MedWatch Today: 6 Million Dollar Preterm Birth Study in Fresno

Med Watch Today

FRESNO, California (KSEE/KGPE) – About 1 in 10 babies in the U.S. are born prematurely–with Fresno county having the second highest preterm birth rate among California counties.
UCSF Fresno, Community Medical Centers and First Five California are working together on more than a six million dollar project to find a solution.

Midwife, Brittany Edwards is one of the lead UCSF researchers looking at whether group prenatal care, bringing women together to support each other during their pregnancies, will help reduce stress and make a difference.

“We’re at an incredible time right now.  This study will be looking at if group prenatal care does lower preterm birth rates in low income communities.  Group prenatal care in itself is a beautiful model that women have used in different places,” said Edwards.

Designed to enhance patient education and provide emotional support, group prenatal care is improving birth outcomes.

“This group model has been utilized in different places across the country and hasn’t been utilized until recently in Fresno and so we’re excited about this opportunity to see whether group or care or individualized care is actually best for our Fresno residents in our community,” Edwards added.

The four year study named EMBRACE for Engaging Mothers and Babies; Re-Imagining Antenatal Care for Everyone, will analyze 26-hundred women – 13-hundred for group care and 13-hundred for individualized care.  The study started in November 2019, has already had one group of mother’s give birth to healthy babies.

Edward says, “And when we’re looking at these outcomes–does group care decrease preterm birth, does it decrease depression, anxiety, how are the experiences with women in group care versus individual care, are they respectful or disrespectful experiences?  So, we’re focusing on experiences with black and Latina women.  And we know that African-American women have the highest rate of preterm birth and far surpassing to their white counterparts and even Latina groups and consistently it’s been that way.”

Darnisha Wiley-Scott gave birth to her baby boy, Maurice in November of 2019.  Being a woman of color, she knew she was at higher risk of having her baby too early, so she was willing to be part of a study that could make a difference.

“I was very skeptical about the care and the information I would receive in a group, prenatal care environment, but after attending, I loved it, I loved it a lot.  You try to be as positive about carrying your baby in an environment that’s not so welcoming for your baby at the first place and so again, going back to my first thought–being in a group prenatal care setting, really definitely helped that stress to lower. Because, like I said, I have the love and support not only of my healthcare provider, but of the women around me. It’s a sense of community,” said Wiley-Scott.

Premature babies, especially those born very early, often experience ongoing medical complications that affect the whole family.  The prenatal group is designed to be a safe place for a variety of topics — especially difficult ones.

Ellen Middleton, a OB/GYN Nurse Practitioner, PhD, with UCSF Fresno said, “And these are topics that if somebody had asked me before we started group care that these women would be so open to discuss this, I would have said absolutely not.  Everybody’s going to sit there and what happened was exactly the opposite.  It was like the floodgates came open and they’re talking about their relationships and they’re talking about potential substance abuse and they’re talking about violence in their neighborhoods to the point where I was just sitting back thinking wow this is amazing.  And when I think you get a group of women together who in many ways feel isolated, they start supporting each other and many of them don’t have families near or close.”

The group care setting involves 8 to 12 women getting together for their regular prenatal checkups and then, for a two hour span, sharing their stories and concerns.

“In addition to that, we provide free child care, we provide groceries, we provide transportation, we provide patient reimbursement so that we can get these ladies to reduce some of these barriers to get these ladies together.  In addition to that, we surround them with community services, so we have different people who come into speak and that can be behavioral health from Fresno county because again, mental health issues and stress all of those things are very important during pregnancy.  Because we know stress increases prematurity,” said Middleton.

The goal of the group model project is to improve the health of moms and babies and provide maternal support.  Additionally, its goal is to help providers become more educated, improve prenatal services in our community and help reduce and eliminate preterm birth and infant mortality.

“It really is a community that’s built and from this group model we’re seeing in other places, there’s a decrease in preterm birth, an increase of breast feeding rates, there’s an increase of satisfaction and so it’s a real opportunity to actually have evidence now through this EMBRACE study — to see does it also work here for us.  We really want to figure out what is going on here and this is an opportunity to make a change and do it together,” said Edwards.

If you are pregnant, ask your doctor about participating in the EMBRACE study.  If you are interested in partnering on efforts to reduce preterm birth, reach out to EMBRACE at embrace@mail.fresnostate.edu or call 559.228.2165.

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