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Future mothers teach each other monthly in prenatal group visits



ASHEVILLE, NC (AP) – In a large room full of expectant mothers, pregnant women check each other's blood pressure and weight, a nurse-midwife measures her growing belly and everyone sits in a sitting circle for two hours of open conversation about it What to expect when you calculate.

A young woman reveals her strange longings for glue and softener. She laughs softly, followed by the nurse, that could indicate strange signs of iron deficiency. It's a bizarre subject that does not always show up on typical 15-minute checkups when doctors rush and patients are reluctant to mention those little nagging worries that may seem insignificant.

But in a more relaxed group, women open up and conversations flow beyond vital signs, weight gain and maturity.

"I can tell you that it's normal, but if you have another mom in the group who says, 'Oh, that happened to me, that's normal. & # 39; It's more acceptable when it comes from a peer, "said Laura Moore, a nurse at the Asheville, North Carolina clinic.

Pregnant women at the clinic may opt for a monthly group session instead of the traditional one-to-one doctor visits with their doctor, which are usually recommended.

Weekly sessions on weekdays include about 1

0 women, all at the same stage of pregnancy. A nurse or midwife usually conducts discussions on issues such as common pregnancy complaints, stress management, nutrition, and childbirth. Fathers or other partners are invited to attend. But expectant mothers take the lead role and teach by passing on their pregnancy experiences.

Kailee Morel Alvarez had never heard of prenatal visits to the group when she learned she was pregnant last summer. However, the 21-year-old and her husband were sold after their first visit to the OB-GYN clinic at the Mountain Area Health Education Center. Her daughter, Sofia, was born in February.

"The best part was certainly that other women go through the same things I did at the same time," she said.

"First I Was Real When the baby gets everything it needs, it grows normally," said Morel Alvarez. Later she was plagued by convulsions and early labor. To find out that other women also experienced all these things, "was very helpful," she said.

This low-tech approach hardly seems to be the epitome of 21st-century medicine. But prenatal care for groups can have some important benefits beyond comradeship. Some studies have found fewer premature births, underage babies and newborns requiring intensive care, and higher breastfeeding rates in women receiving group care.

This is a model that the American College of Obstetricians and Gynecologists has recently advocated as a promising option.

"To be honest, I loved it," said Victoria Tate, 28. She had a traditional prenatal care for her first two children, but decided to do group sessions for the third time. Her son Deklin was born on January 30th.

She said It was invaluable that she had two hours to talk about the health concerns that had befallen other women, and this helped to make the experience less stressful. These included genetic tests that were performed outside the group, and pregnancy diagnoses Abetes, handled by the group's nurse.

"I had to change what I ate and had to test my sugar pretty much," she said.

Health insurance typically covers group care. Jessica Lewis, deputy director of pregnancy research at the Yale School of Public Health, said the increasing number of US centers visit, said that only 3 percent of US women receive group care. Some do not choose, but many are not offered. One reason why there are not more health centers is the start-up costs for staff training and a meeting space.

Lewis co-authored the largest study to date, involving 9,300 women who had group sessions at the Vanderbilt University Medical Center in Nashville. Data from almost six years showed that women who participated in at least five group sessions had a 70 percent lower chance of having low birth weight premature infants than women receiving individualized care. The study included a program that co-founded Lewis, called Expect with Me.

It is unclear how prenatal care in groups can lead to improvements in mother-child health. For some women, it is the first time in their adult lives that they have sought medical help, and Lewis said that pregnancy "provides a wonderful opportunity for women to be motivated to make a lot of behavioral changes." They stop smoking They're starting to eat better. "

Group sessions can facilitate these changes, and much more, which can help improve baby outcomes, Lewis said.

Some doctors say the benefits may be related to reducing stress. High levels of stress and anxiety during pregnancy, relational problems or financial difficulties, struggling with other children during long hours, excessive care for work and childbirth – can increase women's blood pressure and stress hormone levels and have been associated with complications including premature birth.

The Asheville Clinic, which uses a program called Centering, has been providing group care since 2013. Last year, 400 women took part. Less than a third of pregnant women offered this option. The lack of childcare locally is one reason. For other women, the idea just seems too strange, said Amber McCarter, a program outreach specialist.

For Kiana Burgin, the two-hour morning visits made time to get away from her factory job 45 minutes later. She loved the support group environment, but missed the individual, personal attention she got with her now-five-year-old daughter. Her son Christopher was born in January, and Burgin says she would probably go back to single care if she has more children.

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Follow AP Medical Writer Lindsey Tanner at @ LindseyTanner.

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