Nurses for poor mothers linked to healthy births in SC

jself@thestate.comApril 3, 2013 

Newborn Jordyn Jay, born on December 31, 2010, was the subject of a story by The State in February 2011 on the drop in infant mortality in South Carolina as a result of in-home nurse visits provided for some poor women.


— When Brittany Rogers of Greenville found out she was pregnant, she “knew nothing about kids” and was facing single motherhood with no one to turn to for help.

“I was terrified,” said Rogers, now 23, and the mother of a 14-month-old son. “It wasn’t a planned thing.”

Now, because of a program called Nurse Family Partnership that provides low-income women in their first pregnancies with home visits from registered nurses, Rogers’ confidence in motherhood has grown.

“You would think I’m professional now.”

Available in limited areas of the state since 2008, the partnership’s goal is to reduce premature and low-weight births and costly stays in neo-natal intensive care units, specifically among first-time mothers who qualify for Medicaid – the joint federal and state health insurance program for the poor and disabled.

A new study by the state Department of Health and Environmental Control shows the program is working, and its success could mean huge savings for the state in reducing Medicaid costs if the program were made available to more mothers, health officials say.

Just what those savings could be is not clear and will be the focus of upcoming studies, they added.

Expansion may be coming soon.

Tony Keck, director of the state Department of Health and Human Services, said his agency will soon announce plans to expand nurse-family partnerships in the state, recognizing that health is about "much more than health services."

Last year, Keck's department, for the first time ever, set aside money to encourage managed care organizations to expand nurse-family partnerships.

The study analyzed birth outcomes for 354 first-time mothers in the Nurse Family Partnership who gave birth in 2010 and 2011 and compared them to three groups of women: 23,000 Medicaid-eligible pregnant women statewide, 13,000 women who gave birth in the same hospitals as participants, and 352 women who matched the participants’ race, education level and participation in a federal family nutrition program.

In each case, participants had lower instances of premature births, low birth weights, and stays in neo-natal intensive care.

But differences were most dramatic among the 352 women most similar to those studied.

Only 8.2 percent of women in the program had premature births, compared with 17.3 percent of women outside the program. Participants who had low-weight births were at 9.4 percent, compared with 19.3 percent of nonparticipants, and 4.8 percent of participants’ births resulted in stays in intensive care, compared with 13.1 percent of nonparticipants.

The program, which could help keep infants out of intensive care where health care costs skyrocket, is a “wise investment” for the state, said Dan Wuori, chief program officer at S.C. First Steps.

“If we make investments like this, it could be a really good benefit to taxpayers, not to mention the public health benefit to the mothers and participants.”

Mike Smith, an epidemiologist with the S.C. Department of Health and Environmental Control, presented the study Wednesday to members of S.C. First Steps board of trustees, the sponsoring agency for the national nonprofit program.

As the name implies, Nurse Family Partnership is a collaboration of many. S.C. First Steps, the Duke Endowment, the BlueCross BlueShield Foundation of S.C., the Children’s Trust of S.C., DHEC, and dozens of community partners help pay for the program, Wuori said.

The program is available through seven health care providers around the state, including hospitals, DHEC offices and federal health clinics. The providers reach about 19 counties, including Richland and Lexington.

More than medical advice

Rogers was working at Hardee’s and had just enrolled in college when she got pregnant. A friend told her about the program, and she signed up.

“I wasn’t going to be a statistic,” Rogers said Wednesday during a visit with Samantha Brooks, a registered nurse with the partnership who has been visiting Rogers since she was 10 weeks pregnant. The visits will continue until Rogers’ son, Cayden, turns 2.

Brooks guided Rogers through her pregnancy, teaching her about healthy choices and preparing her for motherhood. Since Cayden’s birth, Brooks and Rogers talk about child safety and nutrition, and whatever else is on Rogers’ mind.

Brooks helped Rogers get a First Steps child care scholarship so she can go to school and work full time as the manager of a Kangaroo convenience store.

The program also helps keep mothers from rushing to the emergency room at the first sign of a cough or fever, Brooks said.

Sometimes they do not talk about Cayden at all, Brooks said. Sometimes they focus on what Rogers needs.

“There have been many times that I have wanted to quit,” Rogers said, adding that Brooks has always been a phone call or text message away.

Brooks and Rogers agreed that sometimes best friends do not see each other that often.

Their closeness, built on Rogers’ trust for Brooks, is why the program works, Brooks said, adding that Rogers could have “fired” her anytime.

Improved birth outcomes - the numbers

The DHEC study analyzed birth outcomes for 2010 and 2011 first-time mothers in the Nurse Family Partnership by comparing them with other first-time mothers similar in race and education, and participation in a federal family nutrition program.

Percentage of first-time births resulting in admittance to neo-natal intensive care

4.8: NFP participants

13.1: nonparticipants

Percentage of preterm births

8.2: NFP participants

17.3: nonparticipants

Percentage low birth weight

9.4: NFP participants

19.3: nonparticipants

Reach Self at (803)771-8658

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