By Thomas Goldsmith
Stephanie Chase has worked for Robeson County’s Nurse-Family Partnership long enough to see a group of mothers and babies “graduate.”
Chase, a nurse from Lumberton, has worked for two-and-a-half years as part of a network of registered nurses in Robeson and Columbus counties, part of the national Nurse-Family Partnership effort. Nurses in the program visit first-time mothers weekly from the 28th week pregnancy until their children are two years old.
“It’s been very rewarding,” Chase said at a recent celebration for moms and babies at the Robeson County Health Department in Lumberton. “I’ve been very attached to the babies.”
Partnership nurses felt the community’s need for help escalate after Hurricane Matthew, the catastrophic October storm with an aftermath that has continued to devastate communities in Robeson.
Nurses struggled to keep up their bi-weekly visits with mothers who moved from flooded homes into shelters. Some were “couch-surfing” and difficult to reach because their prepaid phone numbers kept shifting, said program nursing supervisor Darlene Gold.
“I personally have two moms who lost everything,” Chase said. “They pretty much had their diaper bags and the clothes on their backs.”
“Not a clue”
At the Lumberton event, Brooke Hunt, mother of 15-month-old Wyatt, recalled being nervous when she became pregnant for the first time.
“I had not a clue,” Hunt said. “Tamara [Bullard] started coming to my house and she calmed all my fears. I thought he was hyperactive. She said, ‘He’s a baby.’”
“I feel like Ms. Tamara’s a part of my family.”
LaQuanda Jones, of Fairmont, another young woman in the program, concurred.
“Even though you have your mom, she can’t tell you everything,” Jones said. “It’s a great program for support. I can text her or call [my nurse] anytime.”
Jones saw Matthew destroy her carefully made plans to save breast milk so that her son Braylon Regan, two months, could be nourished by it when she went back to work. She had pum
ped milk and saved it in a freezer that lost power when the storm came.
“Since the hurricane I lost a lot of storage; I lost a lot of milk,” said Jones, a collections representative in a call center. “I didn’t really want to put him on formula.”
Stats show health benefits for moms, babies
Part of a national effort started in the 1970s, North Carolina’s Nurse-Family Partnership is known for keeping careful track of the progress made by participants. Most recent numbers show that about one in five of the Robeson mothers had another child when working with the partnership, lower than the equivalent statewide rate of 28 percent.
Chris Bishop, state director of the Nurse-Family Partnership, said mothers in the Robeson County program completely reduced alcohol use during pregnancy and lowered their exposure to violence during pregnancy by more than 78 percent. Among those older than 18, nearly half were employed by the time their children were two years old.
The preterm birth rate for these Robeson mothers was 10.6 percent, lower than the statewide rate of 13 percent. More than two-thirds of mothers started breastfeeding, significantly higher than the state rate for African-Americans, who make up the majority of Robeson’s Nurse-Family Partnership mothers.
“We do a lot of teaching as well as referring them to resources,” said Tamara Bullard, a program nurse from St. Pauls. “We go to them so they don’t have to come to us.”
The positive results are particularly notable in Robeson County, which ranks last in health factors among North Carolina’s 100 counties, according to a survey by the Robert Wood Johnson Foundation. Some 650 families and babies have gone through the Nurse-Family Partnership since it started in Robeson in 2008.
The program began in Guilford County in 2000, and since 2008 has expanded to 22 counties and the Eastern Band of Cherokee Indians with funding from agencies including Duke Endowment’s Health Care and Child Care, the Kate B. Reynolds Charitable Trust and the state Department of Health and Human Services’ Division of Public Health. (see box).
“They are finding success in immunization and in mothers who are not smoking and not drinking alcohol,” said Dr. Laura Gerald, president of the Kate B. Reynolds Foundation, a Robeson County native and former North Carolina state health director.
Mothers interviewed at the Robeson event cited benefits such as help with breastfeeding, learning healthy eating habits and advice on what to do when babies couldn’t be consoled.
Success in breastfeeding
Mothers who remain in the Nurse-Family Partnership said they’re fully convinced of the healthful qualities of breastfeeding.
Even with the loss of her stored milk, Jones was able to feed Braylon with a combination of formula, her own milk and breast milk donated by supportive friends. Even so, she was separated from him briefly because of the storm.
“We had no water for like a week,” Jones said. “I sent him to the county to stay with relatives for a week.”
Some participants drop out, unable for various reasons to meet the program’s guidelines about regular visits, dietary habits and substance restrictions.
“Most of my moms would quit smoking while they are pregnant, so that’s a good thing,” Ballard said.
Nurses hired by the program spend a week in Denver, Col., to receive specific training from program developers before they make home visits. They have to tailor their schedules to meet those of their clients, who are encouraged to go back to work when they are able.
“We can’t encourage them to get a job, then drop them because they don’t get home until 5:30 or 6,” Bullard said.
“The data show that employment for the parent will help ensure better health outcomes for the family,” Gerald said.
Along with requirements for employment and healthy habits, mothers and babies in the program get incentives in the form of educational toys geared to the child’s development and the Halloween party for which the nurses dressed as witches.
The children are also signed up for singer Dolly Parton’s Imagination Library program.
“They’ll get a book for every month until they are five,” Chase said.
Partners in the effort
Among the agencies supporting North Carolina’s Nurse-Family Partnership are the Duke Endowment’s Health Care and Child Care, the Kate B. Reynolds Charitable Trust, the state Department of Health and Human Services’ Division of Public Health, BlueCross BlueShield of North Carolina Foundation, the North Carolina Partnership for Children (NC Smart Start) and Prevent Child Abuse North Carolina.
Since its beginnings in Guilford County, the NC Nurse-Family Partnership program has expanded, now reaching Buncombe, Cherokee, Cleveland, Columbus, Edgecombe, Forsyth, Gaston, Halifax, Haywood, Hertford, Jackson, McDowell, Macon, Mecklenburg, Northampton, Pitt, Polk, Robeson, Rockingham, Rutherford, Swain, and Wake counties and the Eastern Band of Cherokee Indians.