Exploring Creative Solutions to Enhance Prenatal Care in Colombia

June 2013Fanna Gamal

As a child, Corinna Michels had more experience with birth and prenatal care than most adults have in their lifetime.

“I have eight younger siblings, so I grew up seeing a lot of births,” she says. “I was always intrigued with labor, and I knew early on that I was moved by births.” She also recalls a school assignment where she was asked to shadow an adult on the job for a day. “I chose a friend’s mom who was a nurse practitioner. It was just a fit for me.”

But in high school, Michels also felt called to travel, telling her family that she planned to postpone college to backpack across the world. “They were worried,” she says with a laugh. “So I decided, fine, I’ll go straight through college and be a nurse, and then I’ll go see the world.”

Now – after two nursing degrees and two major trips throughout Central and South America – Michels feels prepared to embark on one of her most challenging personal and professional journeys. As a recipient of a highly competitive Fulbright study/research grant, she will begin to implement and study the effects of a prenatal support program in Cali, Colombia.

Nursing in a Global Context

When Michels left high school, she entered the University of San Francisco’s nursing program, where she deepened her love for labor and delivery nursing, but after receiving her degree, she was also ready to fulfill her promise to herself about traveling. As she journeyed for months in Central America, she sharpened her Spanish language skills and thought deeply about her nursing education in a global context. Then she returned to her first nursing job – at the University of Washington Medical Center, in the department of labor and delivery.

“It was a great place to learn to become a nurse,” Michels says. “I worked with a high-risk, extremely diverse population. Many of them were new immigrants and many of them were uninsured.” After three and a half years there, she felt ready to return to school to pursue a Master of Science in Nursing through the UCSF Family Nurse Practitioner Program.

Before beginning her program at UCSF, however, she returned to South America, spending considerable time in the country she would eventually choose for her Fulbright site: Colombia. This experience made her determined to pursue an academic and professional agenda that would ultimately lead her back there.

Honing Her Skills and Finding Her Mentors at UCSF

“At UCSF, one of my early [clinical] sites was at Mission Neighborhood Health Center, with Pilar Bernal de Pheils,” says Michels. “She really molded my path, helped me learn to work with Spanish-speaking patients…[and] taught me about subtle communication styles when working in diverse populations.”

Michels continued her training at the Young Women’s Program (YWP), a nurse practitioner-managed practice established by UCSF faculty and located at the Women’s Community Clinic. “The continuity of this work is why I wanted to be a nurse in the first place,” she says. “You don’t just send your patients out the door; you see the same girls for months.”

Designing Her Project, Making Her Contribution

Corinna Michels with young students in reproductive health class Eventually, it was Bernal de Pheils, a Colombian native, who told Michels about the Fulbright, encouraged her to apply and – along with other mentors – helped her construct a prenatal support program for Colombian women, based in the city of Cali.

“The idea is to work with a particular clinic there and implement a group prenatal program that combines care and education,” says Michels, who notes that transforming prenatal care from an individual experience to a group experience gives women more time to check in with midwives and creates more opportunities for dynamic prenatal education. The midwife plays more of a facilitator role.

“In this model, the women are really hands-on – they do their own vitals and they take ownership over their care,” says Michels. She notes that some studies conducted with teen mothers have demonstrated a 30 percent decrease in preterm births after participation in similar programs. Michels’ program investigates these tactics in a global setting, and will use focus groups and interviews not only to assess the appropriateness of the model before implementation, but also to gauge progress and results.

She knows there will be challenges moving the model to and working in a global health setting, but feels her time at UCSF has prepared her well for this moment. “The level of discussion, depth of readings and language preparation have such a focus on cultural sensitivity and diversity,” she says.

Now it’s time to use that training to pursue her dream of delivering nursing care in an entirely different part of the world.