Objective: The COVID-19 pandemic created opportunities for more flexible prenatal care delivery,
including virtual options for wraparound pregnancy services such as anticipatory guidance
and support. These virtual services may improve healthcare access, particularly for
patients with barriers to in-person care. To address the need for standardized, yet
flexible, pregnancy psychoeducation to supplement routine prenatal care, we developed
a virtual prenatal support program, Stay Home Stay Connected, with a nine-part curriculum
([Table 1A]). Groups of 8–12 participants at similar gestational ages meet virtually for one
hour per month with a maternity care provider (physician or certified nurse midwife)
for semi-structured discussions and activities. Health professional students provide
co-facilitation and logistical support, and detailed lesson plans are provided ([Table 1B]). We describe the feasibility of this virtual support group to inform sustainability
and quality.
Methods: Initial participation data were collected. Following each session, we surveyed facilitators
on four key domains, including satisfaction and motivation, curriculum, logistics,
and sustainability. Quantitative questions and narrative responses were solicited.
Respondents were invited to complete semi-structured interviews conducted by the study
team. The interviews were analyzed to identify core themes for program feasibility
and opportunities for improvement.
Results: In total, 100 patients were divided into 10 groups facilitated by 10 provider-student
pairs. Eight facilitators (80%) completed the survey (5 physicians, 3 certified nurse
midwives) after their first session. All respondents (100%) enjoyed facilitating the
session. Respondents, who participate as volunteers, were motivated by a desire to
provide patient education and patient support (100%), and to participate in group
prenatal care delivery (71%). All found the lesson plans to be comprehensive and easy
to use, and most (88%) agreed that logistical arrangements were “easy.” Most respondents
(63%) dedicate 2 hours or less to the program per month, while 38% dedicate 3–4 hours.
All respondents (100%) agreed that their time commitment is sustainable long term.
Qualitative responses revealed a variety of uses of the standardized curriculum, including
adapting the curriculum into a slideshow for sessions or using it as a script. Preparing
student facilitators was seen as time-consuming for one respondent, however others
noted that students eased program administration overall.
Conclusion: Maternity care providers can facilitate monthly, one-hour, virtual support programs
for pregnant patients with ease when provided logistical support and a comprehensive
curriculum. More research is required to evaluate whether curricular topics match
participant needs, and to connect patient and provider experiences with health outcomes.
Table 1
Core curricular themes by gestational age (A) and lesson plan format (B)
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A: Core curricular themes (gestational age)
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B: Lesson plan structure
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1. Integrating lifestyle adjustments including exercise, nutrition, and weight gain
(12–15 weeks)
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I. Session objectives
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2. Coping with discomforts of pregnancy (16–19 weeks)
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II. Participant milestones (common psychosocial considerations relevant to pregnancy
stage)
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3. Mood disorders and mindfulness (20–23 weeks)
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III. Agenda summary with timing
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4. Making plans for infant feeding and adjusting to deviations (24–27 weeks)
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IV. Icebreaker (opening question)
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5. Values clarification for newborn care and family planning (28–31 weeks)6. Preparing
for childbirth (32–35 weeks)7. Confronting the unexpected during childbirth and preparing
for the postpartum period (36–40 weeks)8. Postpartum peer support 1 (postpartum 0–4
weeks)9. Postpartum peer support 2 (postpartum 5–8 weeks)
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V. Activities and discussion questions with detailed instructions and reference information
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VI. Closer (reflective question)
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VII. Patient resources
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