Reacting to a death rate for black infants three times as high as for white babies in Arlington County, officials are seeking state money for a program to get medical care for more young black women early in their pregnancies.

In the county in 1988, the rate of white infant mortality -- defined as any death that occurs between birth and 1 year of age -- was 3.7 for every 1,000 live births. For black infants, the rate was 11.8 deaths for every 1,000 live births.

Such statistics prompted Arlington officials to look for ways to get more black mothers into prenatal care, which could cut the number of infant deaths. The County Board recently requested a $30,000 grant from the state to pay for a new approach to the problem, targeted at the largely black neighborhoods of Nauck and Highview.

Under the program, the county would recruit three "community support mothers" to identify women not receiving medical care early in their pregnancies. The "support mothers" would refer the pregnant women to county clinics and counselors.

"Less than 50 percent of our clients go into prenatal care in the first trimester of pregnancy, and that's the most important time to get to them," said Donna Caruso, a nurse manager in Arlington's Human Services Department. "There is a direct correlation between first-trimester care and infant mortality."

The program is being proposed at a time when the number of pregnant black women using county human services clinics has declined.

According to a February analysis, blacks accounted for 4.6 percent of total maternity clinic patients. Blacks make up about 9 percent of the total population in Arlington.

"We used to see a lot of black patients, but we aren't seeing very many at all anymore," said Gwen Moore, a clinic aide who has worked in maternity care for 20 years. "You know some are pregnant, and you wonder where they go for prenatal care."

Arlington field nurses, who visit mothers before and after delivery to make medical checkups and advise on early child care, also report a decrease in black clients.

"The field nurses say they are seeing fewer and fewer blacks, but we know that there aren't really any fewer blacks in the general population," Caruso said.

Joan Cooper, a community activist who lives and works in Nauck, blames drugs for the drop in clinic use.

"I do see many black females in this community who are pregnant, and I know they aren't getting any care," Cooper said. "They are in a different state of mind because of drugs. Many of them are very much aware of the services, but, because of drugs, they just don't go."

The community must get these women -- and their babies -- under medical care, Cooper said.

"Grandparents and churches should be brought into this to direct these women to the free services," she said. "This is a baby's life we're talking about."

Many of the clients who are now using the county's prenatal and postnatal programs are Hispanic or of other ethnic backgrounds, officials said.

According to Mary Herdell, a public health nurse who works in the Fenwick Center on South Walter Reed Drive, 25 to 30 women are treated at each of the four clinics held there every week. Typically, patients come in once a month during the pregnancy until the final month, when they are examined once a week.

About 100 new patients are taken on each month, Herdell said.

Officials are emphasizing the Nauck and Highview areas, they said, to take advantage of the existing network of families and community groups there to spread the word about available services such as medical checkups and immunization shots for infants.

"Both of these are old neighborhoods with families that have been there for generations," Caruso said. "The community is very active in dealing with problems like this."

The county's goal is to enroll at least 25 women in prenatal care and to increase the percentage of low-income black women in the maternity clinic during the first trimester of pregnancy.

Low birth weight is often an important factor in infant deaths, and in Arlington, as elsewhere, more black babies than white infants are affected. In 1988, 4.3 percent of white infants were born with a low birth weight. For blacks, the figure was 13 percent.

"A low birth-weight baby doesn't have as good a chance at survival as a baby with a normal birth weight," said Caruso, who added that factors such as a mother's alcohol or drug abuse, smoking or poor nutrition could contribute to a low birth weight.

An infant weighing less than 5 pounds, 8 ounces, is considered to have a low birth weight.

Arlington also is beginning to see more drug-related problems in pregnancies, Caruso said.

"We are starting to see more infants that are referred to us because they had positive drug {tests} or some drug involvement, and those mothers do not seek care until very late," Caruso said.