Support From the Start: Lessons from International Early Years Policy
Jenny North, Maternity Alliance 2005
Pregnancy and early years welfare charity the Maternity Alliance has published a study that uses international evidence to compare different interventions supporting pregnant women and young parents.
Funded by the Sutton Trust, which provides educational opportunities for young people, it compares different countries’ successes in achieving three objectives: improving birth outcomes (particularly birth weight), increasing breastfeeding rates, and fostering healthy cognitive and emotional development.
The study reports that home-visiting can improve birth outcomes by changing the lifestyles of pregnant women, but that no single model is always successful.
One important variable is who does the visiting – programmes that employ qualified nurses to do the home-visiting have higher success rates and fewer women dropping out than programmes delivered by unqualified paraprofessionals or volunteers.
Another factor is the intensity of the programme – the more often, the more effective.
Some women also benefit more from home-visiting than others, with single mothers, pregnant teenagers, heavy smokers and families in deepest poverty benefiting the most.
Home-visiting programmes can also improve children’s emotional and cognitive development by reducing the risk of depression in mothers and supporting mothers to develop good parenting skills. Again, programmes delivered by health professionals seem to be more effective than those delivered by volunteers, and those that begin before the birth have better outcomes than those starting after. For mothers with the most risk factors, intensive parenting programmes based in centres are more likely to make an impact than home-visiting.
Another approach to improving babies’ birth weight is through nutrition programmes, such as food and vitamin vouchers. Parent groups and ante-natal care that prepares for parenthood as well as childbirth have also proved popular and effective in improving birth outcomes. Baby-friendly practices in maternity units, such as accommodating babies close to their mothers, can encourage breastfeeding, but peer support is also important.
The report recommends halving the traditional number of ante-natal visits to GPs, and guaranteeing all parents places at ante-natal classes based in children’s centres instead. These would focus on preparation for parenthood as well as pregnancy and childbirth.
The report says children’s centres should also co-ordinate flexible home-visiting programmes and develop peer support networks.
Child tax credit should be phased out and the money saved spent on improving child care facilities, and on training and paying child care workers. Pregnant women and parents also need better financial support.