Reports From The Field-Obstetrics
Reports From The Field-Obstetrics
Home nurse visits yield lasting benefits
Nurses help reduce subsequent pregnancies
A home visitation program using nurses to improve maternal and child outcomes appears to significantly reduce subsequent pregnancies, increase the space between births, and decrease the number of months mothers spend on welfare, according to a recent study in The Journal of the American Medical Association.
Researchers followed a group of 743 primarily black women for three years following the birth of their first child. The women were patients at an obstetrical clinic in Memphis, TN, who were enrolled in a home nurse visitation program for two years. Women in the study were fewer than 29 weeks pregnant, had no previous live births, and had at least two other sociodemographic risk factors, such as unmarried status, having fewer than 12 years of education or being unemployed.
Women received an average of seven home visits from a nurse during their pregnancies and an average of 26 visits from the time of birth until the child's second birthday. Outcomes of women who received home visitation were compared to a demographically similar group of women from the same clinic who did not receive home visits.
Home visits yield results
The study found that women who received home visits by nurses:
1. had fewer subsequent pregnancies — an average of 1.15 pregnancies, compared with an average of 1.34 pregnancies for the control group;
2. had fewer closely spaced pregnancies than women in the control group — an average of .22, compared with an average of .32 for the control group;
3. had longer intervals between the birth of their first and second child — an average of 30.25 months, compared with an average of 26.6 months for the control group;
4. spent fewer months receiving Aid to Families with Dependent Children — an average of 32.55 months, compared with 36.19 for the control group;
5. spent fewer months receiving food stamps — an average of 41.57 months, compared with 45.04 months for the control group.
[See: Kitzman H, Olds DL, Sidora K, et al. Enduring effects of nurse home visitation on maternal life course: A three-year follow-up of a randomized trial. JAMA 2000; 283:1,983-1,989.]
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