Group Prenatal Care for Afghan Refugees: A Pilot Program and Initial Demonstration of Feasibility.

Abstract

Introduction: In 2018 approximately 2400 Afghan refugees resettled in Washington state, and with approximately 16% arriving pregnant, many were in need of immediate prenatal care and psycho-social support. Because it has been shown to alleviate disparities in pregnancy outcomes, CenteringPregnancy, a group prenatal care model, was chosen as an evidence-based program to meet the needs of this community. This article aims to describe the feasibility and experience of CenteringPregnancy for pregnant refugees from Afghanistan as piloted in a community health center setting in Washington State.

Methods: This retrospective cohort and qualitative analysis utilized pregnancy-related outcome data extracted from electronic health records, as well as post-participation surveys to inform the feasibility of offering CenteringPregnancy in languages other than English. Two separate groups were conducted in 2018-2019 (n = 21) in Dari.

Results: Of 21 participants, 95% were reported to have adequate prenatal care as defined by Healthy People 2030 (> 9 visits during pregnancy). Delivery outcomes were generally positive, with no "very low birth weight" babies, and 86% vaginal delivery. Attendance at postpartum visits was 100% and 90% reported using contraception at 3 months postpartum. Post-participation surveys were generally positive; staff and physicians also reported positive views on the program and their participation in it.

Discussion: Group prenatal care, delivered as CenteringPregnancy in a community health center, is a feasible option for Afghan refugee women with this pilot demonstrating that patient experience and pregnancy related outcomes are largely positive; in addition to providing staff and physicians high levels of satisfaction with care.