Would Group Prenatal Care Make New Mothers Less Lonely?

When I was pregnant with my first baby, I enrolled us in the multi-evening childbirth education course offered by our HMO, where my husband and I sat in a little circle with other couples and took notes when Dot, the doula leading the course, lectured us on the “cascade of interventions” and how long a baby could go between feedings. I signed up for prenatal yoga, and for workshops on breastfeeding, babywearing, and pumping. I treated motherhood like a new job I was tackling, and I studied up. For weeks I sat on a futon at a breastfeeding clinic, dutifully weighing my baby before and after each feeding, surrounded by other new mothers. There we were, a group of new moms in the same boat all together, but I couldn’t tell you the name of a single woman who sat in that room with me, though the babies all had names like Leo and Charlotte.

In a way, my preparation method worked — I left all the workshops with the knowledge and skills I’d set out to gain (though pumping remained a nightmare). What I didn’t get — and what I wouldn’t even have really known how to look for — was a sense of community. I didn’t develop the kinds of friendships with other new mothers that I can now see I really needed. If I had, I would have felt much less alone in my first year of motherhood.

I thought of those courses and workshops when I learned about the concept of "group prenatal care." The concept was first piloted by the Centering Pregnancy program in 1993. While not the only group care model, Centering Pregnancy is the most established one, with providers in 600 clinical sites in 46 states and territories. Large healthcare systems including Kaiser Permanente, OHSU in Portland, and VCU in Richmond, Virginia, are participating, but I only heard of the concept recently, when a friend with a new baby mentioned a meet-up she was going to with her prenatal group.

What is group prenatal care?

In this model, starting in the second trimester of pregnancy, instead of the standard one-on-one biweekly appointments with your OBGYN or midwife, you meet in groups. 8-10 pregnant people (and their partners or support people) meet for 90 minutes to two hours, combining what we think of as regular prenatal check-ups (vital signs, bloodwork, urine tests if needed) followed by group discussion of topics related to pregnancy, birth, and baby care.

My friend told me she stayed in touch via text as each of the women in her group gave birth, and they regularly got together to catch up and meet the new babies. It wouldn’t have even occurred to me to reach out to any of the people from our childbirth class, even if I had their phone numbers or remembered their names. But here was my friend with ready-made group of parents at the exact same stage of newborn life! Instead of trying to make mom friends when she was haggard with new-baby exhaustion, she already had a group of people who’d been with her through pregnancy.

What does the research say?

In addition to building the community I so desperately longed for, there’s good evidence showing that women who receive this kind of care feel more prepared for labor, are less likely to deliver preterm, and are more likely to initiate breastfeeding. The outcomes speak for themselves: Both the American College of Obstetricians and Gynecologists (ACOB) and the American College of Nurse-Midwives endorse group prenatal care, with ACNM calling it “an evidence-based model of care that improved health outcomes for childbearing women and their infants.” Group care may be particularly useful in addressing disparities in perinatal outcomes such as preterm birth among black women.

What I needed most wasn’t an expert or a set of rules but honest conversation with other new parents who could assure me that I wasn’t alone.

Jessica Lewis, a research scientist who helped develop Yale’s Expect with Me program for group prenatal care, told me that it works especially well because the program, as she puts it, “empowers patients to expect to be heard about their own bodies and their own health.” Lewis says that health care providers on the delivery floor have told her they can always identify a group patient because they’re more confident advocating for themselves in labor. According to Lewis, the social support of groups not only reduces stress, but patients get 10x more time with their provider. In addition, the discussion format means that patients are able to learn more about pregnancy, birth, and child care in a way that really clicks — through conversation with other people going through the same thing.

“The community that you get in group prenatal care is one of the most enduring things that patients talk about and appreciate,” reiterates Dr. Rebecca Soderlind Rice, a nurse-midwife at OHSU Center for Women’s Health. “Parents build lasting relationships even after their babies are born.” A new mom who participated in OHSU’s group care noted on Reddit that having more time with the midwife and meeting other new parents were major benefits of the program. Another shared that her Centering Pregnancy group it “gave [her] a lot of agency and involvement in the process,” and that she loved being able to talk with people in the same stage of pregnancy.

So why isn’t everyone doing this?

Because it’s so different from the standard model of one-on-one care in which most providers are trained, making the switch to a group prenatal care practice comes with challenges. Some of these are practical, Jessica Lewis told me, as offices need to have scheduling systems that will allow the front desk to schedule multiple patients for the same time slot. There has to be a physical space where groups can gather, which isn't workable for all clinics, and there’s some up-front cost in terms of materials for the educational portion of the program. There’s also training for providers, who learn to use a facilitative style for the group discussion. “You really have to have buy-in,” says Lewis.

In addition to the benefits of social support and improved patient outcomes, group prenatal care actually saves money for healthcare systems. But health insurance providers are another barrier to group prenatal care. With the current fee for service model in maternity care, Lewis explained, “there’s no money in delivering prenatal care.” As a result, labor & delivery services are prioritized, and improving prenatal care is an afterthought. Lewis says there’s reason to hope that the movement to experiment with different financing models for prenatal care, including models like a “maternity bundle” that includes things like doula services, will make it easier for providers to establish new approaches to the prenatal visit. Group prenatal care is “a real structural change in how care is delivered,” Lewis told me. But because it’s one that delivers dramatically improved outcomes in areas that are otherwise intransigent, like maternal health disparities by race and class, it’s certainly worth the effort.

This isn’t an option near me — now what?

If your provider doesn’t offer group prenatal care, there are options for perinatal care and support in lots of places that explicitly focus on community building. The Parent Collective, founded by Jessica Hill, offers prenatal education courses led by experienced nurses and midwives, which are designed to be a complement to your prenatal checkups. Unlike the courses I took, with their decided slant toward “natural” birth and breastfeeding, The Parent Collective’s offerings aim to be “evidence-based, judgment-free, agenda-free,” Hill told me. Hill is especially interested in helping couples think about how they’ll share the labor of caregiving, and their courses also work to educate partners on signs of postpartum mood and anxiety disorders.

I know I was doing my best in a culture that had taught me that a good mom could figure it out on her own.

Hill says The Parent Collective is modeled after the UK's National Childbirth Trust, or NCT, which she experienced when she lived in the UK during her first pregnancy. The NCT is “part of the fabric of most communities in the UK,” Hill told me. Founded in 1956 with a mission of supporting people as they become parents, the NCT is a national charity with no equivalent in the United States. More than 75,000 people attend the NCT’s antenatal class each year, making it the most popular program of its kind in the country. The course isn’t free, but there are discounts available for households making less than £35,000 a year. Those classes provide prenatal education but are also, as Hill put it, “very much focused on building community.” The NCT reports that 95% of participants are still in touch with other parents from their course after the birth of their baby. Participants in the Parent Collective similarly note that the program led to lasting friendships.

Talking with Hill, I thought back on my own attempts at making “mom friends” when my first son was a new baby. A few weeks after giving birth, I texted one of the moms from prenatal yoga, and we went for a dutiful little walk with our strollers around the neighborhood. She was nice, but I found we didn’t really have a lot to say. It turns out that just having given birth around the same time isn’t necessarily a strong enough foundation for a friendship. And I was too exhausted in those early weeks, when I was basically just a pile of unwashed hair and nursing pads, to think of how I might uncover some deeper point of connection. When Hill and I spoke, she pointed out that this is really common. The newborn period is not actually an optimal time to be meeting new people, so starting to build that community during pregnancy is ideal.

A little more than a decade into motherhood, I can look back on that worn-out, bogged-down version of myself with a lot of compassion. I know I was doing my best in a culture that had taught me that a good mom could figure it out on her own. I can see now that what I needed most wasn’t an expert or a set of rules but honest conversation with other new parents who could assure me that I wasn’t alone. It was only when I started sharing my fears I was messing up in panicky little posts on Instagram that I began to find the community that would help me get through.

Group prenatal care, of course, would have been a great way to start.

Nancy Reddy is the author of The Good Mother Myth, published by St. Martin’s Press in January 2025. Her previous books include the poetry collections Pocket Universe and Double Jinx, a winner of the National Poetry Series. With Emily Pérez, she’s co-editor of The Long Devotion: Poets Writing Motherhood. Her essays have appeared in Slate, Poets & Writers, Romper, The Millions, and elsewhere. She writes the newsletter Write More, Be Less Careful and teaches writing at Stockton University.