The Influence of Group Versus Individual Prenatal Care on Phase of Labor at Hospital Admission

Ellen L. Tilden, Cathy L. Emeis, Aaron B. Caughey, Sarah R. Weinstein, Sarah B. Futernick, Christopher S. Lee

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Introduction: Group prenatal care, an alternate model of prenatal care delivery, has been associated with various improved perinatal outcomes in comparison to standard, individual prenatal care. One important maternity care process measure that has not been explored among women who receive group prenatal care versus standard prenatal care is the phase of labor (latent vs active) at hospital admission. Methods: A retrospective case-control study was conducted comparing 150 women who selected group prenatal care with certified nurse-midwives (CNMs) versus 225 women who chose standard prenatal care with CNMs. Analyses performed included descriptive statistics to compare groups and multivariate regression to evaluate the contribution of key covariates potentially influencing outcomes. Propensity scores were calculated and included in regression models. Results: Women within this sample who received group prenatal care were more likely to be in active labor (≥ 4 cm of cervical dilatation) at hospital admission (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.03-2.99; P =.049) and were admitted to the hospital with significantly greater cervical dilatation (mean [standard deviation, SD] 5.7 [2.5] cm vs. 5.1 [2.3] cm, P =.005) compared with women who received standard prenatal care, controlling for potential confounding variables and propensity for group versus individual care selection. Discussion: Group prenatal care may be an effective and safe intervention for decreasing latent labor hospital admission among low-risk women. Neither group prenatal care nor active labor hospital admission was associated with increased morbidity.

Original languageEnglish (US)
Pages (from-to)427-434
Number of pages8
JournalJournal of Midwifery and Women's Health
Volume61
Issue number4
DOIs
StatePublished - Jul 1 2016

Keywords

  • Antepartum care
  • CenteringPregnancy/group care
  • cesarean birth
  • first stage of labor
  • intrapartum care

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Maternity and Midwifery

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