There was no evidence of impact on the primary outcomes of either intervention. The SHV intervention was popular with women, and was associated with improvement in some of the secondary outcomes. This suggests that greater emphasis on the social support role of health visitors could improve some measures of family well-being. Possible areas for future research include a systematic review of social support and its effect on health; developing and testing other postnatal models of support that match more closely the age of the baby and the changing patterns of mothers' needs; evaluating other strategies for mobilising 'non-professional' support; developing and testing more culturally specific support interventions; developing more culturally appropriate standardised measures of health outcomes; providing longer term follow-up of social support interventions; and exploring the role of social support on the delay in subsequent pregnancy.

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This paper describes the results of a 7-year follow-up survey of families who took part in a randomized controlled trial of research midwife-provided social support in pregnancy in 1986-88. Analysis of data 6 weeks and 1 year after delivery indicated that families offered the social support intervention had better health outcomes than those in the control group. A further wave of data collection using postal questionnaires was undertaken when the index children were aged between 6 and 8 years. The findings indicated that the initial advantage shown by the intervention group appeared to have been maintained. At 7 years, there were significant differences favouring the families in the intervention group in the health and development outcomes of the children, and the physical and psychosocial health of the mothers. The results confirm the health-promoting effect of social support, and the importance of providing supportive care within the routine maternity services, not only as a means to improve women's pregnancy experiences but in order to promote their and their children's health and development throughout childhood.