Centering pregnancy. An interdisciplinary model of empowerment.

This is a time of change within the health care system. This has created a challenge for health care providers to develop creative new patterns that will provide quality service within a system that is mandating more economy and efficiency. The Centering Pregnancy program abolishes routine prenatal care by bringing women out of examination rooms and into groups for their care. The design incorporates the three components of prenatal care--risk assessment, education, and support--into one entity. Women are placed into groups of 8 to 12 based on estimated dates of delivery and meet for ten 90-minute prenatal or postpartum visits at regular intervals. At these visits, standard prenatal risk assessment is completed within the group setting, an educational format is followed that uses a didactic discussion format, and time is provided for women to talk and share with one another. By incorporating these three components into one whole, emphasis is placed on their collective importance. Women are encouraged to take responsibility for themselves; this leads to a shift in the client-provider power base. Evaluative data demonstrated that 96% of the women preferred receiving their prenatal care in groups. This model is interdisciplinary in design and demonstrates provider satisfaction, as well as efficiency in delivery of care. It is an excellent model for the care of teens and for midwives and nurse practitioners to lead. The combination of satisfaction, good outcomes, and effective delivery of care makes this an attractive model for agencies to implement.