About Centering

What is Centering During Pregnancy?

Centering is a unique care model that enables certified nurses, doctors and midwives to provide women with pregnancy and birth-related information in a group setting. As a result, expectant mothers learn together and support each other throughout their pregnancies.

We firmly believe that Centering during Pregnancy gives women a sense of empowerment and participation in their care, as well as access to community support that is not readily available when working one-on-one with a health care provider (1).

Centering During Pregnancy Positive Results

Studies support that the centering model improves outcomes for both the mother and her baby. Participants experience a decrease in preterm birth rates, low birth weight and postpartum depression. They also enjoy more successful breastfeeding efforts and increased knowledge, satisfaction and compliance with care (1).

What to Expect During a Centering Session

Centering pregnancy groups usually consist of eight to 12 moms-to-be with similar due dates, as well as their support partners. Starting around month 3 of pregnancy, the groups meet every two to four weeks for sessions lasting 120 minutes (2).

Moms engage in their care by taking their own weight and blood pressure and recording their own health data with private time with their provider for belly check (3).

Centering Around Conversations

Once health assessments are complete, the provider and support staff “circle-up” with moms and support people. They lead facilitative discussion and interactive activities designed to address important and timely health topics while leaving room to discuss what is important to the group (2).

Providing care in this way allows moms and providers to relax and get to know each other on a much deeper and meaningful level. Members of the group form lasting friendships and are connected in ways not possible in traditional care. Centering groups comprised of women of different ages, races, and socio-economic backgrounds see those differences diminish in importance as they share the common experience of pregnancy, birth, and family care (2).

Centering Versus Traditional Prenatal Care

In traditional prenatal care, a woman has 10 one-on-one scheduled visits with her provider for health assessments and care; these typically take 15 minutes or less. In Centering, patients participate in group sessions with a small number of other pregnant women who are at the same stage of pregnancy (1). 

Centering group prenatal care follows the recommended schedule of 10 prenatal visits, but each visit is 90 minutes to two hours long – giving women 10x more time with their provider (3).

Topics Covered During Centering

The group facilitators help to guide the group’s discussion around pregnancy and postpartum topics, covering everything from normal pregnancy symptoms to labor and delivery and newborn care. It’s not only an efficient way to deliver information, it’s an environment where expectant parents can learn from and support each other (2). Common topics covered include nutrition, common discomforts, stress management, labor and delivery, breastfeeding, and infant care (3). For this session’s official list of topics, please see ”schedule” tab for more information.

Centering Reduces Preterm Birth Nationally

A Yale University randomized clinical trial found the Centering during Pregnancy model reduced the risk of preterm birth by 33%, saving the health care system 40 preterm births for every 1,000 deliveries. A 2012 study found a 47% reduction in preterm birth for women in Centering group care. A 2009 study of women enrolled in the “CenteringPregnancySmiles” model showed a preterm birth rate of 6% compared to a regional rate of 13.7% in rural Kentucky (4).

Reducing Racial Disparities for Preterm Birth

Hispanic women in Centering demonstrated lower preterm births rates than those in traditional care models, 5% v. 13%. Centering further reduced the odds of preterm births by 41% in African American women, the population of women with the highest rate of preterm births in the U.S. (4).

Increasing Rates of Breast Feeding

Nearly twice the number of Centering participants breastfed (46%) than those in a comparison study (28%). Breastfeeding leads to better outcomes because it helps newborns diseases and reduces the cost of care costs because breastfed infants need fewer sick care visits, prescriptions, and hospitalizations compared to non-breastfed infants (4).

Improving Outcomes in High-Risk Teen Pregnancies

Centering during Pregnancy model provides teens with the education, support, and safety needed to manage the associated with pregnancy. A randomized controlled trial of pregnant adolescents showed a 52% reduction in sexually transmitted infection incidence and a lengthening of the “interconceptional period” (4).

Reducing Health System Wide Costs

One pre-term baby costs $54,149, with first year medical costs averaging 10 times greater than full term infants. The cost of preterm birth averages $26.2 billion annually. Medicaid spending represents the single largest portion of state spending, accounting for 23.6% of total state spending in fiscal year 2011. Medicaid finances almost half of all births in the United States, and shoulders much of the costs associated with preterm birth.

More than 100 approved Centering sites saved the health care system an estimated $41 million through reduced preterm births (4).

  1. https://www.uhhospitals.org/services/obgyn-womens-health/patient-resources/pregnancy-resources/centering-pregnancy
  2. https://www.whattoexpect.com/pregnancy/centering-pregnancy/
  3. https://www.centeringhealthcare.org/what-we-do/centering-pregnancy
  4. https://www.centeringhealthcare.org/uploads/files/FX_Fact-Sheet-Full-Set_NoCC.pdf
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