L.Z. was a 10 month old who was scheduled for an ER follow up after an acute illness. It was noted on checking in that the child had missed the 9 month WCC so instead of just doing a quick visit (as the child was better), the MA and provider decided to take care of the 9 month WCC. Because MAHEC FHC performs interconception care screening questions on all mom’s at WCCs, L.Z.’s mom was asked the usual screening questions to assess risks. Turns out L.Z’s mom was not taking her multivitamin any more, had restarted smoking (had previously quit during pregnancy), was actively stressed and mildly depressed due to relationship issues with a PHQ9 of 14 and was on no contraception (she stopped her pill several months ago). She had screened positive for all 4 of our interconception risks!
Looking back, at the initial few newborn visits all was well – at 2 months she was on a multivitamin, not smoking, not depressed and taking the birth control pill. She had missed the 4 month WCC visit. No ICC was documented at the 6 month WCC.
L.Z.’s mom received attention at that 9 month WCC. She was assessed by behavioral health and made a follow up appointment for counselling support. She received counselling about unintended pregnancy and importance of birth spacing of at least 18 months before conceiving again – she decided to get a nexplanon. She received a year supply of multivitamins to take and was encouraged to quit smoking – to be addressed more at future visits.
I recently saw L.Z. back at the 15 month WCC visit. Life is still a bit stressful, but mom’s PHQ9 is now 9 and she feels more supported. She quit smoking again, is taking a multivitamin daily and got her nexplanon 2 weeks after that 10 month visit without any problems.
This is a great reminder of how important it is for us to ask these questions each time. If we had not done the WCC at that visit, if we had not done the ICC screenings, it is highly probable none of those risks would have been identified and the next visit may have been for an unintended pregnancy with a higher risk for poor birth outcome.
There is no doubt in my mind: our interconception care model is working to reduce maternal health risks and is improving people’s lives. Healthy mother, healthy family.
This is really nice to know that your interconception care model is working to reduce maternal health risks and is improving people’s lives. From my entire team of dissertation writing service, I would like to congrats you.
ReplyDelete