Centering Pregnancy: Preventing Diabetes?


ST. LOUIS, Mo. (Ivanhoe Newswire) — As many as nine percent of all pregnant women in the United States develop a condition called gestational diabetes, and the numbers may be higher in urban areas. With gestational diabetes, the body is not producing enough insulin putting mother and baby at risk. Researchers say a prenatal therapy used for low-risk moms-to-be may help those with diabetes.

Thirty-five-year-old Shantel Fisher is a mother of a baby, a toddler, and a teen. During her first two pregnancies, healthy eating was a challenge.

“With my son, my favorite food was ice cream and taco bell,” she told Ivanhoe.

And then Shantel was diagnosed with gestational diabetes.

“In the beginning, I was kinda depressed because I couldn’t do what I wanted to do so I was really rebellious.  Like, no, I’m not taking shots, not testing blood sugar,” she said.

Ebony Carter, MD, MPH, at Washington University School of Medicine in St. Louis wants to see if a program used successfully in low-risk pregnancies can improve the health of women at high risk. It’s called centering pregnancy.

She said, “Women who have around the same due date receive all of their prenatal care together in the course of ten sessions.”

In centering, women have ten two-hour group sessions with their doctor, ten times the amount of medical attention with individual office visits. Each woman is responsible for taking her own blood pressure and weight. Then the group gets intensive nutritional and health advice.

A five-year study found centering reduced pre-term birth in low risk women by 36 percent.

Doctor Carter wants to know if women with diabetes will get the same benefits from centering sessions.

She told Ivanhoe, “Diabetes was a logical choice because diabetes is a difficult disease. The vast majority of management falls on the patient.”

Shantel Fisher was part of a pilot study. She says the other diabetic moms inspired her to stay on track.

Doctor Carter is studying 80 women with type-two and gestational diabetes to see if centering helps women better control blood sugars. The centering study for low-risk moms found that for each pre-term birth prevented, there was a savings of over 22-thousand dollars.

Contributors to this news report include: Jessica Sanchez, Supervising Producer; Cyndy McGrath, Field Producer; Bob Walko, Editor; Brent Sucher, Videographer.



REPORT #5031

“By going to this group—my last son—he was the only one that was full term.” Shantel Fisher, Study Participant

 BACKGROUND: As many as nine percent of pregnant women develop gestational diabetes. Doctors often test for it between the 24th and 28th week of pregnancy. Some women may have gestational diabetes in multiple pregnancies.  It is usually controlled through healthy eating and exercise, but some women must also take insulin. When blood sugar is not well controlled, it may lead to problems for the pregnant woman and the baby, such as an extra-large baby, a greater risk for a cesarean section, high blood pressure, and hypoglycemia. For most women, the diabetes goes away soon after delivery. Some women will go on to develop type 2 diabetes after pregnancy. It’s important for a woman who has had gestational diabetes to continue healthy habits to avoid getting type 2 diabetes, and routinely check her blood sugar.



CENTERING PREGNANCY FOR BETTER HEALTH: CenteringPregnancy is a trademarked prenatal care model that combines monthly health assessments, education, and peer support into one program. With this type of care, women will meet with a group of other pregnant women once a month throughout their pregnancy.  The visits start with a one-on-one health assessment and then move into a guided group session where topics of nutrition, preparing for labor, breastfeeding, parenting, and health are discussed. Receiving healthcare in a group setting has been shown to lead to greater encouragement and learning, which in turn decreases the rate of pre-term and low weight babies and better pregnancy health practices.


PREVENTING FUTURE DISEASE: The Centering Healthcare Institute uses a data system called Centering Counts to track their impact on health and patient and provider satisfaction. Using this data, Centering claims to lower the rates of gestational diabetes, improve the detection and treatment of postpartum depression, and improve breastfeeding practices. Pregnancy Centering influences women to better attend postpartum visits, and aims to prevent gestational diabetes from returning as type 2 diabetes after delivery, as well as preventing other diseases and poor health practices.



 Ebony Carter, MD, MPH

Washington University School of Medicine in St. Louis