Making a plan for progress

Nineteen and pregnant, Amanda had a lot on her plate, so she didn’t need any aggravation– but that’s just what she was getting. Her boyfriend, the father of her unborn child, got louder, wanting to argue, as he stood aggressively over Amanda who was sitting at the kitchen table. That’s when Valerie stepped in.

Valerie Carberry, a nurse home visitor with Nurse- Family Partnership® (NFP), had been sitting with Amanda, offering advice for a healthy pregnancy, when the tirade began. Until now, Valerie had only seen his warm and engaging side – the side that had quickly charmed her young client and led to a pregnancy just five months later.

Valerie looked straight at the young man and asked him to step outside. “You’re out of line,” she said firmly before issuing a threat of her own: if he didn’t calm down, she would call the police. While he stewed, Valerie, cell phone in hand, turned her attention to Amanda. “Do you want me to call 9-1-1?”

“No,” replied Amanda, though she looked uncertain. Valerie was not content to leave matters where they stood. “He’s just cooling off because I’m here,” she said. “You have got to have a safety plan,” she added, handing her phone numbers for women’s shelters in this part of Colorado. Amanda jotted them down and tucked the list away. “I walked out of that visit going, ‘Oh my,’” Valerie would recall later. “But at least we had something in place.”

Amanda did not flee that day, but the wheels in her head had begun to turn—perhaps she could create a brand new life for herself and her unborn child, she thought to herself.

In the three months since her initial meeting with Valerie, Amanda had shared the most intimate details of her family history: her mother’s periodic bouts with homelessness, how she herself had ended up living in her car after her father and stepmother were divorced, a family tree with step- siblings and half-siblings and other relationships almost too complicated to sort out. And then there were the troubling reports about her boyfriend’s behavior. Not only did he regularly chastise Amanda about gaining weight, he made fun of her acne, which flared up due to stress. And he called her names.

These ongoing revelations left Valerie feeling a bit shell- shocked—but she was more than prepared. Though new to NFP, Valerie was an experienced public health nurse, and the NFP program provided her with an arsenal of proven materials to use throughout a carefully designed course   of action. She began by shoring up her client’s self-esteem

just as a builder would reinforce a foundation before doing anything else.

Amanda, who had been concerned that she wouldn’t be a good mother due to her own troubled background, slowly began to recognize the direct correlation between excellent prenatal care and successful parenting. She was diligent about her medical appointments, diet and health. “I stopped dying my hair and tanning. I didn’t even microwave when I was pregnant!” Amanda says now, looking back. Valerie complimented Amanda on every positive step, and continually reminded her that these were, in fact, the very first steps in becoming a good mother.

Amanda continued to endure stress in her relationship—at one point she fled to her mother’s home in Florida, only to return to her boyfriend when he “sweet-talked” her into coming home—but then she delivered a healthy baby boy. Amanda’s already strong maternal instincts were further reinforced by Valerie, who complimented Amanda when little Nolan gained weight. One of the highlights of their visits was weighing the little boy on the scale Valerie brought along with her. Four ounces equaled victory, and clearly, Nolan was thriving under Amanda’s care. “She took to it like a duck to water,” Valerie says. “I was just so motivated and high on being a mom,” says Amanda. “It’s like I was born to be a mom.”

By the time Nolan was six weeks old, however, Amanda began to “crash and burn,” recalls Valerie, who saw the signs of post-partum depression during her visits. Always fastidious about her housecleaning, Amanda would let the dishes pile   up in the sink. The baby’s father wasn’t helping out much, and a new cycle of violence had begun.

When Nolan was three months old, Amanda says her boyfriend choked her as he held her over their son’s crib. “I couldn’t help but think how this would have scarred him for life if he had been five years old and could remember it,” says Amanda. It was finally time to put into effect the flight plan she had developed with Valerie all those months ago.

Scared but determined, Amanda called the police, who arrested her partner. By the time he made bail and returned to their apartment, Amanda had relocated to a shelter with her son. “Before, I remember always thinking I was going to be stuck,” says Amanda. “But it wasn’t just me now. I knew I could do it—but I didn’t know how.”

Always nearby to encourage her client and affirm that she had done exactly the right thing was Valerie, who continued to meet with Amanda in the shelter. Through the resources made available to her there, Amanda was able to enroll in college and move into her own apartment. She then she graduated with an Associate Degree and a plan to study speech therapy when Nolan is a little older. Nolan’s father provides financial support and visits with him regularly, but Amanda is through with him romantically and is currently dating a man who, as she puts it, “would rather die than lay a hand on me.”

Today, the most challenging male in her life is little Nolan, a bright and rambunctious boy who is living his version of the Terrible Twos. “I thought I was going to get away clean with a really even-tempered baby,” laughs Amanda. She watches instructional videos about child behavior and has even been known to throw a tantrum to mimic Nolan’s own, after reading about this technique. “It really works!” she says. Of course, Valerie is still there to help. While on a recent outing with Nolan and Valerie, Amanda watched in awe as Valerie demonstrated how to keep the blue-eyed boy engaged—and calm—in a busy public setting.

“The program is awesome,” says Amanda, who graduated from NFP when Nolan turned two. “I don’t think I would have left Nolan’s father if Valerie hadn’t told me that what he was doing was wrong. She was that one voice. That’s all I needed. She never made it sound like I couldn’t do it. She used to tell me all the time I was a survivor. She really believed in me.”

Valerie tears up when told of Amanda’s heart-felt expression of gratitude, as if she had never quite realized the impact she’s had on her former client. “She did all the work,” Valerie replies modestly. “She just needed the consistency of someone saying, ‘You can do it’. ”

This Nurse-Family Partnership program is implemented through the Jefferson County Department of Health & Environment in Golden, Colorado.

In partnership with the national Nurse-Family Partnership office, Invest in Kids is responsible for program development, clinical consultation and general support for agencies delivering NFP in Colorado.

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