The perinatal period is often described as a time of joy and hopeful expectation for mothers and families of newborns. The mounting pressure for mothers to display excitement and happiness during this time is enormous for some. It is no surprise that mothers of newborns often feel alone and experience increased sadness and low mood. Mental health challenges are very common and can impact any mother or expecting mother, regardless of background, during the perinatal period.

During Mental Health Awareness Month, Family Connects International highlights the importance of maternal mental health and well-being. Mental health disorders in mothers, such as mental health conditions and substance use disorders are major factors contributing to maternal deaths. In 2022, the CDC reported that over 80% of perinatal deaths were preventable. 23% of perinatal deaths are linked to mental health conditions including feelings of despair, restlessness, or substance abuse, which are the most significant problems associated with pregnancy, childbirth, and the postnatal period, affecting one-fifth of women. According to the CDC, one in eight women experience postnatal depression.

Though mental health conditions related to the perinatal period are not completely preventable, they can be managed, making recovery possible when symptoms of depression are detected, and mothers are provided with the resources needed to address their concerns.

Maternal Mental Health Warning Signs

During a Family Connects nurse home visit, registered nurses examine infants and assess mothers for needs and concerns. When a mother shares that she has been experiencing symptoms of depression, anxiety, or any mental health condition, Family Connects’ registered nurses address the need by connecting her to local resources that will support and help her on her path to recovery.

Some risk factors for maternal mental health conditions are:

• History of mental health issues
• Family history of depression and anxiety, or any other health conditions
• Chronic health issues
• Relationship challenges during the perinatal time

During the postpartum period, mental health conditions may interfere with a mother’s ability to bond with her newborn, which is critical during this time. Women with postpartum depression may experience long-term sadness, lack of pleasure or disinterest in activities they usually enjoy, negative thoughts about their newborns or themselves, suicidal ideations, or other signs related to mental health challenges. It is important to understand the signs of perinatal mental health conditions and to connect mothers to resources to address their needs to make a full recovery.

Our mission is to ensure every family of a newborn receives equitable care within three weeks of birth. The Family Connects Universal Home Visiting Model addresses common challenges and concerns, including physical and mental health conditions. It also connects mothers to local support systems and resources to meet their needs. During a Family Connects nurse home visit, personalized plans and goals may be created in collaboration with the mother for childcare, health, and returning to work, if the mother chooses.

How Family Connects International Provides Care and Resources to Support Maternal Mental Health

The Family Connects Model integrates medical assistance with mental health resources. Family Connects International equips our community partners with training, resources, and support to connect families to local resources and provide newborns and their families with quality care. Registered nurses meet mothers and newborns at their homes, or at a location they are comfortable with, free of charge. Meeting mothers where they are most comfortable allows registered nurses and mothers to have conversations they might not normally have in public medical facilities.

The resources Family Connects nurses offer align with the mother’s mental health and physical needs discussed during the nurse home visit. Our registered nurses listen to mothers and work to provide them with needed tools and resources based on the needs identified. By the end of the nurse home visit, mothers are empowered and equipped to get the care they deserve. Studies have shown that the Family Connects early intervention program reduces the risk of mental health conditions. In a 2014 study, evidence indicated that the Family Connects model can reduce the likelihood of postpartum depression or anxiety by 30%.

Family Connects’ registered nurses are trained and equipped to address the whole person’s needs and the needs of their newborns and families. Our nurse home visits are completely confidential. There are countless accounts of new parents and their families who receive a nurse home visit from a Family Connects registered nurse highlighting the exceptional level of care delivered by our community partners and healthcare professionals. The testimonials received underscore the quality services our dedicated teams of nurses provide, ensuring the well-being of families and infants in communities nationwide. Our commitment to excellence shines through in the positive experiences and stories of those who have benefited from our nurse home visits.

By: Melea Rose-Waters, MSW, Senior Policy Director, Family Connects International

Participants who attended the National Home Visiting Summit had a busy and productive day on Capitol Hill! From January 31 to February 2, 2024, our Nation’s Capital was filled with advocates for children and families as they attended the National Home Visiting Summit. During this part-advocacy and part-educational event, participants were given the opportunity to schedule meetings with their congressional delegation, also known as Hill visits. These meetings were organized by a state lead and guided by preparation provided by the Start Early Community of Practice on Advocacy and Policy and a strategy session the morning of the visits on January 31st.

Family Connects International’s senior policy director, Melea Rose-Waters, organized meetings with members of Congress across different states and participated in visits with a number of advocates from home visiting models, early literacy groups, community-based organizations, and academia. We walked the halls of Congress and sat at tables together with members and staffers with a common goal: raising awareness for the need to support children and families.

Moving Upstream

A holistic approach to child and family support begins upstream, and the United States is currently facing a maternal mortality public health crisis. The U.S. has the highest pregnancy-related death rate among developed nations and that rate rose a staggering 40% in 2021 compared to the previous year. The maternal mortality rate for Black women is nearly three times higher than the rate for white, non-Hispanic women. These stats beg the question: how is this happening in a country with one of the most advanced health care systems in the world?

There isn’t one simple solution to prevent potential health complications postpartum, but there is certainly more we could be doing as a country today to demonstrate that the health and well-being of moms and babies is a priority.

Family Connects: A Universal Solution to a Preventable Crisis

Family Connects is an evidence-based program where a nurse visits families with newborns in the first few weeks postpartum. In the select communities where the service is available, it is offered universally to everyone and at no cost to the family. A visit is scheduled with the family before leaving the hospital and three weeks later, the nurse comes to the home to visit mom and baby. The visit is an extension of the medical care provided by their OBGYN and can bridge a gap between the family and an entire community system of care that is available – from childcare resources to breastfeeding support.

Medical assessments aren’t the only areas that the nurses cover during visits. They carry with them a wealth of knowledge about the best care for moms and newborns, and they help connect families to the resources that are available to them in their communities. The program has been shown to reduce postpartum anxiety, increase the likelihood that mom attends the recommended six-week postpartum health check, and improve overall health and well-being for both mom and baby.

In the US, infants typically visit their pediatricians several times in the first few weeks of life, yet moms are typically seen by their providers about six weeks postpartum, leaving a six-week span of zero care. For some moms, these visits are a matter of life and death.

A Call to Action for Policymakers and Providers

The Washington Post featured an op-ed on August 18th, 2023 titled “Want to fix America’s maternal health crisis? Here’s where to start” that highlighted data-driven policy recommendations to provide the best maternity care. These recommendations underscore themes that maternal health experts have been saying for decades: what we’re doing isn’t working.

Providers need to pay more attention to the health and well-being of moms during the postpartum period, prioritize equity to address maternal mortality risks that are disproportionately impacting people of color, and look to what has worked well in other countries to improve maternal health outcomes. A call to action for both policymakers and the medical community, with a roadmap of strategies that can change outcomes and support families during a vulnerable – and sometimes scary – life transition into parenting a newborn.

A Gold Standard of Postpartum Care

Currently, two states are bringing Family Connects statewide, and there is a scattering of communities across the country that have also seen the value in nurse visits for new moms. A national crisis like the maternal mortality rate needs innovative, universal solutions. What we’re doing isn’t enough and it isn’t working. Moms and families deserve more. Imagine what is possible with a gold standard of postpartum care that includes a holistic approach that starts prenatally and continues well into the fourth trimester – the critical time postpartum that is most dangerous for new moms, with the highest risk of maternal death occurring during the first 42 days postpartum. Family Connects nurses are saving lives.

Want to know how you can meet with your policymakers? Stay tuned for our next blog post for Community Partners on how to organize and execute effective meetings with policymakers.

Learn more about the policy priorities for Family Connects International, the home office of Family Connects located in Durham, NC, or connect directly with us at melea@familyconnects.org.  Want to learn more about the Home Visiting Summit? Check out this blog post from Start Early on Four Takeaways from the National Home Visiting Summit.

Universal nurse home visiting for newborns and their families is our priority at Family Connects International. We have made it our mission to strengthen connections for families with newborns and link them directly to health and community care resources. Learn more about Family Connects International today!

“According to Gallup, nurses remain the most trusted professionals for the 22nd consecutive year”

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Interested in Learning More about the Family Connects Model?

FCI is inviting conversation with anyone interested in learning more about Family Connects. Each session will have a different theme.
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Register here for one or more sessions:

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A Universal Approach for Health Equity

March 4, 12-12:30pm EST

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Nurses and Community Health Workers in the FC Model

May 6, 12-12:30pm EST

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Home Visiting in Rural Communities & Maternity Care Deserts

August 5, 12-12:30pm EST

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Using Data to Inform Community Change

October 28, 12-12:30pm EST

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Universal Home Visiting for newborns and their families is our priority at Family Connects International. We have made it our mission to strengthen connections for families with newborns and link them directly to health and community care resources. Learn more about Family Connects International today!

Last November, Washington-Pierce County became a certified Family Connects Community Partner. In this post for our blog series “FCI Voices for Universal Newborn Care”, we will learn from Pierce County about the importance of certification in their own words.

A Message from Pierce County, WA

When we launched Family Connects Pierce County in March 2021, we really had no idea if the program would take or what impact we could truly have on families in our community. What we did know, is that we were confident in our local leaders’ decision to choose a reputable national program able to respond to Pierce County’s enduring child welfare crisis, and confident that our implementing agencies were capable and equipped to deliver the program effectively.  Achieving certification means so much to us in Pierce County. As the only Family Connects site operating in Washington State, certification adds credibility to our program. When families feel like they can trust a program and trust our nurses, they will seek the postpartum care they need and deserve, and we can provide the most comprehensive wraparound support to them.

Our road to certification felt very much like a rollercoaster. As soon as we felt like things were moving along well, we would be humbled by a hiccup requiring a swift change in course to respond and redirect. Our implementation specialist was right there with us from the start, and we honestly could not have achieved as much as we did so early in implementation without her thoughtful feedback, knowledge of our unique community, attention to detail, and moving data. When FCI transitioned to a nonprofit and assigned a new implementation specialist, we felt equipped to pivot and continue to support our families with the best postpartum support knowing we built a strong foundation. We are grateful to FCI for their grace in answering our questions and supporting our team along the way.

I would encourage interested communities to first really center the community’s voice in deciding if this program is a right fit for them. Once you’ve achieved that decision, hop on the rollercoaster, and enjoy the ride. There is beauty in the journey, and for us, that beauty has been learning with and from other Family Connects sites, which has only bolstered our local Family Connects program. We have especially found beauty in the families we’ve served, who have trusted us wholeheartedly with a completely new way of thinking about postpartum and the fourth trimester. Without them, there would be no Family Connects Pierce County.

Thank you, Pierce County, for sharing your experience and for providing resources and home-visiting care throughout the year! Interested in launching a Family Connects Partnership? Visit FamilyConnects.org today to learn more!



Universal Home Visiting for newborns and their families is our priority at Family Connects International. We have made it our mission to strengthen connections for families with newborns and link them directly to health and community care resources. This is made possible by our community partners across the county. But why is universal home visiting important for families and their newborns? We have asked one of the experts at Family Connects International to explain in their own words the importance of home-visiting care. In this post for our blog series “FCI Voices for Universal Newborn Care”, we will learn from our Nurse Manager and Acting Chief Nursing Officer about the benefits of home visiting for newborns and their families.

Here are Bonnie’s thoughts on postpartum home visiting for families with newborns:

“Postpartum home visiting plays a crucial role in supporting families and their newborns. In fact, most high-resource countries across the globe offer some form of universal, in-home support for families with newborns. These visits are invaluable in navigating the physical, emotional, and lifestyle adjustments that come with a new baby. A caring and knowledgeable nurse can help identify and prioritize referrals in collaboration with families as well as help normalize some questions people experience postpartum. From identifying respiratory distress in infants exposed to viruses such as RSV and flu to reminding parents they are doing a great job, every family deserves to feel supported, safe, and seen during the postpartum period”.
-Bonnie Hepler, RN, MSW, MSPH, PhD

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“Postpartum home visiting plays a crucial role in supporting families and their newborns. In fact, most high resource countries across the globe offer some form of universal, in-home support for families with newborns. These visits are invaluable in navigating the physical, emotional, and lifestyle adjustments that come with a new baby. A caring and knowledgeable nurse can help identify and prioritize referrals in collaboration with families as well as help normalize some questions people experience postpartum. From identifying respiratory distress in infants exposed to viruses such as RSV and flu to reminding parents they are doing a great job, every family deserves to feel supported, safe, and seen during the postpartum period. “

FCI’s mission is made possible because of the support, dedication, and drive of both our community partners and the staff here at FCI. Bonnie is one of the many who share that commitment to newborns and families nationwide and utilizes her expertise in nursing to equip our FCI network to deliver quality care year-round.

“I am committed to ensuring that nurses in the FCI network embody excellence and equity in their clinical practice. My passion lies in ensuring that all of our nurses not only possess the knowledge to adeptly support the physiologic processes during the postpartum period but also embody a humble and supportive approach when interacting with families during home visits. It is my belief that a combination of expertise and empathetic care is pivotal in creating a positive and inclusive healthcare experience for every family. My hope is that we can provide nurses with the tools to ensure Family Connects interactions feel helpful and healing in a period that is often associated with trauma and uncertainty”.
-Bonnie Hepler, RN, MSW, MSPH, PhD

Copy Blockquote
“I am committed to ensuring that nurses in the FCI network embody excellence and equity in their clinical practice. My passion lies in ensuring that all of our nurses not only possess the knowledge to adeptly support the physiologic processes during the postpartum period but also embody a humble and supportive approach when interacting with families during home visits. It is my belief that a combination of expertise and empathetic care is pivotal in creating a positive and inclusive healthcare experience for every family. My hope is that we can provide nurses with the tools to ensure Family Connects interactions feel helpful and healing in a period that is often associated with trauma and uncertainty”.

Thank you, Bonnie, for this insight! Visit our website to learn how you can help ensure essential connections for equitable outcomes for every newborn and stay up to date on the strides our community partners and FCI team have made to make our mission possible.

Please read an article written by our own Renée I. Boothroyd: Mechanisms of change in external implementation support: A conceptual model and case examples to guide research and practice

The Center for Implementation does great work with implementation support providers and those who support them.  This article is foundational for building on the momentum in the field and creating definition around what implementation specialists actually do.

The article is featured as a critical thought leader in implementation practice in the upcoming September 2023 issue of Implementation in Action, a monthly bulletin for implementers and intermediary organizations who are seeking to apply implementation science in a thoughtful and systematic way. The bulletin goes out to over 9000+ implementers worldwide.