Walter Reed Bethesda’s OB/GYN Department (Obstetrics and Gynecology) recently implemented an innovative approach to care for expectant mothers: offering group prenatal care that’s focused on empowering patients and community building.
Pregnant women enrolled in care at Walter Reed Bethesda, during their initial prenatal visit, can opt to join the prenatal program, known as Centering Pregnancy. The program allows groups of eight to 12 women, due in the same month, to meet with their care provider and other group participants, in a unique group setting, explained Cmdr. Sara Shaffer, a nurse midwife in the OB/GYN Department. The program has been available since September 2012, and has recently been gaining staff support, Shaffer said.
“[The program offers] expectant mothers an increased opportunity to actively participate in health decisions and ask questions with the goal of fostering a more enjoyable prenatal visit,” Shaffer said.
Shaffer is leading efforts to grow the program at Walter Reed Bethesda. According to her 16 OB/GYN providers completed training last week, Jan. 13-14, certifying them to lead Centering group sessions, bringing the total of facilitators to 20.
Certified nurse midwives and nurse practitioners, registered nurses, licensed practical nurses, obstetricians, a maternal-fetal medicine specialist, a lactation consultant and a corpsman, were among those who completed last week’s training. They will now provide this type of care, in addition to the registered nurse and three midwives currently trained at the medical center, including Shaffer.
Walter Reed Bethesda is one of 17 military sites, and one of more than 300 sites nationwide, to use this program, Shaffer continued. Currently at the medical center, there are about a dozen patients enrolled in the program on a monthly basis. Shaffer said she hopes, with the additional staff now trained, the program will continue to gain momentum.
The program offers 10, two-hour sessions, Shaffer continued. At the beginning of each session, group patients are assessed privately. They have their blood pressure and weight checked, blood drawn, and fundal height measured, to check the growth of their baby - all standard aspects of a prenatal visit, except for pelvic exams and ultrasounds, Shaffer said. Those would still be done in a separate, individual appointment.
The assessment portion of the session typically takes about 30 minutes, Shaffer said. Meanwhile, participants can socialize, which is particularly meaningful for those who may have just transferred duty stations or have a deployed spouse and may not know many people in the community, she added.
“Our patients benefit from the care of a skilled provider as well as the support of peers. The military family is uniquely suited and benefits by developing friends and extended family while experiencing a safe and educational health care experience,” said Col. Joseph Gobern, chief of Walter Reed Bethesda’s OB/GYN Department. He added that this model of care has proven to improve outcomes in the delivery of healthcare in various medical disciplines, most notably obstetrics, and exemplifies how the department has been proactively patient friendly.
“This is an opportunity to discuss their experiences and challenges, and work with their provider to find good solutions, while in a fun and social environment,” Shaffer said.
The remainder of each session, about 90 minutes, is dedicated to education, Shaffer continued. Patients learn about a variety of topics, such as breastfeeding, exercise, post-partum depression, family relationships and infant care. Each group also has a guest/co-facilitator, knowledgeable in the particular topic on the agenda for that session, such as a nutritionists and social workers, she said.
Shaffer made clear, this is not a lecture — the facilitator leads the conversation and activities, while providing information. The emphasis is on the patients, encouraging them to engage and ask questions. One woman’s question, is usually another woman’s question, she noted. “Group prenatal care allows patients 10 times more time with their provider, than one-on-one visits,” Shaffer said. “[The program also] guarantees continuity because it’s always the same nurse midwife that leads each group.”
Describing the program as a “One-Stop Shop,” she added, “Centering empowers a woman to care for herself, her family and her unborn baby,” she said. Having been a facilitator for nearly four years, it has been “the most enjoyable and satisfying part of my career as a Navy nurse midwife.”
In addition to Centering Pregnancy, the OB/GYN Department has plans in 2014 to start personalized OB orientation, offering public cord blood banking and continuing complimentary breastfeeding, infant care and birthing classes, said Gobern.
“I am extremely proud of the providers and staff who have invested their time, energy and personal commitment to group prenatal care,” he said.