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We all know the problems endemic to prenatal
care today: short visits, impersonal
interactions, failure to understand a woman’s
pregnancy within the context of her life, and a
hierarchical model of the doctor/patient
relationship.
A recent multi-center randomized controlled
trial lends support to providing an alternative
model of prenatal care for the same cost. Known
as the Centering Pregnancy model of group
prenatal care, it’s an approach based on
individual responsibility and group discussion.
Here’s how the study worked: After an initial
one-to-one visit, participating women attended
10 prenatal sessions with about 7 other pregnant
women due at the same time. They each met
briefly with an obstetrician or midwife to
evaluate fetal and maternal well being and
address individual concerns. Then they checked
their own weight and blood pressure and recorded
the results themselves in their charts.
The bulk of the visit, though, was spent in a
facilitated group discussion. And it all made a
huge difference when compared to women who
received traditional care.
After controlling for confounding factors, women
who experienced the Centering Pregnancy model of
care were 33% less likely to give birth
prematurely, with an even larger impact on
African American women. These women were also
more likely to initiate breastfeeding, score
better on a pregnancy knowledge questionnaire,
feel better prepared for labor and birth, and
experience more satisfaction with the prenatal
care they received.
The results shouldn’t be surprising. Consider
the total time spent in prenatal care, for
example. In the Centering Pregnancy model,
women received about 20 hours of care overall.
In the traditional model? About two hours
(based on 10-15 minute visits). Group care,
then, addresses other issues in women’s lives,
whether it be alcohol or drug use, smoking,
domestic abuse, or anything else that may be
affecting their pregnancy and well-being.
Secondly, the Centering Pregnancy model is based
on support, empowerment, and self-knowledge.
Common sense tells us that when we have support
in our lives and feel informed and empowered, we
feel better about ourselves and better able to
cope with the changes and challenges we
experience. This is especially true when it
comes to pregnancy, childbirth and new
mothering.
In the end, what’s good for mom is good for the
baby. And what’s good for the mom is pretty
straight-forward.
Source: Ickovics, J. R.,
Kershaw, T. S., Westdahl, C., Magriples, U.,
Massey, Z., Reynolds, H., et al. (2007). Group
prenatal care and perinatal outcomes: A
randomized controlled trial. Obstetrics and
Gynecology, 110(2), 330-339. [Abstract]
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