Working as a labor and delivery nurse for a decade, Kristin Ashford was surrounded by happy beginnings. She helped women and families welcome healthy babies into the world. But Ashford also helped mothers and their families deal with the stressful and heart-wrenching experience of pre-term birth.
As a first-hand witness of the negative outcomes associated with pre-term birth, Ashford was motivated to make a difference. She transitioned from nursing into a researcher, studying risk factors of pre-term birth and creating strategies to prevent them through pregnancy interventions.
“It really got me interested in how to help these women more,” Ashford said of her nursing experience in labor and delivery. “Not only to reduce their risk, but also to help them emotionally cope with pre-term birth.”
Risk factors for pre-term birth
Pre-term birth is defined as delivery prior to 37 weeks gestation. Several risk factors, including smoking, substance abuse, poor socioeconomic conditions and obesity, increase a woman’s chance of experiencing pre-term birth. The consequences for the baby include respiratory illness, gastrointestinal disorders, immune deficiency, hearing and vision problems, and a prolonged hospital sta. There can also be longer-term motor, cognitive, visual, hearing, behavioral, social-emotional, health, and growth problems.
Now, as the assistant dean of research in the UK College of Nursing, Ashford oversees multiple research projects and interventions driven by the common goal of prolonging pregnancy.
“I think that any time that you can prolong a pregnancy, it is a rewarding experience,” she said. “If you can prevent the child from being sick, prevent that family’s stress and prevent life-long complications associated with that risk, that’s extremely rewarding.”
Research and interventions
Ashford’s research covers the issues relevant to pre-natal care, as there are many things that can be changed in order to prevent pre-term birth, like tobacco use. Her interventions aim to prevent tobacco and illicit drug use, manage chronic conditions such as diabetes and obesity, and reduce emotional distress in expectant mothers.
Ashford’s interventions are founded on the CenteringPregnancy model, which prepares women for pregnancy, labor and delivery, and motherhood through a peer support groups led by nursing and other health professionals. Ashford has designed CenteringPregnancy interventions to help pregnant women in high-risk categories like diabetes, tobacco use, substance abuse, or other socioeconomic or ethnic risk factors.
“Our UK program actually wants to put women together that have more in common with one another,” Ashford said. “So, in addition to being put in the group about the same time that they’re pregnant, they also are put in (a group) based on their most high-risk factor for pre-term birth.”
One intervention effort led by Ashford effort seeks to inform pregnant women about the dangers of using tobacco products while pregnant and give them resources to quit. Despite the known risks of using tobacco products during pregnancy, many pregnant women in Kentucky still smoke. Ashford is troubled by the rising popularity of e-cigarettes among women of childbearing age. Her research studies indicate that women are using both e-cigarettes and traditional tobacco products during pregnancy.
“Tobacco causes birth defects in pregnancy — that’s known,” Ashford said. “And so, it’s very clear that electronic cigarettes contain tobacco. Certainly, there’s risks associated with electronic cigarette use in pregnancy.”
Ashford is expanding CenteringPregnancy programs to areas in Eastern and Western Kentucky. She is working with local health departments to provide a Centering support network for pregnant women in high-risk groups.
She said her position in the UK College of Nursing allows her to research and circulate interventions, teach future nurses and nursing researchers, and serve communities by improving the quality of health care.