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[ Recorded presentation ] Recorded presentation

Strategies for successful implementation of group prenatal care in an urban ambulatory care center

Wendy C. Wilcox, MD, MPH1, Barbara Hackley, MS, RN, CNM2, Roy Grant, MA3, Peter Bernstein, MD, MPH1, Sharon Schindler Rising, MSN, CNM, FACNM4, and Irwin R. Merkatz, MD, Chair1. (1) Department of Obstetrics and Gynecology & Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, 1825 Eastchester Road, 7th floor, Bronx, NY 10461, 718-904-2767, wwilcox@montefiore.org, (2) Montefiore Medical Center, Albert Einstein College of Medicine, South Bronx Health Center for Children and Families, Yale University School of Nursing, 871 Prospect Ave, Bronx, NY 10459, (3) The Children's Health Fund, 215 West 125th Street, 3rd Floor, New York, NY 10027, (4) Centering Pregnancy and Parenting Association, 50 Mountain Road, Cheshire, CT 06410

Preterm births and low birth weight infants are continuing major health problems in the United States. African-American and Hispanic women are disproportionately affected. Centering Pregnancy is a group model designed to change the method of delivery of prenatal care and improve outcomes. Participants have been shown to have lower emergency department utilization and higher birth weight infants. Women of similar gestational age enroll in mid-pregnancy and are seen in group visits lasting 1 to 2 hours until delivery. Group visits replace traditional one-on-one visits making this model of care cost-effective. It also allows providers to target health education messages, e.g., weight management, in greater depth and is empowering for women. Despite the benefits of group care, the practicalities of introducing and implementing the model in health centers can be daunting. Both providers and patients can be reluctant to change from traditional care. Space availability, scheduling and staffing issues, group recruitment and hidden tasks that may not be readily apparent at the outset will all pose challenges to successful implementation. Yet despite these difficulties, over the last 3 years we have held 16 groups comprised of 140 patients. Our success is due to the use of strategies such as on- and off-site training for all staff, dedicated personnel, scheduling patients based on their estimated delivery date and making traditional care the default. All obstetrical providers participate in group care. By identifying and disseminating successful implementation strategies, we hope to facilitate the transition to group prenatal care at other health centers.

Learning Objectives:

Keywords: Prenatal Care, Alternative Perinatal Services

Presenting author's disclosure statement:

Any relevant financial relationships? No

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Strategies for Improving Maternal Health and Child Survival

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA