Category: Life Course

Messages from Rebecca Shlafer, Warrior of the Minnesota Prison Doula Project

By: Amanda Wojan, MPH(c)

On September 27th Dr. Rebecca Shlafer, an Assistant Professor in the Division of General Pediatrics and Adolescent Health at the University of Minnesota, came to UIC to discuss her work implementing a prison doula project. Her lecture discussed the crucial nature of implementing policies that humanize incarcerated pregnant women throughout their pregnancy journeys. She discussed that prior to the implementation of this doula program in Minnesota, they lacked the resources and knowledge necessary to provide incarcerated pregnant women with what they needed to maintain their own health/the health of their babies. As Dr. Shlafer stated, the population of women in prison who are pregnant are a vulnerable group, potentially facing environmental risks, physical health issues, and issues related to mental health and substance misuse which in turn can lead to poor perinatal outcomes such as preterm and small for gestational age infants.1 Thus, focus on interventions that promote their health and well-being is of particular interest for public health professionals thinking in terms of lifecourse models. The long term health outcomes of these babies are dependent on both the prenatal and postnatal care that these women receive, as well as their ability to form important attachments with their babies early on.

The Minnesota Prison Doula Project implemented two core components into their programming: 1) a new moms informational group, and 2) one-on-one doula supports for all pregnant women in the prison. These components are meant to provide these mothers with the resources that they need to have a healthy and successful pregnancy, and to learn the skills necessary to form positive relationships with their babies. Dr. Shlafer mentioned that the doulas also provide emotional and social support to the woman post pregnancy when they are separated from their babies. They help the mothers establish healthy coping skills in this incredibly difficult separation process.

Doula support during childbirth is associated with better health outcomes for both the mother and the baby, including better APGAR scores, shorter first stage of labor, less medical interventions required during labor/delivery, and decreased c-sections.2 Doulas are not only helpful before, during, and directly after pregnancy, but they are also key players throughout the weeks postpartum in supporting the mother and baby in activities such as breastfeeding and forming healthy relationships. A key component of forming positive relationships between mother and baby is skin to skin contact. The benefits of skin to skin contact between mother and baby are invaluable: it helps to calm the baby by reducing stress levels in both mother and baby; it helps the mother’s milk to flow more easily; it boosts the baby’s immune system; it builds important neural connections in the baby’s brain via the smells, textures, and sounds that the baby experiences; it lowers the mother’s risk of a postpartum mood disorder; and ultimately it creates lasting connections and strong attachments between the mother and baby.3

This seemingly simple concept is something that can prove extremely challenging for women in prison. Many do not have access to their babies postpartum, as they are entered back into prison after their 48 hour stay in the hospital. This leaves them only their occasional visitations with family to have any human contact with their babies. This crucial issue proposes important next steps for groups that work with these vulnerable women. The implementation of doulas in state prisons is extremely beneficial, and the data show that it improves birthing outcomes. But what comes next? How can we support new mothers who are still in prison to have successful and positive relationships with their newborns? This falls heavily on policy, advocacy, and compassion stemming from the multidisciplinary team that works to promote the health outcomes of these women and children. Our work here is not done and this is of importance considering over the last two decades the number of women in prison in the US has dramatically increased and approximately 76% of incarcerated women are of childbearing age.4

Which leads me to a powerful quote from Dr. Shlafer’s presentation: “Research without advocacy is just a dusty journal on someone’s shelf. Advocacy without research is just a temper tantrum.”5

References:

1 Shlafer, R. J., Hellerstedt, W. L., Secor-Turner, M., Gerrity, E. and Baker, R. (2015), Doulas’ Perspectives about Providing Support to Incarcerated Women: A Feasibility Study. Public Health Nurs, 32: 316–326. doi:10.1111/phn.12137

2 BOlBOl-haGhiGhi, N., MaSOuMi, S. Z., & KaZeMi, F. (2016). Effect of Continued Support of Midwifery Students in Labour on the Childbirth and Labour Consequences: A Randomized Controlled Clinical Trial. Journal of clinical and diagnostic research: JCDR, 10(9), QC14.

3 Breastmilk, Every Ounce Counts. Retrieved from http://www.breastmilkcounts.com/breastfeeding-101/skin-to-skin/

4 Shlafer, R. J., Hellerstedt, W. L., Secor-Turner, M., Gerrity, E. and Baker, R. (2015), Doulas’ Perspectives about Providing Support to Incarcerated Women: A Feasibility Study. Public Health Nurs, 32: 316–326. doi:10.1111/phn.12137

5 Shlafer, R. (2017). Pregnant and parenting among incarcerated women: from research to advocacy. [PowerPoint slides]. Retrieved on September 27 2017.


Mesothelioma, A Lifecourse Perspective

By: Emily Walsh, in collaboration with the Mesothelioma Cancer Alliance, and Amanda Wojan

Exposure to environmental toxins and the subsequent disease exposure can lead to lifelong complications and issues. While people are more commonly aware of the threat of carbon monoxide or lead, asbestos is a toxin that is very much present in daily life and has the potential to be vastly more dangerous. Widespread use in the past century means that existing asbestos can be readily found in homes, schools, and spaces, both across the United States and globally. A known human carcinogen, asbestos has been proven to cause several illnesses including asbestos cancer, more widely known as mesothelioma, which develops in the linings of organs. The most common type of this rare cancer is pleural mesothelioma affecting the lungs, however it can also present in the abdomen and around the heart.7

The risk of exposure to environmental toxins is inequitably distributed and most impacts marginalized communities. Studies have noted that communities that are low-resourced, with higher populations of people of color are more vulnerable to these exposures.1-5 Unfortunately, these communities are also not positioned to adequately address the source of these toxins. Having fewer economic resources can lead people to live in substandard housing conditions, where toxins such as mold and asbestos are present.6 This is a clear example of how social factors can work to determine one’s health outcomes. Because of the unjust and unequal distribution of these exposures, rectifying and addressing this inequity should be a public health priority.

Heather Von St. James is an 11-year survivor, receiving her diagnosis of malignant pleural mesothelioma just over three months after giving birth to her daughter. She was exposed to asbestos as a child, wearing her father’s work coat while doing her outdoor chores everyday. Asbestos fibers were in the dust caked into the fabric from his construction job, and she unknowingly breathed them in as she wore the coat. This exposure eventually led to her diagnosis with this aggressive, rare cancer at the age of 36.

One of the dangers of this cancer, as well as other asbestos-related diseases, is that it can take anywhere from 10-50 years after exposure to develop. This long delay of symptoms, coupled with their general nature, can make it easy to receive misdiagnoses at first. As such, patients are often faced with a poor prognosis and limited treatment options. Heather faced a prognosis of just 15 months to live without treatment. However, an intensive, experimental surgery that removed her left lung, two ribs, half her diaphragm, and the lining of her lung and heart, followed with chemotherapy and radiation, meant that she outlived her best-case prognosis of ten years and is still celebrating her health today.

Heather’s story illustrates a powerful point about life-cycle illnesses in that they do not always have to be chronic, yet they can touch every stage of the life course. While her exposure occurred as a child, her cancer developed years later and her life was irrevocably changed by her diagnosis. Physically, Heather must live with one lung and faces limits on her activity. She had to give up her career, and she faces lifelong anxiety around her bi-annual scans. Her cancer journey will follow her throughout her entire life.
Heather has taken this experience and channeled it into her passion and calling as an advocate. She now works to support the mesothelioma community by connecting with patients, educating people about what mesothelioma is, and spreading awareness about rare cancers. Speaking from experience, she also lends her voice in Washington D.C., often working to advocate for legislation that supports a full and final ban on the use of asbestos in the United States.

Mesothelioma Awareness Day is September 26th and it serves as an ideal opportunity to call attention to the education, awareness and support this community and cause needs.
To learn more about pleural mesothelioma, check out this website: https://www.mesothelioma.com/mesothelioma/types/pleural.htm

References:
1 Sampson, R. J., & Winter, A. S. (2016). The racial ecology of lead poisoning: Toxic inequality in Chicago neighborhoods, 1995-2013. Du Bois Review: Social Science Research on Race, 13(2), 261-283.
2 Moody, H. A., Darden, J. T., & Pigozzi, B. W. (2016). The relationship of neighborhood socioeconomic differences and racial residential segregation to childhood blood lead levels in Metropolitan Detroit. Journal of Urban Health, 93(5), 820-839.
3 Berg, K., Kuhn, S., & Van Dyke, M. (2017). Spatial surveillance of childhood lead exposure in a targeted screening state: an application of generalized additive models in Denver, Colorado. Journal of Public Health Management and Practice, 23, S79-S92.
4 Winter, A. S., & Sampson, R. J. (2017). From Lead Exposure in Early Childhood to Adolescent Health: A Chicago Birth Cohort. American Journal of Public Health, 107(9), 1496-1501.
5 Hao, H., Chang, H. H., Holmes, H. A., Mulholland, J. A., Klein, M., Darrow, L. A., & Strickland, M. J. (2016). Air pollution and preterm birth in the US State of Georgia (2002–2006): associations with concentrations of 11 ambient air pollutants estimated by combining Community Multiscale Air Quality Model (CMAQ) simulations with stationary monitor measurements. Environmental health perspectives, 124(6), 875.
6 Evans, G. W., & Kantrowitz, E. (2002). Socioeconomic status and health: the potential role of environmental risk exposure. Annual review of public health, 23(1), 303-331.
7 https://www.mesothelioma.com/mesothelioma/types/pleural.htm


Want to Know More About MCH?

The students in the University of Washington Maternal and Child Health
(MCH) Program and in other MCH schools of public health training
programs nationwide created a visual narrative of the public health work
and research they are doing in their communities. The presentation was done with the help of Charlotte Noble and the University of South Florida MCH Program.

You can view the presentation here.  If you are interested in engaging in work that improves the health and well-being of women, men, children, and families then you will enjoy this presentation – it may even give you ideas about how you can make a difference!

The stories help illustrate how MCH makes a difference in the lives of
women and children.


Registration Open – July 2012 MCH Leadership and Legacy Retreat

July 22-24, 2012

Hyatt Lodge, Oak Brook, IL

 Leading in Challenging Times: Innovations & Inspiration

Please consider joining us this summer for the 5th annual UIC MCH Leadership, Legacy, and Community Retreat.  This year’s retreat is exciting! Our focus is on Leading in Challenging Times; however, we will not talk about this concept in ways that you may expect. We will begin with sharing personal stories of our journey and work with women, men, children, and families. Dr. Michael Fraser, CEO of the Association for Maternal and Child Health Programs (AMCHP) will lead us in this process. We will continue to connect with one another through a building common ground exercise followed by a thought-provoking discussion about what motivates us!

During the rest of the Retreat, we will explore and practice various leadership concepts including challenging the assumption that these are indeed challenging times. Change is ubiquitous. Everything is always changing and today these changes are happening at an increasingly rapid pace across all aspects of our lives: the economy, the environment, technology, public health, medicine, music, leadership, etc. As we continue to move forward in ever-changing times, what do we know and do in this day and age to support ourselves, each other, the environment, the economy, and the work to which we have devoted our lives?

We will explore a process that will turn our thoughts about leadership upside down. This will be followed with work about managing change as change is a primary leadership challenge we all face. Finally, we will conclude the program with work on the core act of leadership which involves changing the typical conversations in which we engage so that we can ultimately experience the positive outcomes for women, men, children, and families that we all desire!

The leadership training will be facilitated by Dr. Stephen Bogdewic, PhD, Executive Associate Dean for Faculty Affairs & Professional Development at the Indiana University School of Medicine. Many of us have had the honor of working with, learning from, and being inspired by Dr. Bogdewic. He is an innovative, thought leader. He is connected with the human spirit and our core desires to make an impact. He has taken what he teaches and implemented it in practice to help change the face of the Indiana University School of Medicine.  Click on the following link to view the agenda.

*Please note the event starts on Sunday

 

Registration

Professionals: $325 (early registration ends on 07/06/2012) or $425 (late registration)

Students: $150

Click on the following link to register.

 

For more information visit our website.



MCHB Life Course Resources

For additional information and resources related to Life Course, please visit the Maternal and Child Health Bureau’s website.


MCH Life Course Research Network

For additional information about the MCH Life Course Research Network, please visit their website.

 

 


MCH Webcasts

Hi all.

Here is a link to the MCHCom.com website which includes many interesting MCH-related talks including several about the integration of Life Course into our MCH work.