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A Circle of Care - Centering Pregnancy

“The Borgess Women’s Health Centering Pregnancy Program helped me and my husband become even better prepared for our second pregnancy,” said Jennifer Brown, of Coldwater.

“We had additional time with Megan Deibel, Borgess Certified Nurse Midwife, and the program allowed us to learn more at the group prenatal session with Megan and eight other expectant mothers.”

Patients like Jennifer are embracing Borgess Women’s Health “Centering Pregnancy Program,” one of the first programs of its kind in Michigan and a national prenatal health model first conceived by a Yale School of Nursing midwife. It includes group prenatal meetings with Borgess midwives, more time with midwives, pre-scheduled visits during the pregnancy, no waiting the day of appointments, support from others going through the same changes at the same time, and much more.

What is Centering Pregnancy?

“We’re changing the way women receive prenatal care,” said Megan Deibel, MSN, CNM, Borgess Women’s Health. “Through this program, prenatal care, childbirth education, and peer support are offered in ten two-hours sessions to eight to ten women (and partners) who are scheduled to give birth at about the same time. Sessions begin a few weeks after the start of the second pregnancy trimester, typically 16 to 20 weeks from conception.”

“The group dynamics of Centering Pregnancy provides more quality time with expectant mothers and providers, compared to most traditional individual prenatal visit schedules,” said Lisa Adams, Centering Pregnancy/Birthing Family Education Coordinator. “We get to cover important social, behavioral, and psychological factors, in addition to other more customary educational elements.

Assessment, education and support are fundamental aspects of each meeting.

”Each session includes checkups, question and answer sessions, group discussions about healthy pregnancy topics and a chance for everyone to get to know each other,” Adams said. “We ‘Circle Up’ at the end of each session for final thoughts.”

More than 200 women have completed the Centering Pregnancy Program at the Borgess Women’s Health Program since it inception in 2008. The feedback has been positive.

“Couples tell us that they enjoy the continuity of the Centering Pregnancy Program,” Adams said. “They never have to wait for group meetings to start and we never cancel a meeting/appointment. The group cohesiveness also helps participants become comfortable with each other,” Adams said. “They ask important questions that may only arise in a warm, group atmosphere. The resulting answers sometimes need this collective perspective that is ingrained in a group of people going through the birthing adventure along with experienced providers offering their expertise.”

“I think patients like the Centering Model of Care model because it brings all of us together without any doors or desks between us,” Deibel said. “I feel the same way. We communicate better. When we’re done, we feel like we’ve made friends and have accomplished as much as we possibly can to assure a healthy pregnancy.”

Jennifer Brown has kept in touch with the new friends she made during her Centering Pregnancy Sessions.
“The other women in my group were all younger than me,” Brown said. “However I learned so much from the other participants in this very positive environment that has a sense of community.

“If I saw another woman struggling with some aspect of her pregnancy, we would often talk together,” Brown said. “This helped to make my second pregnancy and birthing experience magical. Typically my cheeks hurt after each session because of the laughter and the information we shared. The only sad time came at the end of our tenth session when we had to say goodbye. All this helped to make my second pregnancy and birthing experience magical.”

There are provisions for private physical assessments in the Centering Pregnancy Program.

“Patients sometimes have personal problems that need to be addressed,” Deibel said. “In our individual assessment that is a part of each session, women bring topics of concern. These can be handled at that time, but if a lengthier discussion of a more complicated issue is required, that private talk can be postponed until the end of the Centering Pregnancy session. We also provide ample opportunities for participants to anonymously pose questions in the group setting.”

Participants participate in every phase of the sessions.

“Each session begins with personal assessments from the midwife and also with participants recording their weight, blood pressure and the size of their growing abdomen,” Deibel said. “Patients are given easy to use tools for these measurements and they seem to enjoy using them and sometimes sharing the results with fellow participants.”

The midwives who lead the sessions have prepared materials but each session is unique. The group drives the conversation.

“The health professionals who lead the classes are not ‘teachers’ in the traditional sense of the word,” Deibel said. “As group leaders of adults, we begin discussions, offer solutions or direction to content found in traditional childbirth classes, but we want to increase the sense of empowerment that is inherent in each individual who participates with us. Women may learn as much or more from other women in the group than from us.

“Empowerment, choice, and the concept that more is better than less are all elements of the Centering Pregnancy Program at Borgess Women’s Health,” Deibel said. “These ideas are becoming increasingly more prominent in many other areas of health care.”

In 2010, the March of Dimes Michigan Chapter awarded the Borgess Foundation a $25,000 Chapter Community Grant to support the Borgess Women’s Health Centering Pregnancy program. The award helped achieve official site approval by the Centering Healthcare Institute. It also emphasized two other goals that have also been achieved: a prematurity rate of less than or equal to 10 percent for program participants and the continuation of breastfeeding for at least half of the program participants through their six-week postpartum follow-up visit.

The Centering Pregnancy Program at Borgess Women’s Health is available to all women with low-risk pregnancies. For more information, call 226.6796 or visit centering.borgess.com.

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