The U.S. has one of the highest infant mortality rates of any developed country in the world. Around 5.4 infants die under the age of one per 1,000 live births, which is 71% higher than the comparable country average of 3.4 deaths. Socioeconomic inequality is thought to be a primary contributor. Low-income mothers are much more likely to lose their baby within the first two years of life compared to mothers living above the federal poverty line. They often lack access to healthcare and preventative services that improve the child’s quality of life.
That’s why the U.S. started what’s known as the Nurse-Family Partnership, a nationwide program that pairs first-time low-income mothers with nurses. The program has taken off in Delaware where the Division of Public Health serves some 200 clients across the state. Mothers must be eligible for Medicaid to qualify for the program. The nurse will meet with the mother biweekly or once a month up until the child’s second birthday.
Nurse Nate’ Morris meets with Robin Washington at her home in north Wilmington on their second-to-last visit as Washington’s 19-month-old daughter Delilah plays on the floor.
“She walks around like she’s a little teenager,’’ Washington says with pride.
“She’s a sweetheart,” Morris replies. “So miniature and so cute.”
But Morris turns to business once Delilah goes to her room to take a nap. She tells Washington that her last check-up will be in February 2023.
Washington says she’s thoroughly enjoyed her time in the program since she enrolled two-thirds the way through her pregnancy. The two women met by phone or online for about a year due to the pandemic, but they have been meeting in person ever since the restrictions were lifted. Washington says Morris has been her friend, coach, and confidant through what could have been a painful experience.
“She’s good. She’s wonderful,’’ Washington said. “She’s actually why I really don’t listen to other parents. I did the opposite of what a lot of people, my friends, did. And I achieved more.”
Morris keeps track of Delilah’s growth and development to make sure she hits the appropriate milestones and that she makes all her medical appointments. She also provides information on nutrition, breast feeding, mental health, education, and home safety to her 25 clients.
“We encourage our moms to get down on the floor and play with the babies and read to them, talk to them as much as possible, and to build that language development for them,’’ Morris said. “I like to tell them, pretend you get a dollar for every word you speak to your baby.”
Delaware is set to expand the initiative thanks to a $4 million donation from the philanthropic Longwood Foundation and New Castle County, which is using pandemic relief dollars.
Kirsten Olsen, the director of Children and Families First, said four nurses are being hired to guide the expected wave of new moms.
“There are somewhere between 600 and 700 moms in New Castle County who are eligible for a nurse-family partnership but are not yet receiving it because we don’t have the sufficient resources to meet those needs,’’ Olsen said. “Now we’re going to be able to expand our services to about 120 new moms.”
New Castle County and Longwood decided to join forces to help expand the program.
“There is no greater public investment than investment in neonatal care, prenatal care, in early childhood care, and investments in support for mothers trying to raise children in poverty,’’ said County Executive Matt Meyer. “There’s tremendous human benefit just in terms of potentially breaking a cycle of intergenerational poverty.”
Olsen added that the state is regularly evaluating the program to make sure the appropriate benchmarks are met.
“We have an agreed-upon set of benchmarks that we’re working toward, around enrolling moms in the program, retaining moms in the program, supporting moms who breastfeed if that’s the right choice for them, and making sure that the kiddos get their immunizations, those kinds of metrics,’’ she said.
Olsen said some mothers are weary of applying for government assistance or having a healthcare worker check up on them, while others lack the skills to form a productive partnership.
“There are moms that I have to chase or track down, they’re not answering their phones or their phone is cut off,” Morris said. “And I have to reach out to a family member to try to find them. If they don’t want to talk to me or be in a program, then they will be standoffish or disengaged.”
Morris said still others “don’t have any support or very little or they start off with some support. But then you see as time goes on, there’s nobody there for them. Also, once they have the baby, they are talking to me about needing breaks, but not having anybody to watch your baby for them. “
But she says she’s ultimately there to help, not intervene, judge, or intrude.
“There could be financial issues with these moms so that I will give them some resources out in the community, something like Catholic Charities or someone to reach out to, to get help to pay for an electric bill or something like that,’’ Morris said.
As a single mom, Morris understands how important it is for new mothers to have a network of support.
“I’m a single mom, too, so I try to also be relatable to my clients,’’ she said. “Because I’m a nurse, I don’t think I got it all together. I have single mom struggles just like you guys do. So we’re in this together. We’re going to figure this out together.”