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Indiana and St. Joseph County focus on maternal and infant wellness

South Bend Tribune - 1/27/2020

Jan. 27--SOUTH BEND -- Gov. Eric Holcomb wants Indiana to have the Midwest's lowest infant mortality rate by 2024.

The state has a long way to go in four short years. In 2017, only six states in the country had a worse infant mortality rate than Indiana's 7.3 per 1,000 live births, according to data from the federal Centers for Disease Control.

If the state is going to match or exceed Minnesota's infant mortality rate of 4.8 per 1,000 live births, the work that nurse Chris Wetter does with first time expectant mothers like Alexis Dixon will be a key factor.

Wetter is a home nurse visitor in the Nurse-Family Partnership program, which operates in 36 of Indiana's 92 counties and that began in October taking referrals for women living in St. Joseph, Elkhart and LaPorte counties.

The Nurse-Family Partnership program receives funding from the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program and in-kind funding from Goodwill and other community partners, according to Marchelle Petitt, a nurse guide with the program.

Pettit said the program served more than 3,200 Indiana families since coming to the state in 2011.

The program pairs first time expectant mothers who are less than 28 weeks pregnant with a nurse and nurse guide.

Nurses meet weekly with the expectant mother for a month. If things are going well, those meetings occur every other week, according to Wetter. The weekly meetings resume for the first month of the baby's life.

Regardless, the nurse maintains a relationship with the mother until the child turns 5.

Nurses like Wetter attend to the medical needs of mother and child while nurse guides like Pettit connect the family to a resources and services.

"We are the link between the nurse, mother and the community," Pettit said. "If the mother needs diapers, we connect her with the resources to find those diapers."

This partnership means the nurse can monitor the mother's health during and after pregnancy to ensure things progress normally. The nurse guide connects families with services -- everything from housing, to job training, to child care -- and makes sure the child enters school prepared to learn, Pettit said.

Programs that connect "home visitors" with women during their pregnancies and through the early years of their child's life have shown promise in reducing infant and maternal mortality and in improving outcomes in areas ranging from school readiness to economic self-sufficiency.

For example, a 2017 study by the Office of Planning, Research and Evaluation, found the positive effects families receive from participating in home visiting programs such as the Nurse-Family Partnership continue long after involvement ends.

The state has taken notice and in 2019 Holcomb signed a law establishing a similar initiative called the OB Navigator program. That program, which is a collaboration between the Indiana State Department of Health, the Family and Social Services Administration and the Department of Child Services (DCS), pairs pregnant women with a home visitor who provides guidance and support through at least the first six to 12 months of the baby's life.

Over the next 10 months, the state will bring OB navigators to 20 counties where the risk of babies dying before their first birthday is highest. The program comes to St. Joseph and LaPorte counties in June.

Pettit said she believes the two programs will compliment each other and ensure more women receive assistance.

"It's like we are all under one umbrella with the same goal of connecting moms with services throughout the community," she said.

Dixon and Wetter met at the Starbucks inside the Ireland Road Target, where they talked about breast feeding. Wetter gave Dixon information about how to store breast milk, and then she asked the mother what she knew about nursing.

"I know that the baby has to latch on a certain way, otherwise it can be painful to mom," Dixon replied. "I watched a DVD about (breast feeding) the other day."

Wetter told Dixon that Memorial Hospital and Saint Joseph Regional Medical Center both had consultants who advise new mothers about breastfeeding, and that new mothers could also find resources at the local Women, Infants and Children office.

Dixon said she was 19 weeks pregnant when she learned about the Nurse-Family Partnership program after visiting the WIC office.

"When I found out I was eligible to obtain WIC, they referred me to different groups around the area and I picked Nurse-Family Partnership," she said. "... I would have a lot of unanswered questions about the baby and what I'm supposed to be doing and how I'm supposed to be feeling."

Dixon said she learns things she would not have known, by sitting down with Wetter and others who can help.

"We talk about everything, daily life, how I'm feeling and if I'm dealing with any mental or physical issues," Dixon said. "... Just to have someone to talk to about health and how I'm feeling is nice."

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