title: The impact of Centering Pregnancy Group Prenatal Care on postpartum family planning.
abstract: OBJECTIVE
  The objective of the study was to evaluate the impact of group prenatal care (GPNC) on postpartum family-planning utilization.
  
  
  METHODS
  A retrospective cohort of women continuously enrolled in Medicaid for 12 months (n = 3637) was used to examine differences in postpartum family-planning service utilization among women participating in GPNC (n = 570) and those receiving individual prenatal care (IPNC; n = 3067). Propensity scoring methods were used to derive a matched cohort for additional analysis of selected outcomes.
  
  
  RESULTS
  Utilization of postpartum family-planning services was higher among women participating in GPNC than among women receiving IPNC at 4 points in time: 3 (7.72% vs 5.15%, P < .05), 6 (22.98% vs 15.10%, P < .05), 9 (27.02% vs 18.42%, P < .05), and 12 (29.30% vs 20.38%, P < .05) months postpartum. Postpartum family-planning visits were highest among non-Hispanic black women at each interval, peaking with 31.84% by 12 months postpartum. After propensity score matching, positive associations between GPNC and postpartum family-planning service utilization remained consistent by 6 (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.05-1.92), 9 (OR, 1.43; 95% CI, 1.08-1.90), and 12 (OR, 1.44; 95% CI, 1.10-1.90) months postpartum.
  
  
  CONCLUSIONS
  These findings demonstrate the potential that GPNC has to positively influence women's health outcomes after pregnancy and to improve the utilization rate of preventive health services. Utilization of postpartum family-planning services was highest among non-Hispanic black women, further supporting evidence of the impact of GPNC in reducing health disparities. However, despite continuous Medicaid enrollment, postpartum utilization of family-planning services remained low among all women, regardless of the type of prenatal care they received.
authors.affiliation: Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC. Electronic address: halen@mailbox.sc.edu.
authors.forename: Nathan
authors.initials: N
authors.lastname: Hale
authors.affiliation: Department of Obstetrics and Gynecology, Greenville Health System University Medical Center, Greenville, SC.
authors.forename: Amy H
authors.initials: AH
authors.lastname: Picklesimer
authors.affiliation: Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Billings
authors.affiliation: Department of Obstetrics and Gynecology, Greenville Health System University Medical Center, Greenville, SC.
authors.forename: Sarah
authors.initials: S
authors.lastname: Covington-Kolb
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008484:Medicaid; D008875:Middle Aged; D049590:Postpartum Period; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D057216:Propensity Score; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
keywords: Centering Pregnancy; family planning; group prenatal care; postpartum; prenatal care