CenteringPregnancy is a holistic, relationship-based care concept that offers obstetric providers and patients more time at prenatal appointments. Together, in partnership with Stanford Medicine Children’s Health Obstetrics Clinic (SMCHOC), Stanford University School of Medicine Department of Obstetrics and Gynecology (SUSOMOG), and the Centering Health Institute (CHI); CenteringPregnancy has been developed and launched at SMCHOC.

The development of CenteringPregnancy at SMCHOC was modeled after CHI’s nationally recognized, evidenced-based, group prenatal care program. This patient care model has been shown to strengthen patient-provider relationships to build healthier communities with improved pre and postnatal outcomes. A limitation to the Centering Health Institute’s model that we have identified is that it is only modeled for low-risk pregnancies. The innate goal and vision of SMCHOC and SUSOMOG is to provide equitable quality care to all, this includes patients with low-risk and high-risk pregnancies. We envision the CenteringPregnancy program flourishing once we are able to take a novel approach to group prenatal care with no exclusion of pregnancy classification type. We are seeking funding to develop this novel program which we have named Stanford STRONG (Supportive Team-based Respectful Obstetric Natal Group care). The investment in the success of Stanford STRONG is an investment in the community and these positive health outcomes will not only impact this generation but these effects will ripple on for generations to come.

Stanford Medicine Children’s Health Obstetrics Clinic’s inaugural low-risk CenteringPregnancy group had a successful first session on February 13th, 2023. Prior to the successful launch, months of very hard work went into planning operations, workflow, templates, space planning, the initial training for staff, socializing the program, and ordering necessary supplies. 14 interdisciplinary staff members were trained by a CenteringPregnancy implementation advisor/facilitator trainer, including providers, educators, RNs, MAs, and clinical assistants. To date, we have had 2 groups start and are actively enrolling a third cohort. The initial cohort had 6 patients and 6 partners enrolled and the second cohort had 8 patients and 8 partners. The response so far has been incredibly positive for patients, providers, and staff alike.

The traditional prenatal care model includes brief one on one patient/provider visits. In CenteringPregnancy group care, you will receive group prenatal care based on a nationally recognized group care model, which is facilitated by a multidisciplinary obstetric team including providers, nurses, and medical assistants. Care is provided within a community of six to twelve pregnant persons with similar due dates with the option of including their partners or support person. Group discussion and education topics include, but are not limited to, nutrition, common pregnancy discomforts, stress management, labor and delivery, breastfeeding, and infant care.

This group time offers deep conversations into desired prenatal education topics, truly giving participants more valuable time with their Stanford STRONG team compared to traditional prenatal care. At a time when “the village” is absent, community groups are vital to healthy pregnancies and healthy babies. We are meant to be in conversation with one another and create connections that facilitate togetherness. The cost of preterm birth and related conditions is more than 10 times that of a healthy baby. $26 billion was the annual cost of preterm baby care (a societal economic cost that includes medical, educational, and lost productivity) in 2005 (Centering Health Institute, 2023). In 2018, 379,777, or 10% of U.S. babies were born preterm. CenteringPregnancy could prevent more than 150,000 of all preterm births projected to provide a savings of $8 billion in the first year alone (Centering Health Institute, 2023). Significant savings continue for these children into adulthood as they do not bear the weight of comorbidities acquired from preterm birth.

CenteringPregnancy groups are composed of pregnant people of different ages, races, and socio-economic backgrounds; these differences diminish in importance as they share the common experience of pregnancy, birth, and family care. Evidence has been published to show that CenteringPregnancy increases the rate of preterm birth and low birth weight babies. Therefore, CenteringPregnancy nearly eliminates the racial disparities we see in patients who experience preterm birth. African American women, who are at higher risk for preterm birth in the US, experience a lower risk of preterm birth when enrolled in CenteringPregnancy than in tra-di¬tion¬al care (Centering Health Institute, 2023). These improvements will have a significant impact on individuals, families, and the greater community at large.

CenteringPregnancy empowers patients, strengthens patient-provider relationships, and builds communities by fostering shared-decision making and interactive health assessments. Patients receive one-on-one time with their provider and learn the value of the health assessment performed, engaging them in their own self-care and health promotion. Participation in group care lessens the feelings of isolation and stress while building friendships, community, and support systems.

CenteringPregnancy was created based on the proven principle that when people are actively engaged and involved in a discussion with their peers, rather than being lectured or given a pamphlet, they will have a greater understanding and be prepared to make informed decisions. Providing care in this way allows the pregnant person and provider to relax and get to know each other on a much deeper and more meaningful level. Members of the group form lasting friendships and are connected in ways not possible in traditional care. Receiving health care in a group setting leads to greater engagement, learning, and self-confidence.

CenteringPregnancy is improving the way people receive their prenatal care and should be offered and available to all pregnant persons. Measurable outcomes we are tracking and expect to see improvement in: • Pre and post-surveys tracking program satisfaction • Improved Press Ganey Scores • Reduced preterm deliveries • Improved newborn weight • Improved breastfeeding rates • Improved Edinburgh Postnatal Depression Scale scores • Decreased NICU admission rates