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Strengthening maternal health starts after families leave the hospital

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by Zhandra Levesque, opinion contributor - 05/03/26 12:00 PM ET

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by Zhandra Levesque, opinion contributor - 05/03/26 12:00 PM ET

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In this June 25, 2012 photo, family nurse practitioner Kirsten Roberts, right, examines newborn Sofia while mother Larisa Bezzubets looks on, at Multnomah County’s Mid-county Health Center, in Portland, Ore. (AP Photo/Rick Bowmer)

More than 80 percent of pregnancy-related deaths in the U.S. are considered preventable. And they all happen after the hospital stay.

That number should stop us cold. It should demand an explanation, because we know how to prevent many of these deaths. But we have not consistently made the kinds of supports needed to do so widely available.

In April, the field took one meaningful step toward changing that with the Health Resource and Service Administration’s release of the National Home Visiting Workforce Strategy. It’s a roadmap for building the professional infrastructure that could reach millions of mothers who currently receive no support during the most medically dangerous weeks of their lives. It reflects growing recognition that supporting families after birth requires more than clinical care alone.

The reason we need a program like this is straightforward. Most mothers leave the hospital within 48 hours of giving birth. That is often just when the hardest weeks begin, and families are left to manage the transition largely on their own.

Sleep disappears. Hormones shift. Medical care splinters into separate tracks, with one clinician responsible for the baby and another for the mother. Follow-up visits may be weeks away. Partners and fathers are navigating their own transition at the same time. An entire family is adjusting to a new rhythm that includes feeding challenges, mental health changes and physical recovery, largely on their own.

But imagine something different: A trained professional knocks on the door. She sits at the kitchen table while the baby sleeps nearby. She asks a few simple questions: How are you sleeping? How are you feeling? Do you have what you need for the days ahead? How is the baby doing? She screens for postpartum depression, helps with feeding and infant care and connects the family to health and social services before small problems become emergencies.

This approach — known simply as home visiting — is one of the most rigorously studied and demonstrably proven ways we have to support mothers, babies and families in their earliest moments.

Home visiting programs connect families with trained professionals who walk alongside them starting in pregnancy and through early childhood. Over weeks and months, that professional can become a steady presence during one of life’s most vulnerable transitions. Someone who listens before advising, helps families set goals and notices when something isn’t right. At its best, this work strengthens the caregiver-child relationship, supports maternal mental health and engages fathers and partners as part of the family unit.

Decades of research show that evidence-based home visiting programs improve maternal mental health, strengthen parent-child relationships, reduce child maltreatment and support children’s early development. Cost-benefit analyses estimate returns ranging from roughly $1.80 to more than $5 for every dollar invested.

Few social programs produce results this consistent. Yet despite decades of evidence, millions of American families never receive this kind of support.

Since 2010, the federal Maternal, Infant, and Early Childhood Home Visiting Program has served hundreds of thousands of families each year across the country. That progress reflects sustained bipartisan commitment to strengthening maternal and child health and demonstrates that community-based prevention can be delivered at scale. But it also highlights how much need remains unmet.

The reason is not mysterious. The workforce needed to deliver this care has not kept pace with demand.

Home visitors do complex, relationship-based work. They conduct health screenings, coordinate with medical providers, support families experiencing housing or food instability and build trust over time. Yet compensation often falls in the $30,000 to low $40,000 range nationally. Programs across the country report challenges in recruiting and retaining staff.

In other words, we have an intervention that works. The opportunity now is to build the workforce and infrastructure needed to bring this support to far more families.

Importantly, home visiting is voluntary. Families choose to participate, and in many communities, individuals who once received these services later become home visitors themselves, bringing lived experience along