This is one of the first questions I ask patients as I talk to them during their first prenatal visit. Sometimes I am met with bright eyes and an enthusiastic response. But more often than not, I am met with an uncertain look and a shrug that I have come to know well. “Mixed feelings?” I usually guess. “Yes, exactly”. Then I usually proceed to tell them how often I receive that same response, so they’re not alone in not feeling instantly excited for their pregnancy.
Motherhood is complicated. And I wouldn’t know pretty much the first thing about it. This was one of the biggest mental challenges I had coming into my role as a Maternal Health Care Coordinator serving at UF Health Jacksonville. My excitement was through the roof to start this new opportunity, but I also felt anxious as to how I would best serve a population I felt like I already couldn’t relate to in a major way. My mother kindly gifted me the infamous book “What to Expect When You’re Expecting” that I flipped through repeatedly before service started. My host site supervisor provided me with maternal child health trainings, yet I still felt nervous and unqualified.
I began to shadow staff members at my host site who complete coordinated intake and referrals during prenatal visits and in the postpartum unit. This is the process we utilize to screen women and infants for their risk factors, which we then subsequently assess and address through educational materials, community referrals & resources, and recommendation to a home visiting program. That final piece is one of the most significant aspects of the process. Through enrollment in a home visiting program such as Healthy Start, Healthy Families, and Nurse Family Partnership to name a few, clients are able to have their own personal case manager (sometimes a nurse) who supports them throughout pregnancy and after the baby arrives. This support comes in the form of educating expectant and new mothers on various topics such as leading a healthy lifestyle, breastfeeding, childhood development, family planning, etc. I observed expectant mothers from a variety of backgrounds jump at the opportunity to enroll in a program, through which I quickly learned not to assume that the 18-year-old patient is a new mom, or that a 35-year-old patient isn’t. Whatever the case may be, a home visitor will become an additional support in a patient’s corner, or they may stand as one of the only support systems.
When it came time for me to see patients on my own to conduct coordinated intake and referrals, much of my previous anxieties were slowly dissipating. And the main reason for that is I finally understood I do not need to know every detail of maternal child health education in order to best serve clients. The medical professionals and home visiting case managers will be the appropriate ones to play that role in a patient’s care. On my end, I have tried to become as knowledgeable as I can on the topics I am responsible for covering. I’ve learned the ins and outs of each home visiting program available to a patient so I can appropriately refer them to the one best meeting their needs. I engage in conversations with clients about how their diet has been during pregnancy, and encourage them to join my weekly Moving Moms walking group. Do patients know where they can get baby supplies in the community, pregnancy Medicaid benefits, or the resources of WIC? Are they aware of safe sleep practices, different options for birth control, or the benefits of breastfeeding? Sometimes a patient is unaware of many of these topics, and other times she is well informed and just ready for the baby to arrive.
Throughout the course of my NHC service term, I have learned more about finding the balance between being cognizant of how I may not fully understand someone’s experience, and seeking ways I can nevertheless still assist and empower them. We certainly don’t always need to relate to someone to be beneficial or to simply be a listening ear. I don’t understand what it feels like to be pregnant myself when I ask patients that initial question, and it doesn’t really matter if I do or don’t. I can still listen and support her in the ways that I can.
