Effects of Mothers of Rotterdam on self-sufficiency and stress in vulnerable pregnant women

Background

Low socioeconomic status and disadvantaged circumstances lead to suboptimal health and well-being of individuals. These health effects are already visible at birth, with long-lasting effects in childhood and later life, making them a double victim of poverty. In Rotterdam, 12.8% of households have a low income and 14.3% of children grow up in poverty. The Mothers of Rotterdam (MoR) program, provides (Targeted) Social Care (TSC) across multiple domains to highly vulnerable pregnant women aiming to support them and their children. This study assesses the effects of the program on stress and self-sufficiency in participating women.

Methods

Between 2016 and 2021, 868 women participated in MoR. Data on self-sufficiency (measured by the Self-Sufficiency scale) and stress (measured by the DASS-21) were used to assess change in both outcomes between start and end of care. Additionally, regression models were used to assess the influence of type of care (TSC vs care as usual), scores at the start and degree of vulnerability on the change in outcomes.

Results

Care trajectories lasted on average 414 days for TSC and 224 days for care as usual. Self-sufficiency scores improved from 43 at baseline to 47, and stress scores improved from 28 at baseline to 16 at end of care. Baseline scores were significantly associated with improvements in both outcomes, irrespective of type of care. Higher vulnerability at baseline was associated with larger reductions in stress, while lower baseline vulnerability was associated with greater improvements in self-sufficiency.

Conclusions

Self-sufficiency and stress improved for all women in the study. No significant difference was found in these outcomes by type of care, despite the longer trajectory of TSC. This could be explained by changes in application for social care and recognition of pregnant women as a priority population, which applied to both types of social care.

Key messages

• Pregnant women in vulnerable positions receiving social care show improvement in self-sufficiency and stress. No significant difference was found in these outcomes by type of care.

• No added effect in targeted social care could be due a change in application for social care and recognition of pregnant women as a priority population, which applies to both types of social care.