United States: Group Antenatal Care Promotes Breastfeeding
The CenteringPregnancy® Program conducted at the University of Illinois
in Chicago provides health promotion, group-peer support, a collaborative
patient-provider relationship, and self-management training and activities.
The programme aims to increase women’s psychosocial well-being and
healthy behaviour in order to reduce adverse maternal and infant outcomes
This is a local pilot project that replaces the individual-visit model of antenatal
care for poor, obstetrically low-risk women with a group-visit model.
The target population comprises 110 low-income African-American women
who receive antenatal care in an urban public health clinic. Funding has been
provided by the March of Dimes, Illinois Chapter, and ongoing support is provided
by insurance reimbursement of antenatal services.
The group antenatal-care model consists of 10 two-hour visits beginning
at 16–18 weeks and continuing until delivery, following the recommended
schedule for antenatal care. Each group of pregnant women is led by a nursemidwife
and a co-facilitator, either a clinical nursing-support staff member
or a graduate nursing student. At each group visit, the women practise selfcare
skills such as measuring their weight and blood pressure, each woman
undergoes a short assessment with the nurse-midwife provider in the group
space, and the remaining time is used to discuss concerns as a group, ask
questions and explore the new roles of pregnancy, parenting and motherhood.
The women also receive health information on keeping themselves safe and
healthy during pregnancy and beyond.
Focus groups of pregnant women, providers and health-centre staff report
that the programme has benefi ted the women who participated, despite implementation
challenges such as scheduling changes. The women report that
they enjoy sharing their pregnancy experience with other women. Compared
to women in individual care, the women in CenteringPregnancy attended
considerably more antenatal visits (9.7 versus 8.3) and gained appreciably
more weight during pregnancy (32.2 pounds versus 28.5 pounds). They were
also significantly more likely to have initiated breastfeeding during hospitalization
(59% versus 44%); at hospital discharge 44% were breastfeeding
exclusively, compared to 31% of the women in individual care.
Explore the entire Compendium of Primary Care Case Studies (2009) published by the World Health Organization.