For First Time Moms Someone To Lean On and Learn From
"Strengthening society with an evidence-based community healthcare program.
Nurse - Family Partnership is a community healthcare program that yields quantifiable social benefits and a substantial return on the community’s investment. More than 37 years of evidence from randomized, controlled trials prove this maternal health program’s effectiveness guiding low-income, first-time moms and their children to successful futures. By developing strong family foundations, this program establishes better, safer, and stronger communities for generations to come." nursefamilypartnership.org
Angel Franco/The New York Times -
A nurse makes a home visit to a first time mom, Bronx, NY.
NYC Nurses Aid Low-Income First-time Mothers
Summarized from the article above:
The Family Nurse Partnership sponsors a program in NYC in which "specially trained nurses are matched with low income at risk first time mothers visiting, starting during pregnancy, every week or two, until the child is two years old." They monitor the health of mother, and the health and development of the baby. They evaluate the social situation and make referrals to services as is needed. They counsel and provide support to the new moms as they negotiate parenting and the many other aspects of their lives that are often in turmoil. Many of the mothers are hard hit cases, living within the foster care system, in prison, or in homeless shelters.
Multiple studies have proven that this program is a success, benefiting mothers, children and saving money in the long term. The program started in upstate NY and is now running in 42 states in the US.
Markers of Success:
Women in the program -
1) Had fewer premature babies
2) Smoked less during pregnancy
3) Spent less time on public assistance
4) Had fewer arrests and convictions
5) Maintained longer contact with their baby's fathers
Children in the program -
1) Had fewer language delays
2) Had less reports of child abuse and neglect
3) Had slightly higher IQ scores
4) Had fewer arrests and convictions as juveniles
5) Had less depression and anxiety
A 2011 independent study of the NYC Program projected that by the time a child in this program turns 12 y/o the city, state and federal governments will have saved twice the program's cost per child.
Problems faced by women in this program include:
A history of abuse in childhood
"Most of the women had the poor luck to be have been born in poverty. Like their middle-class counterparts, none came into the world knowing how to raise a baby." from NYTimes
"Part of my work lies in modeling good habits."
Mom - "She teaches me a lot. Like how to deal with things, how to think before you speak. Don't just blurt it out."
Many of the nurses find themselves trying to counteract practices of the babies' grandmothers - like putting cereal in the bottle. This can lead to overfeeding and increase risk of obesity.
Obesity is a major health concern in NY. One mom who is obese was trying to make changes, break from family ways. Her mother "pushed back against the nurse" even though she suffered from obesity and diabetes. Some of the moms do better with the babies than they do for themselves in this regard.
(Although this is program is a success for the families that continue with it many moms do drop out. Research is underway to understand why.)
What learnings can we apply from this program to programs for parents in low income communities in the developing world?
Who can we identify as the knowledgable "someone to lean on?" Is it important for this person to be from the community, outside the community? Will this vary depending on cultural context?
What does this program teach about knowing the context of someone's life as we design interventions?
What does this program highlight about consistency in terms of support for a new mother and her baby?
What is the importance of having a confluence of services? In this case someone who can refer you to care that is needed.
What does this program highlight about the process of becoming a parent and the support that is needed for good outcomes, for mother and baby, the extended family, and society as a whole?