When Sharon Rohrbach found a tumor on her leg in November 2007, she asked herself what she would do with her life if she had no more tomorrows. A surprising question, considering all that this 65-year-old nurse has already accomplished.
Widowed since 1999, with four grown children and three grandchildren, Rohrbach has spent the last 17 years leading her Nurses for Newborns Foundation (http://www.nfnf.org), a nurse home-visiting agency she founded to help prevent infant deaths, child abuse, and neglect. To accomplish these goals, the foundation uses home-based programs that cover education, health care, and parenting skills.
When Rohrbach started the foundation in 1991 with only a single typewriter and a vision to help poor families, she couldn't have dreamed it would attract some 1,200 volunteers and 9,000 donors (including Oprah's Angel Network and the Robert Wood Johnson Foundation, each of which gave $100,000), raise $8,000 a day to support its free services, and submit 52 grants a year. But today, it's precisely because of these efforts that Nurses for Newborns is able to work toward preventing child abuse and neglect in 50,000 families across Missouri and Tennessee and will soon be expanding its services to other states.
As a neonatal nurse for 16 years in St. Louis, Rohrbach knew that after newborns were routinely discharged from the hospital, many were soon readmitted for serious medical conditions. She used to visit the homes of some of these children to have a better understanding of their circumstances, only to find that many new mothers were single, poor, struggling with addiction or mental illness, and without cribs, heat, phones, or transportation.
Rohrbach recalls, "I realized very quickly that you cannot teach a new mother to change a diaper or make formula when she has no means of getting either one."
From that moment on, she was determined to provide new mothers with basic supplies in addition to the health care services they already received and to work with them toward successful outcomes for their children. She hired experienced neonatal ICU or nursery nurses to work with these vulnerable families for up to two years. The nurses use standardized assessment tools to measure the mothers' risk factors. Through a customized database, they can track ED visits, treatment for household accidents, repeat hospitalizations, and immunizations.
Rohrbach's successful fundraising has enabled her nurses to use the latest technology in measuring and tracking outcomes: all nurses have laptops connecting to a custom database, so they can work across states without ever visiting the main office. Plugging in a child's birth date shows expected developmental milestones, enabling nurses to quickly identify delays.
Follow-up with families has shown that 99% of the children served are not abused or neglected, do not have injuries from household safety hazards, have not had preventable hospitalizations, and do have medical homes or a primary medical care source, according to Rohrbach. Moreover, 93% have up-to-date immunizations.
"We have good outcomes because we show our love for these mothers by supporting them," Rohrbach explains. "If they're doing 99 things wrong, we try to find one thing they're doing right and encourage them."
Even with the current nursing shortage, Rohrbach doesn't have a problem hiring enough nurses because, she says, "We allow them time to build relationships and develop the hearts of their patients. For nurses, it's fabulous-it's what we became nurses to do-make a difference in someone's life."
But with 350 referrals a month in St. Louis and 100 a month in Tennessee, it's clear to Rohrbach that babies are falling through the cracks. She points out that the United States ranks near the bottom among industrialized countries in infant mortality. "Our health care system needs to lower the infant mortality rate by making sure that people without insurance and those on Medicaid can get preventive care."
Although her tumor turned out to be benign, the scare inspired her: she used the $100,000 she received as a 2007 Purpose Prize winner for civic leadership (see http://www.purposeprize.org) to start Dynamic Change: Outside the Box Consultants (see http://www.dynamicchg.com), dedicated to helping social entrepreneurs and nonprofit organizations provide services to vulnerable populations.
Maria Parlapiano confronted a different set of problems with new mothers while working as a lactation consultant.
"Many new mothers do way too much after they deliver, when what they need to do is rest," she explains. "They're jumping out of bed at seven in the morning, answering e-mails; no wonder they're exhausted."
For two years Parlapiano spearheaded a breastfeeding program supported by the New Jersey Department of Health, but she found herself with "a lot of bureaucratic things to do," she says. "Going to meetings and compiling statistics are important, but I like to work with the moms."
She had a longtime dream to create a retreat for new mothers where they could spend more time learning to care for and bonding with their newborns. In November 2007, 49-year-old Parlapiano, who has three grown children of her own, approached the owner of a bed-and-breakfast near Postpartum Place, the lactation center she opened in 1996 in Chatham, New Jersey (http://www.postpartumplace.com). He agreed to let her take over two private suites on the second floor of the Parrot Mill Inn, which she named the "Mommy Nest."
For $500 a night, mothers, newborns-and often fathers, too-can get away from the distractions of home at the Mommy Nest (http://www.postpartumplace.com/http://MommyNestBrochure.html). Parlapiano had envisioned couples coming directly from the hospital. "But what happens is that they go home first, and then they realize they're in trouble," she says. She will also make home visits, but finds them "extremely hectic, with people stopping by, the phone ringing, deliveries. Mothers are distracted and stressed out. They're often taking care of the people taking care of them. The inn is a quaint and quiet rest stop for them."
Although the retreat is not covered by insurance, all supplies are included, along with a full breakfast and healthy snacks. Parlapiano, or one of her staff, is available 24 hours a day for lactation consultation and any other parenting needs and will gladly take the baby so parents can sleep or shower.
Parlapiano sees the Mommy Nest-which has been open for only a few months-as a testing ground. Once she has more feedback, she may consider purchasing a building to house a larger "nest." "In other countries, mothers can go somewhere for a week to 10 days until they are comfortable," she says. "The Scandinavians have a beautiful program like this. Throughout history, women have always taken care of women; we have to return to that nurturing idea."
Alison Bulman
senior editorial coordinator