On seeing a baby, most people will smile or hold out a finger to be grasped. But all mothers and fathers understand that looking after a baby is one of the most challenging tasks they’ll ever face.

This is particularly true for first-time mothers who are young, or poor, or both.

As Provincial Coordinator for the Nurse-Family Partnership (NFP) program for the BC Health Ministry, Donna Jepsen says her group is working to secure better care for these mothers and their children through the BC Healthy Connections Project (BCHCP).

Developed in the US over 30 years ago by David Olds, NFP is an intensive home-visiting program delivered by public health nurses. It’s specifically designed to help disadvantaged young women who are preparing to parent for the first time. But the program has never been tested in Canada before.

This scientific evaluation of NFP’s effectiveness is being conducted across BC over the next five years. As part of the evaluation (which includes a randomized controlled trial and a process evaluation) 50% of women will receive NFP. The remaining 50% will receive the services typically provided by their Health Authority. Then, then the two groups will be compared.

“The two groups are equally important,” Jepsen notes, because combined, they will help us understand how to improve public health services in BC. As well, all women taking part in the study have the chance to share their experiences with the researchers — a connection that most mothers value.

NFP itself begins early in pregnancy (ideally before 16 weeks) because one of its explicit goals is to improve children’s wellbeing by starting early — before children are even born.

Women enrolled in NFP through the BCHCP receive weekly visits from their public health nurse initially. Visits may then move to biweekly or monthly as the program proceeds.

At the home visits, nurses and the mothers work together on topics such as:
•    Ensuring a healthy pregnancy
•    Preparing for childbirth
•    Understanding early child development
•    Developing healthy parenting skills
•    Future life planning and
•    Accessing community supports and resources for mothers and children.

“This helps women manage the emotional, social and physical challenges they face and gain the confidence to create a better life for their children and themselves,” Jepsen says.

Many positive long-term effects were found when NFP was tested in randomized controlled trials in the US:

•    Improved prenatal health
•    Improved child physical and mental health
•    Improved early child cognitive and language development
•    Fewer adolescent behaviour problems
•    Increased maternal economic self-sufficiency,
•    Reduced healthcare and social service costs, and
•    Decreased overall mortality for both children and mothers.

“These are significant public health outcomes and we’re hopeful that we’ll see these same outcomes here in BC as a result of more intensive and consistent support to these families,” Jepsen says.

Today BC is also going through a change of practice with respect to prenatal care. All primary care providers — doctors, midwives and nurse practitioners — are now being asked to refer pregnant women to public health as early in pregnancy as possible. Formerly, in many BC Health Authorities, this would happen later in pregnancy, post-partum or only in special circumstances.

Note that NFP is available only through the BC Healthy Connections Project for the duration of recruitment. Practitioners or young pregnant women are invited to click here for details on how to reach public health and participate in the BCHCP.