Pregnancy and Beyond Birth: It Takes a Village

In the Centering model, a group of women start their appointments with their providers around the same time, in a group setting. While they have individual time with their providers, they also have time as a group to discuss common questions and concerns. With so much isolation during pregnancy and postpartum, group support gives the opportunity for women to connect and potentially stay connected during a time that can be a bit lonely.

At Portland Maternal Care Clinic, each woman is works with a midwife, a doula, and a maternal care navigator who helps them navigate the system throughout their pregnancy, as well as an OB who works with the women in case questions arise that would benefit from the OB’s perspective (plus the group-based prenatal visits).

Research is also showing significant benefits from this integrative model of care to birth outcomes, postpartum success, as well as reduced medical costs. Results from the Providence Maternal Care Clinic’s program beginning in 2012 through 2013 include:

• a drop in cesarean rates from 32% down to 20%
• Epidural use in vaginal deliveries decreasing from 85% to 47.5%
• patient satisfaction was 98%

All the while the cost of services actually dropped 15.2%!

These evidence based types of programs have actually been around for over 20 years, starting on the east coast. Now, all across Portland, you can see these models popping up. Women’s Health Care Associates, Legacy Emmanuel Midwifery program, and OHSU are all offering these integrative programs in their facilities to interested families. Some have expanded this offering into doula support as well, now using group-based pregnancy discussion groups as a part of client support throughout the childbearing year. (We have experienced great results at Birthing Stone Doula Services with this approach as well.)

Envisioning what this new model looks like might be a bit tricky for those used to brief appointments with their provider, so Women’s Health Care Associates offers a video on their website that gives families a feel for what to expect: tinyurl.com/centering-pregnancy

Benefits beyond birth interventions include; higher breastfeeding rates, lower preterm birth rates, increase in satisfaction and self-confidence approaching labor, increase relationships between new parents which equal higher levels of support in the postpartum period, and even some evidence pointing to higher birth weights in newborns. Add to that savings in health care for both the medical system as well as the consumer by way of reduced need for interventions, and we can only hope this village approach continues to grow and that other hospitals, providers, doula agencies, etc. join their voices to the conversation and include this method of care as an option for families.

For more information please visit these resources: