CenteringPregnancy® a favorite part of residency
Last fall, Duke Family Medicine Center transitioned prenatal care delivered at the clinic to CenteringPregnancy®. This model of care replaces routine individual prenatal visits with group visits of pregnant women who are due about the same time. Since its implementation last fall, the CenteringPregnancy program has flourished. As residents, we have been very involved in helping facilitate these groups. I have found these experiences to be very enriching, and CenteringPregnancy has quickly become one of my favorite parts of residency.
In November 2014, the residents at Duke Family Medicine trained to become CenteringPregnancy facilitators. This was a new experience for most of us, as we had previously experienced delivering prenatal care in a one-on-one setting. The challenging part of individual visits is that 15 to 30 minutes is not enough time to address all of the questions a woman may have about her changing body, and also prepare her about what to expect as she progresses in her pregnancy.
CenteringPregnancy turns the conventional model of prenatal care on its head. Instead of a short visit, providers and patients have two hours to spend together every four weeks (and later, every two weeks) to cover a multitude of topics regarding prenatal care.
How it works
A CenteringPregnancy® patient checks her own blood pressure at a recent session.
In a typical session, patients first check in and record their own vital signs, including blood pressure, weight and height in their CenteringPregnancy notebook. The patients then meet individually with the provider and we measure their uterus size and listen to the baby’s heart rate. Patients have the opportunity to discuss any specific concerns, which may be addressed then or in an individual visit after the session. Then, the group session begins.
Each session has three to four topics that are discussed, and over the total 10 sessions, we cover everything from nutrition and exercise to preparing for labor, breastfeeding and newborn care. As facilitators, we introduce the topic or activity, and encourage the group to share their thoughts. I have been amazed at how eager the women and their support people are to share their experiences, teach and support each other.
The discussions are robust and I have learned alongside my patients. Over time, each group seems to form friendships and a strong sense of community. I have even seen some women invite their other group members to their baby showers.
Continuity of care
An even more rewarding part of Duke Family Medicine’s CenteringPregnancy initiative is the continuity of care. While working on the labor and delivery unit, I have helped deliver some of our CenteringPregnancy moms’ babies and cared for the newborns in the hospital. And back in clinic, I have followed several of the babies for their well child care.
My favorite part of CenteringPregnancy is the ability to establish meaningful connections with my patients in a relaxed, welcoming environment. I love being able to take the time to get to know these women beyond their health history, address their concerns throughout pregnancy and have open discussions without the time crunch of a short clinic visit.
The relationships I have formed and the continuity I can provide are what sustains me as a family physician. It has been exciting to be with these families during such an important part of their lives and seeing them flourish.
Group-based models of care have become more popular, as they have shown to increase patient engagement and patient experience, and also improve health outcomes. CenteringPregnancy as a group health care model is proven to dramatically improve health outcomes, reducing the odds of premature birth between 33 and 47 percent across studies, and lowering health care costs. CenteringPregnancy’s approved sites are estimated to have saved the health care system $44.3 million in 2011.
As our CenteringPregnancy program continues to grow, we hope to see these outcomes in our own practice. At Duke Family Medicine, we will strive for our CenteringPregnancy mantra of “healthy moms, healthy babies, and healthy families.”
Preyanka Makadia, DO, is a second-year resident with the Duke Family Medicine Residency Program. Email preyanka.makadia@dm.duke.edu with questions.
Editor’s note: Duke Family Medicine residents guest blog every month.