Friday Five (#34)


FRIDAY! It’s been a funny week here in Alaska. We had a few days of melting snow and icicles and sunshine – we could even see the actual ROAD! But then we got 3 more inches of snow. I’m ready for the big melt so the kids can go play outside and ride their bikes. I think all the mamas can probably relate – there is weather that your kids can go out in play in for a little bit and weather that they can go out and play in all day. I think that good weather all day is better for everyone in the household! Especially our cat – we are sure that if she was bigger, she would eat us.

Let’s get to the FIVE!


1. Policy to combat maternal mortality

If you’ve been watching the news over the past month, the stimulus bill has gotten a lot of attention and traction for the extended coverage offered to Medicaid mamas after the delivery of their baby. This is pretty big news. If you didn’t know, Medicaid pays for about half of the pregnancy and birth care in the United States. The stimulus bill offers the states the option to extend their period for postpartum care coverage from 60 days to 1 year – and provides the federal monies to do so. One of the reasons this is so big is that where Medicaid goes, private insurance follows. This is because Medicaid sets the reimbursement schedule for fees provided to the patient.

Also interesting, are the number of bills rising to the top of state agendas with a similar postpartum theme. I’ve seen various bills get more traction to committee hearings about various forms of extended postpartum care.

The interesting (and also disappointing) thing about this new policy is that it is optional. With the Affordable Care Act in 2010, states had the option to expand their Medicaid programs but not every state has done so. Or, some states have been slow to expand their programs. For example, Alaska didn’t expand their program until 2015.

Keep an eye out for what your state is doing. Longer postpartum care is almost going to be beneficial for women and their families. But since policy is state by state, it’s likely the policies will be across a broad spectrum of benefits.

This article, A Call for Comprehensive Postpartum Care, highlights the abrupt change in prenatal care after birth. The system is set up to have weekly visits until birth, then after birth, maybe 1 or 2 visits for most women. The system needs to change. If you have an opinion or experience about your postpartum care, please advocate for a better system to your specific states or specific systems/places of work!


2. A new preventive chart for women’s health care! This is the 2021 version just released. It’s a great desktop handout for anyone doing gynecologic, primary care or well visits for women.

Source

3. What do you think hospital CEOs started and stopped during the pandemic?

This article interviewed 4 CEOs and I found their perspective fascinating. CEOs have a birds eye view of their hospital(s). And the pandemic challenged everyone – no question there. But it challenged these CEOs to do rapid plan-do-study-act cycles, to move to a laborist model for one labor and delivery unit and to improve patient check in/registration processes and experiences.

I know the pandemic pushed healthcare to limits we couldn’t have fathomed before – but I am hopeful that some of those changes will be positive, beneficial and lasting once the pandemic passes.


4. Let sleeping babies sleep!

If there is one topic that new mamas ask about more than anything else it is this: baby sleeping habits! You could be team “sleep train ASAP” or team “they’ll sleep through the night eventually…” – no opinion or thought is right. You do what’s right for you. But a basic review of baby sleep cycles is always nice for mamas to review!

Also, this story must be shared. One time, when my daughter was a newborn, she was asleep and had the hiccups. One of the grandmas was visiting us and went to pick her up, thus waking her up, because she wanted her hiccups to stop. As a VERY sleep deprived, first time mama, that had FINALLY gotten her baby to go to sleep, I was flabbergasted that someone would wake a sleeping baby with hiccups. Oh vey. There were literally no words for the frustration I had! Can anyone else relate?! Okay, moving on…


5. Exercise during pregnancy!


I love March of Dimes. From a midwife perspective, they are always thinking about the babies from embryo to newborn. They have a great site to review exercise in pregnancy for women…check it out here.

Aim for walking 30 minutes a day as a place to start 🙂 Something is better than nothing!


Other goodies…

  • Need a creativity boost within your community? Check out Creative Mornings. I followed them a few years back but they recently popped back onto my radar. They have videos of artists within your community that you can watch online. It’s great for any entrepreneur mind or someone looking for a little creativity spark.
  • This article from the New England Journal of Medicine: A Pragmatic, Randomized Clinical Trial of Gestational Diabetes Screening! The United States uses the 1 hour 50 gram glucose test before and during pregnancy to screen for diabetes. There is also a 2 hour 75 gram glucose test used in some states and countries. This randomized controlled trial examined the outcomes from between the one step or two step screening. Women were either given the 1 hour/50 gram glucose test in a non-fasting state, followed by the 3 hour/100 gram glucose test in a fasting state, OR, the single test of a 2 hour/75 gram test in a fasting state. Sample size was approx 26,000…Researchers found:
    • “Gestational diabetes was diagnosed in 16.5% of the women assigned to the one-step approach and in 8.5% of those assigned to the two-step approach.”
    • Primary outcomes between the two groups were similar:
      • Large-for-gestational-age infants, 8.9% and 9.2% (relative risk, 0.95; 97.5% CI, 0.87 to 1.05)
      • Perinatal composite outcome, 3.1% and 3.0% (relative risk, 1.04; 97.5% CI, 0.88 to 1.23)
      • Gestational hypertension or preeclampsia, 13.6% and 13.5% (relative risk, 1.00; 97.5% CI, 0.93 to 1.08)
      • Primary cesarean section, 24.0% and 24.6% (relative risk, 0.98; 97.5% CI, 0.93 to 1.02)

Hope your weekend is lovely and restful!

Jamie


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