“Babies are such a nice way to start people.”
It’s how we all begin, and science is now confirming what midwives have known for a millennium — the template for lifelong health begins in pregnancy. The perinatal period (pregnancy, birth and postpartum) is a pivotal time in the health of a family. Johns Hopkins Bloomberg School of Public Health and Duke University School of Medicine are just a couple of the institutions asking questions about the effects of maternal health on the long-term health of humans — from childhood through adolescence and into adulthood. The health of a mother can be deeply affected by the support offered her before and after her baby is born.
So, how can our communities support pregnant women and people in making choices and obtaining resources that will set a trajectory of lifelong wellness?
In Rhode Island this has been an issue that brings many professionals to collaborate with the same goal. The past decade has brought significant growth in access, options and supports that aid a family in creating a healthy pregnancy and first year of life. This group of people includes health providers, doctors, midwives and nursing professionals, yoga and fitness experts, birth and parenting educators, birth and postpartum doulas, mental healthcare providers and social workers.
Prenatal and postnatal heathcare is the cornerstone of support for a healthy pregnancy and birth. Rhode Island families have access to a wonderful spectrum of care models. We have a Women’s Medical Collaborative (Lifespan) that provides comprehensive care to women and care specialized for high-risk pregnancies. A wide variety of OBGyn practices are open throughout the state and midwives provide care in community health centers and other clinical settings. Private practices flourish throughout the state and a growing number of people are using the care provided by nurse midwives who attend birth in the hospitals throughout the state and in homes (for homebirth.)
A family is best served in an environment that meets their individual needs. For some families, the Alternative Birthing Center at Women & Infants (also called the ABC) is the most comfortable option. For others, it’s the small and wonderfully supportive unit at Memorial Hospital of Rhode Island, one of the US maternity units that pioneered the gentle cesarean birth. Dr. Susanna Magee, a RI-based family doctor and Director of Maternal Child Health Fellowship Program at Brown Medical School, and Dr. John Morton, OBGyn, endeavored to make cesarean birth a family-centered experience, an approach that has improved the experiences of many families and become a sought-after approach locally and internationally.
Families can choose homebirth with a practice of certified nurse midwives and a nurse practitioner, or certified midwifery care in a licensed practice. The variety of hospitals in state allow parents to choose a large urban hospital with a state-of-the-art NICU for care of sick or premature babies, or families can birth in a smaller hospital setting in a local hospital.
There are many aspects of pregnancy, birth and the time following birth that a healthcare provider may only briefly provide guidance with, making collaboration important. The RI Department of Health has a wonderful visiting nurse program working with pregnant and new families and supporting women in need of services beyond medical care. The RI Doula Collaborative is working to support young parents with no-cost services, and has received funding from the Department of Health’s Health Equity Zone initiative, the National Association for County and City Health Officials and the Warren Alpert Medical School at Brown University.
With the community-building support of the Rhode Island Birth Network (ribirth.net) parents can access a directory of professionals working with families throughout the state. This referral network with dozens of professionals providing a range of services has formed a community.
Doulas (pronounced DOO-LA) work with families to assist in finding compatible models of care, help prepare families for the experience of labor and birth, and provide logistical, informational, practical support in birth and the months following. You can learn more about doulas through Doulas of Rhode Island (doulasri.org) and meet doulas at Meet the Doulas Night events throughout the state.
Other complementary healthcare providers, including chiropractic doctors, doctors of acupuncture, and physical therapists, can support other aspects of pregnancy, including discomfort. Some of these providers hold holistic models of care that address the multi-dimensional needs of the changing families of RI. Childbirth and Parenting Education supports parents through classes and workshops focusing on preparation, information and connection with support professionals. Open Circle: Wellness & Education for families (opencircleri.com) provides massage therapy, education and yoga. Prenatal yoga is a wonderful way to prepare the body and mind for the challenges of pregnancy and birth, and it can reduce stress, which is linked to premature birth and perinatal mood disorders (postpartum depression being the most well-known.)
Author Diana Korte, an award-winning medical journalist, put it well: “If I don’t know my options, I don’t have any.” As our Rhode Island families find resources, they will increase their chances of having healthy pregnancies; satisfying, supported births; and family lives in which they can live their values and watch their children grow with confidence and peace of mind.