The Monarch Centre for Maternal and Newborn Health, which opened in Ottawa last year, aims to offer new moms crucial post-hospital support, writes Sonia Mendes.
About six weeks ago, Kelli White’s baby girl was born a month early. She weighed only four pounds and developed jaundice after leaving the hospital.
That prompted White’s doctor to refer mom and baby Audrey to the Monarch Centre for Maternal and Newborn Health.
“I was three weeks postpartum and I was feeling vulnerable,” White recalls. “The staff at Monarch bent over backwards to accommodate us – to say the experience was amazing is really an understatement.”
The Monarch Centre (monarchcentre.ca), which opened in Ottawa just over a year ago, is a multidisciplinary clinic where patients can access the combined skills of newborn health physicians, nurses and lactation consultants. The centre aims to give new mothers post-hospital support to provide the best start for their babies.
Dr. David Millar, the medical lead and executive director at Monarch, provided a bilirubin screening for little Audrey – a blood test that determines the severity of jaundice and measures the potential for complications. He provided Audrey’s parents with his assessment, so the family could decide how to proceed.
“It wasn’t an easy position for us to be in,” says White. “But the doctor helped us by giving us absolutely all the information we needed.”
Audrey was readmitted to the Civic Hospital, where she stayed in special care for a week to resolve her jaundice.
Bringing Home Baby and Breastfeeding Workshop
In addition to offering a wealth of postpartum services, the Monarch Centre for Maternal and Newborn Health also offers a preparation and breastfeeding workshop for expectant parents.
The Bringing Home Baby & Breastfeeding Workshop focuses on the first week of life at home, particularly the first 48 hours.
The two-hour workshop costs $20/family, and aims to build confidence and realistic expectations in terms of feeding a newborn and the new role of parenting.
Workshops are held at 152 Cleopatra Drive, Suite 108, at 5:30 p.m. on the first Tuesday of each month, May through August 2015 (May 5, June 2, July 7 and Aug. 4). To register, call the Monarch Centre at 613-627-0795.
Monarch rented a breast pump to White, and a lactation consultant advised her how to best maintain her milk supply while Audrey was in hospital.
Then, as the family was leaving for the hospital, Monarch’s staff phoned ahead to ensure they would be ready and waiting to receive the baby.
“They called ahead for us, so they even had her paperwork done when we got to the hospital,” says White, adding that Monarch’s services were covered by OHIP.
She knows firsthand the burden of coordinating special postnatal care – Audrey’s two older siblings, now ages six and nine, also arrived earlier than expected.
“I think because Audrey was my third preemie, I was just so impressed with Monarch – because I’ve navigated through the process before,” says White, recalling how she had to crisscross the city for blood tests, breast pump rentals and help from a lactation consultant.
“To have all those services in one place – my mind just kind of exploded,” she laughs.
“It’s not just emotionally beneficial, but it’s also a physical relief to not have to cart a newborn around, not to mention my other children.”
Millar says that sense of relief is just what Monarch Centre aims to provide.
“We do discharge planning, transitional care, what we consider a ‘soft landing,’ he says. “It’s a nice way to touch down after a relatively short stay in hospital, so you don’t come crashing down.”
In addition to providing access to a physician, nurse and lactation consultant, a care coordinator at the Monarch Centre acts as a crucial liaison between the centre and the hospitals, as well as Ottawa’s community-based partners.
This collaborative approach means patients can be connected with family doctors, pediatricians, City of Ottawa programs, newborn screening services, postpartum mental health programs and more.
And with hospitals phasing in a new, shortened timeline for discharging moms after childbirth, these services are more important than ever.
“The trend is a shorter stay in hospital,” says Millar, who heads the maternal and newborn care division at the Ottawa Hospital.
He says the schedule for a vaginal delivery is typically “one sleep” in hospital, while delivery via caesarean section warrants “two sleeps.”
“We actually don’t think it’s a terrible thing but it has to be associated with proper follow-up care.”
The idea for Monarch Centre was born out of a breastfeeding study last year, sponsored by the Ottawa Hospital Research Institute and funded by the Ontario Ministry of Health.
The study’s premise, says Millar, was that postpartum women who were sent with their baby to a community based lactation support centre would have higher rates of breastfeeding than women who spent a couple of days in hospital – with some support from in-hospital nurses and lactation consultants – and then went home to handle things on their own.
The preliminary results of the study back up the theory – indicating an increase in exclusive breastfeeding rates in the six per cent range for the Monarch group versus the control group.
Importantly, there was also no increase in hospital readmission.
“What we’re saying is one day with a community-based clinic like this – with a proper, systematic follow up – is actually superior to two days with nothing,” he says.
One of the most striking results from the study was the heightened patient satisfaction rates.
“They were through-the-roof improved for the community-based clinic versus staying in hospital,” says Millar. “In many ways, people want to be in their own homes, but they also need the support that they can get from experts.”
Such was the case for White, who juggled the needs of her newborn and her family with Monarch’s help. “It gave us the freedom to go home for our older kids,” she says.
“If I knew someone who was needing postpartum care, I would wholeheartedly recommend they go there.”
Photo: Billie MacDonald