Women in impoverished regions face enormous challenges – a dangerous physical environment, isolation and reduced access to education. For them, the anxiety of an unplanned pregnancy is profound.
A number of studies have proved a mother’s stress can present in her children as well; women with higher levels of cortisol during pregnancy may have children with higher levels of the stress hormone, which can put them at greater risk for a lifetime of health disparity.
These children typically have their first point of behavioral evaluation when they enter into the education system at 4 years old. By then, they may already have deficits in their physical health and cognitive capabilities as well as behavioral issues such as a volatile temperament.
Even at such a young age, attempts to reshape these behaviors can be difficult. The wiring for these children started while they were in utero, when their mother’s environment was stressful and her access to resources was limited.
This is where the Nurse-Family Partnership program comes in. Low-income, first-time moms are partnered with a compassionate public health nurse who schedules home visits with mom and baby, during pregnancy and up to the child’s second birthday. By providing a consistent and reliable relationship to a vulnerable mom, NFP nurses are able to help shape a healthier future for her baby and interrupt detrimental stress patterns.
In the 1970s, David Olds, Ph.D., realized economically disadvantaged children needed help much sooner than 3 and 4 years of age and founded NFP to help families get a better start to life. Today, it is one the most successful national programs. More than 30 years of randomized and controlled clinical trials prove that it works, and a number of independent studies also show that the program can more than pay for itself. The RAND Corp. estimates NFP can return up to $5.70 for each $1 spent.
Nurses establish a powerful relationship with each young mother, transforming their lives and helping them connect with their baby. Children who participated in the program showed better language development at age 4 and moms have greater intervals between births of their first child and second child. The reduction in unplanned, closely-spaced pregnancies is extremely important in reducing risks for other negative outcomes such as child maltreatment and injuries, and continued poverty.
In the last year for NFP at San Juan Basin Public Health, four nurses made more than 975 visits, serving 108 new mothers and 81 infants in La Plata, Archuleta and San Juan counties. Of these, 90 percent of the moms were breast-feeding their babies at birth, and 53 percent continued to 6 months of age. Also, more than 90 percent of the children received multiple assessments of their physical and social-emotional development by age 2 and referrals for support services.
In recent years, the SJBPH NFP program has been hosting gatherings for enrolled moms to help them socialize with each other.
NFP moms are typically faced with challenging lifestyles or environments that make developing meaningful, trusted relationships difficult. Each Mother’s Day and during the winter holidays, NFP hosts parties for the moms and their children so they can meet each other and celebrate their healthy babies. Building these relationships is not only beneficial for mom but is a positive health behavior for their children as well.
For more information, visit www.nursefamilypartnership.org. To enroll, contact Patsy Ford, RN, MS, at 335-2037 or pford@sjbhd.org.
Lauren Pope is communications specialist at San Juan Basin Public Health.
