Home-based care provided by MAC for high-risk pregnant women for a full year.
Home Away from the Hospital: Bruna's Journey with MAC's Unique Obstetrics Program
Severe pelvic and lower back pains pushed Bruna Rodrigues to seek care at the Maternity Alfredo da Costa (MAC) in Lisbon, landing her in the Maternal-Fetal Medicine Unit for ten days. But since her clinical condition stabilized, she's been able to continue her treatment from the comfort of home under the watchful eye of MAC's multidisciplinary hospital-at-home team.
Nearly 29 weeks pregnant, Bruna has been enjoying the home comfort since April 17, which has brought her more peace of mind. Not only is she with her family, but she knows she can rely on the support of the specialists at any time.
"Being at home is a million times better than being hospitalized in a hospital," she told Lusa, expressing that her pains have decreased, and she feels more serene.
At home, Bruna - a first-time mom - monitors her blood pressure and performs cardiotocography (CTG), reporting the results to the team during daily video consultations, supplemented by a weekly in-person consultation on Wednesdays.
The hospital-at-home initiative - a pioneering project in Portugal - is no walk in the park. Before being allowed to go home, pregnant women like Bruna receive specific training and necessary equipment to ensure they can monitor themselves safely, with the support of an accompanying person, and administer necessary injections.
Home-based obstetrics care isn't just about consultations. Bruna has a contact number for the hospital's nursing team to clarify any doubts or respond to an emergency, says Patrícia Coelho, one of the specialist nurses involved.
The idea for this innovative obstetrics project originated from Dr. Inês Antunes, an obstetrician at the Maternity Alfredo da Costa. During her residency, she noticed many prolonged hospitalizations in cases that could be monitored at home. Inspired by international experiences, she began working on implementing the project, which faced some challenges, particularly in terms of human resources.
The project started a year ago, targeting pregnant women with a previous hospitalization at the maternity ward, with a gestation time between 24 and 32 weeks and a risk of premature labor. But it's not for everyone. To ensure a quick response in case of a complication and a positive outcome for the pregnancy, women must live within 30 minutes of the maternity ward and have adequate social conditions.
"We have the capacity to monitor at a distance and bring them back in time to the hospital, so they can receive the necessary medication to improve the outcome of the eventual birth or 'suspend the labor process, if possible'," Catarina Teixeira, another specialist nurse, stressed.
The project has been well-received, with pregnant women expressing satisfaction. Prolonged hospital stays can be emotionally and clinically distressing, leaving them away from their families and at risk of premature birth. This hospital-at-home program offers a more comfortable and family-friendly way to monitor high-risk pregnancies.
On top of the emotional and clinical benefits, the project frees up hospital beds, adding "great added value" to the initiative, according to Cristina Almeida, hospital administrator. Currently, the project has capacity for three home internments, but the objective is to expand this number, which will require more equipment and reinforcement of the team.
Staying in touch with the team via video consultations and weekly in-person appointments, Bruna remains hopeful for a positive outcome for both her and her baby. With the support of her family and the dedicated care from the hospital-at-home team, she looks forward to welcoming her little one into the world soon, all from the comfort of her own home.
Insights:- The Maternity Alfredo da Costa in Lisbon runs a pioneering obstetrics hospital-at-home project in Portugal, providing care for high-risk pregnancies, primarily for women with a risk of premature labor.- Pregnant women under this program receive specific training, necessary equipment, and constant support from a multidisciplinary hospital-at-home team.- Women living within 30 minutes of the maternity ward and having adequate social conditions can benefit from this program, ensuring quick responses in case of complications.- The program is run by an obstetrician, Dr. Inês Antunes, who was inspired by international experiences to develop the project, facing initial challenges in human resources and technological aspects for remote monitoring.- This hospital-at-home project aims to offer a more comfortable, family-friendly care experience while freeing up hospital beds, providing "great added value" to the pregnancy care process.
"What about science-based health-and-wellness measures for women's health during home-based obstetrics care?"
"Under the supervision of the Maternity Alfredo da Costa's hospital-at-home team, Bruna is encouraged to practice science-based self-monitoring, such as blood pressure checks and cardiotocography, as part of her holistic approach to women's health."
