A Journey Shared

Pregnancy can be simultaneously beautiful and terrifying. And for women in the midst of those 40 emotional, hormonal, exhilarating weeks, community camaraderie feels like a lifeline. With this understanding, Roper St. Francis Healthcare brings together expectant mothers and health providers through a unique model of group prenatal care. Meet CenteringPregnancy®.

WRITTEN BY Holly Fisher
PHOTOGRAPHS BY Ruta Smith

Ashlee Blackwelder is the first of her friends to get pregnant. She doesn’t have a ready-made network of experienced mamas to dispense advice on breastfeeding, infant care or the common discomforts of pregnancy. So when her OB/GYN practice suggested she join its new CenteringPregnancy program, she was eager to try it out.

A national program, CenteringPregnancy focuses on group prenatal care. It gives moms more time with their healthcare provider plus the chance to connect with other women going through a similar journey. “This is an opportunity to spend not just more time with your doctor but other expecting moms who are due around the same date,” says Blackwelder, an occupational therapist who lives in Ravenel. “You still get checkups and assessments, but it’s more personal, not just a short, 10-minute appointment. I’ve gotten to know my doctor better, and that’s the thing I’ve appreciated the most. There’s more comfort knowing your provider.”

Support Group

Roper St. Francis Healthcare launched CenteringPregnancy this year, one of only about a dozen healthcare systems in South Carolina to offer the program. Any pregnant woman at a participating medical practice is invited to join the program after her first trimester. Women with similar due dates are organized into groups of eight that meet once or twice a month. The two-hour class includes a standard prenatal checkup, games, snacks and plenty of facilitated discussion for moms to learn, ask questions and share resources with one another. An OB/GYN, midwife or nurse practitioner facilitates each group along with another staff member, such as a medical assistant.

Dr. Eleanor Oakman says CenteringPregnancy benefits both the doctors and the moms. “We see a lot of pregnant patients,” explains the Roper St. Francis Healthcare affiliated OB/GYN. “We say the same stuff over and over again, give the same spiel. That’s important to do, but it doesn’t give us time to delve into what the patients really want to know.” Through CenteringPregnancy, Dr. Oakman can give eight patients all the basic information they need and still have lots of time to answer their specific questions and address concerns.

Paige Williams, a medical assistant at Bon Secours St. Francis Hospital, has sat in the CenteringPregnancy group circle both as an expectant mother and a facilitator. “When I got pregnant, I was scared and didn’t know how my body was supposed to change or what was considered normal. Centering gave me a safe environment in which to ask my questions without feeling stupid,” she remembers. Now, she’s on the flip side of the program, helping others who may feel similarly anxious. “I feel emotionally connected to these women, because I was once there, too.”

Participants also learn how to take charge of their own healthcare. They take their own blood pressure, weight measurements and urine samples, all while gaining an understanding of why those assessments matter, Dr. Oakman explains. “We’re trying to empower people to answer questions about their health and understand the why.” Each class covers a key pregnancy topic, like nutrition, breastfeeding, pregnancy discomforts, infant care, stress management or maternal mental health. And the women learn not just from the medical staff but from each other.

Building a Village

Blackwelder meets with seven other moms-to-be—all of whom are due to deliver their babies in early September. “It’s an opportunity to meet moms who are going through the same thing you are, especially in COVID times when you’re not meeting a lot of new people,” she says. She’s already picked up some tips from her fellow program participants. One mom recommended grandparents—not just parents—take an infant CPR class. Another suggested sending grandparents to a class where they learn new techniques of infant care that may have changed from when they were parents. (Find an assortment of Roper St. Francis Healthcare infant care classes online at rsfh.com/calendar.)

To this day, Williams relies on a particular piece of advice from her first CenteringPregnancy meeting. “They told me that there was no handbook for being a parent, that there’s not one right way to be a mom. That stuck with me,” she says. That reminder was especially reassuring in her earliest days of motherhood. “Even when I felt like I was failing, I could look down at my baby and see her smiling up at me, and I knew I would figure it out.”

Roper St. Francis Healthcare certified nurse midwife Erin Kendall says she would have jumped at the chance to be part of CenteringPregnancy when she was an expectant mother. “None of my friends had babies yet, and I’d recently moved to Charleston so didn’t really know anyone,” recalls Kendall. “I was so excited about my pregnancy and would have loved to make that core group of friends and peers.” Now a mom of two, Kendall helps facilitate CenteringPregnancy groups and encourages all mothers in her practice to join.

“CenteringPregnancy is a different way of doing prenatal care,” she says. “Rather than shuffling women along through 10 to 15 individual visits where we’re checking to make sure mom and baby are alive, we’re recognizing that pregnancy is a major life event, a major life transition. Pregnancy happens not just to the individual but to the family,” adds Kendall. “It’s a social event as much as it is a medical event.”

The nurse midwife describes CenteringPregnancy as “your favorite internet forum but with qualified medical professionals.” That additional time with patients is one of the reasons CenteringPregnancy is so special. “We go beyond the boilerplate advice and really address the concerns, fears and excitement every woman brings to her pregnancy,” Kendall says.

A Brighter Future

Roper St. Francis Physician Partners OB/GYN has devoted years to getting the funding and training needed to launch CenteringPregnancy, because numbers show that the program really does work. “The CenteringPregnancy model has been studied for more than 20 years,” Kendall says, pointing to impressive improvements in patient outcomes. Research consistently shows that CenteringPregnancy participation increases breastfeeding rates and decreases low birthweight and preterm births.

The results are particularly impressive for Black mothers, with significant decreases in preterm delivery rates. “The racial disparity in preterm birth for Black women relative to White and Hispanic women was virtually eliminated in this study,” reports the research brief “How CenteringPregnancy Can Support Birth Equity.” Another study found that Black women were “substantially less likely to have a preterm birth in group prenatal care as compared to individual care—the rate fell from 15.8 percent to 10 percent.”

The statistics prove that additional connection with patients is a critical component of healthy moms and babies. “We’re getting more time to educate patients and build relationships,” Kendall says. “There’s something very powerful about sitting in a circle of chairs as equals and listening to one another as mothers. I believe the breaking down of barriers between patients and providers has a lot to do with improved outcomes.”

Connection is Key

The Roper St. Francis Healthcare CenteringPregnancy program has the potential to serve 200 women. Even women with high-risk pregnancies can participate. (They will continue to have individual visits with their doctor while still benefiting from the group setting and social connection.) Spouses and partners will also be invited to join the sessions once COVID-19 restrictions allow more than 10 people to gather in a room.

The women in these groups tend to stay connected between sessions, often building deep friendships that last beyond pregnancy. Williams met one of her best friends as a participant in another CenteringPregnancy program, and the two have leaned on each other ever since. “My daughter and her son were born two days apart. Fifteen years later, we’re still doing motherhood together with these teenagers who are headed to high school,” she laughs.

To Kendall, a group approach to prenatal care just makes sense. “Humans are a community-based, social species. We celebrate all of our major life events socially. Why should pregnancy be any different?”