Committed to Care

Obstetrics is key to the health of infants and mothers in Philadelphia, but many labor and delivery units closed in the last decade. Dr. Kimberly Arkebauer, associate program director of the Crozer-Chester Medical Center Obstetrics and Gynecology Residency Program, explains the importance of her practice.

›› What drives you to care for maternal and fetal health each day? I’m from Delaware County, and my parents and my sister still live in Delaware County. So for me, working in this community where I grew up is extremely important. 

I’m also one of the one-in-four women in the U.S. that has lost a pregnancy. My very first pregnancy would have been my mom’s first grandchild, and it was a heartbreaking experience. 

One thing with pregnancy loss that I stress to the patient is that it’s not your fault. And when I have patients that lose pregnancies, I’m able to tell them that I have two healthy kids now. You could still have a healthy pregnancy. 

›› How do you tackle some of the causes behind pregnancy risks and barriers to care? I focus on the barriers to getting patients into the office and getting them the care they need. So if they lack someone who can watch their child during care, we have them bring their children in with them to the appointment.

Sometimes it’s transportation: Patients can’t make it or they have to take three buses to get to the office. Sometimes its finances. We have a lot of undocumented patients with no insurance and no access to Medicaid services, and we see them over at the federally funded clinic I also work at. We have in-person translator ser- vices for Spanish, which is wonderful because language is a huge barrier for some women.

›› Where do you feel like you can make the most progress? One of the biggest issues that still exists is the lack of mental health care providers and services. Across the board, there’s a long wait list for counseling services, and there’s a lot of women who could benefit, whether it’s for postpartum depression, anxiety during pregnancy or menopausal changes of mood.

At the clinic I work at, we have social services, so there’s licensed social workers there who help with a lot of the barriers. If a patient comes in and delivers, we can apply for emergency Medicaid and help get at least their delivery covered, so they’re not getting a huge bill.

›› What function does Crozer serve in the community regarding obstetrics? The community knows they can go to Crozer-Chester Medical Center; it’s a big staple in Delaware County, and most people know that it has obstetrics. A lot of places in the Philadelphia area over the last 10 years have stopped doing OB, and that is a barrier to care. Women’s health in this country is valued very poorly, and it’s very poorly reimbursed by insurance companies. If I do a biopsy on a vulva, and a urologist does a biopsy on a penis, the urologist gets paid more than double. So it tends to lose money for health systems, and it’s not sustainable unless there’s a certain number of deliveries. Valuing women and valuing women’s health is what is going to make that turnaround. 

We need more access, and we need more OBGYNs. That’s why the residency program at Crozer Health is important to me. These are young doctors, and it’s important to train them correctly and increase the number of OBGYNs that we have.

This is a paid partnership between Crozer Health and Philadelphia Magazine