At the Controversies in Childbirth conference, Cynthia Wade described Centering, a group approach to prenatal/birth care.
In this model of care, the mothers are active participants. They weigh themselves, they take their own blood pressure, they write everything down in their chart. They are grouped together by estimated due date, so they already have a common link and are able to form a connection to the others in the group.
There are group activities going on while each woman is seen individually off to the side. If she has a question that would apply to the others, she shares it at circle time and gets support and information from the group, and they are able to learn about it.
The point that Cynthia Wade made, and that I really appreciated, is that this process normalizes what the mother is feeling and experiencing. Pregnancy can be a frightening time, especially if it is your first baby. Every twinge and pain, every change in movement or pressure can be cause for concern. But if a woman expresses her experience to the group and then discovers that many other women are also experiencing the same thing and have been wondering about it, then it eases her mind and helps her relax about it – even more so than her practitioner telling her that everything is fine.
Essential Elements of Centering
• Health assessment occurs within the group space.
• Participants are involved in self-care activities.
• A facilitative leadership style is used.
• The group is conducted in a circle.
• Each session has an overall plan.
• Attention is given to the core content, although emphasis may vary.
• There is stability of group leadership.
• Group conduct honors the contribution of each member.
• The composition of the group is stable, not rigid.
• Group size is optimal to promote the process.
• Involvement of support people is optional.
• Opportunity for socializing with the group is provided.
• There is ongoing evaluation of outcomes.
This is a fantastic approach to prenatal care, and I would love to see it implemented wherever possible.
