Helping a pregnant woman find baby clothes, the right health care and other resources is something staff at the Amador Pregnancy Center is prepared to do. Visiting a new mother and telling her about applicable county services is a task public health nurses are more than willing to take on. And informing pregnant women of all of their options, ranging from how to care for a baby to terminating a pregnancy, is something the county's health department has been in the practice of doing for years.

But where to go if a woman decides to go through with an abortion is a question that must be answered outside of Amador County. With a county population of almost 39,000, according to a 2006 U.S. Census Bureau fact sheet, some argue that no abortion clinics are offered in the county simply because the numbers do not create a justifiable demand. Instead, the nearest clinic is about 50 miles away in Sacramento.

"In addition to it (abortion) being controversial, I don't know if the volume is there to support one (an abortion clinic) to be honest," said county Public Health Nurse Lori Jagoda, whose department helps women in their early stages of pregnancy.

Volume could be one reason for no clinic, but politics and an area's demographics play a part too, according to Shanie Scott, director of public affairs, North Central Valley Region for Planned Parenthood Mar Monte, which oversees Amador County. "There are multiple reasons," Scott said. "Political landscape always play a role in how hard or easy it is (to have a clinic)." She added that rural areas tend to lack abortion services because they typically have lower populations.

A more pressing concern for foothill women, Scott said, is their lack of what she deems "basic services" such as annual exams and birth control.

"The foothill numbers are rising for sexually transmitted diseases and teen pregnancy, and one of the correlations is access to reproductive health care," she said, adding that in rural areas, "we're certainly talking about some women who are below the poverty line and that even restricts them more because they only have certain providers."

According to statistics from the state Department of Health Care Services, from 2004 to 2005 the rates of chlamydia cases in the county more than doubled. In 2004, there were 21 reported cases, a number that increased in 2005 to 48 reported cases.

Jagoda agreed that the county's number of chlamydia cases are up, but explained that the jump could be due in part to an increase in chlamydia screenings. "So we're finding more and there probably are more cases so it's a two-fold thing," Jagoda said.

The number of people with gonorrhea in the county jumped in 2004 to 10 times the number of cases in 2003, according to Scott.

As far as teen pregnancies, District 1, which includes the county, ranks No. 34 in the state for teen birth rates. The county's 21 percent "is holding steady," Scott said.

One way to counter unwanted or teen pregnancies, Scott said, is teaching comprehensive sex education in schools. Comprehensive sex education covers not only abstinence but other forms of contraception.

Last year, the Guttmacher Institute reported that California ranked highest in the nation for lowering unintended and teen birth rates. One possible reason, Scott said, could be because of recently passed federal legislation mandating that if public schools are going to teach sexual education, they must teach comprehensive sexual education.

While county women may not have access to an abortion clinic, those women who do have children have a buffet of assistance programs available from local county agencies and nonprofit groups.

"We seem to have a lot of low income families here in our county. Sometimes they can't afford diapers or clothing. That's when our services are used," said Renee Miller, director of the Amador Pregnancy Help Center. At the center, which sees between 25 and 30 people a month, families in need can fill a bag of clothing for free once a month and also pick up other supplies such as diapers.

Miller said she enjoys her work because of its intangible rewards.

"You develop a friendship (with the families) and you get to see all the little babies," Miller said. "That's the perks of the job."

When it comes to talking about terminating a pregnancy, Miller said the center steers away from that conversation and instead informs the mother of other options.

"We do, on occasion, see people that are abortion-minded and we try to give them as much information as possible. We are a pro-life center so we don't refer out for that," Miller said, who added, "We have a book that's 2 inches thick or more with families seeking to adopt."

Miller recalled one story in which a young woman became impregnated after she was raped. While in the hospital, the woman refused to hold her baby and Miller was called to try to help the situation. "I talked to her and told her the baby was a gift from God and it wasn't the baby's fault so she shouldn't hold it against the baby," Miller recalled saying. She suggested the woman hold the baby if only to say good-bye.

Eventually the woman decided to keep the child, Miller said, who has had limited contact with the family. But after a couple follow up calls, found the mother and baby were "doing great."

Most public health nurse services also assist women during and after a pregnancy.

"By the time a public health nurse sees a young lady, they've pretty much decided to keep the baby," said Supervising Public Health Nurse Connie Vaccarezza.

Public health nurses help mothers with food, housing, clothing, prenatal supplies and help the mother finish her education if necessary, Vaccarezza said.

Demographically, public health nurses in the county see females ranging in age from about 14-and-a-half to 40. "You just never know when the rug will be pulled out from underneath you," Vaccarezza said.

Vaccarezza hopes that the services a public health nurse offers to all types of families in the county will help new and seasoned mothers give themselves and their children the care they need.

"When I was younger there was always a community nurse to call when someone was struggling," Vaccarezza said. "It wasn't punitive. It was just a call for a helping hand. It's nice for the public health nurse to get back into that role."

For those who do go to county health departments for family planning advice, Jagoda has dealt with a variety of cases in her almost 10 years at the health department. She says she informs all parents of their options ranging from adoption to abortion to pregnancy.

"When someone comes in with a positive pregnancy test it means we let them know all of their options including keeping the pregnancy, putting the baby up for adoption as well as termination. We give them all the pros and cons and talk about that," Jagoda said.

If someone does decide to terminate a pregnancy, the health department refers them to places where they can make an appointment.

"We want to make sure they know what all their options are," Jagoda said, adding, "Our primary goal in family planning is to prevent any unwanted or unplanned pregnancies."