sober when they learn they're pregnant. Girls barely in their teens finding out they have a sexually transmitted disease like gonorrhea or syphilis.

It can be hard sometimes," admitted Hernandez, "But I really like the work I do here."

When burnout strikes, as it does often in this field, Hillier said staff lean on one another. The county also provides them with access to team building seminars and individual counseling.

But what likely keeps clinic staff going are patients like Marta, who didn't want her last name used for this story.

Though she's eight months pregnant with her second child, walking a mile with her two-year-old son snuggled warmly in a stroller didn't bother her on a recent morning.

The walk, she said, was worth it to hear the heartbeat of the baby growing inside her.

"With my son, I had to go to a place in Modesto," she said through a translator. "I had to ride the bus.

"It would be very difficult if this clinic wasn't here because (of) my son and then having to ride the bus. If I had a car, it would be easier."

Marta is typical of many of the patients who use the clinic. Nearly 75 percent of the clinic's patients are Hispanic, Hillier said. For some, the clinic is their first encounter with professional medical care.

"…We're serving women who would have no medical care, no prenatal care and no family planning that would be effective," Hillier said. "And for some, it's their first time being with a doctor or nurse."

Four local physicians staff the clinic on a rotating basis. Additionally, the clinic has a staff of eight, three of whom are part time.

A nurse practitioner monitors the progress of pregnancies that are not considered high-risk and conducts annual physicals and gynecological exams.

Women whose pregnancies or gynecological health is considered to be high-risk are referred directly to a physician.

The clinic operates as bit of "stepchild," Hillier said. Owned and managed by Stanislaus County, the clinic operates in collaboration with Oak Valley District Hospital.

The county provides the clinic with a $240,000 budget, Hillier said. Oak Valley supplies clinic patients with access to lab services and equipment, and its labor and delivery unit. The hospital also manages all billing for the clinic, which serves eastern Stanislaus County residents.

Funding is provided by government grants for rural health.

While a 550 monthly patient load for a skeletal staff of eight makes for a frenetic pace, staff said there's an almost familial atmosphere in the clinic.

Picturesof babies are everywhere. Letters of gratitude from patients are not uncommon.

Whether clinic staff guided a woman through a difficult pregnancy, helped detect breast or other reproductive cancers or counseled a rape or domestic violence victim, patients always surprised that here they are a person, not a number.

"We get to know them on a personal basis," said Jackie Cavazos, a medical assistant. "We know them on a first name basis because we're small here."

"It's true," interjected Hernandez. "They walk in the door and we greet them by name and they say 'Oh, you remember my name.' They like that".

Reprinted by permission of The Oakdale Leader.