During the 11 years Katherine Autry worked as a neonatal intensive care nurse, she always wished she could follow her patients home from the hospital to give them additional support.
Now, Autry runs a new program at Touro Infirmary aimed to do just that: offer free at-home postpartum visits to anyone who gives birth at the hospital. Autry, the initiative’s nurse clinical manager, and a fellow nurse saw their first patient on Oct. 24 and have since visited five more patients in their homes.
All Orleans Parish residents who give birth at Ochsner Baptist and Touro — which accounted for 70% of New Orleans births in 2020 — are eligible for the free program. After giving birth, residents can receive up to three home visits from a registered nurse, who will conduct health assessments for parents and babies. Though Touro’s program has already launched, a spokesperson for Ochsner said the hospital plans to make the visits available beginning next year.
Proponents of the new initiative see it as one way to help address high rates of maternal and infant mortality in the state, particularly among Black parents and babies. Last year, as the nationwide rate of infant mortality rose, Louisiana had the fifth highest rate of infant mortality in the country. The preterm birth rate among Black women in the state is 55 percent higher than the rate of all other women, according to data from 2019 to 2021.
Still, Touro is facing difficulties staffing the program. Autry and another nurse are the only two people making home visits. The two other nurse positions are unfilled, and Autry said the hospital has not received any applications.
“We’re really recruiting,” she said, noting that the nursing shortage and the specific job requirement of making home visits has made the effort more difficult.
In August, city officials announced the initiative, which uses $1.5 million in federal American Rescue Plan Act dollars to offer up to three home visits for each patient. New Orleans Mayor LaToya Cantrell has said she hopes the initiative will extend beyond the three years it is funded for.
“Every day, we see more families expressing their interest in this service, which validates our belief that this was a much-needed service,” said Isis Casanova, a spokesperson for the city’s health department, in a statement.
New Orleans is the latest city to implement the model, an approach to postpartum care spearheaded by the North Carolina-based nonprofit, Family Connects International. The nonprofit launched its first program in 2008 at Duke University, and now has over 50 programs across 19 states.
The home visiting model is not only more convenient for patients, but also allows for a more expansive health assessment of the parents’ home environment, said Shelby Wynne, the program manager of Family Connects New Orleans.
Under the model, a registered nurse conducts the first home visit around three weeks postpartum. The visit includes a health assessment of the infant and the birthing parent, as well as a home assessment. After the initial visit, the visiting nurse will determine whether a second or third visit is needed within the infant’s first twelve weeks, Autry said. They will also offer supportive calls.
“At home visits, you have a more intimate relationship with the patient because you are in their home,” Autry said. “It’s their environment. They’re the experts of their environment.”
While Family Connects primarily uses a home visit model, the initiative also offers visits at an accessible neutral location, such as the Allie Mae Williams Multi-Service Center, and support over the phone.
Autry also said that the initiative will support high-risk patients with conditions such as preeclampsia, high blood pressure and diabetes. During one home visit last week, she helped a new mom who was out of work register for food assistance. The patient didn’t have a car, so Autry made sure to send resources directly to her home, instead of asking her to make a burdensome trip.
“If I would not have been in the home, I wouldn’t have known that,” Autry said.
Maternal health nonprofit March of Dimes found that pregnant people in Orleans Parish are more vulnerable to poor pregnancy outcomes and pregnancy-related deaths than those in nearby parishes of Jefferson and St. Charles, but less so than those in most parishes in central and north Louisiana. According to data from the Louisiana Department of Health, rates of infant death in the New Orleans area were lower than that of the state as a whole from 2018 to 2020.
Family Connects is also looking into implementing the program in Baton Rouge and Ruston, Wynne said, with the eventual goal of bringing the at-home visits to everyone in Louisiana.
Last year, Oregon became the first state to make the nonprofit’s home visiting initiative available to all families with newborns. Texas and Illinois are currently working toward expanding their programs statewide, she said.
“To make it just a normal thing for you to have a nurse come into your home after delivery — that will be the ultimate goal,” Autry said.
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