This is the first baby that new mom Lydia Bateman has kept.
At 28 years old she lost custody of three previous children due to substance abuse, the children adopted out. “I haven’t used since the day they took my daughter away,” says Lydia.
But it’s still been a rough path to motherhood.
When Pathways RN Stacy Lee met Lydia, she was living in a tent on land owned by her partner’s mother, the home uninhabitable after a fire. She was covered in mosquito bites and scabs. The baby’s father was in jail for drug-related offences.
Baby Ayden was born in mid-September and has problems with his kidneys and needs surgery to remove extra fingers and toes caused by polydactyly and to correct hypospadias, a condition that means the opening of the urethra is on the underside of the penis instead of the tip.
Like many of the high-risk pregnant clients that the Pathways nurses work with, Lydia’s own childhood was marked with instability and trauma.
She has talked matter-of-factly with RN Stacy Lee about how disability checks intended for her childhood care were diverted by a relative. Lydia has explained how she got into drug use, using opiates in an attempt to blunt emotional pain. As a new mom, Lydia is unwavering about staying sober, nurse Stacy Lee says, as is her partner, who was released from prison shortly before the baby arrived.
Lee says Lydia is an attentive and loving mother to Ayden.
“I am very proud of the work she has done to overcome countless challenges to thrive. She continues to inspire me with her indomitable spirit.”
Polydactyly is a rare congenital abnormality that causes extra fingers and toes. Usually it’s benign and affects just one side of the body.
But baby Ayden has the even rarer kind that affects both sides.
Ayden’s condition was detected while he was still in the womb.
Fortunately, genetic testing ruled out Meckel-Gruber syndrome but did reveal polydactyly. More concerning than the extra fingers and toes were the accompanying renal abnormalities often associated with the condition.
But this is a success story.
Ayden’s birth by caesarean section was relatively uneventful and as a newborn he received thorough testing.
The plan is for him to have corrective surgery on his kidneys, fingers, toes and penis (for hypospadias) later in his first year of life.
For nurse Stacy Lee, with the Pathways to a Healthy Pregnancy Program, part of treating baby Ayden has been reassuring his mother Lydia Bateman that she did not cause his health problems. Polydactyly can result from a first trimester developmental glitch or be associated with any of several genetic abnormalities.
Accompanied by nurse Stacy Lee, mom Lydia picks up the last two cans of formula covered by WIC (Women, Infants and Children) for the month. She was concerned that his stomach "felt hard" and the he was fussy after eating, and she intended to see if WIC could switch her formula to one marketed for babies with sensitive digestion.
"One of the great joys in this work," says Stacy "is to be able to show clients, both in word and in deed, that their lives matter. Helping clients recognize the importance of their own roles as pivotal parts of a family unit is an integral part of the Family Navigator Program."
"I believe that helping clients troubleshoot solutions to the challenges they face is good practice — both for a sense of empowerment and to become increasingly comfortable collaborating with others toward a common goal. Building trust through consistency and integrity is key, I think."
Lydia received education on the WIC program, which she had been on during previous pregnancies. The Family Navigator Program actively promotes breastfeeding, as does WIC. Despite this, many women, Lydia included, choose to stop breastfeeding in the early postpartum period. Aside from the loss of breastfeeding health benefits for both mother and baby, formula is expensive. WIC only covers part of the cost of formula, and many low-income families struggle to obtain the money needed to buy formula needed for the last week or two of the month.
Growing up in Ethiopia, nurse Stacy Lee remembers witnessing the suffering around her and thinking, I’m going to change that. She never imagined how that passion would play out.
Working with the Pathways to a Healthy Pregnancy Program in southeast Ohio, Stacy talks with obvious affection about her clients.
She’s been struck by mom Lydia Bateman’s determination to succeed.
During her pregnancy, Lydia received trimester-specific education on fetal development, breastfeeding and the social services available to her. There was also family planning education and medical referrals as appropriate. The testing meant frequent trips to specialists, transportation that nurse Stacy was able to arrange. She was able to call or text Stacy with questions as needed in addition to support at prenatal visits and at home as needed. importance of attending postpartum visits,
But even more than the practical help, nurse Stacy Lee sees one of her main roles as helping counter the stigma associated with having a baby with birth defects and to help Lydia bond with Ayden, which she’s watched the new mother do.
O’Bleness-Ohio Health OB-GYN (where she received both prenatal and postpartum care) is very proactive and positive outcome focused. Their staff consistently treats patients with respect and compassion, and for that we are grateful.
When she found out she was pregnant, 23-year-old Becky Kiser was living in a camper. Fortunately her brother traded places so she could prepare for motherhood in his mobile home, which is just across the street from her parents’ house and next to her sister’s place.
But when Bobby’s roommates left, they took nearly all the furniture, leaving the trailer a virtual empty shell. Searching out low cost and even free furniture can be challenging but here RN Kristin Kerwin, with the help of her husband, delivers a dresser to Becky.
“There are many challenges and many rewards associated with my job as a Family Navigator nurse,” acknowledges Kristin. “The rewards can be as small as a single smile from a client who has barely spoken to me, or as large as a new mother who calls me every time her baby has a ‘first’ — a first smile, a first crawl, first solid food.” For most of her long nursing career Kristin worked in the neonatal intensive care unit, which had its own set of challenges and rewards. “But knowing I am affecting two lives instead of one makes this job especially rewarding. I absolutely love it!”
Becky and her twin brother Bobby are very close.
So close that he’s complained of experiencing morning sickness in sympathy with his sister. Bobby is very supportive — he moved out of his mobile home so his sister could have a better place than her camper to raise her baby.
Becky’s relationship with her boyfriend broke up, but she is fortunate to have good family support. Family is important in the small community of Carbondale, Ohio where the Kisers are related to just about everyone in town
Nurse Kristin Kerwin sits at the dining table with newly expectant mom Becky Kiser, in Becky’s mother’s house. Pathways Family Navigators provide support as well as education. This means either meeting clients at their clinic appointments or sometimes making house calls. Even though this pregnancy was unexpected, Becky is very excited about motherhood. She and Kristin discuss morning sickness and ways to manage it.
“Establishing a relationship of trust with my clients is one of the first and most important components for me,” explains Kristin. “I am not there to judge in any way. I am only there to help and empower. Sometimes clients have just never been presented all of the options that can help them overcome their barriers. I am the presenter.”
The Kisers knew of the Pathways program through another family member, and when Becky realized she had barriers to overcome, she requested help.
The landscape surrounding Becky Kiser’s new home is heavily wooded and peaceful. Out her front window, the expectant mom can look across the street and see her parents’ home where she grew up. At the time of this visit, there were two dogs living in the mobile home with Becky, and a calico cat with a litter of 4-week-old kittens.
Trailers are notoriously poorly insulated and as winter arrives in the hollow, it’s getting cold.
This is Becky Kiser’s first pregnancy and everything aches.
She’s been able to talk with her Family Navigator nurse about the aches and pains in her hands and especially her back. Becky has struggled with epilepsy since childhood, is currently receiving disability benefits, and feels that her condition makes employment impossible.
Everyone in the family knows the sex of Becky Kiser’s baby, except Becky herself, who wants to wait until a ‘gender reveal party’. She gave permission for her Family Navigator nurse to also know the sex of her baby and Becky’s mom whispers in RN Kristin Kerwin’s ear, “It’s a girl!”
Becky thinks she is having a boy.
“I think it is very important to encourage my clients and provide them positivity with their high risk pregnancies,” says Kristin. “Sometimes our clients don’t experience much encouragement in their lives. There was a time when one of our clients was congratulated on her pregnancy and she was surprised and said, ‘Noone has ever said that to me’. After that I began sending congratulations cards to my clients after they give birth.
At 19, Lexie Banks is mother to two inquisitive boys, 3-year-old Josh and baby Cayden.
Shy and softly spoken, Lexie has never had substance abuse issues, but her life has been significantly affected by others’ drug use. Her mother was addicted to multiple substances. Lexie and her siblings were living in a house lacking heat and without enough food when Children’s Services removed Lexie’s siblings. Lexie was discovered to be pregnant with her first child and, in lieu of foster care, she moved in with her then-partner’s unofficial foster mother.
But the family structure was precarious and eventually the household broke apart, at which point Lexie moved back in with her maternal grandmother.
Lexie has said she’s often felt depressed and overwhelmed, especially when there’s turmoil at home.
The Family Navigator program has, with intermittent success, encouraged Lexie to continue beyond her 9th grade education. Lexie has expressed interest in getting her GED someday, but says she doesn’t know what type of work she’d like to do. “I would like to see Lexie continue to develop adult life skills and blossom with greater confidence,” says RN Stacy Lee. “Encouraging her to continue to be a caring mother, further her education and obtain a fulfilling career in the future are maybe the best ways to help her feel empowered.”
The stress of not knowing where the family will sleep the next night shows as grandmother Joyce Ann Brandeberry cries on the shoulder of Family Navigator RN Stacy Lee.
Stacy had spotted Joyce walking along the street in Athens with her granddaughter Lexie, who’d previously been a Family Navigator client. Lexie’s new partner was there, as well as Lexie’s two children in a stroller. They were all homeless, and Joyce said they didn’t have any money; that they were staying in a motel but had only that night paid up, not the following. A caseworker from another agency had been working to obtain suitable housing for them but they were still waiting for the approval.
“As navigators, we are often able to point clients toward community supports,” explains Stacy. “And in this case, two individuals paid some motel costs which bought clients a little more time in which to secure housing.”
The help didn’t stop there.
When the family’s social worker succeeded in obtaining Rapid Rehousing funding, allowing them to take a rental townhouse in nearby Nelsonville, they needed food and furniture. So a trip was made to a nearby food pantry and some food was provided to eat straight away, since the electricity wasn’t yet turned on. A large donation of furniture was provided by an O’Bleness-Ohio Health OB-GYN nurse, and transported to the family’s apartment.
“It can’t all neatly be done in a 9–5 setting,” says RN Stacy Lee. “Sometimes we listen to tearful clients who need to talk late at night. But it’s all worth it. Strong social connectedness positively impacts community health and we’re grateful for the opportunity to help.”
Though the Family Navigator program technically provides assistance up until three months after birth, it’s not a hard and fast rule. “Our timeframe often extends beyond the three-month postpartum period. Kristin and I feel honored when we can still be helpful to our clients, and have no doubt that they will in turn help others as they’re able.”
Through the Family Navigator program, Lexie Banks has received education on prenatal development, pregnancy health, dental care, labor, and more. She received a free crib through the Ohio University Heritage College of Osteopathic Medicine Community Health Program upon completion of Safe Sleep education, and a car seat was provided through Ohio Health O’Bleness Memorial Hospital. Family planning and contraception choices were discussed during her pregnancy.
Dustin Hutchinson isn’t technically a client of the Family Navigator program but nurse Stacy Lee has been helping him too, since he’s the partner of new mom Lexie Banks.
“Taking into account family dynamics makes us more effective,” she says. “Often our clients are struggling with issues related to unmet needs of family members. When we assist with those problems, the benefit is augmented. The client and family recognize that we are able to see them in the context of their relationships, and that they all matter. This builds rapport and trust.”
“For example, a client’s son might need warm clothes. A client’s partner might need a legal referral. A grandmother might need to find a primary care provider. A boyfriend might need to apply for Medicaid.”
In Dustin’s case, it’s getting into college. The 18-year-old is dealing with a lot, thrust into a father role with his girlfriend’s two sons, and living with his girlfriend’s grandmother. All this when he’s still a teenager himself. Dustin wants to study criminal justice with a view to becoming a police officer, which would allow him to support this young family. Nurse Stacy Lee has been encouraging him. “All we can do is offer support. I think young men in this area would benefit from a community support network of some kind.”
A photo column about women in Appalachia struggling to overcome the circumstances of their lives — often drugs, poverty, abuse — in order to become good mothers to the next generation.
At the heart of this story are the nurses who pour their hearts into empowering these women.