By Marybeth Kotrodimos
Photo courtesy of MI-Home<\/p>\n\n\n\n
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Being pregnant and homeless has to be one of the most challenging situations a woman can go through. Living on the street is harsh enough for anyone, but for a woman who is carrying her child, it has to be truly harrowing. For her to know that she has a provider who is not only a medical professional trained in maternal care, but who will also come and care for her wherever she is \u2013 that has to be a deep source of comfort. For many women who have found themselves in this situation during the past two years, that professional has been Le\u02bba Minton, MSN, APRN, CNM, IBCLC. <\/p>\n\n\n\n
In collaboration with two maternal-fetal medicine physicians (high-risk pregnancy doctors) and the support from a part-time assistant and some on-call care coordinators, Le\u02bba serves as the sole midwife in MI-Home (formally known as Midwifery Integrated Home Visitation Program), which operates under the auspices of University Health Partners of Hawaii (UHP) the faculty practice of the University of Hawaii\u2019s John A. Burns School of Medicine (JABSOM). She and her small staff provide family planning, prenatal (including mobile electronic fetal monitoring), postpartum, and lactation care to all Hawai\u02bbi females of childbearing age, regardless of insurance, income, or citizenship status. <\/p>\n\n\n\n
Le\u02bba travels throughout Oahu delivering compassionate care to women wherever they are, regardless of their circumstances. She sees patients on neighbor islands via telehealth. \u201cJust like some people have appointments in offices, I have appointments with people in the community. That might be at their home, at a community park, at a friend\u2019s place, in their car, or at a temporary shelter. I\u2019ll meet them wherever they\u2019re at. If they don\u2019t have a way to communicate with me, I\u2019ll have standing times when they know I\u2019ll be there or I\u2019ll go to the places they frequent to try to connect with them, to stay in touch, or to provide care. We do pretty much everything you would do in an office; we just do it where they are. I spend a lot of time driving, and sweating!\u201d<\/p>\n\n\n\n
Le\u02bba began her relationship with UHP when she met with Dr. Men-Jean Lee, the Division Chief for Maternal Fetal Medicine at UHP and Medical Director for the Fetal Diagnostic Center at Kapiolani Medical Center for Women and Children in Honolulu, and provided her with the concept for MI-Home. Dr. Lee was interested in partnering with her and they worked to find the grants to finance the program. Le\u02bba was named in the grants, so when UHP was awarded the funding, they hired her to be their midwife. That was July 8, 2019. <\/p>\n\n\n\n
Because Le\u02bba\u2019s patients\u2019 needs extend to more than just maternal care, she connects them with community support groups which can provide them with housing, food, healthcare, and other services for themselves and their children. <\/p>\n\n\n\n
\u201cWe\u2019ve really come a long way in being able to connect with the outreach organizations that work with our unsheltered population and in connecting with the governor\u2019s office on homelessness and really kind of building a strong community network with those that are out there doing the work. They\u2019ve been wanting medical providers to participate. It\u2019s been great to develop those relationships and to strengthen networks so that we can help patients meet their needs. Obviously many of those that we see need shelter to be successful.\u201d<\/p>\n\n\n\n
What\u2019s been Le\u02bba\u2019s biggest challenge as MI-Home\u2019s midwife? \u201cDuring COVID,\u201d she said, \u201cbecause so many things were shut down, for a portion of the time, there really wasn\u2019t a consideration for how that impacted people who were unsheltered. Nothing was open, but I was still seeing patients. And this was true for my patients too: One of the hardest things was not having access to a bathroom! For 12 hours I\u2019d be traveling all over the place with nowhere to go.\u201d <\/p>\n\n\n\n
MI-Home exists on grants, which, as Le\u02bba says, can be quite stressful. Staff is hired temporarily due to their dependence on receiving the next grant. Yet, they have received successive grants since their inception, and have been a real lifesaver for women who are at their most vulnerable. Le\u02bba encourages anyone who needs their services to call MI-Home and connect with them.<\/p>\n\n\n\n
\u201cIf anyone needs our services, or is not going in [to see a doctor] for care, we will be happy to facilitate them coming back in or helping them overcome whatever barriers are making it difficult for them to get to appointments. We can provide care where they are.\u201d<\/p>\n\n\n\n