IJDM San Francisco Chronicle AUGUST 27, 1997 A8
de jour
Home Visits Help Poor, Unwed Moms
Study finds fewer pregnancies, less time on welfare

Research Results


Home visits by nurses before and after childbirth can substantially reduce subsequent pregnancies by poor unmarried women, as well as make them less likely to use drugs, collect welfare, abuse their children or tangle with the law, according to a study published today in the Journal of the American Medical Association.

While the program was conducted in the rural, mostly white town of Elmira, N.Y., a companion study found similar early results among black women in Memphis, Tenn.

The findings give new hope to researchers frustrated by the difficulty of working with teen mothers who historically have gone on to long-term welfare dependence.

The first study was a follow-up on one 15 years earlier in Elmira, N.Y., involving 400 women who were pregnant for the first time. Some were given a variety of health services but no visits by home nurses; others received the same services along with home visits through the child's second birthday.

When they went back 15 years later, researchers were able to interview 324 of the original 400, most of whom were white. They found that the women who received home visits had an average of 1.3 more children, compared to 1.6 in the group without visiting nurses. The first group had spent an average of 52.8 months on welfare, compared to 65.9 for the second. Those getting home visits also had fewer arrests, were employed longer and had fewer substance abuse problems.

The results were even more dramatic when just poor, unmarried women were compared: Those with home visits had 1.1 more children, compared to 1.6 in the group with no home visits. The former spent an average of 60.4 months on welfare, compared with 90.3 in the latter.

The nurses were able to produce those effects by first establishing trust among the young mothers, said David Olds, lead author of the study and director of the Prevention Research Center for Family and Child Health at the University of Colorado.

"These women were going through a lot of physiological and anatomical changes during pregnancy," he explained, "and the nurses were helping them deal with everything from common discomforts to learning about managing obstetrical complications like bladder infection."

After establishing that trust, the nurses kept coming for two years.

The second study involved 1,139 women in Memphis, most of whom were black, who were about to have their first child. Again, visits by nurses produced clear benefits, from lower levels of pregnancy-induced hypertension to fewer subsequent pregnancies.


More findings from the two studies of unwed mothers
who received nurses’ visits at home:
They were 46 percent less likely to be accused of child abuse.
They were 69 percent less likely to be arrested.
They were 44 percent less likely to have drug problems.
Their children had 22 percent fewer injuries.
The women were 25 percent less likely to have
pregnancy-induced hypertension.

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