Curbside Care for Moms and Babies provides comprehensive mother-infant dyadic care during the first six weeks of life on Boston Medical Center’s Mobile Unit—at the curb! Often called “the fourth trimester,” the first six weeks of life are a critical period of time for mothers and babies setting the stage for future health outcomes. However, 40 percent of mothers at BMC never return for a post-partum appointment for themselves.
Our Curbside Care program aims to mitigate barriers to care which have increased during the pandemic. In a typical Curbside Care appointment, a nurse practitioner will see the infant and a certified nurse midwife will care for the mother. Moms and babies are recruited from our newborn nursery, and instead of being discharged with separate appointments in the BMC pediatric and obstetric clinics, they are discharged for follow-up care together on our Mobile Unit. Each time either the mother or the baby is visited, the other one will also have an appointment.
Curbside Care provides the full range of comprehensive services that would be provided in the hospital clinic including: feeding assessments, lactation support, evaluation for jaundice, screening for post-partum depression and hypertension, and the full range of contraceptive services. In this model, there’s an opportunity for four or five visits for both mom and baby in that crucial six-week timeline—this is many more touches than traditional models provide. Then, after six weeks, there is a warm handoff of both the mother and the baby to BMC providers.
Highlights of our program include:
- A certified lactation consultant at all sessions, and distribution of breast pumps when needed.
- A Spanish speaking provider at all sessions, and a Haitian Creole speaking provider at half of all sessions.
- Provision of diapers and wipes, feminine hygiene products and gift cards for food for all dyads.
- Thermometer distribution and education to all dyads.
- Inclusion of fathers/support people at multiple visits, while our current hospital policy limits the number of family members allowed at certain visits.
- Reducing public transportation use by moms and babies during a pandemic.
- Immunization of infants at six weeks (and older siblings too!).
- Partnerships with Project REACH, New England Mothers First, Brewster Ambulance and Vital Village.
Curbside Care for Moms and Babies was conceived in the context of the pandemic disproportionately affecting BMC’s patient population. However, as the team works intensely with moms and babies at the curbs outside of their homes, they have come face-to-face with the unimaginable hardships BMC families endure at baseline—independent of the pandemic. The team has visited: a mother with a history of polio who is wheelchair dependent, a single mother without any support system in place who was living in an attic, a developmentally delayed teen mother in the care of her mother, a newborn in the care of his grandmother after the newborn’s mother was readmitted to the ICU, refugees with extremely limited resources, and dyads living in multiple shelters in Boston. For these patients, Curbside Care is invaluable. Now, BMC is starting to collect data and is currently working to streamline linkages back to primary and behavioral health care for mothers after graduation from the program.