Nurse Visitation Programs Reduce Repeat Pregnancies In High-Risk Women, Study Finds

Nurse visitation programs after the birth of a child can help reduce repeat pregnancies in high-risk women, particularly teens and women living in rural areas, according to a study published in the Archives of Pediatrics & Adolescent Medicine, MedPage Today reports. Previous research has found that nurse visitation programs can improve outcomes for women and their infants. The new study was designed to demonstrate the real-world impact of large-scale nurse visitation programs on helping partners plan the timing of subsequent pregnancies.

The researchers assessed the Nurse-Family Partnership -- which serves more than 20,000 families annually in 31 states -- focusing on the program's implementation across Pennsylvania from 2000 through 2007. The study included 3,844 first-time mothers receiving public assistance, who were paired with NFP nurses. A control group consisted of 10,938 first-time mothers who were not enrolled in the program.

During the first three years of the program, there was no advantage for preventing a subsequent pregnancy within two years. By 2004 to 2005, 16.8% of women paired with nurses became pregnant within two years, compared with a 19% of women not in the program. Among women ages 18 and younger, 17.9% of program participants became pregnant, compared with 23.3% of their peers who were not in the program. Women living in rural areas -- especially teens in rural areas -- particularly benefited from the program, with a reduction in second pregnancies that was two times that of urban-dwelling women.

Implications for Health Reform

In an editorial accompanying the study, Kay Johnson of Dartmouth Medical School wrote that the findings support current evidence of the benefits of nurse visitation programs. Such evidence is important under the federal health reform law (PL 111-148), which will fund state-based nurse visitation programs across the U.S. beginning in 2011. The law specifies that at least 75% of federal funds go toward "evidence-based" programs, according to Johnson.

"Congress set an expectation for states to report results on selected benchmarks in three years and to show measurable change in outcomes in five years," Johnson wrote. She added that "states launching new home visiting programs with [health reform] funding are not likely to report improved outcomes in less than three years and that the five-year time frame is more realistic." Johnson noted that the findings "suggest that urban sites may need more intensive programs, staff capacity, community linkages, and/or technical assistance to achieve the same results as rural sites" (Phend, MedPage Today, 11/1).

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