At age 21, Ivory had been through a miscarriage and wasn't sure she could ever carry a baby to full term. She had an ovarian cyst condition that put pregnancy at high risk, so when another pregnancy followed, it came as a surprise that, at 15 weeks along, Ivory learned she was carrying twins.

"The first thing I thought was I'm going to need more information," Ivory says, adding that she turned to Raychelle, a public health nurse in Riverside County who had been the home visitor for Ivory's two older sisters. With Raychelle's guidance, Ivory would learn what she needed to know about her health, carrying twins and taking care of two babies at once.

African-American women are 52 percent more likely to have a preterm birth (before 37 weeks) than other women. Already with a high-risk pregnancy, Ivory also had preterm birth risk factors, including carrying multiples and being underweight. At each home visit throughout the pregnancy, Raychelle checked Ivory's weight, blood pressure and other health indicators, and also encouraged her to eat plenty of nutritious foods, drink lots of water, rest as needed and continue to seek prenatal care, even if she was feeling fine.

When Ivory was about 24 weeks along, she went to the emergency room with back pain, headache and a feeling that something was just "not right." She was experiencing contractions and active labor, and the hospital staff administered medication to help stave off premature delivery. They also recommended avoiding stress and slowing down, which proved difficult for Ivory. She was working 10-hour days on her feet with no accommodations for resting, and she was attending college, carrying 20 units.

"[Raychelle] was with me every step of the way, and I know for a fact, if I was not in the home visiting program, I would be a different mom." — Ivory

"I asked my OB if I could be placed on a maternity leave, but he and his nurse denied my request, stating that he felt there were always going to be complications when women have multiples," Ivory says. "I kept expressing that something was not right."

Raychelle listened to Ivory and vigilantly monitored the health of mom and her babies. She encouraged Ivory to follow after-care recommendations from the emergency room and rest as much as possible. Ivory worked a few more weeks, but then quit her job despite lost wages. Three weeks later, her water broke. Born 10 weeks early, baby girl Ania weighed 2 pounds, 13 ounces and her twin brother, Andre, tipped the scales at 3 pounds 14 ounces. The babies spent their first three weeks in the Neonatal Intensive Care Unit, but made it home in time for their baby shower.

"If it wasn't for Raychelle telling me that early and heavy contractions aren't normal, there could have been a possibility that I would have delivered my babies at my job. I'm grateful to Raychelle for telling me to follow up; she kept reminding me to follow up, stay off my feet and make sure I was getting enough nutrition," Ivory says.

"I'm so thankful for Raychelle and for her being here. She was there with me every step of the way, and I know for a fact, if I was not in the home visiting program, I would be a different mom," she continues. "On a scale of 1 to 10, this program is an 11."

What you can do to reduce your risk of preterm birth

• Go to the doctor as soon as you think you are pregnant.
• Let your partner, friends and family know you need help. Having a baby can be tough!
• Maintain a healthy weight, and exercise before, during and after your pregnancy.
• Wait 18 months after the birth of your baby to get pregnant again.

Download the preterm birth tip sheet.