Date of Award

Spring 5-10-2014

Degree Type




Director of Thesis

Deborah Billings

First Reader

Kristin Van De Griend


Maternal and child health outcomes in the United States are far poorer than in other industrialized nations. To improve women’s experiences with the maternity care system, nurse-midwife Sharon Schindler-Rising developed the CenteringPregnancy (CP) group model of prenatal care (PNC). Research comparing CP with ‘traditional’ one-on-one PNC has found that implementing CP results in decreased rates of preterm birth and low birth weight, increased rates of breastfeeding, and improved outcomes for women who typically experience health disparities, including African Americans. Documented success of the model in the Greenville Health System convinced the South Carolina Department of Health and Human Services of the importance of supporting CP expansion throughout the state. In 2013, five obstetric practices initiated CP as an option for all eligible women; two additional practices were added in 2014. My research focuses on the first phase of expansion and examines the challenges and opportunities associated with incorporating a midwifery-based model of care into obstetric practices, which are staffed primarily by physicians and nurses. Data were collected by members of the research team through semi-structured interviews, field notes, and participation in various workshop and conference venues. Through qualitative analysis several major themes emerged, including the central components of the Centering model, logistics, support and collaboration, and sustainability; these themes emerged as potential facilitators and/or barriers depending on the practice site. Site leaders who wish to implement CP in the future will need to consider their position in these areas in order to determine their readiness for successful and sustainable implementation.


© 2014, Lauren Marsh