Centering Pregnancy: What Is Group Prenatal Care?

By Dr. Kenosha Gleaton, OBGYN

Quality prenatal care is extremely important for supporting a healthy pregnancy. Most traditional models of prenatal care include a patient and a provider always meeting for a one-on-one visit, but some research suggests there may be a different way to get prenatal care that may improve patient education, social support, and health outcomes. Read on to learn more. 

Why Is Prenatal Care Important?

Pregnancy can be a physically and emotionally demanding process, consisting of weight gain, bodily changes, hormonal changes, new symptoms, and much more. Prenatal care is focused on supporting the health of you and your baby before and during pregnancy. [1] Getting regular prenatal care decreases the risk of a low birth rate, birth complications, pregnancy complications, and more. [1]  Check out my guide on the importance of prenatal and postnatal care → 

What Happens During a Prenatal Care Office Visit?

Prenatal care often consists of physical exams, blood tests, imaging tests, ultrasounds, and general education about pregnancy. [1-2] Typically, prenatal visits will occur every four weeks during early pregnancy, every two weeks towards the beginning of your third trimester, and about every week as you approach your due date. [3] Keep in mind that you may see your provider more or less frequently depending on factors such as your age, underlying conditions, previous pregnancy complications, etc. 

During a prenatal visit, your provider will give you a comprehensive exam to ensure that you can have the healthiest pregnancy possible. Your provider can also educate you on what foods to eat, what activities are safe vs. unsafe, what prenatal vitamins you should be taking, and more. [1-2] During prenatal visits, you can expect to learn your estimated due date, discuss your family and personal history, and monitor your baby’s weight, growth, and heart rate. Imaging tests, urine tests, and ultrasounds can all give your provider an idea of your baby’s health and how your pregnancy is progressing. [1-2]  Read up on pregnancy-safe exercises and safe vs unsafe pregnancy self-care. 

What Is Centering Pregnancy?

Centering pregnancy is a model of group prenatal care. Instead of visiting with a provider one-on-one, you join a larger group of pregnant people of similar gestational age under the guidance of a trained healthcare professional. [4] This group prenatal care model allows women and other pregnant people the chance to speak with other people about their pregnancies, including physical and physiological needs, changes, and questions. [4-5] Through facilitated conversations and learning, this model of care equips soon-to-be parents with life care skills and encourages them to advocate for themselves. The centering pregnancy model teaches and allows participants to carry out simple progress charting themselves, including blood pressure monitoring and weight measurements. [4-5] 

Centering pregnancy is just one model of group prenatal care, though it is the most widely studied model. [4] Centering pregnancy was piloted in 1993 and has been used internationally. 

While still up and coming in the prenatal field, group care is not a new concept. Group care has been used in a variety of medical settings for the successful management of conditions such as chronic pain, HIV, cancer, and more. [4] 

How Do Centering Pregnancy Visits Work?

In the centering pregnancy care model, groups of 8-10 people of similar gestational age come together with their support partners, a co-facilitator, and a healthcare provider. [4-5] These groups will meet every 2-4 weeks for about 90 to 120 minutes over a six-month period. These visits will begin with socializing opportunities, self-data collection, and a brief one-on-one interaction with the provider for an individualized assessment. [4-5] Then, the facilitator will encourage discussion of a wide variety of topics, ranging from childbirth preparation to contraception options. In this model, pregnancy complications can still be managed through supplemental individual visits. [4] 

Benefits of Centering Pregnancy

Group prenatal care models such as centering pregnancy have shown many documented benefits. These include [4-5]:

• Increased patient knowledge
• Readiness for labor and birth
• Patient satisfaction
• Improved social support
• Higher birth weight
• Longer gestational age
• Increased rates of breastfeeding
• Fewer neonatal intensive care unit (NICU) admissions
• Decreased complications in the third trimester
• Improved pregnancy-related weight management
• Decreased incidence of C-section deliveries

In addition to these outcomes, patients report appreciating the ease of long-term scheduling, avoiding wait times, and developing unique and long-term social bonds with other patients. 

It is important to note that the existing literature and research surrounding group prenatal care is relatively small, but growing. 

Cons of Group Prenatal Care

While group prenatal care has shown to be very beneficial for many people, there are some criticisms and drawbacks of centering pregnancy and other group care models. For one, access to your provider in a private, individual setting is limited. [5] Another consideration with group prenatal care is the lack of privacy. Some people may not enjoy sharing their experiences with a large group of people, and may even withhold information out of fear of being judged. One study found that women in group care engaged in fewer health-promoting behaviors during pregnancy than those in individual care, however, other studies found no difference among health behaviors or found more positive outcomes associated with a group care model. [5] Lastly, some group prenatal care models can be difficult for providers or clinics to initiate and maintain.  

It is important to note that in group care models, the standard is still to provide risk screening and individual physical assessments while including more opportunities for social support. [4-5] This still allows patients to meet with a healthcare provider individually. Group prenatal care should never be mandatory and if offered, should always be optional. 

Natalist Prenatal Care

Taking care of your health before, during, and after pregnancy is necessary for promoting healthy outcomes, supporting your baby’s health, and healing post-birth. Whether you prefer individualized care or group prenatal care through a model like centering pregnancy, quality care is vital. At Natalist, we’re on a mission to provide you with the products and information you need to support your path to parenthood. Find prenatal vitamins for women, postnatal vitamins, self-care bundles, and more. 

References:

1. What is prenatal care and why is it important? NIH Institute of Child Health and Human Development. Office of Communications. January 2017. https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/prenatal-care
2. Schmitt, John. Prenatal care. February 2021. The Office on Women's Health. U.S. Department of Health and Human Services. https://www.womenshealth.gov/a-z-topics/prenatal-care
3. Pregnant? Here’s How Often You’ll Likely See Your Doctor. January 2022. Cleveland Clinic. https://health.clevelandclinic.org/prenatal-appointment-schedule
4. Group prenatal care. ACOG Committee Opinion No. 731. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018;131:e104–8.
5. Risisky D, Asghar SM, Chaffee M, DeGennaro N. Women's Perceptions Using the CenteringPregnancy Model of Group Prenatal Care. J Perinat Educ. 2013;22(3):136-144. doi:10.1891/1058-1243.22.3.136

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.

Dr. Gleaton is passionate about women, health equity, and mentoring. She is the CEO of The EpiCentre, an OBGYN spa-like practice, and is a Clinical faculty member of Charleston Southern University. She is also a member of the American College of Obstetrics & Gynecology, the American Association of Gynecologic Laparoscopists, and the American Association of Professional Women