Reaching young moms aggressively

Helping: A Baltimore maternity program is having some success in advising poor young mothers.

July 06, 2004|By David Kohn | David Kohn,SUN STAFF

People in Sandtown-Winchester know Sheila Washington, and know she won't burn her sources. So she hears everything: Who's dropped out, who's smoking crack, who's been fighting, who's in jail - and most important, who's expecting.

Most days Miss Sheila, as almost everyone calls her, trolls the neighborhood, scouting. She talks to the ladies braiding hair on stoops, the old men sitting on rickety porches, the glaring drug dealers standing on corners - anyone who might know someone who's got a baby on the way.

"Where the pregnant ladies at?" she asks, over and over.

People give her names, addresses, phone numbers, sometimes just a nickname or a block. And then Washington goes to work.

She's a recruiter for Healthy Start, an aggressive program that provides pregnant women and new mothers with medical care and instruction in parenting, as well as food, furniture, diapers, household supplies and, often, just a sympathetic ear.

A private nonprofit that works closely with the city, Healthy Start was set up 11 years ago in a federally financed initiative that has spread to 96 communities nationwide. Sheila Washington's center covers the Sandtown-Winchester neighborhood, plus a chunk of Harlem Park. (Another center serves the area north of Patterson Park on the east side.)

Unlike most maternal health programs, which rely on referrals and drop-ins, Healthy Start actively hunts for clients - many of whom are barely more than children themselves.

"The people who need the most help are the least likely to seek out the services," said director Peter Schafer.

Baltimore officials say the program, with a $2 million annual budget, has significantly improved the health of the neighborhood's babies.

"It's tremendous," said Lisa Firth, who oversees maternal and child care for the Baltimore health department. "Some of these women wouldn't get any prenatal health care without Healthy Start."

In the wake of the uproar over Sierra Swann, a 17-year-old with a history of child abuse who allegedly killed her twin babies, city officials have wrestled with how to care for at-risk mothers and infants.

Healthy Start illustrates the potential of aggressive outreach, as well as its limits in the face of the city's enormous poverty and social problems.

Karen Sherman is a typical client. When Washington signed her up four years ago, she was getting little prenatal care. During her first pregnancy, a Healthy Start worker noticed that her contractions had started too early, and Sherman saw a doctor, who gave her drugs to stave off labor.

`They really helped'

"They really helped me out," said Sherman, who now has two children, 2-year-old Angela Brown and 4-year-old Jamaiha Thomas. "They used to come and get me and take me to the clinic when I didn't have no money."

Healthy Start gave the 24-year-old Sherman food and clothes, found her a free childcare program so she could get a job (she's a city school aide), and helped her move into a place of her own.

Sandtown-Winchester and Harlem Park are ideal places for Healthy Start. The area's 18,000 residents have high rates of poverty, unemployment, drug and alcohol abuse, and teen pregnancy. Over half of the adults never graduated from high school.

In this setting, it's not surprising that many pregnant women aren't prepared for motherhood. But finding those who need help is not simple. Sandtown-Winchester is an insular, inner-city world, suspicious of interlopers - particularly those bearing clipboards and forms.

So Healthy Start does its job by staying local. Instead of regular social workers, it hires neighborhood women and trains them to work with expectant and new mothers. Some of these "neighborhood health advocates," or NHAs, are themselves former addicts.

"They know the community," says Dana Gaskins, who runs the Sandtown-Winchester clinic. "They get people to buy in."

This is Washington's specialty. In a sense, she's the key to the whole enterprise: She actually finds the expecting mothers. She and her assistant, Tanya Harrison, sign up over 90 percent of the center's clients.

An outgoing 43-year-old with a gold tooth and easy laugh, she grew up in Sandtown and lived there most of her life. She's known many of her clients for years, and has faced the same troubles. She has three sons of her own, and has been unemployed.

Over the years, she's grown close to many of her recruits. To many, she's a mother figure. They call her for advice on breastfeeding or breakups, and send her photos, which she tacks onto her office bulletin board: baby pictures, family photos, and prom portraits - some with the mothers holding their babies.

Cruise neighborhood

On a recent morning, Washington and Harrison - a quiet 27-year-old with three kids of her own - are out looking, cruising the neighborhood, making a right here, a left there, rolling through block after block of crumbling rowhouses.

As she steers, Washington scans the terrain, fiddling with the radio, searching for soul and hip-hop songs she likes.

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