Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
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A group model of prenatal care: CenteringPregnancy©:
Results of a Randomized clinical trial (RCT)
Ms Heather Reynolds CNM, MSN, FACNM
Associate Professor
Yale University School of Nursing
100 Church Street
South Box 9740
New Haven
Connecticut
USA 06519
+ 1 203 737 2370
heather.reynolds@yale.edu
Practicing nurse-midwife engaged in providing Centering group
prenatal care; Associate Professor of Midwifery, and co investigator
on the RCT for Centering©
CenteringPregnancy®, a model of group prenatal care was
developed in 1993-94 by Sharon Rising, CNM, MSN, a nursemidwife
and educator in Connecticut. The Centering® model
provides prenatal care to 8-12 women with similar gestational age
in a group context, and includes 10 prenatal/postpartum sessions.
Each two-hour session reflect the schedule of routine prenatal care
and includes content related to: Nutrition & Fetal Development;
Common Discomforts; Relaxation & Labor; Family & Parenting
Issues; Birth Experience & Tour Birthing Unit; Labor & Decisions
of Pregnancy; New Baby Care & Infant Feeding; Post-Partum
Adjustment; Baby Care; Baby/Mother Care & Birth Control. The
women are taught to do self-care activities and each has a brief
time for individual prenatal exam with the health provider within the
group space. The model uses a facilitative leadership style, skills
building activities, allows for flexibility in group discussions, and
provides opportunities for women to socialize and form community.
The RCT was undertaken following promising data from a cohort
study done on this model.� A two-site RCT was conducted at two
university-affiliated hospital prenatal clinics. Pregnant women aged
14–25 years (n=1,047) were randomly assigned to either standard
or group care. Group participants received care in a group setting
with women having the same expected delivery month. Structured
interviews were conducted at study entry, during the third
trimester, and in the postpartum period.
RESULTS: Using intent-to-treat analyses, women who were
assigned to group care were significantly less likely to have preterm
births compared to those receiving individual care: 9.8% compared
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