My first child’s arrival in 1990 was rather dramatic.
After I was in labor 16 hours, a nurse realized that I was too small-boned for a vaginal delivery. While the doctor was hurrying back to the hospital, my blood pressure started dropping ominously. Suddenly I was breathing into a mask and waking up to learn that I had a healthy daughter. It’s not exactly what I’d hoped for in terms of childbirth. To top that off, a hospital-acquired infection almost killed me.
Nine days later I arrived home in probably less than optimal shape for parenting. Amber seemed so fragile and delicate. When she slept I checked to make sure she was breathing. All of the drugs in my bloodstream and breastmilk made nursing out of the question. I felt sore and exhausted, inadequate to care for the most precious baby ever, and worried about the huge hospital bill. I needed help and reassurance; my family was a thousand miles away.
Thank goodness for Maine’s public health nurses!
Beverly, a public health nurse in the Bangor area from Maine’s public health nursing program, answered all my questions and taught me about infant nutrition and baby and toddler safety. She showed me how to childproof my specific house. She convinced me that Amber was robust and developing beautifully. She assured me that I was a good mother. This confidence enabled me to better parent Amber and, later, her sister and brother.
Many babies are not as fortunate as Amber. My husband, Eugene, earned enough to provide for her. He and I were emotionally ready for parenthood. Neither of us abused substances or each other.
I find the dismantling of the state’s public health nurse system to be morally reprehensible. Many innocent children, including many of the hundreds born each year after they’re exposed to drugs in utero, will suffer needlessly. I also see this as yet another example of fiscal irresponsibility on the part of Gov. Paul LePage’s administration and Commissioner Mary Mayhew’s Department of Health and Human Services. Wellness-wise, the public health nurse is the provider who offers the biggest bang for the buck. When it comes to intervention, the earlier the better.
Unlike a doctor, who sees a patient in a clinical situation, the public health nurse goes into the home where she can observe many things. Is there enough food? Is the house adequately heated? Is the structure safe for the baby and future toddler? Are there signs of spousal abuse or anger management problems? Is an adult on the premises a substance user? Is the mother experiencing postpartum depression? Is she so stressed — say, working multiple minimum wage jobs — that the addition of a helpless baby overwhelms her? Does the infant have disabilities that early intervention could alleviate?
The public health nurse has a wealth of information and the ability to make connections between clients and agencies who offer them valuable services. The seemingly simple act of enrolling a mother and baby in WIC, the Supplemental Nutrition Program for Women, Infants and Children, can help provide a needed nutritional boost. Getting baby and mom out of an abusive environment, a maneuver that requires skills and sensitivity, may be truly life saving. Most of us would need help getting appropriate services for a baby with disabilities — especially if we had the lack of transportation and irregular work schedules with which many low-income people struggle.
I’m certain that the little we save from cutting the number of public health nurses we will end up paying many times over. Special education is one of the biggest mandated expenses in school budgets — but the research is clear that a healthy, positive start to life, the type of start a public health nurse can help a parent provide, can reduce the likelihood a child will need special education later in life. Even a few more students being able to thrive in mainstream classrooms can be a huge money saver.
The same concept applies to criminal justice. Law enforcement is a very costly alternative to social and educational success.
Also aren’t we trying to build up a competent workforce to replace the many retirees we will see in the coming decades?
In the U.S., we can predict a child’s test scores if we know his or her ZIP code. We bemoan the huge and widening achievement gap between rich and poor schools but feel helpless to solve this problem.
Finland, on the other hand, has done just that and eliminated the gap. The government will provide for a baby what his or her parents can’t within the home setting, such as food air and early disability remediation. The idea is for all children to enter school unburdened by poverty-imposed obstacles.
Of course, the first step toward solving the problem here in Maine would be to learn what services are needed to bridge the gap between rich and poor and how they can be delivered efficiently.
The public health nurse would be the most efficient gatherer of the relevant data.
Jules Hathaway of Veazie is a writer, community activist and proud mother of three. She is taking up the interests she put on the back burner for parenting and serving on a school committee.