A program designed to bring nurses into the homes of vulnerable first-time moms is underutilized in North Texas.
While the appointment with that nurse might be free, women living in poverty say follow-up medical care is often too expensive. One local hospital is trying to change that.
Evie Burdette is one of the nurses who provides in-home care. On a recent visit, she stepped out of the cold and into Jasmine Villatoro’s warm Dallas apartment. They sat under a framed picture of the Last Supper as Villatoro pulled out a giant binder filled with notes.
She was just a couple of weeks away from her due date and wanted to be prepared. Her last pregnancy ended in a miscarriage. Burdette spent the next hour answering all of Villatoro’s questions.
“When I go to the doctor like it's just they just go by really really fast, and so sometimes I have questions that I don't understand," Villatoro said. "But I'm glad that I have Evie, that I she prepares me so that I'm fully aware."
That’s just one of the goals of what’s known as the Nurse-Family Partnership. The program helps vulnerable first-time moms during their pregnancies and the postpartum phase. It’s also designed to support them and their babies during infancy and early childhood.
Kate Rose Marquez is the CEO of WiNGS, a Dallas nonprofit that helps low income women.
“These nurses are also one of the few people in these women’s corner," she said.
WiNGS is the largest administrator of the Nurse-Family Partnership in Texas.
“The data shows that without support like this, the incidences of low birth weight are so much higher which leads to infant illness and mortality the incidences of complicated pregnancies and health risks for the mom are so much higher without this program," Marquez said.
Nine out of ten women who participate in the Nurse-Family Partnership in Texas deliver full term, healthy weight babies. However, Parkland’s Vice President of Nursing Marjorie Quint-Bouzid says the program doesn’t always reach moms in the southeast part of Dallas County — where the maternal mortality rate is among the highest in the country.
“We do know that Texas has struggles with maternal mortality higher than others in the nation and most predominantly impact African American women," she said.
Ashley Bradley is a nurse who has been covering Southeast Dallas County for several years. She said it’s hard to keep new moms in the program since most are the primary breadwinners for their families.
“They need to make money, which is most important," Bradley said. "Sometimes we'll go meet them on their lunch break.”
But that’s not always an option, which is why a lot of mothers in Southeast Dallas County drop out of the program.
The cost of medical care is a problem too. Most maternal deaths in Texas happen more than 60 days postpartum, and Parkland’s Marjorie Quint Bouzid says that’s when mom’s with pregnancy Medicaid lose their coverage — 60 days after giving birth.
"Cardiovascular disease just doesn't go away because you've delivered," Quint-Bouzid said. "So if you don’t have insurance it’s really not a good choice because you cannot afford it."
That’s why Parkland is covering healthcare for new moms for 12 months after they deliver, as an extension of the Nurse–Family Partnership. Quint-Bouzid couldn’t say how much that would cost, but said medications for chronic conditions like hypertension are not particularly expensive, especially compared to ER visits, or even emergency surgery.
For women like Jasmine Villatoro, a nurse coming to her house means care, attention and peace of mind.
“I'm so excited. I can't wait to tell my husband it's time to go to the hospital and you know have a baby in my arms," she said.
Knowing her medical care is guaranteed during those uncertain months ahead means she can put all her energy into bonding with baby.