Effects of a home visiting program on prenatal care and birthweight: a case comparison study

Recent reports have stressed the importance of social support services to the health and well being of pregnant women and their newborns. The impact of paraprofessional support services on the amount of prenatal care received and birthweight was studied in a sample of 111 low-income women. Paraprofessionals were women who had been on public assistance and successfully attained health and human services for themselves and their infants. They were similar to the patients they served in educational background and ethnicity. A six-week training program prepared them to counsel and assist pregnant women with health and social services, housing, food, transportation and other basic necessities. Women attending a publically-funded prenatal clinic were randomly assigned to a paraprofessional. A comparison group matched for ethnicity, parity and trimester entering prenatal care was also selected. Women followed by a paraprofessional had significantly more prenatal appointments (8.0 vs 6.5 visits) and infants with average higher birthweight (3125 grams) over the matched comparison group (3273 grams). While intensity of contact with a paraprofessional contributed significantly to the amount of prenatal care received by patients of paraprofessionals, the mechanism for improvement in birthweight is unknown.