June 01, 2019 at 04:00AM by CWC
Once routine checkups no longer end with a lollipop and sticker, going to the doctor just isn’t as fun anymore. And when you’re pregnant, visiting the doctor becomes as routine as grocery shopping. Centering Pregnancy, a model for group prenatal care, is trying to make the experience feel less like a chore.
Instead of meeting with you doctor one-on-one, you have an appointment with eight to 10 other women due around the same time as you. But, if there are any complications, or other things you want to discuss solo, there’s always an option to see your provider in private.
“When you put people together and they can influence each other, the experience is so much stronger and more powerful,” says certified nurse midwife Margaret Taylor. “And certainly more effective than a midwife or physician telling a patient what to do.”
Everything that happens during a traditional appointment—belly check, fetal heart rate monitoring—still takes place, but in a room with other women, healthy snacks, and some music. And once the physical exams are over, the moms (and sometimes, their partners), the provider, and another certified leader (social workers, doulas, or tribal elders) meet for 60 to 90 minutes to learn about everything from safe sleeping practices to breastfeeding and nutrition.
“One woman’s question is likely another woman’s question.”
“One woman’s question is likely another woman’s question,” says Angie Truesdale, CEO of the Centering Healthcare Institute.
Centering Pregnancy was founded in 1993 by Sharon Schindler Rising, a Connecticut-based midwife who was frustrated only having 10 minutes with each patient. She began seeing patients in groups and training other providers in her methodology. More than 25 years later, Centering Pregnancy is available in nearly 500 locations in the U.S., with additional sites in Canada and Germany. They’ve seen rapid growth the past three years, and have doubled how many spaces they operate in the past four years, says Truesdale.
Truesdale says each session starts 30 minutes for a self-assessment, where mothers weigh themselves and take their blood pressure, and have a checkup with a provider. Then, they circle up to discuss all of the things that contribute to their health.
“Whether it’s their commute to work, or to the doctor’s office, and how stressful that might be, or environmental factors, such as secondhand smoke. You have a provider there, that’s not just checking your belly and asking you what you’re eating, but really talking about everything that’s been affecting your pregnancy,” Truesdale says. “And doing that alongside peers, that are due around the same time as you are, making friends and kind of coming out of isolation and sharing your pregnancy with people who can really understand what you’re going through.”
Group prenatal care has shown to decrease rates of preterm birth, neonatal intensive care unit admissions, and emergency department visits in the third trimester.
The American College of Obstetricians and Gynecologist cites Centering Pregnancy as the most widely used and studied model of group prenatal care. Group prenatal care has shown to decrease rates of preterm birth, neonatal intensive care unit admissions, and emergency department visits in the third trimester. It’s also shown increased birth weight, rates of breastfeeding, and improved knowledge of childbirth, family planning, postpartum depression, and early child rearing. This is especially helpful in the U.S., where woman die pregnancy-related deaths more than women in comparable countries. And black woman in particular die at a rate that’s over three times that of white women.
While this group appointment method has its benefits, some moms still prefer one-on-one appointments, sometimes for practical reasons, says Mavis Schorn, CNM, an associate dean at Vanderbilt University School of Nursing. If people don’t have reliable transportation, or have young children, she says it can be difficult to make it to a session that happens at a set time every week. Another issue is anonymity. Schorn says women in rural areas where privacy is more important voiced more discomfort with other people knowing their business, even though the group discussions are meant to remain confidential.
Taylor, who led Centering Pregnancy sessions in Memphis, Tennessee, until 2012, says the group sessions allowed her to provide better care.
“We’re always looking for better ways to do things,” Taylor says. “I can see patients all morning, and then I’d go into a group in the afternoon. And it was just so it was fun for them, fun for me, and it was much more in depth experience for being able to help women.”