Evaluating Centering group prenatal care in rural women with low socioeconomic status to promote access to care and improve pregnancy outcomes

Abstract

Rural pregnant women experience challenges in accessing quality prenatal care (PNC), leaving them vulnerable to disparate health outcomes for their infants. Few studies have compared the effectiveness of Centering group prenatal care (GPC) to traditional prenatal care (TPC) among pregnant women of low socioeconomic status in a rural area. This project evaluates perceived barriers to care and GPC outcomes to address gaps specific to this population. A prospective cohort comparison based on convenience sampling of 32 women used the Barriers Scale survey and satisfaction questionnaire to assess perceived barriers to PNC. In addition, a retrospective chart review used purposeful sampling of 106 charts to evaluate low birth weight, preterm birth, PNC use, and breastfeeding outcomes. Although GPC participants were high users of PNC (χ2 = 28.62, p = 0.0001), they had higher rates of low-birth-weight infants (11.3%, n = 6) and preterm births (13.2%, n = 7) than TPC participants (9.4%, n = 5 and 9.4%, n = 5, respectively). Breastfeeding outcomes were comparable. TPC participants reported provider relationship as a slight barrier, but both groups were satisfied with their care overall. Despite relative progress in promoting evidence-based PNC, maternal and neonatal disparities persist in rural communities. These findings indicate further need to explore social determinants of PNC use and outcomes.