Bearing the wait, together

The three young women weighed themselves and a midwife measured their rounded abdomens. Then one after another, the thrumming sounds of tiny heartbeats filled the room as the midwife held a sound monitor against their pregnant bellies.

Checkups complete, they settled into a circle to talk.

"We had a birth since we last met," said Margaret Taylor, the midwife leading the group at the Park Nicollet Clinic in Brooklyn Center.

This was serious stuff, and all the faces showed it. The three pregnant women were 25 years or younger and their babies, the first for each of them, were due in December.

Now one in their group had given birth weeks early. But what they didn't know is that their very togetherness in this group, a new kind of baby class that combines regular routine checkups with education, support and friendship, is proving to be one of the few ways to prevent preterm births.

Park Nicollet's Centering Pregnancy class is part of a growing trend in medicine to combine patient care with education and camaraderie.

It turns what was a private encounter between patient and doctor -- or midwife, in this case -- into a group experience. Some doctors do group sessions with all kinds of patients who are willing to share their private health issues with others. HealthPartners and other clinics now offer group care for diabetes patients. Both Park Nicollet and HealthPartners are experimenting with the prenatal groups.

No one quite knows why the Centering Pregnancy class appears to make a difference. But midwives, who came up with the idea, say it replaces something often lost in modern society -- that reassuring circle of mothers, sisters, cousins and aunts to share pregnancy and childbirth.

"You are not going through your pregnancy alone," said Diane Feller, director of the midwife program for Park Nicollet Clinic, who initiated the classes there. "You have the support of other women. You realize that what you are going through is what most of the group is going through."

All at the same stage

The women who sign up for a class are all at the same stage of pregnancy. They meet with one another, their midwife and a group leader every two weeks for two hours at a time.

That replaces what are often rushed, 10- or 15-minute appointments that women would have with a midwife, nurse or doctor for a checkup and a brief "how are you feeling" type of conversation.

"I love it," said Turquoise Richardson, 20, of Plymouth. "I can talk about anything and not be judged."

And they did indeed talk about anything at their late October class. First, their midwife, Vida Kent, told the story of the woman in the group who had given birth.

"Her blood pressure went really high," Kent said. "She had to have a C-section. The baby weighed 3 pounds."How did she know it was high?" asked Jen Lindwall, 25.

"She was having headaches. She wasn't feeling well and they found protein in her urine," Kent said.

Taylor, a retired midwife who returned to run Centering Pregnancy groups, jumped at the opportunity for a teaching moment.

"The take-home message is pay attention to how you feel," she said. "She did the right thing. She made the call" to the clinic.

They turned to birth control, one of the planned topics of the day. What kind were you using when you got pregnant? Taylor asked. It turned out that no one was using birth control at the moment she actually conceived. They burst out laughing when one woman said that her form of birth control -- abstinence -- was working fine until she stopped using it.

"I was surprised by how easy it was to be open," Lindwall said. The first time the group met, "we were already talking about bodies and relationships. It felt like a safe place from the beginning."

An unexpected benefit

Feller said that the combination of education and stress reduction from such classes might be why they may help reduce preterm births, a costly and rising problem.

The rate of preterm births, babies born before 37 weeks of pregnancy, has risen to 12.5 percent of births, costing $26 billion a year.

The Centering Pregnancy program was conceived in 1994 by midwives. It grew into the Centering Pregnancy and Parenting Association in Connecticut, which provides training, workshops and conferences on the concept.

A study published in August of more than 1,000 pregnant women showed that the program made a clear difference in reducing preterm births. Half of the women received standard prenatal care and the other half participated in Centering Pregnancy classes. Women in both groups were predominantly African-American (a key group for preterm births) and had the same age range of 14 to 25 years, according to the study published in the journal Obstetrics & Gynecology.

Those in group classes had a better understanding of pregnancy and were more likely to breast-feed; only 10 percent had preterm births, compared with 14 percent in the other group, researchers found.

Maria Pederson, director of midwives at HealthPartners, said the St. Paul clinic is running a group prenatal class for teenagers and hopes to offer the same thing to recent immigrant women from Somalia. "Many are lonely," she said.

Officials at both Park Nicollet and HealthPartners health organizations said they hope to eventually offer a group class to every pregnant woman who wants it.

"It would be a great idea for all our women," Pederson said.

Josephine Marcotty • 612-673-7394

Josephine Marcotty • marcotty@startribune.com