Objective: Implementation fidelity is a key issue in home-visiting programs, as it determines a program’s effectiveness in achieving its original goals. This paper seeks to evaluate fidelity in a 27-month program addressing maternal and child health that took place in France between 2006 and 2011. Method: To evaluate implementation fidelity, home visit case notes were analyzed using thematic qualitative and computer-assisted linguistic analyses. Results: During the prenatal period, home visitors focused on the social components of the program. Visitors discussed physical changes during pregnancy, as well as psychological and social environment issues. Discussions of immigration, unstable employment, financial issues, family relationships and dynamics, and maternity services—though not expected—were found in the case notes. Conversely, health during pregnancy, early childhood development, and postpartum mood changes were not identified as topics in the prenatal case notes. During the postnatal period, most components of the intervention were addressed: home visitors observed the mother’s adaptation to the baby; routine themes such as psychological needs and medical-social networks were evaluated; information on the importance of social support and on adapting the home environment was provided; home visitors counseled on parenting skills and addressed mothers’ self-esteem issues; finally, they helped to find child care when necessary. Some topics were not addressed or were only partially addressed: health education, child development, the home environment, the mother’s educational plans and personal routine, partner support, and playing with the child. Other topics were unexpected but were found in the case notes: social issues, the mother-family relationship, interactions with services, couple issues, the quality of maternal behavior, and the child’s language development. Conclusions: In this program, home visitors experienced difficulties addressing some of the objectives because they prioritized the families’ urgent needs. This research emphasizes the importance of training home visitors to adapt the intervention to the social, psychological, and health needs of families. [author’s abstract]