Group Prenatal Program Brings Expectant Moms Together
The Von Voigtlander Women’s Hospital introduces a program designed to increase the time patients spend with their obstetrics and gynecology teams.
OB-GYN Katherine Pasque, M.D., and certified nurse midwife Melisa Scott, CNM, have introduced a new baby to the University of Michigan Von Voigtlander Women’s Hospital: a group prenatal program offering patients a tenfold increase in the time they spend with their OB-GYN care team.
Modeled after the nationwide CenteringPregnancy program, group prenatal care brings together six to 12 women — some new moms, some veteran moms — who have due dates within four weeks of one another. They meet to discuss the challenges of pregnancy, childbirth and the postpartum period. A provider acts as a facilitator.
“In standard prenatal care, people get about three to five minutes, maybe eight minutes, with their provider face to face, but in this program you get two hours once a month,” says Scott, who hosts group prenatal care at Von Voigtlander.
At the monthly meetings, the expectant moms arrive at a conference room at the doctor’s office, skipping the waiting room entirely. While there, they:
Help each other complete a weight and blood pressure check and record it in a log
Have one-on-one time with a physician to measure the growing baby, hear the heart tones and discuss any issues
Participate in interactive learning discussions complete with a snack and music
Build a community with other expectant moms that supports positive health behaviors
“The idea is to learn from each other and to help prepare these expectant moms for everything, including that so-called fourth trimester, the first six weeks postpartum,” Pasque says.
Partners and support people may attend as well.
Setting the education agenda
Diane Rice, of Saline, Michigan, says the experience boosted her confidence after giving birth to her first child, daughter Alice.
“It was helpful that other members asked questions that I might not have thought to ask,” Rice says. “In addition to the usual medical information, we also learned about things like babywearing (using slings) and breastfeeding, which might not have been discussed at a typical prenatal appointment.”
Group prenatal care isn’t a class where the provider lectures, but it’s a place for the group to explore topics that interest them, like friends getting together to chat, Scott says.
“If a friend tells you something, you usually take it to heart rather than if someone preaches to you,” Scott says.
Sometimes a question raised privately by a patient can prompt Pasque to discuss it with the group. She always gets permission first from the original questioner, who isn’t identified as the one who asked.
“Somebody asked about back pain, so in the group we discussed why it’s happening and what strategies everyone has used to help it,” says Pasque, who offers the group at Briarwood Center for Women, Children and Young Adults. “That’s one benefit to having first-time moms and veteran moms together.”
The gathering is designed to be social, so they offer snacks, have background music — typically an attendee’s favorite playlist — and sit in a circle.
Empowerment leads to better outcomes
The social aspect also influences each health assessment, Scott says.
Participants receive a book to bring to every session. It includes instruction on the pregnancy journey and has space for the expectant mom to log her weight and blood pressure. Taking blood pressure requires help from another expectant mom, which prompts conversation and togetherness. The task also generates more awareness, Rice says.
“Typically at an office visit, I never pay attention to what my vitals are when the medical assistant is taking and recording them,” she says. “Logging them myself made me pay more attention and made them of greater interest to me. I found myself comparing my stats from one visit to the next.”
Because of this awareness, the new moms have better outcomes, Scott says, citing CenteringPregnancy findings. Participants are more likely to gain the appropriate amount of weight for their body size, which often translates to fewer health complications during pregnancy, she adds.
It also translates to fewer preterm births (before 37 gestational weeks) and more healthy weights in newborns, Scott adds. A CenteringPregnancy study found its group prenatal care reduced preterm deliveries by 33 percent overall and 41 percent among African-American women.
Preventing a single preterm baby saves $53,000 in expenses, according to the study.
“Recording their vitals gives them accountability and empowerment,” Scott says.
Trust the process
Pasque and Scott typically write a topic of the day on a dry-erase board to stimulate conversation if participants are shy about sharing.
Some women express initial concern about discussing their medical issues, but they tend to feel more comfortable after signing privacy forms and helping create the rules around the group, Pasque says.
“If that meant no cellphones or posting on social media, then everyone respected that,” Pasque says.
The women rarely held back, she says, bringing up everything from having something unusual show up on an ultrasound to sharing their previous gestational diabetes or miscarriage experiences.
Pasque and Scott were active facilitators, sharing their own pregnancy and childbirth tribulations.
“It was refreshing getting to know them on a more personal basis and being able to relate to them as moms versus just on a doctor-patient level,” Rice says.
Pasque said she found it energizing to have the deep connection, and it led to higher job satisfaction, too.
“There were times when I thought to myself, ‘This has been so much fun’ or ‘This is a great day,’ while with the group,” Pasque says.
She hopes the group continues to get together on their own to help each other as their children grow.
Future of group prenatal care
Currently, only low-risk expectant moms may partake in group prenatal care, although Pasque and Scott see a day when they might have groups for expectant moms of twins — typically a higher-risk group. Women are invited to join a group when they call for an initial prenatal appointment. That’s when they discover that it costs the same as traditional prenatal care.
Word-of-mouth about the group experience has led to more people wanting to join. As a result, more Von Voigtlander professionals are going through CenteringPregnancy training, Scott says.
That makes new mom Rice happy.
“I think the Centering group is a very progressive and valuable resource that U-M has decided to offer,” Rice says. “I hope other groups of pregnant women get the opportunity to benefit from group care. I am very happy with my decision to join the group and would do so again for subsequent pregnancies.”