6 Winnipeg Free Press - saturDAY, May 10, 2014
N URSING WEEK NATIONAL
Mothers’ Helpers Program reaches out to inner-city women who face barriers to prenatal care
By Jennifer McFee – For the Free Press
Most pregnant women struggle to juggle ultrasounds and prenatal appoint- ments with a hectic schedule. But imagine if the pressing issues in your life also included poverty, hunger, abuse, addictions or trauma. In these circumstances, a healthy pregnancy might seem almost unattainable as moms-to-be strive to survive. A project called Partners in Inner-City Integrated Prenatal Care (PIIPC) aims to help women in these situations to achieve a healthy pregnancy, resulting in healthier babies. Based out of the Women’s Hospital, the project focuses on women living in Point Douglas, down- town or the Inkster area who have been deemed at-risk of not having sufficient care during pregnancy. Clinical nurse specialist Lisa Merrill explains that many inner-city women face barriers with transportation, child care and long wait times that prevent them from getting the prenatal care they need. “Often they just have lots of other things that are going on in their lives that makes it maybe not the priority of their day; things like violence, substance use, homelessness. Also we have lots of moms who have housing and food se- curity as huge issues. A lot of them don’t have enough access to food,” Merrill says. “So when you have a list of things of the day that are of importance, food and housing may be more important than coming to the doctor’s office at nine in the morning.” Fear is another factor that may keep some women from seeking prenatal care.
Created by the Winnipeg Regional Health Authority, the program in- cludes representation from Healthy Child Manitoba, Manitoba Health, the Assembly of Manitoba Chiefs and University of Manitoba researchers. By the end of 2013, 105 women had enrolled in the program, and Mer- rill hopes to recruit more. To do so, public health nurses and outreach workers cruise downtown in a harm- reduction van, which allows them to offer on-the-spot pregnancy tests and initial prenatal blood work. Other women find out about the services through community agen- cies and groups, as well as through the Healthy Baby program. Other times, they just show up at the hospi- tal looking for help. “If anyone turns up at Women’s Hospital, they just page me and I come and meet with the moms. We do everything right on the spot, so there’s no waiting and no turning them away,” Merrill says. “I’m always fearful that they won’t come back. If they have enough cour- age to come here the first time, we want to make sure that we connect with them right away and bring them in for care.” If the women return for even one more appointment, Merrill deems it a success. “We have moms that come in with- out having seen a doctor at all in their whole pregnancy, and there are lots of complications that could go along with that,” she says. “We’re try- ing to prevent all of that so we have a healthier mom and a healthier baby.” While medical care is important, it’s equally essential to connect these moms with resources and sup-
Photo by Darcy Finley
Clinical nurse specialist Lisa Merrill tries to ensure that inner-city women have prenatal care.
“Lots of people are afraid to come. They might not have had a great experi- ence in the past in any institution. They’re a marginalized population, so it’s really hard for them to come. They’re afraid,” Merrill says. “Lots of our moms, through Child and Family Servi- ces, have had other children who may have been ap- prehended at birth, so they’re hesitant to come forward for fear that that might happen again.” But PIIPC aims to reduce these fears and challen- ges. To start, Merrill provides bus tickets or taxi vouch- ers to get women and their families to and from ap- pointments. She also provides food vouchers for pregnant moms and their children. “One of the most shocking things I found is that a lot of the moms who show up for appointments haven’t eaten at all. I had one mom who said it had been two days, and she’s pregnant,” Merrill says. “If you ask the questions, then we find that they just don’t have access to a food source. So we have meal vouchers to go to the cafeteria and have something to eat. If they’re not able to do that, then I have snacks and sandwiches from within the hospital. We give them a snack while they’re here waiting. Strangely, it brings them back. They know that when they come, they can have something to eat.” When it comes to waiting times, women in the pro- gram are fast-tracked so health-care providers see them quickly. “We need to get things moving forward. People have done a great job of taking on-the-spot patients who just show up. Maybe it’s not their day, not their time, but they’re here, so we will see them. There’s been great buy-in from our staff around that. They’ve been excel-
lent,” Merrill says. “Even for ultrasounds and fetal assessment, if we have a mom that we’ve identified as part of our pro- gram, they will fit them in. It’s been fantastic.” The evidence-based initiative is now in its second year, and funding is expected to continue for one more year through the Canadian Institutes of Health Re- search and the Manitoba Health Research Council.
port, both in the hospital and in the community. “It’s all of those things that are super important and will help them manage in their everyday life,” Merrill says. “This will help reduce the harm to them and their families.”
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