HOME NURSES: Visits to Young Mothers Improves Outcomes
Young, low-income women have fewer children and longer intervals between their first and second child if they regularly receive intense counseling from nurses before and after childbirth, according to a study published in today's Journal of the American Medical Association. Researchers, led by Harriet Kitzman of the University of Rochester, focused on 1,139 women living in inner-city Memphis, Tenn. The participants, primarily black, unmarried, unemployed teenagers, were divided into two groups: One received standard medical care and the other received regular home visits by nurses during pregnancy and for two years after childbirth. The nurses offered medical instruction on how to better care for children and discussed family planning, relationships and job preparation. During the study, nurses conducted an average of seven visits during pregnancy and an additional 26 visits from birth to the child's second birthday (Kitzman et al., JAMA, 4/19). A follow up review found that those women who received counseling had 14% fewer pregnancies over the next five years compared to the control group. Counseled women also spaced their children farther apart, waiting 30 months, compared to 26 months for the control group, before having a second child. Further, family life was more stable: Forty-three percent of counseled women lived with male partners, 19% of whom lived with their child's father. For the control group, those numbers dropped to 32% and 13%, respectively. The home visits cost $2,800 per year per family, which Kitzman says will be offset in the long run by "producing healthier babies and more self-sufficient mothers" (AP/Nashville Tennessean, 4/19). The research was a continuation of an Elmira, N.Y., study that examined the effect of such visits on low-income, Caucasian women living in rural areas and revealed similar findings. A fifteen-year follow-up of the Elmira trial revealed that nurse counseling had long-lasting effects in maternal life course and child care: The program helped reduce child abuse and neglect, promiscuous sexual activity and cigarette and alcohol abuse (JAMA, 4/19). David Olds of the University of Colorado's Health Services Center, helped design the Elmira study and now runs a nurse-training program for such work (AP/Nashville Tennessean, 4/19). He said, "The nurses help the women establish small goals for themselves, things they can accomplish. They build up a reservoir of successes that increases their confidence [that] they can take on even larger challenges" (AP/Las Vegas Sun, 4/19).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.