Public Health Postpartum Services facilitates timely client access to care and support for new families across the Calgary zone. Public Health Nurses (PHN’s) provide support by providing early assessment, intervention and referral within 14 to 48 hours of a mother and newborn’s hospital discharge and continuing up to 2 months of age (4 months for very low birth weight infants).
Q: What are the hours of operation?
A: The program operations 365 days a year. In the rural areas hours of operations are 0800-1630hrs. In the urban areas hours of operation are 0830-2000hrs.
Q: How do I refer to the services?
A: A Notice of Birth is faxed from every hospital in the zone to Public Health within 2 hours of discharge for every newborn. Service is offered universally to all new families but is not mandatory. Over 99% of the approximately 18,000 families a year with newborns are seen. The notice of Birth is also sent from registered midwives who attend home births and Public Health follow up is offered on referral once midwifery services end. It is extremely important that the contact information on the Notice of Birth is correct so that families can be found and contacted in a timely manner.
Referrals are also received by fax from the Early Start Line at Health Link when client calls indicate issues that require further assessment or follow up.
Health Care Professionals only may refer by calling the Charge Nurse or Office Nurse at each site:
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Urban – Charge Nurse: o East office: 403-852-7600 o North office: 403-660-7293 o South office: 403-813-4316
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Rural – Office Nurse: o Airdrie: 403-912-8400 o Banff: 1-403-762-2990 o Black Diamond: 403 933 6505 o Canmore: 1-403-678-5656 o Claresholm 403 625 4061 o Cochrane: 1-403-851-6130 o Disdbury: 403-335-7292 o High River: 403 652 5450 o Nanton: 403 646 2218 o Okotoks: 587-215-7986 o Strathmore: 403-912-8400 o Vulcan: 403- 485-2285
Q: Are services available to families when their infant remains in the Neonatal Intensive Care
Unit?
A: Yes. The hospital notifies Public Health of the mother’s discharge and that the newborn will be remaining in the NICU. The PHN will connect with the mother to address her postpartum needs, support breastfeeding or pumping, and provide emotional support and resources for the family. When the infant is discharged the hospital notifies Public Health and the PHN or NTT (see below) will then follow the infant.
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Q: Are services available to families where there has been an infant or maternal death in the perinatal period?
A: Yes. The hospital notifies Public Health of any fetal losses over 28 weeks gestation, stillborns, neonatal deaths, and maternal deaths. Service is still offered to follow up on any postpartum ( eg maternal breast engorgement) or postnatal ( eg assisting the father or other care provider with infant care) issues as well as support and referral for bereavement.
Q: Are services accessible for clients who do not speak English?
A: Public Health Postpartum Services uses certified health care interpreters to reduce the risk related to language barriers and miscommunication.
Q: How are services provided?
A: A blended model of home and office contacts provides best access across the client population.
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Home visits are a priority for the medically and/or socially high risk clients as well as those with mobility issues.
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Most contacts in the rural areas are home visits and eighty percent of urban initial contacts are still in the client’s home. This contributes to the high rate of compliance especially in at risk populations.
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Office contacts provide an option for improved access for low risk clients and in situations where there is potential risk to the public health nurse’s safety. Follow up contacts are provided based on individual client need and can be home visits, clinic visits or telephone contacts.
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Telephone support and advice for families is provided until nursing or medical care can be accessed and \or until the supports and care the nurses are following are resolved.
 If clients are a “no show” for an appointment (ie not home for the home visit or do not appear for the clinic appointment) the PHN will call the family the same day to discuss why the contact was missed, complete a telephone assessment of the mother and newborn, reassess whether the contact is most appropriate for a home or clinic visit, discuss with the client the importance of the
PHN follow up, and book another contact the same day or next day.
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If the PHN is unable to contact the client by phone to arrange for a home or clinic visit the PHN may do a drop by home visit based on the discharge information regarding the mother and infant and if there are no concerns regarding the PHN’s safety.
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If a client declines any contact with Public Health, the PHN recommends follow up with the physician and the physician is notified by faxed referral.
Q: Where are services provided?
A: Services are provided at or out of:
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Urban: o 3 main sites:North Hill Community Health Centre, South Calgary Health Centre, East
Calgary Health Centre o Satellite sites: Acadia Community Health Centre, Foothills Primary Care Network
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Rural health centres in Banff, Canmore, Cochrane, Didsbury, Airdrie, Strathmore, Black
Diamond\Turner Valley, Okotoks, High River, Nanton, Claresholm, Vulcan
Q: What services are provided to new families?
A: Public Health Nursing services include assessment, care and referral re:
 maternal & infant health issues
 urban only - specialized support for infants born less than 1250 grams birth weight
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 urban only - newborn jaundice screening with transcutaneous bilirubin meters facilitates early detection and treatment of infant hyperbilirubinemia (critical bilirubin levels have been reduced to zero since the implementation of the program in 2006 and the number of readmissions of newborns for phototherapy has dropped by 18% despite an increasing birthrate)
 newborn metabolic screening
 breastfeeding support, referrals to Public Health International Board Certified Lactation
Consultants for complex breastfeeding concerns
 postpartum depression screening for mothers at risk ( universal screening is done at the 2 month vaccination appointment)
 screening for domestic violence
 anticipatory guidance re infant care & safety
 health promotion
 rural only – Parent Drop In offers new parents an opportunity to weigh their newborns and ask questions about their care, parenting, safety, infant feeding, resources, etc.
 referral to community agencies
 response to referrals from Early Start Line, acute care, community agencies, etc
 urban only - specialized support for physically high risk newborns from the Neonatal Transition
Team
 urban only - Social Work support for family violence, poverty, mental health issues, Child &
Family Services involvement
The team refers to physicians and acute care services as well as many community agencies for:
 in home parenting support for at risk populations e.g. Healthy Families
 supports for postpartum depression, mental health issues

Child & Family Services Authority for child protection issues.
 Alberta Children’s Hospital or nearest rural hospital emergency department for suspected infant sepsis, dehydration, other illnesses
 family physicians for medical issues eg. suspected infected caesarean section incisions requiring treatment, poor infant weight gain
 many supports for finances, food and housing security, cultural supports, addressing isolation and immigration issues, domestic violence issues, addiction issues
PHN’s receive referrals from:
 physicians
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Early Start at Health Link
 multiple community agencies.
Follow up is provided in many cases daily for the first week of life and continues based o n the clients’ needs up to 2 months of age and then continues in our well child services as needed.
Q: How does the jaundice screening program with the transcutaneous bilirubin meters work?
A: The use of transcutaneous bilirubin meter is only available in the city of Calgary, urban program only and not in the rural areas of the zone. Newborns have their first reading with the meters within 24 hours of birth in hospital, daily while in hospital and at discharge. The reading value is plotted on a locally developed and validated nomogram. The actual value and\or the trajectory\trend of the values on the nomogram indicates when a serum bilirubin is required. This nomogram is faxed from the hospital to
Public Health when the newborn is discharged. Bilirubin meter readings are done the day post discharge and plotted on the same nomogram in order to note the trend of the values. Follow up plus subsequent meter readings are based on the results as plotted on the nomogram. Follow up includes:
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 clinical assessment of the jaundice transcutaneous bolometer readings
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 breastfeeding\feeding support
 newborn weight measurement
 assessment of newborn illness
 drawing of serum bilirubin when indicated
 referral to the Paediatrician on call at the Peter Lougheed Centre(PLC) to facilitate a direct readmission for phototherapy when the serum bilirubin results indicate the need
 follow up post discharge from the PLC
Q: How does the jaundice screening program occur in rural communities?
A: Based on a nursing clinical assessment, the Public Health Nurse will follow up with the physician to determine the need for serum bilirubin. The PHN will support the family with infant feeding information and provide teaching regarding the signs of worsening infant jaundice.
Q: What is the Neonatal Transitional Team (urban only)?
A: The Neonatal Transition Team (NTT) follows very low birth weight infants (less than 1250 grams) and/or infants with complex health needs post discharge from the Neonatal Intensive Care Units. Clinical
Nurse Specialists and PHN ’s provide:
 assessment, education, support and referral for growth and development, infant feeding, chronic health issues, and acute illness
 parenting support
 referral to community agencies for respite
Service is provided by home visits or in clinics in collaboration with ambulatory clinics at the Alberta
Children’s Hospital. The nurses work closely with the infants’ paediatricians to minimize unnecessary acute care readmissions and/or emergency department visits.
Q: What is the role of the Social Worker on the team (urban only)?
A: The Social Worker provides:
 in depth psycho-social assessments for complex at risk clients
 engages clients providing very short term interim crisis counselling where needed
 quickly connects clients with sustainable community resources
 ensures the client has “landed” with resources that are meeting their client needs
 consultation to the PHN’s building their capacity for working with families at risk
 referrals to Child and Family Services Authority when necessary
.The Social Worker receives 65 to 80 referrals per month and provides daily consultation to PHNs regarding less complex clients.
Q: Who do I contact if I have more questions about Public Health postpartum services in the zone?
A: For general enquiries contact:
Prenatal and Postpartum Services Program Manager, Public Health Manager:
Marilyn Young marilyn.young@albertahealthservices.ca
Cell: 403-629-2052(urgent issues)
For area specific enquiries contact:
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Urban offices : North Hill, South Calgary Health Centre, East Calgary Health Centre:
Kristin York - Area Manager: Kristin.york @albertahealthservices.ca
Office: 403-955-1361
Rural Offices:
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Northwest Community Health Centre, Cochrane, Canmore and Banff Public Health: o Helen Dutchak - Area Manager o Office: 403-943-9705 / 403-510-5676
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South Calgary Health Centre and Rural South: o Mary McIntyre - Area Manager o 403-943-9522
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Airdrie, Didsbury, Strathmore : o Sandy Phillips - Area Manager o Office: 403-912-8401
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