Program

Nov 08, 2010

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.

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