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'Outreach moms' forge a bond with at-risk mothers

This article first appeared in the St. Louis Beacon, Dec. 14, 2010 - So-called "outreach moms" are among the most important links in the Healthy Start program for pregnant women, infants and families. Their work isn't easy; each of the three moms is expected to be available 24/7 to respond to problems that might crop up among at-risk women.

Genetta Robinson, 32, is one such mom. Recently, she got a call from a mother out of money and nearly out of baby formula. The Robinson family includes two small children. Robinson didn't think twice about delivering some formula, knowing that doing so might make a big difference in a healthy outcome for the infant and peace of mind for the mother.

"We try to mentor them like a mother would," says Robinson, who serves as a surrogate mom for about 30 women. The program works with mothers and children up to age 2.

"It works well. They communicate with us and sometimes feel more comfortable speaking to us than they might feel talking to the nurse," Robinson says.

An example, Robinson says, involved a mother who confided in her that she was pregnant again. Robinson was glad that the woman was willing to confide in someone since the admission helped Healthy Start get her the care she needed. Without being judgmental, Robinson said she also encouraged her to inform the nurse, too.

Finding Common Ground

"They might feel more comfortable talking to me initially because I'm like a peer mom," Robinson says. "A lot of them have parents but may not have good relationships with them, don't feel close. So it's good for the young mothers to have someone to talk to. It makes a big difference. I have a 1 year old and a 4 year old, so we can talk about some of the things that I have done with my babies."

Healthy Start is a partnership between the Maternal, Child and Family Health Coalition of St. Louis and the Nurses for Newborn Foundation. Kendra Copanas, executive director of the Maternal Health Coalition, says one key is to be ready to take in pregnant women on short notice.

"Women enter the program with many needs and at different states of readiness for help," she says. "If they've had experiences with child protective services, if they have been abused or didn't have a strong loving family growing up, they may not be ready to open up to the home visitor."

She says some may be reluctant because of problems in their lives, such as drug or alcohol addiction, domestic violence or sexually transmitted diseases. This contact is crucial because Healthy Start tries to enroll women as early in their pregnancies as possible and work with them until the child reaches age 2.

"The programs need to be ready and accessible to women when they are ready for help."

On the other hand, she says, lots of women also seek out Healthy Start and welcome nurses and outreach moms into their lives.

It's through such connections, Copanas says, that Healthy Start is able to help women set and achieve goals. It's also an important key to reducing infant mortality, she says.

Still, one big challenge is to help the mothers overcome resistance to the good advice offered by Healthy Start nurses and outreach moms.

One example involves sleeping practices for infants. Mothers are encouraged to put infants to sleep in their own beds. But Copanas mentions one nurse who noticed that a mother who nonetheless continued to share her bed with her infant. Later, Copanas says, a program nurse "learned that there were so many bugs in the house that the mother felt the baby was more protected sleeping with her."

This story was written with the assistance of the Dennis A. Hunt Fund for Health Journalism, which is administered by the California Endowment Health Journalism Fellowships, a program of USC's Annenberg School for Communication and Journalism. Funding for health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization whose vision is to improve the health of the people in the communities it serves.