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Birth Outcomes Improved Through Expect With Me Prenatal Care

Yale Public Health Magazine, Focus: Spring 2022


Expectant mothers who received group prenatal care through Expect With Me, a program co-developed by the Yale School of Public Health, had significantly better birth outcomes than their peers receiving traditional one-on-one prenatal care, a new study finds.

Expect With Me was developed in 2014 by YSPH researchers along with representatives of UnitedHealth Group and health care providers at Vanderbilt University Medical Center to address high rates of preterm birth and low birth weight in the United States and racial disparities in birth outcomes.

YSPH researchers Jessica Lewis, Ph.D., LMFT, and Jeannette Ickovics, Ph.D., and co-authors studied 2,402 women receiving prenatal care in Nashville and Detroit for the study, which published in the journal Preventive Medicine.

Mothers who received Expect With Me group prenatal care had a 58% lower risk of having a preterm birth, 63% lower risk of having an infant with low birth weight, and 37% lower risk of having an infant admitted to the neonatal intensive care unit, than mothers who received traditional individual care. The findings build on previous research demonstrating that group models of prenatal care can be beneficial for moms and babies.

“Rates of preterm birth in the United States are comparable to those of developing nations and have risen every year for the last five years. Preterm birth and other adverse birth outcomes are even higher among Black women,” said Lewis, the study’s lead author and an associate research scientist at YSPH. “We need new models of care that can improve both pregnancy outcomes and health equity for growing families. These findings suggest that Expect With Me prenatal care can be part of that solution.”

Study participants received either traditional prenatal care or Expect With Me, which brings together eight to 12 women who are due to deliver their babies the same month for 10, two-hour group medical visits led by a prenatal care provider.

Expect With Me care includes a brief individual check-up and facilitated group discussions about pregnancy, childbirth, and wellness that focus on long-term healthy lifestyle choices and stress/mental health. An Expect With Me information technology platform enables patients to track their weight and blood pressure, connect with group members and health care providers, and access medically reviewed, multimedia resources, including educational videos and tip sheets as well as links to local and national resources.

Expect With Me differs from other approaches by engaging women deeply in their own pregnancy care and connecting them with other pregnant women and their providers both through extended group visits and online engagement between prenatal visits.

“If we are to achieve sustainable improvements in birth outcomes for mothers and babies, health systems and payors such as Medicaid and private insurers must invest in innovations in prenatal care,” said Ickovics, the Samuel and Liselotte Herman Professor of Social and Behavioral Sciences and professor of psychology.

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