New Orleans Revives House Calls to Combat Maternal and Infant Health Crisis

New Orleans is pioneering a return to a traditional medical practice – house calls – to address a concerning maternal and infant health crisis. The city’s Family Connects New Orleans program sends registered nurses to the homes of new parents, offering support and guidance during the critical postpartum period.

Addressing a Critical Need

Louisiana consistently ranks among the states with the worst maternal and infant health outcomes. According to the March of Dimes, the state has some of the highest rates of preterm births, unnecessary cesarean sections, and maternal and infant deaths. A 2023 analysis by the United Health Foundation even designated Louisiana as the “least healthy” state for women, and children. The Family Connects program aims to proactively address these issues by providing early intervention and support to new families.

How Family Connects Works

The Family Connects model, which originated in Durham, North Carolina, in 2008 as a partnership with Duke University, offers up to three free home visits to families who have given birth at a New Orleans hospital, regardless of their insurance status or income level. Nurses provide a range of services, including:

• Weighing and measuring babies
• Checking maternal health and well-being
• Offering advice on breastfeeding, diapering, and sleep routines
• Providing referrals to other community resources
• Addressing practical concerns like safe storage of breastmilk and household safety (including firearm safety)

A “Back to the Future” Approach

New Orleans Health Director Jennifer Avegno describes the program as “going back to the future,” reviving a practice that was common a century ago. “There is no more critical time and vulnerable time than right at birth and in the few weeks to months following birth,” she stated. The program aims to catch health issues early and provide families with the support they need to get off to a healthier start.

Early Results Show Promise

Initial data analyzed by researchers at Tulane University indicate that families participating in the program are more likely to adhere to recommended pediatric and postpartum checkup schedules. There has been a decrease in hospitalizations for both mothers and babies, and overall healthcare spending has been reduced among families insured by Medicaid. Research from North Carolina’s Family Connects program demonstrated a 50% reduction in emergency room visits in the year following a baby’s birth with three to seven home visits.

Screening for Postpartum Depression

A significant benefit of the program is its success in identifying postpartum depression. Approximately 10% of mothers participating in the New Orleans program have been diagnosed with postpartum depression, compared to 6% of those who did not receive home visits. Early diagnosis is crucial for ensuring that mothers receive timely treatment and support, preventing symptoms from worsening and mitigating potential risks.

Bipartisan Support and Future Expansion

The postpartum home visits have garnered bipartisan support in Louisiana. In 2023, the state legislature passed a law requiring private insurance plans to cover the cost of these visits. State Representative Mike Bayham, a Republican, emphasized that the program demonstrates a commitment to the well-being of both mothers and newborns, addressing criticisms that pro-life advocacy should extend beyond birth. Avegno is advocating for the inclusion of the program in Louisiana’s Medicaid program, as over 60% of births in the state are covered by Medicaid.

Addressing Complex Challenges

Louisiana’s maternal and infant health challenges are further complicated by the state’s strict abortion ban, which has led to medical delays and confusion among healthcare providers. Although Family Connects does not provide abortion access, Avegno believes it offers alternative ways to support women’s health, including providing information about reproductive healthcare options and assisting with birth control access.