The dance floor was replaced with a handmade quilt. Attendees snacked on baby formula instead of the traditional dinner buffet. And there was no DJ - just the gentle sound of a soothing lullaby. This was the scene at the reunion for graduates of the most recent CenteringPregnancy Program at Madigan Healthcare System.

The graduates were mothers and newborns who had recently completed the CenteringPregnancy Program, an alternative to traditional prenatal care where pregnant women receive risk assessment, support and education regarding pregnancy in a group setting. Women are placed into groups of eight to 12 based on their predicted due date, and they are encouraged to share and talk to one another about their experiences. "We find that this is an effective model for delivery," said Roxanne Piecek, a certified nurse midwife with Madigan's CenteringPregnancy Program. "It provides an advantage to women."

CenteringPregnancy was developed by a midwife in the mid-1990s, and has since spread to more than 100 medical facilities nationwide. Madigan is the second Military Treatment Facility and one of only three medical facilities in the nation to receive an accreditation for CenteringPregnancy. William Beaumont Army Medical Center at Fort Bliss, Texas, also carries an accreditation.

At their first prenatal appointment, Madigan beneficiaries are given the choice of traditional prenatal care or the CenteringPregnancy Program. They are also given the choice of midwifery care versus general obstetrics care.
Col. (Dr.) Peter Nielsen, Madigan's Department of OB/GYN chief and the consultant to The Army Surgeon General, said that there is some data suggesting that this type of prenatal care may reduce the risk for preterm birth in some patients, and Piecek contends that women who chose CenteringPregnancy over traditional prenatal care are likely to have less medical intervention during their labor. "There tends to be more patients who want less intervention," said Piecek. "Overall, it has to do with personal preference and whether or not the mother is low-risk."

An Unexpected Experience
At this reunion, there were eight new moms with their babies, with new dads learning how to park strollers as well. The babies ranged in age from two weeks to two months, and if there was a consistent theme about each new mom's labor, it was that nothing went as any of them expected it would.
Every woman attending the group had decided that a natural birth was what they wanted, meaning no drugs and no medical intervention unless it was necessary.

Every one of the new moms eventually received medication for pain, and a handful had to have caesarean sections. Mia Davis' husband left for deployment the day her labor contractions began. Finally, after not being able to sleep for three days because of her contractions, she came to Madigan to get some medication for her pain. While she was being admitted, her water broke, and she had the shortest labor in the group at only six hours.
Vanessa Sumpter's husband was en route from Kuwait to see his daughter's birth, but there was a travel delay, and he didn't make it in time. Sumpter's labor was uneventful, but as a result of breastfeeding, she developed an abscess in her breast and a fever, and had to be readmitted to the hospital for five days. Doctors had to make a small incision in her breast to drain the abscess, and she has almost fully recovered.

Heidi Cristel's husband was not present during her delivery, but not because he was deployed. He was sick with the flu, and even though he had brought her to the hospital, he had to return home because he was throwing up. When her daughter, Isabella, was born, Cristel's husband was on the speakerphone in her delivery room. "It's definitely not what you think it's going to be," Cristel said, discussing how she expected her husband to be present during her delivery.

Baby Boom
Nielsen states that Madigan has increased the number of certified nurse midwives to seven in order to provide coverage to pregnant women seeking services like CenteringPregnancy. With an average of 209 babies born every month at Madigan, this year, the hospital will deliver more than 2,500 babies - the largest number in its history.

The OB/GYN department has also increased the number of providers for traditional prenatal care, and recently the department was honored with seven of 14 research awards at the annual Armed Forces district meeting of the American College of Obstetrics and Gynecology. "I am extremely proud of the faculty, fellows and residents in our department," Nielsen said. "Their dedication to patient care, education and research exceeds some of the nation's leading civilian academic medical centers."

CenteringPregnancy groups meet on the same schedule as traditional prenatal care appointments, so members gather about every four weeks until late in the pregnancy when the group starts to meet more frequently.

Piecek states there have been women that began with traditional prenatal care and then transfer to the CenteringPregnancy program. Women have also developed complications while attending CenteringPregnancy, and they have been permitted to stay in the group while receiving additional care through the OB/GYN clinic. "Once they come to the groups, they don't want to leave," Piecek said.

CenteringPregnancy began their 28th group last week, and their goal is to begin two new groups every month.
For more information, contact Madigan's CenteringPregnancy at (253) 968-1143.