Prenatal education outcomes for pregnant adolescents and their infants using trained volunteers

Abstract

This study evaluated the effects of lessons taught by trained nonprofessional volunteers in community prenatal clinics. Project participants ( n = 210) and comparison subjects ( n = 189) were pregnant women, aged 18 years or younger. Participants were divided according to those who attended eight or more lessons (high treatment, n = 94) and those who attended fewer lessons ( n = 116). A system of rewards for attendance was used. The number of prenatal visits was significantly different between the three groups ( p < 0.001), with the high-treatment participants having a significantly greater number of visits than the other groups. The groups differed on gestational age at delivery ( p < 0.006), favoring the infants of high-treatment participants; however, only 8% of gestational age variance was attributable to prenatal visits. A significantly greater proportion of high-treatment participants returned for postpartum care ( p < 0.011 vs. low-treatment participants, p < 0.002 vs. comparison subjects). Postpartum return was not improved by a hospital visit by a volunteer. Regardless of treatment, most (99%) accepted a contraceptive method at their postpartum visit. The groups did not differ on their return for method check at 3 months. However, a significantly greater proportion of the high-treatment participants returned for an annual family planning evaluation ( p < 0.015 vs. low-treatment participants, p <0.005 vs. comparison subjects). Both the high- and low-treatment participants differed significantly from the comparison subjects on having taken their infants for at least one well-child visit during the fast year ( p < 0.001 for both tests). The threee groups did not differ on return to school within 1 year, reported child abuse/neglect within 2 years, or subsequent recorded pregnancy out-come within 2 years. The project was judged to be cost effective for achieving short-term positive outcomes.