Community for Antepartum Patients (CAP): Establishing an Inpatient Model for Group Prenatal Care (2026-2027)

Background

Preterm birth, or delivery before 37 weeks gestational age, is a major cause of illness and death in newborn babies. In the U.S., about 10 percent of pregnancies result in preterm deliveries. About one third of preterm deliveries are preceded by preterm prelabor rupture of membranes (PPROM). Management of PPROM often involves hospital admission to the antepartum unit until delivery, which can span weeks to months. Pregnant people admitted to the antepartum unit often experience loss of their normal psychosocial support systems, ability to work and sense of autonomy in their health decision-making.

Preterm birth and PPROM disproportionately affect Black mothers in the U.S. Non-Hispanic Black women have nearly twofold greater risk for preterm birth compared with non-Hispanic white women. Causes for this disparity are multifactorial and poorly defined but increased psychosocial stress and inadequate access to prenatal care for Black women are often cited as reasons.

In the outpatient setting, group prenatal care models have shown improved pregnancy outcomes such as decreased racial disparities in preterm births. No studies to date have attempted to apply the concepts of connectedness and group prenatal education in the inpatient setting. 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. There were also improvements in breastfeeding rates after the women gave birth.

Project Description

Building on the work of previous teams, this project adapts and expands the CenteringPregnancy© model for hospitalized antepartum patients through weekly group sessions known as CAP sessions, held in Duke Hospital’s antepartum unit.

Each week, providers and CAP team members recruit interested patients for a one-hour in-person session focused on community building, mindfulness and education. Discussion topics reflect patient priorities and may include:

• Common antepartum diagnoses (e.g., preeclampsia, PPROM)
• Pregnancy loss and grief
• Breastfeeding and lactation
• Coping with stress and separation from family
• Pelvic floor physical therapy
• Caring for a baby in the Neonatal Intensive Care Unit (NICU)

This year’s team will broaden the scope of inpatient activities by integrating expertise from additional healthcare professionals and community partners. Planned session features include lactation support, stress-management workshops, physical therapy demonstrations and NICU tours led by neonatologists.

This year’s team will integrate a more formal research component: master’s student will lead hypothesis-driven data collection and analysis with support from undergraduate and medical student collaborators. Monthly “lab meetings” will foster scientific thinking, presentation practice and scholarly collaboration.

Anticipated Outputs

• Sustainable inpatient antepartum group care model ready for adaptation at other institutions
• Quantitative and qualitative evaluation of session impact
• Continued development of educational materials for CAP sessions
• Manuscript or other scholarly product summarizing program outcomes

Student Opportunities

Ideally, this team will include 3 graduate/professional students and 3 undergraduate students, who will collaborate with nurses, midwives, residents, fellows, attending physicians and other clinical staff involved in the project. Interested students are likely to come from health-related disciplines. Students who also possess Spanish language fluency or skills in visual arts would make valuable additions to the team.

Students will gain experience in:

• Patient engagement and recruitment on a hospital unit
• Leading and co-facilitating inpatient group sessions
• Designing and implementing educational materials and craft-based activities
• Conducting literature reviews and contributing to research planning
• Collecting and analyzing quality improvement data
• Presenting findings to clinical partners and at academic meetings
• Understanding reproductive justice, health equity and patient-centered prenatal care

Undergraduates will rotate through weekly hospital and craft sessions, each leading at least one session per month. Graduate students will provide mentorship, guide implementation and strengthen their leadership skills. One master’s student will be selected to serve as project manager and research lead.

In Fall 2026, this team will meet on Wednesdays and Thursdays from 3:30-4:30 p.m. Team leaders should schedule additional time to meet biweekly for project review.

Timing

Fall 2026 – Spring 2027

Fall 2026:

• Begin weekly seminars
• Onboard team members to hospital CAP session workflow
• Read about the history of medical racism

Spring 2027:

• Continue weekly CAP sessions and seminars
• Undergraduates will lead seminars and in-hospital sessions with guidance from medical students
• Read about the birth experience from mothers, midwives, and OB/GYNs
• Compile a literature review or research project

Crediting

Academic credit available for fall and spring semesters

See earlier related team, Community for Antepartum Patients (CAP) (2025-2026).