When I Can't Become We Can
Posted on: Wednesday, December 1, 2010When I first received Jane's referral from a local physician, I wanted to loudly announce to any of my coworkers who would listen, "I can't do this!" Jane was a single, 30 year-old woman who had delivered her first child four weeks premature after going to the doctor for "gallbladder pain". Apparently, she had not even known she was pregnant. The referral listed a vague "history of chemical dependency, possible mental retardation and poor likelihood of ability to parent". The doctor's request: "teach her to be a mother".
Jane was staying with her parents and it was to their house I carried my infant scale and a plethora of parenting information. Surely, I could find something that would be appropriate or give me direction. A slender woman greeted me at the door and when I extended my hand and introduced myself she did likewise. Jane looked away; it seemed difficult for her to make eye contact. However, when she talked of her newborn, Ann, her face beamed.
Other than seeming shy, Jane was fairly articulate. I found out she was a high school graduate and had served in the military. She worked full-time in a local furniture factory, a job I knew required, and screened for, literacy at an 8th-grade level. We seemed to be getting on well, so I decided to jump right in and determine what our challenges were. "So," I began tentatively, "tell me about your pregnancy and how your labor and delivery went." The story Jane told me was vastly different than what the referral had reported. True, Jane had not known she was pregnant until it was near time to deliver. The reason, however, was not "possible mental retardation"; it was because Jane had never had a period. Ever. She was tested at age 17, told she lacked a uterus and that she would never have children. When she gained a few pounds and started having stomach pains, the thought of pregnancy had never entered her mind. She had saved the letter from the specialist who had pronounced her uterus-free and after retrieving it from a file cabinet, handed it to me with a quiet chuckle. "I should've brought this to my doctor; I don't think he ever believed me because they found out I do have most of my parts."
This story was unraveling in a most interesting way. "Well," I started again, "if you didn't know you were pregnant, it would've been impossible for you to know to avoid substances that could've hurt your baby, like drugs and alcohol. Please tell me about that." Again, her answer was a relief. "If I had known I was pregnant, I would've quit smoking. But, I have never used drugs. I used to drink heavy, but I haven't touched a drop in over three years." At this, her mother came into the room and they talked a bit about Jane's difficulty, but ultimate success, over "the bottle".
I weighed the baby and found her to be thriving. We set up the next home visit appointment for three days later. At each visit, Jane reached out further to me and she was always home for our appointments. As her confidence grew, she moved back into her own home. It was a simple, but immaculate two-story with a nice view of a park. We spent many hours watching the world go by as we discussed parenting issues and challenges at her kitchen table. I reassured her at every step. I praised her inquisitiveness. She had a lot of questions about how children grow and develop. Fortunately, I knew people who had the answers. She signed up for our Universal Home Visiting Program and meets periodically with an in-home early child educator. She takes Ann to Early Childhood Family Education classes and checks out books at the library to read to Ann. It did take Jane awhile to absorb new information, but none of the professionals working with her felt that this would prevent her from parenting. She certainly was NOT mentally retarded.
Jane no longer seems at all shy. She has developed a confidence about her that has served her well as a parent and as a newly promoted supervisor at her job (a salary raise along with the title allowed her to get off the Minnesota Family Investment Program). She has moved on from an emotionally abusive relationship with Ann's father and is in counseling to deal with issues that lead to her earlier abuse of alcohol.
When Jane was discharged from our program recently, it was with the understanding that "her public health nurse" would always be available if she had questions or concerns. At our last visit, it almost seemed impossible that the self-assured woman with the big smile was the same person I had met a year ago. I commented one more time to her on how well she was doing. With this, she gave my hand a squeeze and tears welled up in her eyes. "Thank you" she said, "for teaching me things." She hesitated, looking for words it seemed, and then added, "Thank you for helping me to become a great mom."