Strengthening Perinatal Services Through Social Care: Outcomes of a Quality Improvement Initiative for a Health Center-Based Perinatal Care Program.
Rebecca L Emery Tavernier, Peyton Rogers, Mia Shenkman and 5 others
PMID 41160059WHAT IT FOUND
A perinatal program integrating midwifery care and social support served high-risk patients in a safety-net clinic.
While rates of preterm birth and cesarean delivery were lower than national averages, large for gestational age births were higher and only 44% of patients attended the recommended number of prenatal visits.
Key findings
01Patients in the program experienced lower rates of cesarean birth, preterm birth, and small for gestational age births compared with national averages, but higher rates of large for gestational age births.
02Engagement in standard prenatal care was incomplete, with only 44% of patients attending the recommended 10 prenatal visits and 36% initiating care after the first trimester.
03Social needs support was a primary component, with 91% of patients assisted with at least one need, most commonly obtaining a breast pump.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is a single-site quality improvement report without a control group, so it cannot prove that the program caused the observed outcomes. Attrition was high, with 67 of 169 patients discontinuing care, and more than half of those did not specify a reason. The program did not fully implement the CenteringPregnancy model due to staffing delays, so results reflect a hybrid of individual and group care. The analysis compares outcomes to national averages rather than a matched local population, which may not account for local demographic differences.
Declared interests
The authors declared no conflicts of interest. The program was funded by a Health Resources and Services Administration Quality Improvement Fund award.
The easy way to misread this
Do not interpret the lower rates of cesarean and preterm birth as proof that this specific program model is superior to standard care. The study had no control group, and the comparison is against national averages, which may not reflect the local population's baseline risk.