R. Rima Jolivet

I wasn't alone--a study of group prenatal care in the military.

The military has recognized that health and quality of life for service members are closely tied to the resources for their families, including how they are cared for during pregnancy and childbirth. However, there has been little examination of womens experience with different models of prenatal care (PNC) in military settings. The purpose of this article is to describe the results of a qualitative study of womens experiences with the CenteringPregnancy model of group PNC compared to individual PNC in two military health care settings. This clinical trial enrolled 322 women who were randomized into group or individual PNC at two military treatment facilities. Qualitative interviews were completed with 234 women during the postpartum period. Interpretative narrative and thematic analysis was used to identify three themes: 1) I wasnt alone-the experience with group PNC; 2) I liked it but...-recommendations to improve group PNC; and 3) They really need to listen-general concerns across the sample about PNC. Greatest concerns of women in individual PNC included lack of continuity and time with the provider. Our military families must be assured that their health care system meets their needs through personal and family-centered care. Group PNC offers the potential for continuity of provider while also offering community with other women. In the process, women gain knowledge and power as a health care consumer.

A Randomized Clinical Trial of Group Prenatal Care in Two Military Settings

A 3-year randomized clinical trial was conducted to test for differences in perinatal health behaviors, perinatal and infant health outcomes, and family health outcomes for women receiving group prenatal care (GPC) when compared to those receiving individual prenatal care. Women in GPC were almost 6 times more likely to receive adequate prenatal care than women in individual prenatal care and significantly more satisfied with their care. No differences were found by group for missed days of work, perceived stress, or social support. No differences in prenatal or postnatal depression symptoms were found in either group; however, women in GPC were significantly less likely to report feelings of guilt or shame. The findings suggest that women in GPC have more adequate care and no untoward effects were found with the model. Further study is important to evaluate long-term outcomes of GPC.

Early-onset neonatal group B streptococcal infection: 2002 guidelines for prevention

In 1996, the Centers for Disease Control and Prevention (CDC) and relevant professional organizations jointly released guidelines for prevention of early-onset neonatal group B streptococcal infections. The guidelines recommended that all obstetric providers and institutions providing intrapartum services follow one of two strategies. This year, on the basis of multistate surveillance data collected since prevention strategies were initiated, the CDC has released revised prevention recommendations. This article reviews the new guidelines and discusses clinical implications for practice in a variety of settings.