During a recent postpartum checkup, Marlena McFann cradled her sleeping newborn daughter, Nylah, close as a nurse talked with her about bonding, feeding and measuring her baby's important developmental milestones.
The first-time mom's examination wasn't in a doctor's office, though. She was sitting in the living room of her Grand Prairie apartment, where she has been receiving one-on-one medical attention, encouragement and emotional support since she was seven months pregnant from Tarrant County nurse Alicia Collins.
"Everything looks good," Collins told McFann after weighing Nylah with a scale sitting on the coffee table and stretching her out on the couch to measure her growth. "You're doing a fantastic job, Mama."
McFann is one of more than 170 low-income women in Tarrant County who are receiving services through the Nurse-Family Partnership Program, which is aimed at reducing the county's high infant mortality rate. Through the voluntary program, highly skilled nurses like Collins visit first-time Medicaid-eligible mothers throughout their pregnancies and until the children are 2 years old. Visits can be at home, work, school or other locations, such as restaurants.
Tarrant County's infant mortality rate, which has been increasing since 2000, is now at 7.6 deaths per 1,000 live births, according to a December 2009 Tarrant County Public Health report. That's higher than state and national rates.
Mothers are not only given free prenatal care and nutritional advice that are aimed at improving the outcomes of their pregnancies, but they are also connected with area resources to help them reach their educational and employment goals.
"We have a number of girls who are in high school. We want to make sure they graduate and continue their education if possible," said Karen Miller, the program supervisor. "The nurse provides support to get the mothers thinking not only about their child's future but their future as well."
No family support
Though Tarrant County's program is just in its second year, the state-funded Nurse-Family Partnership model has been in existence nationwide for three decades, Miller said. Other participating counties in Texas include Dallas, Bexar, Harris and Travis.
Tarrant County received nearly $1.7 million from the state for the first two years of the program and is seeking funding for two more years, said Vanassa Joseph, Tarrant County Public Health spokeswoman. The county had to match 10 percent of the state grant.
Arlington City Councilwoman Kathryn Wilemon, who serves on the Nurse-Family Partnership's county and state advisory boards, said the knowledge and parenting skills shared with the mothers will translate into stronger, more self-sufficient families that will be less of a burden on the welfare, healthcare and education systems.
"It will change lives for the better," Wilemon said. "You can just see the benefits of every dollar we put into this coming back into the community. We are making money on this program in the long run."
One published study on Nurse-Family Partnership participants found a 32 percent decrease in subsequent unintended pregnancies, a 20 percent reduction in the months a family was on welfare and a 46 percent increase in the father's presence in the household, according to the program's website.
Some of the mothers served by the Tarrant County program have no family support, and some don't even have permanent homes, Miller said. Nearly 135 babies, including a few sets of twins, have been born into the program since it started in January 2009, Miller said.
The Arlington school district refers most of the moms, who are as young as 13, to the program, Miller said. Others are referred through pregnancy-related programs, churches or the Women, Infants and Children program.
McFann, who is 25 and works as an apartment leasing consultant, learned about the program through a pregnancy center. She said that over the months she has built a strong relationship with Collins, who helped her cope with her fear and depression during the unplanned pregnancy.
"Alicia has been a great support system. I could call her at any time," said McFann, who didn't tell her family about her pregnancy until she was five months along. "I had a nightmare about labor once. She reminded me it's only one day."
During her daughter's six-week checkup, Collins gave McFann and Nylah's dad, Matthew Fletcher, advice to make eye contact with their baby during bottle feeding and to sing, hum or talk to her in a high, soothing tone about the world around her.
"I always encourage my moms to talk to their babies. They may not understand, but they are storing those words for later," said Collins, one of the program's eight nurses.
SUSAN SCHROCK, 817-390-7639