Supported by a March of Dimes grant, Upstate introduces new prenatal care program

An $80,000 grant from the March of Dimes is helping Upstate Medical University introduce a new specialized prenatal care program for pregnant women with diabetes that aims to improve their health and that of their babies.

About 20 women who are patients at Upstate’s Regional Perinatal Center are involved in this special program, known as CenteringPregnancy. Unlike a traditional prenatal care appointment, in which the pregnant woman sees her health care practitioner for a routine examination, the CenterPregnancy program offers not only the medically necessary exams, but provides the women with an opportunity to learn together in a group.

Upstate officials say the CenteringPregnancy sessions scheduled throughout a women’s pregnancy provide more than 20 hours of prenatal care from a health care practitioner, compared with under two hours of care for the traditional prenatal experience most women receive.

In a large space, devoid of the starkness of a medical exam room, nurse midwife Kathleen Dermady facilitates a discussion among six women in this particular session on the importance of ensuring a full-term pregnancy.  She’s assisted by Marianne Donovan, a registered nurse.

It’s a serious topic, but the women and Dermady engage in a lively discussion and there is a good rapport among the group.  Registered dietician Julie Mellen, sitting next to Dermady, offers her take on the importance of good nutrition during pregnancy, especially for women with diabetes.

“This CenteringPregnancy program changes the paradigm on how to deliver prenatal care,” Dermady said.  “The women are developing a good support network, learning from each other and using this ‘circle’ time talking about their pregnancy and reinforcing the messages they hear about how to care for themselves during pregnancy and and beyond with diabetes.”

“Good prenatal care for women who are diabetic cannot be over emphasized,” Dermady said, “especially since pregnant women with diabetes are at higher risk to deliver a premature baby.”

“Pregnancy can be challenging enough with the normal discomforts and physical challenges of pregnancy,” she said.  “But these women must also be responsible for managing their illness by balancing food intake, activity, blood glucose levels and medical use, often insulin. Sharing concerns about their pregnancies helps women to normalize the pregnancy experience.”

The program has been implemented elsewhere with great success, said Genie Rotundo of the Centering Healthcare Institute who is volunteering at Upstate as the program gets under way.  CenteringPregnancy is evidenced based and has demonstrated significant improvements in preterm birth rate and reducing the racial disparity, increased breastfeeding rates and increased readiness for labor and birth and parenting. It has also shown increased patient satisfaction with this model of care.

“We have seen dramatic results from many areas that offer CenteringPregnancy programs with more and more babies being carried full term, 40 weeks,” she said. “The longer the baby stays in the uterus the healthier the baby will be.”

Ensuring full-term pregnancies and improving the health of babies is the work of the March of Dimes, which provided the $80,047 grant to Upstate for the CenteringPregnancy program.

Also, the grant is provided in partnership with REACH CNY whose mission is to provide resources, education, advocacy and collaboration for a healthier Central New York.  A key agency priority is to promote system changes in the delivery of health care that will improve pregnancy outcomes and eliminate racial, income, and other disparities in maternal child health.

“We appreciate the generous financial support of the March of Dimes and our supportive partnership with REACH CNY,” said Robert Silverman, MD, professor and chair of Upstate’s Department of Obstetrics and Gynecology, who oversees the Regional Perinatal Center.  “Together, they are helping Upstate break new ground in how it offers prenatal care to women with high-risk pregnancies.”

Caption:  Nurse midwife Kathleen Dermady, second from left, facilitates a CenteringPregnancy session at Upstate’s Regional Perinatal Center, with assistance from registered dietician Julie Mellen, left, and social worker Chevelle Jones Moore. At right is patient Amyrenee Grout.

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