Do your expectant clients ever ask you whether other pregnant women are sensitive to strong smells? Do they wonder about the different ways to hold a baby while nursing? Do postpartum women with whom you interact, wonder if their babies are hitting the right milestones? Group care in both prenatal and postpartum periods of the childbearing years has been shown to improve birth, breastfeeding and parenting outcomes, parent satisfaction, and parent empowerment.

Sharon Schindler Rising first took women out of the exam rooms and into a group setting for education, support, and prenatal care in 1994. Her vision was to bring women together with the goal of empowering them, and giving them autonomy and responsibility for their care. Centering Pregnancyí (CP) , CenteringParenting, and CenteringDiabetes can now be found in more than 300 U.S. locations and in several foreign countries as well.

The University of North Carolina's Department of Family Medicine started providing CenteringPregnancy group care in 2002 and about half of our 170 prenatal patients annually choose group care, as an extension of their () individual care, versus individual care, alone. UNC Family Medicine provides an average of 250 group visits per year.Group care was successful for both diabetics (starting in 2001) and prenatal parents and was followed in 2006 with group care for well child visits. The program is called WellBabies and follows the routine preventive schedule developed by the American Academy of Pediatrics. Like group prenatal care, the intention is to educate, to empower, and to provide care for parents and their babies . Both groups meet in the same friendly room where the initial prenatal visit takes place. There are differences in numbers and types of visits that appears below:

Not many assessments of group versus individual care have been done. However, evidence shows that after experiencing group care, parents valued support from other women, developmental comparisons, learning from others' experiences, increased parental involvement in well-child visits, and more time with care providers. In the Fall 2011 issue of the Journal of Perinatal Education a study of "Midwives - Perceptions Of Implementing the Centering Pregnancy Model of Prenatal Care" recommends, that individual providers and professional organizations embrace the CP model of group prenatal care and that more midwifery, nursing, and medical schools integrate CP into their obstetrical/maternity curricula. (Baldwin and Phillips, 2011).

Group care embodies the definition of patient-centered care by the Institute of Healthcare Improvement and the Institute of Medicine's (2001) report, "Crossing the Quality Chasm". Shared decision making and respecting patients and their families as partners in health-care are assets of patient-centered care found in group care and are endorsed by the National Committee on Quality Assurance, Institute of Medicine, Institute for Healthcare Improvement, as well as other professional healthcare organizations. References_B Hotelling_blog post.

Posted by: Barbara Hotelling, MSN, WHNP-BC, LCCE, CD(DONA) Barbara has been an active birth doula and Lamaze educator for over 25 years. She maintains her certifications with DONA International and Lamaze International, is on the Lamaze Faculty and is an approved DONA Doula Trainer. In addition to teaching Lamaze seminars for training childbirth educators and doula trainings, she has taught Labor Support for Nurses, Labor Support and the Teen Specialist programs of Lamaze throughout the United States , Canada, and in Korea. Barbara has served as President of DONA International, Chair of the Coalition for Improving Maternity Services (CIMS) and President of Lamaze International. Presently she serves on the Certification Council of Lamaze International and the Leadership Team of CIMS.

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