A South Carolina doctor is battling the state - and country's - infant mortality problem in a big way, and the results have already surpassed expectations.
Dr. Amy Crockett started her career in the mid-2000s running a women's clinic in Greenville, South Carolina - which was at the time, statistically, one of the most dangerous places for a baby to be born in the United States. In fact, it was 49th overall, ahead of just Mississippi.
Her appointments with expectant mothers were routine: they would visit one-on-one, she would take their vitals, and ask if they were feeling okay. But it seemed too fast, and she didn't feel like she was doing enough to help mothers prepare for what lied ahead.
In 2008, she made the decision to change things drastically. She applied for a grant to help her do this, but the changes she had in mind weren't about using the latest technology or innovation. They were about people.
They were about support.
"When the goal of the visit is to make sure you’re not sick, that takes a very short period of time,” she said. "But when you change the goal of the visit to prepare women to become mothers, that’s a totally different game plan."
Around the same time she applied for her grant, controlled trials were being done around the idea of group prenatal care, and they were showing promise. For example, a study in 2007 found that group prenatal care reduced preterm births 29 per cent (36 per cent for African-American women), and a study the following year found that group visit participants were less likely to have babies that were low-weight or required a stay in the NICU.
Crockett set her sights set on a program called CenteringPregnancy, which started in the mid-1990s in the northeast part of the country. The idea was for women to have their prenatal care done in big group appointments, versus one-on-one visits. These appointments would last two hours and would look a lot more like a support group than a traditional doctor visit.
At first, she was skeptical.
"The idea that having women sit together in a circle for their medical visits would somehow improve their birth outcomes, I didn’t understand how that could be a thing,” she said.
But she quickly changed her tune. Her clinic's results began to match the results from the studies being done that showed extremely favourable outcomes. Only 8 per cent of her patients were having their babies early, compared to 12 per cent for the rest of the state.
"Even from that first small cohort we started seeing that our outcomes matched exactly what they were reporting from the randomized controlled trials,” said Crockett.
Today, Crockett's clinic is still going strong and is continuing to show results - proving that inexpensive interventions such as CenteringPregnancy are a vital addition to the state - and country's - health care system.
"When you don’t get enough support from the actual main person that you think should be the one to give you support, it means a lot [to come to the group]," said one mom. "It is better and comforting."