Can house calls make a difference in new mothers' lives?

A successful new nonprofit sends nurses into the homes of young, low-income mothers and children.

Published January 19, 2006 2:04PM (EST)

For centuries, midwives have played a cherished part in many women's pregnancies by offering guidance and medical care from conception through birth. But as most mothers can attest, the trials of motherhood don't end at the doors of the delivery room. So why not have midwives for new moms, too? Indeed, an ingenious social initiative -- conceived by Philadelphia's Nurse-Family Partnership -- asks just that question. Hoping to reach young women who might otherwise fall through the cracks, the program extends nurses' traditional roles by sending them into the homes of patients and offering individualized care and support all the way through the first two years of parenthood.

According to an article in the Philadelphia Inquirer, the partnership now helps more than 20,000 families in 20 states. And help it does: Unlike many social initiatives that sound good on paper but fail in the field, the Nurse-Family Partnership has been subjected to rigorous, long-term study and has been proven to work. These nurses don't just tend to scrapes and bruises -- they also help young mothers with parenting skills and work to reduce child abuse, welfare use, arrests and substance abuse, and improve education and employment rates. Finally, the children of mothers in the program are less likely to have serious behavior problems.

Mothers must sign up voluntarily, committing to approximately 64 home visits by the nurses, stretching from pregnancy through their child's second birthday. Officials believe that part of the program's success lies in the fact that while many young mothers reject social workers for fear they will take their children away, nurses appear trustworthy and unthreatening.

Despite the demands, finding nurses has not been difficult. "Nurses get really tired of being at the other end of the problems -- being in the hospital, patching up the kid with the gunshot wound," says Kay Kinsey, a University of Pennsylvania nursing professor and administrator of the program. "A lot of our nurses recruited themselves ... because they wanted to make a difference."

Terri Caddle-Boston, 22, of Cheltenham, Pa., is living proof. Raised in foster care, abandoned by her mother and in trouble at school, she got pregnant at 17. Now she is married, working, reconciled with her mother and set up in a nice apartment. And she will soon start training to become a nurse herself.

During the first two years of her daughter's life, her nurse "was there through most of my ups and downs," Caddle-Boston tells the Inquirer. What made the difference "was counseling, friendship, and finding someone who cares about your feelings."

By Sarah Karnasiewicz

Sarah Karnasiewicz is a freelance writer and photographer based in Brooklyn, N.Y. Until recently, she was senior editor at Saveur magazine; prior to that she was deputy Life editor at Salon. She has contributed to the New York Times, the New York Observer and Rolling Stone, among other publications. For more of her work, visit and Signs and Wonders.

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