On a chilly Wednesday evening in January, Rachael Haines wrapped a thin, white measuring tape around 6-month-old Chandler Roberts’s head and smiled.
“Oh my gosh,” she said, beaming with excitement. “Look how far he’s come!”
Rachael Haines has followed every step of Chandler’s growth from the time his mother, Ashley Roberts, was six months pregnant. The registered nurse visits Roberts every other week in her Warner Robins home through the Nurse-Family Partnership. The free program sends nurses from the North Central Health District into the homes of first-time parents throughout pregnancy and the first two years of their child’s life.
The health department initiative launched in 2012 and has since provided at-home prenatal and parenting support to nearly 500 Houston County families. Its goals are simple: to improve pregnancy outcomes, to boost child health and development and to help low-income parents achieve economic self-sufficiency.
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“Being a first-time mama is very hard,” said Tina Hix, Nurse-Family Partnership supervisor for the North Central Health District. “I wish I would have had something like this when my kids were born.”
Nurse-Family Partnership is one of 18 government-approved home visiting programs across the country that pairs at-risk first-time parents with an early childhood professional to guide them through the early stages of parenthood. The community health program began in New York four decades ago and has spread to 42 states, serving more than 285,000 families.
More than 40 years of research indicates the national program benefits participants in both the short- and long-term. In Houston County, the impact has been huge, Hix said.
“It’s just so nice to see the mom pregnant and then see how scared they were or nervous they were, and then you’re going into the home, once the baby is born and see how they’re doing,” she said. “You know, it’s so rewarding to see that baby, you know, go from brand new to walking down the hallway at you.”
‘A real good buddy’
No two home visits are the same, Haines said as she unpacked her supplies on Roberts’s living room floor.
In the first months, the nurse checks expectant mothers for high blood pressure, spontaneous weight gain and swelling. The goal, Haines said, is to prevent complications that could cause preterm labor.
During her pregnancy, Haines talked to Roberts about changes happening in her body and gave her tips to prepare her for parenthood.
“We’re all about education,” Haines said.
During their most recent visit, the nurse weighed and measured the baby and checked his developmental progress. Haines also observed Roberts and her husband, Ian Roberts, as they played with Chandler, offering advice and feedback along the way.
Haines watched intently as Roberts read a book with Chandler, noting how the new mom raised her voice in excitement as she flipped through each page. Then Haines offered words of encouragement.
“I really like how you really put, like, emotions into your ... you weren’t flat when you were reading to him,” she said. “’Cause studies show that by you reading to him and, like, and you putting emotions and energy into your words, he will enjoy reading and he will start talking a lot sooner.”
The visits provide built-in support during a time when so much is changing, Roberts said. She’s not afraid to ask Haines honest questions and knows she can call for help even after the nurse leaves.
“If I have a question, regardless of whether it’s during the week, on the weekend, at night, early in the morning, she has really been there for any questions that I have had,” Roberts said.
Haines has walked Roberts through big transitions, like when she returned to work at the end of the summer and when she switched from breast milk to formula. She also prepares Roberts for changes to come as Chandler grows.
Watching children progress is her favorite part of the visits.
“One of the rewards with my job is seeing Chandler doing something new and then seeing Ashley getting so excited that Chandler’s doing something new,” Haines said. “To see how big he’s gotten and all the growth he’s doing and sitting up for the first time and trying to crawl by himself – crawl and get his legs underneath him – it’s just, it’s very rewarding.”
As an Early Head Start employee, Roberts knows those breakthroughs come quickly. Haines reminds her to take extra precautions to keep Chandler safe as he gains strength and independence.
“They do grow up fast, yes, and, you know, you have to be on your P’s and Q’s at all times,” Roberts said.
Roberts cherishes her candid one-on-one conversations with Haines. Knowing she can count on Haines for help makes it all a bit less scary.
“It’s like a real good buddy to kind of help you guide you through it as a first-time mom,” Roberts said.
A research-tested solution
A growing body of research suggests home visiting programs improve the lives of children and their parents.
The Maternal, Infant and Early Childhood Home Visiting Program provides federal funding to Nurse-Family Partnership and more than a dozen other programs that send nurses, social workers or early childhood educators into the homes of parents in need of extra support.
Home visiting programs serve families who often lack outside support, Hix said. In Houston County, Nurse-Family Partnership participants must qualify for Medicaid; food stamps; or Women, Infants and Children benefits.
“These are some of the most vulnerable families – I mean, high rates of maternal depression, high rates of, you know, having moms with lower levels education, stress on the family,” said Lauren Supplee, deputy chief operating officer of Child Trends, an early childhood research organization. “So, going to the home reduces a barrier that may be in place if parents had to, you know go into a clinic or something to see someone.”
Supplee has studied home visiting programs for more than two decades, and said they can connect parents with community resources they might not know how to access on their own. Frequent meetings allow home visitors to take the time to learn what their clients need.
“She becomes essentially a friend and a support,” Supplee said. “She, you know, she really gets to know the family, gets to know where they are in a place where they feel comfortable.”
That close relationship doesn’t just build trust. It also improves outcomes, research shows.
Studies of Nurse-Family Partnership have found its participants face lower rates of prenatal cigarette smoking, maternal hypertensive disorders and closely spaced pregnancies. The program also has been linked to decreases in child abuse and neglect and improved cognitive and language development.
Despite a wealth of research on the benefits of home visiting programs, Supplee said, such initiatives only reach a small portion of potentially eligible families. The federal government has allocated $400 million in annual funding for home visiting programs through 2022, but Supplee said it’s not enough.
“If we really, truly want to make population-level change that’s important for communities, the funding would need to increase,” she said.
‘It’s not about me anymore’
So much has changed for Roberts since her son’s birth.
“It’s not about me anymore,” she said. “It’s definitely – everything is centered around Chandler.”
The new mom now worries about public changing tables, nap time and easy-to-reach electric sockets. She tries to see the world through Chandler’s eye, to anticipate his needs and wants.
Roberts is thankful she can always call Haines for advice. She just wishes time would slow down.
“The first six months have been wonderful,” Roberts said. “And so, I’m gonna cry when he turns 2.”
“We’re all going to cry,” she said.
As Ian bounced Chandler in his lap, Haines packed up her bag of supplies and handed Roberts a stack of reading materials. Then she answered a few intimate questions about the baby’s bowel movements and waved goodbye.
Samantha Max is a Report for America corps member and reports for The Telegraph with support from the News/CoLab at Arizona State University. Follow her on Facebook at https://www.facebook.com/smax1996 and on Twitter @samanthaellimax. You can also join her Facebook group. Learn more about Report for America at www.reportforamerica.org.