Women's Health

April 16, 2014

Vanderbilt participates in national study of group prenatal care


Vanderbilt University hopes to enroll about 400 women in a national study to evaluate the effectiveness of a new model of group prenatal care designed to improve the health and well-being of mothers and babies during pregnancy, birth and infancy.

The program, called Expect With Me, offers prenatal care in the group setting based on clinical guidelines from the American Congress of Obstetricians and Gynecologists and the American College of Nurse Midwives. The program provides valuable social and emotional support in addition to standard prenatal care, education and skills.

Expect With Me also includes a secure Web portal and social networking features to ensure that expecting mothers can stay connected between care sessions and have access to a strong support network. Incentives, gaming and videos will help patients engage, follow care recommendations and ultimately promote better health among mothers and babies.

The women participating in the Vanderbilt portion of the pilot study can enroll at either Vanderbilt Health One Hundred Oaks or NorthCrest Medical Center in Springfield, Tenn.

The design and delivery of Expect With Me is based on evidence from two National Institutes of Health (NIH)-funded studies that found that prenatal care delivered in a group setting was associated with fewer preterm births, reduced incidence of infants small for their gestational age, and shorter neonatal intensive care unit (NICU) stays after birth.

“It’s a new and exciting prenatal care program that integrates the high-tech tools of online social networking with low-tech group support and education,” said Deborah Wage, F.N.P., C.N.M., assistant professor of Obstetrics and Gynecology and director of group prenatal care in the Department of Obstetrics and Gynecology at Vanderbilt. “We are confident that our team has created a highly innovative care model that will help to improve perinatal outcomes as well as have long-reaching impact on the well-being of entire families and communities.”

Vanderbilt has offered group prenatal care to its patients at Vanderbilt Health One Hundred Oaks for several years. Their reputation as leaders in group prenatal care led to the relationship with Yale and UnitedHealth to create Expect With Me.

United Health Foundation is piloting Expect With Me in Nashville, Detroit and McAllen, Texas, all communities with a higher prevalence of adverse pregnancy and birth-related health issues. The program will provide more than 1,000 women ages 14 and older with access to medical care from a physician or midwife and educational information on having a healthy pregnancy. Participants also benefit from peer support from other expecting mothers who participate in the group sessions.

While aimed at women in their first trimester, participants may enroll up to 24 weeks into their pregnancy. Commercial insurance, Medicaid or TennCare will cover Expect With Me as it would any other prenatal care.

While expecting mothers typically spend 15-20 minutes with their doctors at each visit in traditional prenatal care, Expect With Me features 10 two-hour care sessions during the second and third trimesters, with the first few sessions held one month apart, moving to biweekly care later in the pregnancy. Each care session includes a physical assessment by a health care provider, an evaluation of the mothers’ vital signs, and a group education and discussion session.

Expect With Me was created by Yale University, in partnership with Vanderbilt University and United Health Foundation, with additional in-kind support from UnitedHealth Group and the UnitedHealth Center for Health Reform & Modernization.

“Our goal in piloting this new prenatal care model is to improve the health of mothers and babies and to reduce the poor perinatal outcomes in the U.S., such as low birth weight and preterm birth,” said Kate Rubin, president, United Health Foundation. “In addition to providing vital medical care for mothers-to-be, Expect With Me is designed to help women access reliable information about their pregnancy and benefit from social and emotional support so they are better prepared to take control of their health and the health of their babies.”

While most babies born in the United States thrive, infant mortality data from United Health Foundation’s America’s Health Rankings® report shows that six out of every 1,000 babies die during their first year of life, due largely to issues including maternal complications during pregnancy, premature birth, birth defects, and Sudden Infant Death Syndrome (SIDS). According to the Centers for Disease Control and Prevention (CDC), nearly 12 percent of all births in the U.S. are preterm, or prior to 37 weeks gestation, placing babies at risk for complications, illness and death. While race, ethnicity, income and age affect pregnancy-related health outcomes, research shows that quality prenatal care and healthy lifestyle choices among women before, during and following pregnancy can help reduce infant mortality among babies born preterm.

In addition to increasing the risk for health problems, preterm births are costly, accounting for more than one-third of all U.S. health care spending for infants. According to the Institute of Medicine, preterm births in the U.S. cost at least $26.2 billion a year – or $51,600 per infant – which is 10 times higher than the medical costs associated with a baby born at full-term. Adverse pregnancy- and birth-related health outcomes also are significant cost drivers.

Community-based and prevention-focused programs such as Expect With Me that work to improve the emotional, social and clinical well-being of mothers and infants have the potential to reduce health care spending in the U.S. by billions of dollars per year.

For more information visit expectwithme.org.