Dr. Warner Huh (Host): . Hi, everyone. Welcome to Women's Health with Dr. Huh, where we share real stories, expert insights, and practical tips to help you navigate life's most important journeys, particularly in the women's health space.

I'm your host and the Chair of the Department of Obstetrics and Gynecology at the UAB Heersink School of Medicine, Warner Huh. And today, we're going to talk about something truly special and unique and something I've been really excited about getting onto the podcast series, the role of the pregnancy nurse navigator. And I think this is, again, something that I think our listeners will truly enjoy.

So if you've never heard of this role before, you're not alone. This is a relatively new concept. Definitely a new concept to the Birmingham metro area in the state of Alabama. And what you'll hear a little bit about is that a pregnancy nurse navigator is part guide, part advocate, part problem solver, and sometimes-- and I mean this sincerely-- a little bit of a miracle worker. And they walk along alongside our expectant moms from the very beginning, helping them feel informed, supported, and care for every step of the way. And I think, after this podcast, you'll very much feel that way.

And so, joining me today are two really awesome nurse navigators, Jasmine Maye and TeShawn Hardy. They've been dedicated to this area for a bit now, and they're going to share with you all an inside look of how they help the lives of patients in the most exciting and oftentimes the most overwhelming part of their lives, which is being pregnant and bringing a child into this world. So, Jasmine and TeShawn, welcome to the podcast.

Jasmine Maye: Thank you for having us. Thank you so much.

Host: All right. Cool. So, let's go ahead and just dive into it. So, Jasmine, let's start with the basics. So if you could just tell me in your own words, what exactly is a pregnancy nurse navigator?

Jasmine Maye: So yeah, our team is comprised of registered nurses whose backgrounds consist of labor and delivery, mother, baby, and newborn care. We are dedicated to helping our patients have the healthiest start to their pregnancy. We serve as advocates who empower patients, giving them the knowledge, including expectations for each visit and their delivery experience. We do not replace the obstetric providers or the nurse for their medical needs. So simply put, we are the extra support that provides education and connects patients with the appropriate resources.

Host: So to you, TeShawn, I mean, I'm interested, and this probably applies to you, Jasmine, as well, how did you guys find your way into this role? I mean, was there a moment of time or a personal experience that sparked your interest in becoming a nurse navigator?

TeShawn Hardy: Yes, absolutely. For me, I began my nursing career as a Labor and delivery nurse, witnessing the miracle of bringing new life into the world. After 10 years in L&D, I provided one-on-one education, support, and advocacy and patients' homes as a nurse-family partnership nurse. I was an NFP nurse for seven years. I started teaching childbirth classes in 2005, and I'm currently an instructor at UAB. I've always had a passion for perinatal education. And I am delighted to now serve as one of the perinatal nurse navigators for my absolute favorite population of patients.

Host: That's awesome. That's fun. And I know you guys are going to get into this a little bit more, but it's been really cool for me to see this program develop. As both of you know, I think this was the kind of the brainchild of Jennifer Kelley, who's one of our point people in the department. And to see this kind of blossom, for me, it has been one of the most gratifying things to see. So, I thought maybe one of you can just comment on, like, how do you typically first meet or connect with the patient during this journey and how often do you meet with your patients during pregnancy?

Jasmine Maye: Yeah. So after patients speak with our access team for scheduling their appointments, we're the first face-to-face encounter for them. So, we conduct our appointments via telemedicine or video call. And currently, we meet with them twice during their pregnancy. Their first encounter is to obtain their health history and provide prenatal education. And their second telemedicine appointment is when they will discuss their birth preferences and we educate them on the expectations for their hospital stay overall.

Host: And when you meet an expected mom, and obviously the listeners out there, they're going to be brand new moms in the future or currently or moms that have already had children, what does that first conversation usually look like? I mean, I think there's probably this general belief out in the community that, you know, you meet your OB-GYN, your nurse midwife, you have that conversation. But what I would love for you to talk about is how the conversation with the nurse navigator aligns or compliments that first OB visit?

TeShawn Hardy: Absolutely. During the initial call, we discuss how early pregnancy brings many changes, including some discomforts. Our focus includes what's normal versus what may be concerning. For example, we provide tips to address nausea and vomiting. Patients are given details on how to reach their care team during the day and after hours. We also share their frequency of clinic visits. In an uncomplicated pregnancy, patients can expect to have two ultrasounds scheduled. Prenatal labs and elective screening information is also covered. Patients are given a list of prenatal classes, including registration details. We also assess patients to identify needs for community resources. For example, if a patient needs transportation to or from appointments, we make referrals to the social workers to assist them. We also make referrals to Maternal-Fetal Medicine if indicated. Our prenatal care here at UAB is driven by a comprehensive team approach.

During the second visit, as Jasmine mentioned, it's devoted to birth planning. This visit is completed at 28 to 32 weeks of their pregnancy. We ask questions like: Who will be present to support you during your labor and delivery? And are you planning to have a medicated delivery or unmedicated labor and delivery experience? Again, we identify what's normal versus what's concerning. We refer to the Maternity Evaluation Unit if necessary. We also reinforce monitoring fetal kick counts beginning at 28 weeks. And patients can use the Count The Kicks app to track their baby's movements. Our patients are encouraged to research, choose, and contact a pediatrician by 34 weeks of their pregnancy. We also share doula information. We explain to them when to go to the hospital, what to pack, and how to prepare for baby, including proper car seat installation and fitting and safe infant sleep. Lastly, we discussed what to expect during postpartum, including breastfeeding and options for family planning.

Host: So, just to kind of recapitulate some of that, it's not just the first OB visit and expectations, you're talking about the entire scope of the obstetrical experience, including after they have their baby. Is that correct?

TeShawn Hardy: Yes, that is correct.

Host: Okay. So, I appreciate that response. But one of the things I've always been curious about is obviously we have women who have gone through their pregnancy journey without a navigator and now their pregnancy journey with a navigator, and I'm pretty certain that, you know, our pregnant moms have shared with you the differences in that experience. I thought maybe for the listeners you could touch upon what that difference is to our patients, basically.

Jasmine Maye: Yeah. One of the experiences I feel like we hear often are parents who probably had their first child or had a pregnancy maybe during the pandemic, and that was one that's totally different in comparison to now. But with having a navigation, particularly here at UAB and during that unprecedented time, now, you have a nurse navigator who really fills you in and provides you so much education, I feel like a lot of patients say that they feel that there is that extra hand held there during that time. And also too, in the day and age of so much technology, there's so much that they can get off the internet. And so, we hear often where patients will say, "Oh yeah, I just saw that online the other day. But you just went over that, and I'm happy that you confirmed that with me because you just never know." You can get down the rabbit hole of being on the internet. And so, speaking with us, they often sit and say that's the difference, is that there's so much more confirmation for them because of the nurse navigation appointment as opposed to what they hear from family and friends or what they see on the internet. So, they just feel that confidence and feel so much more confirmed in comparison to not having one.

Host: I suspect it's somewhat validating for them.

Jasmine Maye: Very much so.

Host: Yeah. Okay. So, I was just curious, what's one of the most common worries or questions that you hear in those early talks and visits with your pregnant patients as a navigator?

Jasmine Maye: Yeah. One of the most common worries we address during that first appointment is the discomfort of nausea or morning sickness. We take the time to provide instructions on the use and benefits of taking Unisom and vitamin B6 together, or ginger juice to relieve their symptoms, as well as making sure that they are getting adequate nutrients. You know, with small frequent meals as well as heartburn being another common worry that we hear often, we offer that reassurance that, for some, their symptoms should decrease as they enter their second trimester. And there just can be just so much hesitancy with the first trimester where often patients may not have shared with their family and friends that they're expecting just yet.

So particularly, around the summer vacation months and fall and winter holidays, we get the question of what foods are safe and travel recommendations, which can sometimes be a giveaway that they're pregnant. And so, when the charcuterie board or the homemade eggnog or the highlights of the event, you now must consider packing your own snacks or even eating prior to the event. And so, giving them those tips of how to confidently navigate those situations for themselves during this time is so important to us is nurse navigators.

Host: That's cool. That's awesome. I love hearing that. So along those lines, I mean, how do you balance sharing a lot of medical information. It's a time like, as we said at the beginning of the podcast, that is known to be overwhelming to women when they're pregnant, there's a lot going on, yet also trying to be calm and reassuring to patients. Can you just talk a little bit about that balance? Because you're trying to educate, you're not trying to scare. You want them to be empowered. You know, I'm just kind of curious about that balance.

TeShawn Hardy: Absolutely. As a mother of two children and with over 20 years of nursing experience, I've learned that both with my children and with my patients, that active learning is vital. Allowing patients time to process the information that we share and to ask questions ensures that their concerns are heard and addressed, which fosters self-advocacy. Our calls usually last about 30 minutes to an hour. Our patient survey comments have revealed that our patients value the space created for open dialogue. Some have even shared how truly supported they feel by having the extended one-on-one time with the nurse navigators. Other comments have also highlighted, by the end of their call, just how much more confident it makes them feel about their pregnancy journey.

Host: I love that. It really speaks to the fundamental nature of why I think what you guys do is so transformative. So, I want our listeners to understand this, you work intimately with the other providers, the physicians, midwives, some of our specialists in addition to the staff, particularly the nursing staff. How do you achieve getting everyone connected, particularly to the patient, right? Because I think in some ways when you think about the word navigation, you're navigating our very complex medical system and making sure that access and their appointments and their care is best they can be. But I thought maybe you guys can comment how you stay connected with the broader team.

Jasmine Maye: Yeah, absolutely. So as TeShawn mentioned earlier, UAB specifically, we have a comprehensive team ready at any time to assist our patients. There are four obstetric teams that are comprised of doctors, midwives, and advanced nurse practitioners. And so as perinatal nurse navigators, we encourage our patients to advocate for themselves. As we establish a rapport with our patients, we assure them that we will always do our best to point them in the right direction. Our telemedicine calls provide a snapshot into their health history, which allows them to spend more time with their providers when they're seen in the office. So, we encourage them to ask more in-depth questions that might not be within our scope of practice.

And so, empowering our patients that they have made a great decision in choosing UAB for their prenatal care. We're a very large system, and so we always work in tandem with our social workers, the ultrasound techs, and making sure patients receive specialized care and that their needs are met. So, we often communicate through the patient portal, which is a great benefit when choosing UAB. And so, that's not only during their pregnancy, but in the postpartum period as well. So, just confirming that they know when to consult with their providers, the maternity evaluation unit, and the lactation consultants at any point, they're available for them.

Host: Okay, thanks. So, our listeners don't see this because obviously this is not a video podcast, but the moment we started talking about the why and the validity of nurse navigators, I wanted to make the listeners know that you both had smiles from ear to ear and clearly are very excited about your jobs. So, I want to kind of impart that and for our listeners to visualize that. But I would love to know, what's the moment that makes you say, "Yes, this is why I do what I do," and be a nurse navigator?

TeShawn Hardy: Absolutely. So, my role as nurse navigator allows me to make a tangible difference in the lives of our patients. I believe the compassionate care that we provide as nurse navigators helps to improve the well-being of these mothers and their babies. For me, this is truly where my passion has met my purpose.

Host: Love that. I think that's a great way to state it. Okay. So, my last question to both of you, and really, I'm very curious of what you're going to say is: If you could give one piece of advice to someone who's expecting a baby, what would it be?

Jasmine Maye: Yeah. So, my one piece of advice that I would give someone that is expecting is to ask questions and understand the standard of care from your healthcare team specifically, but also keeping an open mind to pivot when needed for themselves and for the health of their pregnancy. There are so many factors to be considered prior to implementing an intervention. And informed consent is always a priority for us. So, don't be afraid to ask questions when you need that clarity as a patient.

Host: What about you, TeShawn?

TeShawn Hardy: I would tell them to prioritize their wellbeing both physically and mentally. Our main goal is to provide the highest quality prenatal and health care available. We encourage you to seek care that you need with confidence here at UAB.

Host: Great. Thank you. And I appreciate your being honest and, you know, in a way making yourselves vulnerable to what's really important. Because I think, yes, the journey for our patients have been important. let's be Equally honest. The journey for you all individually in this role has been as fulfilling. So, I just want to make sure that I recognize that and share that with the listeners.

So again, TeShawn and Jasmine, thank you so much for sharing your time and your heart with us today. I think we've all learned just how important this role is. I mentioned this earlier, but just wanted to thank Jennifer Kelley for having the vision to build this out. It was tough in the beginning. And, you know, as with most really important endeavors, it requires a lot of blood, sweat and tears to get off the ground. But I don't think there's a single person that would argue the inherent value of our nurse navigation system, particularly on the obstetrical side. So, I just want to make sure that she's fully recognized. And to our listeners, if you're expecting or know someone who is, remember you don't have to walk this road alone, and there are people like TeShawn and Jasmine who are ready to guide, encourage, and advocate for you every step of the way. And I think you can hear the sincerity in their hearts of how important this is. And, again, pregnancy is exciting, but also can be a scary place, and our job is to kind of tamp down some of that and make it a really special experience.

So again, thank you for tuning in to this episode of Women's Health with Dr. Huh. As with all things, if you've enjoyed this episode, please don't forget to subscribe, share it with a friend, and join us next time for more stories that inspire and empower. As always, if you have ideas or topics that you like for me to create podcasts or subsequent episodes on, please feel free to comment. But until then, take care, be well, and peace out. Bye-bye.