NORTH END – The test sat waiting on the porcelain back of the toilet.

She was sure she was pregnant.

Once the test confirmed her suspicion, all she could do was pace and go back to bed.

“It really hit me, oh my gosh,” said now 19-year-old Leah Roberts. “I had no choice but to really change into an adult. In the blink of an eye I had to be an adult.”

At the time Roberts was 18, had just graduated from North Kitsap High, was swinging a full-time job and a full course load at Olympic College.

Roberts had to find prenatal care, but unfortunately she had to make appointments with a provider in Silverdale or Bremerton, as reproductive health resources are lacking in the North End of Kitsap County.

Roberts was supposed to go to appointments every four weeks, but sometimes six weeks would lapse because she couldn’t make her appointments. It was a challenge to reschedule because she had to accommodate for the extra drive time to and from while juggling her full load.

“It would have been way easier for me to make appointments in Poulsbo. I live here so it would have been a 10-minute drive versus a 25-minute one. It doesn’t seem that far but when you’re pregnant, working and in school, it’s a hassle,” Roberts said. “I just would have seen it as being easier to juggle with my schedule and appointments. I would have had more of an option and leniency to reschedule.”

Currently there are 25 pregnant or teen mothers in the North Kitsap School District and, similar to Roberts, they’ll have to schedule their appointments in Bremerton or Silverdale.

Janis Nixon, a school and teen-parent counselor at NKSD for the last 14 years, said access to pregnancy support services in North Kitsap County has decreased.

The Kitsap County Health District family planning clinic has been discontinued, the Crisis Pregnancy Center closed its Poulsbo office, the teen parent and child care programs at the district have been cut. The majority of obstetrics and gynecologists practice in Silverdale.

“Many of our students are not able to have adequate services to feel support and education through this process,” Nixon said. “What happens is you have limitations on getting anywhere near adequate education or medical interventions. Are we risking the health of our children, of our children’s children by doing that? Yeah, we probably are. I don’t think they’re getting the help.”

To some, driving a few extra miles to get to an appointment may seem like it requires minimal effort, but as Roberts recalled, it’s a hassle to be pregnant, in school and working.

Even more challenges are created when an individual with adolescent skills and needs is thrust into the adult community with adult services.

“How many teenagers do you know who make their own doctors’ appointments?” Nixon said. “They have to look through the screen of daily life challenges to see if they’re following through on their medical needs. So when it’s more difficult for access it just becomes another layer to get through. It just makes it tough. It’s an extra step that shouldn’t have to be there.”

But it’s not just pregnancy resources that are lacking in the North End. Access to the entire medical world could use a booster shot.

Within the last five years, the Kitsap County Health District (KCHD) had to close clinics in Bainbridge, Poulsbo and Port Orchard.

“The issue the county faces is our tax bases don’t allow us to support services throughout the county,” said Scott Lindquist, M.D. MHP, director of KCHD. “There’s no question there’s a need in the North End and South End for family planning services. If voters want to reinstate a stable funding system for public health, then we can address it.”

Barbara Malich, chief executive officer for Peninsula Community Health Services (PCHS), said the North End of Kitsap County is so geographically spread out people are challenged by access to transportation and the ability to engage in accessing care.

“It’s hard to have the wherewithal where they are to access the resources,” Malich said.

Tawnya Weintraub, supervisor of Long Term Care, said a concern for North End seniors is the lack of recruitment

for in-home care givers. She said it’s challenging up north because of the distance care providers are required to travel.

“This is something we hear from providers as their main concerns,” Weintraub said. “It’s across the continuum of long-term care.”

If people have barriers to accessing care, then less effort is spent on preventative care and the outcome is a potential ding on the health of the county, Lindquist said.

“You either pay for it now or pay for it later,” he said. “I really believe in the principal of preventative health care.”

Securing more funding for health care and placing more practitioners around the county will take years, but progress is already being made.

Malich said staff at PCHS recognized they and many others have been under-serving the North End. They’re planning an expansion of their services to remedy this.

In early May PCHS will open a six-provider practice in Poulsbo to be located at 19917 7th Ave. N.E.

The new clinic will provide prenatal and post birth, women’s health, pharmaceutical support and chronic disease management services while supporting all family needs.

“We’re looking forward to expanding our ability to respond to the needs of patients,” Malich said. “It’s really the entire North Kitsap area we’ll be focusing on.”

A health clinic at Spectrum Community School in Kingston is available to the area’s youth and a health clinic at North Kitsap High is planned, but has been stalled because of an inability to find a partner in the medical community. A huge project going on in the North End is the drive to raise funds for a new community center in the Village Green, which is to include a new senior activities center in Kingston. There are several private practitioners throughout the northern reaches of the county.

“Clinicians in the North End are all busy and all work hard and work with the health district,” Lindquist said. “There is a need for more.”