Prenatal Care Programs and Resources Within Grand Rapids

By Eric Nodge and Jenna Martens, Fredrick Meijer Honors College, Grand Valley State University.

• The Baxter Dental Health Clinic was established in response to startling figures concerning the high rate of low birth weight babies within the Black community in Grand Rapids, and a correlation between periodontal disease and preterm birth outcomes. Funded in conjunction with Strong Beginnings and private corporate donations, the Baxter Dental Health Clinic channels these funds toward helping clients recommended by the Baxter Health Community Health Center. According to a spokesperson for the Clinic, Medicaid patients are less likely to receive “peripheral” health care, including Dental Care. The program, “Brush Up for Baby” has emerged to promote oral health among the program’s participants.
• Cherry Street Health Center seeks to forge personal connections with its clients. As a federally funded program, the Cherry Street Health Center puts an emphasis on developing a trusting relationship between clients and the Center’s support network, which includes nurses, social workers, and other professionals. The program is designed specifically to engage the African American population of Grand Rapids; statistically, this community has an infant mortality rate three times larger than the average.
• The Nurse-Family Partnership was founded in response to incidents of child abuse and neglect. The Partnership engages the community by keeping in continuous contact from conception until the age of two, and by initiating dialogue with mothers and soon-to-be mothers on relevant topics such as health, nutrition, and relationships. By educating mothers, the Partnership hopes to foster an understanding of the needs of a child and as a result prevent child abuse.
• Mothers Offering Mothers Support (MOMS) began as a program in which volunteers, often formerly considered “high-risk,” could offer support and empathy to women currently struggling through the child-bearing process. Since that time, it has grown into a grant-funded program that hires workers and follows at-risk women through the process. Furthermore, MOMS offers an opportunity for mothers to become connected to additional resources.
• Maternal Infant Health Program (MIHP) was established in 1993 as yet another resource for at-risk pregnant women to utilize. MIHP uses a multidisciplinary approach through services provided by registered nurses, dieticians, and social workers. All women who seek help from MIHP are automatically eligible to receive care. Most women who use the service are covered by Medicaid, but those who are not are provided the necessary funds through Kent County. MIHP strikes to make its presence known by focusing attention on areas where at-risk women are most likely to seek help first, such as hospitals and social service hubs.

While each organization has had its share of success stories, there are many challenges that remain to be conquered. The high drop out rates seen among “at-risk” women implies that young soon-to-be mothers are not gaining the responsibilities or life skills necessary to provide adequate care for their children. Although the above organizations have done an outstanding job in helping to provide support and education to these individuals, there are several ways that these organizations could operate even more effectively.

Success and Positive Outcomes Within the Community Programs

The overall positive outcome of these programs is physically healthier babies. This includes a lower infant mortality rate, babies with higher birth weights, less medical complications, and shorter hospital stays after birth. Many of the organizations mentioned above are set up in such a way where there are home visits with a nurse or at the bare minimum a nurse-mother relationship is developed. Staff at the Cherry Street Health Center says this aspect of their program is the most important. When young, scared, and generally uneducated mothers enter into the program, they are skeptical and not always willing to open up to others easily. Learning to develop trust with the nurse is the first step in mothers becoming educated.

Once the trust is present mothers are more willing to open up and honestly communicate with their nurses. A seventeen year old mother who went participated in the Nurse Family Partnership program speaks of her nurse very fondly. “I knew I could trust her. She was comfortable talking about things I wouldn’t talk to anyone else about. In an emergency, she was the first person I’d call and I don’t know what I’d have done without her.” Securing such intimate relationships between the mother and nurse also shows better program compliance. If mothers trust their nurse and like their nurse, they are more willing to look forward to meeting with them and show up to their scheduled appointments. Women can then take this relationship and use it as a model for how to build other healthy relationships, especially if she and the baby’s father have/had an unhealthy relation. It is a tool which can be used in all areas of their life.

There has also been notable success is reducing child abuse and neglect. Mothers who are educated through these programs learn the proper way to care for a baby. Many programs help to stop the cycle of child abuse that may have been happening for generations in a family. Emergency room visits drastically decrease after mothers utilize these services as well. NFP specifically has seen a 56% reduction in ER visits for accidents and poisonings. Uneducated mothers will bring their newborns to the ER for minor problems such as a baby who will not sleep the whole night or is throwing up occasionally. These visits are paid for by the government, not the mothers themselves because the ER is the only place they can go where they know that just by walking in the front door, they will receive service. Mothers who have participated in educational programs learn that sleepless babies and split-up are normal and how to deal with uncomfortable or scary situations. Nurses role play scenarios with them so they learn not to panic and rationally think through a set of ideas when their baby is in need. After graduating from the NFP program they see that 91% of the babies have no visits to the ER or hospitalizations due to injury or ingestion by the first 12 months of age.

Improvements in the stage of early infancy are numerous yet success does not come to a immediate halt once a child is taken home from the hospital. These programs help set up children for success throughout their entire lives. NFP specifically has seen a 59% reduction in arrests in children age 15 and a 67% reduction in behavior and intellectual problems in children at 6. The parenting aspect of these programs teaches women about child development and developmental psychology. They learn good parenting strategies and all the responsibilities they must take on. Women learn what to say, what not to say, and how to say it. Being born into a healthy environment provides an enriching and comfortable lifestyle for a child to grow up in where they feel accepted and loved.

Additional successes include the well being of the mother as well. MOMS has seen a decrease in the number of mothers who smoke and abuse drugs after women complete their program. They have also seen less involvement of women in violent relationships. NFP has seen an increase by 49% of women who get enrolled in the workforce after the birth of their child and 39% of mothers who at enrollment did not have a GED or diploma have earned theirs. The Baxter Dental Health Clinic also saw great dental improvement with women who had utilized their services. 27% of mothers had lower plaque levels and a 79% increase in hygiene habits such as brushing and flossing was seen. While these prenatal care programs are centered on the care and wellbeing of the soon to be born child, mothers also benefit greatly. MOMS even connects women with other resources after the birth of their child if they so wish.

While these programs have folders of research and piles of data to back up their success, progress is a hard thing to measure. Their apparent success raises a classic question: How can we measure something if it is not occurring? While measurement of effectiveness is a difficulty, fewer instances of certain aggravating factors point to very effective programs. And while numerical progress may be hard to project, the personal testimony of any mother who has utilized these resources is enough to drive them to keep progressing.

To read more on recommendations for the issue of prenatal care see the following article "Moving Toward Adequate Prenatal Care"

Part one: Prenatal Care Discrepancies within Grand Rapids

Part two: Moving Toward Adequate Prenatal Care

Note: For questions about the use of anonymous sources in this series, please contact Professor Kevin den Dulk, Department of Political Science and Honors Faculty-in-Residence, Grand Valley State University.