Fitting into mothers’ lives
Nurse works to ensure a healthy pregnancy for low-income mothers at risk of poor outcomes.
Catrina Popelier is a nurse, but banish the mental image of hospital scrubs or a starched-white uniform.
She’s most likely to be found in blue jeans, all the better to crawl around on the floor with the babies and toddlers she deals with in her role as a nursefamily practitioner.
Her repertoire is as much about offering advice on Arizona’s medical-marijuana laws as it is breastfeeding tips and potty training.
Her role is key in the child welfare world: to ensure a healthy pregnancy for low-income mothers at risk of poor outcomes and to get their firstborns off to a healthy start. Such intensive home visitations, known as Nurse-Family Partnership programs, can prevent problems, from low birth weight to placement in foster care.
“You take care of the mom, you take care of the baby,” Popelier said.
She describes the nurse-family practitioner program as “upstream prevention.”
“As a hospital nurse, you have patients who are asking for help after the disease has happened,” she said from her office at the Maricopa County Department of Public Health. “But ...we’re able to go upstream and teach the people how to swim instead of coming out almost drowned in the river.”
The concept of pairing nurses with pregnant women traces back five decades, inspired by a
young man who saw the needs of children he worked with in a day care center. That man, David Olds, concluded many issues of neglect or abuse that the children were coping with could be prevented if there was help earlier in the children’s lives — or even before they were born.
Today, Nurse-Family Partnership programs exist in almost every state and are touted as a proven prevention program. The partnership has operated in Arizona for more than 30 years, with most of the activity in Maricopa and Pima counties.
An analysis done for the Strong Families Arizona coalition in 2016 by researchers at Arizona State University concluded the nurse-family partnership program, along with other prevention efforts, resulted in $1.87 in benefits for every
“It’s all based on the mom’s needs and wants. We want to make sure we fit into their lives.” Catrina Popelier
Nurse practitioner, Maricopa County Department of Public Health’s Nurse-Family Partnership program
dollar invested in the programs. Those benefits come from avoiding more costly interventions and from helping families become self sufficient.
The program is open to women who are experiencing their first pregnancy, who are less than 28 weeks into the pregnancy and who live within areas defined as at risk for adverse effects from poverty.
The nurse practitioner visits regularly with that mother and her family until the child is 2 years old.
“It’s all based on the mom’s needs and wants,” Popelier said. “We want to make sure we fit into their lives.” Fathers can be included in the program, but often her clients are facing parenthood alone.
“I’ve had moms who are homeless and 13,” she said of the clients she’s worked with over her seven years in the field. “And I’ve had moms who are in their 40s and working on their master’s degree.”
She takes a holistic approach: addressing medical issues but also focusing on the family environment, living conditions and emotional needs. It’s nursing with a blend of social work.
“I’ve had moms who have had their parents killed in front of them,” Popelier said. “How does that impact you emotionally and mentally and what are your needs then?”
She works with the women to answer those questions and to teach them how to advocate for themselves.
A lot of times, she said, her job just means listening. Other times, it involves hands-on work such as how to soothe a crying baby. And always, it’s problem solving, finding resources and services to help a first-time mother in a low-income household.
Those efforts pay off in terms of reduced emergency-room visits, fewer arrests of children by age 15 and a reduction in pregnancy problems, according to research that tracks outcomes of families involved with the program.
Popelier, a mom herself, said she would have welcomed the kind of assistance the program provides when she was pregnant.
“There’s so much information and not enough education,” she said. The partnership provides hands-on training and in-person discussions, key elements of education. And she’s seen it pay off in healthy kids and stable families.
Sometimes, she said, the hardest part of the job is convincing women that she’s not selling anything.
“I just want to be your nurse,” she said. “I want you to have the best pregnancy ever.”