By Indu Gupta, MD, MPH, Onondaga County Commissioner of Health
Contributing Author: Lisa GreenMills, RN, MPH, Syracuse Healthy Start Project Director

Let us take our focus to the time where the life begins. We all know that to have a healthy baby, the most important thing is a mother’s complete health- physical, emotional, and social well-being.

At our Health Department, we provide amazing support to pregnant women during and after pregnancy, especially to those who need it most through our various programs: Syracuse Healthy Start; home visits to pregnant women, new moms and their babies; and Nurse Family Partnership for first time moms. The success of the these programs is evident by none other than our Syracuse Healthy Start Project Director Lisa GreenMills, a public health nurse by training, who knows this program up close and personal. Lisa told me her story the first time we met and in subsequent conversations.  The following story is an abbreviated version of her story in her own words:

When I was younger my mom worked with Healthy Start. So for me growing up, “Healthy Start” was a household name. My mom and sister even starred in a commercial filmed in 1998 for Healthy Start. My inspiration for my work with Healthy Start today is my brother who I never got to meet. My brother died of SIDS (Sudden Infant Death Syndrome). He would have been my older brother. Even though I never met him, he’s had a profound impact on my life. You know, you hear the statistics- you hear that black babies are three times as likely to die as white babies, but it doesn’t really hit you. It’s not far away in some developing nation- it’s here. It’s not just in my neighborhood; it’s literally in my family. Infant mortality is not just a statistic, “oh, the infant mortality rate is going down, but a disparity still exists.” Yes, but what does that mean?

I did an internship here with Healthy Start back when I was in grad school. My project was to analyze the infant mortality statistics for a set of years and look for local trends. It was a pretty depressing internship, to say the least. But I learned a lot from that experience. I have been the Project Director for Syracuse Healthy Start for two years now. Our focus is on reducing health disparities, on reducing infant mortality, and improving birth outcomes in the City of Syracuse. Healthy Start is part of a national movement, and in Syracuse we are one part of a larger team under the Healthy Families umbrella. In addition to the work we do directly, we’re linked with so many agencies and individuals in the community who share a common goal.

I’m so proud and so excited to be in this role now, and I really feel like this is what I was meant to do with my life. I love that every day I get to work with people who are helping families overcome some really challenging situations, and I love that we also get to think about the “bigger picture” and bring together the community as a whole. It’s really a unique position that can combine the one-to-one support with community wide dialogue and collaboration.

I can see how proud Lisa is to be overseeing the Syracuse Healthy Start program. It is an important part of her own life and now she is teaching many women to benefit from this wonderful program.

Success of such programs is often assessed by various rates such as prenatal care, birth outcomes and maternal health.  According to CDC, as many as 700 women died in 2010 in the US due to problems caused by pregnancy, and 65,000 had serious health complications. Many complications are due to genetic factors and chronic diseases such as diabetes, high blood pressure, depression, and obesity.

Other factors complicating the pregnancy are personal habits including smoking, lack of physical activity, poor eating habits, recreational use of alcohol and drugs, and sexually transmitted diseases including HIV and syphilis, which affect the health of both mother and the unborn baby. The consequences of using illegal drugs, prescription opiates, alcohol and smoking during pregnancy can have significant negative consequences for mother and the fetus (baby), resulting in withdrawal, birth defects, placental bleeding, premature birth, stroke, heart attack, fetal alcohol spectrum disorders (FASDs), neonatal abstinence syndrome (NAS) and sudden infant death syndrome (SIDS) in extreme cases.

So what is the solution? A prenatal care visit to a provider’s office including a detailed history and physical exam along with an assessment of social factors would start the conversation about all these risk factors and catch these problems at any stage of the pregnancy. Social determinants such access to care including transportation before, during, and after pregnancy also play a very significant role.

Where am I going with this discussion? With pregnancy, a woman’s life changes. Mine did as well- from taking care of oneself to two or three. This continues to unfold into something well-articulated as, “It takes a village to raise a child”. This is an old concept but still fresh and true to its value. Social support is very crucial for the changing landscape in a woman’s and baby’s life. What happens if someone does not have that village around to raise the child? Is this a public health concern?  Yes, it is, because the social well-being of a mother and baby is the strong foundation for the next generation. Poverty, transportation, and family support all can affect getting proper health care. Removal of this barrier will result in proper care and reduction in maternal and infant mortality. In addition, a full evaluation of an infant will identify health issues in the baby and ensure effective treatment and reduce our still high infant mortality rates.

Cyber support is here! A new form of social support is now available in today’s virtual world. In this digital age, phone apps and text services have obliterated the distance and information can be provided to anyone at any time and is literally at your fingertips!

• Text4baby is a text message service which provides significant support to the mothers by providing health tips including the importance of regular medical checkups by your obstetrician.
• WebMD has an iPhone app for expectant mothers and there are numerous smart phone apps for the same purpose as well.

It is amazing to see how technology has changed the lives of everyone. Years ago when I was pregnant, besides regular visits to my obstetrician and reading the medical text books, I had relatively limited information. Today’s  pregnant women have this power at their fingertips! Education is empowerment.

So here’s to all those expectant mothers…you have a lot of tools, providers, books, apps, nursing services, and your Health Department! Please USE them to EMPOWER YOU! Be yourself, be healthy, be happy. It may be hard at times, but not impossible. Reach out and find the help and resources you need…you are never alone. This is just the beginning of a new beautiful journey into your future! Welcome aboard!

Resources:

• CDC At-A Glance 2015, Safe Motherhood: http://www.cdc.gov/chronicdisease/resources/publications/aag/pdf/2015/safe-motherhood-aag-2015.pdf
• Healthy Families Onondaga: www.onhealthyfamilies.com
• Syracuse Healthy Start: www.onhealthyfamilies.com/healthystart/
• Home Visiting: www.onhealthyfamilies.com/homevisit.html
• Nurse Family Partnership: www.onhealthyfamilies.com/nursevisits.html
• Pregnancy and Substance Abuse: www.nlm.nih.gov/medlineplus/pregnancyandsubstanceabuse.html
• Illicit Drug Use During Pregnancy: www.marchofdimes.org/pregnancy/illicit-drug-use-during-pregnancy.aspx