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When Johanna first started receiving care at La Clínica, she realized how many things she didn’t know about pregnancy and her baby. “They explained the entire pregnancy process to me, how to recognize alarming signs, which signs are normal, and tips for dealing with stronger pregnancy symptoms,” says Johanna, “they taught me a lot.”

In addition to receiving prenatal care, Johanna receives behavioral health care and dental services. Dr. Siopack has practiced obstetrics and gynecology at La Clínica for over 24 years. “We have good resources to address the needs of patients that go beyond just the clinical aspect of their pregnancy,” he explains, “we provide them comprehensive wrap-around services and are with them through their entire journey.” These services include behavioral health care, dental care, nutrition and health education, and social worker support, among others.

Dr. D’Harlingue, Associate Medical Director of Pediatrics at the Fruitvale Transit Village, explains that the biggest challenges are related to Social Determinants of Health (SDOH). She explains that patients suffer a lot of trauma: “The social-emotional challenges, poverty, and violence in Oakland are a huge factor for the health of our patients.”

Many patients have language, communication, and trust issues with the medical establishment. Cultural and language barriers present unique challenges, as has been the case with the recent influx of immigrants from the Mam community — an indigenous people from the western highlands of Guatemala who speak the Mam language.

Sitting in the waiting room, Johanna talks about her positive experiences and relationships with the clinicians. “I have felt that mental health services have been of great benefit to me. I have participated in both group and individual therapy sessions,” she says, “and I felt safe during the birth because I trust [La Clínica] knowing how familiar they are with my medical history.”

“Many years ago, patients didn’t qualify for health insurance, and they had no perinatal care,” explains Dr. Siopack, “but that changed when Medi-Cal started to insure undocumented people for their pregnancy care about 20 years ago.” Still, more resources are needed to hire more staff and to continue providing services, support, and resources to the community. For example, according to the Centers for Disease Control, there are about 3,400 sleep-related deaths among US babies each year. Black and Native American/Alaska Native infants die at rates more than double that of white babies. These deaths are highly preventable through safe sleep resources such as safety-approved cribs.

Dr. Siopack reflects on the intergenerational impact of his 24 years at La Clínica. “There have been in a handful of situations where I’ve delivered patients who have become young women and have come back to La Clínica to give birth,” he explains, “we have a very good reputation in the community, and the patients see us as part of their family.”

As she gets ready for her appointment, Johanna says that she hopes to continue being a patient at La Clínica. “There are many people who need these services and what La Clínica offers. It ensures economic and social stability. Without them, I don’t think I could survive.”