Home Visitor's Online Handbook

Services to Enrolled Pregnant Women

Some Early Head Start programs may decide to serve pregnant women in addition to children from birth to age 3, pursuant to Section 645A(e) of the Head Start Act. When programs do opt to use home visits to provide services to enrolled pregnant women, they do not have to provide a certain amount of weekly home visits. Instead, they must meet the requirements for services to enrolled pregnant women outlined in 45 CFR §1302.80, as follows:

  • Within 30 days of enrollment, a program must determine whether each enrolled pregnant woman has an ongoing source of continuous, accessible health care—provided by a health care professional that maintains her ongoing health record and is not primarily a source of emergency or urgent care—and, as appropriate, health insurance coverage. 
  • If an enrolled pregnant woman does not have a source of ongoing care as described above and, as appropriate, health insurance coverage, a program must, as quickly as possible, facilitate her access to such a source of care that will meet her needs. 
  • A program must facilitate the ability of all enrolled pregnant women to access comprehensive services through referrals that, at a minimum, include nutritional counseling, food assistance, oral health care, mental health services, substance abuse prevention and treatment, and emergency shelter or transitional housing in cases of domestic violence. 
  • A program must provide a newborn visit with each mother and baby to offer support and identify family needs.
    • A program must schedule the newborn visit within two weeks after the infant's birth.

HSPPS 45 CFR §1302.81 further requires the following prenatal and postpartum information, education, and services:

  • A program must provide enrolled pregnant women, fathers, and partners or other relevant family members the prenatal and postpartum information, education, and services that address, as appropriate:
    • Fetal development
    • The importance of nutrition
    • The risks of alcohol, drugs, and smoking
    • Labor and delivery
    • Postpartum recovery
    • Parental depression
    • Infant care and safe sleep practices
    • The benefits of breastfeeding
  • A program must also address needs for appropriate supports for emotional well-being, nurturing and responsive caregiving, and father engagement during pregnancy and early childhood.

How To

You support the expectant family's understanding of the relationship between the health and well-being of the pregnant woman to the well-being of the unborn child if you:

  • Involve your health coordinator and HSAC to review and recommend prenatal curriculum that meet the needs of the families you serve
    • Specific curricula are available to support culturally competent service delivery for teens, American Indian and Alaska Native (AIAN) families, Latino families, and other more generic populations
  • Are trained in your program's pregnancy curriculum to provide skills for approaching these topics and background material for a deeper understanding
  • Have a process among the team that is responsible for serving expectant families, keeping current on information, and evaluating material on various organizations' websites—some of which may provide appealing, animated explanations of aspects of pregnancy
  • Become familiar with information on the effects of maternal stress, nutrition, tobacco, and alcohol on the developing brain and the impact of maternal oral health on infant health
  • Have relationships with local birthing hospitals and memoranda of understanding with community agencies offering relevant services to women, especially pregnant women
  • Offer screening and information on risk factors such as smoking, depression, substance use, etc.
  • Help families to prepare for the two-week home visit and follow-up
  • Ensure families are connected to services and information as needed
  • Help the family plan for the transition to enroll the newborn into the appropriate program option for the family

Learn More

Breastfeeding Resources
This guide can help you find resources specific to your needs. Remember that families who are making the decision to breastfeed or are breastfeeding their babies need individualized information and support.