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OBGYN: Providing prenatal care in group visits

The idea of seeing expectant mothers who are at about the same stage of pregnancy together in a group for prenatal care is not new – it was described in the 1990s.  Generally, it is for low-risk patients.  Mazzoni & Carter discuss findings in the literature as to the effectiveness of this approach.  A popular model is called Centering Pregnancy, which is addressed in the other articles cited below.

Selected Sources:

Mazzoni, S.E., and Carter, E.B. (2017, February 9). Group prenatal care. American Journal of Obstetrics and Gynecology.  Click here for the publisher’s website: http://www.ajog.org/article/S0002-9378(17)30185-0/pdf

Crockett, A.H., and others. (2017, January). The South Carolina centering pregnancy expansion project: Improving racial disparities in preterm birth. American Journal of Obstetrics and Gynecology. 216(1 Supplement), S424-S425. Click here for free full text: http://www.ajog.org/article/S0002-9378(16)31441-7/pdf

Carter, E., and others. (2016, January). Group compared to traditional prenatal care for optimizing perinatal outcomes: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology. 215(1 Supplement), S382.  Click here for free full text: http://www.ajog.org/article/S0002-9378(15)02081-5/pdf

Garretto, D., and Bernstein, P.S. (2014, January). Centering Pregnancy: An innovative approach to prenatal care delivery. American Journal of Obstetrics & Gynecology, 210(1), 14-15.  Click here for free full text: http://www.ajog.org/article/S0002-9378(13)01039-9/pdf

Fausett, M., and others. (2014, January). Centering Pregnancy is associated with fewer early, but not overall, preterm deliveries. American Journal of Obsetrics & Gynecology, 210(1, Supplement), S9.  Click here for free full text: http://www.ajog.org/article/S0002-9378(13)01111-3/pdf  Posted by AHA Resource Center (312) 422-2050 rc@aha.org

BIRTHS: About 10 percent of the 4 million births each year in U.S. are premature

The federal government collects statistics on all births in the United States.  Here are data for 2014 for premature births:

  • 3,988,076 total births in the United States
  • 381,321 (or about 10 percent of all births) were preterm (under 37 weeks gestational age)
  • Of those, 27,320 (or less than 1 percent of all births) were the most preterm (under 28 weeks gestational age)

The data are also presented according to birthweight:

  • 8 percent of all births in the United States in 2014 were LOW birthweight
  • 1.4 percent of all births were VERY LOW birthweight

Also interesting is PLACE OF BIRTH:

  • 3,988,076 total
  • 3,928,272 in the hospital
  •      38,094 at home
  •      18,219 freestanding birthing center

Source: Hamilton, B.E., Martin, J.A., Osterman, M.J.K., and others. (2015, Dec. 23). Births: Final data for 2014. National Vital Statistics Report. 64(12), 50, 53.  http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

BIRTHS: About one-third of all births are C-sections

THE MOST CURRENT STATISTICS (2014)

In the United States, about one-third of all live births today are via cesarean section, according to national data from the U.S. National Center for Health Statistics.  The most current statistic is:  32.2 percent in 2014, compared to what is described as the peak of 32.9 percent in 2009.  When the data are analyzed according to race/ethnicity, the group with the highest percentage of c-sections is non-Hispanic black women (35.6 percent in 2014).

Source: Martin, J.A., Hamilton, B.E., and Oserman, J.K. (2015, Sept.). Births in the United States, 2014. NCHS Data Brief, 216.  http://www.cdc.gov/nchs/data/databriefs/db216.pdf Posted by AHA Resource Center (312) 422-2050, rc@aha.org

TREND OVER PAST 25 YEARS: Going up

A separate report from the National Center for Health Statistics shows that in the ’90s, the c-section rate was much lower – holding at about 20 to 23 percent overall.

Source: Hamilton, B.E., Martin, J.A., Osterman, M.J.K., and others. (2015, Dec. 23). Births: Final data for 2014. National Vital Statistics Report. 64(12). http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf   Posted by AHA Resource Center (312) 422-2050, rc@aha.org