At the Chula Vista office of the San Ysidro Health Center, a group of mothers-to-be are taking charge of their health.
As one woman checks her blood pressure, another tests her urine for signs of excess sugar or protein.
The women also spend a couple of moments with a medical resident, who measures their tummies and monitors their babies' heartbeats.
After they make the rounds, the women record all of their numbers in a notebook.
Then they sit around in a circle and share their feelings about breastfeeding.
Scripps family medicine doctor Shaila Serpas facilitates the meeting with a light touch.
Dr. Serpas explained this model of care is called Centering. It brings together pregnant women who have a similar due date. The group functions as a support system.
“So they grow together, they share experiences," she said. "Women are sometimes new, first-time moms, and other women have had experiences. So they share wisdom, and common fears, and common concerns, and common excitement.”
The Centering program starts around the second trimester and goes through delivery. Each two-hour session covers different topics based on how far along the women are in their pregnancy.
But it’s not a lecture series; it’s a series of group discussions. Dr. Serpas explained by taking part in these and other activities, women gain more understanding about their own health.
“So for example, they weigh themselves, they graph their weight, and they self-reflect on how their weight gain is," she said. "Rather than a doctor saying you’re gaining too much weight, you’re gaining too little weight, they can self-reflect and can identify if they’re on track with their growth, and what changes and goals they can set for themselves to improve their overall health during their pregnancy.”
Centering takes the place of regular one-on-one prenatal visits. This kind of group healthcare can save clinics money. But second-year medical resident Karen Law, who also works with the Centering group, said it has another, more important advantage over a typical doctor’s visit.
“I think the group setting is great, because it provides a longer timeframe for women to have their questions answered, and topics might come up that they would not have even thought of themselves, or that I would not have time to address in the short 15-minute session. But having the two hours gives you a lot of flexibility,” Law said.
Anaiza Dearte has the earliest due date of anyone in her Centering group. She’s due on August 19.
Dearte said the other women have been terrific.
“Like, sometimes I feel something weird, or I feel sick or something. I just call them, and they help me," she said.
Scripps and the San Ysidro Health Center have collaborated on the Centering program for six years. About 150 women have taken part.
Scripps officials say compared to women who get one-on-one prenatal care, Centering participants tend to have higher rates of breastfeeding, more appropriate weight gain during pregnancy, and have higher use of long-acting contraceptives after delivery.
Scripps family medicine doctor Karla Garcia said this model of group care could be used to help people manage their diabetes, or hypertension.
“At least for our patients here, they love to talk, and they love to interact with each other," Dr. Garcia said. "It makes it easier for them, I think, to express themselves, and then at the same time, it makes it easier for the providers, so that we don’t have to keep repeating the same thing over and over again every visit. I think the way our healthcare system is, definitely it’s going to be a bigger part of our primary care, for sure.”
The American Academy of Family Physicians says nearly 13 percent of its members conducted group visits in 2010.
