3.3 Improving social supports
According to the Public Health Agency of Canada (PHAC, n.d.-c), social support networks are associated with improved health. Not only can healthy social relationships provide emotional support and contribute to feelings of being cared for and respected, it appears they may also help guard against health problems through a sense of fulfillment and overall well-being. Through specific roles – such as helping with problem solving, increasing the ability to cope with adversity and promoting feelings of control when facing challenging life circumstances – social supports may protect and even promote the health of individuals and families (PHAC, n.d.-c).
In the International Epidemiological Association’s Dictionary of Epidemiology edited by Porta (2014), social network is defined as “the network of individuals, groups, organizations, institutions, and social resources to which individuals and groups are connected to or isolated from. Health status has been found to be positively associated with the extent of social networks” (p. 265). People who work in a professional capacity with pregnant individuals and their families may have opportunity to be a formal source of social support.
Watch as Dr. Leslie Roos, assistant professor at the University of Manitoba with appointments in Psychology and Pediatrics, discusses coping with stress in pregnancy and how health providers can take specific steps to support their clients in this stage. Roos explains how providers can intervene by making time to ask about how their clients are doing in terms of their stress levels and mental health, in addition to linking interested clients with further needed supports. She stresses the importance of helping clients connect with care that aligns with their culture.
Next Dr. Robin Williams talks about the relationship between mental health and prenatal behaviours. High priority aspects of prenatal care include support first to pregnant individuals and secondly to the people with whom they are closest.
An analysis of the Canadian Maternity Experiences Survey data supports Williams’ statements. For instance, the Public Health Agency of Canada (2014c) fact sheet, Pregnancy and Women’s Mental Health in Canada: Results from the Canadian Maternity Experiences Survey, reveals the 13% of Canadian women surveyed who reported they had no or little support available to them during pregnancy had higher incidences of smoking, use of alcohol, and physical or sexual abuse than women who reported higher levels of social support.
In the next video, Dr. Wanda Phillips-Beck recommends strategies for health care providers such as empowering social supports in Indigenous communities (including grandmothers and family members) so they are better positioned to provide circles of support during pregnancy and breastfeeding transitions.
Quality of prenatal care
Dr. Maureen Heaman talks next about what her Canadian research found was important to women about quality of prenatal care. She gleaned the information through interviews with women and health care providers at five sites across Canada while developing the quality of prenatal care questionnaire tool.
If you have received prenatal care or could imagine being on the receiving end of prenatal care as either a pregnant person or partner, what qualities would be most important to you in a health provider?
What aspects of prenatal care would be most important for you to feel satisfied with your prenatal care experience?
Consider Heaman’s research findings regarding important aspects of quality of prenatal care as you listen to what Monica relays regarding her own experience of prenatal care over the course of three pregnancies.
The continuity of relationships with health care providers over time builds trust when it is based on sound judgment, accurate information, as well as competent, genuine, and non-judgmental care. Midwives can play an important and much needed role in the provision of prenatal care. When care requires expertise beyond the midwife’s capacity to practice, a referral to an obstetrician is made (as we can see from Monica’s example). According to the Canadian Midwifery Regulators Consortium (2013), midwifery care is legal and regulated in some (but not all) provinces and territories in Canada. Explore more information about midwifery from a global perspective on the WHO webpage Quality Midwifery Care for Mothers and Newborns.
Public health nurses are frequently involved in the postnatal period in partnership relationships with families to promote health and prevent illness and injury. Listen as Williams describes additional aspects of a public health nurse’s practice.
Read the next fact sheet, Prenatal Education in Ontario: The Evidence for Prenatal Education, on the Best Start website. It discusses evidence-based benefits of prenatal education and other important considerations, such as barriers and facilitators.
Access to prenatal care
In addition to addressing health topic learning needs during preconception and pregnancy, public health nurses educate people about community resources that may provide assistance with specific areas of need. In many instances, these resources may also promote opportunities for the important development of new relationships. Many other determinants of health – such as education and literacy, healthy behaviours and access to health care services – may be further strengthened through these processes that expand social support networks. For people who work with prenatal families, an accurate knowledge base of what is available within a community is key to building these linkages so that they are appropriate for both the need and the context of each individual or family.
In Winnipeg, Manitoba, public health nurses within the Winnipeg Regional Health Authority have been one of the many partners working with other agencies and health care providers to increase access to prenatal care. Listen as Heaman describes the experience of seeing her research implemented into practice through four specific initiatives.
Pregnancy is not always a time of easy transitions. The Government of Canada (n.d.-a) reports for instance that experiencing prenatal depression can make seeking health care challenging. Scroll down the webpage Your Guide to a Healthy Pregnancy on the Government of Canada website to read about mental health in pregnancy and some ways partners can be supportive.
Featured next are examples of websites and programs which may be helpful and relevant to childbearing-aged populations, depending on context and needs. Joining a supportive group of peers who are also pregnant is one of the suggestions outlined in the preceding reading that can be of benefit to one’s mental health during pregnancy.
From a global perspective, there are many practices that may influence outcomes at birth and in the early postpartum period. Read the “Priority strategies” and “WHO Response” sections in the in the Newborns: Improving survival and well-being fact sheet on the WHO website.
Future directions in child development practice
There are many windows of opportunity to influence child development throughout the life cycle. Listen as Dr. Stephen Lye, professor in the Departments of Obstetrics & Gynaecology, Physiology and Medicine at the University of Toronto as well as executive director of the Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, describes this concept as a life cycle for child development interventions, where each phase presents unique intervention opportunities.
