A new study reveals that group prenatal care leads to higher care attendance and better mental health during pregnancy compared to traditional one-on-one visits.
Group prenatal care boosts attendance and health outcomes | Image Credit: © Pixel-Shot - © Pixel-Shot - stock.adobe.com.
Attendance in prenatal care group visits increase the odds of women continuing with their care and experiencing better birth outcomes, according to a recent study published in PLOS One.1
Alongside better outcomes compared to women receiving one-on-one care, participants in a prenatal care group reported a preference for this care in future pregnancies. Investigators concluded these results may allow health providers in the United States to provide more effective and sustainable prenatal care.
“Bringing women together for group prenatal care allows them to form meaningful connections with peers and their midwife," said Crystal Patil, PhD, lead study author and professor of nursing at the University of Michigan. "They don’t just come to care and get a lecture about having a healthier pregnancy—instead, they collaboratively problem-solve."
The hybrid effectiveness-implementation trial was conducted to determine the impact of group prenatal care on outcomes in pregnant women.2 Participants were randomized into a control arm of individual care vs group care, with the former group receiving standard antenatal care.
Standard care included meeting with a midwife for health assessments, with 8 visits offered to participants. In comparison, group care involved 7 antenatal sessions lasting 2 hours each and 1 session approximately 6 weeks after birth.
During these visits, 30 to 45 minutes were dedicated to socializing and health assessments. Additionally, participants underwent one-on-one sessions with the midwife in the group space. This included being able to have confidential discussions about personal concerns.
After the initial 30 to 45 minutes, the following 75 to 90 minutes were dedicated to group-wide interactive health promotion activities. Topics were discussed interactively, and group members participated in games, role plays, and sharing of knowledge and experiences.
Participants included pregnant women presenting for their first antenatal visit and completing a baseline self-report survey. Those aged under 15 years or beyond 24-weeks’ gestation were excluded from the analysis.
Interventions were implemented through a 3-step model, robust training and mentoring program, support and interactive assistance, and minimizing the need for additional materials. The impact of group care was measured based on rates of low birth weight, with demographic and socioeconomic variables considered covariates.
There were 1887 women included in the analysis, over 40% of whom were pregnant for the first time, nearly 60% aged 20 to 29 years, and over 90% married or in a relationship. Food insecurity within the prior year was reported in nearly 70%, and nearly 38% were anemic at baseline. These characteristics did not differ between care groups.
Participants receiving group care showed greater supportive relationships and peer connectedness than those receiving individual care, with a point estimate of 1.43. These patients also had higher pregnancy-related empowerment scale (PRES) scores, with a point estimate of 2.14. Higher PRES scores were also reported in multiparous women.
Wait time, satisfaction with care, care attendance, and preference for future group care were also positively impacted by group care. A 3.26-fold increased chance of reduced wait time was reported in the group care arm, and the point estimate for satisfactions vs the individual care arm was 1.21.
Group care was linked to more diverse diets in late pregnancy, higher healthy pregnancy knowledge, and increased partner communication scores vs individual care. While no association with low birth weight was reported, lower mental distress scores were noted in the group care arm, with a point estimate of -0.61.
Most clinical outcomes did not differ based on group vs individual care. However, the results highlighted the efficacy of group prenatal care toward providing important health promotion topics.
“While most women do know what supports a healthy pregnancy, group visits help them turn that knowledge into action—by sharing strategies, building confidence, and finding practical ways to eat well and prepare for childbirth,” said Patil.1
References
Get the latest clinical updates, case studies, and expert commentary in obstetric and gynecologic care. Sign up now to stay informed.