The purpose of this article is to systematically review the literature on group-based prenatal care related to patient participation, attendance, satisfaction, knowledge, pregnancy and birth outcomes, and program cost. MEDLINE, CINAHL, and PsycINFO sources were searched for English-language articles published any time prior to June 2010. Manual searches of bibliographies were conducted and experts were consulted to identify possible sources. Descriptive, cross-sectional, cohort, and randomized control studies that assessed group-based prenatal care were selected. Of the 15 articles reviewed, 11 studies met inclusion criteria for analysis of the study attributes and outcome data related to patient participation, attendance, satisfaction, knowledge, as well as breastfeeding, pregnancy and birth outcomes, and program cost. Results from the review show that group prenatal care may be associated with improved patient and birth outcomes including reduction in the number of preterm deliveries, higher patient participation and satisfaction, and increased initiation of breastfeeding. Prenatal group care research is limited by relatively few studies, most of which lack rigor. The current model of prenatal group care lacks a theoretical framework for describing and evaluating group processes as well as intermediary factors of prenatal and birth outcomes. Research on group care would benefit from additional randomized controlled trials that assess cost and sustainability and formally evaluate group process and intermediary factors thought to account for improved outcomes.

No abstract

Group prenatal care (GPNC) is an alternative model to traditional individual care and may improve public health outcomes. Prior studies suggest that interest in GPNC varies widely and few studies have examined characteristics predictive of interest in this model. The purpose of this study was to inform GPNC recruitment efforts by examining likelihood of participation delineated by characteristics and GPNC perceptions. Pregnant participants received information about GPNC then completed a survey measuring demographic, psychosocial, and reproductive characteristics, likelihood to participate in GPNC, and factors influencing selections. Respondents expressed varied levels of likelihood to participate in GPNC; 16.2% low likelihood, 44.9% moderate likelihood, and 38.9% high likelihood. Characteristics were similar between groups, and thus their use is not recommended when targeting recruitment efforts. Benefits outweighed barriers and threats for the high likelihood category, barriers and threats outweighed benefits for the low likelihood category, and benefits, barriers, and threats were balanced for the moderate likelihood category. Accurately assessing likelihood of participating in GPNC efficiently identifies individuals who are clearly either going to decline or participate, as well as promotes targeted recruitment efforts directed at those who are ambivalent. Understanding and addressing perceived benefits, barriers, and threats supports effective GPNC recruitment.