Nurse Kim Bracy, left, and client ChaunTia Murray weigh son Christian, 4 months old, on a scale. Murray said Bracy's support gave her the confidence to decide not to terminate her pregnancy. (David Coates / The Detroit News)
Like many Detroit mothers, ChaunTia Murray is young, single and caring for a baby with significant health problems.
But in a city with high infant mortality and maternal death rates, she is involved in a program — the Detroit Wayne County Nurse-Family Partnership — that could vastly improve the chances for Murray and her baby.
After serious complications with her pregnancy, Murray gave birth to Christian on April 21. He weighed 5 pounds, 2 ounces, and suffers from health problems. But she and her baby receive two to four visits a month — and unlimited phone conversations — with a registered nurse. The visits, research shows, could prolong both of their lives.
A 20-year study published in JAMA Pediatrics in July found that the Nurse-Family Partnership, which provides low-income first-time moms with regular home visits from nurses with bachelor’s degrees, reduces preventable deaths for mothers and their infants.
“We help people get into care, and we continue to work with them postpartum to make sure that the mother gets care, and also the child gets care,” said Katie Moriarty, a nurse and director of the Detroit Wayne County Nurse-Family Partnership, which receives funding from a variety of sources including the Jewish Fund, the Kellogg Foundation and federal grants.
“It changes the mom’s outcome, the child’s outcome, the family’s outcomes and hopefully the outcomes for the community.”
The findings published in JAMA Pediatrics are particularly relevant for Detroit, where mothers die from pregnancy-related causes at three times the national rate, as The Detroit News reported in July. A News study published in January found the city has the highest death rate for children 18 and younger, among the nation’s largest cities.
Researchers in the two-decade study found that children in a control group who did not receive visits from nurses had a death rate of 1.6 percent from preventable causes such as sudden infant death syndrome, unintentional injuries and homicide — compared with no preventable deaths among babies visited by nurses.
The mothers who didn’t receive nurse visits were nearly three times more likely to die during the two decades than mothers enrolled in the Nurse-Family Partnership — and eight times more likely to die from causes linked to behavior or environment, such as homicide, suicide and drug overdose.
Putting 'steps in place'
Kim Bracey, a registered nurse, spent two hours with Murray during a recent visit, getting detailed information about how Murray feeds and cares for her baby, and providing information about what to expect next.
Nurse Kim, as she’s called, measured the 4-month-old’s weight, length and head circumference, and checked Murray’s blood pressure.
Christian weighed 12 pounds, 2 ounces.
Since Christian was recently diagnosed with seizures and may have respiratory problems, Bracey said she will start teaching Murray how to give her son CPR.
Then they worked out a plan for what Murray will do if her son stops breathing during a seizure.
“Let’s put some steps in place,” Bracey suggested, noting she’ll accompany mom and baby on their next visit to the pediatrician.
Bracey congratulated the 21-year-old mom on her success with breastfeeding and noted it will soon be time to introduce Christian to solid foods. Murray showed off a photo of her freezer packed with bags of breast milk she’s pumped.
“I was going to bottle feed, but she convinced me to breast feed,” Murray said.
This month, Michigan received a $3 million federal grant to support home visiting programs statewide out of $106 million awarded across the country. The money will go to Nurse-Family Partnership programs in Kent, Ingham, Genesee, Muskegon, Saginaw, St. Clair counties.
The Detroit program received grants in prior rounds of funding.
Program accused of spying
Some conservatives say the program should not be publicly funded, arguing it is a thinly veiled effort to collect personal information about families.
“Home visiting — originally sold as a child abuse prevention strategy — is actually a family surveillance system,” Twila Brase, co-founder of Minnesota-based conservative Citizens Council for Health Freedom, said following announcement of the recent federal grants.
Angela Minicuci, spokeswoman for the Michigan Department of Community Health, said home visiting programs have existed in Michigan for more than 20 years.
“As with any of our programs involving Michigan residents, any and all health information that we have access to is highly protected and is used only in aggregate form to track the success of the program and in no way identify a family,” Minicuci said. “The family support services are locally sponsored, voluntary and parents/caregivers can opt out at any time.”
Murray said Nurse Kim’s support gave her the confidence to decide not to terminate her pregnancy. Now she wouldn’t dream of parting with her baby boy.
The News reported in May that nearly one-third of all pregnancies in Detroit end in abortion.
“When it came to being pregnant, I was having second thoughts,” Murray said. “Some people, when the baby cries, they would shook the baby. I (worried) I could do that. I didn’t want to do the wrong thing.
“She helped me understand. She gave me documents. And she told me the things that I should do, what I should expect when the baby’s first born.”
Bracey remembered one client who wanted an abortion, but decided to keep her baby after talking through her fears of motherhood.
“I said, ‘Can I help talk you through it, what your options are?’ ” Bracey recalled. “Later on, (the grandmother) told me, ‘I’m so happy that you guys were there for her, because now I have my grandson.’ ”
This story is part of a series written with support from the National Health Journalism Fellowship, through the Annenberg School of Journalism at the University of Southern California.