Date of Defense

4-8-2014

Date of Graduation

4-2014

Department

Nursing

First Advisor

Kimberly Searing

Second Advisor

Ruth Zielinski

Keywords

CenteringPregnancy, Prenatal care, breastfeeding, group care, smoking cessation, pregnancy

Abstract

Background: Despite efforts to increase participation in prenatal care, outcomes for women and infants remain below global and national health targets. CenteringPregnancy, a model of group prenatal care developed in the 1990s, incorporates practices consistent with IOM guidelines. This model allows for greater freedom in providing care content that is tailored to the specific needs of the women receiving care.

Objective: To determine whether the CenteringPregnancy model improves maternal and neonatal health indicators such as attendance at prenatal care, smoking cessation, weight gain during pregnancy, gestational age at delivery, mode of delivery, breastfeeding initiation and continuation of breastfeeding.

Methods: A retrospective study was conducted including all pregnant women participating in CenteringPregnancy at two prenatal clinic sites in southwest Michigan from January 2010 through April 2012 (n=173). A comparison group of women receiving traditional prenatal care from certified nurse-midwives was created using propensity scores to match for age, race, and insurance status (n=170). A chart review was performed to analyze maternal and neonatal health indicators including attendance at prenatal and postpartum visits, gestational age at delivery, maternal weight and weight gain during pregnancy, smoking cessation, infant birth weight, mode of delivery (vaginal birth vs. cesarean section), and initiation and continuation of breastfeeding.

Results: There were no significant differences in pre-pregnancy weight, amount of weight gained during pregnancy, prenatal care attendance, gestational age at delivery, or infant birth weight. The CenteringPregnancy group had significantly higher rates of smoking cessation during pregnancy, as well as higher rates of breastfeeding initiation and continuation of breastfeeding.

Conclusions: This study provides more support for the use of CenteringPregnancy in prenatal care clinics, although more research is still needed.

Access Setting

Honors Thesis-Restricted

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