Obstetrics and Gynecology
The Obstetrics and Gynecology Clinic (OB/GYN Clinic) is located on the second deck of Naval Hospital Camp Pendleton. This specialty clinic provides the following services: Obstetrics, High Risk Obstetrics (with consultation services to Naval Medical Center San Diego as needed), Centering Pregnancy Group Prenatal Care, Postpartum care, Well Woman care, Gynecology care, and Dysplasia services. The OB/GYN Clinic is committed to providing outstanding, family-centered care for all of our patients. We are professional health care providers who understand the unique needs of our military families, especially in today's climate of increasing deployments.
Frequently Asked Questions (FAQs)
What is Centering Pregnancy?
Centering Pregnancy moves prenatal care from the exam room into group space to integrate the three major components of care: health assessment, education, and support. Ten to twelve women with similar gestational ages meet together, learning self-care skills, participating in a facilitated discussion, and developing a support network with other group members. Each pregnancy group meets for two hours for nine sessions throughout pregnancy and early postpartum. The practitioner, within the group space, completes standard physical health assessments.
Through this unique model of care, women are empowered to choose health-promoting behaviors. Health outcomes for pregnancies include reduced preterm birth, enhanced knowledge, improved breastfeeding initiation and duration and, in all studies, significantly improved patient satisfaction with prenatal care.
Centering Pregnancy groups provide a dynamic atmosphere for learning and sharing that is impossible to create in a one-to-one encounter. Hearing other women share concerns which mirror their own helps the woman to normalize the experience of pregnancy. Groups also are empowering as they provide support to the members to increase individual motivation to learn and change.
How is Centering Pregnancy different than 1:1 prenatal care in the exam room?
There are many differences between group care and exam room care. Here are a few that make Centering unique.
•Extended time with midwife/physician: Over the course of the pregnancy women spend 20 hours face to face with their provider allowing relaxed conversation and an opportunity to really feel heard and understood. In exam room care women are together with their provider for less than 2 hours over the course of the pregnancy.
•Social Support/Community Building: We are learning more and more about the benefits of social support and community in protecting pregnant women and babies from unnecessary stress. In Centering Pregnancy social support and socializing is intentionally fostered and developed. Women tell us the group feels like a circle of friends sharing common concerns and the experience of pregnancy and parenting. Often the relationships developed in group extend past the pregnancy and women become friends. In our military community this is extremely significant as it is not uncommon for a mother to be going through her pregnancy alone.
•No waiting: Centering is designed to be respectful of women's time. Groups start and stop on time and something is happening all the time.
•Education and learning: Centering Pregnancy utilizes a facilitative leadership style that honors basic principles of adult education. It is not a didactic class format and in no way is the group leader viewed as the "teacher." Women learn as much or more from other women in the group and this contributes directly to an increasing sense of empowerment exhibited by each woman. Content that is found in traditional childbirth classes is woven throughout the nine Centering sessions eliminating the need for outside classes. There is always time to address common concerns of the group members.
•Mom's Notebook: Women receive a Mom's notebook developed for Centering Pregnancy. The materials in the notebook are used to guide the discussion in facilitated groups. The notebooks provide a written record of your pregnancy and provide take-home educational content. Women love these notebooks. They often become a keepsake to share with families and their new babies.
•Self-care Activities: Women are involved in self-care activities and are supported to learn to read and monitor their own blood pressure, weight gain, gestational age, fetal growth and other components of prenatal care. Involvement in self-care leads to improved health behaviors and a feeling of empowerment.
Two hours seems like a long time for a prenatal visit. What happens during the two hours?
At the start of a Centering Pregnancy session, you will have a brief individual assessment by the care provider, participate in self-care activities, complete a Self-Assessment Sheet on a particular topic, enjoy refreshments, and have informal conversation with the other participants. When the group “circles up” together, there is facilitated discussion about topics of interest to pregnant women. There is time to practice skills such and breathing and relaxing and holding and comforting baby. Groups are lively, interactive, focused on issues important to you and are FUN.
Will I still get my ultrasounds and lab tests that I expect in prenatal care?
Centering is your prenatal care. The nurse midwife or physician is responsible to see your care meets all the standards for prenatal care. The reason for and significance of testing and medications is often a topic for group discussion. Women in group tell us they better understand lab testing and medications prescribed during pregnancy. Labs, prescriptions and ultrasounds will be ordered for you as appropriate by your provider. Results of the lab tests and ultrasounds will be shared privately with you.
This is a "group." How is my privacy protected?
We are required to protect your privacy and take that responsibility seriously. Your first prenatal visit which includes a pelvic exam/ultrasound is completed in the privacy of an exam room. No pelvic exams are done in group. The space for the "belly check" within the group room is situated to enhance the feeling of privacy and safety. If you require an exam or have issues that require additional privacy, you will be seen in the exam room after group. Concerns about privacy are reduced after you understand how the assessment portion of the group works.
In addition, at the first group session (your second prenatal visit) each person signs a Confidentiality Agreement and it is emphasized that a person's particular concerns should not be discussed outside the group setting. Ground rules agreed upon are posted in the group space and reviewed periodically. Although each woman's chart (medical record EMR if appropriate) is in the group space for use by the woman and her provider, others do not see that record. The decision to share information with the group is made by each person; no one ever is pressured to disclose personal concerns.
What should I wear to Centering?
There is no rank recognition in Centering. We go by first names only. We prefer that you wear civilian attire to your group session, however, we realize that you and your support person may be coming from work. If there is no time to change, then we ask that you remove your outer blouse so that there is no rank visible. We do not want anyone in the group to feel intimidated by another member due to rank.
Can my partner or other support person attend my prenatal groups with me?
Participation of family/support persons is optional. Many women attend groups without support persons, finding support within the group. Others prefer to attend with their partner or another supportive family member. Some sessions will be more appropriate for support persons, like preparing for the birth and the hospital tour. We especially encourage family members to come for the first part of group to "hear the baby's heartbeat." Support people sit in the circle and fully participate in the activities and discussions, so there is no disruption to the group process or crowding.
Will my command and/or my partner’s command support these two hour groups?
Centering is approved by the Department of Defense as an encouraged form of prenatal care. You will receive your entire schedule of appointments at your initial OB visit if you choose the Centering path. It is recommended that you give this schedule to your chain of command so they can plan your absence in advance.
I have problems with childcare. May I bring my children to my prenatal groups?
Children of any age find two hours in a group boring. Group time is a special time for women and they find children, their own or others, distracting. Two great things about group are that you will have the group schedule for your whole pregnancy and group starts and ends on time. For those reasons it is easier to make child care arrangements in advance.
So please, no children.
When do the groups meet?
Groups are formed based on expected month of delivery. You will need to as your provider to give you the day and time for the group that shares your due date. Groups meet together over six months, from early pregnancy until middle of the due date month. The groups will meet monthly for four months then every two weeks after that, for a total of 8 sessions. A "baby reunion" is scheduled after everyone has given birth. You will be given a complete schedule at your first group session.
Is Centering Pregnancy appropriate for everyone?
Most women expecting a normal pregnancy can enjoy and benefit from group prenatal care. If risk conditions emerge during the pregnancy, those conditions may be managed in group or may require additional visits to specialists. Ask your midwife or physician if Centering is right for you.
How can I get more information and sign up for my Centering group?
Ask at your prenatal registration appointment or at your new OB visit for Centering Pregnancy. Welcome aboard for a wonderful experience ahead!