prenatal health


Opinion: Why Gut A Program That Truly Helps New Mothers?



By Claudia M. Gold, M.D.
Guest Contributor

As any parent knows, caring for an infant is a 24/7 job. Contrary to the idealized “myth of motherhood” — which usually involves a quick, seamless return to pre-pregnancy weight, emotions and all-around functionality — there is no “schedule” to be had. Life has officially turned upside down.

All kinds of research suggest that new moms need help.

But in our culture today, where extended family may be far away, where spouses often return to full-time work almost immediately after the birth, mothers may be very much alone in the task of caring for a new baby. Mother-baby groups have a critical role to play in filling that void.

I have seen these groups in action working as a consultant to the William James College Freedman Center. When mothers feel supported and listened to, extraordinary thing happen: they share experiences not only about the lack of sleep and ability to take a shower, but also fears, anxieties, self-doubt, sadness and even depression. By the end of these groups, many mothers developed powerful, sustaining bonds with each other and interact with their babies with new confidence and joy.

A particularly innovative Massachusetts-based program for mothers is now at risk.

Massachusetts Child Psychiatry Access Project for Moms is a collaboration between the Massachusetts Psychiatry Access Project and MotherWoman, an organization that offers a network of groups as well as training for group leaders and seeks to make these groups available to mothers all across the state.

The program has its roots in a special legislative committee chaired by Representative Ellen Story. While at first the focus of the commission was to implement statewide screening for postpartum depression, it quickly became clear that such a step was meaningless without first having resources in place to help mothers identified by the screening.

That is where MCPAP for Moms comes in to play. In collaboration with William James INTERFACE referral service, when a mother is struggling, she can find support that is available close to home and right away. When a new mother feels alone, scared and overwhelmed, a three-month- or even a three-week-wait is unacceptable. She needs help today.

MCPAP for Moms offers a unique constellation of services: it offers toolkits and training for primary care clinicians — obstetricians, pediatricians and family practitioners, many of whom now do not know where to turn when they see a mom struggling with postpartum depression and/or anxiety. Second, it helps mothers connect with help — individual clinicians experienced in treating perinatal emotional complications as well as groups — right away. And last, MotherWoman has a growing network of support groups and trainings for group leaders so that the service can extend throughout the state. So, it’s a whole safety net that involves many things.

“I was so overwhelmed and stressed as a new mom that I didn’t know what to do and felt like a failure. Without MCPAP for Moms I don’t know where I would be today,” said one postpartum mom, Amanda Martin. “I am so grateful for them helping me get the help I needed to feel better for me and for my family.” Continue reading

Texting For Prenatal Health

A small study found text messaging improved prenatal care for young women

Text messaging for health isn’t new. Patients are now dinged with messages on their phones about a range of health matters: from remembering to take their birth control pills to finding out the mercury content of their fresh fish. (Here’s a story I wrote in 2007, as the phenomenon was starting to proliferate.)

Now, a new study suggests that texting — which, let’s face it, isn’t much more than a virtual nagging mom — may be a fast, cheap and effective way to improve prenatal care, or at least boost prenatal doctor visits, among at-risk pregnant adolescents. The results were part of a small study published in the The Female Patient, a peer-reviewed journal for office- and hospital-based ob/gyns, primary care physicians and nurse practitioners.

Here’s the slightly edited news release:

In a pilot study developed as a collaboration between the Partners Center for Connected Health, Partners Community Health and the Lynn Community Health Center, data suggests that women receiving text messages found the messages to be helpful and had a higher level of attendance at their prenatal visits compared to a similar cohort in the same medical practice.

“We are using technology in exciting and new ways to deliver quality care to patients, connect providers and patients and provide educational messages and support. Text messaging provides a big opportunity to better engage patients in their care by communicating with them in a channel they prefer,” said Joseph C. Kvedar, MD, Founder and Director of the Center for Connected Health, and study co-author.

In this pilot, 25 patients between 14 to 32 years of age were enrolled; the average age was 22 years old. Participants received informational and supportive text messages throughout their pregnancies and two months post-partum. The messages were personalized to each patient based on date of enrollment, language preference (English or Spanish) and the stage of their pregnancy. Messages were designed to help patients stay connected to their clinical team, and provided educational tips, reminders and motivational support related to the development of the baby and preparation for childbirth, and encouraged newborn and postpartum care.

One hundred percent of the study participants reported reading most or all of the text messages and 95% found the program helpful. 84% said the program helped them learn how to take care of themselves and their baby. Seventeen out of the 25 participants preferred to receive the text messages in Spanish. By potentially increasing attendance at prenatal visits, text messaging can be an important tool to remind patients about the importance of regular care and contribute to improved health outcomes for pregnant adolescents and young adults and their newborns.