More than 110,000 women at the highest risk for delivering low birth weight babies will be eligible for a new preventive care program through the Georgia Department of Community Health starting in January.

If effective, the Planning for Healthy Babies waiver could have a dramatic effect on cutting the rate of Georgia babies born below 5 pounds, 8 ounces.

But some local physicians say the biggest roadblock will be getting women to sign up.

"These are the people who don't access medical care to begin with," said Dr. Jeff Reinhardt, chairman of the division of women's health at The Longstreet Clinic. "These are the people that show up in the ERs seven weeks pregnant, bleeding, who didn't know they were pregnant."

"If we can get this group of women to actually access and take advantage of the care that's going to be offered to them, I think it will make a difference," he said.

A 2007 study by the Kaiser Foundation ranked Georgia 38th in the nation in the number of low birth weight deliveries.

Many factors contribute to the problem, but those at risk for delivering low birth weight babies tend to be from lower socioeconomic groups and suffer from substance abuse or other untreated chronic medical conditions. A mother that has children less than 18 months apart is also at risk for delivering a low birth weight baby.

The new program, which goes into effect Jan. 1, was approved by the Centers for Medicare and Medicaid Services in October and will be funded mainly by federal Medicaid funds.

Janice Carson, deputy director of performance, quality and outcome for the Georgia Department of Community Health, said the program has three main objectives: improving overall health of childbearing-age women, expanding access to family planning services and improving access to prenatal care.

To be eligible for the program women must be between the ages of 18 and 44, U.S. citizens, not pregnant and below a set family income level. Carson said 110,000 Georgia women fit into that group and all eligible applications will be approved.

Once approved, those women will receive an annual doctor's visit and follow-up visits, treatment for sexually transmitted infections, access to multivitamins and family planning aid.

Women who have delivered a low birth weight baby are at high risk for delivering a second one, Carson said, so the program will also provide post-delivery care to 2,500 women who deliver very low birth weight babies - below 3 pounds, 5 ounces - on or after Jan. 1.

Those women will be eligible for primary care visits, substance abuse treatment and medications to treat chronic illnesses as well as individualized attention from a case manager.

"A resource mother will be available to help them develop more health-seeking behaviors, help them to take better care of themselves and whatever chronic illnesses they have as well as help them in the care of their very low birth weight infant," Carson said.

Reinhardt said previous efforts to curb low birth weight rates in the state have not been successful, but there has never been a large-scale program that approaches the problem pre-emptively.

Sara Dyer, director of women and children's services at Northeast Georgia Medical Center, said women are often pregnant again at their 6-week post-delivery checkup, which makes it difficult to educate on the risks of not properly spacing pregnancies.

"I think overall, the more education, the more services we can provide before a woman is pregnant, we're going to see better health outcomes across the board," she said. "If the woman is already pregnant, most of these services are not going to improve her outcomes at that time."

Applications are available online and at local public health department or Division of Family and Children Services offices.

Carson said the Centers for Medicare and Medicaid Services will be monitoring this program and if it is successful, possibly mirroring it in other locations.

"We're expecting tangible results within the first year," Carson said.