How Can We Improve Postpartum Care for Mothers with Substance Abuse Disorders?

  [00:00:00] Jared: Hello everyone and welcome back to the MedDesign podcast. Today we're honored to have with us Sarah Hobgood and her colleague Chelsea Hunter. Sarah is a registered nurse with a deep passion for maternal and perinatal mental health. Honed through nearly two decades of experience on the mother baby unit.

Sarah is a certified lactation consultant, providing crucial support to mothers navigating breastfeeding challenges during a critical time. Sarah's dedication extends beyond clinical care. She's a vocal advocate for mothers in the NICU, particularly those facing the complexities of caring for babies going through withdrawal.

Her commitment to improving the well being of babies in the NICU is reflected in her work on the Hope Recovery Project, further demonstrating her dedication to supporting mothers and families facing difficult circumstances.

With their unique perspectives as nurses and advocates, Sarah and Chelsea offer invaluable insights into the challenges and opportunities for innovation in the NICU and beyond. So today we'll delve into their experiences and explore how advancements like the couple care bassinet can improve outcomes for both mothers and babies.

So welcome Sarah and Chelsea, we're happy to have you.

[00:01:03] Sara: Thank you. Thank you.

[00:01:05] Jared: Yeah, let's just dig in. So if you could just share with us a little bit about your background and what really drew you into focusing on the postpartum experience for mothers, especially with substance abuse disorders.

[00:01:16] Sara: I've always had a passion for working with moms and babies. Once I had my oldest almost 22 years ago. And just started becoming aware of the issue that there were mothers that were struggling with substance use disorder. And their infants were struggling with withdrawal. And just could always see their struggle and just started to develop a passion for working with them.

I felt a little bit of a connection with them because the more I learned a lot of them have what it's called aces or adverse childhood events. And I had several of those, and that's very common in mothers with substance use disorder. There's a big connection. With that and my family and myself we have a lot of mental illness in our family and actually what really just narrowed my focus with them was a time it was several years ago, but I was, like, in the middle of a depressive episode and I was just laying in my bed.

And a lot of people don't realize that there really is a physical component, a physical pain when you're dealing with depression or anxiety. And I just remember thinking in that moment if I didn't have the support and the hope that I had. Because I was just, I was suffering, I was like miserable and I could see how someone if they didn't have support and they, didn't have a way out might go to a substance to find relief, not just to have a good time, but just to find a moment's relief from their suffering.

And since then I've just really focused on them and just really feel a connection to those moms.

[00:02:56] Jared: Yeah, thanks for sharing that with us. And I feel like mothers that are, challenged with substance abuse, they don't really get a lot of empathy from people.

And I guess, If you could maybe dive into just a little bit deeper into what are some of the unique challenges that mothers with substance use are facing, especially during the postpartum period.

[00:03:16] Chelsea: All right. So I'll talk to that a little bit. So a lot of the extra challenges we see, and this is on top of the baseline challenges.

All moms that are in their postpartum period are facing significant challenges whether they have substance abuse, history and things that they're dealing with or not. And so when you add in that component of the substance abuse, you're also seeing less family support. They are coming into the hospital with already feeling guilty.

They feel shame. They are already worried about what people are going to say about them, how they're going to be treated, because likely in lots of situations up till now, they have already been treated very poorly. We've heard of situations, we've experienced situations where patients have told us, where other people have told us that all it takes is one simple interaction, one negative comment from one provider when they come in that can, truly almost change the entire course of this whole postpartum experience they're going to have.

So there's those challenges that they're dealing with. In addition to, I think, unfortunately, there's also a lot of issues where providers, doctors, nurses are hesitant to provide the same level of pain relief, pain control, and medications to patients that have this history of substance abuse for biased reasons.

So they're going to have that physical difficulty in addition to all of the mental and emotional difficulty. And then that's not even adding in the extra challenges that they're getting ready to face with a newborn who's going to withdraw. You're taking one of the hardest times, truly physically and emotionally challenging times for a woman, for a family, and then you're adding in all of these extra components that just almost set them up for failure. And we're a little bit helping with that in the way that things are right now.

[00:05:13] Jared: Yeah. It reminds me of a family member that was also suffering some from substance abuse and was in the hospital and I just remember the treatment that they got from folks and it was like they anyways just reminds me that people are not understanding.

And I also was curious of if you're not going through substance abuse, what are some of the typical challenges that you're experiencing anyways?

[00:05:37] Chelsea: Severe lack of sleep. There, there is no sleep to be had. Whether you have a withdrawing baby or not, you are in, intense physical pain, especially our postpartum moms that have had C sections, which in a lot of cases, the moms we have that come in with a history of substance abuse, they end up having C sections so they are in intense pain, so you've got no sleep, intense pain, you are learning how to take care, whether it's the first baby or not, learning how to take care of this new human being while you're trying to recover yourself and for anybody that is an extremely difficult and challenging time period.

[00:06:18] Jared: I can imagine. And also in your role as nurses, one of the many sort of hats that you wear is as an advocate as well. And so in your work, how do you really approach patient advocacy for such a vulnerable group of new mothers?

[00:06:30] Sara: One thing we both actually have something to share. So in caring for these families, a lot of them, like Chelsea was saying they don't have a lot of family support. A lot of them are single moms and they are just sleep deprived and struggling and they may be in the hospital for a little extended period of time.

And have other things that they need to attend to see their other children, go to their doctor's appointments other things that they need to do to be compliant, and we have one of the hospitals that I've worked at had a very good volunteer program, and I took that and started a cuddler program specifically for infants that are going through withdrawal and did a whole training for them to help educate the volunteers on the special and unique needs that those babies have, because they're going to be definitely more fussy and harder to calm and to make sure that they had a accurate understanding of what that mom was going through and just so that they could walk into that room and offer a supportive presence. And so they would come and and sometimes we would schedule it and sometimes not, but they would come and sit there. And hold that baby for two hours. We would tell the moms you can leave for two hours.

Like we want you to do some self care. We have somebody that's going to hold your baby the entire time. So you don't have to feel guilty about it. Or if there were like a couple, mom and a dad, like sometimes they would go to dinner. And that was something that I saw a lot of just fruit come from that and I'm hoping to get that started back again at some point.

But that was one thing that I did to advocate for our patients because I just saw that they just needed a little extra help.

[00:08:17] Ty: Such an impact. Yeah, no, just like those early days being able to have that little moment to just feel human again after, like just dealing with a brand new human. Yeah.

[00:08:27] Chelsea: And speaking to what Sarah just said, and what you just said, Ty, that's another thing that at least I've noticed is that some of these moms, these families, they think that they don't deserve that.

They think that they don't deserve the chance to be able to do that. That they're not worthy of it. So offering that to them helps. And then another advocacy piece of it goes back to what I was saying before with the challenges with the medication. So we, have to be strong advocates, when it comes to the providers that we're dealing with, when we notice that these moms and or these babies need additional medication assistance that maybe isn't being noticed or given for whatever reason they're holding off. So we have to be able to stand up and say, hey, this is important. We need it. I think you need to recognize that. It's the time to do it. And so there's been multiple experiences I've had, where we've had to work through that.

And then also on the other side of it, which this 1 to me is almost harder is. I know there's been a couple situations where I've also had to advocate for these patients with coworkers and with other nurses that are taking care of them and working with them that maybe don't have either the same connection, the same understanding for them.

And, I've heard the words more than once before from caregivers, from nurses who, are frustrated in caring for these patients and say, oh this is their fault. They did it to themselves. And it's just as soon as you hear that, you're like, oh, gosh, can I please let me help you?

Let me know. Can we talk about this for a minute? Because don't take that in there. So I think there's a lot of advocacy within our own staff with each other.

[00:10:11] Ty: I'm curious, Chelsea, Sarah, how did you guys discover this shared passion for patient advocacy?

And how did you jump into this together?

[00:10:18] Sara: I shared a little bit already about, just with having a similar childhood upbringing and the ACEs, but I will let Chelsea kind of jump in. Share her story a little bit.

[00:10:26] Chelsea: So this particular one and I'm not really going to speak to past things here.

This is just directly related to this situation. It was so I'll first bring up what kind of got me into postpartum nursing to begin with. I have a number of years of nursing experience before I came over to the postpartum side of things, a lot less than Sarah. So after I had my second baby I truly believe that if there are times in life where a person can be significantly affected by other people is in the postpartum time period.

After I had my second baby, I was, basically, I had two nurses that still work with me today that impacted me enough to completely change my course. I completely went from a totally different type of nursing with what my plan was, what I love to do. And they made such an impact on me that I was like, this is what I got to do.

I want to do for other people what they did for me. And so that's when I got into the mother baby nursing that, I still do now. And then that's when I was introduced to our, nest units or units where we take care of families with substance abuse and babies that are withdrawing.

And it was actually after 2 particular families in kind of a short period of time that were really struggling. And I was lucky enough to get to spend a decent amount of time with them more than we normally get to spend with certain families, because of our schedules and things like that.

And some of the compounded situations together, it affected me enough that at that point, I was for many reasons. I was frustrated. I was upset. I was angry. And then Sarah and I just happened to have a conversation about it one day in a break room at work, just talking about how I was feeling about all this.

And then literally, that is when this Hope Recovery Project started. We were both like, you know what? Let's do it. We've got to figure this out. To do better.

[00:12:26] Sara: We felt like we could do so much more for them.

[00:12:29] Jared: And maybe can you dive into the Hope Recovery Project a little bit? I know that's your something that you've been working on.

[00:12:34] Sara: So as Chelsea and I began to just as bedside nurses and just talking with other postpartum nurses, we started to realize some patterns that were happening. A lot of the hospitals now have gone to a model that's eat, sleep, console.

Which is wonderful and basically it's, can that baby when they're going through withdrawal, are they able to eat? Are they able to be consoled by their caregiver? Are they able to sleep, you know for uninterrupted for at least an hour? And so in that the baby stays in the room with the mom and essentially the mom is the treatment and we started to see that these moms were very underprepared to, most moms are going to be overwhelmed with taking care of a newborn and these moms were like, just, I don't even know the right adjective, but just so just did not know what was going to happen were unprepared, didn't know how to take care of the baby, how to calm the baby.

They just weren't ready for this experience. And so we just started looking in to see what supports already out there, we want to make sure we weren't like reinventing the wheel and just through searching through the literature and seeing what other things are being done.

I didn't really see anything being done quite what we wanted to do. And what it is, so HOPE Recovery Project is Holistic Ongoing Patient Engagement Recovery Project and what we're hoping to do were hoping to get grant funding for it in the future, but Chelsea and I are hoping that if we get grant funding, we will be a hope recovery advocate for them.

And what different there's so many things that are out there already that are helping these moms. There's like money that's being poured into this population, but it's completely ineffective and we're just getting the same results. That we have been getting. So ours is different in that we start from the very beginning to build a therapeutic relationship with these women before we do anything else. They have to know that we are there for them and we are on their side before we can do any kind of education. That kind of thing. And it's all like evidence based. So we start with a therapeutic relationship and we meet with them 1 on 1 or in a small group is what we plan to do and do hands on in person education that is specific to helping them with how to calm their baby, how to feed their baby and just manage the whole process, expectations, go ahead and start getting all of their resources try to identify some resources early on and taking that relationship through when they come in the hospital inpatient there, they already are educated.

They know what to do. And we just come and visit them, reeducate them, support them, and then they get discharged. And then we follow them through the first year postpartum, which that is something that you need. A lot of programs stop. Yeah. It ends like a 2 months or something postpartum, but the highest risk of relapse for these moms is the 1st year and particularly between months, 7 and 12 and so we want to continue working with them.

It's just a continuous hands on a warm handoff type of approach. That's like a new word that I didn't know that's what we were doing, but I didn't know that it was like, called something where you sit down and you make an appointment with them, you call the person or you go see the person or the organization that can support them.

You go together and introduce it to those people so that it's not as overwhelming for them to do it. And that helps them with compliance with doing everything that they need to do, staying engaged in their treatment and then hopefully staying well and healthy and keeping their baby with them.

[00:16:24] Jared: What an incredible mission. Just wow. I'm so glad that you're taking this on and about to change all these ladies lives. I am curious also just of like, how big is the population size of what we're talking about here?

How many mothers that are giving birth are experiencing substance abuse disorders. What would you say the portion of the population, I know it's probably very different everywhere you go, but just in your particular health system, what would you say generally the numbers are?

[00:16:53] Sara: I would say generally probably just for a decent size hospital that serves several counties would have somewhere between 100 to 200 couplets, like moms and babies that are going through that. That come through the mother baby units every year.

[00:17:11] Jared: Wow. It's a sizable portion. More than people would expect.

[00:17:14] Ty: Each one of those warm handoffs, like therapeutic interventions can make a significant difference in the lives of each of those women.

[00:17:21] Jared: I know we also want to talk a little bit about unsafe sleep practices. Co sleeping due to exhaustion, mothers just have to stay up so long and it's just so difficult. And so can you talk about maybe some of the consequences of this for the mother and the baby?

[00:17:36] Chelsea: Yeah. Okay.

It's actually one of the issues that I brought to Sarah at the beginning of this. And it was the fact that the unsafe sleep was one of the issues that I felt in hospital that we as providers were failing moms with because we, like I already spoke to, there's extreme exhaustion specifically with the babies that are withdrawing.

They are difficult to console. They don't sleep for long periods of time. They need a lot of active consoling from mom. And With that being said, mom's getting even less sleep. She's in and out of the bed getting the baby. So eventually, at some point she's going to fall asleep in the bed with this baby.

Not because she wants to, not because she is trying to do something that is unsafe for her baby, but just because At a point, there's nothing else to do. We're setting them up with this environment where they either have to be awake and up to console this baby, or if they want to get some sleep, if they can't help it, but fall asleep, the baby's going to be in bed with them.

And then, they're opened up to the risks of of SIDS, which these babies that are withdrawing are already at an increased risk for SIDS just because of their withdrawal. So then adding in the co sleeping, there's an even higher risk for SIDS. This also contributes to, if there is frequently documented notice that babies are asleep in the bed while mom is asleep, that can significantly contribute to reasons why newborns are removed from mom's custody.

And so really overall, when it comes to the safe sleep in hospital setting, like I said, setting these families up for failure because we're not providing them with an adequate option to be able to provide a safe sleep space for their baby while they still get to get some rest. And so then at some point we add in things like Mama Roo, which those are amazing and they're a great tool, but they become used as a crutch.

Because that's the only way that baby can go in there. Mom can get some rest. It's used as a crutch by mom by nurses. They end up in something like the mamaroo for way longer times than is recommended and then also we're creating a sleep environment. That's not recreatable at home so they've gotten used to something that helps in the hospital, but they can't take that home with them they don't have that situation when they leave and so inevitably when they go home, they don't have this bassinet rocks and moves their baby to sleep.

They're going to have the baby back in the bed with them. And then they're going to be back to, these issues of the SIDS and things like that. We're creating a risky environment by how it's set up in the hospital that they're going to continue to go home and keep on creating this risky environment.

[00:20:20] Sara: And I also want to add to just in some of my school assignments, like I've been looking up some just throughout the research of the safe sleep. And this is like a problem just throughout the country. There's a lot of studies that show that there are unsafe sleep practices happening in the hospital just, all throughout and we're teaching safe sleep.

And we're not showing it. But the problem is these women can essentially have a PhD in safe sleep, but if they don't have the tools to be able to implement it, then they're going to put that baby in the bed.

[00:20:57] Ty: And could you touch on that? What are the limitations of the standard bassinets currently?

Why are those not the right tools for that?

[00:21:03] Chelsea: Because there's no easy way to get from the bed to the bassinet to get the baby in and out of the bassinet. They can, sit. relatively close next to the bed, but especially for moms that have had a C section, it is almost impossible for them to sit where they are in the bed with their, abdominal incision, be able to twist to the side to get the baby up out of the bassinet into the bed when they are crying, which when it comes to these withdrawing babies is all the time.

And they're, In and out of the bed, which they really shouldn't be doing anyway when it comes to their recovery. They shouldn't be up and down as much as they are to get to and from the bassinet. And then the other risk is that the only other possible option to be able to try and get the baby in and out of the bassinet without getting out of the bed is for them to raise their whole hospital bed up to be able to be above the bassinet.

And then that puts mom in an unsafe situation because if her bed is up high, she tries to get off the bed before putting it back down, she's way off the floor. That's a risk for falls. So it's just all of the things compounded. It's just negative.

[00:22:08] Sara: Yeah, most of the standard bassinets that you see in the hospitals, they're for us as nurses.

They're really made for a nurse convenience, I feel like. And you can't just reach in and get your baby. You basically what Chelsea's saying, you have to get up out of the bed. to go get your baby. And it's just really hard to do over and over.

[00:22:27] Jared: And so we talked about co sleeping as a unsafe sleep practice. And just out of like pure curiosity are there other unsafe sleep practices that are happening? What, what else could happen other than just co sleeping? And then what does like an ideal safe sleep scenario like look like?

[00:22:45] Sara: So we teach one of the things that we teach the moms a non pharmacological intervention is skin to skin. And it's an amazing intervention and it works really well but you can't do that 24 7. And that's when we already talked about this a little bit, but that's when the moms are falling asleep in the bed with the babies because they want to be close to the mom and they can't do it.

And then just with them being in those mama roo swings like they're, they don't have the head support to be able to stay in there for extended periods of time that a lot of the moms are leaving them in there for just to try to get some sleep. And then they risk when they fall asleep in the bed with the baby, especially in the hospital they put that baby at risk for falling out of the bed onto the floor or even just rolling over on the baby.

[00:23:36] Jared: So I know we've painted the picture as far as maybe the best net solutions on the market that are maybe not meeting the needs of, mothers and babies currently. And so I think flip side, we have the incoming Couplet Care bassinet. And so I guess, building on these limitations that we've described can you maybe tell us about how the Couplet Care bassinet would emerge as maybe a potential answer to these challenges that we're undergoing currently?

[00:24:03] Sara: So I was doing a school project and I just think about things a lot, just process things. And, most of hospitals are becoming what you call like baby friendly. And it's just encourage moms and babies with bonding and there is a large emphasis on supporting moms who do want to breastfeed.

And so we have this very like beautiful and natural thing that we're trying to do in this completely unnatural environment. And I start to wonder what does everybody else do in the rest of the world?

What are other countries doing? Surely there's got to be some kind of other bassinet out there that, you could keep your baby close. And I was just going through the literature and just randomly came across the Couplet Care bassinet learning that it wasn't out on the market yet, but it was being built and designed and I just contacted them immediately.

And I was like, this is it. This is what we need. This is what all moms need. And it's something that it's great for all moms. I think it should be the new standard of care in all hospitals. And I think it will be within the next 10 years because of how we're evolving, but for the population that we're talking about moms with substance use disorder, it is a profound change in their experience, because those that haven't seen it it could come right across the mom, like a meal tray and it has a space for the mom to put her arms in there and she can be in her own space in her bed and have her arm and her hand near like the baby to keep baby calm or to console and they're in their own safe sleep space.

She doesn't have to get up. If that baby starts to fuss, you can like quickly calm the baby down before it gets escalated or it's close enough the baby feels good that they're near mom or if baby needs to eat or something, they could just easily reach in there, get baby, and if baby falls asleep, they can easily just put the baby back. It's just profound.

[00:26:01] Chelsea: It's conducive to mom's healing too and that they're not up and down. It's conducive to the breastfeeding. Because one thing by the time mom gets up to get the baby who's crying, she's uncomfortable. She's finally back in the bed with the baby at that point.

Is she even going to feel like she's ready to relax and sit there and breastfeed her baby? Probably not. So with baby being right there in front of her and she can just easily get baby onto her. It's going to increase mom's healing. It's going to increase rates of breastfeeding. It's going to increase baby's comfort and their consolability.

[00:26:35] Sara: Absolutely.

[00:26:36] Jared: Curiosities around this also is you think that there's an aptitude for hospitals and maybe administrator level people to want to change the standard of care as it is currently? Do you think that people at that level see that there's a problem and understand that things actually, there's, things need to change and there's already a way to make things better?

[00:26:56] Sara: Well, I think that like Chelsea and I are in a unique position as bedside nurses, we're on the front line, like we see it and it's really hard for people who are not. Sitting outside of a room, hearing that baby cry, or hearing that mom getting up and down, to even realize just how excruciating that can be, just like miserably tired so tired you just have to cry, and I think you have to really see it with your own eyes or hear someone's story as they tell it and tell their experience of how difficult it was for people to be able to capture that image.

[00:27:33] Ty: It's asking change to happen in a already complex system. And you've got, you mentioned that the current bassinets are really designed for the comfort of nurses and back in the day when, infants would be brought over to a nursery and, nurses would care for the infant in a separate room.

And that change we're asking, or that would be asked with Couplet Care, it's prioritizing the couplet, right?

[00:27:58] Sara: Absolutely.

[00:27:59] Chelsea: Another thing is hospitals today, healthcare today. They like to put forward and say, we are patient centered. This is all about patient satisfaction, patient care.

But unfortunately, that's a big change that has to be made for us it's easy to say, but in general, we're not doing a whole lot that's patient centered. And that's a big change that has to be made. And this is just a very small part of it.

[00:28:27] Ty: Yeah, the journey you just described with the hope grant that you've put forward, right?

You're starting from the, like early, pre delivery stage all the way through follow up to 1 year. And this addresses an acute need that's in a narrow 48 hour range, but there's a whole follow up to this. This is 1 part of a much bigger patient centered experience you're trying to offer.

[00:28:48] Sara: Absolutely. These moms they're, I think everyone's, heard of like postpartum depression and I think it's like one in nine moms will suffer from postpartum depression and moms with substance use disorder are at much higher risk for postpartum depression and a higher risk for not being able to bond with their baby just from the properties of the opioids themselves. And then sleep is huge a component of postpartum depression. And these moms are, all moms having a baby are going to be sleep deprived, but this is, it's just beyond imaginable.

And so I feel like, with the current standard of care, like we're just setting them up. For like utter failure, like they're just going to be more sleep deprived. They're having to stay in the hospital, a longer stay because the baby needs to be monitored for the withdrawal process.

And even if you weren't a patient in the hospital and didn't have any kind of recovery to happen, if you were to try to sleep in a hospital room for five days in a row, you would be exhausted. .

[00:29:51] Ty: Yeah.

[00:29:51] Sara: But then take it, your body is, just given birth. And then you have this baby who is extremely high needs that's going through withdrawal.

And you're dealing also with the guilt of, every time you hear that baby cry, like feeling okay. That's my fault. It's just, it's really, it's it's really upsetting that's, where we're at. And so that's 1 thing that we're hoping to a hump that we're hoping to get over to improve that experience for them so that they can have a better postpartum recovery and a recovery to stay, sober with their substance use.

[00:30:28] Jared: I also want to ask you about the feedback that you've gotten from other health care providers about the bassinet solution in the sense of we've talked about the executive level folks where it's like maybe they're not really seeing eye to eye on this. They're not really seeing the impact like a health care provider would because like I said y'all are on the front lines with this every day.

And so would you say that the conversations around the bassinet are just easier to have that healthcare providers maybe are more open to changing the standard, standard of care and adopting something like the Couplet Care bassinet solution?

[00:31:02] Sara: Yeah, our colleagues, other nurses that we work with some of the pediatricians, we've shared a little bit about the Couplet Care bassinet and they are like, wow, that's amazing. I wish we could have that. And then the moms that we have shared that with Oh, there's this bassinet that's, it's not on the market yet, but it's really amazing. We describe it to them. And they're like, wow. That's like a game changer. Like I can't imagine how amazing that would be to have something like that.

[00:31:31] Jared: And also from your experiences what would you say some of the biggest barriers to adoption for the couple of care bassinet? What are they going to be facing? That's coming up ahead. Is it like value analysis committee? Is that where things are going to get hit or is it like the letters of intent from hospitals or where do you see the largest barriers for them to get adopted in the hospitals.

[00:31:50] Chelsea: Them to, see the impact that they could have and be willing to change and spend money on something that we already have that isn't serving our patients in the way that it should.

[00:31:59] Sara: And, it's not on the market yet and there's a huge emphasis and rightly so on evidence based care, it's so new.

That right now there's not a lot of, information. Although you could just look at it and you could know that it's going to do amazing things.

[00:32:15] Chelsea: We were able to see that we're able to see that it would be revolutionary, but I understand how other people who don't do what we do would look at it and be like why, we don't get it.

[00:32:26] Sara: That's one reason why we're hoping to we thought about doing like a video or something, just like in school in my leadership class one of the things that they emphasize is, never underestimate the power of a story. Someone's story and, that's what made me think about doing a video and just getting a glimpse of someone's story and just seeing like how right there it's making a big difference in how much more improved that their postpartum experience is.

We're just so excited about it and so passionate about, Couplet Care. We just are trying everything we can to get the word out so that people can learn more about it and start asking for it.

[00:33:06] Ty: I'll share a quick story because, Couplet Care, we've had a role to play with the development of Couplet Care and there was a study that was done at UNC where it was, in use with moms and babies for a period of time.

And so I've got, we've got three kids and was at my youngest soccer game and I was standing around at the sidelines talking to the parents and sharing what we do. And one of the parents said, Oh, that sounds like something that we participated in for their child who was sitting there and one years old and all cute and you know like working on a bottle and whatnot and the child that was sitting there that was happy and healthy and all of that was part of that study and you could just see that impact that it had just with that study on a family and like having a better experience that they had and could compare the difference between a traditional bassinet versus, like having the Couplet Care for that one study.

So it's cool to see some of that, track record starting to come through and some of that research to come back that shows that this is something that's making an impact. It was just, it was, as a designer, it was really rewarding to just have those conversations, just spur of the moment.

[00:34:09] Sara: So that's, yeah, that's incredible. When you were talking about it, it just made me think about, because I've been a lactation consultant for about 13 years. And it's just really interesting. You're talking about being out like in the ball field and I've just observed like people were like, Oh, what do you do?

You know what I say? Oh, I'm a postpartum nurse. I'm a lactation consultant. And it's really interesting. The responses that you get from people. A lot of moms who might not have had the breastfeeding experience that they had hoped for. They almost are like yeah, I really tried, but I just didn't make enough milk or this happened.

And you can hear just a little bit of regret and a little bit of guilt in there because they were not able to achieve the goals that they had wanted to achieve and I think that's another reason why I think this bassinet is just so amazing because it is incredibly supportive of breastfeeding and it's gonna stick with that mom forever like that experience and how she breastfed, when her kid is 40 they're going to remember that always and, not only the memory of it and that experience of it, just the health benefits.

We all know breastfeeding is good and healthy, but it's incredibly good for maternal health, infant health, significantly decreases morbidity, mortality. And it's just, I think we just really don't have a full appreciation of how amazing it can be.

And I really think that this bassinet is going to help support the moms that do want to breastfeed. It's going to give them a tool and a step up to be more successful than they would have been. Otherwise,

[00:35:49] Chelsea: It seems so trivial and silly, just to think about it this way, but a postpartum experience will drive years and years of thoughts, choices. It sticks with a woman forever. It can change somebody's life. It's truly, I don't think there's a whole lot of moments in somebody's life where their life can be changed and it will actually change the direction of things going forward and postpartum is one of those times and it will, the things that happen, the experience, it changes things.

[00:36:17] Jared: Wow. Thank you for sharing just the human impact of, what this device could do when it reaches a wider adoption and inherently when it does reach a wider adoption, we're talking about a change in a standard of care. And I am curious of throughout your career, like how often do standards of care change?

I know that like from an innovation perspective, healthcare is very slow to adopt new technologies that are coming out. It's usually the latest or one of the later sectors to adopt innovation. And so just throughout your time, like how often does standards of care change. How often do things update? I guess you could say

Not very often.

[00:36:54] Sara: Speaking to the population that we're working with that we work with a lot that, I feel like there is a push to increase the standard of care. It definitely doesn't happen as quickly as we would like, but we have moved to a space where we're really trying, working hard to keep moms and babies together.

When the infants are going through withdrawal because it's just better overall, around and improving that and just moving forward, better, more accurate, like scoring tools and setups. And so things are moving, I want them to move faster and with our project it's really interesting because it's just very basic stuff relationship building, patient specific education and just walking with them through an experience, not just sending them, here's a list of support, go find some help.

[00:37:49] Chelsea: So in a way to me that almost the whole concept of what we're talking about is almost going backwards to where things are how they used to be when it was less of just here you go do this yourself and you know being with people and assisting them you know face to face one on one which is what honestly it's sad we've gotten away from that in health care as well. We've tried to find ways to rely on things other than people.

And at some point, especially for families that need this connection, moms that need this connection, we need to go backwards in a way instead of forwards back to when we're relying on each other and not telling them, hey, figure this out for yourself and pulling people out of it.

[00:38:37] Ty: Yeah, there's like a technology push. We'll just create an app for this to try to replace a human connection. How can we be more efficient? How can we reach this vast number of people? And that's a word that we hear nonstop in healthcare these days is efficiency and productivity. And that takes the human component of health care out of it, which, and I'm sure for Sarah as well as me, that's not why we do what we do.

[00:39:03] Chelsea: And at some point, it's easy to even forget as a nurse that the reason why we even started this to begin with was to be with people. It's simple. And it, like she said, it seems like it's this big thing, but it's not, it's super simple and it's going back to just being there and being with the people that we want to support.

[00:39:23] Ty: And it's the leadership you're bringing to this. Cause you've got a vision for where the gap is for where the standard of care needs to get to the human connection that needs to be consistently made to make an impact in the lives of a very critical time. And like the lives of that newborn infant, the life of that mother, to make a profound change that impacts society as a whole.

And that leadership you're bringing. I just deeply appreciate the, you guys are being champions for a couple of care and, bringing your voice to the table to recognize what, there's intended by this to make a positive impact for a lot of people, and also recognizing the additional supports to deliver on better standard of care.

[00:40:03] Sara: It's just so rewarding. It's hard to depict, but just how rewarding it is when you've been working with a mom. And, she's finally getting it. She feels like she's doing something well. And being able to encourage them. It's just phenomenal. And just to see them light up and feel good about themselves.

It's empowering and, gives you that boost to keep going. And, I can do this. I can do it.

[00:40:31] Jared: So we're real, real close on time here. And I do want to touch on two more topics. One is just what's going on next with Couplet Care and I think ties actually really tied into what's going on next.

And so I guess Ty, yeah, just what can people expect coming up in the next few months? And then also how can folks maybe get involved that are, really itching to make a difference?

[00:40:53] Ty: Sure. We'll be, with Sarah and Chelsea at the North Carolina AWHONN convention coming up here in New Bern, North Carolina in a little bit.

So we'll have the bassinet on display there. We've been pulling together a champion program. So that if you believe in the mission and you want to be part of it, we're looking to really put together a program around this to build a community of support around this vision for what we're pulling together. So those are some of the key kind of first steps here, but yeah I think it's definitely something that's exciting. There's an upcoming study at Johns Hopkins where there's going to be, three pre production units that'll be like, they are for a full of year as part of a phase two SBIR study.

So there's a lot of really exciting stuff that's coming to fruition where it's been a, definitely a long journey to get it right. And now it's really about trying to really, bring about the new standard of care. That's, hopefully this plays one part of that.

[00:41:44] Jared: Yeah. Yes, indeed. And just finishing things off for Sarah and Chelsea just what message would you like to leave our listeners with regarding supporting mothers with substance abuse disorders, and the work that you do.

[00:41:56] Sara: I would say, just to anybody, but especially health care providers just really, be aware of your bias. A lot of us really like to think that we're not biased but we are. And I just encourage people, like whether you're in health care or not, to educate yourself about adverse childhood events. There's like a documentary that's out there that you can watch it's just mind blowing how much there's a connection between those and substance use.

And learning a little bit more about the struggles of substance use and, these moms, their brains get rewired from it. And it's just so much harder to get to that place of sobriety than I think people imagine. And we hit on this earlier, but an encouraging word goes a really long way, and, you can, just when you're working with them or talking to them, you can validate somebody's feelings.

You don't even have to agree with them, but you can validate their feelings focus on the good things that they can do now. These moms were like, they're feeling guilty. We're like, this is what you can do now. This is what you're doing well.

[00:43:02] Chelsea: All they see is the bad.

Entering in something good is so simple and so easy and can make a big difference. And I challenge people just, as human beings to, challenge yourself to look at them and to see value in them so that when you interact with them, they can see value in themselves. And

[00:43:23] Sara: there's definitely different organizations that are out there. There's a lot of nonprofits that are out there that are working to support these families, bringing them meals or providing respite care or supplies those types of things so I definitely, encourage you to reach out and see how you can become involved, maybe even doing like some mentoring that kind of stuff.

[00:43:42] Jared: So wonderful. Thank you, Sarah and Chelsea for taking the time to join us today. Thank you for supporting the health of mothers and babies in the future by advancing the Couplet Care agenda with the bassinet and also just really good luck to you with the with what you're working on as well, the Hope Recovery Project.

And yeah, just thank you so much for joining us. We'll see you at AWHONN thank you. See you there.

‍