Rural help for expecting and postpartum moms is coming from someone new with a 'baby phone'

Paramedic Darren Forman sees a Project Swaddle
patient in her home. (Photo via RHI Hub)

Rural women, infants and toddlers often need special supports that are difficult to get in more remote areas. The fire department in an Indiana town of 16,000 is filling that need with a "baby phone," reports Gretel Kauffman of the Rural Health Information Hub. "Through Project Swaddle, a home visitation program in which a community paramedic brings wrap-around care to pregnant and postpartum patients, the Crawfordsville Fire Department has provided education, support, and medical care to more than 200 women. . . . Bringing resources and support to women experiencing at-risk pregnancies or other social or environmental challenges, the program aims to keep vulnerable patients from falling through the cracks in a maternity-care desert."

Darren Forman is a Project Swaddle paramedic and Kauffman's object example: "When Darren Forman's baby phone rings, he answers." Callers have been "a young mother calling for help on a Friday evening after a domestic dispute. A pregnant 17-year-old girl stopped by law enforcement after a methamphetamine relapse. A woman in need of a listening ear following a miscarriage. Through the baby phone, expectant and new mothers can reach Forman at all hours of the day and night with questions, crises, medical needs, or just to talk."

The need for Project Swaddle arose in 2011, when Crawfordsville's main hospital, Franciscan Health, closed its birthing unit. Five years later, "a community needs assessment revealed a gap in care and resources for mothers and babies in Montgomery County. But the severity of the issue came as a wake-up call for many community members and leaders, including first responders," Kauffman reports. The Crawfordsville city and county leaders moved to find a way to bridge the gap. "They turned to the Crawfordsville Fire Department, which had already begun to launch a home visitation program focused on chronic disease management. With that foundation laid, the department decided to pivot to try something new: shifting the focus of the home visitation program to moms and babies instead."

Wikipedia map, adapted

Kauffman reports, "Since then, Project Swaddle has expanded into a mobile integrated healthcare program offering wrap-around services to pregnant and postpartum women, with a holistic approach that requires coordination between paramedics, physicians, nurses, social workers, and other service providers in the community. Patients can enroll in Project Swaddle as early as the first trimester of their pregnancy and receive care up to 90 days postpartum; the program is in the process of expanding to serve mothers up to one year postpartum." Samantha Swearingen, Project Manager for the Crawfordsville Fire Department, told Kauffman: "We like to say the program is physician-led but patient-centered."

Project Swaddle developers put together a how-to guide with best practices for communities that want to start a similar program. "Swearingen notes that the Crawfordsville Fire Department was fortunate to have already had a relationship with the Franciscan Health Network after partnering with the local hospital for previous programs, making it easier to establish a partnership for Project Swaddle," Kauffman adds. "Having 'passionate, dedicated practitioners' has also 'been huge for us,' Swearingen said. Still, funding has been an ongoing challenge for the program, organizers say. After initial funding through a one-year grant from the Montgomery County Community Foundation and the Indiana Department of Health, the program is primarily funded today by the Franciscan Health Network and the city of Crawfordsville."