The Nurse-Family Partnership, a program of prenatal, infancy, and toddler home visitation by nurses for low-income mothers bearing their first children, is designed to improve the outcomes of pregnancy, children's health and development, and parents' economic self-sufficiency. This study examined the effect of statewide dissemination of the program on subsequent pregnancies of first-time mothers. There was no effect of the program on second pregnancies in the first few years of the program. Subsequently, the program significantly reduced the risk of second pregnancies among mothers aged 18 years or younger, and the effect was twice as strong among young mothers in rural locations compared with urban locations. The finding of potentiated benefit in rural locations would seem to justify implementation in such locations in addition to urban areas, greatly expanding the reach of the program.