A group-based program in East Austin is empowering mothers to better care for their children — and themselves.
In East Austin, mothers gather with their babies to celebrate one of early parenthood’s most important milestones: the first birthday. There’s cake. Music. Decorations. The party looks like any other … except these babies will receive a physical exam and their 12-month vaccinations along with their birthday gifts.
At CommUnityCare’s East Austin Health Center, a federally qualified health clinic serving low-income women and children of Central Texas, faculty in the Dell Medical School Department of Pediatrics residency program run CenteringParenting — a group-focused approach to well-child care. Six to 10 pairs of mothers and babies with birthdays within weeks of each other attend 10 checkups together during the children’s first three years of life.
While providing babies with the standard exams and vaccines delivered in a traditional clinic, the program builds supportive communities of women who educate and empower one another as they experience the ups and downs of motherhood.
“Through the CenteringParenting program, I’ve met many women like me, whose goals are to be the best mothers and wives possible,” says Maria, a repeat participant who asked that her last name not be used.
Benefits to Mothers
Groups meet for two hours in a bright, open room. Books and toys clutter the floor. With the supervision of the clinic’s medical assistant, each mother takes her baby’s measurements — height, weight and head circumference — as well as her own weight and blood pressure.
Visits include a facilitated discussion on a parenting or child safety topic related to the children’s ages or the time of year. Talk spans car seat and water safety, introducing solid foods and baby-proofing the house. Care providers and participants both weigh in, sharing personal experiences and insights.
“Centering allows us to have this fantastic dialogue that we don’t necessarily have time for in traditional clinic,” says Michelle Gallas, DO, assistant professor for the Dell Medical School at The University of Texas at Austin and the program’s lead pediatrician. “As moms listen to and share with one another, they feel validated and empowered in their mothering, which helps them make better decisions related to their children’s health and wellness.”
Groups include a mix of first-time mothers and those with multiple children. Often, the most powerful feedback comes from fellow participants.
“We had a young, first-time mother break down in tears as she told us about how her daughter had started choking,” Gallas recalls. “She felt so guilty that she didn’t know what to do. It was comforting for her to hear that even our ‘veteran’ moms make mistakes.”
The program’s culture of openness and trust helps care providers learn about challenges and experiences that patients might not otherwise disclose.
“When issues and concerns come up, like domestic violence, familial separation or mental illness, we are able to connect our moms with care and community resources so that they get the help they need,” says Lynce Espinoza, supervisor of OBGYN programs at CommUnityCare and CenteringParenting group facilitator. “The program gives these women a healthcare home — a place to turn to for information and support when they need it most.”
While traditional pediatric care focuses solely on the baby, CenteringParenting is a dyad model, meaning pediatricians monitor both mother and child. Mothers complete detailed, confidential paperwork at each visit, updating care providers on a variety of factors both directly and indirectly related to the family’s well-being, including access to food and housing, immigration status, marital concerns and their own mental health. Doctors address any concerns during brief exams conducted with each mother-child pair before and after the group discussion.
CenteringParenting builds supportive communities of mothers who educate and empower one another.
Background & Results
CenteringParenting is an extension of CenteringPregnancy, a similar, group-focused model for prenatal care. Both are promoted by the Centering Healthcare Institute, a nonprofit founded by Sharon Schindler Rising, the nurse-midwife who developed the models.
CommUnityCare first implemented the pregnancy program in 2007 at its Rosewood Zaragoza Health Center, and it has since expanded to three locations, including the East Austin Health Center. In 2009, Gallas helped launch the CenteringParenting program at the East Austin clinic. It now serves more than 25 groups, with a total of 206 pairs of mothers and babies. It was the first certified CenteringParenting site in Texas.
“The pregnancy program has been proven to reduce pre-term births, meaning participants’ babies spend less time in the hospital,” Gallas says. “While we haven’t officially crunched the numbers, I can say anecdotally that CenteringParenting participants have fewer emergency room visits, are more up-to-date on their children’s vaccines and are more knowledgeable about best parenting practices, which helps decrease both morbidities and mortalities.”
For Maria, the program participant, it’s about a healthier baby, yes. But it’s also about her, finding her way as a mom.
“I’ve found emotional support with the women in my group, and the Centering leaders gave me the information and tools I needed to achieve my goals.”