I had a dream last night. In it pregnant women from all over the community gathered at community wellness centers. They came with their big bright bellies in colorful array. They were in all stages of pregnancy. The experienced pregnant women acted as mentors to the first time pregnant women, coaxing them along and encouraging them. As they entered these 'wellness centers' they were greeted and welcomed to 'their' center. There were no waiting rooms because it was more like a community center- a place that belonged to them- they were not visitors, they were owners. As the women entered they went straight into the communal learning center, a big open room with sofas and comfy chairs all around. The women sat and told their stories and asked their questions facilitated by a nurse, and counselor/social worker. The nurse did a brief presentation on something birth related, and again the women asked questions, sometimes answering among themselves, not always looking to the professionals to have the answers. After about an hour, the sharing session ended and the women began to wonder out of the community room into an assessment area. Here they began to dip their own urine, and weigh themselves, etc. and record their findings on information sheets left for them to do so. There were also computers available for the women to enter their information into their computerized patient record that they kept possession of (not the healthcare organization). After their self assessments, they had one on one time with their midwives. This time consisted of relaxed conversation and positive reassurance. There were no exam tables, again only sofas and chairs in private attractive rooms. There was no medical paraphernalia to be seen. If the midwife needed a measuring or assessment apparatus, she carried it in with her and took it out again when she left. If she wanted to examine the woman's body, it was done on the sofa, but there was little of that. The time together was mostly talk and this talk was mostly initiated by the women, not the midwife. If she elected to have her mentor or partner with her, then it was so. When the time ended, there were hugs all around before the women departed and went on about their days.
When I woke up this morning, I knew I had dreamed of a new model of prenatal care. It was on my mind because I had spoke to my academic advisor about my research project for this semester on the topic of infant mortality and the impact of breastfeeding. She asked me what else impacts infant mortality and I told her the delay or lack of prenatal care. When she ask why there might be a lack or a delay, I told her about all the factors that influence a woman's (especially a woman already at high risk) choice not to seek healthcare during pregnancy. I talked about our questionable approach to prenatal care and how it could much be improved upon. I'm sure these thoughts led to the dream. Many of these features I've seen enacted, but not all together. I've read that when we think a thing, we create it on one level, when we think and speak it, we create it on yet another level, and when we think, speak, and act on it, we bring it into being. Now is the time to think, speak, and act on new models of care for pregnant and birthing women.