The goal of the S.M.I.L.E. Program is to reduce the number of premature and low birth weight infants among Black women in Montgomery County, Maryland by addressing key factors such as stress, hypertension, diabetes, smoking, drug use, mental health, and social health. Once issues that negatively affect pregnancy are discovered, we refer women to a number of social/health service agencies within the Montgomery County community.

We also help to improve parenting skills and knowledge among Black women through our home visitation nurse case management program, so that infants are received into a safe, nurturing, and positive environment. While on home visits, we work to empower women to identify issues that affect their overall health.

Our services include:

• Nurse case management
• Monthly home visitation
• Caring Connection infant loss program
• Referrals to community services
• In-home HIV testing for pregnant/parenting women
• Breast pump loan program
• Free childbirth education classes
• Free breastfeeding education classes
• Health education presentations for teen/adult groups

Nurse Case Management/Monthly Home Visitation

The nurse case management/home visitation service is offered to any African American woman or any woman of African decent, residing in Montgomery County, who may be in any trimester of pregnancy. We also have a limited number of case management slots for very high risk newborns. The pregnant/parenting woman is assigned a nurse who will visit her in the home throughout pregnancy, until the infant turns one year old. Each visit consists of one-on-one health education with materials outlining healthy pregnancy and infant care. The goal of each home visit is to ensure that the woman can effectively care for herself and her infant, be able to access the necessary community resources in Montgomery County, ensure that the pregnancy is progressing as normal, and that the infant is reaching developmental milestones along with adhering to the immunization schedule. Women who are seen as high risk in pregnancy, i.e. those with diabetes, hypertension, and social/emotional problems, are also welcome to enroll in this free program, so that they have a chance to experience a healthy pregnancy and birth outcome. Visits are conducted once a month or as needed in the home of each client.

Caring Connection Infant Loss Program

The Caring Connection Infant Loss Program was initially funded through a grant from the March of Dimes, awarded to the Fetal Infant Mortality Review Board (FIMR). This service is offered to any African American woman, or any woman of African decent, living in Montgomery County who has experienced a fetal loss in any trimester during pregnancy. A nurse case manager from the African American Health Program's S.M.I.L.E. Program will visit the woman in the home on three occasions to offer bereavement counseling and referrals. The nurse will also conduct a Maternal Interview Assessment Survey, which is a series of questions surrounding the pregnancy and the fetal loss. The goal of this survey is to better understand the stressful conditions surrounding pregnancy for women of color, and how Montgomery County can better serve these families to ensure healthy birth outcomes. Each participant is given gifts of appreciation for participating in this program.

Referrals to Community Services

We provide referrals to various community organizations on behalf of our clients enrolled in the S.M.I.L.E. Program. Some of our most frequent referrals are for WIC, temporary cash assistance, Maryland Car Seat Program, Child Care/Child Care Voucher Program, health insurance, OB/GYN services, community clinics, pediatricians, shelters/transitional housing, and counseling services, just to name a few. Each referral is given based on the client's need, and the nurse follows up to ensure that the family was able to obtain the service.

In-Home HIV Testing

Nurse case managers are trained and certified to provide in-home HIV testing to their clients enrolled in the S.M.I.L.E. Program. This service is solely voluntary. The African American Health Program uses the ORAQUICK testing device which reveals results in 20 minutes. A negative HIV test performed by the woman's physician or by the nurse case manager is a requirement before the client can participate in the breast pump loan program.

Breast Pump Loan Program

The breast pump loan program is a service offered to women who are enrolled in the S.M.I.L.E. Program. Upon proof of a negative HIV test, clients are welcomed to use a Medela Lactina pump for free, until the infant is one year of age. Each client participating in the breast pump loan program must live in Montgomery County. If she decides to leave the county or the state, the breast pump must be returned to the African American Health Program promptly.

Free Childbirth Education Classes

Childbirth education classes are offered to the residents of Montgomery County for free. Classes are held three times a year at various locations throughout the county. The three classes run for two hours each and are conducted by nurses from the S.M.I.L.E. Program, who are also certified childbirth educators. The classes are very interactive and informative as we prepare the mother-to-be, and her partner, for the beautiful journey ahead. We offer plenty of examples and illustrations, detailed explanations, and hands-on demonstrations. Classes are offered in a relaxed atmosphere with refreshments provided during these evening sessions.

Free Breastfeeding Education Classes

Free breastfeeding education classes are targeted to Black women in Montgomery County who are breastfeeding, or wish to nurse their infants as a way to increase breastfeeding in our community. Classes are held three times a year around the same time as the childbirth education classes. The three classes run for two hours each and are conducted by the S.M.I.L.E. nurses who are certified lactation counselors. These classes are also very interactive, offering various illustrations and explanations, and allowing the participants to voice feelings and concerns. The goal of the class is to ensure that women know the benefits of breastfeeding and are comfortable when nursing their babies.

Health Education Presentations for Teens/Adults

The nurses of the S.M.I.L.E. Program are available to conduct group presentations to teen/adult groups on various health topics such as peer pressure, making responsible choices, sexually transmitted diseases, prenatal nutrition, healthy pregnancy, newborn/infant care, and exercise and nutrition. These presentations are usually one to two hours and are offered to groups within Montgomery County. These topics are presented in a fun and interactive way to engage the audience and get important points across. Each presentation is tailored to meet the needs of the particular age group.