Connected care – Amani’s story

Amani is unexpectedly pregnant with her first baby. She’s a refugee and has recently arrived without her husband. She is unfamiliar with the health system in her new country. She’s scared and doesn’t know what to do: she feels lost. Thankfully, a new friend has recently had a baby. Amani calls her and gets a number for a publicly funded midwifery group practice.

From this first call, Amani feels so reassured. She meets up with her midwife, Anne, who arranged for a translator to be present so she could explain the pregnancy and birth care Amani can expect, including when her visits will be, what the health system here is like, and how she’ll be looked after during in the early weeks of parenting. Amani feels relieved.

Amani decides on a 20-week ultrasound scan. The news isn’t good: there may be some problem with the baby – no-one’s sure yet. Right away, Amani meets with Anne and the translator to discuss the results and work out a plan. She is connected with a feto-maternal specialist who she’ll see as needed during the pregnancy to monitor the baby. The doctor and Anne communicate about how they’ll work together for the best outcome for Amani and her baby.

As the weeks go on, Amani continues to see Anne with the translator present and they develop a close bond. She can discuss all her concerns, and learns so much about what might happen at the birth and how to cope, and about breastfeeding and parenting. Even though Amani is concerned about her baby’s wellbeing, she’s reassured that Anne or her back-up midwife will be with her no matter what happens, and that she has someone making sure everything is ok.

Anne connects Amani to a social worker who can help her work out some of the challenging details of her life in this new country, and she also recommends a physiotherapist when Amani begins to get debilitating back pain caused by a previous injury. Amani is relieved that Anne can help her navigate this system, and she feels empowered in her choices and knowledge with everything she and Anne talk about.

When labour starts, Amani calls Anne. Anne stays with her throughout labour. As arranged, the neonatal specialist arrives close to the time of birth to be on hand if needed, but it’s Anne that Amani is trusting to help her through this experience. She understands that a gentle, physiological birth will give her baby the best start in life.

The birth goes beautifully and the baby is able to stay with Amani and breastfeed right away. They are able to go home when Amani feels ready after the birth, knowing that Anne will be visiting at home and making sure Amani has everything she needs for herself and the baby.

Over to you

Reading through Amani’s story, how do you imagine her pregnancy, birth and early weeks of mothering might have been if Amani was in a standard fragmented maternity care system?

What challenges might she have faced navigating the system?