Cutbacks hurting infants, or help for moms who need it most?
A revamped program aimed at helping women before and after they become new moms is either an improvement or a step backward depending on who you talk to.
Until now, a public health nurse has offered a home visit to every new mom in Cowichan, usually within 24 to 48 hours of hospital discharge. Cowichan Tribes and midwives schedule their own visits.
Under the redesigned provincial Healthy Start program, a Nurse-Family Partnership program will provide visits from public health nurses to low-income, first-time mothers under the age of 25 from the third trimester of pregnancy until the child's second birthday.
But mothers not deemed at risk will be telephoned within 48 hours of hospital discharge and will be asked how they and the baby are doing. The new mom's response to this will be the barometer for follow-up advice and to gauge whether a home visit is necessary.
That has health practitioners worrying the program will disadvantage many new moms and newborn home visits by public health nurses will not be available to everyone who needs them.
For example, they say, you can't tell over the phone whether a baby is jaundiced, and a new mother may not recognize the symptoms.
According to the government however, some new moms don't need the individualized home visits.
And that's made Cobble Hill mom Amie Roman see red.
"We're so blessed with our community nurse program. If I hadn't had that initial visit, I wouldn't have known where to turn or who to ask," she told the News Leader Pictorial.
"Without those home visits, serious issues like breastfeeding problems, neonatal jaundice and postpartum depression may fall through the cracks," she said.
Cowichan Valley MLA Bill Routley agrees.
"We're (NDP) concerned that cutting back newborn nurse visits could lead to a failure to recognize life-threatening illness," contends Routley.
"As well, the B.C. Medical Association says new mothers could be kept in hospital longer if they're not scheduled to receive a nurse visit. That's an extra cost to the system."
The government is terming the new program for at risk moms a reorganization of current services.
B.C. Nurses Union president Debra McPherson has called it a good program that shouldn't come at the expense of other services to newborns and new moms who need support but fall outside the new program's parameters.
And that's the catch.
The program's $23-million price tag is to be absorbed within health authority budgets, meaning no new money and no new nurses.
“You have to get into a newborn's family home before you can assess their needs," said Duncan's Wendy Robb, a public health nurse and lactation consultant speaking as a union rep at the BCNU media conference.
"Assistance in the early days is essential for breastfeeding," she added.
"Not only does the nurse assess the health and well-being of mother and child, but we assess the social supports in the home. We do all the public health messaging — such as urging mothers to stop smoking — and refer them to other services in the community. It's a package deal."
But according to Health Minister Mike de Jong there are mothers who have an extensive support network and might not need the support.
"They have relatives. They have midwives. They have family physicians who are there for them on a regular basis," said Health Minister Mike de Jong in a statement at the legislature earlier this year.
Provincial health communications' Kristy Anderson says the system is already being used in parts of VIHA, and a full launch of the program is expected in early fall.
"When we speak about families first, this is exactly what we are talking about: putting vulnerable women and their children first and growing healthy families," Anderson said.
"How health authorities manage these changes will be up to them," she confirmed. "It is the understanding of staff in the program at VIHA that there will not be staff cuts."