We evaluated a comprehensive program of prenatal and postpartum nurse home visitation for socially disadvantaged women bearing first children. Eighty-five per cent of the participating women were either teenagers (less than 19 years at registration), unmarried, or of low socioeconomic status. Women were randomly assigned to either nurse home visitation or comparison services (free transportation for prenatal and well-child care and/or sensory and developmental screening for the child). During the first four years after delivery of their first child, in contrast to their counterparts in the comparison group, nurse-visited White women who had not graduated from high school when they registered in the study returned to school more rapidly; nurse-visited, poor, unmarried White women showed an 82 per cent increase in the number of months they were employed, had 43 per cent fewer subsequent pregnancies, and postponed the birth of second children an average of 12 months longer.