Women entering pregnancy can now benefit from an expanded, multifaceted group approach to prenatal care offered at Bon Secours St. Francis Medical Center.

CenteringPregnancy® is a nationally recognized program led by certified providers usually nurse midwives; it augments individual prenatal visits with group sessions and gives expectant women better control of their pre-natal care, through a group setting.

“Expectant women are more empowered today than 10 or 20 years ago in making their own health care decisions, and CenteringPregnancy helps them achieve this by bringing women out of isolated exam rooms and into groups for their care,” said Mary Anne Graf, vice president of women’s services, Bon Secours Virginia Health System. “CenteringPregnancy has a proven track record of ensuring healthier babies and healthier, well-informed new mothers. While moms often desire to be in the driver’s seat of their pregnancy, labor and delivery by making their own choices, they also can find pregnancy to be isolating and intimidating at times. CenteringPregnancy provides a supportive setting of women who often share the same ‘pains and passions’ of pregnancy.”

After completing their first obstetrics appointment at a Bon Secours-affiliated practice or clinic, women receive information on CenteringPregnancy and are offered the choice to participate in the program. Women are grouped by similar due dates. In each weekly session, they receive a private, prenatal check up by a certified nurse-midwife, including weight and blood pressure monitoring. This is followed by a two-hour group educational session led by a certified nurse-midwife. The weekly sessions enable the women to discuss health concerns and expectations in a supportive setting. Weekly topics including nutrition and healthy lifestyles, labor and childbirth options, breastfeeding, pregnancy discomforts, newborn care, child development and more.

Through this unique model of care, women become empowered and feel confident to play a more active role in their pregnancy and overall health. They have access to all their charts, ultrasounds and lab work, and they are acutely aware of how their pregnancy is progressing. Each woman is supported physically, spiritually, psychologically and socially, through bonds that develop within the group.

Initiated in the early 1990s by a nurse-midwife in Connecticut, and today with sites nationwide, the CenteringPregnancy model has resulted in positive health outcomes for pregnancies, specifically increased birth weight, fewer preterm births, shorter postpartum hospitalizations, and fewer unnecessary visits to the emergency room. The satisfaction expressed by both the women and their providers support the effectiveness of this model for the delivery of care.

“Women often are each other’s best teachers, and groups enable them to share a wealth of information with one another,” said Jean Curtacci, RN, a certified nurse-midwife and a group leader of CenteringPregnancy at St. Francis Medical Center. “The women in my groups are more willing to express what they’re really feeling, and they feed off of each other. The experience also is enhancing the way I provide prenatal care in a traditional setting, because I am learning more about what these women are going through in any given week of their pregnancy.”

“CenteringPregnancy has proven to be a really powerful process for a woman’s pregnancy, and it’s changing the way women are receiving their prenatal care,” said Graf. “New mothers especially are seeing this group approach as what prenatal care is, and will be in the future. The support setting will enrich their prenatal health, and the bonds they form will play an important role in each other’s lives. We see this as a new paradigm in the way prenatal care is delivered in the future.”

CenteringPregnancy comes to Bon Secours as a result of its 12-month qualitative and quantitative research, revealing how women today are more empowered than the previous generation of women to seek options and resources to pursue their own health needs. To support this, Bon Secours also is introducing other new programs this year, including Moms in Motion®, a nationally recognized fitness program.

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When diabetes starts during pregnancy, it is called gestational diabetes. Women with diabetes (whether or not it is classified as gestational diabetes) need special care during pregnancy.

Diabetes is a condition that prevents the body from using food properly. The body receives its major source of energy from a sugar known as glucose. Insulin, a hormone manufactured in the pancreas, must be available for glucose to be used in the tissues. During pregnancy, some of the hormones produced by the placenta have a blocking effect on insulin. Gestational diabetes occurs when the pancreas produces its maximum amount of insulin, yet that is not enough to overcome the effect of the placenta’s hormones.

What are the risk factors for gestational diabetes?

Gestational diabetes is more common in women who

• are overweight or obese
• are older than 25
• have had gestational diabetes in a prior pregnancy
• are African American, American Indian, Asian American, Hispanic, Latina or Pacific Islander
• have a family history of diabetes
• have previously given birth to an infant that weighed more than 10 pounds
• had excess amniotic fluid in a prior pregnancy
• had an unexplained stillbirth or miscarriage in a prior pregnancy

How is gestational diabetes diagnosed?

At Virginia Women’s Center, we screen for gestational diabetes at 28 weeks of pregnancy. You will have to drink a syrupy glucose solution and then have your blood sugar level measured one hour later. If your blood sugar level is higher than normal, you will have to do a follow-up glucose test. The follow-up test involves drinking another glucose solution and having your blood sugar level checked every hour for a three hour period. If at least two of the blood sugar readings are higher than normal, you will be diagnosed with gestational diabetes.

What if I am diagnosed with gestational diabetes?

If you are diagnosed with gestational diabetes, you will work closely with our nurse practitioners to create an individualized food plan. You will not have to give up foods you love, but you may have to limit them or eat them with other foods so that your blood sugar isn’t negatively affected. During pregnancy, you will have to manage your blood sugar so that it stays in the optimal range and reduces your risk for complications. Usually, this can be done through diet and exercise. You will also work closely with our physicians and may need additional testing to monitor the baby’s health and reduce the risk of complications throughout your pregnancy.

For most women, once the baby is delivered, gestational diabetes will go away. You will be tested again at your postpartum visit. If it does not go away, it is reclassified almost always as type II diabetes. Women who had gestational diabetes are at high risk of having diabetes later in life. Choosing to pursue a healthy lifestyle by eating nutritiously and exercising regularly may help prevent or postpone diabetes.

Additional Resources:

• Frequently Asked Questions on Gestational Diabetes
• Healthy Weight Management

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