Although frequent, most prenatal visits are quick after the initial intake appointment.
When women are pregnant, they usually see their obstetric provider at some point in the first trimester, and then once a month. Once the third trimester begins, the visits become more frequent, occurring first every other week and then every week for the last four to six weeks.
In our office, most return prenatal visits are allowed a 7.5-minute time block in the schedule. There is time for a quick chat about how the mother is feeling and any concerns she may be having, followed by a “belly check,” during which the provider listens to the fetal heart tones and measures the interval growth of the fundus of the uterus.
There is usually little time left over for teaching the basics of maternal and fetal health, or for answering questions about childbirth, breastfeeding and parenting, or assessing the mother’s emotional and mental well-being.
Thankfully there is a better way to care for pregnant women. Our practice is just beginning to implement a method called CenteringPregnancy.™
CenteringPregnancy™ is group prenatal care, and so much more. Pregnant moms join a group after their initial intake prenatal visit. The group, facilitated by a provider, consists of eight to 12 women at similar gestational ages. They meet regularly for 10 sessions during the prenatal and initial postpartum period.
According to CenteringHealthcare,™ the method is a multifaceted model of group care that integrates the three major components of care — health assessment, education and support — into a unified program within a group setting.
During each session, women learn and participate in self-care activities, such as measuring their weight and taking their own BP. The practitioner does each woman’s “belly check” in a semi-private area within the group space. The group then spends at least an hour in facilitated discussion and education, which is usually fun and interactive.
Studies show that CenteringPregnancy™ effectively reduces preterm birth rates and increases birth weight. It may also help decrease rates of postpartum depression and increase breastfeeding rates.
Both moms and providers report a higher satisfaction with CenteringPregnancy™ compared with traditional prenatal visits.
The benefit of CenteringPregnancy™ for moms is that there is no waiting and no downtime. Sessions start and end at the same time, and group members are doing something during the entire session. Expectant parents can meet peers and tend to form bonds that last beyond the pregnancy.
The beauty for me as a healthcare provider, is that I’m getting to know my patients better. I’m not repeating the same rushed education 10 times. Instead, I’m facilitating discussion about important topics, and learning as much from the groups as they learn from me. The CenteringPregnancy™ method truly rethinks the way we deliver health care. It is worth considering implementing similar programs in your practice.
Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.
- Ickovics et al. Group prenatal care and perinatal outcomes: a randomized controlled trial. Obstet Gynecol. 2007;110:330-339.
- Klima CS, Vonderheid S, Norr K, Handler A. Introduction of CenteringPregnancy™ in a public health clinic. J Midwifery Womens Health. 2009;54(1):27-54.