Nurse-Family Partnership’s first stated goal is improved pregnancy outcomes: healthier mothers who can deliver healthier babies.
Nurse-Family Partnership is a program of prenatal and infancy home visiting for low-income, first-time mothers and their families. The nurses begin visiting their clients as early in pregnancy as possible, helping the mother-to-be make informed choices for herself and her baby. Nurses and moms discuss a wide range of issues that affect prenatal health — from smoking cessation, to healthy diets, to information on how to access proper healthcare professionals. It’s this trusted, expert guidance that has been proven to lead to healthier pregnancies.
Among the improvements in pregnancy outcomes that have been observed in each of the randomized, controlled trials of the program are:
- Decreases in prenatal cigarette smoking
- Fewer hypertensive disorders of pregnancy
- Fewer closely-spaced subsequent pregnancies
Prenatal health problems and exposures to substances can compromise the health of the fetus, and especially the developing fetal brain. Prenatal tobacco exposure, for example, increases the risk of preterm delivery, low birth-weight, behavioral problems, and adolescent crime, and is substantially more prevalent in low-income than high-income women.1, 2 Preterm delivery and low birth-weight, in turn, are the leading contributors to infant mortality.
In the Denver trial of the Nurse-Family Partnership program, nurse-visited women identified as smokers at registration had greater reductions in the biochemical marker of tobacco use than did women identified as smokers in the control group.3 Corresponding effects were found in the Elmira trial.4
Nurse-visited women in the Elmira trial also had diets that improved significantly more over the course of pregnancy than did women in the control group, and had significantly fewer kidney infections than their control group counterparts. In Memphis, nurse-visited women had significantly fewer diagnoses of pregnancy-induced hypertension, a condition that can compromise the health of the mother and the developing fetus.
The amount of time between pregnancies also has a strong effect on the health of children. Closely spaced pregnancies (within 18 months after the previous live birth) are associated with poor birth outcomes (preterm birth, low birth weight infants and neonatal mortality) and reduced prenatal care5. In all three trials, nurse-visited women had longer intervals between the births of first and second children, due to better pregnancy planning.
Beyond the randomized control trials, research on the national replication of Nurse-Family Partnership finds that for mothers who received Nurse-Family Partnership, they had 18% fewer preterm births, and 21% more mothers breastfed at 6 months and 19% more infants were immunized at 6 months compared to a similar reference group of low-income women nationally. (Thorland & Currie, 2017).
1. Kramer MS. Determinants of low birth weight: Methodological assessment and meta-analysis. Bulletin of the World Health Association 1987: 65:667-737.
2. Wakschlag LS, Pickett KE, Cook E Jr., Benowitz NL, Leventhal BL. Maternal smoking during pregnancy and severe antisocial behavior in offspring: A review. Am J Public Health 2002: 92(6):966-974.
3. Olds DL, Robinson J, O’Brien R, Luckey DW, Pettitt LM, Henderson CR Jr., Ng RK, Sheff KL, Korfmacher J, Hiatt S, Talmi A. Home visiting by paraprofessionals and by nurses: a randomized, controlled trial. Pediatrics 2002: 110(3):486-496.
4. Olds DL, Henderson CR Jr., Tatelbaum R, Chamberlin R. Improving the delivery of prenatal care and outcomes of pregnancy: a randomized trial of nurse home visitation. Pediatrics 1986; 77(1):16-28.
5. March of Dimes (2015).Fact Sheet: Birth Spacing and Birth Outcomes. https://www.marchofdimes.org/MOD-Birth-Spacing-Factsheet-November-2015.pdf
Thorland, W., & Currie, D. (2017). Status of Birth Outcomes in Clients of the Nurse-Family Partnership. Maternal and Child Health Journal, 21(5), 995-1001. doi:10.1007/s10995-017-2267-2
Thorland, W., Currie, D., Wiegand, E. R., Walsh, J., & Mader, N. (2017). Status of Breastfeeding and Child Immunization Outcomes in Clients of the Nurse-Family Partnership. Maternal and child health journal, 21(3), 439. doi:10.1007/s10995-016-2231-6