February 3, 2026

Group Prenatal Care: A Promising Approach Supporting Maternal Mental Health

Postpartum Psychiatric Disorders, Psychiatric Disorders During Pregnancy

Prenatal group care models like CenteringPregnancy and Pregnancy Circles may improve maternal mental health, reduce isolation, and enhance social support.

Ruta Nonacs, MD PhD

In This article

Group prenatal care models such as CenteringPregnancy and Pregnancy Circles combine clinical assessment, education, and psychosocial support and have been associated with improved engagement and pregnancy outcomes.
A systematic review found small but potentially meaningful benefits of group prenatal care for depressive symptoms, particularly in younger and higher-risk women, with mixed findings for stress and anxiety.
Pregnancy Circles in the UK offer longer visits, continuity of care with midwives, and participatory care, enabling women engage more actively in their care.
Qualitative data highlight mechanisms such as reduced isolation, peer learning, more in-depth conversations with midwives, increased confidence and sense of control, and the formation of ongoing peer networks that extend into the postpartum period.
While effects on mental health outcomes are modest and heterogeneous, group prenatal care appears to offer a promising, relatively low-cost approach to support maternal wellbeing, especially for women facing psychosocial adversity or fragmented care.

In the United States, obstetric care is typically delivered individually, where the patient meets 1:1 with their obstetric provider. However, there has been increased interest in group models of prenatal care like CenteringPregnancy. These group models of obstetric care have demonstrated improved outcomes, including better prenatal visit attendance, lower rates of preterm birth, and higher breastfeeding rates.

Such models of group prenatal care typically consist of three key components: clinical assessment, education, and psychosocial support. Group perinatal care can thus provide social support while also making obstetric healthcare and education delivery more efficient and accessible. This mode of delivering care may also have maternal mental health benefits.

Mental Health Benefits of Group Prenatal Care

A systematic review from Buultjens and colleagues examined published studies reporting on the effect of group pregnancy care on mental health and wellbeing outcomes (i.e., stress, depression, and/or anxiety) in childbearing women. Nine studies were included, comprising five randomized controlled trials and four observational studies.

The CenteringPregnancy (CP) group philosophy was utilized across eight of the nine studies. In brief, women who participate in a CP program receive prenatal visits, acquire knowledge and skills related to pregnancy and childbirth, and develop relationships with other women in a group setting. Each group session lasts approximately two hours, starting with individual medical assessments followed by a group discussion. The curriculum focuses on topics such as nutrition, exercise, relaxation techniques, understanding pregnancy problems, infant care and feeding, contraception, communication and self-esteem, comfort measures in pregnancy, sexuality and childbearing, abuse issues, and preparation for childbirth and parenting.

All of the reviewed studies reported on the prevalence or severity of postpartum depression; three reported on stress, and three reported on anxiety symptoms. The review described benefits to maternal mental health:

Several, but not all studies, demonstrated that individuals receiving group prenatal care had lower depressive symptoms than those receiving individual care.
The most robust improvements with group prenatal care were seen in certain subgroups, particularly among women at higher psychosocial risk.
Findings for stress and anxiety were mixed, with some studies showing significant reductions in stress and anxiety among women in group care and others showing no significant differences compared with standard care.
Considerable heterogeneity across study participants (e.g., young women, military settings, medically complicated pregnancies) and variation in how group care was structured likely contributed to differences in mental health outcomes.
The authors emphasized that even small effects on mental health outcomes may be meaningful in the context of low-cost, preventive interventions that can be delivered at scale.

Overall, the findings from the systematic review suggest that there may be promise for group prenatal care to benefit women’s psychological health.

Understanding the Benefits of Group Prenatal Care

In the United Kingdom, Pregnancy Circles (PC) are a model of group prenatal care adapted by the National Health Service (NHS) that is aligned with the CenteringPregnancy model in the United States. Prenatal care is provided on the usual schedule, with 90–120 minutes per visit (rather than the typical 15–30 minutes), to a group of around 6–12 women/birthing people with similar due dates. Each visit is facilitated by two midwives using a participatory, facilitative approach.

In a recent qualitative process evaluation of Pregnancy Circles in the NHS, McCourt and colleagues key elements of group prenatal care.

Building social support and community: Pregnancy Circles created a strong sense of social support and community, helping participants feel less isolated and more connected to others going through pregnancy at the same time. Women described the group as a place to share worries, ask questions, and feel understood by peers and midwives.

One woman contrasted her group care with her prior 1:1 care: “This is my second pregnancy and I feel the antenatal care support I have received as part of the pregnancy circles is far superior to that of the 1:1 sessions I had previously. It is great to be a part of a group of other women and I enjoy the fact that we receive the usual 1:1 midwife care but also discuss other topics as a group.”
Another participant emphasized how the group reduced isolation and anxiety: “I would totally recommend the pregnancy circle option to anyone especially if you are quite shy and anxious like me it’s a good way to not feel so alone during pregnancy and then have friends to do things with after babies are born.”

Learning together and from each other: The group format supported shared learning through discussion, demonstrations, and peer-to-peer advice, making health information feel more relevant and accessible. Women reported that hearing others’ experiences and seeing practical examples helped them feel more confident in their own decisions and behaviors.

In one session, a participant demonstrated cloth nappies (diapers) and led a practical discussion: “One woman does a small demonstration of cloth nappies for the others in the circle… This leads into a discussion about individual choice, environmental issues, cost.”
Another woman described how seeing others’ behavior motivated her to adopt healthy activities: “When you hear that all the people with you are… practicing these exercises or going through these sessions, it makes you… feel like I could probably do it too, like, so I signed up for yoga sessions and ended up walking more.”

Having more time and better conversations with obstetric providers: Participants and midwives emphasized that Pregnancy Circles allowed more time for discussion and continuity with the same midwives, which improved trust, communication, and satisfaction with care. Women described having more opportunities to ask questions and receive individualized advice in a group setting that still included 1:1 clinical checks.

One woman noted: “This is my second baby and I feel that I have had more chances for open and honest discussion and have been given a lot more advice.”
A midwife explained that this model helped address complex topics and reduce anxiety: “…a longer lasting health promotion benefit… their mental health has to be improved as well, because often that can be quite daunting, hearing ‘well how’s it gonna affect my baby if I’ve just been diagnosed with gestational diabetes’, and we don’t have enough time to devote to that patient… we usher them in, usher them out….”

Building confidence and a sense of control: The combination of peer support, active participation, and accessible education appeared to enhance women’s sense of confidence, self-efficacy, and ability to cope with pregnancy, birth, and the postpartum period. For some, this included feeling more prepared for potential complications or interventions.

One participant described feeling better able to cope with an emergency cesarean after group discussions: “I was terrified of having a c section but pregnancy circles helped me feel a lot better about the procedure… I was still nervous but felt a lot better after our talks in pregnancy circles.”

Another woman described how group support in the early postpartum period helped her manage distressing infant symptoms without unnecessary emergency care: “I probably would have rushed to hospital because I didn’t know what to do, but because something so simple and somebody else was going through it… it didn’t seem… very invasive anyway.”

Creating ongoing connections and community after birth: Many participants continued to connect through social media and informal meet-ups after the formal Pregnancy Circles ended, extending social and informational support into the postpartum period. These ongoing networks were especially valued by women who were socially isolated or lacked nearby family support.

One woman noted, “It’s really nice how everybody is still very much in touch and there are plans every month and if there’s something that somebody’s worried about or ‘is this normal’… it’s nice that the WhatsApp group was proposed and even and everyone’s open about their experiences.”
Midwives also noted that when in-person groups were disrupted (e.g., due to the COVID-19 pandemic), women often maintained contact virtually, preserving some of the community benefits.

Supporting culturally safe and inclusive care: For many Black and minoritized women and those facing social disadvantage, the group model offered a more welcoming and responsive environment than other parts of the maternity system that were sometimes experienced as fragmented, stigmatizing, or dismissive. At the same time, the study identified situations in which women felt less included or when sensitive topics were not handled well, underscoring the importance of skilled facilitation and attention to diversity.

One woman contrasted group care with experiences of trying to access standard services: “No one is there to listen to you… it makes you feel tired, it’s so heart-breaking, so that group with my first pregnancy was fantastic.”
Another participant described feeling unheard and wondered whether racism played a role in her labour experience: “I definitely don’t feel like in my labour they listened [to me]… I don’t know if my experience would have been different if I was a white person maybe… I don’t know if it’s because we don’t always get the best treatment.”

Group care aims to enable a more active and interactive approach to learning, with a facilitative rather than didactic style, engaging pregnant women/birthing people more fully in their care, including conducting their own routine health checks, such as blood pressure monitoring, within the group space. It also seeks to enable a higher level of social support from peers and from midwives. Previous studies have identified a range of potential benefits, including improved attendance and experience of care.

The findings of this qualitative study suggest that group prenatal care may support maternal mental health not only through symptom reduction, but also by reducing isolation, enhancing knowledge and confidence, and offering more relational and culturally informed care experiences.