Baltimore City has one of the highest infant mortality rates in Maryland — and received an F in the 2024 March of Dimes Report Card. The report cites smoking, obesity and hypertension as major contributors to preterm births, defined as babies born before 37 weeks of pregnancy. Preterm birth is a key measure of maternal and infant health, and reducing it is a primary goal of programs like Centering.
Some health care providers have turned to a holistic model of prenatal care called the Centering Program for better birth outcomes. Used internationally, it offers group-based prenatal care that starts around week 12 of pregnancy.
Most participants are in their twenties and attend 10 sessions that combine medical checkups with peer support and education.
In each session, participants learn practical skills such as how to check their blood pressure, monitor fetal growth, practice birthing positions, and swaddle a baby.
Birth workers — including obstetricians, lactation consultants and nutritionists — join the group to offer specialized guidance. C-section preparation and cooking demonstrations are also modeled.
For Kia Hollis, a midwife at Metropolitan OBGYN who leads the sessions, correcting misinformation is one of the program’s most important outcomes.
“For example, a woman would ask, ‘Is it untrue that I can't put my hands above my head because my grandmother told me that it might wrap the cord around the baby's neck?’ And It's an opportunity to correct myths and introduce real evidence-based medicine,” said Hollis.
Empowering women with accurate information and community support, she said, plays a critical role in improving outcomes.
Since the program launched at Mercy, the hospital reports higher rates of breastfeeding, healthier birth weights and more vaginal deliveries among Centering patients. According to the data:
- 8.81% of Centering patients had preterm births, compared with 15% of non-Centering patients at Mercy.
- 65.4% of Centering participants delivered vaginally, compared with 56.5% of other patients.
- 72.3% of Centering patients breastfed, compared with 66.7% of non-Centering patients. The American Academy of Pediatrics considers breastfeeding a “public health imperative.”
94% of Centering participants are African American, and more than half are covered by Medicaid.
While these results reflect one health system, the benefits of Centering are supported by plenty of studies throughout the world.
Lauren St. Pierre, a facilitator, at Metropolitan OBGYN said the impact goes beyond the clinic.
“They can go and teach their friends or their family or their cousins,” she said. “We recognize that not everybody has access to care.”
About 300 patients, most on Medicaid, participate in Centering yearly at Mercy.
