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By Taylor Knopf

Two years ago, Jasmine Hopkins was living out of her vehicle with a toddler and a newborn in Pitt County.

“At that time, I was going through some personal things. I just needed a little more support and help,” Hopkins, 25, said.

A social worker referred Hopkins to a state-funded program called Healthy Beginnings, which is designed to reduce the infant mortality rate in the African-American community.

In 2016, North Carolina’s infant mortality rate was 7.2 deaths per every 1,000 babies overall, meaning that seven of every 1,000 infants in the state died in their first year of life. But African- American infants were 2.7 times more likely to die than white infants in that first year.

North Carolina Health and Human Services Sec. Mandy Cohen previously has pointed out that this rate puts the black infant mortality rate in the state on par with Mongolia.

In Pitt County, rates are even higher. Between 2012 and 2016, the five-year average infant mortality rate for African-American babies born throughout North Carolina was 13.0, while in Pitt County, it was 16.8 deaths per 1,000.

The Healthy Beginnings program works with moms with multiple children who need additional support through the first two years of their youngest child’s life. The county health department runs the program and holds monthly support group meetings with classes on topics such as breastfeeding, safe sleep practices and healthy eating.

Additionally, two Pitt County program workers (called resource moms) conduct at least six home visits a year and help participants meet their goals.

For example, Hopkins wanted to find housing, get back in school, and live a healthier lifestyle. She’s a mother to three little boys, the oldest is almost 5 and the youngest is 4 months old.

Now, she has her own three-bedroom apartment and is enrolled in a career training program.

Being relatable

Beltina Brown and Kiera Clemmons follow up with all of the mothers in the Healthy Beginnings program. Each woman has two children and both were teenage mothers themselves.

“I know a lot of the barriers that I had to overcome when I was trying to be a teenager but also be a mom at the same time,” Clemmons said. “I can walk in their shoes.”

“Just because we got a badge and drive the county car doesn’t mean we don’t have a story to tell. Everybody has a story to tell,” she added. “I’ve been there. I’ve been in poverty. I have seen my mother raise four kids… And experiencing all of that helps me work with the women I serve.”

Healthy Beginnings staff L to R: Dionne Dockery, Beltina Brown and Kiera Clemmons. Photo credit: Taylor Knopf

When Brown started working with Healthy Beginnings in the summer of 2016, her first home visit was with Hopkins.

“When I met her, I cried,” Brown said, wondering if every participant’s story would be so sad.

“The main joy of it is being able to see them move from one level of self-sufficiency to the next,” she said. “Like Jasmine’s story… now she has her own place. It’s remarkable.”

Emotional support

“There were a lot of things I really didn’t know about being a parent, even though I already had one,” Hopkins said. “As I go through this program, I learn more and more.”

One support group meeting that really struck home for Hopkins was during domestic violence awareness month.

“I went through a situation like that with my last baby’s father,” she said. “It told me I had to step back or something serious was going to happen to me. And that person don’t care.”

Poster for an upcoming event for moms in Pitt County. Photo credit: Taylor Knopf

Hopkins remembers thinking, “I love me, and I love my life, and I love my kids. I’m going to be here as long as possible.”

She said she appreciates the relationships with other moms in the program as well. There are about 40 women currently in the program, about a third show up at support meetings.

“You get to know other people and find out some people have been through things that you’ve been through,” Hopkins said. “And some have been through worse and can relate and pull you out of certain situations and really give you that encouragement and support.”

On top of the emotional learning, Hopkins said she has also learned a lot about healthy eating and maintaining a healthy weight.

“I pass it down to my children and my youngest siblings and my mom,” she said. She’s trying to get her sister to join Healthy Beginnings as she is getting ready to have another baby.

Full-term babies and first birthdays

Healthy Beginnings uses a curriculum called Partners for a Healthy Baby from Florida State University, which encourages activities such as breastfeeding, safe sleeping, folic acid consumption, physical activity, healthy weight, smoking cessation and reproductive life planning.

“We don’t want to see any child go to the NICU,” said Dionne Dockery, maternal and child health outreach supervisor at Pitt County’s health department. “We want every baby born as close to full-term as possible and to live past their first birthday.”

She said that, for African-American women, the infant mortality is often higher after the first baby, which is why the program is focused on women with more than one child.

“Often times going to the doctor is not a priority,” Dockery said, noting that when a woman is struggling to figure out basic life needs, such as housing and groceries, going to another prenatal visit can be the last thing on her mind.

“I’ve heard patients say, ‘Well all they are going to do is weigh me, and I take my prenatal vitamins,’” she said. “While that may be how it appears sometimes, it’s not everything. Every pregnancy is different.”

While Healthy Beginnings is primarily focused on the African-American population where the infant mortality rate is the highest, 20 percent of program participants can come from other ethnicities.

Dockery said Pitt County has a large Hispanic population, as do many agricultural North Carolina communities. However, she said there has been a decline in the number of Hispanic patients seeking care through the health department.

“With the political climate, they don’t often seek services like they were in the past,” she said.

The nuts and bolts

There are some issues Dockery, Clemmons and Brown find themselves reiterating to participants over and over.

Many mothers have all their children sleeping in the same bed, including the new baby. So the health department provides a new Pack ‘n’ Play for $10 along with a 45 minute class about safe sleep practices.

“They just want their baby sleeping close to them,” Brown said.” We stress the need for the baby to have his or her own sleep area.”

Smoking cessation efforts are also a big part of Healthy Beginnings. Tobacco is a tough habit to break for these mothers, who are often stressed and expecting another child can only add to the stress.

Dockery said another big push is reproductive life planning. She said many women don’t want to have more children, but they are sexually active and don’t use any birth control. So Brown and Clemmons go over the options so moms can pick something that will work best with their lifestyle.

And condoms are always free at the health department.

While the program has helped hundreds of mothers and babies over the past two decades, Dockery said the improvement in infant mortality numbers hasn’t seen a lot of change.

“We saw a small improvement, a little dip, a few years back. It was a celebration,” she said. “But as you know, it’s a continual process to work through social inequities. And accessibility is an issue in rural areas.”

She said getting the word out about the services at the health department is a challenge.

“People don’t know about us,” Dockery said.

But folks like Hopkins telling their families and circles of friends is key.

“She’s telling everybody. We want to multiply people like Jasmine out in the community,” Dockery said. “She becomes a lay health advisor and the voice of the health department while we are not there.”

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Taylor Knopf

Taylor Knopf writes about mental health, including addiction and harm reduction. She lives in Raleigh and previously wrote for The News & Observer. Knopf has a bachelor's degree in sociology with a...