Women‐centered care: Implementation of CenteringPregnancy® in The Netherlands

Abstract

Introduction In response to a relatively high perinatal mortality rate in The Netherlands, the Dutch Health Ministry recommended changes to maternity care, opening a pathway toward more integrated woman‐centered services. Because of its potential to positively influence risk factors for adverse pregnancy outcomes, CenteringPregnancy (CP) group prenatal care was implemented. Methods We performed a retrospective cohort study (n = 2318) and survey on women's experiences (n = 222) in eight primary care midwifery practices to investigate outcome differences between CP and traditional individual prenatal care. Data from the period 2011‐2013 were analyzed. Results Primiparous and multiparous CP women attended more prenatal care visits compared with women who received individual care (adjusted odds ratio [aOR] 1.23 [95% confidence interval [CI] 1.18‐1.29] and 1.29 [1.21‐1.36]). Fewer primiparous CP women used pain relief during labor (0.56 [0.43‐0.73]), and they initiated breastfeeding more often (1.74 [1.15‐2.62]). Women participating in CP were more likely to feel that their wishes with respect to medication use (69.1% vs 54.4%, P = 0.039), physical activities (72.8% vs 52.5%, P = 0.008), and relaxation exercises (67.9% vs 35.6%, P ≤ 0.001) were listened to by care providers. They also felt more supported to actively participate in their care (89.6% vs 68.5%, P = 0.001) and felt more able to voice opinions about care (92.7% vs 73.9%, P = 0.002). Conclusions The CP model is a good approach aligning with Dutch policy calling for women‐centered care and responding to the needs of pregnant women. This study supports CP scale‐up in The Netherlands and adds to the pool of international knowledge about CP implementation.

CenteringPregnancy in the Netherlands: Who engages, who doesn’t, and why

“…About one third of eligible women contributed to CP throughout this investigation, and this investigation is comparable to other studies describing the first phase of implementation of CP 27,28 . Similar to other research, our current study shows that more nulliparous than multiparous women participated in CP 17,18,28 . A lower involvement rate of women who stopped smoking before the first prenatal visit was also found in this study.…”

“… 27 , 28 Similar to other research, our current study shows that more nulliparous than multiparous women participated in CP. 17 , 18 , 28 A lower involvement rate of women who stopped smoking before the first prenatal visit was also found in this study.…”

“…Other studies showed that active smokers are less likely to participate in CP 18,28 . However, in this study, a lower participation rate was found for women who stopped smoking before the first prenatal visit.…”

“…Other studies showed that active smokers are less likely to participate in CP. 18,28 However, in this study, a lower participation rate was found for women who stopped smoking before the first prenatal visit. Low participation rate among smokers can be explained by a woman's fear of having their smoking habits discussed within the group.…”

Teaching to Get Nurses an Midwives Empowering Women: Nursing Students’ Perceptions on Professional´s Roles during Perinatal Care

“…-Teaching to get Nurses and Midwives fter a long period in which a patriarchal model of perinatal care has predominated (Cahill, 2001), characterized by an unequal distribution of responsibilities among health professionals and women, during past decades women's empowerment is increasingly relevant to the field of perinatal care (Hsia, 1991;Kwee & McBride, 2015). The use of this term, and similar terms, such as womencentred care (Rijnders et al, 2019), is evidence of the change that these strategies of women's empowerment are producing (Prosen & Tavcar, 2019), as the experience of childbirth has repercussions on women's lives (Garcia & Yim, 2017).…”