Program in south Arkansas provides free nurse visits to mothers with newborns

After her third child, a daughter, was born premature in May and spent 22 days in a neonatal intensive care unit, Hannah Rosson was grateful for a program in El Dorado that sends nurses to the homes of mothers with newborns.

At Rosson's house, a nurse with South Arkansas Regional Hospital weighed the baby, checked Rosson's blood pressure, screened her for postpartum depression, asked how her breastfeeding was going and "just made sure we had everything we needed," Rosson said.

"They don't really feel like just nurses coming out to your house," Rosson said. "The way they speak is more encouraging, and they just make sure you're OK."

Rosson, 33, is one of hundreds of mothers with newborns who have received visits from a nurse through the Family Connects program in Union County since 2019.

The program, which expanded last month to Magnolia, is one of eight in the state supported by the Arkansas Home Visiting Network at Arkansas Children's and the only one that is available to all mothers with newborns within its service area without regard to factors such as income or health status.

Starting three weeks after they give birth, mothers receive up to three visits from a nurse with the El Dorado hospital.

During the hourlong visits, the nurses connect mothers with child care resources and make sure the mother is scheduled for a checkup with a doctor six weeks after the birth, Heidi Klappenbach, one of the nurses who perform the visits, said.

The visits are free to the mothers, and their insurance plans aren't charged. Each nurse performs about eight visits per week, Klappenbach said.

Funding for the program comes from a $3 million donation in 2018 by Robert R. Brown Jr. that was dedicated to Joyce B. Brown, a lifelong El Dorado resident who died in 2016.

The money was given to Arkansas Children's to be used for dental outreach and to expand efforts to educate new parents through the Home Visiting Network in south Arkansas, with a focus on Union County.

Since the inception of the program, nurses at the hospital in El Dorado have conducted 670 home visits, Melea Rose Waters, senior policy director for Family Connects International, said.

For about a year, the checks were conducted over the phone due to the covid-19 pandemic, which posted challenges for the nurses, Klappenbach said.

"With postpartum depression issues, I felt like over the phone people could say, 'Oh, I'm doing fine,' and it wasn't as conversational as a visit. So it was frustrating, but we still were able to do a lot of teaching," she said.

When Rosson gave birth to her first two children, a nurse checked on her over the phone. Having an in-person visit with her third child was "one million times better," Rosson said.

"You don't really realize how much you just need someone who's not just a family member but a medical professional to come out and check on your well-being." Rosson said.

Nationally Family Connects has been adopted in 19 states with 30 community partners, Rose Waters said.

The program, which originated as a project under the Center for Child and Family Policy at Duke University, was initially launched in North Carolina under the name Durham Connects in 2008 and created to "prevent child abuse in Durham County by helping families with newborns deal with stressors such as substance abuse, depression, financial distress, lack of childcare, and social isolation--all of which create increased risk for child abuse," according to the center's website.

Last year, Family Connects International separated from the center and became an independent nonprofit, Rose Waters said.

From July 2022 to October 2023, 22,303 families were served by the program.

According to information presented by Family Connects International to the state House Committee on Aging, Children and Youth, Legislative and Military Affairs last month, randomized controlled trials found that mothers who received visits were about 30% less likely to experience possible postpartum depression or anxiety and about 40% less likely to be the subject of a child abuse or neglect investigation.

The community partners who work with Family Connects all have different funding sources, with some receiving state funding and some billing insurance companies, Rose Waters said.

"This is a program that's different to other home visiting models because it's available to everyone," Rose Waters said. "If it's offered in your community, you can benefit."

Arkansas has one of the nation's highest rates of maternal and infant mortality. Between 2018 and 2019, 54 women in Arkansas died of pregnancy-associated causes, a pregnancy-associated mortality ratio of 73.7 deaths per 100,000 births, according to the Arkansas Maternal Mortality Review Committee, which was established under a 2019 state law to review and make recommendation to prevent maternal deaths.

The committee deemed 91% of the pregnancy-related deaths preventable based on the probability that the death could have been averted by "one or more reasonable changes to a patient, family, provider, facility, system and/or community factors."

At the meeting of the House Committee on Aging, Children and Youth, Legislative and Military Affairs last month, state Rep. Julie Mayberry, R-Hensley, said she hoped to see programs similar to Family Connects in other parts of the state.

During this year's legislative session, Mayberry sponsored House Bill 1103, which would have directed the state Department of Health to establish a "Universal Newborn Home Nurse Visitation Program" and required health plans and the state Medicaid program to cover the services offered by the program.

The bill died in the House Public Health, Welfare and Labor Committee, but Mayberry said she plans to reintroduce it during the next regular session in 2025.

"I feel that every new mom is at high risk, and whether it's your first child or your fifth child, every birth experience is different and everybody could use a little extra support," Mayberry said.

My Ly is a Report for America Corps member.

CORRECTION: Melea Rose Waters is the senior policy director for Family Connects International. An earlier version of this story included an incorrect spelling of her name.

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