SLU/Glennon support of postpartum moms via text is growing

Lisa Johnston | lisajohnston@archstl.org
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Sarah Caldera Wimmer remembers how overwhelming it felt to have two children 18 months apart. Danis Pediatric Center turned out to be a support not just for her sons' care, but also her well-being.

Caldera Wimmer was among the first participants in a St. Louis University research program to support mothers through post-partum depression via text messages. The Happy Mothers, Healthy Families program was launched in 2013 to evaluate the feasibility of sending supportive text messages to mothers of varying backgrounds at risk for postpartum depression.

More than 4,100 text messages were successfully delivered to 54 mothers. The informative messages were simple, providing the opportunity for a follow-up care via phone call. Other messages were motivational. Participants also received access to traditional counseling services.

The uplifting messages helped Caldera Wimmer know that she wasn't alone in her parenting journey. "The questions were like, 'Did you know it's common for moms to feel like this?'" said Caldera Wimmer, who had her third child a few months ago. "And it was great, whether you could take a second to read the message right then or wait for another moment to read it. It was a nice little moment of mindfulness in the middle of a crazy day."

Staff at Danis Pediatrics also helped her connect with a therapist on several occasions and offered additional breastfeeding support.

Dr. Matthew Broom, associate professor of pediatrics at St. Louis University and SLUCare physician at SSM Health Cardinal Glennon Children's Hospital, formed the program, which primarily identified mothers who visited the Danis Pediatric Center at Cardinal Glennon for well-child checkups. The program received nearly $320,000 in grant funding from the Maternal Child and Family Health Coalition in 2012. He and several colleagues authored a research paper in 2015 with the results of the study.

In July, Broom was awarded nearly $428,000 in grant funding from the Missouri Foundation for Health to launch a new two-year program, Bridge for St. Louis, which will serve as a portal for obstetrics patients at SSM Health St. Mary's Hospital at risk for perinatal mental health issues. The goal of the program is to increase their health care literacy to make good health care choices for their children, thus lowering the risk for infant mortality.

"So much of how a mother is doing can be linked to how her baby is doing," said Broom. "We're now moving toward how do we advocate for the children who will unfortunately not be set up with the success they deserve if we don't address the care for them."

Well more than half of parents of pediatric patients at the Danis Pediatric Center have low health literacy, he said, and are identified through Newest Vital Sign, a screening tool for low health literacy.

"We ask parents to evaluate a food label, for example," he said. "It's really sobering to see the inability to interpret it. If that's the case, your ability to navigate a health care system is challenging."

Bridge for St. Louis will connect with mothers in need of mental health care while they're still receiving prenatal care, instead of encountering them through their child's doctor visit. Broom anticipates about 50-60 mothers will participate in the first year, with more slowly added over time.

"Instead of me being dependent on a mom failing a screening at a pediatric visit, I will already know this mother who has a higher likelihood of perinatal mental health concerns, because she's already disclosed this to our OB partners," Broom said. Support staff will be available to follow up with mothers through one year postpartum and to provide education on choosing a pediatrician and scheduling regular pediatric visits and vaccines, among other topics.

The majority of mothers who participated in the text messaging program were single and do not have a support system. "There is a major disconnect from the time you are pregnant — and if you are resource poor, you have mental health concerns during pregnancy — then we're at delivery and immediate postpartum. And then we don't acknowledge your existence until you're pregnant again. This is bridging that care and setting them up for success."

The text message model was successful in part because of the simplicity of the types of messages sent and the convenience factor of receiving messages. Broom said text messaging is endemic, because of the wide availability of mobile phones, and crosses societal barriers. "It's the type of communication where you put content out there and the receiver can use it when they are ready to receive it. That has a lot of value." 

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