Designing a Group Prenatal Care model for Phoenix's refugee population: Does it improve birth outcomes?

A program was funded by the March of Dimes Arizona Chapter (MOD) to introduce CenteringPregnancy®, a group prenatal care program, at St. Joseph's Hospital Family Medicine Residency Clinic in Phoenix, AZ. Out of 14 patients in the program, 4 were refugees. Clinic providers expressed concern with how best to provide care for refugee patients, noting poor outcomes within our current system. As a preliminary investigation, 2007 Arizona birth records were reviewed. Babies born to women from Somalia had an 11.4% admission rate to the Newborn Intensive Care Unit (NICU), compared to babies of other foreign-born women (4.8%). The odds ratio for NICU admissions for Somali mothers was 2.54 (p-value < 0.001). There was no difference in pre-term birth. Burmese refugees have recently immigrated to Arizona and only 23 birth records were captured in 2007 data. Burmese births included (5) 22% pre-term deliveries and (3) 13% admissions to the NICU, a concerning trend. There may be additional poor outcomes not recorded in the birth records. In response to these numbers MOD asked the International Rescue Committee (IRC) refugee relief organization to submit a proposal to coordinate group prenatal care for refugees through St. Joseph's. IRC will provide transportation and interpretation services, culturally appropriate training for providers, and interface with St. Joseph's and MOD to implement the program. St. Joseph's will conduct focused interviews with refugee patients, followed by a plan to implement targeted improvements in care. Results will include better coordinated maternity care with Phoenix-area refugee assistance organizations and improved outcomes.