Centering Pregnancy

Categories

Categories associated with best practice:

  • Individual
  • Organization
  • Best Practices
  • Health Care Setting
  • Maternal and Infant Health

Determinants of Health: Personal health practices and coping skills, Access to health services, Healthy child development

Overview

CenteringPregnancy is a model of group care that integrates health assessment, education, and support, into a unified program within a group setting. Adolescents with similar gestational ages meet together, learn care skills, participate in facilitated discussion, and develop a support network with other group members. Program participants are provided with information and engage in goal setting. Each group meets for a total of 12 sessions throughout pregnancy and early postpartum. Teens meet with a social worker once a month to address any social needs or concerns. The practitioner, within the group space, completes standard physical health assessments.

Program participation is associated with a decrease in preterm delivery and low birth weight among adolescents.

Primary Source Document

M Grady and K Bloom, Pregnancy outcomes of adolescents enrolled in a CenteringPregnancy program. Journal of Midwifery and Womens Health, 2004, 49(5): 412-20.

Contact information of developer(s) and/or implementer(s)

The CenteringPregnancy Model was developed by Sharon Schindler Rising.

Intervention Focus

Intervention Goal / ObjectiveLevel(s) TargetedEquity Focus
Determine the extent to which the CenteringPregnancy program influence perinatal outcomes among pregnant adolescents. outcomes of interest were incidence of LBW de?ned as infants weighing less than 2500 g at birth, preterm delivery rate de?ned as delivery at less than 37 weeks’ gestation, caesarean birth rate, breast-feeding rate de?ned by client report of breastfeeding recorded on the postpartum progress note when discharged from the hospital, and identi?cation of a pediatric provider at the time of delivery recorded on the labor and delivery nursing admission assessment.
  • Individual level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.

Health Issue(s) that is/are addressed by the Intervention

Health Promotion

  • Maternal and Infant Health

Risk Reduction

    Specific Activities of the Intervention

    • Information sessions offered about a risk factor or condition
    • Group process/program

    Priority/Target Population for Intervention Delivery

    Life Stage

    • Prenatal

    Settings

    Educational Settings

      Community Setting

      • Health care setting

      Outcomes

      Outcomes and Impact Chart
      Level of ImpactDescription of OutcomeEquity Focus
      Organizational LevelCenteringPregnancy encouraged excellent health care compliance: The Centering group adolescent clients had a lower no-show rate compared with all women seen for traditional prenatal care at the Barnes Jewish Hospital obstetrics clinic in 1998 (19% versus 28%, respectively).Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
      Individual LevelThere were no signi?cant differences in the number of caesarean births between groups.Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
      Individual LevelCenteringPregnancy increased satisfaction with prenatal care: Almost every adolescent who participated in Centering groups was extremely satis?ed with her prenatal care experience. The peer support, group sharing, and discussions were the best part of prenatal care for most of the adolescents who completed an evaluation. The staff at the Teen Pregnancy Center has also expressed this high level of satisfaction. They believe the Centering model has promoted bonding and empowerment in the adolescents who participate.Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
      Individual LevelThe Centering group had a low rate of preterm delivery (10.5%), as well as a low rate of LBW infants (8.9%). The caesarean section rate was 13.7%. The Centering group had breastfeeding rates at hospital discharge of 46%, and 79%identi?ed a pediatric provider at delivery.Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.

      Adaptability

      Implementation History

      • Multiple implementations - Different settings/populations/providers - The intervention showed significant adaptability as it has been implemented in different settings or with different populations or by different provider(s). This can include multiple implementations during the same time period. Each implementation of the intervention must have been substantially the same and must have demonstrated positive results for the primary objectives of the intervention.

      Expertise Required for Implementation within the Context of the Intervention

      • Specialized skills training provided as part of the Intervention - The intervention does not require individuals or groups with highly specialized training, but requires that individuals or groups be trained as part of the implementation of the intervention.

      Are there supports available for implementation

      No.

      Are there resources and/or products associated with the interventions

      Yes. Notebooks, group supplies, and facilitator guides and resources are available for those who wish to implement the program at: https://www.centeringhealthcare.org/Store/index.php https://www.centeringhealthcare.org/Store/pages/departments.php?Dep=38&TypeId=