5058.0: Wednesday, October 24, 2001 - Board 10

Abstract #29229

The agoraphobic pregnant - a prisoner of phobia and the challenge to access prenatal care

Lisa L. Palmer, RN, Perinatal Case Management, Georgia Public Health, 1609 Newcastle Street, Brunswick, GA 31520, 912 264 3907, llp@gdph.state.ga.us and Linda R. Huddleston, RN, MSN, District Director of PHN and Clinical Services, Georgia Public Health, 1609 Newcastle Street, Brunswick, GA 31520.

A 22 year old female was in the local mental health crisis center. Public Health and Mental Health share a mutual grant to provide HIV education and testing. The nurse who works for Public Health and through her consistent counseling kept in touch with her after the patients' discharge. The patient called this nurse and told her that she was pregnant. The first pregnancy test was negative and despite the nurses' contraceptive counseling, the patient did not want contraception. The patient subsequently became pregnant. The patient then was referred to the Perinatal Case Management Nurse. The challenge then was to provide good nutrition and prenatal care. This was extremely difficult due to the patients' mental health diagnosis of agoraphobia. Thus begin a series of home visits due to the patients' inability to leave her home. WIC certification and Medicaid presumptive eligibility was performed in the home. A psychiatrist and a mental health case manager went to the home to provide in home counseling services. The family members were taught intervention methods to deal with the patients' phobia. Desensitization interventions were incorporated into the care plan.

Learning Objectives: 1. To recognize agoraphobia in clients. 2. To list three interventions in desensitizing the agoraphobic client. 3. Develop a care plan to access prenatal care in the agoraphobic client. 4. Discuss methods of intervention for family members.

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Public Health, Mental Health, Local Hospital, Department of Family and Children Services, WIC.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA