Perinatal child abuse prevention projects are rarely rigorously evaluated. Women were referred to the Child Parent Enrichment Project (CPEP) project during or just after pregnancy if identified as at-risk of engaging in child abuse by community professionals. Clients were randomly assigned to CPEP services (n = 97) or traditional community services (n = 94). CPEP services are based on ecological theory and involve six months of home visiting by paraprofessional women and linkage to other formal and informal community resources. No advantages on self-report measures for the CPEP group were measured at posttest, and follow-up reports of child abuse were similar for both groups. Consumer satisfaction indicates that clients highly valued the program. Some indication of greater success with families with less serious problems was observed. The results argue for caution regarding the capacities of perinatal child abuse prevention services to serve the high-risk clientele they often receive.