Sometimes she can hear their stomachs growl. Other times it's a gaunt stare.
"I have mothers who come in and haven't eaten," said Bettye Jordan, a doula for Hillsborough County. "Their blood sugar drops and you just know."
It's Jordan's job to teach mothers who receive health care at a county clinic how to take care of themselves during pregnancy.
But as the economy worsens, Jordan and the other doulas have expanded their roles. Each week, one takes turns stopping by the grocery store to pick up fruit, granola bars, yogurt and juice. They serve the food during parenting classes.
If they don't, they fear many will go hungry. They estimate it costs them about $100 out of pocket each month, said Susan Garcia, director of the program.
"We've never had to provide services that meant life or death issues like feeding people," Garcia said. "Not like we've had to in the last year."
As social service and nonprofits struggle to work with shrinking budgets, employees of these groups increasingly shoulder some of the load.
And it's only going to get worse, said Rhonda Miller Sheared, vice president of programs and development for Family Service Centers Inc., a nonprofit that provides child abuse, rape crisis and family counseling to Pinellas County residents.
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In good economic times, social service agencies like FSC were given discretionary money for clients who needed help with things like bus fare or baby formula. But this year the money isn't there.
Sheared remembers confronting the agency's child abuse workers who were buying items for clients with their own money.
"I could not stop them," she said. "They told me, 'Rhonda we know the agency says don't do this, but there's no way if I walk into someone's home and their baby's been wearing the same diaper for three days that I'm not going to immediately take $20 out of my own pocket.' "
Last year she got help from the county's Juvenile Welfare Board, which provided $10,000 in emergency funds.
This year, the FSC's budget will get 18 percent less than the $5.3-million it received last year.
"We're going into this crunch again and every year we're looking at this issue," Sheared said. "This is going to keep happening; this is an issue that is not going to stop."
At the St. Petersburg Free Clinic, executive director Jane Egbert says it's common for workers to pitch in.
Her agency feeds more than 6,000 people a year entirely from donations of food, but often runs low on personal hygiene items.
"It's all too normal to say 'I'm sorry we just don't have that at the moment, when all someone really wants is a razor or soap,' " Egbert said. "It's hard to say no."
So volunteers often bring in bags of toothpaste, razors, soap and deodorant, Egbert said.
In the short run, it's a benefit to clients when volunteers and employees pitch in financially, but experts caution it could be detrimental in the long run.
"It contributes to burnout and turnover," said Linda Spears, vice president for policy and public affairs for the Child Welfare League, who worked in the Massachusetts foster care system for more than a decade. "Sooner or later, people, if they're not getting raises and they're spending more of their own money to do things, they have to make hard decisions … like going into another field."
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The National Society of Social Workers has a strict code of ethics that highly discourages workers from giving personal money to clients.
But enforcing a no-personal spending rule is sometimes tough for social charities when budgets barely meet the needs.
"It's like a teacher buying school supplies, we know it's happening, but it's not supposed to," said Adam Mayefsky, spokesman for FSC. "It makes it look like the agency isn't doing its job or that we don't have enough money to help the client directly, but often we don't."
And those in the trenches say they don't have an option.
"I don't think you can do this work without the compassion of wanting to help," said Johnnie Greene, 71, a family support worker at FSC. "We get our gratitude from the feeling that we did something to help someone."
Last week as Greene made her rounds through Pinellas, she dropped by three homes. Each was in need. The least Greene could do was help out with cleaning supplies.
She gave away three bottles of a purple soapy cleaner and three scrub brushes — items she routinely buys for her clients and stashes in her car. She didn't even think about getting reimbursed.
"I've been here long enough to understand the budget has been cut," said Greene, a 22-year veteran at FSC. "But I put my heart and soul into this, so it's what I do."
Nicole Hutcheson can be reached at email@example.com or (727) 893-8828.