New collaborative program at London, Ont., hospital helps ease tensions of high-risk pregnancies
When Allison Zietsma of London, Ont., learned she was pregnant with her son Sawyer justĀ a few months after her daughter was born, the 41-year-old was anxious because of how difficult her experience was the first time around.Ā A new London Health Sciences Centre program, however, has helped ease her fears.
TIME has served 60 patients, newborns in London since October launch, similar programs elsewhere in Canada
Isha Bhargava Ā· CBC News
Ā·
When 41-year-old Allison Zietsma of London, Ont., learned she was pregnant with her son Sawyer just a few months after giving birth to her daughter, she was riddled with anxiety because of how difficult her experience was the first time around.Ā
Both of Zietsma’sĀ pregnancies classified as high risk due to medical challenges, including high blood pressure and a risk of hemorrhaging, as she experienced during her first delivery.
“Our biggest concern was pregnancy loss,” Zietsma told CBC News. “Having twoĀ pregnancies close together can also increase risks for both the baby and myself, so I was concerned for my own safety and health as well.”
That fear was putĀ to ease when she was referred to the Interprofessional Midwifery/Maternal-Fetal Medicine Expanded (TIME)Ā program at the London Health Sciences CentreĀ (LHSC).
The collaborative program pairsĀ midwives and maternal-fetal medicine (MFM) specialists, who deal withĀ high-risk pregnanciesĀ together to provide extra care and support for patients and their newborns.
This includes extra time at their prenatal visits, mental health supports, breastfeeding supplies, and six weeks of postpartum care for moms and their babies at their homes in London.
Easing strain on health-care system
A key pillarĀ for TIME is the additional supports available to patients, while also keeping them out of hospital for non-urgent matters at a time when staffing challenges and burnout are plaguing theĀ health-care system, said MFM specialist Dr. Harrison Banner.
“We saw a lot of people coming back to hospital who could’ve probably been served in their own community, so this allows us to keep that care in the community and keep people out of the emergency department,” he said.Ā
“Allowing patients to contact the midwife by pager and having somebody available to answer their questions is a form of proactive [preventive] medicine as well, which is something our system should have a lot more of.”
Dr. R Douglas Wilson, president of the Society of Obstetricians and Gynaecologists of Canada, says programs like TIME that combine different skill setsĀ are an absolute necessity, given potential risks that can come with any pregnancy.Ā
The COVID-19 pandemic highlighted many areas of weakness within the health-care system, which now requires a revamping of old models of care,Ā using teamwork and being patient focused,Ā the Calgary-based doctor said.
“There’s no greater gift at the end ofĀ obstetrical processes that you have a healthy mother and baby, and the best way for that to happen is to have the health-care systems recognize the priority that maternity care requires so that appropriate funding and human resources are put into the beginning of life.”Ā
MFM specialist Dr. Barbra de VrijerĀ saidĀ factors contributing toĀ high-risk pregnancies include:
- Birthing twins or triplets.
- Placenta issues.
- Babies who are smaller than average.
- Babies with birth defects.
- Moms having high blood pressure, or heart and kidney disease, requiring them to be monitored more closely.
“The hospital always needs to dischargeĀ patients within 24 to 72 hoursĀ [after birth]Ā so thereĀ might be a gap for patients who haveĀ needsĀ that exceed a family physician’s ability, andĀ this is where the program truly comes in,” de VrijerĀ said.
Best of both worlds
TIME received funding from Ontario’s Ministry of Health, and is open to London residents. But there are similar programs in Canada, such as the South Community Birth Program in VancouverĀ and the Humber River Hospital in Toronto.Ā
Since launchingĀ in October, TIME hasĀ served about 60 high-risk patients and has received overwhelmingly positive response so far, saidĀ midwifeĀ LaurenĀ Columbus.
“Many patients felt like they were getting the best of both worlds where they had these very skilled doctors taking care of them, but they also benefited from their midwives who canĀ bridge the gap between the hospital and the community, and provide that holistic care,” she said.
“We’re seeing a patient population that is not our typical wheelhouse and doctors have really seen value in the care that we provide, soĀ it’s been a really wonderful experience.”
Zietsma credits the TIME staff in helping her navigate the past six weeks since Sawyer was born, along with combatting her postpartum depression, she said.Ā
“They were really proactive at giving me resources to deal with issues that we anticipated, and the midwives really helped to debrief me on [preventive]Ā measures to take and how things might affect me,” she said.Ā
Zietsma and SawyerĀ are now ready to be discharged from TIME. The now six-week-old, who was born on Dec. 15, is physically thriving, his mom says.Ā
ZietsmaĀ hopes programs like this can be expanded and help other parents makeĀ informed choices, she said.Ā
“It’s so easy for new parents to feel alone and overwhelmed with the amount of noise and information that’s out there, soĀ seek out whatever supports are available to you and ask questions.”
ABOUT THE AUTHOR
Isha Bhargava is a multiplatform reporter for CBC News. She’s worked for Ontario newsrooms in Toronto and London. She loves telling current affairs and human interest stories. You can reach her at isha.bhargava@cbc.ca or on Twitter @isha__bhargava
