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Context: Group perinatal care (GPC) offers a 'one stop' approach to clinical care and perinatal education. It has been shown to be associated with high levels of patient satisfaction and improved clinical outcomes. Co-facilitation of GPC (including postpartum care) by midwives (MW) and family medicine residents (FMR) in a family health team (FHT) has not been previously assessed. Objective: To explore the experience of participants in the academic FHT model of GPC. Study design: Descriptive qualitative study using semi-structured telephone interviews with participants who had completed GPC. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was conducted by team members. Setting: Academic family health team (FHT), Toronto, Canada. Participants: 18 patients who had participated in GPC at the Mount Sinai Academic FHT who delivered between November 7, 2016 and October 26, 2018. Findings: The major theme was the value of the relationships established and the positive consequences of those relationships. Participants describe relationships with health care providers that were built on comprehensiveness, continuity and credibility. Relationships with other GPC participants were facilitated but also developed organically, continued outside the structure of GPC and persisted well beyond perinatal care. The consequences of these relationships included creating support networks, shared knowledge and experience with their partners, improved self-confidence during the pregnancy and labour journey, decreased anxiety and extended commitment to breastfeeding. Conclusions: Participants in GPC at the Mount Sinai Academic FHT, in essence, became part of a social network for their labour, birth and early parenting journey by developing relationships with their healthcare providers, partners and fellow participants through the group process. This resulted in informational and emotional support which positively affected their experience. In particular, the contributions to self-confidence and decreased anxiety deserve further exploration., Presenters Anne Biringer, MD, CCFP FCFP, Natalie Morson, MD, CCFP, MScCH, Sakina Walji, MD, MPH, Tutsirai Makuwaza, MA, BSc, Susannah Merritt, Registered Midwife, Natalie Tregaskiss, BA, BHSc, BSc, RN, RM, [...]

Objective To determine the likelihood of participating in group prenatal care (GPC) and associated factors among low-risk women receiving traditional prenatal care from obstetricians, family physicians or midwives, and to determine factors associated with likelihood of participating. Methods Prior to completing a self-administered questionnaire, a 2-min compiled video of GPC was shown to pregnant women receiving traditional prenatal care. Data were collected on opinions of current prenatal care, GPC, and demographics. Biologically plausible variables with a p value ≤0.20 were entered in the multivariable logistic regression model and those with a p value Results Of 477 respondents, 234 [49.2 %, 95 % confidence interval (CI) 44.6-53.6 %] reported being 'definitely' or 'probably likely' to participate in GPC. Women were more likely to participate in GPC if they had at least postsecondary education [adjusted odds ratio (aOR) 1.84, 95 % CI 1.05-3.24], had not discussed labour with their care provider (aOR 1.67, 95 % CI 1.12-2.44), and valued woman-centeredness ('fairly important' aOR 2.81, 95 % CI 1.77-4.49; 'very important' aOR 4.10, 95 % CI 2.45-6.88). Women placed high importance on learning components of GPC. The majority would prefer to be with similar women, especially in age. About two-thirds would prefer to have support persons attend GPC and over half would be comfortable with male partners. Conclusion Approximately half of women receiving traditional prenatal care were interested in participating in GPC. Our findings will hopefully assist providers interested in optimizing satisfaction with traditional prenatal care and GPC by identifying important elements of each, and thus help engage women to consider GPC., Author(s): Sarah D. McDonald[sup.1] , Wendy Sword[sup.2] , Leyla N. Eryuzlu[sup.3] , Binod Neupane[sup.4] , Joseph Beyene[sup.5] , Anne B. Biringer[sup.6] Author Affiliations: (1) Division of Maternal-Fetal Medicine, Departments of [...]

Objective: This study aimed to understand physical, knowledge, psychological, and lifestyle factors associated with planned excess gestational weight gain (GWG), a strong and potentially modifiable predictor of actual excess GWG, which contributes to maternal and child obesity along with other adverse maternal and fetal outcomes. Methods: This is a secondary analysis of data from a prospective cohort study where women completed a questionnaire in early pregnancy. Women were asked to report their planned GWG, which was then categorized as above, within, or below the Institute of Medicine (IOM) guidelines. Univariable and multivariable analyses were performed to identify variables associated with planned excess GWG. Results: Of 970 women included in the analysis, 300 reported a planned GWG above the IOM guidelines. Predictors of excess planned GWG included reporting healthcare provider recommendations to gain weight above the guidelines (adjusted odds ratio [aOR], 62.17; 95% confidence interval [CI], 13.75–281.03), overestimating first trimester weight gain recommendations (aOR, 1.83; 95% CI, 1.21–2.77), believing in risks to the baby with inadequate GWG (aOR 2.16; 95% CI,1.29–3.60), inaccurate self-perceived prepregnancy body size (aOR, 1.88; 95% CI, 1.22–2.89), low or high emotional suppression (aOR, 1.78; 95% CI, 1.06–2.99; and aOR, 2.57; 95% CI, 1.21–5.45, respectively), physical inactivity (aOR, 1.10; 95% CI, 1.03–1.17), and overweight or obesity (aOR, 5.76; 95% CI, 3.70–8.98; and aOR, 11.46; 95% CI, 6.54–20.06, respectively). Protective factors against planned excess GWG included increased maternal age (aOR, 0.95; 95% CI, 0.92–0.99), and believing in risks to themselves with inadequate GWG (aOR 0.64; 95% CI, 0.42–0.97) or believing in risks to the baby with excess GWG (aOR, 0.49; 95% CI, 0.27–0.88). Conclusions: Women with overweight or obesity are at greater risk of prospectively planning excess GWG, and may especially benefit from healthcare provider counseling on appropriate GWG. Other modifiable factors for planned excess GWG included knowledge about risks of inappropriate weight gain and physical inactivity. [ABSTRACT FROM AUTHOR]