"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?
- 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.