Navigating the stressors of a medically complicated birth can seem overwhelming, even for those that may have good health insurance and few barriers to resources. For families struggling to overcome disparities involving the social determinants of health, like lack of access to basic necessities (e.g. housing or food) or even managing addiction or mental health concerns, giving birth to a NICU baby can create further insecurities experienced by the whole family. This is where our team of social workers at ProgenyHealth play such a pivotal role in the lives of these vulnerable infants and their families, connecting them to vital local resources like food and housing, drug rehabilitation programs, and counseling services.
March is National Social Workers Month, and our dedicated team of social workers at ProgenyHealth tell us that they love the rewarding nature of their work – and that it comes with expected challenges.
“The baby isn’t going to do well if mom isn’t doing well,” says Lisa, a social worker at ProgenyHealth, “Moms are so focused on their baby’s health that they can neglect their own.” Recent data from the Mayo Clinic shows that as many as 40% of mothers do not attend postpartum visits, largely due to financial insecurity or a lack of health insurance. This means that they may receive little guidance or access to resources in a crucial stage of any baby’s life, let alone a baby coming home from the NICU when there is no case manager or social worker involved.
Katie, also a ProgenyHealth social worker, says that a common issue faced by mothers in this situation is postpartum depression. Many mothers struggle to get the help they need. Katie’s primary focus in working with a mother presenting with postpartum depression is to assess her safety, the safety of her baby, and help her to get in touch with critical resources. “Postpartum depression is not something that just happens within the first 60-90 days,” she says, “and a lot of these moms do not have health insurance beyond this period. They are not seeing their general practitioner to get assessed, or not able to get in with a psychiatrist or counselor. I am working to connect them with options in their community, but in the moment, I am engaged to ensure that mom and baby are safe. I ensure that mom is not going to harm herself or someone else, and coach mom on what to do if she feels like she is not in control — who to call, who to reach out to.”
This does not always mean that families are immediately receptive to the assistance of social workers. Often this is because people have preconceived notions about what social workers do. The team at ProgenyHealth tells us this is a common misconception that can be difficult to overcome. “At ProgenyHealth, our job is to help support them and connect them to resources. We are not a stress adder, we are simply there for them in any way they need. We are here to offer support, not judge,” says our social worker, Sarah. According to her, the best way to overcome those misconceptions and develop a relationship can be summed up in one word: empathy.
Being empathetic is never more important for our social workers than when a mom is struggling with addiction and her baby has complications due to neonatal abstinence syndrome, or NAS. In areas of the country hardest hit by the opioid epidemic, this additional burden on the family brings with it a stigma that can be another barrier to resources. Social worker Nanane says: “These moms face a lot of judgement in the NICU. They are watched more closely than any other moms out there. There is a reason for that, but at the same time our job is to support them and have a non-judgmental attitude.”
Katie works with these families on a regular basis. She adds, “Sometimes we are the only people in these mothers’ lives who say things like: ‘Congratulations, this is so exciting!’, or, ‘Wow, good for you, you got clean to have your baby! That is a huge deal. Not everyone can do that!’ It is as simple as being genuinely happy for them that they have had a baby.”
So how do our social workers overcome barriers to get through to families that need our help?
“Being more mom-focused,” says Sarah. “There may not yet have been anyone to give a mom a positive message about her baby. The medical teams are so focused on the baby and their numbers, like how much the baby weighs, or when the baby’s next appointment is, that they may not have the time to spend to get to know the mom or her unique circumstances. When I first talk to moms in the ProgenyHealth program, I say: ‘Tell me about your baby, tell me about your family.’ I take the time to get to know the mom and where she comes from, and what the whole family is like. She knows we personally care about her and her family.”
Developing this relationship not only helps the member to feel like they have a dedicated, supportive team at ProgenyHealth, but learning more about a family and their unique needs and circumstances helps their social worker build a case for them to receive additional supports, such as low income housing. “Housing lists are closed, or wait lists are not accepting new people. However, one thing our social workers excel at is determining extenuating circumstances that might help a family stand out in terms of a need. I had a family that I knew needed housing, and I found out that the mom was HIV+. That opened up so many more resources for her—because of her clinical situation—that she might not have known were available to her.”
Refugee or immigrant families can also suffer from a lack of resources, simply because of a language or cultural barrier. These families may not be aware that there are entire refugee or immigrant communities ready to help them get basic necessities and offer a network of support and education. There may also be cultural differences or a lack of education that could affect a vulnerable infant’s health—a barrier that our social workers encounter frequently. Lisa says: “It is important to teach them what is safe in the home versus what is a cultural norm for them, and we find ways of making those two things mesh so that the baby remains safe and healthy.”
Every March we celebrate National Social Workers Month, and the life-changing work our team of social workers at ProgenyHealth perform on a daily basis. “We have a unique perspective from our training,” says Lisa. “We think outside of the box: thinking of the whole family, not just the medical aspects. That digging deeper comes from a different place than, for example, a nurse or a counselor.” By taking an approach that focuses not only on the baby but the wellbeing of the whole family, our team of social workers at ProgenyHealth develop meaningful relationships that benefit the entire family. “Being a social worker is who you are, not what you do. It is truly a calling!”
A heartfelt thank you to ProgenyHealth’s Social Workers for all you do for the families we serve each and every day!
Madeline Szabo is Senior Vice President of Clinical Operations at ProgenyHealth.