Enhancing the Vital Connection Between Expectant Parents and Their Care Team

Ideally, pregnancy is a time of anticipation, joy, and promise, the beginning of a new, richer life a family will share together. But, as happens in about eight percent of all pregnancies in the United States, when an unexpected complication arises, it can also become a time of anxiety, confusion, and fear.

“When, in addition to revealing a baby’s gender, a routine 20-week ultrasound discovers an issue that threatens the health of the child, a normal, happy pregnancy can change, for everyone,” says UT Health Austin fetal medicine specialist Kenneth J. Moise, Jr., MD, who serves as the Director of the Comprehensive Fetal Care Center, a clinical partnership between Dell Children’s Medical Center and UT Health Austin. “Immediately, there are questions: ‘Did I do something wrong? How did this happen? How can we fix it?’ A pregnant woman needs answers, and support, from her partner, her family, and from the medical professionals who commit themselves to deliver the care she needs across her entire pregnancy, including preparing her to meet her child’s needs, whatever those needs may be. And while the physical health of mother and child are important, at the Comprehensive Fetal Care Center, we believe care must extend its reach and its support.”

Addressing the Psychological and Social Needs of the Mother During Pregnancy

While many of the reasons for the things they feel during the emotional journey of welcoming a child into the world are related to relationships and preparations, for expectant mothers there are also physiologic causes for the emotions they experience—from hormonal changes, to sleep deprivation, morning sickness, and more. Although the available evidence does not yet offer a definitive answer, it has long been suspected that emotions like stress and anxiety can increase certain hormones that may affect a baby’s developing brain and body.

“So, to help a mother and her child get and stay as healthy as possible,” says Dr. Moise, “truly comprehensive fetal care must deliver sophisticated medical and surgical interventions before or after a baby is born, and also personalized emotional and mental health support that starts early on, and that monitors a woman’s frame of mind over time. That’s why, at the Comprehensive Fetal Care Center, we’re always adding skilled people to our team, and we’re making some exciting new technologies available to our patients. By listening over time, trending a woman’s progress and perspective, and customizing her care to include things like smart-phone technologies that help her stay connected, conveniently and efficiently, to her care team, we make sure that the support an expectant mother needs is always available, whenever and wherever it is needed most.”

Because the Comprehensive Fetal Care Center offers diagnosis, treatment, and management for rare and complex fetal conditions, its multidisciplinary team includes a wide range of experts, including fetal medicine specialists, nurse navigators, genetic counselors, obstetricians, neonatologists, and more. The team also works with many different community physician partners, such as pediatric surgeons, neurologists, and neurosurgeons, orthopedic specialists, among many others. And, most recently, Delaney Herman, LCSW-S, a licensed clinical social worker, joined the team to act as a direct, helpful presence across the entire care continuum.

“Pregnancy is a time of great change and stress in a person’s life, even when the baby is healthy,” she says. “Add in a potential fetal anomaly and, understandably, you’re looking at even more stress and worry. This, along with the normal hormonal shifts that occur during pregnancy, can increase the stressful feelings pregnant people and their partner experience, and even put them at increased risk for depression, or other mood disorders. My job is to help parents recognize these signs and symptoms, link them to resources, and be a warm and supportive presence throughout their pregnancy. Approximately 15-20% of pregnant people experience symptoms of a mood disorder throughout pregnancy or postpartum, and they are very treatable. It’s important to normalize these experiences so pregnant people feel empowered to reach out for help, which can include talking to other parents who share their particular experience.”

New Technology Brings Support for Expectant Parents

Long recognized as providing a uniquely meaningful level of support for an entire range of often serious medical situations, support groups bring people together to share their experiences living through a medical event of their own, or of someone they love. Recently, a perinatal and reproductive psychiatrist, Lisa Boyars, MD, a mental health professional who provides specialized treatment during infertility, pregnancy, postpartum, and parenting, joined the Comprehensive Fetal Care Center. Working together, social workers, perinatal psychiatrists, and neonatal intensive care specialists will coordinate their expertise to connect expectant parents with parents, and former patients, who experienced a particular condition so they can talk, bounce ideas and impressions back and forth and develop their own, personal and interpersonal support structures.

“Which brings us to the smart-phone technology we’re making available to our patients as part of a research study,” says Dr. Moise, ending on an area of particular interest for him and his team. “The interactions we have with our patients in the clinic are important and useful. But most of a person’s life happens between office visits. In healthcare, we learned a long time ago, that a trend that follows a patient’s progress over time is very valuable, and tells us a lot by connecting the snapshots we see, which are those office visits, into a patient’s story.

“That’s why we’re currently working with a technology company on a research project that allows us to push validated survey tools for depression and anxiety on a regular schedule to the smartphones of our patients who choose to participate. By answering these questions, our patients will give us important information about how they are doing, helping us determine when and how we can best help them.

“Personally, I think this kind of technology, combined with things like Telehealth appointments that, when used appropriately, save patients the time and trouble of driving, parking, taking time away from work or school, are the future of how patients and their care providers will work more closely together. And that’s a wonderful thing about the Comprehensive Fetal Care Center. As an academic practice, associated with the Dell Medical School and The University of Texas at Austin, we are committed to making the care we deliver today the best it can be, and also to doing everything we can to make the care we deliver tomorrow, even better. Our patients can help us achieve that goal by being among the first to use some of the digital tools we’re making available, so in a sense, our patients are not only our partners in their own care, but they are also our partners as we work to make tomorrow healthier for everyone. I think that’s really exciting.”

For more information about the Comprehensive Fetal Care Center, click here.