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OB Group Visit Curriculum

Group 1 - 12-14 weeks - Build Rapport & Nutrition
Group 2 - 16-18 weeks - Changing Body, Exercise & Yoga
Group 3 - 20-22 weeks - Breastfeeding
Group 4 - 24-26 weeks - Becoming a Parent
Group 5 - 32-34 weeks - The Birth Experience
Group 6 - 34-36 weeks - Birth and Post-partum

Each group is scheduled to last for 90 minutes and will take place at the FMI.

Patients will also have individual visits with their PCP at...

First OB Visit
After Group Visit #3 and after #4
weekly from 35 weeks to delivery
for any acute concerns

Group 1

Gestation: 12-14 weeks

Themes: Meet the Group, Nutrition, Smoking Cessation

Please note - - - For the first group all participants will start in the main conference room for meet and greet and ice-breakers. All subsequent groups will start with the "medical" part of the visit.

10 min	Introduction	Rationale for group visits / General schedule of the visits Acknowlege fears, concerns / Discuss confidentiality & sign consent
10 min	Connector	Chat with neighbor, then introduce your neighbor to the group
40 min	Visits Trivia	Intake by RN, Residents see pts for FHT, fundal height, questions Double check genetic screens, initial labs, AMA?, AFP timing While waiting, other patients have pregnancy trivia questions to generate chat
25 min	Nutrition	Has anyone had any cravings? Have you had nausea or morning sickness? Has anyone told you about foods to avoid in pregnancy? Why? Are you really eating for two? How much extra food do you need? Exercises: Pregnancy True-False, Diet Recall & Food Pyramid Handouts: Food Dont's, Pregnancy Tips, Group1 Hand-out, Nutrition Details
	Smoking	Is anyone smoking now / has in the past? Have you tried to quit? Handout: March of Dimes - Tips to Quit
	When to call	When would you call the doctor? Has anyone called so far? How did you do it? What happened? Discuss our coverage system
5 min	Wrap-Up	Questions, Feedback, Planning for next time
	Next Visit	Time & Place / Wear comfortable clothes for yoga

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Group 2

Gestation: 16-18 weeks

Themes: Changing Bodies, Stretching and Yoga

30 min	Visits Birth Stories	Patients check their own weight and BP, perhaps fundal height Residents check FHT and VS, double check that AFP has been done, Address issue of second U/S While waiting, other patients could chat or read a birth story from online collection Handouts: Talia's Birth Story
25 min	Birth Stories Changing Bodies Keeping Active	What did people think of the written birth story? What other birth stories have they heard - prior pregnancy, a friend or relative, your own birth? What changes have you noticed in your own body already? How are you keeping active? Any concerns about exercise? Handouts: Constipation & Anemia , Local Walking Trails / Nature Center Map
30 min	Yoga	Judi Ekholm, RN will be coming to conduct a 30 min Intro to Yoga in Pregnancy Session She may come at 3 or 3:30 to be a part of the group discussion above and get to know people a bit Room needs to be cleared out with as large an open space as possible. Teachers have to try the yoga too! Handout: Yoga in Pregnancy
5 min	Wrap-Up	Topics people are interested in for the next visit? Questions and Feedback
	Next Visit	Time & Place / Planned topic is Breast-Feeding

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Group 3

Gestation: 20-22 weeks

Themes: Breast-feeding

35 min	Visits	Patients check their own weight and BP, perhaps fundal height Residents check FHT and VS, answer questions Review 20 week packet, Consider fetal survery
20 min	Ice Cube Contractions You will need: Ice cubes - fridge in break room Dixie cups	Has anyone experienced contractions before? How have people coped with pain in the past? - menstrual cramps, injuries, etc. There are many ways to cope with pain in labor - we will practice the idea of distraction. Handouts: Ice Cube Contractions - Give to group after the exercise.
20 min	Breast-feeding	What do you know about breastfeeding? What have you heard that is positive? negative? Why are you considering or not considering it? Handout: Benefits of Breastfeeding
5 min	Wrap-Up	Topics people are interested in for the next visit? Questions and Feedback
	Next Visit	Next visit will be with PCP Next group topic is Parenting / Visit from Healthy Families

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Group 4

Gestation: 24-26 weeks

Themes: Parenting and Baby Care

35 min	Visits	Patients check their own weight and BP, perhaps fundal height Residents check FHT and VS, questions Set up Glucola and Rhogam before next visit
20 min	Healthy Families	Representative from Healthy Families will meet with patients This is a free service to first time parents in Kennebec Valley. Handouts: (and gifts) provided by Healthy Families folks
10 min	Parenting	What worries do you have about being a parent? What have you learned from how your parents parented you? What kind of a parent do you want to be?
20 min	Baby Care Circumcision	Ask if people want to discuss circumcision (may have a group with all girls??) What questions do people have about baby care? - Address as they come up. Demonstrate and have group members practice swaddling - a great technique for soothing a crying baby. Handouts: Circumcision from AAFP. Baby Supplies list. Tips for First-time Dads.
5 min	Wrap-Up	Topics people are interested in for the next visit? Questions and Feedback
	Next Visit	Next visit is with PCP Next group topic is The Birth Experience

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Group 5

Gestation: 30-32 weeks

Themes: The Birth Experience

35 min	Visits	Patients check their own weight and BP, perhaps fundal height Residents check FHT and VS, questions Review that Glucola and Rhogam have been done, who is Peds??
20 min	Birth Experience	What have people read, seen, experience of birth, labor? Has anyone been in labor or been with someone in labor? What questions do people have? Anticipate topics including: When to come in? Pain management? What to do in early labor? Role of support person? Handouts:
5 min	Ice Cube Contractions	You will need: Ice cubes - fridge in break room Dixie cups There are many ways to cope with pain in labor - we will practice the idea of distraction, visualization. What did people remember about the exericse last time? Handouts: Ice Cube Contractions - Give to group after the exercise.
25 min	Movie	Watch sections on Early Labor and First Stage of Labor - end with Transition. Discuss?
5 min	Wrap-Up	Topics people are interested in for the next visit? Questions and Feedback
	Next Visit	Next visit is with PCP Next group topic is Delivery and Post-partum

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Group 6

Gestation: 32-34 weeks

Themes: Delivery and Post-partum

35 min	Visits	Patients check their own weight and BP, perhaps fundal height Residents check FHT and VS, questions Consider GBS, who is Peds?, Birth control - BTL consents signed?
15 min	Labor and Delivery	Any new thoughts since last time about labor and delivery? Role of partner in delivery - cutting cord? Who will be there? To breast right after? What questions do people have?
10 min	Post-partum	It's good to plan now for bringing the baby home. Who will be there to help you? Does anyone have experience, advice? Think about balance of help v. too many visitors, sleep when baby sleeps, etc. Handouts:
25 min	Movie	Watch sections on Second and Third Stages. Discuss?
5 min	Wrap-Up	*** Take group picture with resident leaders! Expect to receive in the mail a feedback questionnaire and consider writing down your birth story to keep or to share. We will also be inviting them back to a group "reunion" in a couple months to meet babies!
	Next Visit	All subsequent visits are with PCP Best of Luck to everyone!!!