Categories: Schenectady County
Nichole Weber wants to make sure J’Nai Grimes is ready to go.
Is her birth plan finished? Is her bag packed?
Weber looks through the bag, which includes a nursing bra, an outfit for a baby, a hat and two pairs of socks. “Good,” Weber says, approvingly. “You’re so prepared. I’m so glad.” The two women are sitting on the couch in Grimes’ Schenectady apartment while her husband sleeps in the bedroom.
Grimes, 19, is due on Jan. 13. She has a thick binder filled with information about pregnancy and parenting; pictures of the ultrasound taken of her unborn daughter, who will be named Trinity, are pasted on the front. During her visit, Weber provides information about breast-feeding. “Before you got pregnant, did you know a lot about breast-feeding?” Weber asks.
Grimes shrugs. “No,” she says. Weber then ticks off the reasons why women should breast-feed. “There’s less obesity in children,” she says. “They have a better immune system. They get stronger. [Breast milk] is high in protein. Babies are less likely to get ear infections.”
The two women have a good rapport, and it’s clear that they like each other. But Weber isn’t a friend or relative. She’s a trained family support worker who visits Weber through a program called Healthy Schenectady Families.
The program provides Schenectady County families with regular visits from trained family support workers, as well as a community health nurse, with the goal of improving the health and well-being of at-risk children by educating and supporting their parents. Parents must enroll in the program before the baby is 3 months old; visits from the nurse continue until the baby is 1, while the trained family support workers visit until the child is 5 or enrolled in Head Start or kindergarten.
The average mother enrolled in Health Schenectady Families is between 20 and 24 years old. More than 90 percent are low-income, but the program is open to anyone.
Recently, the New York State Department of Health announced $2.1 million in funding for a new program, called the Welcome Baby! Universal Prenatal and Postpartum Home Visiting, that seeks to provide home visits and basic health education to women who do not already receive those services. The hope is to build upon the work of existing home visiting programs such as Healthy Families, and reach the approximately 10 percent of pregnant women who do not have prenatal care. Many of those women are low-income, said Wendy Shaw, the associate director of the Division of Family Health at the New York State Department of Health.
“Low-income women are certainly at high risk,” Shaw said. “Sometimes their highest priority is not pregnancy. It could be getting a stable home.”
Checking up at home
In 2004, local health departments in New York conducted 39,419 home visits to 4,615 pregnant women and 12,293 postpartum families, accounting for 4.8 percent and 12.7 percent, respectively, of live births that year, according to the New York State Department of Health. These visits can yield more information about a baby’s home environment than a routine check-up in a doctor’s office.
“You’re really engaging the mom and baby on their own turf,” Shaw said. “You have the ability to see the home situation.”
“Welcome Baby! is a step in the right direction,” said Jenn O’Connor, a senior policy analysis at the Schuyler Center for Analysis and Advocacy in Albany, a nonprofit organization that supports expanding prenatal/postpartum care and home visitation throughout the state. “If a county has only one program, and does only prenatal but not postpartum home visitation, they’re missing out on a whole group,” she said. “There are a lot of people who fall through the cracks.”
In the past, new mothers relied on an extended network of relatives to provide advice and tips on child rearing, O’Connor said. “That doesn’t necessarily happen anymore,” she said. “There’s no training manual that goes along with having a child.”
Peggy Sheehan, program manager for Healthy Schenectady Families, which is based at the Schenectady County Public Health, said expanding prenatal and postpartum home visitation would benefit children throughout the state.
“It’s so hard for families who don’t have a network of support,” she said. “We’re creating a web of support for families. We provide them with information they need. We connect them to other people.”
Healthy Families Schenectady is part of a national program, called Healthy Families America, that has 28 sites in New York. The Schenectady program marks its 10th anniversary this year; almost 1,000 families have enrolled in the program, which is voluntary. Some families receive an initial visit, but decide not to enroll, while others stick with the program.
In the beginning, visits from the family support workers are weekly and last about an hour. The workers interact with the baby once he or she is born. “They get on the carpet and point out what the baby is doing,” Sheehan said. They have flash cards, called “Baby Cues: A Child’s First Language,” that depict different expressions; parents can look at these cards to better understand what their baby is trying to tell them. They make sure the baby’s immunizations are up to date. After about a year, the visits start to become less frequent.
Healthy Families Schenectady has 10 family support workers. The program is in demand, and Sheehan estimates that about 20 percent of county families would enroll in the program if they could. “That means we should serve over 300 families at one time,” she said. “We’re not even up to 200. We could have another four or five support workers.”
Sheehan and others at the Schenectady County Public Health became interested in starting a program to serve needy mothers about a decade ago, when they noticed that women they had visited as children were coming to them for services as adults. “They were young, single, they hadn’t finished school,” Sheehan said. “They were struggling with the same things their mothers did.”
Weber, who has a caseload of 16, said Grimes is one of her best young mothers. “She’s been pretty interested in the program,” she said. “I see people who want to get into the program for the free stuff you can get. She reads the books. She gets into it. We have a good bond together.”
Grimes, in turn, said she enjoys the visits with Weber. “She’s more than just a worker, she’s a friend,” Grimes said. “With my other friends, I talk about regular stuff. With Nichole, I talk about the baby. … She’s young, she’s not some old lady telling me stuff.”
Grimes learned about Healthy Schenectady Families while taking a prenatal class at Hometown Health. “I wanted to get more information,” she said. “This is my first baby. I knew stuff, but this gave me more information.”
Last week Grimes received a visit from Weber and community health nurse Lisa Whitman.
“The baby is moving a lot, especially when I try to relax or when I eat something,” reported Grimes, who is soft-spoken and calm.
Weber and the other family support workers are employed by Catholic Charities of Schenectady County. Weber, a Colorado native who worked as a child correctional officer before moving to the Capital Region, said she sees the value of the Healthy Families program. “I saw a lot of girls [in Colorado] who left and got pregnant and didn’t have anyone to talk to,” she said.
She likes her job. “You get to be a part of something you wouldn’t ordinarily be a part of,” Weber said. “This program can be invasive. A lot of people don’t like people coming into their home. Sometimes people don’t take to it very well. I like to encourage [Grimes]. I want to encourage her to be the best mom she can be.”