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Am J Obstet Gynecol. 2014 Jan;210(1):50.e1-7. doi: 10.1016/j.ajog.2013.09.001. Epub 2013 Sep 7.

The impact of Centering Pregnancy Group Prenatal Care on postpartum family planning.

Author information

1
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC. Electronic address: halen@mailbox.sc.edu.
2
Department of Obstetrics and Gynecology, Greenville Health System University Medical Center, Greenville, SC.
3
Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC.

Abstract

OBJECTIVE:

The objective of the study was to evaluate the impact of group prenatal care (GPNC) on postpartum family-planning utilization.

STUDY DESIGN:

A retrospective cohort of women continuously enrolled in Medicaid for 12 months (n = 3637) was used to examine differences in postpartum family-planning service utilization among women participating in GPNC (n = 570) and those receiving individual prenatal care (IPNC; n = 3067). Propensity scoring methods were used to derive a matched cohort for additional analysis of selected outcomes.

RESULTS:

Utilization of postpartum family-planning services was higher among women participating in GPNC than among women receiving IPNC at 4 points in time: 3 (7.72% vs 5.15%, P < .05), 6 (22.98% vs 15.10%, P < .05), 9 (27.02% vs 18.42%, P < .05), and 12 (29.30% vs 20.38%, P < .05) months postpartum. Postpartum family-planning visits were highest among non-Hispanic black women at each interval, peaking with 31.84% by 12 months postpartum. After propensity score matching, positive associations between GPNC and postpartum family-planning service utilization remained consistent by 6 (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.05-1.92), 9 (OR, 1.43; 95% CI, 1.08-1.90), and 12 (OR, 1.44; 95% CI, 1.10-1.90) months postpartum.

CONCLUSION:

These findings demonstrate the potential that GPNC has to positively influence women's health outcomes after pregnancy and to improve the utilization rate of preventive health services. Utilization of postpartum family-planning services was highest among non-Hispanic black women, further supporting evidence of the impact of GPNC in reducing health disparities. However, despite continuous Medicaid enrollment, postpartum utilization of family-planning services remained low among all women, regardless of the type of prenatal care they received.

KEYWORDS:

Centering Pregnancy; family planning; group prenatal care; postpartum; prenatal care

PMID:
24018309
DOI:
10.1016/j.ajog.2013.09.001
[Indexed for MEDLINE]

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