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To evaluate the effect of participation in group prenatal care (GPNC) compared with participation in traditional prenatal care (TPNC) on enrollment in the post-partum family planning waiver program among South Carolina women enrolled in Medicaid during pregnancy.
South Carolina Medicaid billing data was linked to birth certificate records to create a retrospective cohort of women delivering at a single hospital between May 2009 and May 2010. Women who chose to participate in GPNC were matched with women in TPNC using propensity scores. Multivariate logistic regression was used to examine differences in rates of participation in the Medicaid family planning waiver program by 3 months post-partum.
339 women participating in GPNC were compared with 602 in TPNC. With the exception of tobacco use during pregnancy, the propensity matched cohort was balanced across all descriptive covariates. The rate of enrollment in the family planning waiver was 57.8% (n=196) for GPNC, as compared with 43.7% (n=263) in TPNC (p<0.05). Multivariate analysis confirmed women in GPNC were more likely to enroll in family planning by 3 months post-partum (AOR 2.02, 95% CI 1.48-2.75).
This study found GPNC to be associated with improved enrollment in the family planning Medicaid waiver program. It expands the evidence base supporting GPNC by documenting improved transitioning into other important health service programs during the post-partum period compared to a rigorously matched cohort of women receiving TPNC. Previous studies have found participation in GPNC to be associated with improved birth outcomes. The current project evaluates ways GPNC participation could have a more lasting impact on women's health.