Wednesday 13 April 2016

Very Low Birth Weight; understanding it from a Public Health Perspective


LaDiamondtishia Beaumont (not real name) of 21 years  was brought to an emergency room complaining of abdominal pain. On examination she showed all signs of onset of delivery. Within the next 55 minutes she had delivered triplets. One male and 2 females. The male weighed 2.5 pounds, the second female weighed 2 pounds and the third weighed 3 pounds. These are very low birth weights. 

According to the Healthy People 2020 (Healthy People 2020), the well-being of mothers, infants, and children translates into a healthy next generation as well as the entire nation. In addressing the needs of women, pregnant women, unborn babies, infants and children, we are instituting  a bedrock of healthy living and outcomes.

 A medical care system that ensures healthy birth outcomes, early identification and treatment of health conditions among infants can prevent death or disability and enable children to reach their full potential. Maternal, Infant, and Child Health (MICH) is is a leading Health Indicators. Very low birth weight can impact on good MICH. Very low birth weight babies are born before 30 weeks of pregnancy. Being born early means that a baby has less time in a mother’s uterus to grow and gain weight. Another cause of very low birth weight is intrauterine growth restriction (IUGR) (Very low birthweight). 

There are cultural biases faced by a mother, male spouse and family with a diagnosis of very low birth weight. One such bias is an assumption that very low birth weight is due to carelessness and lack of initiative on the part of the patient or the family. There are real causes resulting from internal and external influences as well as due to a prevailing unequal and unjust health treatment in populations. Adequate insurance would ensure access to medical care (California Newsreel. (2008). Unnatural Causes… Is equality making us sick?). But that is not the entire story in very low birth weight. A range of biological, social, environmental and physical factors are linked to, say, maternal, infant, and child health e.g., race, ethnicity, age, income level, educational attainment, medical insurance and access to medical care.

The story of low birth weight is a tip whose submerged base is heavy with a range of biological, social, environmental and physical factors linked to, say, maternal, infant, and child health e.g., race, ethnicity, age, income level, educational attainment, medical insurance and access to medical care.This can be further be broken down into a social ecology of health model. Low birth weight  impacts the intrapersonal, interpersonal, organizational, community and societal levels.

At the intrapersonal level, the individual on seeking health/medical care is taken through counseling and education that reassures her and in turn prepares her psychologically to care for self and her babies as well going through healing roles. Her behavior will be such that she works with the medical team to help the children go through a growth and development that ensures healthy outcomes.

At the interpersonal level, she will be encouraged to inform her spouse and other relatives about the newly-borns. These in turn will learn the care needs for premature babies as well as the vulnerability surrounding this kind of birth. The peer groups, family and home members will be aware of practices that are needed to maintain healthy living.

At the organizational level, the mother, will be taken through capacity building sessions to empower her as a mother of triplets who will need care once discharged. The father will also be invited to attend caregiving sessions with other parents of newly-borns. Under this support network, it will be possible to share experiences and perhaps get leads into job opportunities or other support services.
At the community level, the time the mother will spend at the hospital will be a phase when she has access to very good bathrooms, warm/hot water and a sanitized environment ensuring she does not pick up germs to infect herself and the children. She will have a community of friends aware of her needs and perhaps willing to help her nurse and nurture her little ones on being discharged.

At the societal level, LaDiamondtishia Beaumont will be provided referral to support organizations providing skills development for a mother of her kind. There are schools that take back nursing mothers and these schools provide day care services. She may qualify. The father may be encouraged to enroll in a training to work program to help him gain skills to earn money for caring for his family. This will impact income level, educational attainment, medical insurance and access to further medical care.

This is a review of how she may fit in the world of care using the social ecology of health model. The interaction of her individuality, the general environment and the social environment are analyzed to see how best she can fit in to continue participating in good practices to ensure healthy outcomes. 

One way to prevent very low birth weight is ensuring prenatal visits to check: progress of pregnancy; high blood pressure; diabetes; provide nutrition advice; recommend folic acid supplements; control depression and self medication. The care given in case of very low birth weight includes: admittance at neonatal intensive care unit.

Any pregnant mother who is insured, has good home-based care and is motivated to access medical care is assured of better health outcomes before, during and after pregnancy.



                                                      References

California Newsreel, 2008. California Newsreel. (2008). Unnatural Causes… Is equality making us sick? [Documentary trailer]. Retrieved from http://www.unnaturalcauses.org/video_clips_detail.php?res_id=80. Retrieved on April 13th 2016.



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