Getting Together For Prenatal Care

Getting Together For Prenatal Care

For some women, prenatal care might best be experienced as a group activity.

You might find that concept somewhat puzzling or even bizarre, but a couple of recent studies have found that group prenatal care can substantially improve the health of mothers and their newborns. Think about how much support you get from friends who are also pregnant, then add a knowledgeable health-care professional to the mix, and you can begin to get an idea of the potential benefits of group prenatal care.

The new research focused on a program called “Centering Pregnancy Plus,” which consists of 10 2-hour group prenatal care sessions, held at the same points during pregnancy at which women typically see a doctor or midwife for prenatal care. Each group consists of eight to 12 women who are all due to deliver at around the same time. Centering Pregnancy Plus was developed by Yale University researchers, who conducted the two new studies.

When women arrive at a group session, they weigh themselves and take their own blood pressure, charting their progress in their health records, and then a doctor or nurse checks the fetal heart rate and the fundal height (the distance from the top of the pubic bone and the top of the uterus).

That is followed by group discussion, led by a health-care professional, covering such topics as childbirth preparation and prenatal and post-delivery care as well as prevention of sexually transmitted infections. Family members are invited to join in.

The two new studies enlisted the help of 1,148 pregnant women 14 to 21 years old who were randomly assigned to either conventional or group prenatal care at one of 14 health centers in New York City. The research focused on low-income adolescent mothers because they have a higher risk of pregnancy problems.

One study, published in December, found that the women who received group prenatal care were a third less likely to deliver a baby who was small for gestational age. In addition, the group-care women had a lower risk of having a premature and/or low birth weight baby, and their babies spent fewer days in the neonatal intensive care unit. Plus, the group-care women were less likely to get pregnant again soon after delivery, and this “birth spacing” reduces the risk of a premature birth in the next pregnancy.

The second study, published in November, found that the women who had been assigned to group prenatal care gained less weight during pregnancy and lost as much as 10 to 12 pounds more in the year after delivery than those assigned to conventional prenatal care.

Exactly why the women in group prenatal care fared better and whether other pregnant women besides low-income adolescents might also benefit isn’t yet known, but the researchers are working on answering those questions. They’re collaborating with the United Health Foundation and UnitedHealth Group and scientists at Vanderbilt University and the Detroit Medical Center/Wayne State University on a new group prenatal care program called “Expect With Me.”

Women seem to be interested in group prenatal care, if a recently published survey of pregnant Canadians is any indication. The survey found that half of the respondents reported being “definitely” or “probably likely” open to participating in group prenatal care.

Given the growing rates of obesity and the importance of women’s health before and after delivery, the researchers write in one of their recently published papers, “It is time to implement a more holistic approach to the obstetric care of women.”

Makes a lot of sense.

Rita Rubin
An ob-gyn's daughter and the mother of two teenage daughters, Rita Rubin has covered medicine ever since earning a BSJ from Northwestern. Based in Washington, D.C., Rita has written for WebMD, JAMA, POZ, and NBCNews.com and previously worked for USA TODAY. She has won numerous awards for her stories and authored What If I Have a C-Section? Rita earned an MA in writing from Johns Hopkins and spent a year as a fellow at the Harvard School of Public Health. You can follow her on Twitter @RitaRubin.

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