Expectant mothers in Southeastern North Carolina have the opportunity to experience prenatal care in a group setting that offers patient education augmented by group discussion and, ultimately, improved outcomes. NHRMC Physician Specialists - OB/GYN Specialists has adopted centering, a method that offers women group prenatal care in a comfortable setting.
Candace Briles, a new mother who recently participated in a centering group at OB/GYN Specialists, praises the program. “It humanized the experience rather than being so medical. It was a very relaxed and casual interaction.”
"Centering Pregnancy is a patient-centered model of care that provides childbirth education and peer support,” said Jeffrey Stinson, MD, of NHRMC Physician Specialists - OB/GYN Specialists. “It is more efficient for the clinic and provides an innovative approach to resident education.”
OB/GYN Specialists implemented the program about four years ago at the suggestion of two nurse practitioners. It was certified by the Centering Healthcare Institute in October 2016.
During centering, expectant mothers with similar due dates are placed into groups of up to 10 that meet 10 times during their pregnancies.
Centering tends to offer a pleasant, personable experience. Upon arrival, the centering patients gather in the meeting room and begin visiting. “From the moment they arrive, they're interacting with providers and socializing,” Stinson said. “The total time is not much more than a traditional visit, and all that time is used.”
The women receive handbooks that discuss each topic in detail, and they record their vital signs in the book. Once their vital signs have been taken, the women move behind a screen for private belly checks. They visit while others check in and then move into a circle of chairs to discuss the topic of the day.
“It's a very conversational style. We often have music on, and the women are having snacks, socializing, and hanging out with each other,” says Ann Jaworski, a nurse practitioner who helped implement the program. “The patients are coming in smiling and happy.”
Each session lasts one and a half to two hours. The residents and medical assistants lead the sessions, but the women are active participants. “We're letting them problem solve and share stories, and we guide the discussions,” Jaworski said.
Discussing what was normal and what to look out for helped Briles relax. “It reduced that fear of all the unknowns. For me, it took the fear out of giving birth.”
A recent session focused on preterm labor, and one of the moms actually went into preterm labor two days later. By knowing the signs and heading to the hospital, she was able to save her baby. She said if she hadn't understood it, she might not have gone to the hospital and there could have been a different outcome.
Aside from the better care, the women also gain extra support from the other members. Jaworski said, “They are developing a network of support that you simply don't get in traditional care. They make connections that last way beyond pregnancy.” The groups often have reunions six to eight weeks after the last member has given birth. One group has continued to meet for playdates a year after giving birth.
In addition to the support benefits, there are also improved health benefits. Stinson says, “they come out more confident about their healthcare.”
Ultimately, women who participate in centering tend to see improved outcomes. “There are a lot of benefits proven over time, such as lower pre-term deliveries, lower c-section rates, higher breastfeeding initiation, higher rates of contraceptive use after delivery and higher show rates for postpartum visits,” Stinson said.
Briles says she would definitely do centering again. “I'd recommend it to anyone.” One of her favorite parts was getting to spend extra time with her providers. “I think you form a better relationship with your providers because you're spending more time with them.”
The practice is hoping to add more groups and continue to expand the program. The providers are also looking forward to offering the program to Spanish-speaking women in the near future.
To learn more about centering at the Betty H. Cameron Women’s & Children’s Hospital, call 910.662.9300.