By Faith Daniel
The Maternity Pavilion at SBH has embarked on an innovative endeavor to improve patient health outcomes. With the United States ranking 26th out of 29 countries in terms of infant mortality and pre-term birth, with black women being nearly 50 percent higher when compared to white women, something needed to be done.
In response, The SBH Centering Pregnancy program, a group based prenatal care model, will launch this fall. The program gives expecting mothers the opportunity to not only receive their routine prenatal care, but also to get extensive group education and make lifelong connections with other women.
The Centering Pregnancy model was established by midwife Sharon Schindler Rising in 1993 with the mission to improve the patient experience and address provider burnout. The Centering Healthcare Institute was founded in 2001 to expand Rising’s mission and support the growing demand for quality group care. The Centering Pregnancy model consists of cohorts of 10 – 12 women with similar due dates meeting each month for 90 – 120 minutes in length until their last month of pregnancy. Each session is accompanied by a midwife and a nurse who facilitate the program providing rich educational information and addressing each new mother’s private concerns.
“Centering is being offered across the country and at SBH, we believe the program will demonstrate better outcomes and save the hospital money,” says Caroline Wilson, CNM and SBH’s Centering Pregnancy coordinator.
The Centering Pregnancy model is outlined as follows:
- The patient is taught how to take her own blood pressure,
urine sample and weight to update her chart during each visit.
- Patients sit in a circle and participate in an interactive,
educational program that includes games, snacks, and
discussions in each session on topics ranging from dental
care to safe food preparation.
- Patients meet with their provider one-to-one during the
session for addressing private issues, pelvic exams, maternal
fetal assessments, etc.
Institutions that have implemented the program see a decreasein the rate of preterm and low weight babies, increased rates of breastfeeding, and improved immunization rates. Even more astonishingly, Centering Pregnancy has been shown to significantly decrease racial disparities in preterm birth. In recent studies, this has resulted in an approximately 36 percent reduction in risk of preterm birth, 44 percent reduction in low birth weight, and a 28 percent reduction in risk of NICU stay.
It is expected that the savings will be as robust as the improvements in health outcomes. For every 22 patients in the Centering program, it is estimated that at least one low birth weight baby will be eliminated, resulting in first-year savings of nearly $30,000. For every 30 patients, it is estimated to eliminate at least one baby from the NICU, generating approximately $27,250 in savings in the first year.
“Traditional prenatal care that a pregnant woman gets for 15 minutes a visit just isn’t enough time,” says Wilson. “With Centering, you not only get two hours with your provider, but you also make connections with your community, create relationships and foster bonds. It’s also just a lot of fun. It takes the chore out of healthcare.”
Creating a sense of camaraderie and sisterhood, she says, createsa safe space for mothers to seek emotional and social support. In many instances, mothers remain friends after the program and even babysit each other’s children. They also receive a sense of autonomy as they actively participate in their healthcare.
“Groups are interactive, so it is not the typical one person teaching and one person listening,” says Wilson. “It breaks down the power hierarchy that we normally see in care now, and is far more interactive.”
The power struggles within a traditional doctor’s visit, she adds, can hinder a patient’s ability to ask questions and address lingering concerns. Creating these spaces strips away the anxiety that is usually induced when speaking one-to-one with a provider and allows for participants to educate each other.
“I want doctors to feel like they can normalize this,” she says. “There are hospitals that do this for other types of patients and are seeing success among their pediatric, diabetes and cancer patient groups. We’re very excited about starting it for pregnant patients at SBH.”