Jen Jurgensen recalls a time eight years ago when she felt physically, mentally and overall biologically in a different state shortly following the birth of her first child.

After returning home from Olympic Medical Center and with questions accumulating by the minute and a need for reassurance, Jurgensen said that when a nurse with New Family Services pulled into her driveway she felt an “immediate sense relief and it was a powerful experience” she’ll never forget.

Since 2000, OMC’s New Family Services has offered home visits to mothers and their newborns, but beginning Oct. 1 that service will no longer be available. New Family Services staff still will offer the same type of care, but in the clinic setting only.

Although each home visit experience is unique, Jurgensen’s is just one of hundreds that women within Clallam County share. Jurgensen is the moderator of the Peninsula Moms Yahoo Group, (an online group for moms, moms-to-be and families living in the Sequim and Port Angeles area) and corresponds with 345 members, giving her a good sense of the community impacts home visits have.

However, the members of Peninsula Moms Yahoo Group are only a small pool of local mothers, as more than 500 births occur annually at the OMC birth center, according to OMC’s website.

“There is great value in getting that style (home visits) of care, but we had to look at costs and the efficiency of the service,” said Lorraine Wall, chief nursing officer at OMC.

Because OMC is the only public hospital in the state to offer home visits by lactation consultants to mothers and newborns, Rachel Anderson, a health and wellness educator at Peninsula Community College, said the board should instead act on the opportunity to influence change, set an example and not look at it as a burden.

Anderson was among the standing room only crowd at OMC’s board of commissioners meeting Wednesday, Sept. 17. The group of concerned residents, including many mothers with their families and health care professionals, addressed the board during the meeting. Many of those attending had heard about OMC’s decision to no longer provide home visits via Facebook, Anderson said.

“OMC is a public hospital and they’ve made a huge decision without having a public discussion,” Anderson said.

Inefficient

Roughly 14 years ago when OMC began offering home visits, it had received a grant, but after the grant funds dwindled, the OMC Foundation was able to provide some financial help to maintain the service until now, Wall said. In the past year New Family Services lost more than $200,000, Wall said.

Given the low reimbursement rates from government insurance policies including Medicaid and Medicare, OMC officials are having to reflect on the services they offer and trim additional expenses without hindering their ability to provide basic, quality care to the community as a whole, Wall said.

“Eventually maybe we’ll be able to offer this type of service again,” Wall said.

OMC officials made the decision to cut the home visit aspect from New Family Services because it was financially “inefficient,” Wall said. The costs associated with one nurse driving to often unincorporated areas of the county to see one patient were too high in comparison to the amount of patients that nurse could see if she remained at the clinic. Also, home visits aren’t recognized by private insurances.

Anna Swanberg, leader of the La Leche League for Sequim and Port Angeles, tends to look more at the health benefits and therefore costs benefits from a service like home visits. Home visits are a form of preventative care because the nurses are able to assist mothers and/or newborns at home instead of the hospital or if it’s after hours, the emergency room – sparing the time of the hospital staff and family.

“I have to believe it is most cost effective to pay one nurse for two hours than a whole staff at the ER to see one patient,” Swanberg said. “I think there can be an outside the box solution for this. There is a saying, ‘one ounce of prevention is a pound of cure.’”

Health impacts

Other than one nurse with New Family Services that just retired, OMC will keep the other four nurses “more than busy,” but within the clinic, Wall said. The nurses at New Family Services provide specialized expertise to the community given they’re all trained and certified lactation consultants – a rigorous education on the clinical management of breastfeeding.

This specialized knowledge allows the nurses the ability to provide new mothers with general medical attention and support, as well as the tools to effectively teach and promote breastfeeding.

Both Anderson and Swanberg point to breastfeeding as having both short- and long-term health benefits, as well as a mental health benefit for the mother and child because of continued skin-to-skin contact.

“Scientific research overwhelmingly shows that breastfeeding is important for short-term health effects, aiding in the prevention of ear infections, allergies and preschoolers are less likely to be overweight and less anxious,” Anderson said in a letter to OMC officials. “There are also long-term health effects as a person ages, including lower blood pressure and cholesterol levels.”

Given the associated health and mental health benefits, the promotion and support of new mothers to breastfeed can arguably keep future health costs down, Anderson said.

For women that simply cannot breastfeed or don’t want to, lactation consultants are able to help them learn how to use a breast pump properly and how to transition an infant to formula.

“As a health and wellness educator, I look at the health of the whole community,” Anderson said. “These women (home visit nurses) are the ears and eyes of the community and they often have the first shot at providing the education to support for a healthy community.”

Home visits allow the nurse to recognize and respond accordingly to things such as drug abuse, lack of resources, domestic violence and signs of postpartum depression, Anderson said. Such insights into a mother and her newborn’s lives aren’t always something a health professional can gain in a clinic setting.

Wall explained there are alternative organizations that offer home visits for maternity and early child education, such as First Step Family Support Center.

“We’ve been working with New Family Services hand-in-hand and we’ll continue to work with them in anyway we can,” said Nita Lynn, First Step’s director. “We will continue to provide home visits for prenatal and postpartum women.”

Although First Step Family Support Center does work closely with New Family Services, it does not have certified lactation consultants, Lynn said, and she isn’t familiar with any other local program that offers home visits from certified lactation consultants, making New Family Services a unique level of care.

Beth Barrett, a mother of six children, has both professional and personal experience with New Family Services and the home visiting nurses. Barrett had home visits for three of her children, including the birth of her twins. She also is a general photographer and photographer for the organization Now I Lay Me Down To Sleep. In order to promote awareness and facilitate a dialogue and flow of ideas surrounding the soon-to-be void in home visits beginning Oct. 1, Barrett is interested in spearheading a community meeting.

If interested in attending or getting involved, contact Barrett at elizabeth@morningstarphotography.net.