Promoting rigorous, actionable research in maternal and newborn health in the United States

Given the importance of contraception in promoting health and workforce engagement, two studies are assessing interventions to increase contraception use.

The M-CARES study is evaluating the impact of subsidies for long-acting reversible contraception on two groups that experience high rates of unintended pregnancy: pregnancy-capable individuals living in poverty and those who are pregnant and are seeking an abortion.

Additionally, insufficient spacing between pregnancies contributes to morbidity and mortality risk for birthing parents and babies. A pilot study surveyed postpartum individuals and found that many respondents were not using contraception, and few exhibited knowledge of family planning. When asked about the idea of pediatricians providing contraceptive counseling, most respondents showed support. Findings from this pilot will be used to design a full-scale randomized evaluation assessing the impact of contraceptive counseling for birth parents at their infants’ pediatric visits on postpartum contraceptive use. 

Programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) aim to promote healthy lifestyles for pregnant individuals and their children. However, not all eligible pregnant individuals participate.

 A growing body of evidence points to behavioral nudges as impactful at increasing benefit take-up. A pilot study, “Increasing Uptake and Improving Health: Experimental Evidence on Take-Up of the WIC Program,” builds off of this evidence and studies the impact of a menstruation and pregnancy smartphone app on encouraging WIC take-up among WIC-eligible individuals.

Interventions that expand mental health and socio-emotional support for pregnant individuals, beyond standard-of-care, are being evaluated by two studies as promising solutions to supporting the health of both birthing parents and children. 

The South Carolina Nurse-Family Partnership study is evaluating the impact of a nurse home visiting program on maternal and early childhood outcomes. This landmark study represents the first modern randomized evaluation of nurse home visiting programs at this scale. 

Early evidence showed the program had no impact on birth outcomes, suggesting that home visiting programs may not be sufficient to address the myriad barriers pregnant individuals face. Over the coming decades, the evaluation will continue to assess program impacts on a range of outcomes related to families’ health and well-being.

The 123-MOMS evaluation seeks to understand the impact of Cognitive Behavioral Therapy and information about parenting skills on low-income pregnant individuals with depressive symptoms. It will aim to study the effect on child development, mothers’ mental health, and economic outcomes. 

Increasing health care utilization for postpartum individuals may promote long-term chronic disease management and health care utilization. An ongoing study is testing whether targeted messaging, default primary care appointment scheduling, reminders, and other behavioral-science informed interventions can bridge transitions from postpartum care to primary care for individuals with a chronic disease. 

While much evidence links poverty and poor health, there is little known about this relationship's causal nature. Two studies aim to garner clearer ideas of the impact of financial support on young children’s outcomes.

The Baby’s First Years study aims to understand how financial support affects the health and well-being of children growing up.  

One-year outcomes indicate that poverty reduction affected children’s brain activity, as children in families who received the transfer displayed different brain activity patterns than children whose mothers received a nominal sum of $20 a month. The activity pattern found in the high-cash group has been correlated in other studies with higher language, cognitive, and social-emotional functioning later in childhood and adolescence, though more research is needed.

A pilot study, “Overcoming Financial Barriers to Caring for Preterm Infants,” evaluated the impact of financial support on caregivers’ ability to breastfeed and provide skin-to-skin care to preterm infants. Preliminary findings demonstrate the potential for financial support to increase parents' engagement with caregiving behaviors for preterm infants during the NICU stay. A larger trial funded by the National Institute of Child Health and Human Development will launch in 2023.