Patients participating in group prenatal care gather together with women of similar
gestational ages and 2 providers who cofacilitate an educational session after a brief
medical assessment. The model was first described in the 1990s by a midwife for low-risk
patients and is now practiced by midwives and physicians for both low-risk patients
and some high-risk patients, such as those with diabetes. The majority of literature
on group prenatal care uses CenteringPregnancy, the most popular model. The first
randomized controlled trial of CenteringPregnancy showed that it reduced the risk
of preterm birth in low-risk women. However, recent meta-analyses have shown similar
rates of preterm birth, low birthweight, and neonatal intensive care unit admission
between women participating in group prenatal care and individual prenatal care. There
may be subgroups, such as African Americans, who benefit from this type of prenatal
care with significantly lower rates of preterm birth. Group prenatal care seems to
result in increased patient satisfaction and knowledge and use of postpartum family
planning as well as improved weight gain parameters. The literature is inconclusive
regarding breast-feeding, stress, depression, and positive health behaviors, although
it is theorized that group prenatal care positively affects these outcomes. It is
unclear whether group prenatal care results in cost savings, although it may in large-volume
practices if each group consists of approximately 8–10 women. Group prenatal care
requires a significant paradigm shift. It can be difficult to implement and sustain.
More randomized trials are needed to ascertain the true benefits of the model, best
practices for implementation, and subgroups who may benefit most from this innovative
way to provide prenatal care. In short, group prenatal care is an innovative and promising
model with comparable pregnancy outcomes to individual prenatal care in the general
population and improved outcomes in some demographic groups.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Obstetrics & GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A small group can go a long way.MCN Am J Matern Child Nurs. 1988; 13: 414-418
- Centering pregnancy: an interdisciplinary model of empowerment.J Nurse Midwifery. 1998; 43: 46-54
- “Expecting and Connecting” group pregnancy care: evaluation of a collaborative clinic.Women Birth. 2016; 29: 416-422
- Group prenatal care and perinatal outcomes.Obstet Gynecol. 2007; 110: 330-339
- The effect of CenteringPregnancy group prenatal care of preterm brith in a low-income pouplation.Am J Obstet Gynecol. 2012; 206: 415.e1-415.e7
- Group versus traditional prenatal care: a retrospective cohort study.Am J Obstet Gynecol. 2016; 214: S161
- Group versus conventional antenatal care for women.Cochrane Database Syst Rev. 2015; : CD007622
- Group prenatal care compared with traditional prenatal care.Obstet Gynecol. 2016; 128: 551-561
Parikh LI, Jelin AC, Iqbal SN, et al. Glycemic control, compliance, and satisfaction for diabetic gravidas in centering group care: glycemic control, compliance, and satisfaction for diabetic gravidas in centering group care. J Matern Neonatal Med. 2016 Jul 21:1-6. [Epub ahead of print].
- Comparison of selected outcomes of CenteringPregnancy versus traditional prenatal care.J Midwifery Womens Health. 2006; 51: 266-272
- The effect of Centering Pregnancy versus traditional prenatal care models on improved adolescent health behaviors in the perinatal period.J Pediatr Adolesc Gynecol. 2015; 28: 395-401
Schellinger MM, Abernathy MP, Amerman B, et al. Improved outcomes for Hispanic women with gestational diabetes using the Centering Pregnancy group prenatal care model. Matern Child Health J 2017;21:297-305.
- Pregnancy outcomes of adolescents enrolled in a CenteringPregnancy program.J Midwifery Womens Health. 2004; 49: 412-420
Brumley J, Cain MA, Stern M, Louis JM. Gestational weight gain and breastfeeding outcomes in group prenatal care. J Midwifery Womens Health 2016 Jul 18. [Epub ahead of print].
- A randomized clinical trial of group prenatal care in two military settings.Mil Med. 2011; 176: 1169-1177
- Effects of centering pregnancy group prenatal care on breastfeeding outcomes.J Midwifery Womens Health. 2013; 58: 389-395
- Outcomes of Latina women in CenteringPregnancy group prenatal care compared with individual prenatal care.J Midwifery Womens Health. 2013; 58: 396-403
- Comparing CenteringPregnancy to standard prenatal care plus prenatal education.BMC Pregnancy Childbirth. 2013; 13: S5
- A comparison of health behaviors of women in Centering Pregnancy and traditional prenatal care.Matern Child Health J. 2010; 14: 202-208
- Effects of group prenatal care on psychosocial risk in pregnancy: results from a randomised controlled trial.Psychol Health. 2011; 26: 235-250
- The impact of group prenatal care on pregnancy and postpartum weight trajectories.Am J Obstet Gynecol. 2015; 213: 688.e1-688.e9
- Comparative effectiveness of group and individual prenatal care on gestational weight gain.Matern Child Health J. 2014; 18: 1711-1720
- The impact of Centering Pregnancy group prenatal care on postpartum family planning.Am J Obstet Gynecol. 2014; 210: 50.e1-50.e7
- Cluster randomized controlled trial of group prenatal care: perinatal outcomes among adolescents in New York City health centers.Am J Public Health. 2016; 106: 359-365
- Mini-review: risk factors for rapid repeat pregnancy among adolescent mothers: a review of the literature.Pediatr Adolesc Gynecol. 1998; 11: 115-126
- Vital signs: repeat births among teens—United States, 2007–2010.MMWR Morb Mortal Wkly Rep. 2013; 62: 249-255
- Which pregnant adolescents would be interested in group-based care, and why?.J Pediatr Adolesc Gynecol. 2015; 28: 508-515
- A tri-service perspective on the implementation of a centering pregnancy model in the military.J Obstet Gynecol Neonatal Nurs. 2012; 41: 315-321
- Group prenatal care outcomes in a military population: a retrospective cohort study.Mil Med. 2015; 180: 825-829
- Women’s experience of group prenatal care.Qual Health Res. 2011; 21: 97-116
- Introduction of CenteringPregnancy in a public health clinic.J Midwifery Womens Health. 2009; 54: 27-34
- Improved adequacy of prenatal care and healthcare utilization among low-income Latinas receiving group prenatal care.J Womens Health. 2013; 22: 1056-1061
- Exploring group composition among young, urban women of color in prenatal care: implications for satisfaction, engagement, and group attendance.Womens Health Issues. 2016; 26: 110-115
- Comparison of Centering Pregnancy to traditional care in hispanic mothers.Matern Child Health J. 2009; 13: 407-414
- Outcomes of group diabetic care in a Hispanic population: the DULCE program.Am J Obstet Gynecol. 2009; 201: S106
- Group prenatal care for women with diabetes.J Matern Fetal Neonatal Med. 2016; 29: 2852-2856
- Group prenatal care for women with pre-gestational type II diabetes mellitus: a cost-effectiveness analysis.Am J Obstet Gynecol. 2014; 210: S190
Ohno M, Rodriguez MI, Wiener S, Caughey AB. Centering Pregnancy for the prevention of preterm birth: a cost-effectiveness analysis. Presented at the 34th Annual Meeting of the Society for Medical Decision Making, 2012, Phoenix, Arizona.
- Group prenatal care results in Medicaid savings with better outcomes: a propensity score analysis of CenteringPregnancy participation in South Carolina.Matern Child Health J. 2016; 20: 1384-1393
- Group prenatal care: review of outcomes and recommendations for model implementation.Obstet Gynecol Surv. 2014; 69: 46-55
- Group prenatal care: a financial perspective.Matern Child Health J. 2016; 20: 1-10
- Group prenatal care: an analysis of cost.J Health Care Finance. 2008; 34: 31-41
Cross-Barnet C, Clark W, Hill I, et al. Strong Start for Mothers and Newborns evaluation: year 2 annual report volume 1: cross-cutting synthesis of findings. March 2016. Available at: https://downloads.cms.gov/files/cmmi/strongstart-enhancedprenatalcare_evalrptyr2v1.pdf. Accessed October 28, 2016.
Cunningham SD, Grilo S, Lewis JB, et al. Group prenatal care attendance: determinants and relationship with care satisfaction. Matern Child Health J 2016 Aug 2. [Epub ahead of print].
- Perceptions of barriers and facilitators during implementation of a complex model of group prenatal care in six urban sites.Res Nurs Health. 2015; 38: 462-474
- A qualitative descriptive study of the group prenatal care experience: perceptions of women with low-risk pregnancies and their midwives.BMC Pregnancy Childbirth. 2014; 14: 334
- Voices along the journey: midwives’ perceptions of implementing the CenteringPregnancy model of prenatal care.J Perinat Educ. 2011; 20: 210-217
- A qualitative study of the experience of CenteringPregnancy group prenatal care for physicians.BMC Pregnancy Childbirth. 2013; 13: 56
- Midwives’ experiences of becoming CenteringPregnancy facilitators: a pilot study in Sydney, Australia.Women Birth. 2013; 26: e31-e36
- A review of prenatal group care literature: the need for a structured theoretical framework and systematic evaluation.Matern Child Health J. 2012; 16: 177-187
- CenteringPregnancy and the current state of prenatal care.J Midwifery Womens Health. 2004; 49: 406-411
Article Info
Publication History
Published online: February 10, 2017
Accepted:
February 6,
2017
Received in revised form:
January 26,
2017
Received:
November 23,
2016
Footnotes
Support for this work was provided, in part, by a grant from the Robert Wood Johnson Foundation (74250) to Dr. Carter. The views expressed here do not necessarily reflect the views of the Foundation. Dr Mazzoni receives funds from the Administration for Children and Families .
The authors report no conflict of interest or financial disclosures.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
