Photo Credit: Hispanolistic
The following is a summary of “Effect of an Intensive Nurse Home Visiting Program on Postpartum Contraceptive Use and Birth Spacing: A Randomized Controlled Trial,” published in the January 2025 issue of Obstetrics and Gynecology by Steenland et al.
Individuals eligible for Medicaid with a first pregnancy in South Carolina face challenges in postpartum contraceptive use and birth spacing. The Nurse-Family Partnership (NFP) program provides intensive home visits to address these issues.
Researchers conducted a prospective study to evaluate the effect of intensive nurse home visiting on postpartum contraceptive use and birth spacing among individuals with a first pregnancy.
They conducted nonblind RCTs of the NFP program involving individuals eligible for Medicaid with a first pregnancy less than 28 weeks of gestation (April 1, 2016, to March 17, 2020). Participants, n=4,932, were randomized 2:1 to either NFP, n=3,295, or standard care, n=1,637. Primary outcome measures included birth intervals of less than 21 months between the index and subsequent pregnancies. Secondary outcomes assessed intervals of less than 15 and 24 months, postpartum contraceptive implant or intrauterine device (IUD) use, and family planning visits at 6 weeks and 1 year postpartum. Data sources included linked birth certificates and Medicaid claims.
The result showed that 11.0% of participants in the NFP group and 12.2% in the usual care group experienced subsequent pregnancies within 21 months of the index pregnancy. The program did not significantly affect birth intervals under 21 months (adjusted coefficient −1.1, 95% CI, −2.9 to 0.8). No statistically significant differences were found in 8 secondary outcomes, including postpartum contraceptive use and family planning visits.
They concluded that nurse home visits did not significantly affect postpartum contraceptive use or birth spacing among individuals with a first pregnancy.
