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.
