Family Ties
An innovative prenatal program from Monfort Inc. eases the burden of pregnancy and rising health care costs
by Ken Krizner, senior editor
Maria Sanchez never received any formal training in prenatal care prior to her first two pregnancies. She delivered two healthy boys, but she had difficulties with both pregnancies.
Last December, Sanchez-whose husband Adauto works at Monfort Inc.'s Greeley, Colo., lamb plant-delivered her third child, a girl. And again, she had complications with the pregnancy.
But by taking advantage of a program offered by Monfort, Sanchez was given the support and guidance needed to get through that traumatic time.
Monfort has embarked on a multi-faceted program, "Healthy Moms, Babies and Families," to educate women about the importance of caring for their health, which in turn, can help ensure the health of their babies.
Healthy Moms is unusual, not only because it is the only known program of its kind in the meat industry, but because it is the basis of a partnership between government and the private sector.
The program, which began in January 1994, is in 19 company facilities. At Monfort's vast complex in Greeley alone, the number of women eligible for the program is about 1,700. Company officials hope to expand the program through its entire operation, which would encompass about 6,400 women of child-bearing age.
"We were finding that some women were not seeing a doctor until their eighth month of pregnancy," notes Lucille Gallagher, Monfort's vice president of risk management. "This program is a way for those women to get early access to prenatal care."
Three years ago, Monfort's Risk Management Department was examining the rising cost of health care. Complications of pregnancy-defined as low-birthweight babies, premature babies and early detection of any genetic problems-was becoming a cost burden for Monfort.
Based on earlier figures, complications of pregnancies were projected to cost Monfort $3 million in 1993, or one-third of its health care expenditures. That equated to about 340 women at risk company-wide.
Among the maternal risk factors that can lead to complications of pregnancy are lack of early and continuous prenatal care, lack of good nutrition, and abuse of smoking and alcohol.
Monfort projected that if a prenatal program could result in a 5 percent decrease in the number of complications of pregnancies and a 5 percent decrease in prenatal costs annually during a five-year period, the program would pay for itself.
The reason for Monfort's problem was less about the strenuous nature of meatpacking line jobs and more about demographics and cultural differences. Monfort employs a large portion of minorities and many lack formal education.
Access to medical care was difficult in their native countries, and many women do not receive adequate prenatal care.
"That's what we zeroed in on-prenatal care," points out Pat Campbell, Monfort's director of Employee & Family Health and Wellness Department. "We could best target that area for improved results."
Campbell developed the Healthy Moms program to support all women of child-bearing age covered under Monfort's health plan.
Benefits for pregnancy were revised to 100 percent coverage (from the traditional 80-20 split) when plan requirements are met. The requirements include a visit to a licensed provider within the first four months of the pregnancy; and a minimum of six visits during the full course of the pregnancy, or additional treatments or appointments recommended by the consulting physician. Another new benefit introduced is two postpartum visits-the first within 48 hours of the baby's birth.
The program assists the women with referrals, education and support to meet lifestyle changes for healthier moms and babies, Campbell says.
Women who enroll in "Healthy Moms" are given a guidebook to record pregnancy events, such as a baby's first movement, doctors appointments, exercise schedules and weight gain. The guidebook is available in English and Spanish.
For Sanchez, who does not speak English, "Healthy Moms" gave her peace of mind during her third pregnancy. Through an interpreter, she says it is difficult to explain how much of a difference her last pregnancy was compared to the first two.
"The program made me feel special and important," she says. "In most places, a person does not mean anything to anyone. But this program has made me feel very welcome.
"During my first two pregnancies, I really didn't know what to do," she adds. "This time, the program gave me a lot of information on how to take care of myself, as well as how to take care of my child."
Sanchez adds that it was "extremely helpful" that Monfort provided the information in Spanish so she would not have to waste any time seeking an interpreter.
Campbell notes: "We try to keep the materials simple and use a lot of illustrations. We are trying to communicate with people who have varied educational and cultural backgrounds. We hope to capture and keep the awareness of healthier lifestyles for our employees and their families."
One such strategy is through Family Health Tracks, a quarterly newsletter sent to families enrolled in Healthy Moms that reviews and comments on family health issues.
The father as a partner
Not only is it important to ensure the women's awareness of health risks, Campbell stresses it is equally important to involve the father as well.
Support from fathers encourages mothers to keep prenatal appointments and helps them adjust to the normal lifestyle changes that occur after giving birth.
"If the father is supportive, we believe the mother's compliance level with the program will be higher," Campbell points out. "We try very hard to put emphasis on the role of the father."
Glenda Schneider, director of Community Health Nursing for the Weld County (Colo.) Health Department, says: "Once a father is educated on why prenatal care is important and what the benefits are, he is more supportive."
To encourage participation, women who comply with required prenatal care receive a $50 gift certificate to be spent on items for the baby. If they send a receipt showing the money was spent on the baby, the couple gets an additional $50 congratulatory check from the company.
Dovetailing with "Healthy Moms" is Monfort's partnership with Weld County (where Greeley is located).
The company contracts with the County Health Department to provide prenatal care to Monfort employees and their spouses through a clinic staffed by two nurses and a part-time nurse practitioner. They are employed and paid by Weld County, which is reimbursed by Monfort. The clinic also provides educational materials and home visits.
"In our clinic, the women get a lot more tender loving care," Schneider says. "The nurses sit down with them, they ask how things are going, and make sure everything is fine."
County commissioners agreed to this unusual public-private partnership after Health Department officials discovered they were turning away Monfort employees or spouses who wanted to see a doctor late in their pregnancies. Because the employees were insured, the county was forced by statute to turn them away, Schneider says.
Gallagher notes the public-private partnership that the program has fostered. "It is an example of the way businesses and the public sector should work together to find solutions to common problems," she stresses.
An added initiative to the prenatal program is a $132,000, three-year Pre-conceptual Health Promotion Grant from the Colorado Trust, a philanthropic group that funds initiatives to improve the health and well-being of the state's residents.
The trust became interested in Monfort for two reasons. "They wanted to work with a large employer that had a large female population to see what could be done with education at the work site," Gallagher notes. "And they were intrigued by how we overcame language and cultural barriers in our work force."
It will be at least another two years before Monfort fully realizes the program's affects. But "if the program prevents one problem childbirth each year it will more than pay for itself," Campbell says.
Gallagher believes the program is already a success.
"It's a win for women and their babies because they receive the proper care at an early stage of their pregnancies," she says. "It's a win for families because it can prevent the heartache that could result from complication of pregnancies. And it's a win for Monfort because we save on health care costs."
Sanchez recommends the program to any woman who is pregnant, or wants to become pregnant.
"There is an entire group of people who will do everything to support you," she says. "I can't tell you what it means to have that support."