Preterm Birth Prevention: Marrying Centering Pregnancy and Community Health Workers


Poster Presentation

Purpose for the program

To test a new model of coordinated and enhanced services for pregnant women, beyond traditional prenatal services, to improve perinatal outcomes for high-risk low-income women on Medicaid. The goal is ultimately to reduce the risk of preterm births and improve health outcomes for infants in the first year of life. The innovative collaborative interdisciplinary program is designed to improve patient care and coordination, improve maternal and perinatal health outcomes, and ultimately, reduce healthcare costs by using a centering model of care. The proposed project has selected areas of high risk and high need that are served by different healthcare delivery systems where preterm birth statistics are alarming.

Proposed Change

To transform existing models of prenatal care to centering models of health for improved maternal and perinatal health outcomes and reduced healthcare costs.

Implementation, Outcomes, and Evaluation

Low-income pregnant women will be identified by their Medicaid provider and prenatal care provider. By using the components of Rising's Centering Pregnancy Model, participating prenatal care Federally Qualified Health Centers (FQHCs) with advisory support from an academic setting will implement and support the Centering Pregnancy group education model of enhanced prenatal care. Four FQHCs will participate in the transformation of a traditional medical model of prenatal care to a centering model of care; women who are pregnant will be enrolled in the centering program. All pregnant clients will be partnered with a culturally and linguistically appropriate trained community health worker that will serve as the client's pregnancy peer mentor. Data will be extracted from the FQHCs and tracked for perinatal health outcomes, healthcare utilization and costs, care coordination, and birth outcomes.

Implications for Nursing Practice

Preterm birth is a critical public health problem in the United States. Preterm birth is a complex, multifactorial process that accounts for 12% of all live births and more than 500,000 premature births annually. One in eight infants born in the United States are premature. Infant prematurity is the leading cause of neonatal death in the United States and is responsible for 27% of infant deaths, or one million infant deaths annually. Prematurity is the leading cause of death among African American newborns as compared with non-Hispanic White newborns. The centering pregnancy model of care, primarily used in midwifery care centers has demonstrated reductions in preterm birth. The implications for improved maternal–child outcomes are vast.