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Centering

Improving health by transforming care through Centering groups.

Photo of Marena Burnett
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"This is my first pregnancy. It is exciting and wonderful, but also terrifying. I have so many questions and am not sure where to get information I can trust."

"I am far away from my family and support systems, living in a country where everything is foreign to me. No one in my clinic understands where I come from. I am feeling isolated and alone."

"I wait and wait and wait for my appointment, and then it feels so rushed. There is never enough time to talk about my concerns with the doctor and I leave with more questions than I went in with." 

"I get that I am overweight and should quit smoking, but it’s not that easy. Now that I am pregnant, I would really like to try."

"It’s my fourth child. So much is different than my others, but everyone assumes I know everything I need to know."

"I did that test with the nasty sweet drink. Now they tell me I have gestational diabetes and tell me to change my diet. What does that even mean?"

"I am 16 and pregnant. None of my friends have babies and they have no idea what I am going through." 

"They keep giving me paper handouts at the clinic. They do not know that I cannot read."

"I heard “breastfeeding is best” but no one in my family has ever breastfed a baby. They think I am foolish to want to try it."

"I answer the same questions from patients all day long. Appointments are too short, there is never enough time, and I have no idea if my patients are even listening to what I tell them. Honestly, I’m bored, frustrated, and kind of burned out." 

"I grew up in a family with a lot of yelling and hitting and other pretty awful things. I want to be a different parent to my child."

"I put on my makeup and my smile. I answer their questions, but does the pediatrician even care? No one really sees the pain and sadness inside me. Having a baby is supposed to be a happy time."

"The doctor at the clinic asked me if I knew about safe sleep. Sure, I said. They don’t know that I can’t follow all of those rules when we are living in a shelter."

Imagine if all of these voices could come together with one another for their prenatal care and well-child visits. What could that look like?

Imagine….

  • Healthcare that is accessible, especially to the most vulnerable patients
  • A safe place where differences in language, age, cultural backgrounds, literacy and learning styles are honored and respected
  • Patients who are empowered to be actively involved in their own self-assessment and encouraged to be collaborative partners in their healthcare 
  • Trusting relationships
  • Group visits for prenatal and well-child care, providing continuity where it may have the greatest potential impact (P-2)
  • Two hour group visits with ample time for learning 
  • Discussions that bring people together in community, so they are not alone in their experiences
  • Opportunities for honest conversation and learning
  • A team approach to care that is re-energizing, productive and fun for providers
  • Improved outcomes for mothers, babies and families


Centering, an evidence-based model of group medical visits, brings women with similar due dates, parents and babies, and their healthcare team together for group prenatal and well-child care where they learn from each other. In each two-hour visit, there is ample time for health assessment, interactive learning and community building. Sessions meet nationally recognized standards, and are facilitated by a credentialed health provider. Patients receive the highest quality of care and, as part of an ongoing group, form a supportive community where they develop skills and confidence to take control of their health. Providers report higher satisfaction with their practice because it allows them to get to know their patients in a more relaxed and meaningful way.

CenteringPregnancy and CenteringParenting group care is for every expecting and new parent, including all of the personas described in this challenge. Centering groups are in every type of care setting, including community health centers, FQHCs, teaching hospitals and clinics, and private practice. Innovations include high risk, opioid addicted, HIV, diabetes and teen moms.

What is a provocation or insight that might inspire others during this challenge?

Centering has been shown to have a profound positive impact on health outcomes and increase the chances every new family has to thrive. The available evidence suggests that Centering has a combined effect of stress reduction, education and empowerment that brings about this impressive effect.

How does this research relate to our use cases and personas?

In nearly 100 published studies and peer-reviewed articles Centering demonstrates improved outcomes, including a 33% - 47% decreased risk of preterm birth, more consistent attendance at prenatal and postpartum visits, greater readiness for birth and infant care, higher breastfeeding rates, and improved satisfaction scores. One promising recent study showed a flattening of racial disparity for women in Centering, with a similar overall preterm birth rate for black women as white women.

Tell us about yourself:

That's me in the CenteringParenting group photo, holding the most delicious baby! I am a mom, health educator and member of the CHI team - passionate about making Centering accessible to all.

Are you currently an employee of Sutter Health or UCB Pharmaceuticals?

  • No

2 comments

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Photo of Kate

Hi Marena!

Thank you for posting. Is this the website for Centering Parenting - https://www.centeringhealthcare.org/about?

How do expectant mothers find out about the service?
Are the fathers involved in this process or the support network of the mothers e.g. friends, family etc.?
Have you encountered any resistance from healthcare providers in participating in the program?

Photo of Marena

Thanks for the thoughtful questions, Kate. Centering is group healthcare - the prenatal visit or the well-child visit. Moms, dads, partners and support people can all be a part of a Centering group. You'll see some fabulous dads in the photos I posted from a CenteringParenting group at Einstein Medical Center. One of the dads confided in me that he worked all the time but had not missed a single one of his daughter's well-child visits. He loved being a part of the group. And typically it is the healthcare provider who is the champion for bringing Centering to their practice or health system. They may have learned about it in residency or med school, or experienced Centering at another practice. We hear that they love providing care in this way, because it allows them to get to know their patients in a more relaxed and meaningful way. Instead of fifteen minute individual visits, Centering providers are with their patients for two hours. Spending this time together allows for deeper connection and more time to discuss the topics that are important to both patient and provider. You can learn more at https://www.centeringhealthcare.org or join the conversation on our online forum, CenteringConnects.