The Nurse-Family Partnership: What is It and How Does It Work?

Amanda Luzzader

Nurse-family partnership provides medical care, support, and education to first-time, at-risk mothers before and after they give birth

No one would ever say that having a baby is easy. Although becoming a parent can be rewarding and fulfilling, pregnancy can be very challenging both physically and emotionally, even for mothers who are prepared for and looking forward to the experience.

On the other hand, for a mother who is pregnant for the first time, less than 21 years old, unmarried, and low income, the experience can be stressful and even overwhelming. Also, the stress experienced by first-time, at-risk mothers can lead to adverse conditions for both the mother and the baby. These conditions can severely affect the quality of life of both individuals, and the effects can be long-lasting and even multi-generational.

One program that provides effective intervention for first-time, at-risk mothers is the nurse-family partnership. In a nutshell, the nurse-family partnership provides medical care, support, and education to first-time, at-risk mothers before and after they give birth.

The assistance and care are delivered during frequent visits by a registered nurse to the mother. The model upon which the program is based was established in the United States during the 1970s. It was part of a scientific study that eventually demonstrated that certain kinds of care, support, and training could be instrumental in improving the quality of life of first-time, at-risk mothers, their babies, and their families.

The model was eventually converted to a non-profit home-visiting program for first-time, at-risk mothers. Many nonprofit programs offer forms of the nurse-family partnership, but the organization best known for the practice is the Nurse-Family Partnership (NFP). The NFP has been operating for more than 45 years and has assisted approximately 369,000 first-time, at-risk mothers throughout the United States, in the United Kingdom, and the Netherlands.

One of the main underlying principles of the nurse-family partnership is that the best time to train mothers in healthy child-rearing skills is before their first pregnancy and that the best time to eliminate unhealthy parenting behaviors is before the first-time mother’s child is born.

The NFP’s two initial qualifying requirements for joining their program are that the applicant is a first-time mother who has been pregnant for twenty-eight weeks or less, but most of those involved in the program are also young and low-income. According to program data collected between 1995 and 2017, the median age of the mothers assisted by NFP was 20 years of age, 84 percent of them were unmarried, 43 percent had not completed a high school education, and their average annual income was $9,000.

The NFP also seeks to put first-time, at-risk mothers in touch with other programs that provide assistance with housing, food, medical care, insurance, and other needs.

Prenatal NFP visits are designed to be flexible and may vary according to client. Typically, weekly visits are made during the first month of the program and then every other week until the baby is born. The content and structure of the visits may also vary, but they’re generally aimed at monitoring the mother and baby’s health, coordinating and confirming physician care, and providing personal and emotional support for the mother. Visits may also include education about child care, dietary advice, counsel about drug and alcohol use, and other training.

Postnatal NFP visits follow suit. The client typically receives visits every week for the first six weeks after the baby’s arrival, then visits are made every other week for twenty weeks. Additional monthly visits may follow. The purpose of the postnatal visits are to ensure mother and child are establishing healthy attachment bonds and that both mother and child are physically and emotionally well. Training for the mother includes topics such as child care, self-care, identification of illness symptoms, identifying and nurturing the baby’s cognitive development, and ensuring the baby’s emotional development.

The nurse-family partnership is considered an evidence-based program, meaning that its success has been measured and demonstrated. For example, the NFP claims that for every dollar invested in its program, more than five dollars are saved in societal costs such as medical and mental health care. Other evidence-based outcomes include the following:

48% reduction in child abuse and neglect56% reduction in emergency room visits for accidents and poisonings50% reduction in language delays at 21 months of age67% reduction in behavioral and intellectual problems at 6 years of age59% reduction in child arrests at 15 years of age

The NFP is funded by private donations, charitable foundations, and corporate donors. These include the Bill and Melinda Gates Foundation, the Robert Wood Johnson Foundation, W.K. Kellogg, Johnson & Johnson, and many others.

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