The CenteringPregnancy® Model
The term Centering comes from the belief that health care should be centered or focused on the individuals participating in the care experience at any given time. That starts with the individual patient and extends to the whole group, including clinical care providers. The Centering model of care brings people together who share common goals, but their personal preferences and values make each group unique. When a group of people come together for a common purpose of health and well-being to share information and learn together, a transformation happens at both the personal and collective level that brings about better understanding, greater engagement, and self-confidence. All of that translates into personal decisions and actions that are supported by the group and that lead to better health outcomes.
Through CenteringPregnancy®, women are brought together with other women who are at the same stage of pregnancy for their visits. Women take their own blood pressure, weigh themselves, set personal goals and have an individual check-up with their clinician. Then the group, along with the clinician, engages together in a facilitated discussion around important and timely health topics. In this group setting, there is more time for women to explore the issues that impact the health of themselves and their babies and families. Women experience greater learning, feel better prepared for labor, birth and infant care, gain friendship and support in the group and have overall greater satisfaction.
Centering is Better Care
Centering is a team approach to care that actively engages patients in goal setting, skill-building, and peer support. Provider facilitated group health care allows more time to explore important health topics. The model includes three components of care: assessment, learning, and community building.
Centering is Better Health
Centering is an evidence-based innovation that has been nationally recognized by leading healthcare experts because of the improved outcomes for important maternal child health factors including preterm birth rates, low birth weight rates, small for gestational age, breastfeeding rates, and immunization rates. Centering replaces routine individual visits, and follows the ACOG Guidelines for prenatal care.
CenteringPregnancy® is a multifaceted model of group care that integrates the three major components of care: health assessment, education, and support, into a unified program within a group setting. Eight to twelve women with similar gestational ages meet together, learning care skills, participating in a facilitated discussion, and developing a support network with other group members. Each Pregnancy group meets for a total of 10 sessions throughout pregnancy and early postpartum. The practitioner, within the group space, completes standard physical health assessments. Centering replaces routine individual visits, and follows the ACOG Guidelines for prenatal care.
CenteringPregnancy groups provide a dynamic atmosphere for learning and sharing that is impossible to create in a one-to-one encounter. Hearing other women share concerns which mirror their own helps the woman to normalize the whole experience of pregnancy. Groups also are empowering as they provide support to the members and also increase individual motivation to learn and change. Professionals report that groups provide them with renewed satisfaction in delivering quality care.
Assessment (health care) is provided by a licensed health care provider during the group time and in the group space. Each participant has a brief individual check-up with the provider. For privacy reasons, these health assessments occur:
- In a private corner of the group room
- On a mat/mattress on the floor or slightly elevated comfortable area below knee level
- With background music playing
- Optional: a large plant or decorative piece may designate the assessment space
Patients participate in self-care activities including assessing their own weight and blood pressure.
Education is conducted in a facilitative style with two Facilitators lead each group. There are content guidelines for every session, but the actual group discussion is determined largely by the interests, needs, and concerns of the group.
Each patient receives a Centering Notebook with educational material for at-home reference. Critical to the empowering design of Centering are the Self-Assessment Sheets (SAS) which are used by participants at the beginning of each session. These SAS introduce the topic(s) for that session and provide a springboard for the facilitated discussion.
Support, friendships, and community-building are important to the Centering model. These are fostered by the use of nametags, stability of the group, interactive activities, and refreshments at every session. Because the facilitators and the group participants meet for 90-120 minutes on a regular basis, trust and camaraderie develop. Often members choose to meet socially outside the appointment time.