Introduction

Pregnant with her first child, Teresa is hoping to pass on traditions and customs her own mom taught her. However, living thousands of miles away from her family of origin, Teresa is building her own community of peers, friends, mentors and trusted people to help support her in pregnancy and early parenting. One of the people on her team is a home visitor.  A home visitor, available at no cost, was offered to Teresa as she arrived for her prenatal appointment. Established with federal funds, home visitors are perinatal and early childhood professionals who build a trusting relationship with expectant and new families. While childbirth educators may only get to spend a few weeks with pregnant families, as they build confidence for a safe and healthy birth, home visitors are able to establish a much longer relationship that allows families to begin parenthood with confidence and social support, versus social isolation and stress. Teresa's choice of welcoming a home visitor who will see her each week or biweekly during her pregnancy through till her baby turns two, will craft support and care long after her childbirth classes have ended. 

The Home Visitor Program

 As childbirth educators, we get to meet families with various gifts and strengths. I often teach expectant families who like Teresa, are new to the area or may be dealing with socioeconomic challenges. So years ago, when I first learned about home visitation, which is both free and voluntary and specifically designed for pregnant and early parenting, I simply slipped a flyer about home visitation into my packet of handouts provided to expectant parents in my classes, so they could seek more information if they were interested.  Sometimes, I show a short video on home visitation, designed by my local program, as parents are walking into class that has many resources for expectant and new parents. In addition to providing this information on home visitation, sharing our local regional resource center may also be of help for families. 

 Since our mission as Lamaze educators is to advance safe and healthy pregnancy, birth and early parenting, sharing websites on free and voluntary evidence-based home visiting is a great tool for your classes.  According to the National Home Visiting Resource Center, evidence-based home visiting programs operate in all 50 states, the District of Columbia and 5 U.S territories. Home visiting is also provided to American Indian and Alaska Native families both on and off reservations, including families in 25 tribal communities that have received MIECHV funding. Approximately 53 percent of all U.S. counties have at least one local home visiting agency offering evidence-based home visiting. 

There are various kinds of programs, with Nurse-Family Partnership serving first-time expectant pregnant individuals before 28 weeks of pregnancy and doing weekly visits until the baby is two years old. Other home visiting programs, like Family Spirit, is an evidence-based home visitation model that was crafted in coalition with Native communities including the Navajo Nation and White Mountain and San Carlos Apache Tribes to use a culturally appropriate curriculum for pregnancy and early parenting. The home visitation program Family Spirit works to leverage cultural assets and an indigenous understanding of health; encourages the use of paraprofessionals to deliver the program; and addresses behavioral health disparities, emerging globally as an urgent priority.

States must balance limited resources with a desire to reach as many families and communities as possible. Some fund home visiting in all counties. In Kentucky, for example, Health Access Nurturing Development Services (HANDS) offers home visiting to first-time parents in every county across the state. Nineteen states offer evidence-based home visiting services in 75 percent or more of their counties. Other states concentrate funds in high-need communities or urban areas or do not have funds to serve families throughout the entire state. In 2017, more than 3,450 local agencies delivered evidence-based home visiting to families. Local agencies are usually housed in a central location and serve families in nearby communities. They are operated by state and local government offices, such as the Departments of Health & Human Services, or Education, as well as schools and school districts, hospitals and health clinics, tribal organizations, nonprofit organizations, and faith-based organizations. 

How can childbirth educators increase awareness of these important programs?

1. Know that evidence-based home visitation is free and voluntary for pregnant and new families. It is paid for from federal dollars and a family may begin and end at any time during pregnancy or after the child is born.  Many evidence-based home visitation programs have socialization programs for new families, like free infant-parent music classes, trips to children’s museums and other ways that new families get to build community in addition to their specific home visitor.
2. Find the home visitation program in your region! Get to know the staff and learn how they are meeting expectant families. Ask them to share your birth class flyer in their online newsletter or provide physical copies to the families they meet.
3. Review the different models of home visitation and learn more about what is offered in your specific region. “Minding the Baby” is a program in both Connecticut and Florida that supports reflective parenting, secure attachment, maternal and child health, mental health, and self-efficacy using an interdisciplinary approach with first-time young parents and their families.  The PALS model, (Play and Learning Strategies) which is used in Texas and Wisconsin doesn’t begin until the infant is five months old. PALS works to strengthen the bond between parents and children using a responsive caregiving model.  You can find out more information about the different models listed in different states and regions to learn what home visiting model is offered in your area.
4. Perinatal professionals can learn about other free federal programs for expectant families and early parenting services that you can share with your class members. 
5. Looking for employment to augment your own childbirth education expertise? Check out the job boards for home visitors in your region! It is a fun way to connect more closely to individual families and offer support and information.

Conclusion

The book ‘On the Day You Were Born’ by Debra Fraiser, weaves the vision of an infant and family connected to the natural world, each other and greater community. 

“On the day you were born the Moon pulled on the ocean below, and, wave by wave, a rising tide washed the beaches clean for your footprints.”

My hope is that each family in our Lamaze workshops all over the world feel roots to community and traditions that support pregnancy, birth, and parenting. For some expectant families, evidence-based home visitation may offer these relationships, resources, and roots.

About Jill Wodnick

Jill Wodnick, M.A., LCCE, facilitates Lamaze prenatal workshops for expectant parents at Montclair State University. Jill continues to be invited to give testimony on maternal health to NJ Senate hearings and to write op/eds for regional media outlets on maternal health, weaving in the critical role of respectful, family-centered maternity care. Prior to MSU, Jill led a Community Doula Program in Hudson County, NJ  and was the Expert Doula for Pregnancy Magazine. She has been part of the United Nations Commission on the Status of Women's Global Prenatal Initiative as well as on local and statewide programs for improving maternity care, dismantling racism and the intersection of early childhood well being through birth. Earlier this year, Jill led webinars for Lamaze International on the first 1,000 days and grassroots advocacy for maternal health. Jill can be found at @JillGW, #SpeakingofBirth or JillWodnick.com 

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