Chronic condition / Preterm birth
Monica is 29-year-old African American woman in her first trimester of pregnancy with her third child. She works as a financial analyst and on top of spending time with her husband and two daughters, she is completing her MBA.
Her busy work and family life has led to a sedentary lifestyle complete with fast food meals that are easy to pick up after a long days work. This lifestyle has resulted in weight gain and the diagnosis of hypertension two years ago. After regularly seeing her primary care physician to address her weight and high blood pressure, she was advised to buy healthy and fresh produce for her and her family, but because she lives in a rural area designated as a “food desert”, she has to drive over 45 minutes to a grocery store limiting her consumption of such foods.
Her OBGYN has warned that her chronic hypertension could lead to preterm delivery along with other complications affecting her unborn baby. Although she wants to keep her baby safe and healthy, this news just exacerbates her already stressful day-to-day life and leaves her feeling hopeless and alone.
Social Determinants of Health
Ashley is a 24-year-old Caucasian woman in her second trimester of pregnancy with her second child. Her first child was born preterm and was required to remain in neonatal care for one month after birth. She works as an hourly daycare provider while her husband travels often as a sales representative. Working as a daycare provider, one of the perks is free childcare for her toddler, which is crucial as her family and friends live hundreds of miles away.
Due to her previous preterm pregnancy, her OBGYN has recommended weekly progesterone shots starting immediately which requires approval from her state's Medicaid program. With her husband traveling with their only vehicle and the inability to take off work, Ashley has already missed two appointments and is struggling to keep a consistent appointment schedule.
Often exhausted at the end of the day, Ashley struggles to find a support system and wishes there was an easier way to connect with her provider on a consistent basis.
Aiden was born six weeks ago to first-time mom Jennifer. Due to complications during labor he was delivered via cesarean and has been primarily stable after birth. Aiden has been having a hard time breastfeeding causing mom Jennifer to supplement with formula as needed.
Jennifer has been suffering from extreme mood swings and depression after Aiden’s birth and has tried mentioning this while at Aiden’s pediatrician appointments, but is simply told that the “baby blues” are normal and that she’ll be feeling better soon.
She has also just returned back to work and has enlisted Aiden’s grandmother, Sandra, to watch him during the day. His grandmother knows that breast milk is beneficial to a newborn's development, but insists that cow’s milk is much less expensive than formula and will “do the trick” if he won’t breastfeed.
Watching a newborn has been very taxing, so whenever Aiden is tired, she lets him sleep no matter what position he’s in (after all, her kids did just fine sleeping on their tummies). She of course wants the best for her grandbaby but insists that things have gotten too complicated since she raised her own children.
Although Jennifer sternly asks for her mother Sandra not to smoke cigarettes in the house, she will occasionally smoke inside when it’s cold outside, leaving Aiden to inhale smoke from time-to-time.
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