Members in Action Case Study: CenteringPregnancy®

Overview

South Carolina suffers from a high rate of preterm birth, with 11.1 percent of women delivering prior to 37 weeks gestational age (according to the March of Dimes 2016 prematurity report card for South Carolina). If South Carolina were its own country, it would tie Madagascar for the 18th highest rate of preterm birth, higher than Bangladesh, Sudan and Iran. Infants born preterm are at risk for lifelong neurosensory and neurocognitive disabilities. There is also a racial disparity in rates of prematurity, with 14.1 percent of African-American women in South Carolina delivering preterm.

To address these issues, Greenville Health System (GHS) partnered with the March of Dimes and the South Carolina Department of Health and Human Services (SCHHS) to start implementing CenteringPregnancy (CP) group prenatal care at GHS and across the state. CP, developed by the Centering Healthcare Institute, is comprehensive prenatal care in a group with other women who are due in the same month. CP empowers patients, strengthens patient-provider relationships, and builds communities through three main components:

• Health assessment – Both provider and patient are involved in the health assessment. Patients receive one-on-one time with their provider and learn to take some of their own assessments. This engages them in their own self-care and care of their child.
• Interactive learning – Engaging activities and facilitated discussions help patients to be more informed, confident, and empowered to make healthier choices for themselves, their children, and their families.
• Community building – One person’s question is another one’s question. Patients quickly find comfort in knowing they are not alone. Participation in group care lessens the feelings of isolation and stress while building friendships, community, and support systems.

Research shows that CP patients are less likely to have preterm births compared with patients in individual care. Participants also indicate a better patient experience. With funding from the March of Dimes and SCHHS, GHS has trained 596 people in CenteringPregnancy facilitation at 24 practices across the state, including 83 physicians, 54 nurse practitioners/nurse midwives, 36 administrators, and more than 200 students and residents. Enhanced reimbursements from South Carolina Medicaid and Blue Cross and Blue Shield of South Carolina help with sustainable funding. Patients have embraced CP. More than 5,600 women have participated since the state started the project, with new groups meeting every day.