Client story – Sarah.
At the tender age of 16, Sarah hears the news that has changed the lives of so many teenage women across America: she's pregnant. And like so many others, Sarah doesn't have to look far to see how much her world is about to change. Sarah was born to a teenage mom and has an older sister who gave birth to two children before she turned 20. So when Sarah hears the news, she wastes no time.
She immediately visits her local health department in High Point, North Carolina, and signs up for a program for first-time teenage parents that she has heard about. From watching the daily struggles of her mother and sister, Sarah knows the Nurse-Family Partnership is exactly what she needs.
Sarah is matched with a nurse, Keisha Lucas, who will guide her through her pregnancy and the first two years of her baby's life. For their first meeting, held at the house where Sarah lives with her mom, Keisha arrives carrying a thick binder in which she will track every stage of Sarah's pregnancy and her baby's development. Sarah is delighted to see the big notebook; she loves writing things down and checking things off, and the binder – which could seem large and imposing to some – appears to her as a personal diary of possibilities. The first visit resembles a doctor's appointment, with lots of weighing, measuring, and questions to be answered. Sarah is glad to have a knowledgeable nurse to work with, but more importantly, she is relieved that Keisha doesn't judge her or her family. As Sarah describes to her friends, Keisha is just "really, really, really nice."
Keisha also has a sharp eye, trained by years of experiences in households just like Sarah's. As she takes notes and answers Sarah's questions in their first few meetings, Keisha also scans the environment, looking for any potential obstacles to a healthy pregnancy and successful motherhood. Keisha observes that Sarah's mom is frequently at work in one of multiple jobs. She is concerned that Sarah's sister's two children – ages five and three – run rampant around the house each time she visits. Sarah is quick to praise her mom and sister for doing the best they can as single parents in a small town, but she admits to Keisha, somewhat hesitantly, "I want more for me." Keisha knows that this desire for a better life is the spark of hope that she must fan into flame.
Over the next few months, Keisha works with Sarah on personal goal setting, an important component of the Nurse-Family Partnership program. Sarah determines that her short-term goals are to stay in school and eventually rejoin the track team, which she loves. Longer term, she wants to graduate from high school, continue on to college, become an elementary school teacher and have her own apartment. What may sound like modest goals to some are, of course, extremely challenging when you have an expanding belly, little money, and even less support from the people around you. This means that another important component of Keisha's job is to be Sarah's cheerleader. As Sarah's pregnancy progresses and she complains about being too tired to go to class, Keisha is always there to motivate her. "Remember that you want to be a good role model to your daughter," she says frequently to keep Sarah going.
Keisha also helps Sarah consider her relationship with the baby's father. The two met while he was attending a nearby university and dated for several years. He is supportive of the pregnancy and attends a handful of Sarah and Keisha's meetings, but Sarah has concerns about the way he lives his life and ultimately realizes he cannot be counted on to play a significant role in her future plans.
Beyond supporting Sarah with personal goals and relationship issues, Keisha answers Sarah's questions about the changes in her body. She comforts Sarah over the phone when the teenager has nightmares that she is bleeding. She assures her that strange cravings are normal for pregnant women when Sarah calls her in a panic because of a scary craving for laundry detergent. Keisha is also the first person Sarah reaches out to when she develops a major pregnancy complication during her ninth month: a terribly itchy, chicken-pox-like rash all over her body.
"Miss Keisha, I have broken out in this rash, and I don't know what it is!"
Sarah exclaims over the phone. Keisha asks a few questions and advises Sarah to go to her doctor immediately. The doctor diagnoses PUPPPs (Pruritic urticarial papules and plaques of pregnancy), an uncomfortable but benign rash that disappears from the mother when the baby is born. Sarah is in terrible discomfort during the final weeks of her pregnancy, ultimately landing in the emergency room due to a worsening PUPPPs condition. The doctors decide to induce labor.
And then, after two long days of labor, the PUPPPs disappear when Sarah gives birth to her daughter, Nevaeh. The baby's father is there, as are Sarah's mother and sister. Nurse-Family Partnership nurses do not normally attend their clients' births, but Sarah feels Keisha's presence in the delivery room nonetheless. During the pain of her contractions, Sarah remembers the breathing exercises Keisha taught her. And when she hears Nevaeh cry for the first time, she feels a surge of gratitude for all she has learned about being a good mother to her child.
When Keisha hears the good news about the successful delivery from Sarah, she beams with pride and shared joy, and recalls a conversation they had a few weeks earlier, when Sarah had shared the name she had decided to give her daughter.
"Nevaeh is a beautiful name," said Keisha. "How did you come up with it?"
Sarah beams as she replies, filled with expectation and a new sense of confidence thanks to the woman across from her. "It's heaven spelled backward."
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Postscript
Three years later, Sarah has graduated from the Nurse-Family Partnership program, and Nevaeh is a healthy, happy three-year-old girl who always wears pink ribbons on her pigtails. Sarah, who graduated high school on time and lost her baby weight while running on the track team, is in her second year at Winston-Salem State University, Keisha's alma mater. She is majoring in elementary education.
This agency is operated through Guilford County Child Development in Greensboro, North Carolina.
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