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Centering Yourself for a Healthy Pregnancy

Frustrated by short prenatal visits that leave you with more questions than answers? You might be a candidate for the latest trend in prenatal care.

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Now, if you're thinking adult education -- or even childbirth classes -- guess again. While each meeting is semi-structured in terms of topics -- such as nutrition, common pregnancy complaints, labor and delivery concerns, even sex -- the atmosphere is far from a classroom setting.

"The doctor or midwife orchestrates each session, but it's really the women themselves who take charge and play an integral role in not only their own care, but the care of each other," says Peter S. Bernstein, MD, MPH, medical director of obstetrics and gynecology at the Comprehensive Family Care Center of Montefiore Medical Center and a pioneer in orchestrating hospital-based centering pregnancy programs.

At the start of each meeting every woman gets a few minutes alone with the provider. Here the doctor or midwife listens to the baby's heartbeat and gives a general "belly check," while the mom gets to ask any deeply personal questions or discuss any troubling symptoms, privately.

"If there is any indication of a serious problem, [the patient] is seen privately for a full exam, either directly following the meeting or the next day," says Bernstein. In this respect, no benefits of private care are sacrificed.

While each mom is being checked, the others are busy taking their blood pressure and weighing in -- either on their own or with the help of a nurse -- and then writing the results in their own charts.

"We encourage them to participate in their care as much as possible, even down to keeping their own charts. They take charge of their pregnancy, they own that chart, and it's a very empowering feeling," says Rising.

The next step: The women form their chairs in a warming circle of life, where in a comforting and safe environment, each patient is encouraged to share her personal pregnancy concerns. Providers and group members give advice and provide caring together.

"It is like nothing I've ever experienced as a doctor; the compassion and the nurturing that emerges is phenomenal," says Bernstein. Other doctors have witnessed similar results.

"I think the whole group concept really engages women in their care in a way that might be otherwise difficult with provider influence alone," says Urania Magriples, MD, a Yale professor of obstetrics who was the first in the nation to train other doctors in the centering care philosophy.

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