Online Program

Improving Prenatal Care for Medically Underserved Latina Women

Tuesday, November 3, 2015

Claire Ojima, MD, Department of Family Medicine, Scripps Chula Vista Family Medicine Residency Program, Chula Vista, CA
Miriam Erdosi, MSW, Programs Department, March of Dimes Foundation, Irvine, CA
Maura Georges, MPH, MSW, Programs Department, March of Dimes Foundation, San Francisco, CA

Disparities exist in San Diego related to birth outcomes.  CenteringPregnancy(CP) is an alternative, evidence based, validated prenatal care model known to improve birth outcomes, breastfeeding rates, and target the needs of high risk populations.


Through an IRB approved practice intervention, we will evaluate CP in a predominantly Latina population, age 14-45, entering prenatal care at one of four resident clinic sites, when compared to individual prenatal care.  Women who present to training clinics are considered.  If low risk, patient will be scheduled for a group visit.  If patient would like to continue CP, consent is signed.  If not, patient is rescheduled for individual care.


Preliminary data include 100 women.  70% of women in CP reported breastfeeding at 6 weeks postpartum.   47% gained the appropriate amount of weight based on initial BMI and 37% gained more than recommended (compared to control groups who were 38% and 50% respectively).  100% delivered after 37 weeks.  Of these women, 12% delivered early term infants (37-38 +6/7 weeks), 88% of patients delivered at term (39+ weeks).  Control data show 23% early term, and 72% term infants.


CP has shown improvements in breastfeeding, weight gain, and gestational age at delivery.  Lessons learned and barriers identified include: resident run groups, patient recruitment/retention, data collection and patient follow up.  Working with March of Dimes and Centering Healthcare Institute, we are looking forward to overcoming obstacles to improve birth outcomes.

Learning Areas:

Implementation of health education strategies, interventions and programs

Learning Objectives:
Discuss Centering Pregnancy as an effective model of group healthcare Discuss the impact of group prenatal care on birth outcomes, breastfeeding rates and appropriate weight gain during pregnancy among a high risk population Articulate the process for implementing a group prenatal care model within a family residency training program Identify two challenges and solutions to implementing group prenatal care as the standard of care (opt out model) within a four-clinic system

Keyword(s): Prenatal Care, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 10 years of field study and onsite medical training in the United States, Sub-Saharan Africa and Latin America with a focus on maternal and child public health policy and implementation. Currently in second year of post graduate medical training at Scripps Mercy Chula Vista, Family Medicine Training Program
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.