Centering: Group OB Appointments

When my girlfriend Emarie first told me that she’d attended two-hour-long group pre-natal check-ups with her OB, I had a million questions…

Leading with… “Say what?!”

The basics
Sharon Schindler Rising, a nurse-midwife, began offering group prenatal care called “Centering Pregnancy”  in 1993 after realizing that she was answering the same questions over and over, but not necessarily getting the time with each patient to establish the sort of deeper discussions the mothers might be after.  She appreciated the community the women developed but also: it’s estimated to cost roughly $2000 less per patient. More remarkably: the model was shown to reduce preterm deliveries by close to 30%.

The American College of Nurse-Midwives is encouraging all physicians and midwives to get training in group clinic situations, so I wanted to know more about this. Emarie was kind enough to answer all my questions, like… what if you don’t like your physician? Were you ever embarrassed? How was your husband involved? and Two hour appointments?! Did you ever feel like rolling your eyes?

The nitty-gritty
How did you get started?
“I didn’t even flinch when they first told me my OB (who is also a family practician) does her sessions in a group, or think to mention it until [my husband] and I were headed to our first appointment. ‘Oh, and by the way, there are going to be other people there.’ When we arrived I think he was a little, ‘uh-oh, Kumbaya.’ The first two were maybe a little awkward: You don’t know anyone. And you’re sitting there thinking ‘we’re supposed to talk about gas and farting… and morning sickness… with people we don’t really know?”

“I think I was the first person to say really inappropriate things, and I’m sure people were like ‘oh my gosh, she’s going there.’ I’m like, we’ve got nine months, people! ‘Get used to it.'”

What about the physical examination? 
“Groups are usually between five and eight people. You go in, check in at counter with nurses and get a number. Belly checks are first, then heartbeats. You check your own blood pressure (with the nurse). You weigh yourself. You do the urine test. … I think it’s empowering—you really know what’s going on.”

And then you just talk?
“My doctor usually has a topic or theme in mind—usually pertaining to the week we are at. One girl always came with questions. And I never, ever have questions so it was really nice! You ever go to a doctor’s appointment: ‘you have any questions for me?’ and then damnit, your mind goes blank?”

“Someone would come with a notepad and all these questions and [I’d think]: ‘I would’ve never thought of that!’ So it was good to play off each other. If you were having a really bad week, you knew you weren’t the only one. There were always other people to relate to and with whom you could create these relationships. You could email them in the middle of the night… you know you’re not alone.

Like when you get that first Charlie Horse and you feel like you might never walk again. 
“Right. In my first session, all but one of us were first time moms. And we had all the same questions. The doctor would ask ‘Is anyone else experiencing this? What’s working for you and what’s not?’ … There’s a fine line between interjecting all the time and telling someone how to solve a problem, and speaking up to offer experience and suggesting something.”

Learning how to do the one and not the other would be helpful beyond the pregnancy. That’s a valuable skill—especially for being friends with other moms! 
“Chat groups and blogs can be great resources, but I don’t want to be judged. … We were all able to talk about the blues afterward, too. And someone would say ‘That’s normal! And I’m feeling that way, also.’ And that’s because we were all really comfortable.”

“We talked about everything. From sex to… I can’t control my bowl movements… to everything.”

Okay, what about partners and husbands? 
“A lot came at the start, and a couple of husbands were there all the time.” (“I suppose that could be awkward… we do get together for birthdays and some of the holidays…”)


I suppose it could be more of an obstacle to someone who is very modest.
“It’s really a personality thing. You have to trust your gut.”

Did you have to deal with any tragedies—miscarriages? 
Thank goodness there were no real scares or tragedies, but had there been, I think there would have been an amazing support group.

What about the time commitment? Two hour appointments?
“Two hours is a big commitment. If you’re working, if you have another kid… but I think the benefits outweigh the costs of additional childcare or an additional hour off of work.”

“Instead of a 15-minute appointment, you’re with your doctor for two hours. Now I have a great relationship with my doctor. I wanted her at the delivery—we’d gone through a long nine months together.”

“[And with the first] we had all the time in the world. We had more time to get together: ‘let’s do yoga’ and we’d get together once a month and really formed a strong bond. Once babies were born, we’d get together every week—and it’s incredible to have all of these babies at the exact same stage as yours. Even four months can feel huge at the start. It can get really lonely. It can get super lonely.”

That’s so true. I remember being a new mother in New York and most of my friends had older children. Getting out to a playground with an infant might mean two naps on the go, sometimes with a screaming cab ride; meanwhile they’d need to be moving around with the older kids. Even though it was social, it often felt more isolating.

“It took quite a few appointments before I realized that we were all going to be friends. You work up to it.”

“And my OB does pediatrician visits, too. So now, all of these kids are being seen in a group together—when most of us have known each other since we were nine weeks pregnant!”

You would recommend Centering or Group prenatal care if it’s an option?
“Most definitely. Like most things, of course: it’s really about getting back what you put in.”

Thank you, Emarie!  

What do you think? I’ve since had a few friends attend the group appointments. It wasn’t for everyone, but I can see how it could be the start of some really amazing friendships. You’ve gone through so much together! Would you be interested in a group appointment if you could sign up? Are any of you already doing Centering groups? 

P.S. Some other family posts: Announcing you’re pregnant; Packing for Labor & Delivery; Taking a babymoon; Making a registry checklist (with registry tips); and the first week of life.

[Photos courtesy of Emarie’s Centering Group]

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