×

Better together: The benefits of group prenatal care

  • Group prenatal care is becoming a popular alternative to the traditional individual visits. Getty Images Stock photo



For the Recorder
Wednesday, April 18, 2018

Historically, pregnant women lived within communities and extended families which provided information and support during pregnancy and birth. In today’s society, however, women often find themselves isolated, over-scheduled and turning to internet searches and social media to answer their questions and find support.

Prenatal care is intended to provide medical care and education throughout the course of a pregnancy. It includes regular health assessments such as blood pressure screening, laboratory testing and information targeted at preventing or identifying risk factors. In the United States, prenatal care usually consists of 12 to 15 one-on-one visits with a doctor or midwife.

However, many women are not satisfied with this due to short visit times, long waits and the focus on prenatal tests and procedures.

Group prenatal care is becoming a popular alternative to the traditional individual visits. It provides a forum for questions and an opportunity to build a community of families with children of similar ages. The group usually consists of 8 to 10 pregnant women and their support person, a group facilitator and a certified nurse midwife. Two-hour sessions occur every two to four weeks, often during the evening to accommodate busy work schedules.

Group prenatal care emphasizes the woman’s capacity to make her own choices and take control of her pregnancy and health. She weighs herself, takes her own blood pressure and documents the findings in her chart. She then has a “belly check” with the midwife to check on the baby’s health.

The rest of the session is an opportunity for each woman and her support person to meet and learn with other pregnant couples. Group discussions are led by the midwife and facilitator, and include a wide range of topics including nutrition, exercise, discomforts of pregnancy, stress management and choosing a pediatric health care provider. Groups also can address how to deal with unexpected complications, or what to do if a woman needs a cesarean section.

There is ample opportunity in sessions for people to share questions, concerns, joys and fears. Families get to know each other, and often establish friendships that last long after the birth of their children.

The majority of research on the outcomes of group prenatal care has shown significant benefits. It is associated with a decrease in preterm birth, decreased admissions to a neonatal intensive care unit and decreased emergency room visits in the third trimester of pregnancy. It is also associated with increased infant birth weight, longer time breastfeeding, increased knowledge of childbirth, family planning, postpartum depression and early child rearing.

In one study that compared 207 group prenatal care patients with 414 traditional care patients, the group care was associated with a decrease in low birth-weight infants, lower likelihood of cesarean delivery, and less incidence of a low APGAR score (a measure used to evaluate the newborn’s transition after birth) or need for neonatal intensive care.

Studies that included low-income black women found even more pronounced benefits suggesting that group prenatal care may be a way to address health disparities in diverse populations.

Group prenatal care for adolescents is associated with increased self-esteem, decreased social conflict, improved attendance to prenatal visits, more appropriate weight gain, increased breastfeeding, increased use of postpartum contraception and decreased rates of a repeat pregnancy in 12 months after birth.

Large studies on the impact of group prenatal care by race, socio-economic class or ethnicity are lacking. Nonetheless, the positive evidence that is available has encouraged many providers to endorse it as an exciting alternative to traditional individual care.

“I can’t say enough good things about the prenatal care group,” recalls one mother. “We learned so much from listening to other couples and have made good friends in the process. We often reflect back on how special the process of meeting in a group was, and how lucky we feel to have been offered that experience.”

Annemarie Heath, certified nurse midwife, is co-medical director of Cooley Dickinson Women’s Health.