Nurse-Family Partnership strives to give vulnerable, first-time moms the best start possible. Here is an example of how your support helps give these moms a good start:
As Holly Poole scans the file of her newest client, Nely, she looks carefully for any red flags. Drug use? The report says no. Drinking? Another no. Holly feels some relief, but when she scans further, she sees it: red flag number one. Newly pregnant Nely is just 14 years old.
Driving through the outskirts of Philadelphia to Nely’s home, Holly is concerned but optimistic. After seven years with Nurse-Family Partnership, she has a laser focus on goals for each young client: a healthy pregnancy and delivery, and development into a confident young woman with plans for her future.
Holly knows that guiding Nely through her pregnancy and the first two years of motherhood will be only part of her assignment. She must also acknowledge that Nely will deal with pressures about continuing her education, relationships with boys, self-image and a host of other issues relevant to young teens. Holly wonders how Nely will handle these issues while also facing the stresses of pregnancy and motherhood.
At this first meeting, Nely sits quietly at the kitchen table. She is young and looks it, with her hair pulled back into a ponytail. It is clear from her downcast eyes and silence that she is shy. Terrified may be a better word.
During their 90-minute introductory meeting, Holly does most of the talking, asking questions to get a fix on Nely’s health, family structure, relationships and interest in schoolwork.
Nely sits next to her mother, who works six days a week at a big-box store and had to request time off – no small thing – to attend this meeting. She was upset about the pregnancy at first, seeing it as another mouth to feed, but seems to have come around a bit. Nely has questions swirling in her head and Holly seems easy to talk to, so she decides she wants Holly to be her Nurse Home Visitor. Nely promises to abide by the program’s rules, such as “I will always call in advance to cancel any meetings I can’t attend.” Her relationship with Holly is now official.
Every other week, Holly and Nely meet for one hour, usually at the same kitchen table. In addition to discussing each stage of pregnancy, Holly focuses immediate attention on Nely’s plans, especially for her education. “What do you want to do after you have the baby?” Holly asks.
“He wants me to drop out of school,” Nely responds, talking about her boyfriend, the baby’s father.
“Okay…” says Holly, “But what do you want?” trying to help Nely’s focus on her own desires and needs – her heart’s desires. She knows that even a small step is significant. Her question prompts the discussion Holly frequently has with her young clients about careers and education options. She hopes Nely can envision a plan for her life beyond being a teenage mom. Holly asks gently, “If things don’t work out with your boyfriend, how might you support the baby? What kind of job would you be able to get?”
Nely is hesitant, so Holly continues, “Sometimes we don’t find out right away what we want to do. We just start someplace and get things going.” Nely mentions that she likes playing with kids like her nephew. Bingo, thinks Holly, a place to start. Knowing that full-time school is of little interest to Nely, she introduces Nely to the possibility of vocational-technical school in a child development career. Nely decides to enroll after giving birth to her baby.
Although the father of the baby never attends Holly and Nely’s meetings, his presence is felt. He is older than Nely and controlling. During one visit, he calls 20 times over the course of an hour. This is when Holly introduces Nely to the “cycle of abuse.” She explains the concept of emotional abuse, prompting Nely to open up.
“He says that no man will want me because I have a baby with him,” Nely confides. “He wants me to drop out of school because I’m not that smart anyway.” She even admits that he has hit her on occasion. “But I never thought of it as abuse,” says Nely. “He always apologized afterwards.” Holly focuses many subsequent sessions on strategies for building Nely’s self-esteem while learning how to communicate with her baby’s father even when his comments are negative and hurtful.
While Nely’s self-confidence is building, she is simultaneously preparing for motherhood. As it turns out, Nely is something of a natural. She begins to come out of her shell and is eager to learn everything she can. She is so eager, in fact, that Holly begins to jokingly call the beginning of their meetings “the attack.”
“I have so much to tell you!” Nely exclaims the moment Holly walks through the door for a meeting during her third trimester. “The baby is always moving! And I have a new pain. Is it a contraction?” Holly is thrilled that Nely has become the one asking the questions. The two discuss labor and delivery—Nely’s biggest fear—frequently. “Is it as bad as it looks on TV?” Nely asks.
Their discussion moves from labor and delivery to nutrition and care for the baby after birth. As the hour comes to a close, Holly shares one more tidbit. “Did you know that the baby can hear you when you talk? When your baby is born it will recognize your voice.” Nely stares at Holly with wide, amazed eyes. A spontaneous smile bursts onto her young face. Moments like this are the best part of Holly’s job.
Almost a year later, Holly and Nely are still meeting regularly at Nely’s mother’s house. Now, when Nely greets Holly at the door, she is carrying Bryanna, her nine-month-old daughter. Bryanna is a healthy, happy baby. She is shy like her mom but possesses the same wide-eyed smile.
Holly is pleased with Bryanna’s development and growth, but even more so with Nely’s. She is now in the tenth grade at a vocational technical program in early childhood development. She has ended her relationship with the baby’s father, although he still visits the baby occasionally. She’s even stepped out of her shell to have some fun, attending a recent school dance with friends.
Holly’s work is not done—the two will continue meeting until Bryanna is two years old. There are no guarantees that Nely will stay in school and maintain her growing self-esteem. But for now, it’s clear that the red flags in Nely’s life have transformed into green lights. With the help of Holly Poole and the Nurse-Family Partnership, Nely is on the path to becoming a successful mother, a high school graduate and a strong, confident woman.
Here's an example of how your support of Nurse-Family Partnership helps young families:
Nineteen and pregnant, Amanda had a lot on her plate, so she didn’t need any aggravation –but that’s just what she was getting. Her boyfriend – the father of her unborn child – got louder and angrier as he stood aggressively over Amanda, who was sitting at the kitchen table. That’s when Valerie stepped in.
Valerie Carberry, a nurse home visitor with Nurse-Family Partnership®(NFP), had been sitting with Amanda, offering advice for a healthy pregnancy, when the tirade began. Until now, Valerie had only seen his warm and engaging side –the side that had quickly charmed her young client and led to a pregnancy just five months later.
Valerie looked straight at the young man and asked him to step outside. “You’re out of line,” she said firmly before issuing a threat of her own: if he didn’t calm down, she would call the police. While he stewed, Valerie, cell phone in hand, turned her attention to Amanda. “Do you want me to call 9-1-1?”
“No,” replied Amanda, though she looked uncertain. Valerie was not content to leave matters where they stood. “He’s just cooling off because I’m here,” she said. “You have got to have a safety plan,” she added, handing her phone numbers for women’s shelters in this part of Colorado. Amanda jotted them down and tucked the list away. “I walked out of that visit going, ‘Oh my,’” Valerie would recall later. “But at least we had something in place.
”Amanda did not flee that day, but the wheels in her head had begun to turn—perhaps she could create a brand new life for herself and her unborn child, she thought to herself. In the three months since her initial meeting with Valerie, Amanda had shared the most intimate details of her family history: her mother’s periodic bouts with homelessness, how she herself had ended up living in her car after her father and stepmother were divorced, a family tree with step siblings and half-siblings and other relationships almost too complicated to sort out. And then there were the troubling reports about her boyfriend’s behavior. Not only did he regularly chastise Amanda about gaining weight, he made fun of her acne, which flared up due to stress. And he called her names.
These ongoing revelations left Valerie feeling a bit shell shocked—but she was more than prepared. Though new to NFP, Valerie was an experienced public health nurse, and the NFP program provided her with an arsenal of proven materials to use throughout a carefully designed course of action. She began by shoring up her client’s self-esteem just as a builder would reinforce a foundation before doing anything else.
Amanda, who had been concerned that she wouldn’t be a good mother due to her own troubled background, slowly began to recognize the direct correlation between excellent prenatal care and successful parenting. She was diligent about her medical appointments, diet and health. “I stopped dying my hair and tanning. I didn’t even microwave when I was pregnant!” Amanda says now, looking back. Valerie complimented Amanda on every positive step, and continually reminded her that these were, in fact, the very first steps in becoming a good mother.
Amanda continued to endure stress in her relationship—at one point she fled to her mother’s home in Florida, only to return to her boyfriend when he “sweet-talked” her into coming home—but in October she delivered a healthy baby boy. Amanda’s already strong maternal instincts were further reinforced by Valerie, who complimented Amanda when little Nolan gained weight. One of the highlights of their visits was weighing the little boy on the scale Valerie brought along with her. Four ounces equaled victory, and clearly, Nolan was thriving under Amanda’s care. “She took to it like a duck to water,” Valerie says. “I was just so motivated and high on being a mom,” says Amanda. “It’s like I was born to be a mom.”
By the time Nolan was six weeks old, however, Amanda began to “crash and burn,” recalls Valerie, who saw the signs of post-partum depression during her visits. Always fastidious about her housecleaning, Amanda would let the dishes pileup in the sink. The baby’s father wasn’t helping out much, and a new cycle of violence had begun.
When Nolan was three months old, Amanda says her boyfriend choked her as he held her over their son’s crib. “I couldn’t help but think how this would have scarred him for life if he had been five years old and could remember it,” says Amanda. It was finally time to put into effect the flight plan she had developed with Valerie all those months ago.
Scared but determined, Amanda called the police, who arrested her partner. By the time he made bail and returned to their apartment, Amanda had relocated to a shelter with her son. “Before, I remember always thinking I was going to be stuck,” says Amanda. “But it wasn’t just me now. I knew I could do it—but I didn’t know how.”
Always nearby to encourage her client and affirm that she had done exactly the right thing was Valerie, who continued to meet with Amanda in the shelter. Through the resources made available to her there, Amanda was able to enroll in college and move into her own apartment. In May, she graduated with an Associate Degree and plans to study speech therapy when Nolan is a little older. Nolan’s father provides financial support and visits with him regularly, but Amanda is through with him romantically and is currently dating a man who, as she puts it, “would rather die than lay a hand on me.”
“The program is awesome,” says Amanda, who graduated from NFP when Nolan turned two. “I don’t think I would have left Nolan’s father if Valerie hadn’t told me that what he was doing was wrong. She was that one voice. That’s all I needed. She never made it sound like I couldn’t do it. She used to tell me all the time I was a survivor. She really believed in me.”
Valerie tears up when told of Amanda’s heart-felt expression of gratitude; as if she had never quite realized the impact she’s had on her former client. “She did all the work,” Valerie replies modestly. “She just needed the consistency of someone saying, ‘You can do it’.”
Nurse-Family Partnership is currently serving more than 22,000 moms and thier babies in 32 states in the US and everyday brings the potential of a better day. By being part of Nurse-Family Partnership the mother is more likely to have a healthier pregnancy for both her and her baby, the baby is less likely to face abuse or neglect and more likely to be ready for school and the mother is more likely to have a job to help support her family. The support you have provided to Nurse-Family Partnership has helped make this happen!
After posting our call for help during the Mother's Day season, five new donors stepped up and gave $195 to assist low-income women who are pregnant for the first time. Their generosity will enable Nurse-Family Partnership to help serving vulnerable women and their kids and improve pregnancy outcomes, child health and development and economic self-sufficiency. Thank you!
According to the federal government, more than 650,000 Medicaid-eligible women give birth for the first time each year. For many, it's a time of anxiety and uncertainty. A lot of the women don't have good role models and nurse home visitors provide that support through their clients' pregnancy and until their child reaches two years of age. Your help through GlobalGiving helps immensely. As a small thank you, we invite you to send a free virtual bouquet to your Mom or anyone else special in your life by visiting http://www.facebook.com/nursefamilypartnership#!/nursefamilypartnership?sk=app_10467688569
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