Access to quality health care during pregnancy is critical. Although very concerned about their health care, many women unfortunately do not have the means to afford health insurance. This is why the obstetricians/gynecologists (OB/Gyns) at PAMF's Castro Valley Women's Health Center (CVWH) have been providing care to expectant mothers who are patients at the community health care clinic Tiburcio Vasquez Health Center in Hayward.

"For me, treating the uninsured and underinsured women who rely on the Tiburcio Vasquez Health Center is very gratifying," said Anna Maria Sapugay, M.D., head of CVWH OB/Gyn Department. "They are profoundly grateful for the care they receive, and that is a very humbling experience to a physician."

In the four years that PAMF has been working with Tiburcio Vasquez Health Center and Eden Medical Center – the hospital where Tiburcio Vasquez patients' babies are delivered – there have been some significant improvements in care, said Dr. Sapugay. Patients now get three prenatal appointments with an OB/Gyn instead of just one and are screen more systematically for diseases, such as HIV infection. In addition, record keeping procedures have been streamlined, and Eden now offers birthing classes in Spanish.

For many patients, the prenatal appointment with a PAMF doctor – such as Dr. Sapugay, Leslie Hardy Hood, M.D., or Nancy Wigginton, M.D. – is the first really empowering health care experience that patient has had with an obstetrician, said Dr. Sapugay.

"A lot of our patients have had previous pregnancies and births in countries where the medical system just tells patients what to do," she said. "For example, when I start to explain the risks and benefits of a repeat caesarian section versus a vaginal birth after caesarian (VBAC), many will just say, 'Oh, just do whatever you think is best.'

"I have to explain that I would much rather help them make their own decisions," Dr. Sapugay continued. "I tell them it is their body and their baby, and they have the right to ask me as many questions as they want and make their own decisions with full knowledge of the risks and benefits. They will often respond with a surprised look, and then a smile."