CenteringPregnancy is a model of group prenatal care that replaces routine, individual prenatal care. The program brings women together into small groups to receive their care and prenatal education, and is based on three components: risk assessment, education, and support. The model is client-centered, designed to empower pregnant women and support persons, and involves the woman in small group discussions of 8-10 other women of similar gestational age. The group discussions provide support, help women educate each other, and invoke self-monitoring. Currently, there have been few publications that closely examined maternal weight and obesity and associated outcomes in women involved in CenteringPregnancy; and there are a limited number of studies that examined Spanish-speaking CP groups with Latinas. Therefore, the primary purpose of this retrospective cohort study was to compare pregnancy outcomes of Latina women who completed CenteringPregnancy in a public health clinic to women who completed individual care in the same clinic during the same time. The secondary purpose of this study was to understand perceptions of care among multiparous women who recently completed CenteringPregnancy and completed individual prenatal care in the past. Both quantitative and qualitative methods were employed to examine differences in pregnancy outcomes and maternal factors in both prenatal care groups, and to understand women's perceptions and experience in both CenteringPregnancy and individual prenatal care. A total of 487 patient charts were obtained for data collection (Intervention n= 247, Comparison n=240) and 10 women who recently completed CenteringPregnancy at the health department and completed individual prenatal care in the past completed in person in-depth interviews. The results indicated that there were no differences in infant birthweight or gestational age at delivery between the groups. Compared to women in individual care, women in CenteringPregnancy had increased odds of: having a vaginal birth as opposed to a primary cesarean section, aOR =2.57, (95% CI: 1.23-5.36), attending prenatal care visits, aOR=11.03, (95% CI: 4.53, 26.83), attending postpartum care visits, aOR=2.21 (95% CI: 1.20, 4.05) and formula-only feeding their infants, aOR=6.07 (95% CI: 2.57-14.31). Compared to women in individual care, women in CenteringPregnancy had decreased odds of gaining below the recommended amount of gestational weight, aOR=0.41, (95% CI: 0.22, 0.78). Qualitative findings indicated that women who complete CenteringPregnancy were more satisfied with their care, received more education and support and were more empowered to make decisions about their pregnancy and childbirth. The program provides a system of social support that encapsulates all types of social support to provide relief of stress, encourage positive relationships and empower women to help facilitate healthy pregnancies. CenteringPregnancy at the Pinellas County Health Department increased health care utilization and informed and empowered women through social support.

Introduction: Appalachian women have high rates of preterm birth and low birth weight infants. A new format of group prenatal care, known as CenteringPregnancy, decreases the rate of preterm birth and low birth weight when compared with individual care. However, clinics in Appalachia often struggle to recruit women into group care. Theory & Methods: Using critical realism and the middle-range theory of motivation-ease as frameworks, this qualitative study had two research questions: ‘What influences Appalachian women’s choice of traditional prenatal care instead of CenteringPregnancy care?’ and ‘What are Appalachian women’s perceptions of prenatal care and their access to prenatal care?’. Twenty-nine Appalachian women, who had declined CenteringPregnancy care, were interviewed about their perceptions of prenatal care, what facilitated care, and their decision to decline CenteringPregnancy. Verbatim transcripts of these semi-structured interviews, in-depth demographic questionnaires, and field notes were coded and analyzed using conventional (inductive) content analysis. Findings: Two meaning units were identified, information concerning women’s reason(s) for declining CenteringPregnancy and facilitators of prenatal care access. The reasons women provided for declining CenteringPregnancy care fell into three overarching categories, preferred one-to-one care, experienced barriers to Centering, and did not know Centering was an option. The most common reason for declining Centering was a preference for individual care. This category had three subcategories: do not like groups, don’t want to put everything out there with other women, and no need for change from existing care. Women predominately named two facilitators of prenatal care access, insurance and compassionate care. Conclusions: Clinicians should decrease barriers to CenteringPregnancy utilization and should partner with the local community to better market this new model of care. In addition, small modifications in Centering may make the model more appealing and accessible. However, clinicians should continue to provide individual care for women who cannot access group care. Participants stated state-provided insurance greatly facilitated prenatal care which supports the need for ongoing Medicaid funding. Women also stated compassionate care enhanced their ability and desire to get prenatal care. Healthcare providers should renew efforts to provide personalized and unrushed clinical environments to assist women in obtaining needed prenatal care.