Community Health Center Pilot Program
The Community Health Center Pilot Program is an initiative to prevent postpartum depression and promote perinatal emotional wellness. The initiative is housed in four community health centers in Massachusetts and was originally funded by the state budget in 2013. In the fall of 2014, funding was eliminated in the 9C cuts. Read on to learn more about this innovative program...
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Funding for this initiative is included in the Massachusetts legislature's final budget, but Governor Baker vetoed this line item. Please call your Senator TODAY (or by Thursday July 23) and ask them to vote to override the Governor's veto on the Postpartum Depression Pilot Program (account 4510-0600). |
Background and overview
When I became a postpartum doula, I enjoyed working with new moms and families, but I was interested in finding a way to make postpartum support services more accessible. I kept thinking, “What if there were postpartum doulas in pediatrician’s offices? What if when a new mom goes to see her pediatrician- like new moms frequently do-- a postpartum doula could answer her questions about sleep, feeding, and soothing her baby? What if the doula could connect with with mental health services if she was struggling? What if this became the standard of perinatal support--not just for a baby or a mom, but for both of them together?”
Thanks to Rep. Ellen Story and the Legislature’s Special Commission on Postpartum Depression, this idea came to fruition. In 2013, Rep. Story introduced a line item in the House budget for funding for a postpartum depression prevention and perinatal emotional wellness promotion initiative housed in four community health centers in Massachusetts.
When I became a postpartum doula, I enjoyed working with new moms and families, but I was interested in finding a way to make postpartum support services more accessible. I kept thinking, “What if there were postpartum doulas in pediatrician’s offices? What if when a new mom goes to see her pediatrician- like new moms frequently do-- a postpartum doula could answer her questions about sleep, feeding, and soothing her baby? What if the doula could connect with with mental health services if she was struggling? What if this became the standard of perinatal support--not just for a baby or a mom, but for both of them together?”
Thanks to Rep. Ellen Story and the Legislature’s Special Commission on Postpartum Depression, this idea came to fruition. In 2013, Rep. Story introduced a line item in the House budget for funding for a postpartum depression prevention and perinatal emotional wellness promotion initiative housed in four community health centers in Massachusetts.
Why community health centers?
Community health centers are the largest primary care network in the state and serve over 900,000 people annually. Over 10,000 pregnant women were seen at community health centers in 2013. For medically underserved folks, especially women and children, community health centers are their only access to care. Regardless of insurance status, patients can be seen at community health centers.
We know that women in poverty or who are disenfranchised are at higher risk for depression during and after pregnancy--the risk is about twice as high among low-income women. We know that there are many factors that increase a woman’s risk for depression during the perinatal period—incidences of previous depression, life stresses, previous trauma, intimate partner violence, poverty, and lack of social support. These same risk factors are also barriers to accessing healthcare, treatment, and support. By integrating comprehensive perinatal support services into existing systems of healthcare, this pilot initiative lowers barriers and increases timely access to care.
Community health centers are the largest primary care network in the state and serve over 900,000 people annually. Over 10,000 pregnant women were seen at community health centers in 2013. For medically underserved folks, especially women and children, community health centers are their only access to care. Regardless of insurance status, patients can be seen at community health centers.
We know that women in poverty or who are disenfranchised are at higher risk for depression during and after pregnancy--the risk is about twice as high among low-income women. We know that there are many factors that increase a woman’s risk for depression during the perinatal period—incidences of previous depression, life stresses, previous trauma, intimate partner violence, poverty, and lack of social support. These same risk factors are also barriers to accessing healthcare, treatment, and support. By integrating comprehensive perinatal support services into existing systems of healthcare, this pilot initiative lowers barriers and increases timely access to care.
The work of the pilot program
In late 2013 and early 2014, pilot initiatives began at the Lynn Community Health Center, Southern Jamaica Plain Health Center, Holyoke Community Health Center, and the Family Health Center of Worcester. At Southern JP Health Center, where I work, we see all new babies and moms at their first appointment in pediatrics, as early as three days postpartum. We screen all moms (both prenatally and after their baby is born) for perinatal emotional complications and connect them with mental health services in-house and in the community. Sometimes, I walk moms in crisis upstairs so that they can be seen by a mental health professional within the hour. Since these programs began, over 2000 women have been screened for depression and anxiety, and hundreds of women have been connected to mental health services and/or other community supports.
I also provide lactation and postpartum doula support and help moms with breastfeeding, soothing their babies, and accessing other resources and services that they may need. I walk into the exam room after the pediatrician leaves and chat with moms and families about what’s going on--lack of sleep, cracked nipples, and soothing a fussy baby. Moms will often call me months after their babies are born to ask questions or get additional information, and it’s comforting to know that there is someone at their pediatrician’s office that is there to assist them with issues that extend beyond their baby’s medical care. I provide home visits as well.
We see a mom and baby as a dyad. We understand that issues within the dyad (such as breastfeeding or lack of sleep) can affect a mother’s emotional health. Because our services are comprehensive and include lactation and postpartum doula support, we can address these types of issues while also working collaboratively with mental health providers to help a mother experiencing emotional complications.
In late 2013 and early 2014, pilot initiatives began at the Lynn Community Health Center, Southern Jamaica Plain Health Center, Holyoke Community Health Center, and the Family Health Center of Worcester. At Southern JP Health Center, where I work, we see all new babies and moms at their first appointment in pediatrics, as early as three days postpartum. We screen all moms (both prenatally and after their baby is born) for perinatal emotional complications and connect them with mental health services in-house and in the community. Sometimes, I walk moms in crisis upstairs so that they can be seen by a mental health professional within the hour. Since these programs began, over 2000 women have been screened for depression and anxiety, and hundreds of women have been connected to mental health services and/or other community supports.
I also provide lactation and postpartum doula support and help moms with breastfeeding, soothing their babies, and accessing other resources and services that they may need. I walk into the exam room after the pediatrician leaves and chat with moms and families about what’s going on--lack of sleep, cracked nipples, and soothing a fussy baby. Moms will often call me months after their babies are born to ask questions or get additional information, and it’s comforting to know that there is someone at their pediatrician’s office that is there to assist them with issues that extend beyond their baby’s medical care. I provide home visits as well.
We see a mom and baby as a dyad. We understand that issues within the dyad (such as breastfeeding or lack of sleep) can affect a mother’s emotional health. Because our services are comprehensive and include lactation and postpartum doula support, we can address these types of issues while also working collaboratively with mental health providers to help a mother experiencing emotional complications.
What can you do?
Comprehensive perinatal support should be the standard of care: this is the ounce of prevention. This is how we invest in mothers, in children, and in families—especially those most in need. The ground-breaking work in our community health centers is a model for sustainable healthcare that should be replicated—not de-funded. Please consider supporting an investment in the women, children, and families in the Commonwealth and advocate for continued funding for this initiative so that we can continue to provide comprehensive perinatal support to families in need of services.
Funding for this initiative is included in the Massachusetts legislature's final budget, but Governor Baker vetoed this line item. Please call your Senator TODAY (or by Thursday July 23) and ask them to vote to override the Governor's veto on the Postpartum Depression Pilot Program (account 4510-0600).
Don't know who your senator is? You can look up your hometown state senator and his/her contact info at www.wheredoivotema.com
Also, check out the Boston Globe's Editorial in support of continued funding for the Pilot Program!
Comprehensive perinatal support should be the standard of care: this is the ounce of prevention. This is how we invest in mothers, in children, and in families—especially those most in need. The ground-breaking work in our community health centers is a model for sustainable healthcare that should be replicated—not de-funded. Please consider supporting an investment in the women, children, and families in the Commonwealth and advocate for continued funding for this initiative so that we can continue to provide comprehensive perinatal support to families in need of services.
Funding for this initiative is included in the Massachusetts legislature's final budget, but Governor Baker vetoed this line item. Please call your Senator TODAY (or by Thursday July 23) and ask them to vote to override the Governor's veto on the Postpartum Depression Pilot Program (account 4510-0600).
Don't know who your senator is? You can look up your hometown state senator and his/her contact info at www.wheredoivotema.com
Also, check out the Boston Globe's Editorial in support of continued funding for the Pilot Program!