Photography by LYDIA THOMPSON
Writing by Serena Lei; LYDIA THOMPSON
Sitting on the floor of her Duncanville, Texas, home, 20-year-old Mariah Gaines gently rolls a ball to her 8-month-old son Ezekiel. When he catches it, he drops the ball into his mother’s outstretched hands and looks up at her, uncertain of his task, only to be reassured each time by her smile.
This small act is helping Ezekiel develop his motor skills. The back-and-forth rhythm teaches him social interaction and communication, and the connection brings Mariah and Ezekiel closer, bonding them as she teaches him how to play.
That a simple game could mean so much to Ezekiel’s development is something Mariah learned from Vickie Ghent, a nurse home-visitor who was paired with Mariah through one of Dallas’s Nurse-Family Partnership programs.
“I don’t have a mother to teach me how to do motherly things,” Mariah said. “If it wasn’t for [Vickie], I don’t know what kind of mother I’d be.”
But what matters for good health goes well beyond medical care, said Alison Collazo, director of the Nurse-Family Partnership program at WiNGS, a Dallas nonprofit.
“You can’t have an impact on health if there are so many other factors in a woman’s life that are causing her to be in chaos: if she doesn’t have secure housing, if she doesn’t have access to healthy food, if she lives paycheck to paycheck or has unreliable transportation,” Collazo said. “All of those things are going to impact her health and well-being and that of her child. So our job is to go in and try to stabilize everything.”
The instability in Mariah’s life started when she was young.
She has no memory of her mother, who has been in and out of jail for most of Mariah’s life. Mariah’s father, Frank Gaines, raised Mariah and her siblings in California. They moved twice, landing in Picayune, Mississippi. The stability they had then was ripped away when Hurricane Katrina destroyed their home in 2005. For the next eight months, the Gaineses lived in a trailer on the side of an airport landing strip. Mariah was 9.
The family moved back to California for five years and then to Texas. In late 2013, Frank, who has type 1 diabetes, was hospitalized with kidney failure. As Mariah finished her last semester in high school, Frank’s health steadily declined. He suffered a stroke and a heart attack and lost hearing in his left ear. As the only child living at home, Mariah became his primary caregiver.
Although she finished high school while caring for her dad, Mariah didn’t pass the Texas Assessment of Knowledge and Skills, so she could not graduate. Before she could retake the test, she found out she was pregnant.
“I took 10 pregnancy tests. I took the cheap ones and I took the expensive ones, and they all came out positive. I didn’t know what to do,” Mariah said. “I was stuck. I was alone. I felt like I had no one.”
She told Ezekiel’s father (her boyfriend, Justin) but initially kept her pregnancy a secret from her family and friends. When she finally told her father, he helped her find a doctor. Through Medicaid and Planned Parenthood, Mariah was able to get prenatal care, but she was still anxious about how she would care for her baby. She had no income, no high school diploma, and she didn’t know how to be a mother.
The Nurse-Family Partnership program offered Mariah something these other programs could not: a lifeline and a friend.
Vickie Ghent has been a nurse for 37 years, the past 10 with a Nurse-Family Partnership program. “It’s just everything that I love to do, and that’s to encourage moms to succeed in life. That’s what I wanted to do in the hospital, but you just don’t have time.”
Mariah was paired with Vickie when Mariah was 5 months pregnant. When Mariah recounted their first meeting, she described it as friendship at first sight.
“We could talk about anything,” Mariah said. “I’ve never had a grown woman be my friend before, and she is.”
Working one-on-one with mothers until their child’s second birthday gives Vickie time to make a deeper connection. She talks to her clients about eating well, managing stress, and ensuring a safe environment for their kids.
She also helps mothers become more self-sufficient, whether that means going back to school, learning job skills, or getting professional clothes for interviews. “I see a lot of people who are one foot away from being homeless,” Vickie said. “We want them to become self-sufficient because we know that’s going to help their whole situation [including] their mental health, their well-being.”
Vickie is most concerned about the social interaction between mothers and babies. That interaction influences children’s brain development and sets a critical foundation for lifelong health and learning. But when mothers are sick or depressed, “it’s hard to interact with your child, to talk with your child, play with your child. And it’s easy to get frustrated with your child,” Vickie said. She often has to remind mothers to take care of themselves as well as they take care of their children.
Rigorous studies show that Nurse-Family Partnership programs lead to improved prenatal health, fewer subsequent pregnancies, and increased employment among mothers. Children from these programs are more prepared for school, less likely to be abused, and less likely to be arrested or convicted of a crime later in life.
Mariah said she isn’t sure what course her life would have taken without the help of Nurse-Family Partnership. She wonders if she would have ended up homeless or in a shelter and what that would have meant for the health of her father and her child.
“I used to be the laziest, most selfish, most inconsiderate person before I got pregnant. I really didn’t care about much except for myself,” Mariah said. “But now I know that it’s not about me anymore....My family—that’s what I’m about.”
“He’s taught me a lot, that little boy,” she added. “He’s just made me so happy.… He’s the best person ever.”
With Vickie’s help, Mariah was able to get her driver’s license, buy her first car, and find GED classes. She also signed up for a program that pays her to be an in-home caregiver for her father. And she’s learning how to coparent with Justin, who works full time.
Vickie also encouraged Mariah to set goals for herself. Mariah plans to get an apartment of her own someday with Ezekiel, get a college degree, and eventually go to veterinary school.
For now, “my goal is to be healthy and happy,” Mariah said. “Make sure my dad’s OK, make sure my family’s OK.”