VA Maternity Care Coordinator (MCC) program facilitates specialized care for military Veteran parents

For new families, healthy, evidence-based infant feeding education and support can be hard to come by, but among this often barren landscape of support, the VA Maternity Care Coordinator (MCC) program provides an oasis for military Veteran mothers.  

Retired USAF Lt Col Tammy Tenace BSN, MS, APRN-BC, now Women Veteran Education, Outreach and Research Coordinator  for James A. Haley Veterans Hospital in Tampa, Fla. says that the VA understands that pregnancy and parenthood often requires specialized care.

About a decade ago, as care providers started to notice that lactation and breastfeeding support was severely limited in civilian communities, they established the MCC role. MCCs maintain contact with Veteran families throughout the perinatal period, facilitating care that meets their specific needs. 

Because the VA does not provide obstetric care, the MCC acts as a liaison between the VA and the community obstetrical provider. MCCs follow Veterans through pregnancy and postpartum at one and six weeks postpartum. [https://link.springer.com/article/10.1007/s11606-019-04974-z]  The VA supplies Veterans with lactation supplies like breast pumps, nursing bras, nursing pads, storage bags, etc.

The MCC role has been established at every VA medical center, and Tenace has served as MCC at her hospital since 2016.  

Photo by George Pak : https://www.pexels.com/photo/family-sitting-on-sofa-beside-house-plant-near-the-windows-7983863/

Throughout the COVID-19 pandemic, what little perinatal support existed in civilian spaces, dwindled to almost nothing, Tenace points out. 

Hospital breastfeeding support groups, while only meeting a couple of times a week, stopped meeting altogether. Women weren’t allowed support people or their partners at appointments, and they began to feel isolated. 

“I realized I needed to do something; I couldn’t depend on the community,” Tenace says.  

Working through the Office on Women’s Health as a subject matter expert, VA National Consultant for Lactation Ashley M. Lauria, MA, RD, LDN, IBCLC helps establish standards of care in lactation programs at VA facilities nationwide. 

Tenace and Lauria both comment that among the hundreds of parents they have cared for, it is truly a rarity for an individual to express disinterest in lactation. Their experience reflects national numbers, where most dyads start out breastfeeding. 

Women Veterans are the fastest growing group among the Veteran population. In fact,  “by 2040, VA estimates they will comprise 18% of the Veteran population, versus just 4% in 2000,” according to a VA Pittsburgh press release.

In order to keep up with this demand, Tenace and her colleagues are in the process of curating a Certified Lactation Counselor (CLC) program. Made possible through funding from the Women’s Health Innovations and Staffing Enhancements (WHISE), ten of their staff members are completing the Lactation Counselor Training Course (LCTC), including Tenace, physicians, a health coach, advanced practice nurses, among others. 

“The most up-to-date information is really important,” Tenace begins. “[We are all] unlearning the things we thought we knew. The course has been instrumental to helping us feel like we are actually helping women, instead of relying on the knowledge that we thought we had. The course is detailed and professional, yet practical. The practicalness is what’s to our advantage. It’s how we actually help women breastfeed.”

Photo by Timothy Meinberg on Unsplash

Tenace and Lauria go on to explain that their efforts are Veteran-led. That is, their facilities host quarterly focus groups where they can learn about Veterans’ requests. 

“We want to know from women: what do they want?” Tenace comments. 

Because Veteran women often prefer support groups comprised of other Veterans, Lauria offers virtual lactation support groups that also act as social circles and a place for comradery. 

As James A. Haley Veterans’ Hospital designs new facilities, Tenace has been invited to offer input on the creation of lactation space for both employees and patients. Tenace applauds their leadership for focusing on improvement for the patient and employee experience. She also highlights that the newly designed main entrance will host a lactation pod. 

“I can’t think of a better way to show commitment,” she adds.  

Tenace and Lauria have embodied a passion for birth and lactation since their youth. Their work with the VA allows them to continue their mission to celebrate parents and their families and position themselves as life-long learners, evolving with the needs of Veteran mothers. 

 

Photo by Brianna Lisa Photography: https://www.pexels.com/photo/mother-breastfeeding-her-child-in-park-11620457/

For more on VA maternity care services visit https://www.womenshealth.va.gov/docs/WomensHealthReproductiveHealthBrochure508.pdf

More on Veteran Health https://www.commonwealthfund.org/blog/2021/birth-equity-Veterans-and-servicemembers  

Regulations and resources for all military branches https://www.mom2momglobal.org/bficb 

Coverage for pregnancy and lactation care in the military health system https://www.military.com/daily-news/2021/11/01/tricare-cover-doulas-lactation-consultants-some-starting-jan-1.html 

Progress through podcast: Care provider supports families through relevant lactation education

When Tangela L. Boyd, MA, IBCLC, CLC, CLE, CCCE, CPD, a Union Institute & University affiliated faculty member and owner of Mommy Milk  & Me, Inc., had her twin boys 14 years ago becoming a mother of four, she simultaneously entered a space of advocacy.

“I had a very adventurous time with those guys in the NICU,” Boyd remembers. “It changed the way I thought about breastfeeding.” 

As a young Black mother, Boyd says she feels fortunate to have had support from hospital staff to feed her twins (which she went on to do for three years), acknowledging that this is not often the case for BIPOC families

“That support in turn gave me the desire to help other mommies,” she says.

Boyd’s passion lies in uplifting underserved communities, particularly families living in the rural regions of the Southeast U.S. where she lived for nearly 20 years. 

Now located in Florida, Boyd’s newly released podcast, The Early Postpartum Period, offers a way to stay connected and reach underserved mothers with basic, relevant breastfeeding information. 

Boyd admits that the technology was something new to her and it required much patience to bring the project to fruition. Still, she says, it’s something that she wants to commit to for a long time to come, connecting with families especially in the time after they’ve left the hospital. Boyd hopes to soon host focus groups to get a better understanding of what kind of information families would like her to cover in the episodes. 

In the meantime, she plans to release more episodes over the summer. Her practice emphasizes the importance of organization, so she’s planning a podcast featuring organizational skills and time management tips. 

“There is a lot of lactation education out there and I don’t want to be repetitive,” Boyd begins. “I want to hit areas that will really be relevant and give [parents] something they can use, not just something they can listen to.”  

Boyd explains that learning organizational skills can bring a sense of calmness which allows parents the energy to move forward with daily tasks, rather than getting engulfed by an often chaotic world. She suggests things like preparation, avoiding procrastination and working up endurance through taking a breath and stepping away when necessary. 

Especially as our country examines our foundations and current events have brought race to the forefront, Boyd emphasizes the urgency to address high Black maternal mortality rates.

The pandemic has illuminated ways in which to address these rates, Boyd explains, like out of hospital birth and doula support. 

“We have to move forward,” Boyd encourages. 

You can connect with Boyd on Twitter here and find her website here

Boyd has been featured on Ifeyinwa Asiodu’s PhD, RN, IBCLC Blacktation Diaires for her work on increasing breastfeeding and perinatal education rates among BIPOC. She has also written for Kimberly Seals Aller’s Mocha Manual.