Angie Reinoehl/MDN Ami Yale, left, Bonnie Riely, center, and Karla Fannik, right, are First District Health Unit’s team that specializes in maternal and infant health.

The First District Health Unit (FDHU) has three programs designed to support pregnant mothers before and after birth. The BABY & ME – Tobacco Free Program, Optimal Pregnancy Outcome Program (OPOP) and High Priority Infant (HPI) program are designed to work together to promote healthy pregnancies and infants and are open to any household, regardless of income.

Bonnie Riely, Tobacco Cessation coordinator at FDHU, said prior to the COVID pandemic in 2020 that FDHU had good participation rates. However, due to the pandemic the programs temporarily shut down to focus resources and efforts to COVID testing, immunizations and contact-tracing. With the programs opened back up, participation hasn’t risen back to pre-pandemic numbers.

The BABY & ME – Tobacco Free Program is an incentive-based program that encourages pregnant mothers and their households to quit tobacco and “to stay quit.” Mothers up to 36 weeks pregnant receive monthly appointments with Riely where they will receive education, counseling and the tools to quit smoking, chewing and vaping. Riely said that quitting tobacco while pregnant reduces risk of preterm birth, sudden infant death syndrome, placental abruption, ectopic pregnancy and high blood pressure.

After patients’ third prenatal visit during the BABY & ME program, they can qualify to receive $50 in Hello Baby gift cards that can be used at Walmart to purchase baby items if they’re nicotine free. Patients are tested for nicotine consumption with a carbon monoxide detector or a saliva test. Partners of mothers that occupy the same household who are willing to give up tobacco products are also eligible to earn the Hello Baby gift cards. Mothers can earn up to $400 in gift cards individually while enrolled in the program, but if a partner participates alongside her, the household can earn up to $800 in baby bucks.

“It’s really important that these moms know that there’s no judgment in these programs at all,” said Riely, “I mean, I’m an ex-smoker and that’s the last thing I would do is judge these moms. I give them a lot of credit for coming in.”

Riely said that visits continue up to six months postpartum to support the mother’s needs during the newborn stage, which can often be an emotionally charged and stressful period where tobacco relapse can happen.

The OPOP program provides additional medical support to women during pregnancy. Ami Yale, OPOP coordinator for FDHU, said the goal of the program isn’t to replace the physician’s role during pregnancy, but to act as a medical advocate between regular doctor appointments. During an OPOP appointment, patients will meet with a registered nurse and in addition to having their blood pressure taken and fetal heart tones monitored with a doppler device, patients can expect to receive education on pregnancy and newborn care. Because OPOP appointments last an hour, Yale said that she has time to discuss concerns and questions more in depth than what an OB/GYN doctor may have time for during busy clinic hours.

“Sometimes it’s just nice to have an advocate for you to get connected with. Maybe they don’t know how to explain what’s going on to their health care provider or they don’t know the significance,” Yale said.

The OPOP program is free of charge and available to all pregnant women, at any stage of pregnancy, regardless of income.

During the last prenatal appointments with Yale, she will refer her patients to Karla Fannik, the coordinator for the HPI program, to get set up for postpartum support.

Fannik said because the program is called the High Priority Infant Program that only “sick babies” will qualify, but it is open and free to all infants under one year of age. Fannik and her team will check babies to see if babies are meeting general developmental milestones, are receiving adequate nutrition and are growing on track. During an HPI visit babies will also receive a physical exam and address newborn care questions and concerns and parents also have the option to have their babies immunized at the FDHU. As needed Fannik can connect individuals to community resources and local organizations for additional help.

Riely, Yale and Fannik work together as a team to make pregnancy care more accessible to women in the community. They currently serve Bottineau, Burke, McHenry, McLean, Renville, Sheridan and Ward counties. To make care easier for patients, the trio will coordinate multiple appointments to be scheduled on the same day, so individuals don’t need to make multiple trips to Minot.

“We’re here for them,” said Riely, “I mean, we are really here for our clients. We just want them healthy, and we want them to know that we are here for them. It’s important because I think a lot of people think that public health is for lower income, but we are here for everybody.”