This is part of a series of stories about people working on solutions to New Hampshire maternity care challenges. Catch up with our cover here.
In New Hampshire, many factors determine the quality of maternal health care and well-being.
Dr. Trinidad Telz is a family doctor and health practitioner. She is also a representative of the democratic state of Manchester. NHPR ALL THINGS CONSIDERATE, JULIA FURUKAWA spoke with how to improve quality and access to maternal health care for all New Hampshire birth communities.
Transcription
What do we know about the disparities that exist in maternal health care here in New Hampshire?
New Hampshire is like the rest of the country, insofar as we see the types of disparities and the differences in results. We know that we have a problem of maternal health deserts and limited access to many of our populations who live in more rural parts of the state, which is a significant fraction of the population. We know that access to care is partly determined by access to health insurance (like) Medicaid.
There are a few figures on the entry into prenatal care. Ideally, we want everyone to enter prenatal care at the beginning of the first quarter and we have seen that there are differences by population groups. It is a little lower for black or African-American women in New Hampshire than for white, non-Hispanic and Asian women. And we have a history in this country where there are good reasons why certain communities are not necessarily also eager to seek health care.
So in a recent projectYou and many others have heard nearly 50 post-partum people through the State on their perinatal experiences. What did you hear about them?
Thus, the types of comments that were shared, there was a lot to describe a lack of communication, which caused a break in confidence between them and the health care providers around them. Sometimes this led them to question the reasons for decisions taken about their care. Sometimes they shared difficult interactions with health care staff. So we have a few quotes.
“I felt humiliated when the nurse made fun of me and said, good luck with that. When I told him I wanted a natural birth. ”
“I was pushed to make an enthronement by making me say that more time in the hospital would cost more money.”
When we sit down and listen to these quotes, we could say: “Ah, it’s not a big problem, right?” Especially if you work in a health care framework (and) you see people every day. But for some people, it is a new experience. They could be alone. They might be afraid. And so, they have the impression that their concerns are updated or that they feel stupid or inadequate to have and share these concerns.
I think what we have discovered is this disconnection, this gap, between what patients experience and describing in relation to what we think we do as a very well -intentioned (and) care providers. Some of the conclusions of the conversation, especially since we are talking about mental health and postpartum depression, the participants revealed this desire to be able to obtain support in the community.
How do community systems register in efforts to resolve these disparities?
So we want to think about how to reshape, recreate and re -entertain the way we think of maternal health care so that it is more a conversation between community needs and health care systems.
We really thought that what would be charming would be to have a combined community health employee, a doula and a mental health support role. We know that there are ongoing projects in New Hampshire where perhaps community health workers are combined with doubles. The main thing is to have the ability to have people who are of the community, who are trusted people, that without having to reach a health care institution, could be accessible and can serve as a source of support. And also, when they recognize a need, someone who can help bind, refer, provide resources and connect people to care when it is a more acute need for real health care.
We want to hear from you: what do you want to know before you have a baby here? What made a difference for your family when you or your partner were pregnant? Where have you been surprised to find support-or, where did you feel like you need more help? Let us know voice@nhpr.orgAnd your stories could help further shape our journalism on this subject.