Small Group Pregnancy: A New Way to Build Community with Other Moms

Aug 13, 2018 | Survival Skills

Dr. Carol Brees has been hooked on helping women deliver healthy babies since day one. In fact, her very first night as a medical student, she delivered three babies. “I went home on such a high that night,” she says. “I have always loved obstetrics as a specialty.” Early in her career, Carol practiced family medicine overseas, but in between trips, she completed her residency in Obstetrics/Gynecology at University of Louisville Hospital, where she now has been practicing for more than a decade.  

Helping the Vulnerable

In 1987, Carol and her husband, a Presbyterian pastor, moved to Pakistan and practiced for 16 years at a hospital there. “It was an amazing experience,” Carol says. “Despite all you hear on the news, Pakistani people are incredibly hospitable. Hospitality is an important value in South Asian cultures. They treated us as honored guests.”

While Carol admits it was sometimes an intense experience practicing medicine in Pakistan, she says she felt needed there. “The maternal mortality rate in the United States in a busy academic practice is maybe one or two a year, if that,” she says. “In Pakistan, it is much higher, and often for very preventable reasons. We estimated that about 50 percent of the women we delivered had never had prenatal care,” Carol says. Another challenge in the culture of a developing country, Carol says, is that women are wary of medical care. “Still today, in many parts of the world, hospitals are where you go to die, so to convince women to even go to a hospital, much less think about having a surgery like a C-Section, is difficult,” she says.

By the time Carol and her husband left Pakistan to return to the United States in 2008, they had established a busy nursing school there, training midwives and performing about 8,000 deliveries a year. Carol says she was a little surprised at the amount of infertility work she encountered but came to understand it as a societal aspect of Pakistan. “I expected to deal with maternal mortality and family planning issues, but in a culture where a woman’s worth is based on her ability to bear children, many of them ended up in my office for that as well,” she says.

Women Sharing Common Experiences

One thing Carol says she brought back from her experience abroad was the ability to hear different points of view. “It’s about understanding we don’t always have to do things the same way.” It was that open-mindedness about cultural diversity that inspired Carol to begin the Centering Pregnancy Program in November 2016, supported with a March of Dimes grant. The idea of Centering Pregnancy is to bring together women of similar gestational stages for two-hour group appointments that provide a pregnancy check-up, education, and a support network.  

“I started looking at this because some of our refugee populations at University of Louisville Hospital are used to a group society and a group way of doing things, and I thought this might be a way to improve their compliance with prenatal care,” Carol says. “It’s a fun model, and the residents get to lead it, and they are really loving it, too. When I first heard about the Centering Pregnancy model, I thought, ‘Why wouldn’t you want to do it that way?’”

Carol’s practice is the only one in Louisville currently offering the Centering Pregnancy program. A new class is beginning about every other month, Carol says, but the classes need to reach an average of eight to 10 patients to be completely self-sustaining. Right now, sign-ups for the classes are coming from Carol’s own obstetric patients and average five or six per class. There is no additional fee for the sessions since they are actual prenatal appointments. “We are trying to spread the word,” she says.

Centering Pregnancy Offers Convenience, Community

Benefits to Centering Pregnancy are numerous, but convenience is certainly key, Carol says. Rather than having to come to your prenatal visit and wait sometimes two hours in a room by yourself to see your doctor, and then also carve out a night of the week to come to prenatal classes, it’s all done together, Carol says.  

Since the women in each group are all due around the same date, they are walking through the experience together, something the first-time moms truly appreciate, Carol says. “It’s nice. At the sessions, I’ve had some of the women come in and say, ‘I was texting with another member of the group,’ or they ask if so and so has come in yet. It’s become, ‘What happens in group stays in group.’” 

Carol says she is just as enamored with helping women deliver babies today as she was 20 years ago on her first night. “It’s an immense privilege to be able to take care of women in the time their families are expanding and they are learning to be new moms. It’s a really special time that we’re included in for those women.”

Top 5 Tips for a Successful Pregnancy  

  1. Get healthy before pregnancy. Many women come in with medical problems and think pregnancy is no big deal, and it might not be if they didn’t have medical problems. Optimize your health before pregnancy.  
  2. Know how you relax. Pregnancy and everything after will give you a lot to be anxious about, from the process of the pregnancy to labor and delivery to taking care of your child. Knowing you have good mechanisms for coping and relaxing is important.
  3. Don’t forget about water. Hydration is key.
  4. Have your support system in place.
  5. Educate yourself about pregnancy and your body.

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