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ASHEVILLE, NC (AP) – In a large room full of pregnant women, pregnant women check their partner's blood pressure and weight, a nurse midwife measures their growing belly and they join a seated circle to two hours frankly Talk about what to expect when you expect.
A young woman's revelation about her strange glue and softener cravings elicits some laughter, followed by the nurse's explanation that such strange signs may indicate a deficiency in iron. This is the kind of weird subject that does not always surface in typical prenatal checkups of 15 minutes, when doctors may seem in a hurry and patients who are reluctant to mention those little concerns that may seem unimportant.
But in a more relaxed group, women open up and the conversation goes beyond vital signs, weight gain and deadlines.
"I can tell them it's normal, but if you have another mother in the group who says, 'Oh, that's happened, it's normal.' It's more acceptable, if it comes from a peer, "said Laura Moore, a nurse at the Asheville, North Carolina clinic.
Pregnant women in the clinic may choose to participate in a group session for their monthly checkups instead of traditional visits with their doctor, usually recommended.
Weekly sessions on weekdays involve about 10 women, all at the same stage of pregnancy. A nurse or midwife usually supervises discussions on topics such as common discomfort during pregnancy, stress management, nutrition and work induction. Fathers or other partners are invited to attend and participate. But future mothers take the lead role in teaching by sharing their experiences of pregnancy.
Kailee Morel Alvarez had never heard of prenatal group visits when she had learned that she was pregnant last summer. But the 21-year-old woman and her husband were sold after their first visit to the OB-GYN clinic at Mountain Education Health Center. His daughter, Sofia, was born in February.
"The best thing was that other women are going through exactly the same things as me, at the same time," she said.
"At first, I really worried about whether the baby had everything he needed, if it was growing normally," said Morel Alvarez. Later, she was disturbed by cramps and early contractions. To learn that other women were living all these things too "" was super helpful "" she said.
This low-tech approach does not seem to be the quintessence of 21st century medicine. But group prenatal care can have important benefits beyond fellowship. Some studies have found fewer premature births, low birth weight babies, and newborns requiring intensive care; and higher breastfeeding rates among women receiving group care.
This is a model that the American College of Obstetricians and Gynecologists recently adopted as a promising option.
"I loved it, honestly," said Victoria Tate, 28. She had traditional prenatal care for her first two children but decided to try group sessions the third time. His son, Deklin, was born on January 30th.
She added that having two hours to discuss the health problems that other women faced was also invaluable and helped to make the experience less stressful. For her, this included genetic testing, performed outside the group, and gestational diabetes, treated by the group's nurse.
"I had to change what I ate, I had to test my sugars a lot," she said.
Health insurance usually covers group care. Jessica Lewis, Assistant Director of Pregnancy Research at the Yale School of Public Health, said the research showed that only 3% of American women had group care. Some choose not to do it, but many do not offer it to them. An additional reason why health centers do not have them, is the start-up costs for staff training and meeting space.
Lewis co-authored the largest study to date, involving 9,300 women who participated in group sessions at the Vanderbilt University Medical Center in Nashville. Nearly six years of data showed that women who attended at least five group sessions were 70% less likely to have preterm and low birth weight babies than women who received individual care. The study included a program co-founded by Lewis, called Expect with Me.
The extent to which collective prenatal care can improve maternal and child health remains unclear. For some women, this is the first time in their adult life that they consult a doctor and, according to Lewis, pregnancy "offers a tremendous opportunity when women are motivated to change their behavior in depth. to drink, they start to eat better. "
Group sessions can facilitate these changes and more, which can help improve outcomes for babies, said Lewis.
Some doctors think the benefits may be related to stress reduction. High levels of stress and anxiety during pregnancy, related to financial or relationship difficulties, difficulties in raising other children while working long hours, worry excessively labor and delivery – can increase blood pressure and stress hormone levels of women and have been associated with complications, including premature birth.
The Asheville Clinic, which uses a program called Centering, has been providing group care since 2013; Last year, 400 women participated. Yet less than a third of pregnant women who have offered this option choose it. The lack of on-site child care is one of the reasons. For other women, the idea seems too foreign, said Amber McCarter, program broadcasting specialist.
For Kiana Burgin, the two-hour morning visits were stressful. She loved the support group but was missing the individual, the personalized attention that she had when she was pregnant with her daughter, now 5 years old. His son, Christopher, was born in January and Burgin said she would probably go back to individual care. if she has more children.
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Follow AP medical writer Lindsey Tanner on @LindseyTanner.
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The Health and Science Department of the Associated Press is receiving support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.
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