A Personal Account of Group Prenatal Care with Family Practice Physicians
My first birth was an elective cesarean for “cephalopelvic disproportion” performed by an OB at a Midwestern hospital. I began planning my VBAC even before becoming pregnant again. I knew that my success would depend on my choice of healthcare providers. When we relocated to the Triangle, I initially received women’s health care through a large OB-GYN practice at a university medical center. But there I heard “Once a c-section, always a c-section” and “I can’t imagine why any woman would choose a vaginal birth!”Then my husband and I attended an information session on Centering Pregnancy at UNC Family Practice. Centering Pregnancy combines prenatal care, education, and support within a group of pregnant women and partners. While I’m not much of a “group” person, I liked the idea of accepting responsibility for my own healthcare, checking my own weight and BP and making notes in my own medical record. We were also impressed by the midwifery model of care, the high success rate among VBAC attempts, and the overall low cesarean rate [at UNC Family Practice]. Centering Pregnancy turned out to be the best thing I could have done for myself and my baby. The whole Family Practice team (attending, residents, midwife, and nurses) was incredibly supportive of childbirth and parenting practices outside the mainstream, including natural childbirth, doula support, bed-sharing, and extended breastfeeding. And they unequivocally supported my determination to attempt a VBAC. They responded to my first birth story with empathy and also bewilderment: over and over I heard, “We believe every woman deserves a trial of labor.” My daughter Nora Kate arrived on Veteran’s Day, 2005, a natural vaginal birth following 80 hours of labor but just 5 hours in the hospital. It is the finest thing I have ever done.
In fact, all eight women in our group delivered their babies vaginally, in an era of obstetrics in which the cesarean rate approaches 30%. We continued to meet as a group until all the babies were birthed, all the birth stories shared. Throughout my daughter’s first year of life, UNC Family Practice has provided a true continuity of care, including well-baby visits and outstanding lactation support. We have also stayed in close contact with the other Centering families, meeting at first for long walks during maternity leave, and then keeping in touch through e-mail, pot-luck suppers, moms’ nights out, and most recently a joint first birthday extravaganza. My only regret is not having access to this kind of care during my first pregnancy.
Margaret D Lineberger