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Getting A Healthy Start In The Keys Can Mean Long Journeys

Healthy Start of the Florida Keys
Arianna Nesbitt is executive director of Healthy Start of the Florida Keys.

If you live in the Florida Keys, there are some real challenges to having a baby. If you want to go to a hospital, you have two options. One is at mile marker 5 in Key West. The other is to go all the way to on the mainland in Homestead. And if you’re a new patient with Medicaid, it gets even harder.

WLRN recently spoke with Arianna Nesbitt, executive director of the Florida Keys Healthy Start Coalition. That's the nonprofit that works with pregnant women and families with young children to keep young kids in the Keys healthy and safe.

She started by talking about the challenges for women on Medicaid who get pregnant.

NESBITT: So right now our physicians in Key West are not taking what's called new Medicaid. Basically because their practices are full. You can only physically deliver and be at so many births in a month. And so OB/GYNs historically limit the number of women in their practice per month to make sure they can be there and take care of them.

So what has happened is, there's a federally qualified health clinic in Marathon. That does accept Medicaid. And one of our physicians from Key West, actually drives to Marathon and sees those women on Wednesdays.

We're working on trying to figure that out because if our women are coming from Key West and our physician is coming from Key West, how can we make that 100 mile roundtrip decrease?

WLRN: And what does that mean for those women?

It looks a little different for each one. Many ride the bus. If you think about a 50-mile one-way bus trip — the further along in your pregnancy, the more bathrooms mean to you and the more making sure you have enough to eat means to you and those types of things.

It usually costs them the day at work, which for many they're paid by the hour. They don't have vacation time. So it's a double cost.

What does the geography of the Keys mean for pregnant women, young families here?

If you are living in our county, which is 125 miles long, you can give birth at a hospital at mile marker 5 or in Miami-Dade. You have to cross the Stretch — that's the next delivering hospital.

We do have three hospitals in Monroe County but two of them do not have labor and delivery units. So that means if you live at mile marker 50, which direction are you driving? These things have to be factored in.

It also means that you may find if your baby is sick or your pregnancy is a challenge that you need a specialist based out of Miami. Those trips come into play. We have purchased gas cards. We have paid Uber. We have helped with hotels. Because families need to be together especially in the beginning of life.

We had one woman, her baby needed four specialists. And when she started to try to call to make the appointments, she didn't speak English but her husband did. The transportation system through their insurance company would only let one parent travel. So we had to call and explain, both parents have to go. They wouldn't allow it. So we ended up partnering - this was before Uber, this was a few years ago - but we partnered with the cab company who found us the right driver who found us the right vehicle. We had the conversation of you know, you're going to have to stop because this is what the mom's going to need. And we worked it out.

Then they wanted to make all the appointments on different days. And I was like, tiny human, car seat, has to stop often — it's a lot of education. Once you explain to somebody why it's in the best interest of a mom or a baby or their family — most companies are willing to help out. But again they have these policies that they have to follow. So we have to figure out to make sure that everybody's healthy at the end of it.

Nancy Klingener was WLRN's Florida Keys reporter until July 2022.
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