Research Article|Articles in Press

Midwives’ experiences of becoming CenteringPregnancy facilitators: A pilot study in Sydney, Australia

Published:August 27, 2012DOI:



      A pilot study was undertaken between 2006 and 2008 to explore the feasibility of implementing the CenteringPregnancy model of group antenatal care in Australia. The study was undertaken at two hospital antenatal clinics and two community healthcare centres in southern Sydney. This paper reports on one arm of the pilot study, known as the ‘Midwives’ Study’, which aimed to explore the experiences of the midwives as they moved from providing traditional one-to-one antenatal care to facilitating group antenatal care.


      The Australian pilot study used Action Research. Eight midwives, the group facilitators, and three researchers formed the Action Research group. A qualitative descriptive approach was undertaken to describe the experiences of the midwives. Data were collected using focus groups, surveys and checklists and analysed using thematic content analysis.


      The midwives’ initial fears and misgivings about undertaking the new role of group antenatal care gave way to a growing confidence in their abilities and group facilitation skills. They appreciated: the benefits of the CenteringPregnancy model for pregnant women; new opportunities to develop positive relationships with women and their colleagues; and the structured support and education throughout all stages of the Action Research process.


      The midwives were enthusiastic about their experiences of becoming CenteringPregnancy facilitators and described the benefits of this model of care compared to traditional one-to-one antenatal care. Support and education of the midwives through structured Action Research cycles enhanced the effective implementation of this new model.


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        • Rising S.
        • Powell Kennedy H.
        • Klima C.
        Redesigning prenatal care through CenteringPregnancy.
        Journal of Midwifery and Women's Health. 2004; 49: 398-404
        • Rising S.
        CenteringPregnancy: an interdisciplinary model of empowerment.
        Journal of Nurse-Midwifery. 1998; 43: 46-54
        • Ickovics J.
        • Kershaw T.
        • Westdahl C.
        • Rising S.
        • Klima C.
        • Reynolds H.
        • et al.
        Group prenatal care and preterm birth weight: results from a matched cohort study at public clinics.
        Obsterics & Gynecology. 2003; 102: 1051-1057
        • Ickovics J.
        • Kershaw T.
        • Westdahl C.
        • Magriples U.
        • Massey Z.
        • Reynolds H.
        • et al.
        Group prenatal care and perinatal outcomes: a randomized controlled trial.
        Obstetrics & Gynecology. 2007; 110: 330-339
        • Klima C.
        CenteringPregnancy: a model for pregnant adolescents.
        Journal of Midwifery and Women's Health. 2003; 48: 220-225
        • Massey Z.
        • Rising S.
        • Ickovics J.
        CenteringPregnancy group prenatal care: promoting relationship-centered care.
        JOGNN – Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2006; 35: 286-294
        • Baldwin K.
        Comparison of selected outcomes of CenteringPregnancy versus traditional prenatal care.
        Journal of Midwifery & Women's Health. 2006; : 4
        • Baldwin K.
        • Phillips G.
        Voices along the journey: midwives perceptions of implementing the CenteringPregnancy model of prenatal care.
        The Journal of Perinatal Education. 2011; 20: 210-217
        • Teate A.
        • Leap N.
        • Rising S.
        • Homer C.S.E.
        Women's experiences of group antenatal care in Australia – The CenteringPregnancy Pilot Study.
        Midwifery. 2011; 27: 138-145
        • Gaudion A.
        Findings from a UK feasibility study of the CenteringPregnancy model.
        British Journal of Midwifery. 2010; 19: 796-802
        • Wedin K.
        • Molin J.
        • Svalenius E.
        Group antenatal care: new pedagogic method for antenatal care – a pilot study.
        Midwifery. 2010; 26: 389-393
        • Kennedy H.
        • Farrell T.
        • Paden R.
        • Hill S.
        • Jolivet R.
        • Willetts J.
        • et al.
        “I wasn’t the only one”: Women's experience of group prenatal care in the military.
        Journal of Midwifery & Women's Health. 2009; 54: 176-183
        • Grady M.
        • Bloom K.
        Pregnancy outcomes of adolescents enrolled in a CenteringPregnancy program.
        Journal of Midwifery and Women's Health. 2004; 49: 412-420
        • Creswell J.
        Research design: qualitative, quantitative and mixed method approaches.
        2nd ed. Sage, London2002
        • Sandelowski M.
        Using qualitative research.
        Qualitative Health Research. 2004; 14: 1366-1386
      1. Reason P. Bradbury H. Handbook of action research. 4th ed. Sage, London2006
        • Somekh B.
        Action Research: a methodology for change and development.
        Open University Press, Glasgow2006
        • Hansen E.
        Successful qualitative health research: a practical introduction.
        Allen and Unwin, Sydney2006
        • Burns N.
        • Grove S.
        The practice of nursing research: conduct, critique, and utilization.
        5th ed. Elsevier Saunders, St. Louis2005
        • Graneheim U.
        • Lundman B.
        Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.
        Nurse Education Today. 2004; 24: 105-112
        • Hunter B.
        Emotion work in midwifery: a review of current knowledge.
        Journal of Advanced Nursing. 2001; 34: 436-444
        • Hunter B.
        • Berg M.
        • Lundgren I.
        • Ólafsdóttir Ó.
        • Kirkham M.
        Relationships: the hidden threads in the tapestry of maternity care.
        Midwifery. 2008; 24: 132-137
        • Leap N.
        The less we do the more we give.
        in: Kirkham M. The midwife–mother relationship. 2nd ed. Palgrave Macmillan, London2010 ([Chapter 2])
        • Stevens T.
        • McCourt C.
        Changing practice. One-to-one midwifery practice. Part 3: meaning for midwives.
        British Journal of Midwifery. 2002; 10: 111-115
      2. Homer C. Brodie P. Leap N. Midwifery continuity of care: a practical guide. Elsevier, Sydney2008
        • Ball L.
        • Curtis P.
        • Kirkham M.
        Why do midwives leave?.
        Royal College of Midwives, London2002
        • Kirkham M.
        • Morgan R.
        • Davies C.
        Why do midwives stay?.
        Women's Informed Childbearing and Health Research Group: University of Sheffield, Sheffield2006
        • Sullivan K.
        • Lock L.
        • Homer C.
        Factors that contribute to midwives staying in midwifery: a study in one Area Health Service in New South Wales. vol. 27. Midwifery, Australia2011 (pp. 331–335)
        • Kirkham M.
        • Stapleton H.
        Midwives’ support needs as childbirth changes.
        Journal of Advanced Nursing. 2000; 32: 465-472