Ashley Santiago

2-week postpartum home visit. Mom recovering well, vaginal delivery. Lochia appropriate; no fever or redness. BP 118/76, pulse 74. Mom reports sleep "broken but OK" — roughly 5 hrs total in 2-hr blocks. Mood variable: "mostly OK, some days hard." Plan: EPDS screening at 6-wk visit. Elena feeding well, combo breast + 2 oz supplement at bedtime. Reviewed safe-sleep checklist, swaddling, PURPLE crying. Discussed when to call OB (heavy bleeding, fever, severe headache). Ashley's sister helping with overnight feeds 2 nights/wk.

Birth outcome confirmed from Good Samaritan Medical Center HL7 feed on Mar 13. Verified with Ashley by phone: baby Elena, 3,246 g, Apgar 8/9, vaginal delivery at 39 wk 4d, no NICU stay. Mom discharged Mar 14. Follow-up 2-wk postpartum home visit scheduled Mar 26.

Final prenatal home visit. Reviewed birth plan: Ashley wants unmedicated but open to epidural. Car seat installed (verified by Maria with install photo). Hospital bag packed. Anxiety around delivery — offered doula referral, Ashley declined for cost reasons. Discussed when to go to hospital and what to bring. BP 122/78, fundus 35 cm, fetal movement normal. Confirmed Lakeside OB 38-wk appointment 3/7.

Bi-weekly check-in call. Ashley reports feeling "big and tired" but doing well. Attending all OB appointments. Gained 28 lbs total, within recommended range. Eating regularly thanks to WIC. No concerning symptoms. Has maternity leave approved through Kravis Center (employer). Next appointment with Lakeside OB Jan 28.

Completed all three virtual childbirth-education sessions through HSMN curriculum (weeks 30, 32, 34). Topics: labor stages, pain management options, comfort measures, newborn care, breastfeeding basics. Ashley engaged, asked good questions in each session. Received electronic completion certificate.

Referral to Palm Beach County WIC completed. Ashley enrolled Nov 5. First appointment with Wendy Rios, RD, Nov 12. Reports receiving food package, satisfied. Will continue through postpartum period (up to 6 mo for non-breastfeeding, 1 yr for breastfeeding).

Prenatal Florida Healthy Start risk screen completed. Score: 3 · Low-Medium. Flags: first pregnancy (primip), limited family support (mom deceased, dad out-of-state). No medical risk factors. No substance use. Housing stable. Insurance: Medicaid pregnancy active. EDD March 14 per 20-wk ultrasound. Established with Lakeside OB (Dr. Ruiz) on Oct 1. Program of care approved.

First home visit. Ashley lives alone in a 1-bedroom apartment in West Palm Beach (clean, well-lit, safe). Works part-time at Kravis Center box office. Ex-partner not involved. Close friend (Jessica) lives 10 min away. Ashley excited but nervous. Identified goals: attend all prenatal visits, complete childbirth education, establish pediatrician before delivery. Scheduled risk screen for 10/14.

Healthy Start MomCare Network enrollment complete. Referred by Lakeside OB/GYN after initial prenatal visit. HIPAA authorization + program consent signed electronically. 17 wk gestation per Dr. Ruiz. Insurance: Medicaid pregnancy active. Initial home visit scheduled for 10/12 with Tamika Monroe.