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Spark

Advancing Global Maternal Healthcare

Mon, Aug 05, 2024

Growing up in Tamale, Ghana, Yenupini Joyce Tonlaar Adams ’12 knew a pharmacist in her community whose work in healthcare and social justice she admired. Inspired, she dreamed of following a similar path and came to Calvin as a biochemistry major with a pre-pharmacy focus. 

At the time, her eldest brother, Obed, lived and worked in Michigan, and her brother Nathan was a recent Calvin graduate and medical student at the University of Chicago. 

Studying biochemistry, however, was not all Adams hoped it would be, and some of the classes she took did not match her strengths, so Obed suggested she study nursing instead. At the time, she resisted the suggestion, but “nursing kept coming across my path. God had a different plan for me that I didn’t want to pursue, and he needed to get me there,” she says. 

Adams is an assistant professor of the practice and the global maternal research lead for the Eck Institute for Global Health at the University of Notre Dame. She conducts research to improve access to and quality of postpartum care services. 

Based on her research findings in Malawi, Ghana, and the United States, Adams developed a new model of postpartum care called Focused Postpartum Care (Focused-PPC). To address the global problem of maternal mortality, Focused-PPC provides mothers more frequent contact with healthcare providers for clinical assessments and standardized education for up to 12 months after birth, going well beyond the six weeks women typically receive. Women in the program also have access to peer support in a group setting. 

Adams’ commitment to maternal health work solidified during a Calvin study abroad program in India with Professor Cheryl Feenstra. There, Adams learned about and became involved in the Comprehensive Rural Health Project, a program that provided village health workers with vital medical training in prenatal and maternal healthcare. 

The program directly impacted the women it served, significantly decreasing neonatal and maternal mortality. 

“I thought, this is what I want my future to look like,” Adams says. 

As a PhD candidate in nursing science at Michigan State University, Adams discovered a gap in maternal health research. “Most research focused on prenatal care and skilled birth attendants at delivery,” she says, “but there was evidence that a lot more women die after delivery as opposed to during pregnancy and labor and delivery.” 

Initially, her research focus was not well-received. “I was years ahead of what was happening, and so I had people try to convince me to explore other topics, topics I was not passionate about.” 

Yet, reception of Adams’ research went from lukewarm to welcome in a short span of time. “This has become a big deal now because the global medical community has caught up with the fact that we need to be doing more during the postpartum period.” 

That realization led to the American Rescue Plan Act of 2021, which provided states the option to extend Medicaid postpartum coverage from 60 days to 12 months. Under the Consolidated Appropriations Act of 2023, that option has now been made permanent in 47 states. 

Expanding care has been vital because data show women often do not receive consistent, standardized education about post-birth recovery. Adams says both the content and timing of the education matter. “Some women may get education at discharge, but they can’t remember it. Education is going on at a time when they have decreased ability to absorb it. That is why there’s a need for that follow-up contact, when they’ve settled in at home, and now they have questions.” 

A survey among non-Hispanic Black women in St. Joseph County, Indiana, for example, revealed “many women’s postpartum educational needs were unmet.” When Adams asked about warning signs of complications, on average, women surveyed were able to name only two of nine warning signs. 

Other studies revealed similar data, so Adams’ current research focuses on testing and evaluating her integrated group postpartum care, education, and support model to improve outcomes for women after birth. So far, results are positive. 

As an undergraduate, discerning God’s vocational call was Adams’ greatest challenge. “Yet when I got on the right path, it worked out somehow,” Adams says of the way God intervened through people who loved her, listened to her ideas, and believed she had something valuable to offer women’s maternal healthcare. 

Mentors like her advisor Adejoke Ayoola, now dean of the School of Health, helped her realize that nursing was a way to do what she had dreamed of as a young woman in Ghana: making a direct, tangible, and meaningful impact in the lives of mothers and infants.