CenteringPregnancy

The Problem:
Studies have shown that preterm and low birthweight babies are at increased risk for both immediate life-threatening health problems as well as long-term complications and developmental delays. In South Carolina, a disproportionate number of preterm and low birthweight babies are African-American.

The expenses of preterm birth and related conditions can often increase the cost of the birth by more than 1000%, equating to roughly $8 billion in additional healthcare spending.

The Goal:
Implement a CenteringPregnancy model where small groups of 8-12 women have their prenatal care appointments together throughout their second and third trimesters.

Method & Implementation:
Starting in 2008, the OB-GYN Center at Greenville Health System moved to the CenteringPregnancy model. The model then spread to 18 additional providers thanks to training and start-up funding from the Centering Expansion Project, which grew out of those efforts. Thanks to that program, more than 3,200 women have participated in CenteringPregnancy groups.

Each group has four monthly sessions during their second trimester, then they meet every two weeks through 40 weeks. There’s also one session four to eight weeks postpartum. Each session includes an initial 30-40 minutes for self-assessment and individual assessments with the provider in the group space, followed by 60-75 minutes of “circle up” facilitated discussion time which encourages questions and interactive learning.

Challenges & Barriers:
Training for staff
Scheduling difficulties
Appropriate space for group meetings

Successes:
Babies are less likely to require admission to the neonatal intensive care unit and fewer infants are born with a low birthweight (less than five pounds) in CenteringPregnancy groups. The rate of preterm births for women in CenteringPregnancy is 8%, a 34% reduction. The racial disparity gap for preterm births is largely eliminated in CenteringPregnancy models, with 8.3% pre-term births for African-American mothers vs. 8% pre-term births for Caucasian mothers

Return on Investment:
Research by Dr. Amy Crockett, MD at GHS, in collaboration with the Division of Medicaid Policy Research and Institute for Families in Society at the University of South Carolina, has shown CenteringPregnancy in South Carolina has led to more than $10 million dollars in savings to date.

To learn more about Dr. Crockett’s CenteringPregnancy efforts, a full SCHA story is available here. For (now) Prisma Health Greenville Memorial’s page, click here.

For more information about this story or to tell us about your own best practices, email us at stories@scha.org.