Celeste Hines doesnt hesitate when Alberta Jackson-Freeman asks her if theres anything she needs.
I need you to visit again, says Hines, a first-time mother. Her son, Noah, is nearly 9 months old.
Hines, 36, has enjoyed regular visits from Jackson-Freeman, a registered nurse, since early in her pregnancy through the Nurse-Family Partnership, a program aimed at reducing childhood health problems through home-based education and mentoring.
The support has been great, Hines said. My family doesnt live here, and this is my first child. Alberta helped prepare me for motherhood.
Last week, the two women spent their hourlong session discussing opportunities and issues facing Hines, who has landed a job and recently moved to a larger apartment. They also spent time considering ways to interest Noah in words and books.
You might have to tap on the book to get his attention, Jackson-Freeman said, demonstrating with a life-size baby doll she brought to the session. Hes not going to sit too long, but the idea is to get him to focus a little as you say the words.
This advice from the nurse is soaked up by Hines, who takes the book and starts reading to Noah in their tidy North Raleigh living room. A quilt on the floor is dotted with toys but no books, which catches the attention of Jackson-Freeman.
You have these toys out here for him to play with; its a good idea also to have a couple of books within reach, she explains.
Hines, who is single, was newly pregnant when she found out about the program that provides regular nurse visits throughout pregnancy and for two years after birth. Visits typically take place every other week, but the schedule increases to once weekly during the first month of the partnership, when the mom-to-be and visitor are getting to know one another, and again during the first few weeks after the baby is born.
In 17 N.C. counties
Wake is one of 17 counties in North Carolina served by the Nurse-Family Partnership program, which is funded largely through a federal grant but also gets contributions from private sources,
Founded 30 years ago in Elmira, N.Y., the program became available in North Carolina four years ago. Women eligible for the program are pregnant with their first child and have incomes low enough to qualify for the federal Women, Infants and Children nutrition program below $21,000 annually for one person or less than $28,000 per year for a couple.
Jackson-Freeman is one of four participating nurses in Wake County, each with a caseload of 25 first-time moms. The nurses target moms in neighborhoods where problems such as low birth weights in babies have been identified, said Sue Lynn Ledford, public health director for Wake County.
Its so important children get the right care, activities and nurturing during the first few months and even years of life, Ledford said.
Research studies and controlled trials have demonstrated that having nurses offer medical information and healthy lifestyle advice to women during pregnancy, and for two years thereafter, can significantly improve childrens health and safety.
According to program data, the Nurse-Family Partnership has been shown to reduce by 50 percent or more instances of child abuse and neglect, emergency room visits for accidents and poisonings, arrests of children and young teens, and behavioral and emotional problems for preschoolers. For the mothers, theres a 72 percent reduction in criminal convictions between the time of their childs birth and his or her 15th birthday.
Jackson-Freeman was introduced to Hines during her first trimester of pregnancy. Hines said she heard about the program after signing up for childbirth classes at the Wake County Health Department.
At first, their visits revolved around steps Hines could take to deliver a healthy, full-term baby. When Noah was born last June, two weeks ahead of schedule, Jackson-Freeman helped the new mom make the adjustment from pregnancy to motherhood including strong support for breastfeeding.
The milk is like a vaccination, Jackson-Freeman said. It helps them stay healthy.
Discussions may range from nutrition and household safety to the importance of building a strong network of family and friends.
Jackson-Freeman also has put Hines in touch with such programs as Wheels for Hope, which is helping her purchase a car, The Green Chair, where she found low-cost furniture for her new apartment, and even a counseling program to deal with postpartum depression..
Ready for school
Stephanie Senegal, nursing supervisor for Wake Countys Nurse-Family Partnership, said along with helping ensure full-term, normal-birth-weight babies, the program encourages lots of stimulation for infants who may be at risk of falling behind their peers.
Children who receive lots of stimulation between birth and age 3 are more likely to be ready for school when the time comes, Senegal said. Without that stimulation, they may go to school with a language deficit and continue to fall behind.
Studies conducted by the private agencies, including the Pew Center on the States, have concluded that Nurse-Family Partnership gives taxpayers a return of up to $9.50 per dollar invested in the program by avoiding the costs associated with preterm births and other health problems later in life.
From a financial perspective its extremely smart, and from a community perspective its extremely important, too, Ledford said.
Hines who for a period of time was homeless says she feels especially good about the progress she has made over the past several months.
I grew up in the country where I could play outside, and I want Noah to have that opportunity, Hines told Jackson-Freeman, as their most recent visit concluded. My long-term goal is to own my own house someday./
The nurse, her friend, nodded and smiled.
I dont know of anything youve talked about doing that you havent done, Jackson-Freeman said. I have no doubt youll do that, too.