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August 1, 2005
Prenatal health program centers on group support

BY Michael terrazas

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 relatively new prenatal health program that is quickly gaining popularity at Crawford Long and Grady hospitals.

Called “Centering Pregnancy,” the program is directly adapted from an approach pioneered by Sharon Rising, a nurse-midwife and former Yale University faculty member who first introduced its concepts at the University of Minnesota. Centering Pregnancy is based on 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,” said Maureen Kelley, clinical associate professor and chair of family and community nursing in the Nell Hodgson Woodruff School of Nursing. Kelley implemented the program in place at Crawford Long, with the sessions taking place at the nursing school. Centering Pregnancy first found its way to Grady through Claire Westdahl, assistant professor of obstetrics-gynecology and director of Grady’s nurse-midwifery program.

In the program, groups of up to 10 women (and often their partners) meet regularly 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 (if there is a problem, the woman is referred back to the traditional office setting).

But 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 professionals (the midwives) but also from their peers.

“It’s very focused on women’s own experiences,” said Kathryn Woeber, instructor in the nursing school, who has the unique perspective of having participated both as a midwife and a patient; Woeber’s first child is due in August. “Some of it is practical information—maternity clothes, for example. Most of the women in our group are very well-educated—a lot of them work at the CDC or as nurses—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 really is ‘prenatal plus,’ Kelley said. “We wanted to offer something special for Emory employees. We care about the community at Emory and wanted to bring this model to Emory women.”

Not only Emory women but their partners as well. “The men get as much out of it as the women,” Kelley said. One of our new fathers came back to the group and talked about how he went through a sort-of post-partum depression when the reality of life with a newborn at home set in. Where else are men going to get feedback like that?

Andrew Woeber, Kathryn’s husband, who dutifully accepted his wife’s invitation to accompany her to group sessions (“He’s a very smart man,” Kathryn quipped), agrees on the merits of the program.

“The closer you get to the due date, they do things like take you to the hospital and show you: ‘This is where you would actually come in; you talk to this desk first; now let’s go look at a labor and delivery room,’” Andrew said. “They try to fill in as many blanks as possible and make it comfortable for both parties.”

Something must be working, because in just a short 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.

“We had three couple in our group in the hospital this past weekend, having their babies,” Kelley said. “They were checking on each other. So they’ve got this community of people who are going through the same thing they are, and that’s a really nice experience.”

For more information on Centering Pregnancy, call Emory Women’s Care at 404-686-3643. Though the program was established as a service for Emory employees, it is open to anyone covered by Emory Healthcare.

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