THE STORY

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THE STORY
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INFORMATION AT INITIAL ENCOUNTER
who? what? where? when? how? why?
Lives with the father of the baby in a poor
house- hold, but doing ok
Social contacts limited to hus- bands unstable,
risky job and some neighbors
Migra-ted recen-tly due to higher levels of
pover-ty in Mexico
LAURA
Illegal status as undo-cumen-ted immi-grant in
the US
Young healthy Latina woman pregnant for the
first time
First winter in Wis-consin
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ACCESS COMPONENTS IN PLACE
Place for care
Necessary skills present
New policy!!
Old policy
Provider
Works at a Community Health Center near Lauras
home.
Jan 06 new state health policy!! Badger Care
coverage for pregnant undocu-mented women
Federal and state funding for CHCs to take care
of the under-served (low)
KAREN
Bilingual, culturally sensitive nurse midwife
Mission of the CHC providing language- and
culture- sensitive care
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OUR MISSION To improve the health of Latinos in
Wisconsin
KAREN
LAURA
Make sure interaction happens
resources
need
OUTREACH
Laura was informed of available access
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KAREN
The interaction never happened
Lauras baby died
LAURA
Why?
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Lauras poor level of functionality

• was stressed and lonely, got depressed
• Did not eat well, the baby was born 8 weeks
  early
• Breast feeding became problematic
• Did not know how to dress for winter
• Did not know how to take care of a sick baby
• Was not able to reach babys dad at work
• Did not get a good interpreter at the emergency
  room, did not understand the babys condition
• She knew she had no rights to services and was
  afraid that any institution would deport her if
  she ask for help
• She knew LHO was a struggling non-profit that
  did health education only (not care) so she
  didnt call us

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Information gathered after access failed

• Without her familys approval, she and her
  boyfriend used the money saved for their wedding
  to pay the coyote to cross the border, her
  parents didnt want her leaving
• The babys dad depended on a friend to get to
  work so he was saving to buy a car, the baby was
  an unexpected expense, she waited to tell him
  about the pregnancy
• She wanted to wait until she could send money to
  contact her family so they could see the benefit
  of her leaving, and she didnt call her mother or
  sister for advice about the baby

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Information gathered after access failed

• They considered it too risky to ask the employer
  for a poof of (low) income, a requirement to
  receive the coverage
• She knew she had no rights to services and was
  afraid that any institution would deport her if
  she ask for help
• She knew LHO, as many other non-profits, is
  struggling for resources and that only gave
  health education, not health care so she didnt
  call us