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Beyond the traditional models of group prenatal care: the case for Moms2B

Published:September 06, 2017DOI:https://doi.org/10.1016/j.ajog.2017.08.117
      To the Editors:
      We read with interest the review of Mazzoni and Carter
      • Mazzoni S.E.
      • Carter E.B.
      Group prenatal care.
      of the topic of group prenatal care (GPNC). As noted, GPNC is a complex and difficult model to achieve in health systems designed for individual prenatal care (IPC).
      We have developed an alternative, scalable community-based group model (CGM) that addresses the barriers faced by health systems in utilizing GPNC. The model, called Moms2B, has been implemented to date in predominantly African-American neighborhoods in Columbus, OH, to address disparities in infant mortality, preterm births, and low birthweight babies.
      We recently described our model and reported a 5-fold reduction in infant mortality at our first site.
      • Gabbe P.T.
      • Reno R.
      • Clutter C.
      • et al.
      Improving maternal and infant child health outcomes with community-based pregnancy support groups: outcomes from Moms2B Ohio.
      At Moms2B, a multidisciplinary team of health professionals empowers women living in poverty through weekly, 2 hour sessions focused on pregnancy and parenting education, stress reduction, and healthy nutrition. This CGM serves as an adjunct to traditional IPC and addresses the barriers to the implementation of traditional GPNC models as outlined in the Table.
      TableBarriers to implementation of traditional group prenatal care models and Moms2B’s approach
      GPNC barriersMoms2B CGM

      response to barriers
      Accepts only women with low-risk pregnanciesAll low-income pregnant women are welcome, including those with high-risk pregnancies
      Requires adequate space for group sessions in clinicsCommunity based and can be easily implemented in churches and other public meeting spaces
      Children of pregnant women are not allowed at the prenatal group sessionsProvides developmentally stimulating childcare for children of all ages
      Appointments must be scheduled in groups based on women’s gestational ageSessions are held at the same time every week in the same setting. Women of all gestational ages attend together. Once delivered, women are encouraged to continue to attend with their children until their newborn’s first birthday.
      It is difficult to recruit and retain women at the same gestational age to maintain a cohesive group experienceReferrals come from multiple sources: prenatal clinics, WIC clinics, and community outreach. Women are excited to attend and often develop close relationships with other mothers in the community.
      CGM, community group model; GPNC, group prenatal care; Moms2B, CGM model; WIC, Women, Infants, and Children.
      Gabbe. The case for Moms2B. Am J Obstet Gynecol 2018.
      In summary, we suggest the CGM that we have developed allows health systems to continue to use their current IPC model while also addressing the social determinants of health in high-risk populations, thereby improving maternal and infant health. This alternative to GPC could be replicated in other sites and details regarding the program are available from the authors.

      References

        • Mazzoni S.E.
        • Carter E.B.
        Group prenatal care.
        Am J Obstet Gynecol. 2017; 216: 552-556
        • Gabbe P.T.
        • Reno R.
        • Clutter C.
        • et al.
        Improving maternal and infant child health outcomes with community-based pregnancy support groups: outcomes from Moms2B Ohio.
        Matern Child Health J. 2017; 21: 1130-1138

      Linked Article

      • Group prenatal care
        American Journal of Obstetrics & GynecologyVol. 216Issue 6
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          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.
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      • Reply
        American Journal of Obstetrics & GynecologyVol. 218Issue 1
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          We are excited to learn of other programs working to improve the quality of prenatal care for women in the United States. We appreciate the authors’ comments.
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