Vulnerable Women’s Perceptions of Individual Versus Group Prenatal Care: Results of a Cross-Sectional Survey

Abstract

Introduction Vulnerable pregnant women (e.g. women with low socio-economic status or recent immigrants) are less likely to receive adequate prenatal care or to attend perinatal education classes. CenteringPregnancy (CP) is a model of group prenatal care which combines assessment, education and support. This study aimed to assess patient experience among vulnerable women in group prenatal care compared to individual care. Methods Women participating in CP at a community-based health centre in urban Alberta were eligible to participate. A convenience sample of women who received individual care at a low-risk maternity clinic served as comparison. Women were asked a series of questions on their prenatal care experience. Demographic and patient responses were compared using Chi square, fisher's exact and t tests. Results Forty-five women accessing CP and 92 women accessing individual care participated. Women in CP were younger, more likely to be single and having their first baby than women in individual care. Women in CP were significantly more likely to report having received enough information on exercise during pregnancy (92 vs. 66%, p = 0.002), breastfeeding (95 vs. 70%, p = 0.002) and baby care (95 vs. 67%, p = 0.001). Women in CP were more likely to report that they felt their prenatal care providers were interested in how the pregnancy was affecting their life (100 vs. 93%, p ≤ 0.001). Discussion Group prenatal care provides a positive experience and improved information exchange among vulnerable populations. Programs interested in engaging, educating and empowering vulnerable pregnant women may benefit from implementation of group care.

Evaluation of human immunodeficiency virus–adapted group prenatal care

“…To further decrease perinatal HIV transmission by improving consistent prenatal care and improve long term maternal health, group prenatal care should be considered an option with significant benefits. n (18) .003…”

“…MATERNAL Original Research studies have reported improvement in social support, especially in women with more psychosocial stress at entry to care, 16,17 whereas others reported no change. 11,18 Similarly, studies in adolescents 19 and women with increased psychosocial stress 20 reported improvement in depressive symptoms with participation in group care, whereas others reported no difference. 11,16,17,21 In terms of specific disease-adapted group prenatal care, a recent randomized clinical trial for women living with diabetes reported higher levels of social support as a result of the intervention but did not report a significant difference in baseline, 38-week, or postpartum EPDS scores.…”

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“…The evidence in this field is building, with studies indicating improvements in preterm birth and low birth weight, 36 maternal knowledge and patient satisfaction, [37][38][39] social support 40 and reduced costs of healthcare provision. 41 However, a Cochrane systematic review including four randomised and quasi-RCTs (n=2350, English speaking women) evaluating group antenatal care found no clear evidence of improvement in rates of preterm birth, low birth weight, small-for-gestational age infants or perinatal mortality comparing group-based models of antenatal care with one to one antenatal care.…”

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“… 3–5 Regarding satisfaction with care on the other hand, research shows that satisfaction is greater among women who receive GANC. 3 , 6 …”

“…[3][4][5] Regarding satisfaction with care on the other hand, research shows that satisfaction is greater among women who receive GANC. 3,6 GANC offers an alternative to traditional individual care, which is still the predominant model in most Western countries. 7 Standard antenatal care entails individual visits with a healthcare provider, such as an obstetrician, a midwife, or a GP in a hospital or another clinical setting.…”