It Takes a Support Group Centering Pregnancy Makes Those Nine Months a Time of Learning — and Sharing

For generations, checkups during pregnancy were a private matter between an expectant woman and her doctor. In recent years, midwives have made a comeback, with many women choosing them over doctors for their care.

The Baystate Ob/Gyn Group offers both options, with midwifery care available through its All About Women practice. But there’s a third option — a much less private one — that’s becoming more popular: Centering Pregnancy.

All About Women is one of the first area practices in the area to offer the Centering Pregnancy group care concept. Checkups and support all take place in a group setting, with each woman having some private time with the midwife facilitator, but most care and education is conducted as a group.

“It’s a discussion and support group of women who meet 10 times during their pregnancy,” said Mary Barber, one of the practice’s certified nurse midwives. “They’re all due within a month, or a month and a half of each other, so there are several groups going at once. Some are first-time moms, and some have other children.”

About a third of the women in the midwifery practice currently opt for Centering Pregnancy, Barber noted.

“We have an agenda for each session based on how far along they are in their pregnancy,” she continued. “Then the discussion evolves with the interest of the women.” Topics might include comfort measures in pregnancy and childbirth, nutrition, family planning, choosing a pediatrician … really anything that affects the mother’s life and health through gestation, the postpartum stage, and beyond.”

Although Centering Pregnancy isn’t what some might consider alternative health, it is just that, in the sense that it offers an alternative from the mainstream option of one-on-one visits. But proponents like Barber say it can actually provide a fuller experience.

“It’s different than just a private visit,” she said. “Women have a full two hours with a provider, as opposed to 10, 15, maybe 20 minutes during a traditional prenatal visit. And a lot of women find they’re able to learn about health and lifestyle issues that affect not just pregnancy, but their long-term health. They get ideas from other women, and get answers to questions they might not have thought of asking.”

Get Together

The women in the Centering Pregnancy group do have a couple of private sessions with their midwife at the beginning of pregnancy and as the due date approaches, and also around the time of the main fetal ultrasound. And anyone who needs an appointment between group sessions may do so, usually on a same-day or next-day basis. “I’ll even call someone at home if I get the sense they need to talk one on one,” Barber said.

But other than that, get used to sharing — and learning

“A lot of women work or have other responsibilities, and it’s important to be able to sit down every two to four weeks during their pregnancy and have this support and this time for themselves,” Barber said. “I think it really enhances pregnancy. I’ve been in this field since 1986, and it really gives me the sense that I can finally educate women about pregnancy and healthy lifestyles, and have more time to do it.”

She said it makes sense for women to start making long-term changes to their health during pregnancy.

“Most women are ready to shift their lifestyle and prepare to be a parent, and you have to have a healthy environment for the child, so this is an ideal time to consider preventative health care,” Barber explained. “We teach nutrition, help women with mindfulness, and work to develop a healthy lifestyle every day.

“This program isn’t just for you or just for your healthy baby. You’re doing it together as a team,” she said, adding that the team concept applies to the support group as well. “You might have better success with some of your goals when you get ideas from other people about how to stick to them.”

Barber’s feelings about the program have been echoed by past participants.

“They’ve been thrilled to do it this way, and they can’t imagine having prenatal care in any other way,” she said — partly because of the emphasis on total well-being that’s not reliant on a doctor. “They learn self-care, they do their own blood pressure and weight, and we encourage journaling along the way.”

Also unlike a doctor visit, Centering Pregnancy meetings start and end precisely on time, so women can better slot them into their busy schedules. All About Women varies the times to give participants options — perhaps 12:30 to 2:30 so they can take an extended lunch hour, or 3:15 to 5:15, for those who prefer to leave work early.

Not only is Centering Pregnancy enriching for staff and expectant mothers alike, the program also doesn’t alter the administrative flow of the practice or hinder anyone’s ability to see a doctor, and it’s cost-neutral, said Jackie Bouchard, assistant administrator at All About Women. That, she noted, is a positive quality at a time when health reform and rising health costs have many people anxious about the future.

“No one is sure where health care is going to go,” she said, “but we’re thinking outside the box in terms of, ‘how can we have a wonderful patient experience and meet the needs of the practice?’ Financially, this is a good program, and that’s another great asset to Centering Pregnancy.”

A Woman’s Touch

Although the support-group model of prenatal care might not be the norm, said Barber, it shouldn’t seem odd, either.

“Before we lived in these modern times, it really was the women of the village who helped other women and taught them how to take care of a child,” she said. “That support can really go a long way.”

That’s not to say men are excluded; there are certain sessions where they are invited to share in the educational portion of the agenda.

“Those are times when we’ll discuss parenting, what to expect in labor, the idea of support in labor, and what to expect when you go home, the first few weeks,” she said. “But the first half-hour, when the checkup component is done, is just women.”

Indeed, the strength of Centering Pregnancy lies in the give-and-take among the expectant mothers — conversations that don’t end with childbirth.

“We gave a reunion a month or two later, and everyone can come in and share their birth experience,” Barber said. “Some of them continue to get together with each other after the baby is born, especially during postpartum leave, and I think that’s an asset; they can share ideas about child care, day care, breastfeeding, issues like that.”

Because, especially on the challenging days, it’s nice to know there’s a village out there, waiting to help.