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Grace Health Centers Care for Pregnant Women, Reduces Premature Births

Friday, January 6, 2017  
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In some Michigan counties, infant mortality rates rival those of developing nations. This is especially true among certain racial and ethnic groups, many of whom are needy and have limited access to comprehensive prenatal care. 

That didn’t sit well with Grace Health in Battle Creek, Michigan.

Although many socioeconomic determinants impact the infant mortality rate, many neonatal deaths are associated with prematurity and low birth weight. Increasing access to prenatal care and improving overall health literacy can help keep moms — and their infants — healthier.

“We knew we wanted to pursue a model of care that would help women feel successful, prepared, and empowered during their pregnancies,” said Jill Wise, Vice President and Chief Operating Officer of Specialty Services for Grace Health.

Fortunately, a proven model for that type of personalized care exists in CenteringPregnancy. CenteringPregnancy offers a whole-health, whole-person approach to prenatal care.

In Centering, pregnant women with similar due dates into small peer groups for their 10 prenatal visits. Health assessments, interactive learning, and guided discussions are all facilitated through these groups. Each mom-to-be has the opportunity to connect — not just with their providers, but with each other. And, as they do, they break through the age-, race-, and socioeconomic-driven barriers that might otherwise divide them.

“When women have the support of other women alongside their health care professionals, they can access that community’s resilience,” said Loretta V. Bush, Chief Executive Officer, Michigan Primary Care Association (MPCA). “Those relationships cultivate trust and help Health Centers meet the needs of their communities.”

Visits range from 90 minutes to two hours, giving women nearly 10 times more time with their providers. During those visits, each woman is empowered to do more, like take her weight and blood pressure, and record her own health data. She is effectively given ownership of her own care.

Once health assessments are complete, the group circles up to learn about nutrition, infant care, stress management, labor and delivery, breastfeeding, and any other issues the group wants to address. No question is too strange or too personal. According to one participant, “The group discussions left me feeling like I actually accomplished something at my prenatal appointments.”

In fact, many women shared glowing recommendations. “I loved my Centering experience,” Erin Kyle said. Kyle and her boyfriend entered the program after visiting Grace Health for a pregnancy test. “After receiving a positive [pregnancy test], we were assisted right away in creating a health care plan, which included the opportunity to participate in a process called Centering.”

Kyle noted that Centering also placed a heavy emphasis on actively engaging fathers throughout the process. Program facilitators taught fathers what to expect with regards to labor, birth, and recovery — as well as how to handle the first few days with a new baby.


By actively engaging women and their partners with practical knowledge and advice rather than directing them to outside resources, Centering aims to increase health literacy and promote healthy behaviors. And that translates directly to better outcomes for moms and babies — exactly what Grace Health had hoped to accomplish. 

To quantitatively prove that its patients receive excellent care, Grace Health decided to pursue accreditation through The Centering Healthcare Institution. Achieving model fidelity necessitates strong support from staff, administrators, and patients, as well as meeting 13 program metrics. During the accreditation process, site assessors identified program strengths and made suggestions for improvement.

“One of the most important things we look for in a site visit is how well integrated CenteringPregnancy is in the fabric of the organization,” said Peg Dublin, consultant for the Centering Healthcare Institute.  “At Grace Health, it was very obvious that Centering was well-respected.”

According to Dublin, Centering was featured prominently throughout all aspects of the organization, making it clear that leadership took great pride in having Centering as an important model of care for pregnant patients.

“During the session I observed, Grace Health’s staff did an excellent job making the group interactive, engaging, and supportive,” Dublin said. “I was also impressed by the support Grace Health receives from the MPCA, including the start-up process, staff training, and monthly phone calls. It’s an excellent model that allows Federally Qualified Health Centers to learn from one another and solve any challenges that arise.”

Grace Health met and exceeded the accreditation requirements in many areas this past October. A full 100 percent of participants were satisfied with their care, and four out of five women were breastfeeding when they were discharged from the hospital. Perhaps most notably, only 5 percent of babies were born prematurely, a full 2.2 percentage points lower than the site approval standard. That’s clinically significant, particularly given the fact that few true preterm-birth prevention strategies exist.

“When mothers go into parenting with the tools and confidence they need to make well-informed choices, the evidence is in a healthy child,” Bush said. “As an added benefit, it’s also a much more efficient use of funds.”

According to The Centering Healthcare Institute, reducing the number of preterm births nationwide could save $8 billion in preterm baby care costs in the first year. Centering doesn’t just create better lives; it also improves bottom lines — for Health Centers and the families they serve.

Grace Health is determined to build on Centering’s success. Its team has set firm goals to increase the number of patients who receive Centering care over the next year and continue improving health outcomes for its community.

“[Centering] set my boyfriend and me up for so much success,” Kyle said. “That’s something we can never repay. We are better prepared parents because of Centering at Grace Health.”

For more information about CenteringPregnancy, please visit


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