Group care boosts breastfeeding, knowledge, and satisfaction
The RCT and the cohort study showed increased rates of breastfeeding initiation (NNT=8 and 6, respectively).1,3 The RCT demonstrated that patients in group care more often had adequate prenatal care (NNT=16).1 One cohort trial found that women enrolled in group prenatal care used the emergency department less during the third trimester (NNT=2, P=.001).4
Several studies have reported improved pregnancy knowledge and high levels of satisfaction with group prenatal care. The RCT showed increased knowledge and readiness for labor, and higher satisfaction compared with individual care (P<.001 for all outcomes).1 Lower-quality studies of group care support these findings.3-5
An innovative model that requires further study
Group prenatal care is a relatively new, innovative model of care, and limited data are available for review. The evidence from 1 RCT and 1 cohort study supports the protective effect of group prenatal care against preterm delivery for women at higher risk of adverse pregnancy outcomes.1,2 Trends toward improved health outcomes were found in lower-quality studies; the trends were large enough to have potential clinical significance. These preliminary findings should be evaluated as primary health outcomes in future research to define the optimal population for group care.
Recommendations
No published guidelines or textbook recommendations exist for group-based prenatal care. In other areas of medical care, including diabetes and low back pain, specialty societies such as the American Diabetes Association and systematic reviews have supported practice changes, including group visits, to improve care.6,7