Power in Numbers: Group Prenatal Care at the Brigham

August 18, 2021 Christine Armstrong

During pregnancy, it can be helpful to spend time with others experiencing the same kinds of things you are. You and your peers can learn a lot from one another, and the sense of community that exists in a group setting can give you a real psychological boost.

That’s why in addition to traditional one-on-one prenatal visits, the Brigham and Women’s Ambulatory Obstetrics Practice offers group prenatal care. This program provides routine prenatal care, as well as pregnancy education and social support, for groups of eight to 10 people who are at a similar stage in their pregnancy. The groups meet from the first trimester until 37 weeks.

The American College of Obstetricians and Gynecologists reports that patients who receive group prenatal care have a better understanding of their pregnancy health, feel better prepared for labor and birth, are more satisfied with their health care and are more likely to breastfeed their baby than others.

Participants drive conversations around pregnancy

Prenatal care groups at the Brigham get together for about 10 prenatal visits, each of which lasts 1 to 2 hours. Either Julianna Schantz-Dunn, MD, MPH, an obstetrician-gynecologist and medical director of the Ambulatory Obstetrics Practice, or Chiamaka Onwuzurike, MD, MPH, an obstetrics and gynecology fellow, leads each group. Sometimes a nurse and/or physician’s assistant is present at a session as well.

In the first part of each session, participants check their own health. They weigh themselves, take their own blood pressure, check their baby’s heartbeat and record other medical data. The second part is devoted to a group discussion on a topic that relates to the participants’ stage of pregnancy. Often times, the participants drive the conversation.

“We encourage patients to lead sessions either by talking to us about their experience or asking questions,” said Khady Diouf, MD, an obstetrician-gynecologist and director of the Brigham’s obstetrics and gynecology practices. “We leave it to other patients who have already had babies to answer. In this way, we become facilitators of discussion rather than running the session ourselves. I think this allows for a more fruitful exchange of information.”

“Early on with one group, a couple of patients were struggling with nausea and vomiting,” Dr. Schantz-Dunn recalled. “Some of the other people who had been through that in their first pregnancy had recommendations for what worked for them. I think people appreciate knowing that others have gone through what they have and had the same anxieties.”

Virtual prenatal care during the pandemic

In light of the COVID-19 pandemic, the Brigham began hosting virtual prenatal care groups in December 2020. Participants alternate between meeting virtually with their group and having one-on-one visits with their obstetrician. Each is given a blood pressure monitor to self-test during the virtual sessions.

The virtual model has been well received by participants, according to Dr. Schantz-Dunn. Besides making it easier for those who have children at home to attend, it also opens the door for partners to join in. Even after in-person groups are reintroduced, Dr. Schantz-Dunn said, virtual sessions will likely remain an option at the Brigham.

‘An instant support group’ for pregnant patients

The length of group prenatal sessions leaves much more time for patient education than the standard clinic visit. As a result, participants can better manage their own care during pregnancy and labor and delivery. Participants also benefit from having what Dr. Diouf called “an instant support group.”

“The support part of it is very important,” she said. “They don’t need to go out in the community to find this; it’s right here in their group at the Brigham. And often times they form long-term friendships with the other participants.”

Beckie Moses was already several months pregnant when she and her husband Blake moved from Maryland to the Boston area in September 2020. She joined a virtual prenatal care group led by her obstetrician, Dr. Onwuzurike, around her 20-week mark.

“We were all going through our firsts together. The first time something was happening with me, I’d hear from others who had experienced the same thing or had similar questions as me. It was good to know it wasn’t just me going through these things. And being new to the area, it was just nice being around other people who were pregnant.”

Beckie Moses, group prenatal care participant

Due to pandemic-related restrictions, Blake couldn’t accompany Beckie on her in-person visits with Dr. Onwuzurike. But he could attend the virtual group sessions, which gave him a chance to speak with Dr. Onwuzurike and feel more involved in the pregnancy.

For her part, Beckie liked being able to bond with the other participants, most of whom were first-time parents as well.

“We were all going through our firsts together,” she said. “The first time something was happening with me, I’d hear from others who had experienced the same thing or had similar questions as me. It was good to know it wasn’t just me going through these things. And being new to the area, it was just nice being around other people who were pregnant.”

Addressing racial and ethnic disparities in care

Group prenatal care also brings together people of various races, ages and socioeconomic backgrounds. Everyone in the group receives the same education and access to the doctor.

“You eliminate any discrepancies in terms of what people are educated about or what is addressed topically,” Dr. Schantz-Dunn said. “And prenatal groups have been shown to have lower rates of preterm birth and of caesarean sections, which disproportionately impact Black and Latinx people. In that sense, group is helping address inequities in outcomes.”

Dr. Schantz-Dunn leads Spanish-language groups at the Brigham. She said participants feel more comfortable talking about pregnancy-related issues in their own language. The format has also led to enlightening discussions about things like COVID-19 and vaccinations in pregnancy.

“COVID hit the Latinx community much harder than other communities in the Boston area,” she said. “That was an interesting example of where the conversation was a little more nuanced than it would have been with some of my English-speaking patients.”

Moving forward, Dr. Diouf said, the Brigham may add more prenatal care groups for individuals who are at risk due to certain medical or social conditions. “We hope to give all participants a well-supported pregnancy that will enhance outcomes for both patients and their babies,” she concluded.

Interested in enrolling? Please call the Ambulatory Obstetrics Practice at 617-732-4740 and ask to speak with the group prenatal care coordinator.

The post Power in Numbers: Group Prenatal Care at the Brigham appeared first on Brigham Health Hub.

Previous Article
Incontinence and Pelvic Organ Prolapse: Hard to Discuss, But Highly Treatable
Incontinence and Pelvic Organ Prolapse: Hard to Discuss, But Highly Treatable

Overactive bladder. Weakening of the pelvic floor. These are the types of problems that can be difficult to...

Next Article
Biologic Drug Got Brigham Patient Back to His Pre-Asthma Life
Biologic Drug Got Brigham Patient Back to His Pre-Asthma Life

Peter O’Rourke developed asthma in his mid-40s and at first, he was able to control it with just a rescue i...