Finding Community Through Group-Based Care

When I was a new midwife, and prior to starting my own practice, I worked at quite a large midwifery practice and was introduced to a bit of an alternative approach to prenatal care that involved group prenatal appointments. The specific program that we used was called “The Centering Pregnancy Program” and though it encouraged partner participation at the end and beginning of pregnancy and allowed for individualized assessment during each session, it focused on group-based sessions for the pregnant person for the bulk of the pregnancy. Our team of four midwives piloted the project for our practice and each group contained clients who were all due the same month, which would be anywhere from 10-14 clients. Initially it was a bit of a struggle because on a midwifery team, call/clinic schedules are very complicated at the best of times and shifting it to allow for two midwives to be present at every session and to have the sessions in the middle of a clinic day was quite challenging. Cue my fear of public speaking (and speaking to a group of 10-14 people who I may not know that well feels like public speaking) and it was not something I looked forward to. 

To my surprise, our sessions quickly became some of my favourite times in clinic. Not only did they give me the opportunity to get to know our clients better (when you have 14 clients a month and there are four of you, it is very difficult to get to know everyone), but also it was amazing to see the way everyone opened up and talked more freely about whatever concerns they had. In addition to the time spent with us acting as facilitators, they had the opportunity to get to know one another without our involvement while we did our short individual assessments. Interestingly, there is a lot of research that supports programs like Centering Pregnancy. These programs have positive impacts on pregnancy outcomes, and surprisingly, the level of satisfaction reported by both clients and providers. Evaluative data demonstrates that 96% of the clients preferred receiving their prenatal care in groups and beyond that, in our specific groups, many of them kept in touch and continued to see each other on a regular basis even once their time in midwifery care was over. I have a good friend who participated in group prenatal care 10 years ago and she has told me that her group still keeps in touch, even now. 

The benefits of this program, of course, extend into the postpartum period when you could have a group “drop-in” for anyone from two weeks through to six weeks or even longer. This would allow for efficient assessments, feeding assistance, and socialization, which can be so lacking during the initial postpartum period. 

What’s recently occurred to me is that treatment and therapy tailored to groups would benefit many different patient/client populations beyond pre- and postnatal care. The value of being in a safe group setting with others who are going through the same or even similar life events or stressors as you are cannot be overstated. Sharing experiences while going through treatment for infertility, pregnancy loss, or addiction, for example, creates a sense of community, making you feel less alone. Especially when used in conjunction with individualized treatment or therapy, group sessions enable participants to engage in conversations and ask questions that allow for a broader coverage of topics and ideas than what occurs in a one-on-one session. This work can and should be built upon in one-on-one sessions, but what occurs in a group setting can help individuals make meaningful connections that may carry over into other aspects of their life. 

While interacting in person is optimal when it comes to group sessions, groups can be attended virtually, which increases accessibility for those who may not be able to attend in person for a variety of reasons. There may be some initial hesitation when it comes to sharing in a group setting, but it is often helpful to start by listening. 

Eventually you will be comfortable being more vulnerable and participating more. One important key is being aware of the background of whoever is facilitating the group. Ideally it would be someone that you already have a relationship with or who has been providing some type of care for you. 

Life holds many challenges for all of us, challenges that often require us to seek out treatment. Or, perhaps we are engaged in routine treatment for a specific time of life, like prenatal or postnatal care. In many of these scenarios, we would benefit from group-based care being a part of our treatment plan. We need the community aspect of group care now more than ever, after we have been so isolated for over two years. If you live somewhere small like we do, you might have to create an opportunity yourself or find a virtual group that would suit your needs. Speak with your provider to see if a group approach would work for what is happening in your life. 

Happy Spring!