The need for prenatal health services in Whittier’s community
Women within Whittier’s primary service area face increased risk of poor birth outcomes, especially African American women, who are at the greatest risk nationally and locally for unhealthy births. These disparities can be seen through the available data for Roxbury and Boston’s African American community. The table below outlines national Healthy People 2010 goals for birth outcomes and how Boston, Roxbury, black or African American residents of Boston, and white non-Hispanic residents of Boston compare
| Healthy People 2010 Target |
Boston | Roxbury | Black or African American | Non Hispanic White |
Adequate Prenatal Care |
90.0% | 81.4% | NA | 75.8% | 86.7% | Low Birthweight | 5.0% |
9.6% |
12.3%* |
12.7% |
8.6% |
Preterm Births | 7.6% |
10.7% | 13.8% | 13.6% |
9.3% | Infant Mortality | 4.5 per 1,000 live births | 6.4 |
9.4* |
11.3 |
3.4 |
Breastfeeding in Early Postpartum Period (at 2 months) |
75.0% |
NA |
NA |
69.6% |
98.6% |
Source: Health of Boston Report, 2009
The Centering Pregnancy program at Whittier
To address these disparities, Whittier Street Health Center has implemented a new and innovative program. The Centering Pregnancy program is a group visit model of prenatal care delivery that is designed to promote safety, efficiency, effectiveness, timeliness, culturally appropriate patient-centered care and more equitable care. The model incorporates three critical areas of effective health care, which are: health assessment, education and support. The program begins at 16-18 weeks of gestation and consists of 10 two-hour visits in a group prenatal care model. The 10 visits follow the recommended schedule for prenatal care.
At each group visit, women:
• Perform self-care skills, such as weight and blood pressure.
• Have a short assessment with their provider.
• Discuss their concerns and ask questions.
• Learn about necessary health information to keep themselves safe and healthy in pregnancy and beyond.
The last point is of special importance for Whittier’s community. Whittier has found, and studies support, that pregnancy often acts as a first point entry, or reentry, for underserved populations into primary care. Therefore, while ensuring the healthiest birth for the baby, Whittier is also able to work closely with expectant mothers who have historically not been connected to health care to provide health education, screenings and connection to other needed services, such as behavioral health, eye care and oral health.
Program effectiveness
Whittier has particular interest in implementing the Centering Pregnancy program because if its documented success in improving healthy birth indicators that are particularly poor in Whittier’s community. Several studies have been published regarding the effectiveness of the Centering Pregnancy program. Relevant outcomes include:
• Group prenatal care appears to improve early preterm delivery rates, low and very low birthweight infants, and neonatal mortality.
• For adolescent patients, the program appears particularly effective in lowering preterm birthrate.
• Group prenatal care results in higher breast feeding rates and higher prenatal knowledge scores.
Under the leadership of Dr. Laura Holland, Whittier’s OB/GYN Department is extremely excited to offer this program to its patients to improve the delivery of prenatal care. To find out more information about this program, please call 617-989-3123 and ask for Mildred Bailey.
