To review evidence regarding the role of paraprofessional support in improving maternal and infant outcomes in pregnant and parenting women. Although support provided by significant others (social support), by professionals, and by paraprofessionals are frequently considered together in literature reviews, this is inappropriate because the components of the support in each case differ.
Data were limited to published studies. Searches of computerized databases (CINAHL, Medline, PsychLit, Social sciences abstracts, Social sciences citation, and Social work abstracts), hand searches of journals, and backward searches from reference lists of studies were conducted. Nursing, medicine, psychology, public health, sociology, and social work literatures were searched.
The studies included had statistically significant outcomes of paraprofessional support to pregnant and parenting women. Studies were published in 1985 or later, were conducted in the United States or Canada, and included maternal and/or infant outcomes.
Data were extracted from each study concerning the theoretical framework, design, sample, measuring instruments, interventions, and outcomes.
Programs providing paraprofessional support to childbearing women are clearly providing an important service, but empirical evidence is not adequate to determine which specific paraprofessional program works for a specific population of women to achieve the best long-term outcomes for both women and children. Although proponents of paraprofessional support programs for pregnant and parenting women have reported some successes, more data are needed. Researchers should continue to conduct well-designed and controlled studies to compare outcomes from the three types of support. Nurses in practice should build on services provided by paraprofessionals in order to meet women's need for support and to achieve desired outcomes.