Becoming a new mom is exhilarating. It is also exhausting and can be a bit terrifying, especially for first-time mothers.

When Meg Payne, the Director of Public Health and Wellness at the Visiting Nurse Association of Cape Cod, gave birth to her first child six years ago, the thought of leaving her house to go to the bank, the gas station or even attend breastfeeding classes was daunting.

“I thought I was going to be home for the rest of my life,” she said. “I know personally that I would have absolutely benefited mentally, physically and emotionally by having a nurse come into my house to, at the very least, reassure me that I’m doing all of the right things.”

That is why Payne hopes every woman who gives birth at Cape Cod Hospital takes advantage of the VNA’s maternal child health program. The program began providing postpartum home visits to new moms 11 years ago and continues to fill that need today.

“After somebody has a baby at Cape Cod Hospital and they are discharged home, we send one of our nurses out and they treat mom and baby as a couplet patient. So they will do the vital signs on mom and baby,” she said. “Our nurses are certified lactation counselors, so they will answer any questions and assist with any difficulties around breastfeeding.”

Any baby who resides in Barnstable County is eligible for a visit, even if they were born at another hospital. Infants in the foster care system also qualify.

Cape Cod Hospital is a Baby-Friendly hospital that encourages breastfeeding and skin-to-skin contact for bonding. Payne considers the VNA maternal child health program to be an extension of labor and delivery. They relay all of the same messages as the hospital about safe sleep, the benefits of nursing, mental health issues to be aware of, and the difference between postpartum blues verses postpartum depression.

“When you are in the hospital, and have just given birth, it’s overwhelming,” Payne said. “You’re not necessarily absorbing all of the information that you are hearing. By having us come into the home and relaying the same messages that you are hearing at the hospital, it’s just another way to absorb the information.”

When the nurses go into the homes, they can also see if the family needs other services such as food, a crib or even more secure housing. If they see a need, they refer moms to local agencies that can help.

One common misperception is that if a VNA nurse comes into your home, something must be wrong. That is not the case, Payne assured. They are there to do well-baby visits and want to provide support and answer any questions new mothers might have. Questions can be as simple as ‘Why does my baby hiccup so often?’ Or ‘Is my c-section incision healing properly?’ Or ‘Is my baby gaining the appropriate weight?’

“Even if they think everything is going well, and nothing is wrong, we are still there as a peace-of-mind visit to reassure them that yes, you are doing a great job,” Payne said. “It’s really about empowering women and new moms.”

Some new moms have declined the visit because they were worried about having a nurse show up when their house might be messy. Payne assures new moms that the nurses don’t care what your house looks like. If you didn’t have time to vacuum during the last weeks of your pregnancy, or if your toddler has scattered toys all over the house, the nurses understand that those things are perfectly normal.

Pre-Natal Visits

In July, the VNA received a grant from the Cape Cod Healthcare Community Benefits Program to provide prenatal educational visits to certain populations of moms. The VNA is working with Cape Cod Healthcare OB/GYNs to coordinate the care. Any time someone that fits certain criteria calls to make an OB appointment they are automatically referred to the VNA pre-natal home visit education program. That program also happens in their own home. The three criteria are:

• Non-English speaking,
• MassHealth insurance recipient,
• A young adult mother under the age of 24.

“The nurse will go into the home and they talk a lot about mental health and breastfeeding expectations, what to expect in the upcoming trimesters and labor and delivery,” Payne said. “We’re decreasing barriers by going to their house because we don’t require them to come into an office for a visit. Transportation is an issue for a lot of our moms in those demographics, so we go to them and we answer any questions that they have.”

The nurses see the moms multiple times during their pregnancy to act as a comfortable added support that strives to build a trusting relationship between patients in the community and the healthcare system.

The Community Benefits grant also supports translation services through Cape Cod Healthcare translators for all pre-natal and post-natal materials. When making a visit, the VNA nurse can use a translator for any language. They have printed materials in either English, Spanish, Portuguese, or Haitian Creole.

Loss Programs

Thanks to a grant from the Cape Cod Healthcare Foundation, the VNA Maternal Child Health program has also recently partnered with the non-profit organization Sharing Kindness to provide perinatal loss support groups. There will be two groups starting in March.

The first group is for women who have experienced pregnancy and stillbirth loss. It will meet from 5:30 p.m. to 7:30 p.m. on the first Tuesday of the month, beginning February 7. The second group is for women who experience early infant loss of a child from birth to 12 months of age. It will meet from 5:30 p.m. to 7:30 p.m. on the second Tuesday of the month, beginning February 14. Both groups will be held in Yarmouth and will include a light supper provided by the Family Table Collaborative. To register, visit the Sharing Kindness website.

“All of the grief support leaders are all trained in the Dougy Center model, so they’re especially trained to lead these types of groups,” Payne said. “When somebody calls to inquire about a group, they have to go through an intake process and they speak to one of the Sharing Kindness social workers to make sure they are appropriate for the group.”

It doesn’t matter whether the loss was recent or years ago. If you are still struggling with it, you are welcome at the appropriate group.