Sixteenth Street finds success with a new model of care

A “View from the Waiting Room” column I wrote in early July about a midwives’ conference in Madison prompted an invitation for me to attend last week’s open house at Milwaukee’s Sixteenth Street Community Health Center, where a new model of care called “Centering Pregnancy” is being used to improve health outcomes for young mothers and their infants.

Although Wisconsin is home to a few Centering Pregnancy sites, the one at Sixteenth Street (1337 S. Cesar E. Chavez Dr., Milwaukee) is the first to receive an official stamp of approval from the national Centering Healthcare Institute in Cheshire, Conn. The institute is the headquarters for this model of prenatal care developed in the mid-1990s by Sharon Schindler Rising, a certified nurse midwife.

According to nurse midwives on staff at Sixteenth Street, the Centering Pregnancy site — now part of the health center’s Women’s Health Department — is at the forefront of health care system reform. National studies of the practice show improved health outcomes in key areas such as fewer premature births, fewer low-weight babies, lower c-section rates and higher rates of women choosing to breast feed their babies.

Early results from Sixteenth Street’s participating patients mirror the national results of improved incomes according to Ellyn McKenzie, the health center’s vice president of communications.

Centering is one of many efforts by Sixteenth Street, a federally qualified Community Health Center, to improve infant survival rates in the city of Milwaukee. Of the 1,000 babies delivered by Sixteenth Street health providers in 2009, 95 percent of the babies were at or above normal birth weight. That’s promising news because infants born at or above normal birth weight have a better chance of survival beyond their first year of birth.

Sixteenth Street’s Women’s Health Department has eight certified nurse midwives to provide primary care, prenatal care, birth attendance, postpartum care and other health services to women who typically come from low-income households or are uninsured or underinsured.

The clinic began offering the Centering Pregnancy method in April 2009, said Barbara Torres, a certified nurse midwife at Sixteenth Street since 2004.  Since then, 142 women have gone through the low-cost program, which the health center launched after receiving a grant from We Energies.

According to Torres, the Centering Pregnancy model involves three key components: health assessment, education and support.

The model sets up groups of eight to 12 pregnant women, all due around the same time, who meet regularly with each other and a nurse midwife to assess their health status, learn important health information, and discuss common topics of interest. A group meets at least 10 times for two-hour sessions, sometimes more if the women need it.

At a session, each woman weighs herself and takes her own blood pressure, then records the results in her chart. Torres says that aspect of self care is intended to empower the women to look out for their own health. Next, each woman meets individually with the nurse midwife for a health examination. Finally, the rest of the session is open to education and discussion about nutrition, oral health, common pregnancy problems, parenting preparation, relaxation techniques and birth preparation and recovery

Having so much time to learn and talk about their pregnancy experiences is not only reassuring to the women, but also lowers stress and increases overall patient satisfaction.

“We’ve had some very good statistics here,” Torres said.

The friendship and support that develops between women is a key reason for the program’s high rate of patient satisfaction, she added. Many moms become so close they continue their emotional support of each other after their babies are born.

That certainly has been the case for Giselle Esparza, a Milwaukee mother who participated in Sixteenth Street’s first Centering Pregnancy group. Giselle had such a positive experience that she brought her baby to the health center’s open house to let the community know what a difference it made for her and her son. As if to endorse his mother’s opinion, little Angel Feliciano Ruiz smiled and cooed while Giselle talked with the health center’s visitors.

When asked what she liked most about the Centering Pregnancy method, Giselle spoke of the support she received from her midwife and the other women in her group. Being allowed to ask questions and talk freely about what was on her mind at the group’s regular meetings was an empowering feeling, she said.

Would she recommend Centering Pregnancy to other women?

Absolutely. In fact, now pregnant with her second baby, Giselle said she soon will start the process all over again.