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Mom-to-be learning in monthly groups of prenatal visits

ASHEVILLE, NC (AP) – In a large room full of mums, pregnant women control each other's blood pressure and weight, a nurse-midwife measures their growing abdomen and they all join the sitting circle for two hours of honest talk about what to expect when you expect.

The appearance of a young woman about her strange desires for adhesives and fabric softeners has some laughter, followed by a nurse's explanation that strange symptoms may indicate iron deficiency. It is the kind of unpredictable topic that is not always in a typical 15-minute prenatal examination when doctors may seem rushed and patients are reluctant to mention those small annoying concerns that may seem insignificant.

But in a more relaxed group environment, women open up and conversations run out of vital signs, weight gain and deadlines.

"I can tell them it's normal, but if you have another mom in the group who says," It's happened to me, it's normal. "It's more acceptable if it comes from a peer," said Laura Moore, a nurse in Asheville, North Carolina.

Pregnant women at the clinic may decide to join a group meeting for their monthly checkups instead of a traditional visit to one doctor who is usually recommended.

Monthly business days include approximately 10 women, all at the same stage of pregnancy. A nurse or nurse-midwife typically supervises discussions on topics including common pregnancy inconvenience, stress management, nutrition, and work induction. Fathers or other partners are invited to participate and participate. But mothers-to-be take a leading role, teaching by sharing their maternity experiences.

Kailee Morel Alvarez never heard of a group prenatal visit when she found out she was pregnant last summer. The 21-year-old and her husband were sold after their first visit to the OB-GYN clinic in the Mountain Area health center. Her daughter, Sofia, was born in February.

"It was definitely the best thing that other women went through the same thing I was," she said.

"At first I was really afraid that the child would have everything he needed, it's normal," said Morel Alvarez. Later, she suffered from convulsions and early contractions. To learn that other women are also experiencing all these things was "" super helpful, "she said.

This low-tech approach hardly seems to be the embodiment of 21st century medicine. However, group prenatal care can have important benefits beyond camaraderie. Some studies have found less premature births, low birth weight infants and intensive care infants; and higher breastfeeding rates for women receiving group care.

It is a model that the American College of Obstetricians and Gynecologists recently confirmed as a promising option.

"I loved it, honestly," Victoria Tate said, 28. She had traditional prenatal care for her first two children, but she decided to try out a group session for the third time. Her son, Deklin, was born on January 30th.

She said invaluable are two hours to discuss the health concerns of other women. For her, this involved genetic testing conducted outside the group and gestational diabetes, treated by a nurse group.

"I had to change what I ate, I had to try a lot of sugars," she said.

Health insurance usually includes group care. While a growing number of US centers provide visits, Jessica Lewis, Deputy Director of Pregnancy Research at Yale School of Public Health, said research shows that only 3 percent of US women receive group care. Some decide not, but many are not offered. One of the reasons why health centers do not have them is the cost of starting employee training and meeting space.

Lewis co-authored the largest study to date, involving 9,300 women who had group sessions at Vanderbilt University Medical Center in Nashville. Nearly six years of data showed that women who attended at least five group meetings were 70% less likely to have premature babies and low birth weight children than women who had individual care. The study included Lewis co-founded Expect with Me.

How a group of prenatal care can lead to an improvement in the health of the mother and child is unclear. For some women, it is the first time in adult life they have been looking for medical care, and Lewis said pregnancy "offers wonderful opportunities for women to be motivated to make many changes in behavior. they start eating better. "

Group meetings can make these changes easier and more, which can help improve children's performance, Lewis said.

Some doctors think the benefits may be related to stress reduction. High levels of stress and anxiety during pregnancy, from relationship or financial distress, struggle with raising other children to work for hours, excessive worry about work and childbirth – can increase women's blood pressure and stress hormone levels and have been associated with complications including premature birth.

The Asheville Clinic, which uses the Centering program, has been offering group care since 2013; 400 women participated last year. Less than one-third of pregnant women have offered this option. Lack of childcare on site is one of the reasons. For other women, this idea seems too strange, said Amber McCarter, a program support expert.

A two-hour morning visit to Kiana Burgina prevented 45 minutes of stress. She loved setting up a support group but lacked the individual, personal attention she received during her pregnancy with her daughter, now 5. Her son, Christopher, was born in January and Burgin says she would probably go back to care for one person if she has more children.


Follow AP Medical Writer Lindsey Tanner at @LindseyTanner.


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