Online Program

Advocating for the Undocumented, Pregnant Latino Women: Utilization and Outcomes of Centering Pregnancy (CP) prenatal care in an Urban, Community Setting

Wednesday, November 4, 2015

Dr. Joy P. Nanda, DSc, MS, MHS, MBA, Johns Hopkins Medical Institutions (Ret), Johns Hopkins University (Ret), Baltimore, MD
Maxine Vance, M.S., R.N., Baltimore Healthy Start Inc., Baltimore, MD
Shawana Ramirez, M.S., Baltimore Healthy Start Inc., Baltimore, MD
Shymaine Davis, MBA, CPA, Baltimore Healthy Start Inc., Baltimore, MD
Tiffany Majors, MBA, MHA, Baltimore Healthy Start Inc., Baltimore, MD
Since the ACA lacks health financing provisions for undocumented pregnant women, the risk of adverse pregnancy outcomes and increased societal cost is tremendous.  Noticing a substantial increase in undocumented Latino population in the area, Baltimore Healthy Start (BHS) utilized a Centering- Pregnancy (CP) model, and is piloting a privately funded CP-based, prenatal “group services” to undocumented, pregnant Latino women (UPLW) as  a cost-effective initiative.

The CP is peer group-facilitated instead of didactic classes and is culturally competent. Eight to twelve women per CP group meet bi-weekly in a supportive and collaborative environment to assess and discuss unmet need and peer support and their health during pregnancy, in addition to receiving prescriptive clinical care.  The CP process – developing community-building spirit thru positive peer influence, family support, problem-solving skill development and sharing common life experience surrounding pregnancy, has not been fully evaluated in terms of improvements in pregnancy outcomes.

Thus far, 116 UPLW (mean age: 27.5 yrs;  parity:1.33, previous c-section:0.3) have participated in 267 CP group sessions. Compared to similar African American pregnant (AAPW) participants (N=180) receiving BHS services and delivered a live birth during the same time period, birth outcomes for 50 CP participants who have delivered to-date show newborn average gestation age at 39.37 weeks (AAPW:38.8 weeks), 0.5% (only one) Low Birth Weight (<2500 gm) births (AAPW:12.2% ) and no c-section delivery (AAPW:3.3%). Forty-seven UPLW (94%) were exclusively breastfeeding their infants at hospital discharge (AAPW:none). Final findings may demonstrate CP benefits for the undocumented pregnant Latino women.

Learning Areas:

Advocacy for health and health education
Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Describe and discuss components of a Centering Pregnancy (CP) model for socially disadvantaged pregnant women Evaluate the benefits of CP services and compare them to that of services related to individualized care during pregnancy Compare pregnancies and their outcomes of undocumented pregnant Latino women with Medicaid recipient pregnant African American women with comparable risk at pregnancy

Keyword(s): Latinos, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Have been working in this area
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.