Group Prenatal Care was started around 2001-2002 and we offer 12 groups yearly. Baby groups were piloted in the 2005 timeframe and packaged/started in 2007. We have done multiple national presentations on group care at organizational meetings.
New care delivery model
As a Patient-Centered Maternity Home, two components of our Maternal-Child Health Care are evidence-based practice and shared decision-making. While ACOG guidelines are not always evidence-based, they have recently released guidelines allowing us all to offer trial of labor to women with two prior cesareans or twins. Our cesarean rate is 19% and our VBAC rate is 50%. North Carolina Medicaid is currently reimbursing cesarean birth at the same rate as vaginal birth.They were proactive in setting the rates pretty close to each other in years past.
HPC Community Doulas is a non profit 501(c) 3 maternal-infant agency dedicated to serve low income pregnant women receiving prenatal care at federally qualified health centers in Hudson County, NJ. Our grant is committed to reducing perinatal disparities in birth outcomes, so we offer free community doulas to pregnant women on Medicaid and/or enrolled in the WIC program.
The Birth Trust provides funding for projects that advance midwifery and woman-centered childbirth or reduce birth disparities through educational, policy, and research projects. The Birth Trust is a grant-making fund where donors and birth activists commit a certain amount monthly and then vote and select which projects get funded. Since the Birth Trust launched in 2010, nine very diverse projects have been selected.
In the Literature: Geisinger’s ProvenCare safely reduces cesarean rate with implementation of evidence-based guidelines
Geisinger Health Systems in Pennsylvania set out “to demonstrate that a large integrated health care delivery system, enabled by an electronic health record (EHR), could successfully reengineer a complicated clinical process, reduce unwarranted variation, and reliably deliver evidence-based care.” Geisinger has successfully demonstrated effectiveness in acute care specialties with their ProvenCare system and sought to adapt it to perinatal care, for the first time addressing a largely well population and integrating multiple outpatient clinics.
In the Literature: Intermountain Healthcare’s recurrent preterm birth consultation clinic is associated with improved care, outcomes
Intermountain Healthcare established a recurrent preterm birth prevention clinic in an effort to provide consistent, evidence-based medical care and education to women who have already experienced at least one prior spontaneous preterm birth and are at high risk for recurrent preterm birth. A retrospective cohort study evaluating the program found that referral to the clinic was associated with reduced likelihood of spontaneous preterm birth, longer gestation, and lower rates of neonatal morbidity.
This legislation would alter the organization of and payment for maternity services by: creating a mechanism to deny Medicaid payment for elective deliveries before 39 weeks, bundling payment for the full episode of maternity care for low-risk women, enabling access to midwives and birth centers providing high-quality, high-value care, and developing standards and a certification process for “pregnancy care homes”
Grant funds were acquired to implement a doula program for Crittenden Regional Hospital, a rural hospital in Arkansas. Trainings were established to train lay women to work in the program. Trainings were also provided for healthcare professionals to introduce gentle birth practices, and the role of a doula, and doulas working as part of the health care team.