Poster Presentation
Thursday, 20 July 2006
10:00 AM - 10:30 AM
Thursday, 20 July 2006
3:00 PM - 3:30 PM
Pregnancy Outcomes of a Group-Oriented Model of Prenatal Care for Low-Income Women
Kathaleen C. Bloom, PhD, CNM, School of Nursing, University of North Florida, Jacksonville, FL, USA
| Learning Objective #1: discuss the principles of group-oriented prenatal care. |
| Learning Objective #2: identify the effects of group-oriented prenatal care on maternal-infant outcomes. |
The infant mortality rate in the US is higher than that of 27 other countries, primarily due to births of preterm and low birthweight infants. Prenatal care that includes psychosocial as well as medical support has been shown to have positive effects on these outcomes. This study is a clinical trial of CenteringPregnancy, a group-based prenatal care model that includes assessment, education, and support. Specific outcomes measured include prenatal care utilization, preterm births, low birth weight infants, satisfaction, breastfeeding rates, infant immunization rates, repeat unplanned pregnancies as well as associated factors including perinatal complications, risk behaviors, self-esteem, knowledge, and health locus of control. The program has been implemented in two health department clinics serving populations with high rates of preterm and low birth weight infants. All women enrolling in prenatal care before 20 weeks gestation are invited to participate by choosing either CPP or conventional prenatal care (CPC). Women in CPP are then scheduled for all subsequent prenatal visits in small groups with other women of similar gestational age. Group sessions include self-assessments, assessment by the practitioner, and educational and support activities within the group context. Women in CPC receive prenatal care from the practitioner. Follow-up data collection occurs at 35-37 weeks gestation, 3-6 weeks postpartum, and one-year post-birth. To date, 51 women have enrolled, 24 in the CenteringPregnancy groups and 27 in conventional prenatal care. Enrollment will continue until there are 75 women in CPP and 75 in CPC. Preliminary data analysis reveals high levels of satisfaction and increased prenatal care utilization with CenteringPregnancy. CPP emphasizes a holistic approach to pregnancy directed toward self-responsibility, hallmarks of advanced nursing practice. It is an effective and efficient model of care provided in an atmosphere where learning and support enhanced by group resources including the guidance of the advanced practice nurse.
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