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Comparative Study
. 2019 Sep;46(3):450-460.
doi: 10.1111/birt.12413. Epub 2018 Dec 27.

Women-centered care: Implementation of CenteringPregnancy® in The Netherlands

Marlies Rijnders  1 , Suze Jans  1 , Inger Aalhuizen  2 , Symone Detmar  1 , Matty Crone  3
Affiliations
Comparative Study

Women-centered care: Implementation of CenteringPregnancy® in The Netherlands

Marlies Rijnders et al. Birth. 2019 Sep.

Abstract

Introduction: In response to a relatively high perinatal mortality rate in The Netherlands, the Dutch Health Ministry recommended changes to maternity care, opening a pathway toward more integrated woman-centered services. Because of its potential to positively influence risk factors for adverse pregnancy outcomes, CenteringPregnancy (CP) group prenatal care was implemented.

Methods: We performed a retrospective cohort study (n = 2318) and survey on women's experiences (n = 222) in eight primary care midwifery practices to investigate outcome differences between CP and traditional individual prenatal care. Data from the period 2011-2013 were analyzed.

Results: Primiparous and multiparous CP women attended more prenatal care visits compared with women who received individual care (adjusted odds ratio [aOR] 1.23 [95% confidence interval [CI] 1.18-1.29] and 1.29 [1.21-1.36]). Fewer primiparous CP women used pain relief during labor (0.56 [0.43-0.73]), and they initiated breastfeeding more often (1.74 [1.15-2.62]). Women participating in CP were more likely to feel that their wishes with respect to medication use (69.1% vs 54.4%, P = 0.039), physical activities (72.8% vs 52.5%, P = 0.008), and relaxation exercises (67.9% vs 35.6%, P ≤ 0.001) were listened to by care providers. They also felt more supported to actively participate in their care (89.6% vs 68.5%, P = 0.001) and felt more able to voice opinions about care (92.7% vs 73.9%, P = 0.002).

Conclusions: The CP model is a good approach aligning with Dutch policy calling for women-centered care and responding to the needs of pregnant women. This study supports CP scale-up in The Netherlands and adds to the pool of international knowledge about CP implementation.

Keywords: CenteringPregnancy; group prenatal care; pregnancy outcomes; vulnerable women; women-centered care.

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References

REFERENCES

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