Centers to focus on enhancing prenatal care in Ohio

The Columbus Dispatch

COLUMBUS

The Ohio Department of Health has selected four community-health centers to share a $900,000 grant aimed at enhancing prenatal care and infant health.

CenteringPregnancy is a nationwide program that has proved to increase live-birth rates and decrease infant mortality, said Dyane Gogan Turner, a health-planning administrator with the health department.

The centers that will be served by the grant are PrimaryOne Health in Columbus; Five Rivers Health Centers in Dayton; Muskingum Valley Health Centers in Muskingum County; and Neighborhood Health Association in Toledo.

Every day in Ohio, nearly three babies die before their first birthday. The chances of that baby dying in Mahoning County are arguably greater than in any other county in the state.

“We are 50 out of 50 for black infant mortality,” Erin Bishop, health commissioner for Youngstown, said in a Vindicator article on the issue in January.

In 2012, Mahoning County was 10th-highest in the nation for infant mortality among counties with 250,000 people or more, but that’s largely because of the sky-high black infant mortality rate of 23.7 for every 1,000 births.

Under the CenteringPregnancy program, groups of eight to 12 pregnant women join together, based on their due dates, said Dr. Arthur James, an associate clinical professor of obstetrics and gynecology at Ohio State University’s Wexner Medical Center.

The program allows those groups to meet with clinicians who then teach them about prenatal and post-delivery care, said Dr. Pat Gabbe, a clinical professor of pediatrics at OSU and Nationwide Children’s Hospital.

Babies are most at risk during their first year.

“The program helps them have good social support to address how to have a healthy baby, especially during the first year of life,” Dr. Gabbe said.

Ohio ranks sixth among the states with the highest infant-mortality rate, according to a 2013 Centers for Disease Control and Prevention report. In their first year of life, 7.8 Ohio babies die out of every 1,000 born.

That is too high, Dr. Gabbe said. Some of the reasons: premature deliveries, a lack of a safe-sleeping environment, and smoke in the environment or pregnant women who smoke.

Centering Healthcare Institute is the national model for the program. Founder Sharon Schindler Rising said the model is based on three main pillars: care, interactive learning and community building.

Schindler Rising, who developed the model in the 1990s, came up with the idea to create groups for pregnant women when she realized as a clinician that she often repeated the information over and over when working with women.

“I thought that groups were more powerful than anything in working with [pregnant] women,” she said.

Dr. James said a Nationwide Children’s Hospital program for pregnant teens has been a CenteringPregnancy model and has been able to reduce infant mortality among babies born to that age group.

Since its launch at the hospital in October 2013, the care model has reduced pre-term births to about 5 percent of babies born to girls in the program, said Sarah Saxbe, program coordinator of the teen and pregnant program. That’s lower than the 15 percent in 2012.

Women typically start CenteringPregnancy sessions between their 20th and 22nd week of pregnancy, Dr. James said. They complete 10 sessions that typically are about two hours each.