Ann Arbor Times

Women who receive prenatal care in group settings are more likely to continue with their visits and experience better health outcomes, according to a study led by the University of Michigan. The research, conducted in Malawi, compared group prenatal care to traditional individual appointments.

The trial involved 1,887 women across seven clinics in Malawi. Participants were randomly assigned either to standard one-on-one care or to groups of eight to twelve women led by a midwife and a community volunteer. Women in the group setting reported stronger connections with peers, greater empowerment during pregnancy, more services received, and increased discussion of health topics. They also experienced shorter wait times and expressed higher satisfaction with their care.

“Many pregnant women, particularly in low-resource settings, are facing challenges. Mental well-being is often overlooked, and accessible health care information is problematic. However, bringing women together for group prenatal care allows them to form meaningful connections with peers and their midwife,” said lead study author Crystal Patil, U-M professor of nursing. “They don’t just come to care and get a lecture about having a healthier pregnancy—instead, they collaboratively problem-solve.”

Beyond pregnancy benefits included better preparation for childbirth, improved communication with partners, increased use of condoms—which points toward safer sexual practices—and reduced mental distress late in pregnancy.

“Midwifery-led models that are respectful and encourage the sharing of experiences and ideas, help get women into care, and then they stay in care,” Patil said. “Attending more visits gives midwives more opportunities to address health issues like high blood pressure. While most women do know what supports a healthy pregnancy, group visits help them turn that knowledge into action—by sharing strategies, building confidence, and finding practical ways to eat well and prepare for childbirth.”

Group prenatal care was developed by Sharon Rising as an alternative approach aiming to address some limitations found in standard individualized appointments such as long waits or limited time between patients and providers. In this model participants begin with an initial one-on-one visit before joining regular meetings alongside others at similar stages of pregnancy where self-assessment activities—like measuring blood pressure—are encouraged.

Patil emphasized the reinforcing nature of group engagement: “We reported that women had more diverse diets and were more prepared for their birth. They know what to do and what to bring when they come to the health center, which means that they’re more aware and can act on things they should be concerned about such as bleeding and HIV prevention,” she said.

The implementation plan used during the trial enabled clinics not only to run group sessions during the study but also after its conclusion; since then several additional clinics have begun offering this model within Blantyre District as well as other districts through support from Malawi’s Ministry of Health. Similar programs are now being adopted elsewhere on the continent including Ghana, Kenya, Nigeria, Rwanda, Tanzania and Zanzibar.

“There is a shift in the power hierarchy that comes with group care. Compared to a one-on-one visit group care is more relaxed and encourages belonging through the sharing of experiences,” Patil said. “Having the right information and being able to translate that into solutions and apply them to your daily life—that’s what happens when you get a group of women together.”

Researchers from both Malawi—including Ellen Chirwa among others—and from University of Illinois Chicago contributed alongside Patil’s team at Michigan Ann Arbor.

The project received funding from the National Institute of Nursing Research (R01NR018115).