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The Power of Group Pregnancy Care: BMC’s CenteringPregnancy® Program

CenteringPregnancy® group session.

When we go through any new experience, it is natural for us to seek out advice from those who have faced something similar. We often ask a friend or family member, “What was it like for you?” as we determine what plan makes the most sense. Having a community to rely on and relate to throughout a life experience is invaluable—finding a common thread with others helps manage the situation and ease anxiety. Pregnancy is certainly no exception to this.

From what to purchase for your new baby to how to treat backaches, Boston Medical Center’s CenteringPregnancy® program recognizes the value of peer input during pregnancy, especially for those who are missing this social connection. Caring for more than 1,250 women since 2008, the group prenatal care program continues to place the shared pregnancy experience at the forefront of its mission. Transforming prenatal care from an individual care setting where patients typically see their doctor for only 10 to 15 minutes at each appointment, Centering patients are joined by eight to 12 fellow expecting mothers with similar due dates, and they spend two hours together at each appointment—a total of 20 hours over the course of the pregnancy. With each appointment involving a health assessment, education and support, women learn how to take their own blood pressure, spend one-on-one time with their doctor or midwife and unite as a group to discuss important topics related to pregnancy.

During the sessions, the clinician facilitates a discussion from a comprehensive curriculum and everyone exchanges questions, answers and experiences. Some groups even include the fathers. “Group represents the natural progression of how we learn and change our behaviors—the core of a healthy pregnancy—because it’s about learning from each other,” says Beth Monahan, CNM, MPH, director of Centering Group Care at Boston Medical Center. “A doctor may recommend a certain type of pain management for labor to her patient, but it may not always resonate right away. When the patient is able to hear from her peers about their experiences with that type of pain management during group, that’s when the information really sticks because she is able to hear firsthand about real-life examples from women who are just like her.”

Through a collaborative conversation, this revolutionary approach is deeply empowering for patients—including both first-time and veteran moms. “Women get the experience of being the expert, giving each other advice about anything from the practical, like what to look for when purchasing a baby carrier to topics like how to tell if you broke your water. The opportunity of being the expert is really rewarding and self-affirming, and it’s also really fun,” says Monahan.

Jodi Abbott, MD, obstetrics and gynecology and maternal fetal medicine specialist—who became involved to see if group prenatal care would reduce the risk of preterm delivery among her at-risk patients—has found her interactions with her patients to be more multifaceted. “With group, the medical elements don't change from individual care. What's enhanced is everything else. So without taking away the face time with your doctor, you add so much more and build a deeper kind of relationship,” says Abbott. “There are a lot of voices in one’s decision-making and Centering brings all the voices together. In a lot of ways it's about creating the proverbial ‘village.’”

Over the course of their time together, a bond grows between the women in the group. They laugh and share in the lighter moments of pregnancy, like candidly weeding out what you really don’t need to pack in your hospital bag, to more personal ones like coping with unstable living conditions. For one mother-to-be who was living in a shelter, she explained that she did not have anyone to call if she needed something. Another woman in the group gave the woman her number, saying, “You can call me. I’m your person now.”

“It’s a profound ability to be so vulnerable to confess to a group of people that you are so isolated,” explains Abbott. “But you have a group of people who are responding and saying, ‘It's going to be okay, I know what you’re going through.’ That’s what makes it a beautiful model for everybody.” And the communal spirit does not stop there—women in the program are often connected with family partners from Boston Healthy Start to help them with housing, jobs and education. Leveraging resources within their own community, family partners offer support and care to new moms. “This is about engaging a community as much as it is about providing health care,” says Abbott.

By having a group prenatal care program available, women who participate in the program have healthier pregnancies, which has reduced complications and preterm deliveries. As one of only a few hospitals in the country with a program of this size, BMC continues to research the effect of group prenatal care on its patients and will soon be publishing the data. “The outcomes mirror what others have found, which is that this model is very safe, very effective and helps women feel supported and have healthy outcomes in their pregnancy,” concludes Monahan. “The basis for why this model has yielded significantly positive results is because of the peer-to-peer social support—something that had never been incorporated into the pregnancy care setting before.”

In addition to facilitating healthy pregnancies—something truly priceless in and of itself—the peer-to-peer connection enriches the lives of the women in CenteringPregnancy®. Whether it is sharing tips or phone numbers, the time spent together and the bond that grows readies these women to take on the most rewarding challenge of all: motherhood.

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