Examining Delivery Method and Infant Feeding Intentions between Women in Traditional and Non-Traditional Prenatal Care

Abstract

Introduction The purpose of the study is to evaluate delivery method and breastfeeding initiation in women enrolled in group prenatal care (CenteringPregnancy) and in traditional prenatal care. Methods Data were obtained from medical records of a hospital-based midwifery practice in south central Connecticut that offered both types of prenatal care programs. Medical information from 307 women enrolled in this practice was included in the analysis. Out of the 307, 80 were enrolled in group prenatal care. Socio-demographic, lifestyle, and previous and current obstetrical information from medical records formed the basis of comparison. Bivariate and logistic regression analyses were carried out. Results Women in Centering had fewer planned cesarean sections (1.3 vs. 12.8%) and had a higher breastfeeding initiation (88.7 vs. 80.0%). However, Centering women were found to have a higher portion of unplanned cesarean sections (27.5 vs. 11.0%). Both the unadjusted and the adjusted odds ratios of having a cesarean planned delivery were lower in the group care. Women in Centering had 2.44 (95% CI 1.05, 5.66) times the odds of breastfeeding initiation compared to the odds for women in traditional prenatal care after adjusting for maternal age, smoking status, gestation and race. Discussion CenteringPregnancy can have positive impact for the woman and baby. This program implementation saw lower rates of elective cesarean sections and increased breastfeeding compared to women in traditional care.

Breastfeeding: The Basics, the History, and Barriers in the Modern Day

“…This approach to care has been shown to increase the overall breastfeeding rates as well as specific benefit to adolescent and Black patients who have lower breastfeeding rates in the United States. 62,63 These findings suggest that clinic and individual level interventions may be a powerful tool in addressing persistent health disparities in breastfeeding rates and postpartum care. Community health worker support has been incorporated in to the women, infants, and children program to provide additional breastfeeding support to lowincome parents.…”

CenteringPregnancy: A Review of Implementation and Outcomes

“…30 A comparative cohort study found that patients enrolled in group prenatal care (n = 80) demonstrated lower rates of elective cesarean deliveries (1.3% vs 12.8%, P = 0.001) compared with those in traditional prenatal care (n = 227), which may decrease their risk for maternal morbidity. 39 One of the most studied outcomes of group prenatal care is breastfeeding rates. Overall, CP has been shown to have short-and long-term benefits for breastfeeding with multiple retrospective studies demonstrating higher rates of breastfeeding at postpartum visits.…”

“…Overall, CP has been shown to have short-and long-term benefits for breastfeeding with multiple retrospective studies demonstrating higher rates of breastfeeding at postpartum visits. 39,40,43,45,46 One of these studies demonstrated that these effects were lasting, such that higher rates of breastfeeding were reported in subsequent pregnancies even despite not being enrolled in group prenatal care a second time. 40 For patients with prenatally diagnosed fetal anomalies, the CP-inspired model of group care led to higher knowledge about breastfeeding and a rate of 87.1% breastfeeding dyads by NICU discharge.…”

“…For patients with Medicaid insurance, group prenatal care provided cost savings benefits at an average of $22,667 for every preterm birth prevented 30 . A comparative cohort study found that patients enrolled in group prenatal care (n = 80) demonstrated lower rates of elective cesarean deliveries (1.3% vs 12.8%, P = 0.001) compared with those in traditional prenatal care (n = 227), which may decrease their risk for maternal morbidity 39 …”

“…One of the most studied outcomes of group prenatal care is breastfeeding rates. Overall, CP has been shown to have short- and long-term benefits for breastfeeding with multiple retrospective studies demonstrating higher rates of breastfeeding at postpartum visits 39,40,43,45,46 . One of these studies demonstrated that these effects were lasting, such that higher rates of breastfeeding were reported in subsequent pregnancies even despite not being enrolled in group prenatal care a second time 40 .…”