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Updated Tuesday, January 22, 2013 at 02:14 PM

First-time, low-income mothers get help from successful Nurse-Family Partnership

By Sara Jean Green
Seattle Times staff reporter

It took a few gentle, prodding voice messages before Christina Dudder finally returned Jen Price’s calls.

Dudder, then 17, was 15 weeks pregnant the first time she spoke with Price, a registered nurse who works for the Nurse-Family Partnership.

“I’m so grateful Jen kept trying” to make contact, said Dudder, the mother of a now 3-month-old girl.

Dudder and her boyfriend, Earl Park, 18, say they don’t know how they would have made it through the pregnancy, the birth of their daughter, Penny, or bringing the baby home without Price’s guidance, encouragement and knowledge about babies and early-childhood development.

The young Shoreline couple had no idea the program they signed up for — in which specially trained nurses make in-home visits to first-time, low-income mothers until their child reaches age 2 — has been shown to drastically reduce cases of child abuse and neglect, decrease involvement of both mothers and children in the criminal-justice system, and improve a child’s health and a mother’s economic self-sufficiency.

But “it definitely makes sense,” said Dudder, now 18, who calls Price a “walking encyclopedia of babies.”

The Nurse-Family Partnership, which started in Elmira, N.Y., in the late 1970s, has served nearly 5,000 Washington families since its launch here in 1999. The program — which has tracked groups of participants over the course of years in three separate research trials — is now offered in 42 states and the U.S. Virgin Islands, serving more than 23,000 women nationwide. Most of them — an estimated 80 to 85 percent — are single moms.

In King and Snohomish counties, limited funding has meant the program has only been offered to eligible first-time moms younger than 24, said Lauren Platt, the Seattle-based regional program developer for Washington, Oregon, Montana, Idaho, Nevada and Missouri.

The Seattle City Council in November unanimously voted to bolster the amount of money Mayor Mike McGinn already had budgeted for the program in 2013 and 2014. The City Council added $527,000 for this year, bringing the total to a little more than $1.6 million; next year, an additional $1.145 million added by the council will see the program funded with $2.285 million.

The extra money means Seattle will join a handful of big cities across the country — including New York, Indianapolis and San Diego — in offering the program to all women who qualify, regardless of age.

“This program has been probed and poked, and it’s stunningly good,” said Councilmember Tim Burgess, who took the budget proposal to his council colleagues.

In 2012, 212 Seattle women participated in the program. The number is expected to increase to 349 this year and to 450 in 2014.

An estimated 40 percent of all pregnant women — both first-time moms and women who already have had at least one child — qualify for Medicaid, the most commonly used indicator for determining low-income status. First-time moms who qualify for Medicaid also are eligible for participation in the Nurse-Family Partnership.

Citing research by the Washington State Institute for Public Policy, Burgess said that for every $1 invested in the Nurse-Family Partnership, local communities can expect to save $2.61 in future spending on health care, welfare and the criminal-justice system. In other states, the figure is as high as $5 saved for every $1 invested.

“This program shows that when we invest early, we can reap huge dividends” down the road, Burgess said.

By offering help to poor, first-time moms, “we’re going to lower crime, we’ll impact the economic stability of that little family and we’re going to improve education and safety for the children.”

According to Platt, mothers involved in the program had 60 percent fewer arrests and 72 percent fewer convictions compared to low-income mothers not served by the Nurse-Family Partnership.

Similarly, children of mothers in the program had 59 percent fewer arrests by age 15 than children whose mothers did not participate, Platt said. The program also has been shown to improve a mother’s economic self-sufficiency and a child’s readiness to start school, while decreasing language delays, behavioral and cognitive problems, and injuries to a child, she said.

In addition to answering a mother’s health-related questions, nurses act as personal cheerleaders, confidantes and advocates, helping new moms access a variety of social services, from housing to education, Platt said.

The Nurse-Family Partnership was started by David Olds, a developmental psychologist in the pediatrics department in the School of Medicine at the University of Colorado, Denver.

A woman’s first pregnancy represents a major life change, when she experiences both “heightened vulnerability and receptivity to help,” especially from someone who is an acknowledged expert in the issues a first-time mom is concerned about, Olds said in a phone interview from Denver.

Studies have shown that the brains of babies and young children who are abused, neglected or exposed to neurotoxins like tobacco and alcohol are compromised and typically lead to problems with regulating behavior — and those children have a greater susceptibility to later criminal delinquency, Olds said. By intervening early in a woman’s first pregnancy and arming her with knowledge, she’ll make better choices that can have long-term impacts on her child’s health, he said.

For mothers, having an ongoing relationship with a nurse can help them to “start envisioning what kind of life they want to create for themselves,” especially in terms of schooling, work and relationships with men, Olds said.

“They become attached to the world of work and self-sufficiency. It’s a positive cycle between their own accomplishments and care of their children that makes them less vulnerable to anti-social influences,” Olds said.

Dudder and Park say they consider Price a member of the family — so much so that they’ve told Price not to bother knocking when she arrives for visits at Dudder’s grandmother’s house, where the couple live with Penny in a basement bedroom.

Dudder said she was “totally freaked out” when she learned she was a pregnant teen and dealt with a lot of judgment, from family and strangers alike. But Price, she said, never judges, no matter what Dudder reveals.

Price has not only answered a slew of health-related questions but she also helped Dudder contest a hospital bill and found a counselor to help her through a bout of depression. Price is helping the couple find an apartment of their own.

“It’s definitely made me the best mom I can possibly be,” Dudder said of her relationship with Price. “It’s definitely like, OK, no matter what we go through, we have Jen.”

Added Park: “I really do believe that as a father, I wouldn’t have known anything without Jen. ... She’s there all the time and she’s the only person available for us to call and ask questions.”

For Price, it’s been satisfying to see Dudder and Park bond with Penny and watch the baby hit her developmental milestones. A big part of the job, she said, is focusing on parents’ strengths and telling them when they’re doing a good job, something few new parents ever hear.

“I think they have really amazing instincts for parenthood. It’s easy to just affirm their instincts,” Price said of the young couple.

She praised them for the strength of their relationship and the devotion they’ve shown to their daughter.

“This is a stressful time in your lives,” she told the couple. “I hope this gets you on that road so you can do this yourselves, which you’re already doing.”

Sara Jean Green: 206-515-5654 or sgreen@seattletimes.com

Nurse-Family Partnership

More information:www.nursefamilypartnership.org

Eligibility: Soon-to-be, first-time moms in King County can find out more about the local program and see if they qualify by visiting www.kingcounty.gov/healthservices/health/personal/NFP.aspx or by calling 206-205-7220.


Ellen M. Banner / The Seattle Times
Earl Park plays with his daughter, Penny, as her mother, Christina Dudder, leans on his arm. Nurse Jen Price, at right, watches.




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