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Mavis Schorn, Ph.D., CNM, left, and nurse midwifery student Galit Church, R.N., talk with patient Dayana Moran at the Shade Tree Clinic. (photo by Mary Donaldson)

Shade Tree program bolsters prenatal care options

BY: CAROLE BARTOO

1/08/2010 - When 27-year-old Dayana Moran heard about the Shade Tree Clinic's new prenatal care service she signed up right away.

“I didn't know how I would get prenatal care until a friend told me about this,” Moran said.

The mother of two small girls said she would like to have a boy, but last year she had a “molar” pregnancy, which is a pregnancy that never develops into an embryo, while implanted tissues continue to grow. The resulting tumorous growth can become cancerous and must be removed. When Moran recently found out she was pregnant again, she was worried.

Seeing patients at the Shade Tree Early Pregnancy clinic are, from left, Charles Rush, M.D., Charmaine Jackson, R.N., Elaine Bishop, R.N., third-year VUSM student Nneamaka Agochukwu and first-year VUSM student Michael Stokin. (photo by Mary Donaldson)

Seeing patients at the Shade Tree Early Pregnancy clinic are, from left, Charles Rush, M.D., Charmaine Jackson, R.N., Elaine Bishop, R.N., third-year VUSM student Nneamaka Agochukwu and first-year VUSM student Michael Stokin. (photo by Mary Donaldson)

“With the molar pregnancy, I was able to get state insurance, but because of cuts, this time I was not eligible. This clinic is a real blessing — good for the health of the baby and the mother,” Moran said.

Moran is one of the first patients to be seen in the Shade Tree Early Pregnancy Program (STEPP), a clinical partnership between the Vanderbilt University's School of Medicine and School of Nursing.

Second-year medical students Marissa Blanco, Kelly Bingham and Erin Toaz saw a need for comprehensive prenatal care, so they applied for grants to support the once-a-month clinic held at Shade Tree, the free full-service clinic run by VUSM students.

Blanco, Bingham and Toaz co-direct STEPP one Saturday each month. The students have received a $5,000 grant from the Community Foundation of Nashville, and another $12,000 from a private family foundation.

“Dr. (Charles) Rush stepped in and said he would help with a monthly clinic and would bring third-year students who are in their OB/GYN rotation,” said Bingham.

First-year medical student Katie Kudyba works with patient Dyostin Alcantar. (photo by Mary Donaldson)

First-year medical student Katie Kudyba works with patient Dyostin Alcantar. (photo by Mary Donaldson)

“Then the VUSN Nurse Midwifery clinical faculty agreed to come and bring nurse midwifery students, so now we have a team. The interesting part is how much the medical students are learning from the nurse midwife and midwifery students, and vice versa.”

The goal is to get women who are currently without care into STEPP as early in their pregnancy as possible. Students start the women on prenatal vitamins, provide all the needed lab work, and they receive a comprehensive prenatal visit from either an OB/GYN or a nurse-midwife.

“STEPP is a bridge to get people in need into care.” said Tonia Moore-Davis, M.S.N., R.N., C.M.N., head of the VUSN nurse midwifery practice.

“These women and their unborn babies needed to see a practitioner right away, and get to a place that can offer continuous care covering prenatal, birth and postpartum.”

Low-risk patients will automatically be admitted into the nurse-midwifery practice as a patient and seen at regularly scheduled intervals throughout their entire pregnancy.

“The money the students raised was originally slated to purchase supplies and tools for the prenatal exams, but since state funding has been reduced, the students are now planning to use most of the money to pay any sliding scale fees for their referrals,” said Robert Miller, M.D., medical director at the Shade Tree clinic. “In essence, they are paying for the prenatal care of these women.”

The School of Medicine is holding a drive to collect baby goods for the women served by the STEPP clinic. Between Jan. 11 and Feb. 1, look for the boxes in the lobbies of the Monroe Carel Jr. Children's Hospital at Vanderbilt, Medical Center East, and Light Hall. They would appreciate baby products such as diapers, bottles, new or lightly used toys and clothes.

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