In early 2020, Courtney McWhorter was “basically homeless.” She was in what she described as a toxic relationship. She was using methamphetamine. And she was pregnant.
“I also had some felony warrants hanging over my head,” she said. “I gave birth in April 2020. A social worker was involved, and so I got picked for the START program through [Child Protective Services]. I remember getting a phone call from the very cheery nurse from the Baby Steps program.”
Today, McWhorter is a peer support specialist at St. Elizabeth’s Baby Steps program, which works with mothers to support them in myriad ways – including mental health services – through their recovery. McWhorter is also a mother of three and nearing her five-year sober mark. She’s lived the experiences that many of the women referred to the program go through.
A mother’s health, both physically and mentally, can have a profound and lasting effect on her children, especially in the first years of life, according to the National Institutes of Health and other health experts.
Northern Kentucky state health officials and health providers recognized this fact and have come together to offer programs targeted to pregnant and parenting moms in our region. They’ve found that the most successful of these programs are those that provide direct support to mothers and their families.
Baby Steps program
For pregnant and parenting women with substance abuse challenges, the road to recovery affects not only them but their children. Experts say many will reach out for help during pregnancy. Yet, with all the stresses that come with having a newborn, it can be a vulnerable time that can lead to a relapse.
St. Elizabeth’s Baby Steps program works with mothers to support them through their recovery. In Northern Kentucky, the program has three nurses and three peer support specialists on staff.
Dr. Teresa Koeller-Brueggemann is the medical director for St. Elizabeth Physicians Journey Recovery Center and Baby Steps, which is housed in the recovery center. Program staff will meet patients where they are and work with them through their recovery, she said.
“Our doors are always open,” Koeller-Brueggemann said. “If we send you someplace else because you need to go to residential (treatment), we want you back. We try to stay in contact with patients or their families while they’re in treatment.”
Patients can come to Baby Steps through Journey and other recovery agencies, the hospital itself, the court system or Children’s Protective Services.
“We work with any woman who has substance use, either pregnant or while they’re still parenting children at home,” said Angela Scroggins, nurse manager at St. Elizabeth’s Maternal Fetal Center and the Baby Steps program. “Our first goal is to get them sober and to help them sustain that sobriety. We want them to be able to parent their children, and then we want them to just grow in their own recovery.”
Scroggins said the program tries to support the women in any way they can. They connect them to services, community resources, and provide transportation and access to WIC, parenting classes and anything else they might need. WIC is a supplemental nutritional program that provides free food, breastfeeding support and referrals to other services for low-income women and their infants or children.
“My nurses are like case managers,” she said. “We can work with any treatment center. We work with Crossroads, Brightview, the methadone clinic,… just about every group in Northern Kentucky that provides some type of substance use assistance to women.
“Our peer support specialists are women who have recovered from addiction, and all of them had babies or small children while they were in addiction. They use that lived experience to help guide women. They go to court with them. They are a huge bridge through CPS.”
Courtney’s story
While in a residential treatment center, McWhorter continued to hear from that cheerful nurse and from a peer support specialist, another woman who had been through what she was facing. McWhorter said she was committed to recovery and was able to be with her daughter in the last two weeks of residential treatment.
It was rough going. She relapsed, went to jail for a time and lost custody of her daughter, she said. Determined, she asked her social worker about the Journey Recovery Center and began an intensive outpatient program there while continuing to see and work with the Baby Steps staff.
“We had a group once a week that we would meet with a group therapist, and there were other moms in there,” McWhorter said. “The group I remember was kind of small at first for me, and it’s just a struggle to keep attendance in a group setting and treatment.… But I really liked the therapist, I really liked the group and I really enjoyed the support.”
The peer support, she said, was crucial.
“Peer support would reach out to me every week asking, ‘Hey, how are you?’ ‘Is there anything that you need?’ ‘Is there anything you’re struggling with?’ And they got to know me really well, because I’m a talker,” McWhorter said. “Every time they would call and check in, it was like, at least 45 minutes conversation, because I just really utilized that support. It helped me to be accountable.”
McWhorter continued to work on her recovery and regained custody of her daughter. She got a job with an employer who accommodated her therapy schedule. She also continued with Baby Steps, and, when a position to be a peer support specialist opened, staff encouraged her to apply. She did, and now she has been in the position for three years.
Today her life looks very different, and she is full of hope, she said.
“I have a fiancé,” McWhorter said. “He’s also recovering. He’s got a son – he’s 13 – and then we have a daughter together. We bought a house back in October. We’ve got brand new cars in our driveway. I mean, life is good. And the best part of all of that is I get to help other women in similar situations. I get to be a part of their story and walk alongside them in their early recovery days and help them build that foundation, that support for them to be able to be successful long-term.”
Every Child Succeeds
Another program created to help mothers and their children is Health Access Nurturing Development Services, also known as HANDS.
The program partners with Every Child Succeeds to provide home-visit professionals who work one-on-one with parents to ensure they have what they need to handle the many stresses and challenges that can come with having babies and small children.
Depression and anxiety can have a detrimental effect on mothers and their families. A nurturing and stimulating environment is essential to child development, especially in the first few years. As a part of the Every Child Succeeds program, patients are screened for depression to identify those who may need additional support.
Funded through HANDS and private donations, Every Child Succeeds serves low income families in Boone, Campbell, Grant and Kenton counties and is offered at two sites – St. Elizabeth Healthcare and Brighton Center, said Jennifer Frey, its president and CEO.
“It’s a completely voluntary program where a home visitor is assigned to the family either prenatally or within 90 days after a baby is born,” Frey said. “They go to the house to support the family in all things with the end goal being to optimize infant and toddler development.”
If a mother’s mental health is in any way impacted or stressed, Frey said, that affects how a baby thrives – or doesn’t. “And so, we take this whole-environment approach and very much focus on the relationship between the mother and the baby,” she said. “Therefore, we screen moms for postpartum depression.”
Every Child Succeeds uses the Edinburgh depression screen with moms at three different intervals. They screen at six to eight months before giving birth, two to 12 weeks after giving birth, and then when the baby is eight to 12 months old.
If the screening identifies that a mom may be suffering from depression, the organization will refer her to one of their partner agencies, such as mental health providers NorthKey or Sun Behavioral Health or ION Center, a personal violence prevention center in Covington.
Mothers may be referred to the National Maternal Mental Health Hotline, a 24/7 free, confidential support line. They also can connect with a support group run through the local chapter of Postpartum Support International.
“We are a prevention program, rather than a treatment program,” Frey said. “We then strive to make sure, because we’re there frequently, we are focused on the family and we’re there to create nurturing environments, that we’re paying attention to maternal stress, maternal social supports, maternal depression so that we can tailor our services to meet their strengths and needs.”
Amy Knapke, the Every Child Succeeds coordinator at Brighton Center, said home visitors meet with families in the prenatal year, and then visits are weekly through the first year and move to biweekly once the child turns 2. Referrals come through the health department, hospital or other agencies, or from Brighton’s own programs. In the last fiscal year, the program served 543 parents and their children.
“Parents, especially new parents, have a lot on their plate,” she said. “One way we can meet them is in their home setting…. We go into the home and just sit on the floor, because we know that’s the easiest way, a safe place for the babies. We want to help partner with parents on their parenting journey.”
Knapke noted that 93% of the children in families that participated in the home visit program were found to have age-appropriate cognitive and language skills. This is huge, she said, because it is significant compared to the region’s overall kindergarten readiness scores: Boone County’s score is 54% and Campbell County’s score is 55%, according to the Kentucky Department of Education. It shows the program puts children on a better track to prepare for school, Knapke said.
St. E Behavioral Health
Stacey Gripshover is a psychiatric mental health nurse practitioner in St. Elizabeth Healthcare’s Behavioral Health Department. She’s worked in labor and delivery and provided care to women in Baby Steps. She now works with all new moms who are suffering from depression and anxiety during and after pregnancy. She’s seen what this depression can do and focused her practice on helping all moms dealing with it.
“St. Elizabeth has roughly 4,000 births a year, and we know that one in five women will suffer postpartum depression.That’s roughly 800 potential moms who, if we do not provide proper screening or proper support, could be suffering,” she said.
She noted that the term postpartum depression is very specific. Women can experience a wide range of symptoms that fall into a broader category known as perinatal mood and anxiety disorders.
Gripshover said she is passionate about working to protect maternal mental health. She sees about 50 patients a week that come to her through referrals. She provides one-on-one therapy and can prescribe medications as needed. One of her initial goals is to assure mothers experiencing a wide range of emotions after giving birth that they are not alone.
She is also certified by Postpartum Support International, an organization with a chapter in Northern Kentucky, that runs support groups for new moms suffering after birth. Support, Gripshover said, can make a big difference.
“And the beautiful thing I have witnessed by doing this for the past two and a half years is that you give a mom just a little bit, and she takes it and runs with it and makes it special. And … you can just tell this mom is probably doing way better in her home with this little bit of support than if she had not had it.”