Baby and Mother Bonding Initiative (BAMBI)

A School of Nursing Collaborative Project

History

UTMB has a long history of working with underrepresented groups, including the uninsured and incarcerated populations. The Baby and Mother Bonding Initiative (BAMBI) was established in 2010 by the Texas Department of Criminal Justice (TDCJ) in collaboration with UTMB to allow low risk, eligible offender mother to be housed with their babies in a secure residential facility following delivery rather than sending the newborn to family or alternative care. Offender mothers must be eligible based on length of sentence, nonviolent offenses along with other specifications.

In 2016, the unique out-of-prison nursery program, BAMBI (TDCJ & CMC) partnered with UTMB’s Health System and UTMB’s School of Nursing to create the BAMBI/School of Nursing Collaborative Project. This partnership formed when a TDCJ Hospital Galveston nurse, Brenna Ferguson inquired what could be done to better support the BAMBI offender mothers in breastfeeding efforts and bonding. This initiative was formed through the work of a campus wide committee, which included the Women’s Infant & Children department leadership, the SON leadership, TDCJ Hospital Galveston leadership, and TDCJ leadership to help improve maternal- newborn bonding and breastfeeding by partnering the BAMBI Program with the UTMB BSN student cohort.

UTMB alumna (SON ’99) and current SON faculty member, Jacquelyn Svoboda, has graciously served as a liaison between the collaborators and has continued to maintain the initiative that impacts countless lives throughout our community. Svoboda started her work with BAMBI because of her strong passion for women’s health and working with vulnerable populations. Her enthusiasm and commitment have been the driving forces to expand this initiative into the SON BSN Program, and to provide a template for other states to scale and implement in their communities.

As Svoboda, Veronica Kwarteng-Amaning (TDCJ/UTMB and SON alumna 2002, GSBS alumni 2017), Natalie Bachynsky (SON ’98, 2008 UTMB alumna) and Elizabeth Moore (BAMBI Liaison) and the other team collaborators began their work with the project initiative, the team identified three primary needs for the program to become more effective, meaningful and to increase bonding between mother and baby: pre/postnatal education, resource and access in the inpatient setting. As a team, they recognized three tangible solutions that could improve the outcomes for all offender mothers including BAMBI:

  1. Student-led pre/postnatal educational sessions for all offenders
  2. Resources (both financial, supplies and personnel) for the prison and BAMBI facility
  3. Bedside student birth and postpartum companions to improve mother-newborn access

These efforts would assist the offender mothers and their newborns, while also creating a unique service-learning opportunity for our BSN students.

How It Works

The BAMBI/School of Nursing Collaborative Project was launched to meet the unique needs of low-risk* incarcerated mothers housed in the established out-of-prison nursery. The innovative service-learning project was created by the leadership teams and faculty within the UTMB School of Nursing, UTMB Health System and TDCJ Hospital Galveston System to support the mission of the BAMBI program while also capitalizing on the clinical and leadership skills acquired by current BSN students.

Teams of senior BSN nursing students (up to 12) and faculty were established each semester to provide collaborative care, education and bedside companion support to offender mothers. Students must apply and qualify to be part of this project. Students receive specific and unique training through lactation sessions, childbirth education sessions and through security specific training at the beginning of the semester. The chosen student cohort provide seven educational sessions for all offender pregnant mothers at TDCJ’s Carole S. Young Medical Facility to improve the mothers’ knowledge of prenatal, postnatal and infant care. Students who participate in the project are matched with BAMBI offenders and offer mentorship time following each education session. Students who are matched with the BAMBI offenders then remain on call for the duration of the semester as well as the faculty, Svoboda. When the BAMBI offender mother is in labor, the nurse contacts Svoboda and she contacts the student to prepare to arrive in labor and delivery. Students then serve at the bedside as birth and postpartum companions through the mother’s hospital stay. In addition, within this project, the nursing staff support the mothers by promoting skin-to-skin contact with their babies as well as breastfeeding during the initial stages after childbirth.

Benefits of the Program

Since the spring of 2016, participants in the BAMBI collaboration have served more than 800 hours at the bedside, participated in more than 40 labor and postpartum experiences, and conducted 56 educational sessions. This collaboration not only helps incarcerated mothers, it also promotes leadership and advocacy among BSN students.

Julie Stefanick, a 2018 BSN graduate, is confident that Mrs. Svoboda and the BAMBI Collaborative Project shaped her educational experience at UTMB and guided her career trajectory.

"Professor Svoboda passionately introduced the initiative to our cohort, and I knew immediately that I wanted to participate," Stefanick said.

After working in both the public-school system and the prison system, Stefanick found her calling in women’s reproductive health. She recently accepted a job with M.D. Anderson Cancer Center working in gynecologic oncology and reproductive medicine. She will be responsible for assessing patients for clinical trial eligibility, then following them through the trials. She will also collaborate with multidisciplinary teams to monitor and evaluate both the patient and family response to the treatment protocol.

Stefanick attributes her educational success to her experience in BAMBI, noting how Svoboda worked hard to incorporate both clinical experience and education into the initiative for her students.

"As student nurses we prepared and presented classes on prenatal and postnatal nutrition, breastfeeding, newborn and mother bonding and several other topics," Stefanick explained.

Svoboda understands that this type of innovative project has the potential to not only promote the bonding for the offender mothers with their babies today, but to also strengthen the mother’s confidence and understanding in how to care for them as they grow together outside of the prison nursery system. As an educator, she also sees the impact of this project to be profound and empowering for the BSN student cohorts. The project impresses on the importance of caring for patients without bias, the importance of educating patients so they can make better choices and the importance of advocacy in nursing.

Future of BABMI

Because there is no other project in the country which supports pregnant offender mothers by utilizing students’ nurses as educators and companion support, one of the major goals of the collaboration was to inform other states about the initiative. Svoboda and Dr. Veronica Kwarteng-Amaning (UTMB Alumna) and Dr. Natalie Bachynsky (UTMB Alumna) have presented their collaborative efforts at state and national conferences, including ACNN National Magnet Conference, American Academy of Nursing (AAN), American Correctional Association, AWHONN and others. Svoboda, Kwarteng-Amaning, Elizabeth Moore and Dr. Tammy Cupit are also working on future research opportunities to look at the outcomes of this project.

The BAMBI Program is now in its ninth year and will continue to reach pregnant and mother offenders throughout the state of Texas. The SON is grateful for the opportunity to collaborate and to have a part in improving outcomes for mothers and newborns. Svoboda will continue to serve as the strong faculty lead working with current nursing faculty and students to provide a meaningful and long-lasting service-learning experiences.

The School of Nursing is extremely fortunate to have Svoboda impact our curriculum and mission of helping underrepresented populations. She has been instrumental in the BAMBI/SON Collaboration and will continue her efforts to work with this campus wide collaborative to ensure the state-wide initiative be an example to other communities.