A New Standard in Prenatal Care


Story Number: NNS150723-16Release Date: 7/23/2015 4:03:00 PM
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By Mass Communication Specialist 2nd Class A.J. Jones, Naval Hospital Camp Lejeune Public Affairs

CAMP LEJEUNE, N.C. (NNS) -- Upon walking into the room, you forget you're in a hospital.

The walls are an earth tone color, with quotes written on the walls and decorations that make you feel more like you've entered into someone's living room.

The laughs of ten or so pregnant women are heard as they trickle in, signing their names on a sign-in sheet before taking their own vital signs and recording the results.

Afterward, the moms-to-be, and a few dads-to-be, grab a snack and chat as they wait for their turn with the provider to have 'tummy time' as the group calls it.

Conversations erupt and stories are told. You would never suspect that this room is a group prenatal appointment for eight to twelve women. This is Centering Pregnancy.

Centering Pregnancy is an evidence-based redesign of prenatal care developed by Sharon Schindler Rising, CNM, MSN. It uses the concept of group care to promote safety, efficiency, effectiveness, timeliness, and culturally appropriate patient-centered equitable care.

Centering participants are empowered in their prenatal care by learning to assess their own vital signs and weight. They are able to track their weight gain, fetal growth and fetal well-being with the assistance of the licensed practitioner. They take part in education that is geared toward their needs.

The first Centering Pregnancy group at Naval Hospital Camp Lejeune (NHCL) began in October 2012, under Lt. Cmdr. Angela Bartow.

The beginning was small, with one new group a month starting. Since its inception, NHCL's Centering Pregnancy program has grown to the point of four to five groups starting each month.

"This room is busy every day," said Heidi Walker, the centering coordinator for NHCL.

Centering groups are designed to be a two-hour interactive session between a group of patient peers, and at least two facilitators. NHCL's model ensures that there is a provider (either a nurse midwife or a doctor) and a co-facilitator (a nurse, nurse's aide, or a hospital corpsman).

"There is no rank in here," stated Walker. "Patients and the facilitators come in civilian clothes and call each other by their first names."

As patients enter the Centering Room, the atmosphere is calming and inviting. Patients are generally greeted by a provider or co-facilitator. They check themselves in, take their own vital signs and weight, and document this in their own chart.

Patients then begin to have light conversation with each other and enjoy a healthy snack while waiting for their turn to have 'tummy time'. 'Tummy time' is the patient's time with the Nurse Midwife or Doctor where, typically the same as any usual appointment during pregnancy, they will listen to the baby's heartbeat, measure fundal height, and discuss any changes and concerns. If the patient believes it to be a sensitive issue then they will be afforded a private room to speak to the provider.

Centering groups will receive about an hour of education that is geared toward their needs. Groups engage in fun activities that help to retain what they're learning, all the while making new friends that will provide a network or expand the soon-to-be parent's support system.

"People learn and retain so much more in this setting, because it's an interactive setting," said Cmdr. Kirsten Harvison, a nurse midwife and the head of the Centering Pregnancy program for NHCL. "This is a great program."

Patients can expect to start Centering appointments to begin at around their 16 week point. Patients in the Centering Groups have due dates that are close to one another, enabling the group's appointments to be scheduled for the entire pregnancy. Each of the appointments is with the same provider, and appointments are scheduled every four weeks. Once the patients reach about 28 weeks, the groups start meeting every other week.

The concept of group prenatal care may be difficult for some to understand. In a society in which individualism and privacy is extremely important, group centered care may seem awkward. However, those that have participated see the benefits.

Patients are more vested in their own healthcare. Military beneficiaries can reap even more from the developed relationships since many of our pregnant women are far from friends and family and may even be going through this eventful time while their significant other is deployed.

According to Harvison, providers also benefit from this type of prenatal care. No longer do they have to answer the same questions over and over again throughout the day. They are able to get to know their patients on a much deeper level. Providers will feel confident that their patients are getting the necessary education to make healthy choices. All without feeling rushed or overwhelmed.

The Centering model of care allows providers to provide better continuity of care for patients, and it also allows more patients to be seen. By having the appointments in a group setting a provider can see as many as eight to twelve women in the group in a two-hour period, versus seeing six patients with 20 minute appointments.

"I love it," exclaimed Harvison. "I think that the patient's get so much more out of it."

For more news from Naval Hospital Camp Lejeune, visit www.navy.mil/local/nhcl/.

 
 
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