1. Cara Buskmiller, MD1, Cristie Columbus, MD2, Jeffery Gavard, PhD1
Maternity Homes Improve Relationships and Connection Among Underserved Pregnant Women
Cara Buskmiller, MD1, Cristie Columbus, MD2, Jeffery Gavard, PhD1
1: St. Louis University, Department of Obstetrics, Gynecology, and Women’s Health, St. Louis MO
2: Baylor University Medical Center, Department of Infectious Disease, Dallas TX
Background
Objective
Methods
Results
Results
Conclusions
References
Interpersonal relationships affect obstetrical outcomes.1-4 Many interventions to assist pregnant patients in high social risk situations have been tested to improve maternal morbidity. A 2005 study by the Department of Health and Human Services identified maternity group homes as an “innovative and intensive” approach.5
To determine whether maternity group homes improve social support and nontoxic interpersonal relationships, as proxy measures of modifiable social risk for adverse pregnancy outcomes.
A cross-sectional study was performed using a 13-item survey written at an eighth grade reading level, administered to women living in United States maternity homes (residents) between August 1, 2015 and February 28, The survey first assessed residents’
Women who reported feeling less connected had fewer factors that improved their future relationships; women who reported feeling more connected reported many more factors (p < 0.01).
Residents with decreased Support Score tended to report no help with current (p = 0.07) and future relationships (p <0.01). They also identified fewer helpful factors (2 compared with factors; p < 0.01 for current relationships, <0.05 for future relationships).
Maternity group homes improve social support for women with low Support Scores. They improve current and future interpersonal relationships for a large majority regardless of support. Factors most beneficial include program workers, other residents, the resident’s baby, and religion.
This survey is the first of its kind and the largest survey of maternity group homes to date. Notably, women frequently reported that their baby was a factor in feeling connected and supported, as well as a help to improve current and future relationships. This phenomenon has not been reported prior to this study.
The survey is limited by its small sample size. A remarkable number of programs had closed or shifted their focus to other, less intensive social services.
A total of 95 responses were recorded from 14 states. The study population was disproportionately black (29%, compared to 13.3% of 2015 census data). Non-Hispanic black residents were at increased risk of decreased support (p < 0.05). 53.8% of women had increased Support Scores after a stay in a home and 36.6% had stable Support Scores. 77% and 82% of all residents reported their stay in a home would help current and future relationships, respectively. This included % of women with stable or increased support (p = 0.07 current, p < 0.01, future relationships).
Figure 1. Support Scores in residents who reported a change after participating in a maternity group home. The median entry Support Score was 5. The median score of those with stable support was 6 (range 1-10). * = p<0.05.
Fig 2: Factors assisting current relationships. * = p < 0.05 in pairwise comparisons and across all three groups.
The factors most frequently identified as helpful were the workers at the home and the other residents of the home, as well as the respondent’s baby. Across all Support Scores, “God, religion, or a higher power” was described as helpful (60%, 51.7%, and 58.1%, p = 0.85). *
social support before and during their stay with a ten-point “Support Score.” Second, it asked the number of nontoxic relationships residents had, whether the home helped current and future relationships, and what factors provided this help. English-speaking, literate residents were eligible to participate.
43 sites participated and the response rate was 60%. Chi-square test, Fisher’s Exact test, analysis of variance, and independent students t test were used in statistical analysis. *
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Hulsey L, Wood R, Rangarajan A, U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (2005). The implementation of maternity group home programs: serving pregnant and parenting teens in a residential setting. Mathematica Policy Reseach: Princeton NJ.