Hospital offers new prenatal care
May 22, 2009
Reynolds Army Community Hospital began a new approach to prenatal care in 2008, and the women who've tried it are raving about the care they've received.
Centering Pregnancy offers group support and education to pregnant women. The prenatal care groups are formed by women with their babies due around the same time. During Centering Pregnancy, pregnant women meet on the same schedule that they would see a doctor. They have their first appointment with a doctor at 12 weeks, and from then on they meet with their group. Group prenatal care begins when the women are roughly 16 weeks pregnant. The group meets for 10 sessions <m> once a month for the first four months and then once every two weeks for the last three months.
As apposed to a 15-minute appointment with a provider, the group meets for two hours each session with a provider and nurse. During the meeting each patient individually will meet with the group's provider, who measures fetal heartbeat, positioning and size, discusses any concerns the mothers-to-be might have and orders any additional testing expectant mothers might need.
The pregnant women themselves monitor their height and weight, with oversight from the provider. The group also discusses things like nutrition, common pregnancy problems, family issues, parenting issues, family relationships, relaxation measures and comfort measures for labor among many other topics.
"At the beginning of the class, the women document their vital signs; they take their blood pressure, record their weight in their chart, calculate how many weeks pregnant they are," Lenora Nepper, licensed nurse midwife, said. "Basically, they are taking ownership of their care."
Then the moms rotate through to see their provider for "mat time." During the mat time, it's much like a routine visit. The provider finds out if the pregnant women have any particular issues or concerns. If they have issues that are not normal, then they consult with the provider after the group session ends. In some cases, expectant moms may have other appointments in addition to their centering group if they have issues like preclampsia or gestational diabetes. Otherwise they don't have other appointments; this is their prenatal appointment.
The first three centering groups have been small, and Nepper said she hopes more women will join the group. The bigger the group is, the more interactive it is. The ideal group size is eight to 10 women, but the largest a centering group has yet to be is six women.
Nepper said there are lots of benefits to joining Centering Pregnancy.
Members of the group sign a confidentiality agreement on the first day of the group, so basically what is said in the group stays in the group. All appointments for the entire pregnancy are set on the first meeting.
One of the key draws for mothers who join Centering Pregnancy is that they never have to wait for an appointment; the group meets on time every time. Expectant mothers also get more time with their providers than they do if they had traditional prenatal care and can address more issues.
"We are not from here, obviously, being military, and I though it would be a good place to get extra support and people around who are going through the same thing as I was, being a first time mom and not knowing what to really expect," said Priscilla Martin, who now has a three-week-old baby boy. "I was really worried about not being able to see a physician very often and being tossed around from one physician to the next, whoever happened to be available that day, and this was a way for me to really get to know the person who was going to be taking care of me."
According to Lisa Singleton, head of the OB/GYN clinic, mothers who choose Centering are more empowered, have better support networks, are more satisfied with their care, have a lower chance of preterm birth and a higher chance of successfully breastfeeding.
"They have done studies, and it helps prevent pre-term births," said Singleton. "Plus, the empowerment it gives the women in a group setting, to be able to get that support from other women. There are some women who are experienced, who have had other children, then there are first time moms who are learning from the experienced moms. Our job is to facilitate the conversation, not to take over.
"We let them talk and tell us about their experience. They believe that the support in a group and the education that you get from this group empowers you and you're not home sitting alone, you're not under a lot of stress, and especially in the Army, you have the moms that do not have the support. Their spouse is deployed; they're alone, and they need that support. They really do."
"I feel like I've gotten better care than the two girls I work with who are not in a centering group," said Kimberly Gray, who is due in July. "I answer their questions for them because we talk about everything here."
Most of all, Singleton said the group is fun.
"They get to interact with others; they joke; they talk about issues, and it's just a fun time," she said.
From the hospital's standpoint, Centering Pregnancy offers better care for the patient.
"It creates an empowerment for them; it shows that we care about them and we want them to have the best experience they can have during their pregnancy," Nepper said.
Spouses are welcome to attend the Centering Pregnancy session, and free child care is provided by Army Community Service at 442-6962 or 442-4916. Children are not allowed to attend the sessions. To find out more about Centering Pregnancy or to join a group, call Reynolds OB/GYN clinic at 458-2276 or 458-3069. Reynolds also has a support group for pre- and post-partum women who are suffering from depression. The group meets every Tuesday from 1:30 to 3 p.m. For more information, call the OB/GYN clinic.