Sarah Ramey has become a fixture in Nancy Wingert’s house. Every other week, Ramey visits 26-year-old Wingert, a new mom, and her 21-month-old son, Emery.
On a recent visit, Ramey went over potty-training milestones, asking Wingert if Emery had started transitioning to using the toilet. Wingert listened as Emery climbed over her, a constant ball of movement — except for when he’s watching his favorite TV show.
Ramey works for HANDS, Kentucky’s Health Access Nurturing Development Services, a statewide program that provides home visits to help new and expecting parents ensure healthy, safe environments for their children.
The hourlong session is part of an almost two-year program that teaches Wingert best practices in parenting. It helps her to be aware when Emery should hit different developmental milestones — like potty-training — and gives her other tips to keep him safe.
“Her little book over there has so much stuff that I don’t know,” Wingert said. “Like, I didn’t know my pans could cause lead poisoning. So I’ve been investing in cast iron.”
Kentucky has some of the worst health outcomes in the nation, and that’s especially true around Appalachia. A report from the Foundation for a Healthy Kentucky in August found the rate that infants die shortly after birth is higher there – even compared with Lexington and Louisville.
The town of Grayson, where Wingert lives, sits in the middle of Carter County and is close to the West Virginia border. And there, HANDS is working to help reduce one of the region’s worst infant mortality rates.
The program is pretty straightforward: one family support worker per family; six very large binders full of information on each month of a baby’s life; and a visit every other week at the parents’ home. To qualify to be a family support worker, one must have a high school diploma and a background in working with children, which could be experience working at a daycare.
The outcomes from the program are striking. According to data from the University of Kentucky Research Foundation, moms in the program had fewer complications during pregnancy, and babies in the program were less likely to be born prematurely or have a low-birth weight.
Jana McGlone, the HANDS program coordinator in Carter County, explains a potential reason for these numbers.
“We do developmental screenings every two months to make sure their babies are where they need to be developmentally, and if something happens that they’re not, we refer them to an early intervention program,” McGlone said.
Wingert found out about the program after signing up for WIC, a food assistance program, shortly before Emery was born. This is how most people find out about HANDS. There’s no income requirement for the program – a fact McGlone emphasizes. She said any parent can enroll in HANDS.
McGlone said one of the key elements is structuring the program toward what the parents need. She conducts a deep-probing assessment at the beginning to learn how parents were brought up, and what they want for their babies. McGlone rattled off a list of characteristics that are most common.
“Smart, healthy — to be able to say no is a big one,” she said. “To be self sufficient, to be independent, a lot of things that a lot of our parents didn’t have when they were growing up. A lot of our parents, they didn’t have the empathy, and we’re trying to teach them how to have that and how to give that to their children.”
The only eligibility requirement is to have an infant up to 3-months-old or not yet born. If moms are pregnant when they start, Ramey lets them know what the signs of premature labor are, questions to ask their doctor, what to take to the hospital and how to secure a newborn in a car seat. It’s a lot of the same information parents might get at a doctor’s office. But the information has a bigger impact on moms when they’re in their own home.
“Their doc might say, ‘you need to take your prenatal vitamin,’ but he may not tell them, ‘OK, this is why you should take this,’” McGlone said.
She said HANDS goes a step further and explains the why.
“When they get that understanding and knowledge, it makes them want to do it more,” she said.
Sarah Ramey teaches her clients a lot they wouldn’t otherwise know. The success Emery’s had – knowing right from left before he’s even two – and the support Wingert gets has largely been based on her relationship with Ramey, in addition to helpful information.
“It might have been a little bit — I won’t say lonelier — I wouldn’t have that extra person to talk to, and sometimes I just vent about the terrible things going on that you can’t vent to other people,” Wingert said.
In December, Emery will transition out of the program at the two-year-old mark.
“I’m going to be heartbroken in December,” Wingert said. “I think about it, the closer we get the more sad I get.”