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South Florida 'maternity health desert': Nonprofits work to make up for lack of doctors

No location or doctor available in Okeechobee County to deliver baby
Posted at 5:27 PM, May 21, 2024

OKEECHOBEE, Fla. — During WPTV's recent visit to Okeechobee for our "Let's Hear It" community meet-up event, one word we heard a lot was "desert."

It's not what you might expect in a city on a lake. But it's not water that's scarce.

Advocates in Okeechobee County consider it a "maternity desert" — a place where there's little to no access to obstetric care.

The labor and delivery unit at the county's only hospital closed decades ago.

At the time, Dr. Trinidad Garcia was the only obstetrician there and had to be on call around the clock, every single day.

"The hospital here decided to close the (obstetrics) department because we didn't have any more pediatricians to take care of the babies," Garcia said.

Dr. Trinidad Garcia explains to WPTV chief investigator Jamie Ostroff why she moved her practice to St. Lucie County more than 30 years ago.
Dr. Trinidad Garcia explains to WPTV chief investigator Jamie Ostroff why she moved her practice to St. Lucie County more than 30 years ago.

Garcia moved her practice to Fort Pierce and transitioned to gynecology.

Since 1989, when Garcia said she delivered her last baby in Okeechobee County, there's been no place — and no one — to deliver a baby in the county.

Patients now have to drive about 45 minutes to the nearest delivery room.

Samantha Ayala gave birth to her first child earlier this year in Fort Pierce. She said her baby, Russell, arrived early at 34 weeks and spent about two weeks in the neonatal intensive care unit.

After commuting from Okeechobee to West Palm Beach for prenatal appointments throughout her pregnancy, Ayala and her husband, who is battling cancer, had to continue commuting while Russell was in the neonatal intensive care unit.

Three months later, her baby is healthy, but she is struggling. If Russell needs to see a doctor, Ayala takes him 40 miles to Port St. Lucie, where her insurance is accepted.

Samantha Ayala had to drive to Fort Pierce to have her child born.
Samantha Ayala had to drive to Fort Pierce to have her child born.

"I have my hands full," Ayala said. "My postpartum is bad. I try to take it day by day."

Ayala is one of about five million women of reproductive age across the U.S. living in a county with little or no access to pregnancy and postpartum care, according to a report by March of Dimes, which links a lack of such care to worse outcomes for mothers and babies.

"If we can't get doctors, how can we wrap around the mom and have better birth outcomes?" Andrea Medellin, the executive director of the Healthy Start Coalition of Okeechobee, said.

The coalition works year-round to bring what resources it can to moms in the community while bringing those resources under one roof for its annual Community Baby Shower. More than 100 mothers signed up for this year's shower on Indian River State College's Okeechobee campus.

Twenty-two organizations were at the event, providing supplies, information and resources, including access to transportation.

Medellin said it's not uncommon for a baby to be born in the emergency room in Okeechobee's hospital, or on the side of the road, while the mother is on her way to a distant hospital with a delivery room.

"We're able to provide them with something that ... gives them a safer home environment, such as safe sleep with the crib safe car seats, ride home from the hospital and stuff of that nature," Medellin said.

Andrea Medellin discusses the challenges facing Okeechobee given its lack of prenatal resources.
Andrea Medellin discusses the challenges facing Okeechobee given its lack of prenatal resources.

Ayala left the event with a stroller full of supplies for Russell, and a sense of community she desperately needed.

"It was nice just having just to get to talk to people," Ayala said. "I usually don’t talk to anyone."

Ayala also had a doula provided by Healthy Start throughout her pregnancy and will have a postpartum doula until Russell's first birthday. It's a lifeline for Ayala, who said she'd be "lost" without the doula's support.

But it still does not replace the presence of a doctor in the community.

"Sometimes we get interested providers that want to come and serve our ... community and be here. But a lot of times it just comes down to unfortunately the dollar, and that's what's so difficult," Medellin said. "We are such a small coalition. And the things that we're doing. We just work beyond our measures to pull in grants and pull dollars down as much as possible."

According to state financial records, the Florida Department of Health has awarded $6.7 million in grants to Healthy Start coalitions statewide during the current fiscal year, which ends in June. That's well below the more than $30 million awarded during the previous fiscal year.

While Medellin said Healthy Start does not take a stance on abortion policy, she believes Florida's newly enacted ban on abortions after six weeks will further strain Healthy Start's resources.