Success Stories

Kelly
Kelly, a registered nurse, and her husband Jack, a physician, were expecting their first baby. Kelly was in her 11th week of pregnancy when she enrolled in MedCost’s Smart Starts Prenatal Program. Her history included three gynecological surgeries that put her at high risk for a premature delivery.

The prenatal nurse knew that Kelly’s surgeries could cause cervical changes that would likely lead to a premature birth. She also knew that proactive treatments might prevent this from happening. The prenatal nurse told Kelly about a new, non-invasive ultrasound technique that could detect early changes in the cervix. She also explained surgical procedures that could aid in strengthening Kelly’s cervix during the pregnancy.

Kelly discussed this information with her obstetrician. As a result, the doctor decided to do a cervical ultrasound during Kelly’s 15th week of pregnancy. This test revealed that Kelly’s cervix was, in fact, already beginning to change, putting her at risk for an extremely premature delivery. To prevent this, the doctor placed a stitch in Kelly’s cervix to strengthen it and keep it from changing further. He also told Kelly to limit her activities.

As Kelly’s pregnancy progressed, her prenatal nurse stayed in close contact with her and also with her doctor. Thanks to the early, aggressive interventions suggested by the Smart Starts prenatal nurse, Kelly’s pregnancy continued to 41 weeks, when she gave birth to a healthy, 7-pound baby.

During Jessica’s 19th week of pregnancy she became concerned about how she was feeling and placed a call to her prenatal nurse. As the nurse listened, she realized that Jessica was describing symptoms of premature labor. The nurse urged Jessica to call her physician immediately. The doctor met Jessica in the emergency room and evaluated her uterine contractions.

Meanwhile, the Smart Starts prenatal nurse and a MedCost nurse case manager talked about how to help Jessica. They thought Jessica might benefit from a home uterine monitor. The case manger called Jessica’s physician with this suggestion. The physician agreed, and this equipment was placed in Jessica’s home so her contractions could be monitored. In addition, the physician placed Jessica on an oral medication that helps control contractions.

One week later, the Smart Starts nurse called Jessica to follow up. Jessica described symptoms that alerted the prenatal nurse that contractions may not be under control. The prenatal nurse talked with the case manager again. This time they discussed the possibility of using a Terbutaline pump. (Tebutaline is a medication that helps relax the uterus.) The case manager discussed this idea with Jessica’s doctor, who agreed with this approach. The prenatal nurse arranged for Jessica to start the Tebutaline pump during the 21st week of her pregnancy. This home-based measure successfully controlled Jessica’s contractions and she did not have to be admitted to the hospital. Jessica delivered her triplets at 34 weeks. Each of the babies weighed over three pounds and had to stay less than a month in the hospital.

The prenatal nurse created a long-term plan of care for LaToya. Managing this case required frequent phone contact between LaToya and the Smart Starts nurse. The nurse continually re-assessed LaToya’s risk factors and encouraged her to comply with her doctor’s instructions. The Smart Starts nurse also negotiated a discount on weekly injections of a medication that prevented LaToya from having premature contractions. As a result of these aggressive interventions, LaToya was able to sustain her pregnancy for 38 weeks. With the support and help of her Smart Starts prenatal nurse, LaToya delivered her first full-term, healthy baby!

Rosa
Rosa spoke Spanish but no English. To mentor Rosa in the Smart Starts Prenatal Program, her prenatal nurse enlisted the help of the AT&T Language Line. Language Line is a professional over-the-phone interpreter service. Whenever the Smart Starts nurse had a phone appointment with Rosa, or whenever Rosa called her nurse, the nurse would call a special 800 number and within minutes, a three-way conference call was underway, with an interpreter translating between Rosa and her prenatal nurse. Rosa’s prenatal nurse also mailed Spanish language prenatal educational materials to her. With these tools, Rosa’s Smart Starts prenatal nurse was able to communicate with her and establish rapport with this mom-to-be. Rosa enjoyed the relationship too, calling her prenatal nurse often to ask questions and express her concerns.