Centering Pregnancy

OVERVIEW

CenteringPregnancy is a 10-week prenatal care program, delivered in a group setting, which targets pregnant adolescents.  The program begins when women are in their second trimester of pregnancy and is based on three primary components: assessment, education, and support.  For two hours each week, women begin each session with a health assessment.  Education sessions follow, led by trained practitioners.  An evaluation found a reduction in preterm births, and lower levels of inadequate prenatal care; and increases in breastfeeding initiation, prenatal knowledge, readiness for labor and delivery, and satisfaction with prenatal care. 

 

DESCRIPTION OF PROGRAM

 

Target population: Pregnant women less than 24 weeks pregnant.

 

CenteringPregnancy is a 10-week prenatal care program delivered in a group setting of approximately eight to 12 women with similar delivery dates.  The program is designed for pregnant adolescent girls and is based on three primary components of care: health/physical assessment, education and skills building, and support.  The program begins when women are in their second trimester – approximately 16 weeks--of pregnancy.  The group setting is facilitated by a trained practitioner, such as a midwife or obstetrician.  Women begin each two-hour session with a health assessment that might include a blood pressure screening, blood  tests, and fetal heart rate monitoring – all of which can be completed in a group setting.  Women are encouraged to maintain copies of their own health information to increase their self-empowerment and self-efficacy.  Education sessions follow the health assessment and are led by the trained practitioners.  These educational discussions, based on a structured manual, often center on prenatal care, preparation for childbirth, and caring for infants after birth.  Except for the initial assessment, all prenatal care takes place in a group setting.  In these two-hour sessions women can receive “one-stop shopping,” with all services provided in a group setting of mutual support.  Group sessions can be held at community centers or conference rooms, thereby reducing the need for medical examination rooms. 

 

EVALUATION OF PROGRAM

 

Ickovis, J., Kershaw, T. S., Westdahl, C., Magriples, U., Massey, Z., Reynolds, H., & Schindler Rising, S. (2007). Group prenatal care and perinatal outcomes: A randomized controlled trial. Obstetrics and Gynecology, 100(2), 330-339.

 

Evaluated population: A total of 1,047 adolescent girls and young women (14-25 years) from one of two publicly-funded clinics in Atlanta, GA and New Haven, CT.  The group’s mean age was 20 years, and had a mean of 11 years of education.  Approximately 80 percent of the participants were black, and 15 percent were Latina.  Participants were less than 24 weeks pregnant.

 

Approach: Women entering one of two publicly-funded prenatal care clinics were enrolled and randomly assigned to either the groupcare intervention (n = 653) or the standard-care control group (n = 394).  Participants were assessed on birth and psychosocial outcomes: preterm birth, infant birth weight, adequacy of prenatal care, Apgar score, breastfeeding, pregnancy knowledge, prenatal distress, labor and delivery readiness, infant care readiness, and satisfaction with prenatal care.  Women assigned to the control group received the standard one-on-one prenatal care.  Participants were assessed at baseline and were followed for one year after the baby’s birth, and they were paid $20 for completing each interview. 

 

Results: Analyses showed a significant improvement in the rates of preterm births and inadequate prenatal care among women in the intervention group compared with those in the control group.  There were also significant positive effects on breastfeeding initiation, prenatal knowledge, readiness for labor and delivery, and satisfaction with prenatal care.  There was a marginal impact on readiness for infant care, and no impacts on rates of fetal death, low birth weight, Apgar score, or prenatal distress. 

 

SOURCES FOR MORE INFORMATION

 

http://www.centeringhealthcare.org/

https://www.centeringhealthcare.org/Store/index.php

 

References

Ickovis, J., Kershaw, T. S., Westdahl, C., Magriples, U., Massey, Z., Reynolds, H., & Schindler Rising, S. (2007). Group prenatal care and perinatal outcomes: A randomized controlled trial. Obstetrics and Gynecology, 100(2), 330-339.

 

KEYWORDS: Adolescents, Youth, Young adults, Female-only, Black/African American, Adolescent mothers, Community-based, Parent training, Births, Sexual Activity, Condom use and contraception, STD/HIV/AIDS, Manual, Cost

 

Program information last updated on 11/8/10.

 

 

 

 

 

		© Child Trends 2004