A new study shows that group prenatal care—or sharing your prenatal visits with other pregnant women—is good for mom and baby, even in high risk pregnancies.
You might not have heard of group prenatal care before—and we're not talking about seeing a group of doctors, but rather having your checkups in a group with other pregnant women. Part doctor's appointment, part education, part support group, this model of care is showing promise for healthier moms and babies, according to a new study in the American Journal of Public Health.
A different approach to prenatal care
Researchers randomly assigned more than 1,000 pregnant women at 14 health centers in New York City to either traditional individual care, or to care in a group setting. The women in the group setting were 33 percent less likely to have babies who were small for gestational age. They also had less risk of preterm delivery and low birth weight, and spent less days in the neonatal intensive care unit (NICU). The group women were also less likely to get pregnant again right away after birth, which is itself a risk for preterm delivery of their next child. "We learned through this study that participating in group care improved birth outcomes," lead study author Jeannette Ickovics, Ph.D., a professor at the Yale School of Public Health, tells Fit Pregnancy.
What exactly does group prenatal care look like? It begins the same way as individual care, with an initial visit that includes a physical exam, medical history and lab tests with a doctor or midwife. Then, following a traditional prenatal checkup schedule, groups of eight to 12 women who are all due around the same time meet monthly (every two weeks later in pregnancy) along with their practitioner. They have a private check-in with the doctor to monitor the baby's growth and heartbeat, but often record their own blood pressure and weight.
For most of the two-hour appointment, though, the women sit in a circle with their provider discussing and learning about topics relating to their stage of pregnancy. "Instead of the usual 15-minute checkup, group care patients meet with their doctor or midwife for two hours every time," Ickovics says. "The same provider facilitates the two-hour group visit each time, so women really get to know their provider, and the provider gets to know each of the women much better. There are no medical risks."
Strength in numbers
In this type of setting, women can benefit from learning from, and having the support of, other moms going through the same things. "Groups improve learning, change attitudes, increase motivation, and provide social support, as women share their experience and learn together," Ickovics says. "Women get exposed to more information, and if one woman asks a question, all women benefit from the answer, even if they are too embarrassed to ask."
Women also benefit from more time with their providers. Because they are seeing multiple patients at a time, doctors can spend more time with them. It's also cheaper this way. "Group care is a cost-effective way to provide much more provider contact, education, and support to women in pregnancy," Ickovics says. There is also less need for separate childbirth education classes, because those topics would be covered here as well.
Although it's not clear exactly how the group setting improves birth outcomes, Ickovics has some theories. "It may be the increased social support leads to less stress, which can affect birth outcomes," she says. "It may be that having more time for education and skills-building leads to better health behaviors during pregnancy." Further research, she says, is needed.
Who should receive group care?
The benefits of group care are especially crucial for low-income, young and disadvantaged expectant moms, like the ones included in this study, because they are less likely to find support and information elsewhere. "Mothers who have high rates of adverse birth outcomes—for example, young, black, poor—benefit a lot because their baseline risk is so high," Ickovics says. But, "research suggests that all women can benefit from group prenatal care."
Group care isn't necessarily right for everyone, though. "Some may not be comfortable in a group setting or have specialized medical needs that would require additional visits with a specialist," Ickovics says. High risk women can still receive group care, she says—they just might need extra individual appointments with a high-risk OB.
If you are interested in finding out more about group prenatal care in your area, ask your doctor or visit the website for the Centering Healthcare Institute, which developed the group model. "We think it is the best way to get prenatal care," Ickovics says. "All pregnant women want to have the healthiest pregnancies and babies—and all of us can benefit from the deep support of others."