Juanita visiting Maria and her son.

Just a Little Support to Succeed: The Nurse-Family Partnership

When I first met Christina at her home, she was a shy and guarded 15-year old. She was enrolling in the Nurse-Family Partnership® (NFP) program – a maternal and child health program for low-income, first-time moms. I knew from her WIC (Women, Infants and Children Supplemental Food and Nutrition Education Program) referral form that she had a high-risk pregnancy with gestational diabetes and hadn’t checked her blood sugar level in days.

Christina’s pregnancy was unplanned – the result of a casual encounter with a friend. As a NFP nurse home visitor, I was there to guide her to have a healthy pregnancy and help her give her child a brighter future, and I knew we had a challenging road ahead. I first began by encouraging her to take her prenatal vitamins and check her blood sugar to monitor her diabetes.

I asked her, “If poverty weren’t an issue, what would you like to do with your life? If you think beyond the block where you live, what would you do for you and your baby?” These were questions that Christina had never been asked before.

Cassandra with Christina and her son.

Cassandra with Christina and her son.

Much of the dialogue she had with adults was surrounding the mistakes she had made or the trauma of abuse from her mother. Christina had been neglected and allowed to drink at an early age. Her mother is an alcoholic and her father was incarcerated – circumstance that had left Christina homeless at times. I asked myself, “How can I as the only stable person in Christina’s life position myself to increase preventative care and lessen the effects of the childhood trauma, so as to improve the outcomes for her baby and support Christina in stopping the cycle of abuse, neglect and poverty?”

Fortunately, after she gave birth, I had the next two years of her child’s life to continue exploring these questions with Christina. By visiting in her home approximately every other week, I would earn her trust.

When Christina’s baby arrived the possibilities that she saw for herself really broadened. Slowly some of her walls she had constructed, as a result of years of not feeling supported, started to come down. Christina began opening up and sharing that she wanted to continue school. She was supposed to be in the ninth grade, but her attendance was low. Christina didn’t have an adult in her life parenting her, let alone directing her toward education. With a lot of encouragement, Christina realized her strengths and the importance of education. Today, she is working to complete her GED.

School has been a safe haven for Christina, a place where she can work toward her future goal of getting her GED that will allow her to pursue a job and save up enough money to get her own place and be fully independent from her family.

She has shared that her goals are for her son to have a brighter future. Christina wants him to be strong, healthy and safe. She realizes that she is her child’s first teacher and how to establish love as a safe base, making parenting choices different from her own parents.

I have supported her to make improvements in monitoring her diabetes. Christina knows that it us up to her to take care of her son and thinks, “Who will be there to take care of him, if something happens to me?” She is meeting her goals of learning to cook healthy foods for her son and herself and to lose weight.

Christina has transformed since the first day I met her. She now walks taller and smiles brighter. I am proud of the transformation she has made and the direction she is heading. She is not a scared teenager anymore. She is a mom that wants the best for her child.

As her son – healthy and happy – reaches his second birthday and Christina prepares to graduate from Nurse-Family Partnership, she no longer has that guarded demeanor when we first met, but instead confidence as a new mother. When asked what she has learned, she responds matter-of-factly, “Everything! You gave me hope! You showed me that someone cared, and I learned how to be a mom, take care of my son. I know my life. I know what I can do. You taught me that.”

About the blogger:

Cassandra Standifer, BSN, PHN-NFP, is a public health nurse who conducts home visitations as a part of the Nurse-Family Partnership program in King County, Washington. Nurse-Family Partnership currently serves over 30,000 low-income, first-time moms and their children in 43 states. Learn more at Nurse Family Partnership.


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