Preterm birth, or delivery before 37 weeks gestational age, is a major cause of illness and death in newborn babies’ first month. In the U.S., about 10 percent of pregnancies result in preterm deliveries. However, this rate is 48 percent higher among Black women.

In the outpatient setting, group prenatal care models such as CenteringPregnancy© have shown improved pregnancy outcomes such as decreased racial disparities in preterm births. In a pilot study of an inpatient Centering model for the Duke Hospital antepartum service, women enjoyed being brought together to create a community. Participants had significantly longer pregnancies, with greater effect among Black women. 

This project team adapted the CenteringPregnancy group model, traditionally used as an outpatient service, to an inpatient antepartum service by expanding the pilot study performed in 2019-2020. The team developed and implemented a sustainable inpatient antepartum intervention through Centering groups to benefit both pregnant women and their babies by increasing length of pregnancy and breastfeeding rates. The intervention also fostered community to support emotional and mental well-being.

Providers and team members recruited current patients and enrolled them in inpatient Centering groups. Patients completed pre- and post-intervention surveys to assess their emotional and mental state, preparedness for the Neonatal Intensive Care Unit (NICU) and plans regarding breastfeeding. They also provided feedback on the content of the team’s prenatal education topics. Team members analyzed the survey data to assess the impact of the Centering groups and compared the data to to controls in the Duke Hospital PPROM database. 

Timing

Summer 2022 – Summer 2023

Team Outputs

Education and Connection for NICU Moms (2023 Fortin Foundation Bass Connections Virtual Showcase)

Pilot Postpartum CAP Session (poster by Alyzea Benjamin, Michelle Kwan and Jocelyn Reyes, presented at Fortin Foundation Bass Connections Showcase, Duke University, April 19, 2023)

See related teams, Community for Antepartum Patients (CAP): Establishing an Inpatient Model for Group Prenatal Care at Duke (2023-2024) and Centering Pregnancy: Establishing an Inpatient Model at Duke (2021-2022).

Image: CenteringPregnancy® at Duke Family Medicine Center, by Duke Family Medicine and Community Health