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 4years 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 Corporation 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 Health, five nurses made more than 1,250 visits to 70 families in La Plata, Archuleta and San Juan counties. Of these, 98 percent of the moms were breast-feeding their babies at birth, and 50 percent continued to 6 months of age. Also, all of the children were up to date with immunizations at 18 months.
A young mom in a rural part of the region enrolled with NFP and early this year gave birth to a healthy girl. Her nurse not only helped her have a healthy pregnancy but has continued to provide her with learning skills to support the development of a healthy child and encourages her in finding and achieving her life’s dreams.
At a time when government work and spending is criticized, it’s important to recognize the value in services provided by San Juan Basin Health. The Nurse-Family Partnership program is an investment and a community health program that works and will continue to transform the lives of vulnerable, first-time moms.
For more information, visit www.nursefamilypartnership.org. To enroll, contact Patsy Ford, RN, MS, at 335-2037 or pford@sjbhd.org.
Lauren Pope is an assessment, planning and communications specialist at San Juan Basin Health Department.
