Durga, who is 28 years old, is pregnant for the first time. She has a loving and supportive family who works in the fields. Together with her husband she runs a general shop. She has been careful with her health during pregnancy and does not carry any heavy loads.
She attends the group care meeting for the third time. The group discusses how little they knew about health issues during pregnancy before the clinic started offering group antenatal care. Before these meetings her only source of knowledge was her family, especially her mother-in-law. Durga explains to the group that she only ate what her mother-in-law advised. “She said I shouldn’t eat curd, meat or spinach because it might harm me and my baby. But in the group I learned that nutritious food is very essential for both of us.” Other women also explain how little they knew before they joined the group. They all make sure they attend at least 4 group sessions and they talk about how they learned that it is safer to give birth in the hospital.
Durga says “when I feel tense I just think about the group and I remember the topics that we shared in the sessions and that helps me a lot!”
The midwife: “It was lovely to see how Durga changed her habits and became more positive in her thinking. The group really supported her to improve her health.”
Sherry, is 14 years old and her 15 year old boyfriend, Dean discussed parenting options with the social worker from the hospital. They decided to give their baby up for adoption.
Sherry accepts the midwife’s offer to join the antenatal group care sessions and she attends every single one. She is very open with the group about her plans to have her baby adopted after it is born. Dean is very supportive of his girlfriend: riding his bike he meets her every time to accompany her to the clinic where the group sessions are held. The group grows attached to the teenage couple and becomes a real support to them, listening carefully to how they are planning to manage their feelings about placing the baby for adoption.
In preparing for the reunion session the midwife is plagued with worries: Should she invite Sherry and Dean even though they won’t have their baby to bring to the group? The midwife knows they have followed through with their plans for adoption but she decides to invite them anyway. Much to the group’s surprise the adoptive father also comes to the group meeting and brings the baby. The adoptive mom has taken all her time off already and now it was the dad's turn to do something for his new baby. He offers the biological parents the baby to hold during the meeting. It is the first time Dean actually holds the baby. Both Sherry and Dean ask the adoptive father for advice: “How do I hold the baby? Am I doing this right?" They get to spend some time with the baby before they hand the baby back. The rest of the group is moved to tears. There is a lot of respect for these teen parents who have grace and courage.
The midwife: “We didn’t know if we should offer Centering to Sherry because she was placing her baby for adoption. We thought she would feel uncomfortable. But then we thought, why not? She will say no if she feels uncomfortable with the idea. To my surprise she said yes! Again I had my doubts for the postpartum session, but I thought, of course she is part of the group. And when the adoptive parents indicated they wanted to come to the meeting, again I had this feeling of -oh, gosh, what is going to happen, now?- What I love most about this story is how the group helped to normalize this experience for the couple. Instead of being a shameful chapter in these teens lives, it was respectful and supportive.”
Maria is an undocumented 27 year old woman from Mexico. Together with her husband, she has been in the United States for a couple of years now and has been working as a cleaning lady. When Maria finds out she is pregnant, she isn’t sure what to do. She is not very happy about her life in the States. She feels depressed. Maria feels her life is compartmentalized, with her going to work, going to school, and being home with her husband. None of these parts of her life are integrated. May be she should return to Mexico now that she is pregnant.
When she turns up at the antenatal clinic, the midwife encourages her to join a Centering group. Maria says that to sit and talk to a group of women is the last thing she wants to do, she is too depressed for this. But the midwife is persistent and eventually convinces her to give it a try. During the first meeting Maria holds back and doesn’t say much. But over the course of the next couple of sessions, she comes out of her shell, starts to participate and actually finds the meetings enjoyable. So much so that she is looked to as a leader in the group.
The midwife: “We kept in touch with Maria. She told me that looking back, Centering was a bridge for her between her culture and the United States’ culture. It is what got her feet on the ground in the country.
She had her baby and then returned to the health center to give something back to Centering as a member of a group we call "graduadas", or "graduates": Spanish-speaking women who have experienced Centering and who have shown leadership potential. They work together doing community outreach and education, and become helpers in our Centering groups. Currently Maria is moving forward in her education and is on her way to college with the goal of becoming a midwife!”
It is the seventh session, so the group is quite comfortable by now with the check-in and the discussion process. The sessions for this group are held with the partners present who are usually dressed in jeans and cut-off shirts. Most of them have lots of tattoos. During the check-in time they gather around the food table, casually teasing each other. The co-facilitator, a young male physician, sits on the floor with dolls and blankets around him, ready for a discussion about breastfeeding and baby care. All of the group members start talking about what they know or don’t know about babies. For some it turns out to be very little. Then one of the men says, “Doc, I heard that if I’m sitting near my old lady on the couch toking up, my kid gets a hit inside her. Is that true?” The men look at each other startled. The women are suddenly at full attention. The physician facilitator talks a bit about brain development and the possible impact of drugs and alcohol. Several men comment: “no way”, “you gotta be kidding”, indicating their amazement.
Suddenly, one of the men gets up, walks to the corner, retrieves a trash basket and comes back to the circle where he goes from one man to another. “Throw it in here,” he says, “all of it.” “We aren’t doing this anymore.” Man after man empties his pockets of glassine envelopes, pipes, and other smoking related paraphernalia. When he puts the basket down, he proceeds to give the men his cell phone number. “Call me and I’ll call you. We can do this for our kids’ brains.”
The midwife: “I didn’t anticipate this and never could have made it happen myself. The group took over and I just watched as the men responded to the power of the discussion and their ability to do something positive for their growing baby. It was an amazing moment!”
After an uneventful pregnancy Kaitlin experiences an intra uterine fetal death. She is admitted to the hospital for induction of labor. Fortunately the midwife who facilitated the antenatal group care sessions is on duty and supports her during the birth of her baby.
Kaitlin has no family in the area and she and her husband do not have many friends. When the midwife visits her at home, she observes severe symptoms of postpartum depression and refers Kaitlin to the appropriate services. The reunion session happens to be in the afternoon on the same day. Although she doubts very much that Kaitlin will attend, the midwife makes sure she knows that she is very welcome, acknowledging that it may be difficult for her to listen to the birth stories of the other women and meet their babies.
Just as they start talking, Kaitlin arrives. There is an awkward silence at first since the women know that Kaitlin’s baby had died. She joins in the circle and cries softly. One of the women holds her hand. The group continues to share their stories. After everyone has told their birth story, the midwife lets Kaitlin know that if she feels like telling her story they are here to listen. Kaitlin doesn’t speak at first, but she then softly tells to the group the details of her experience. Kaitlin tells the group how 'beautiful and perfect' her daughter was at birth, and how she treasured the moments that she was able to hold her. Even the grandparents were able to make it to the hospital and hold their grandchild. When she finishes her story, the Centering women get up one by one, come over, and give her a big hug. As always the group exchanges contact information as is the custom during a Centering reunion. Many of the women reach out to her with an intention to stay in touch.
The midwife: “I really did not expect her to attend, and when she remained quiet for a while, I thought that perhaps I had made a mistake. But I turned out to be so wrong. Kaitlin told me later on that she was glad she came, and that she felt better for it.
This story epitomizes one of the purposes of Centering: to provide a support group to our young women who may be socially isolated.”
Araati is 26 years old and is pregnant for the first time. She comes from East India and has absolutely no family near her. Her husband has been denied an immigration card and is still in India. The midwife encourages her to join a Centering group. Araaiti agrees. Clearly it provides her with the community she needs. One of the women, whose grandmother always comes with her, asks Araati about her labor support. Araati admits she has no one to accompany her. Hearing this, the grandmother offers to be with her. Then one day before her due date, Araaiti’s baby dies. The grandmother sticks to her promise and accompanies her during her labor. What’s more, the family invites her to stay with them so that they can look after and support her. Postpartum Araati stays for a week with the family. At the reunion session 6 weeks postpartum, Araati joins the group and shares her experience.
The midwife: “A very special community developed around this woman.”
The Centering group has nine participants. Everything goes well until Beverly, a young 22 year old girl, experiences an unexplained IUD when she is 32 weeks pregnant. Another participant, Joana, a 31 year old school teacher, loses her son Freddy 10 days after birth from complications of cystic fibrosis (CF). The midwife is concerned how the other women in the group will deal with the news. She decides to circulate an email, which the parents of both babies help to compose. The email is followed up with an individual consultation with each woman in the group. Every single woman shows great concern for the parents who lost their baby. Two women of the group attend the memorial of the baby who died from CF, days before they give birth themselves. Freddie’s memorial is also attended by the couple who had the stillbirth.
At the postpartum group session, the group collects money to send the parents away on a weekend break. They all sign cards.
The midwife: “I was astounded at the powerful acknowledgment of the grieving parents’ experience and at the affirmation of their babies’ beautiful but short lives. This experience made me realize that we don’t talk about adverse outcomes as possible ‘normal’ parts of life and we don’t share the experiences when they happen. We do two things: First, we marginalize the parents whose experience of birth and/or early parenting has been different—less than optimal. Second, we also create more stress for ourselves as caregivers, as the silence supports the idea or myth that maybe we could have done something to prevent the outcome, when in truth neither mother nor caregiver did anything to make it happen, nor could a mother or caregiver do anything to prevent the outcome.”
 Rolling a joint.
Su, a nervous 29 year old, is pregnant for the first time. It is a planned pregnancy. Like many Chinese women, against the background of traditional culture, she feels shy about being pregnant. She is also very worried about giving birth. As a first time mother, Su has very little knowledge about pregnancy and childbirth and doesn’t know how to deal with some of the typical pregnancy symptoms. The books she has bought give her information but haven’t reassured her. The women in the group understand her and encourage her to ask questions. Su embraces this opportunity despite her shyness and eagerly communicates with the group, gaining more knowledge. She finds a friend in Hong, a second time mother. They often meet outside the group meetings so that Hong can share her experience with Su.
During the second trimester, Su gets a serious cold. She is very worried that the cold will affect her and her baby's health. She discusses her worries and doubts with the group. The other women reassure her and give her advice such as drinking lemon tea.
With support of the group Su has become a confident pregnant woman by the end of the pregnancy. She is no longer worried about the birth. With the help of the stories the women have shared in the group, she knows what to expect.
The midwife: “The group gave Su all the reassurance and knowledge she needed to feel confident about her pregnancy and the birth. In one-to-one care she would have never have found this important friend. The group method allowed the midwife to introduce more targeted discussions and spend more time on the subjects that were needed by the group.”
After a difficult procedure Tao Tao is pregnant through IVF. It is her first pregnancy and she feels very anxious. At the beginning of the pregnancy Tao Tao suffers from severe hyperemesis. Fortunately for her, she is not the only woman pregnant through IVF. Some of the other women also experience nausea. The women eagerly share experiences and give each other advice on how to deal with this. Tao Tao realizes she is not the only one experiencing problems and this allows her to relax. The women have agreed to let their husbands participate in the group sessions. Both the women and the men. They all join in the group activities. In the third trimester the group discusses the birth. Tao Tao’s husband says he has encouraged his wife to choose a caesarean section. Tao Tao says that he is afraid of the pain. Some of the other participants agree with her husband. The midwife asks questions about the benefits of normal birth and together they conclude that normal birth may be less traumatic, may cause less bleeding, less risk of infection and take less recovery time. A second time mother, who previously had a caesarean section, tells the group about her experience.
Together with her husband, Tao Tao decides to have a vaginal birth. She is visibly happy and very proud when she announces this to the group.
The Midwife: “Each group meeting is an emotional event, not just a meeting about theory and practice. The group supported Tao Tao to make her own decision regarding the birth of her baby. The participants were able to reassure and teach the couple. The group discussion about what to expect during the birth made her see that she was not the only one who was worried. The group members helped each other to cope with the stress around birth so that they felt better prepared and experienced more peace of mind, especially the husbands.
Mother and grandmother
Esmerelda is a 42-year-old woman who is unintentionally pregnant by her husband. She already has a 25 year old son. Coincidentally his girlfriend is also pregnant. Esmerelda finds it hard to accept that she is pregnant at the same time as her ‘daughter-in-law’. The midwife advices her to join the antenatal care group.
Reluctantly Esmeralda agrees. During the intake prior to the start of the group sessions, Esmerelda tells the midwife she feels depressed. She didn't want to be pregnant at this age. Terminating the pregnancy is no option, it is against her faith.
During the first session the women introduce themselves one by one. They tell their name, who they are, if they have any other children and also how old they are. It turns out that Esmerelda is not the only one who is a bit older. One woman in the group is 40 years old and another is 42 years old, just like Esmerelda! “Hey, I belong in this group!” she says visibly relieved. Esmerelda no longer feels alone. The women admire the fact that she will also become a grandmother. Esmerelda feels proud.
The midwife: “From the moment Esmerelda discovered that she was not the only older pregnant woman, she felt at home in the group and she could accept her son's pregnancy. With the support of the group, she was able to be both a grandmother and raise her own child. She is very proud of her own child ánd her grandchild who are about the same age, thanks to the group. And the best thing is that her baby is the only girl. The rest of the children in the family are sons."
Researchers and policymakers regularly hear impressive stories about the results of group care according to the Centering model, which are not visible in research results. These stories from healthcare show in a different way how group care works. With the help of interviews with women, midwives, nurses and doctors, these powerful and often moving stories will be collected and written down during the GC_1000 project.
The process of implementing group care will start at the end of 2021. The following stories have been collected before 2020 and were published in the book "Little Pearls, short group care stories with a large impact". The book was a joint publication of TNO, the KNOV, the Centering Nederland Foundation and Group Care Global. The book was first distributed in the English version at the GC_1000 launch meeting in Leiden, Netherlands, February 2020.
Read the full publication here:
We would love to hear your group care story, big or small! Please send an e-mail to firstname.lastname@example.org to share your story.