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The comparative effects of group prenatal care on psychosocial outcomes

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Abstract

To compare the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care, we conducted a prospective cohort study of women who chose CP group (N = 124) or individual prenatal care (N = 124). Study participants completed the first survey at study recruitment (mean gestational age 12.5 weeks), with 89 % completing the second survey (mean gestational age 32.7 weeks) and 84 % completing the third survey (6 weeks’ postpartum). Multiple linear regression models compared changes by prenatal care model in pregnancy-specific distress, prenatal planning-preparation and avoidance coping, perceived stress, affect and depressive symptoms, pregnancy-related empowerment, and postpartum maternal-infant attachment and maternal functioning. Using intention-to-treat models, group prenatal care participants demonstrated a 3.2 point greater increase (p < 0.05) in their use of prenatal planning-preparation coping strategies. While group participants did not demonstrate significantly greater positive outcomes in other measures, women who were at greater psychosocial risk benefitted from participation in group prenatal care. Among women reporting inadequate social support in early pregnancy, group participants demonstrated a 2.9 point greater decrease (p = 0.03) in pregnancy-specific distress in late pregnancy and 5.6 point higher mean maternal functioning scores postpartum (p = 0.03). Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 point greater increase (p < 0.01) in prenatal planning-preparation coping strategies in late pregnancy and a 4.9 point greater decrease (p = 0.02) in postpartum depressive symptom scores. This study provides further evidence that group prenatal care positively impacts the psychosocial well-being of women with greater stress or lower personal coping resources. Large randomized studies are needed to establish conclusively the biological and psychosocial benefits of group prenatal care for all women.

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Acknowledgments

This project was supported by grant number R36HS021975 from the Agency for Healthcare Research and Quality and by the Research, Innovation, and Development Grants in Economics (RIDGE) Center for Targeted Studies, Southern Rural Development Center (SRDC), Mississippi State University, Dissertation Grant Program. This project also received support from the University of South Carolina Advanced Support for Innovative Research Excellence Grant Program and the Institute for Advancement of Healthcare, Greenville Health System. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

Ethical standards

This study was concurrently approved by the Institutional Review Boards at the Greenville Health System and the University of South Carolina. All study participants provided written informed consent prior to their enrollment in the study.

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Public Health Sciences, College of Health, Education, and Human Development, Clemson University, Clemson, SC, 29634, USA

    Emily C. Heberlein

  2. Greenville Health System, Department of Obstetrics and Gynecology, 890 W. Faris Road, Greenville, SC, 29605, USA

    Amy H. Picklesimer & Sarah Covington-Kolb

  3. Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA

    Deborah L. Billings & Edward A. Frongillo

  4. College of Social Work, University of South Carolina, 902 Sumter St., Columbia, SC, 29208, USA

    Naomi Farber

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  1. Emily C. Heberlein
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  2. Amy H. Picklesimer
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  4. Sarah Covington-Kolb
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  5. Naomi Farber
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  6. Edward A. Frongillo
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Correspondence to Emily C. Heberlein.

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Heberlein, E.C., Picklesimer, A.H., Billings, D.L. et al. The comparative effects of group prenatal care on psychosocial outcomes. Arch Womens Ment Health 19, 259–269 (2016). https://doi.org/10.1007/s00737-015-0564-6

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