Impacts of healthy marriage and relationship education for expectant and new mothers

• Published date: 01 October 2023
• Author: Ankita Patnaik,Robert G. Wood,Kathryn Gonzalez
• Date: 01 October 2023
• DOI: http://doi.org/10.1111/fare.12818

RESEARCH

Impacts of healthy marriage and relationship

education for expectant and new mothers

Ankita Patnaik

1

|Robert G. Wood

2

|Kathryn Gonzalez

3

1

Mathematica, Washington, DC

2

Mathematica, Princeton, NJ

3

Mathematica, Oakland, CA

Correspondence Ankita Patnaik, Mathematica,

1100 First Street, NE, 12th Floor, Washington,

DC, 20002-4221, USA.

Email: apatnaik@mathematica-mpr.com

Funding information

This study was supported by contract

HHSP233201500095G from the

U.S. Department of Health and Human

Services, Administration for Children and

Families. The views expressed herein are those

of the authors and do not necessarily reflect the

views of the U.S. Department of Health and

Human Services.

Abstract

Objective: To build the evidence base on healthy marriage

and relationship education (HMRE) programs serving

individual adults, this study examined the 1-year impacts

of the MotherWise program, which serves women with

low incomes who are pregnant or have just had a baby.

Background: Despite the increasing prevalence of HMRE

programs serving individual adults, few studies have

rigorously examined their effectiveness.

Method: Women were randomly assigned to either (a) an

intervention group offered MotherWise (n=512), or (b) a

control group not offered MotherWise (n=437).

Women’s relationship skills, attitudes, and outcomes were

measured by a 1-year follow-up survey.

Results: MotherWise improved women’s relationship skills

and attitudes, and reduced the likelihood of unintended preg-

nancy. MotherWise did not affect levels of intimate partner

violence, coparenting quality, and emotional well-being.

Among women in a relationship with their baby’sfather,

MotherWise improved the quality of that relationship.

Conclusion: MotherWise met its immediate goal of helping

women develop the skills and attitudes to make informed,

healthy decisions about relationships. The program’simpact

on unintended pregnancy suggests the program encouraged

women to make more deliberate decisions about family

planning.

Implications: Programs like MotherWise can improve cer-

tain outcomes of new and expectant mothers with low

incomes by offering them HMRE services and other

supports.

KEYWORDS

healthy relationships, marriage education, randomized controlled trial,

relationship skills and attitudes, Within My Reach

Received: 19 April 2022Revised: 18 October 2022Accepted: 15 November 2022

DOI: 10.1111/fare.12818

© 2022 National Council on Family Relations.

1456 Family Relations. 2023;72:1456–1473.wileyonlinelibrary.com/journal/fare

Decades of research have revealed that stable, low-conflict families support the well-being of

parents and children (Waldfogel et al., 2010). Healthy family environments can be a buffer

against the negative effects of poverty and other stressful life events (Amato, 2005). However,

maintaining healthy relationships can be a challenge for parents. This is particularly true for

parents with low incomes, who may experience economic and other stressors that make it diffi-

cult to achieve stable, low-conflict relationships (Conger et al., 2010).

Healthy relationships are particularly important for new and expectant mothers. Many

women experience psychological distress during pregnancy and after the birth of their child

(Gavin et al., 2005). Access to social and relationship supports (O’hara & Swain, 1996) and pos-

itive relationship behaviors (Khaled et al., 2020) during the perinatal period have been linked to

improved maternal well-being. In contrast, exposure to destructive conflict behaviors during

and shortly after pregnancy, such as intimate partner violence, is linked to worsened maternal

mental and physical health (Malta et al., 2012; Sharps et al., 2007). More broadly, research

reveals that healthy relationships between mothers and fathers can reduce maternal stress and

support maternal well-being (Bloch et al., 2010), which can in turn influence children’s develop-

mental trajectories (Crnic et al., 2005).

Healthy marriage and relationship education (HMRE) programs, including those serving new

and expectant parents, have emerged as an approach to help people build the skills needed to

develop and sustain healthy relationships (Stanley et al., 2020). The federal government funds many

HMRE programs through grants that are administered by the U.S. Department of Health and

Human Services, Administration for Children and Families, Office of Family Assistance (OFA, n.

d.). Many HMRE programs serve individual adults (rather than couples) and aim to help partici-

pants form and maintain romantic relationships and avoid unhealthy relationships, regardless of

their relationship status (Stanley et al., 2020; Stanley & Rhoades, 2009). These programs cover

topics such as how to choose a partner wisely, how to improve communication skills, how relation-

ship choices can affect many aspects of life, and how to recognize unhealthy relationships and leave

them safely (Rhoades & Stanley, 2011; Visvanathan et al., 2015).

There are an increasing number of HMRE programs for individual adults, as indicated by the

currentlistofHMREgrantsawardedbyOFA(OFA,n.d.), yet there is limited rigorous evidence

on their effectiveness (Stanley et al., 2020; Visvanathan et al., 2015). A handful of mainly

quasi-experimental studies have examined the impacts of HMRE programs for individual adults

(Adler-Baeder et al., 2018; Bradford et al., 2016; Nowlan et al., 2017;Owenetal.,2017;VanEpp

et al., 2008). Only one study used a random assignment design: Nowlan et al. (2017) evaluated an

online HMRE curriculum adapted for use with individual adults and found that it had positive

impacts on individuals’self-reported quality of life, work functioning, and perceived health at pro-

gram exit. Moreover, only one of these studies (Adler-Baeder et al., 2018)examinedanHMRE

program that exclusively served women. Adler-Baeder et al. (2018) examined the Together We Can

HMRE curriculum to mothers of children enrolled in a Head Start program and compared the out-

comes of program participants to those of mothers from the same Head Start program who chose

not to enroll. Program participants reported greater improvements in coparenting quality 1 year

after program enrollment compared with mothers who chose not to participate in the program; the

two groups had similar levels of punitive parenting behaviors, however. To the best of our knowl-

edge, no studies to date have used a random assignment design to evaluate the impact of HMRE

programs that exclusively serve women or mothers—or more broadly, the impact of HMRE pro-

grams for individual adults on outcomes beyond program exit.

Current study

This study presents findings from a random assignment impact study of MotherWise, an

HMRE program for new and expectant mothers. MotherWise integrates the Within My Reach

HMRE FOR EXPECTANT AND NEW MOTHERS1457