Childbirth with You: A Community-Based Pregnancy Support Program

Childbirth With You The high rate of infant mortality in the Pittsburgh area highlights the need to improve access to high quality health care. Magee-Womens Hospital of University of Pittsburgh Medical Center piloted a new model of care, Childbirth with You, at Mt. Oliver Neighborhood Health Center in 2006.  The new model combines complementary models that have demonstrated successful outcomes separately, Centering Pregnancy and doula care.  These models integrate group support, childbirth education and prenatal care with concentrated individual support for pregnant women from ethnically diverse cultural and low socioeconomic backgrounds.  The doula is a trained professional who provides ongoing social support to the birthing family. The investment in the combination of the two models was to create a synergy and increase participation by women of the community in more healthy pregnancy behaviors and thereby improve outcomes. The outcomes measures of weeks of gestation, weight in grams, Apgar scores at one and five minutes, cesarean rate and breastfeeding rate are compared to the Magee-Womens Hospital population as a whole and national rates.  The 15 mothers who enrolled in the program and delivered in 2006 faired better than average.  There were no preterm deliveries in the group and no babies born less than 5 and a half pounds.  The national cesarean rate is above 30%, the Magee rate 26% and the CWY group only 6%.  The Apgar scores averaged 8 and 9. The national breastfeeding rate is 70%, the Magee rate 62% and the rate for the program mother’s was 53%.    It is important to note that the breastfeeding rate at 3 months was 33%, which is the national average.  The doula maintained contact with the breastfeeding mothers for support and questions.  The 15 mothers rated their satisfaction with the program highly.  The program is currently being instituted in a second neighborhood health center.