A Mission Of Compassion Mercy Women’s Health Center Meets Challenges In The Heart Of Holyoke

While the face of a community might change over 40 years, the mission to provide comprehensive women’s health services should not, says Arnie Malin.
Malin should know. As director of prenatal and ob/gyn services for Mercy Medical Center, he has seen the Mercy Women’s Health Center in downtown Holyoke develop into a crucial component of health care in the region, particularly for poor and underinsured patients.
“From the very beginning, when it opened as the Providence Hospital Prenatal Center, the purpose was to provide much-needed health care and support services to the needy and underserved in the community,” Malin told The Healthcare News. “They’ve been mission-focused for four decades.”

These days, that mission goes far beyond prenatal services, although they remain a key element, including midwife care and deliveries. Over the years, however, the clinic has become a center for ob/gyn care, nutrition services, substance abuse counseling and treatment, and even primary care.

“It’s a tough go for folks out there today, a challenging environment,” Malin said. “But we do a great job. We’ve got a lot of talent, caring professionals with a lot of experience. It makes a difference, and we’ve significantly impacted infant mortality in Holyoke and Springfield.”

Mission of Service

Margot Ellard, a certified nurse midwife and women’s health practitioner who arrived in Holyoke from Texas only a few months ago, would agree. She calls working at the Mercy clinic “wonderful,” partly because of that mission Malin talks about, but partly because of the sheer range of services offered.

“It’s a full scope of services to women of all ages — obstetrics of all sorts, including high-risk, and ob/gyn, including complicated gynecology, abnormal pap smears, and colposcopies,” Ellard said. “We provide services to all kinds of women for multiple needs.”

And key in those needs is the ability to pay for services, which many patients who visit the clinic do not have, Malin said. That’s where a social worker, Maritza Smidy, enters the picture, handling not only social issues such as domestic violence and lack of housing, but also lack of fiscal resources and health insurance.

“She really unlocks the door for their insurance coverage,” Malin said. “We look at the individual circumstance and seek out whatever type of coverage we can get, which is generally with Mass Health-sponsored programs.”

But Ellard said that, with the emphasis on caring for poorer women, the center’s capacity to serve all women sometimes gets lost on the public.

“We would love to see more Mercy employees come here for their routine health care and routine gynecological care,” she said. “We’d love to see their daughters. I’d promote it to anybody to come here. In all the years I’ve been in women’s health care, I’ve never seen a center with such a wide variety of services.”

But her positive impression goes beyond the medical treatment itself. The emphasis on attentive care extends to the clinic’s ability to arrange rides for patients who are unable to get to the Maple Street center.

Meanwhile, the clinic is flexible with scheduling, allowing even non-urgent patients to schedule visits only a day or two in advance.

In addition, “the amount of time allotted each patient is more than at any clinic I’ve ever worked at,” Ellard said. “They do not rush you through here. At a lot of offices, doctors are looking at their watches and rushing out of the room, but we don’t do that.”

And for good reason, Malin said. Pregnant women, particularly those with financial or other needs, are often confused about what to do, and as a mission-focused clinic, he said the Mercy center has an obligation to provide not only care, but compassionate care at a vulnerable time in a woman’s life.

“Our services include full-service gynecology, but the main focus from the get-go has been obstetric and prenatal services,” he said. “We’ve changed with the times — we’re not providing service on the same model we were in the 1960s — but the heart of our business is still to provide that core service.”

Mission of Deliverance

Judy Atkin is more than aware that some aspects of obstetrics, especially in the inner city, have changed over the years. As the center’s high-risk coordinator — as well as a certified Catholic chaplain — she deals with pregnant women who are fighting substance abuse, from tobacco and alcohol to harder drugs.

“I do an assessment on every woman who comes through the door, even those who have no history,” she said. “Women who come into the clinic use anything from tobacco to IV heroin, and everything in between. About a third of the patients use some substance, the primary one being tobacco.

“Working in this field for 25 years, I’ve seen the ravages drugs and alcohol can cause during pregnancy, and I want to give women that information,” she continued. “We try to give them as much education and support as possible.”

Atkin helps women get into treatment and counseling programs and can check in on their progress with their counselors, methadone clinics, and other services, but treatment is always a choice — and watching women make the wrong choices can be difficult.

“I think we’ve seen a resurgence of heroin use in this area,” she said. “It kind of goes in cycles; sometimes it seems a little worse than at other times. With my younger patients, in the teen population, it’s still tobacco and marijuana, and the heroin and other opiate use, I usually see in women a little older, mid-20s and up.

“I think the worst long-term effects I’ve seen are caused by alcohol,” she continued, “but I’ve buried a lot of babies and seen a lot of miscarriages around cocaine, crack, and heroin. With any kind of addiction, my concern is that the woman gets into treatment as soon as possible.”

In many substance abuse cases, there’s a spiritual healing component, and that’s where Atkin’s experience as a chaplain comes in. And the issues requiring counseling don’t begin and end with drugs and alcohol.

“I met with a woman whose son was murdered in Holyoke last year,” she told The Healthcare News. “These women really do have issues and need pastoral support.”
One instance when that becomes apparent is when pregnancies end in miscarriage, a situation where Atkin melds pastoral care with her skill as a childbirth educator. “When women have a stillbirth in the hospital, they get a pastoral visit, but often, after a miscarriage, nothing happens,” she said. “I’m on site to offer support to any women who is miscarrying or has any pastoral issue.”

Malin said Atkin is “one of a kind” in Western Mass. clinics in that she mixes a nursing background with substance abuse and chaplaincy services.
“Alcohol, cigarettes, heroin, and other drugs are part of the reality of the community,” he said, “and we provide the necessary support so women can have a healthy pregnancy and a successful birth outcome.”

Mission of Outreach

The idea is to provide a continuum of coordinated care, Malin said, which is why the clinic works closely with Mercy’s Family Life Center for Maternity to coordinate care. And that coordination also means bridging cultures, of which Holyoke and Springfield boast many.

“Our population in Holyoke is largely Hispanic, but not exclusively,” he said, noting that the Latino population hails not only from Puerto Rico but also Central America and the Dominican Republic, while an increasing number of area residents hail from Africa and Asia. Often, these are the ones most in need of financial assistance.

“We don’t turn anyone away, but we make sure we hook them up with whatever resources are available to them,” he said.

Both in Holyoke and at two Springfield locations, where the clinic partners with the Southwest Community Health Center on Main Street and Sumner Street, the Mercy Women’s Health Center strives to “provide quality outcomes to many, many challenged patients,” Malin said.

The clinic spreads that message with the help of an outreach worker, Omaida Perez, who speaks at schools, community organizations, and grass-roots groups. And she’s speaking to women who may just have need of what Mercy’s clinic can offer.

“They have more than just addiction issues,” Atkin said. “Some don’t have food on their table or a roof over their head. If there are domestic violence issues, you need to make sure patients have a safe place to live.”

The clinic plugs patients into the appropriate state and local agencies in all these cases, as well as providing home visitors for expectant mothers and funneling teen mothers into a program that helps them get back into school. In all, it’s more than just medical care.

“It really is a wonderful place because people treat people with respect here,” Atkin said. “Families and friends of patients come here because they hear they get such excellent, comprehensive care.”

“We care about women holistically,” Ellard added. “There’s really not much lacking in this clinic. It’s more than just a pap smear.”