As any mother can attest, pregnancy is not exactly a stroll through the nursery. But belonging to a group of similarly expectant women can help, and that is the thinking behind a patient-centered prenatal health program available through Emory Crawford Long Hospital.
Centering Pregnancy provides a group approach to prenatal care, combining three essential elements of care every pregnant woman needs: health assessment, education, and support.
"It creates a community of pregnant couples," says Maureen Kelley, clinical associate professor and chair of family and community nursing in the Nell Hodgson Woodruff School of Nursing at Emory University and director of the nurse-midwifery program at Emory Crawford Long Hospital. Kelley implemented the program for women delivering at Emory Crawford Long based on an approach pioneered by well-known nurse midwife Sharon Rising.
In the program, groups of up to 10 women, and often their partners, meet regularly at the Emory University campus starting at the women's 16-week mark of pregnancy. Each session is facilitated by one or more midwives, and the visits take the place of prenatal health checkups. In the event that there is a problem, the woman is referred back to the traditional office setting.
The health assessments take up very little of the two-hour sessions, and the rest is devoted to education from the midwives and support from the women themselves. Everything from delivery to nursing to postpartum depression to sexuality is covered, and the women gain knowledge not only from the midwives but also from their peers.
"It's very focused on women's own experiences," says Kathryn Woeber, associate professor in the nursing school, who has the unique perspective of having participated both as a midwife and a patient; Woeber had her first child last month. "Some of it is practical information -- maternity clothes, for example. Most of the women in our group are very well-educated so they have a lot to offer."
Women are matched in groups with similar due dates, and the entire program is billed to insurance just like conventional prenatal checkups. In one sense, the program is not at all cutting-edge (all of the aspects of Centering Pregnancy have long been available in part through other avenues), but it is the first to bring such a comprehensive approach together in a single format.
And that format works. Centering Pregnancy covers the same prenatal classes that a couple would usually take on top of the traditional care covered by insurance. "It's really 'pre-natal plus'," says Kelley.
"The Centering Pregnancy program is empowering to women. It allows women to assume control for their own health and the health of their fetus. It also is a creative way that women can increase their knowledge regarding pregnancy, childbirth, and parenting," says Joyce King, clinical assistant professor of family and community nursing at Emory. Since women get to combine their prenatal visit with childbirth education, "Centering Pregnancy is like a one stop shop -- you get everything you need at your prenatal visit."
The men get as much out of it as the women, says Kelley. "One of our new fathers came back to the group and talked about how he went through a sort of postpartum depression when the reality of life with a newborn at home set in. Where else are men going to get feedback like that?"
Something must be working, in the year since the first Centering Pregnancy group was launched at Crawford Long, the first "alumni" have had their children and reconvened for reunions, suggesting that not only pregnancy support but lasting friendships can be a product.
For more information on Centering Pregnancy, call Emory Women's Care at 404-686-3643.