Thanks to the collaborative efforts of Triple-S, March of Dimes, and the Hospital UPR-Dr. Federico Trilla (HUPR), an innovative group prenatal care program is being implemented at a Puerto Rican hospital facility with the objective of reducing preterm births and improving the health of the pregnant mother and their babies. This program is a framework called Supportive Pregnancy Care, which was established in 2016 by March of Dimes in the state of Tennessee. It has already been implemented in 25 states and jurisdictions across the United States, at more than 50 locations offering health services to pregnant women. Evidence shows that group prenatal care can lower preterm births by more than 33% of participants of all races and ethnicities. Moreover, it was scientifically validated by the medical faculty at the University of Puerto Rico, Medical Sciences Campus in San Juan between 2013 and 2015.
Feeling confident about these positive results, Triple-S announced its commitment to continue supporting this framework at other interested local hospital facilities. In addition, this would also benefit Puerto Rico as it would not only involve improving the health of pregnant mothers and their babies, but also change how current prenatal care is provided by transforming this type of care into a group practice.
According to the 2021 March of Dimes Report Card, Puerto Rico has the lowest rating regarding preterm births, infant mortality, social drivers of health, low-risk Cesarean birth rates, and inadequate access to prenatal care. Given this alarming situation, and with its commitment to address the island’s health inequities as part of Blue Cross Blue Shield, Triple-S sought to establish group prenatal care in Puerto Rico by following the March of Dimes framework. As a result, the first program of its kind was established in a hospital facility on the island.
“As a company dedicated to health care, our mission is to foster and strengthen the wellbeing of the island’s population,” explains Roberto García Rodríguez, CEO of Triple-S Management. “We are strongly committed to addressing and reducing the disparities in women’s health care. We believe this program aims to improve pregnant people’s health as well as that of their babies, while looking to reduce complications during pregnancy in Puerto Rico through the implementation of a flexible group prenatal care framework with proven results,” he elaborated.
“March of Dimes’ mission has always been to guarantee that every mother and child has a healthy start, with access to services tailored to their needs,” stated Alma Seda, Executive Director of the organization. “A premature baby can face lifelong health problems since they may not be fully developed at birth. This is why, for an organization like ours, it is an achievement to be able to implement an already established framework that has yielded positive results in Puerto Rico, thus giving our families and pregnant women access to an uncommon service,” added Seda.
The program participants have shown better prenatal understanding and a higher preparedness for delivery. Furthermore, it has also resulted in the birth of babies who spend less days in the intensive care unit. “We examined the pilot study conducted in Tennessee and its results showed a lower probability of a pregnant person having to visit the emergency room during pregnancy, which reflects a direct link between the program and the pregnant person’s health,” states García, CEO of Triple-S Management. “In addition, 68% of participants held a higher probability of attending their postpartum appointments, 84% began breastfeeding from the moment of birth, and it was three times as likely for them to continue doing so during their postpartum appointments,” he adds. “This also shows a great progress in infant health,” concluded the executive.
The HUPR in Carolina receives 8,500 hospitalizations per year and 4,400 visits to the obstetrics and gynecology clinics. In 2021, 467 births were recorded at the hospital, a very similar number to the previous year. As an academic institution, the hospital operates under a strict protocol to reduce elective deliveries prior to 39 weeks. As such, HUPR has been recognized by March of Dimes as the hospital with the lowest rate of Cesarean births in all of Puerto Rico. “We are proud to become the first hospital facility to implement this program alongside March of Dimes and thanks to the support of Triple-S,” explains Executive Director, Yelitza Sánchez Rodríguez, Esq. “For Hospital UPR, it is an honor to offer a program to the community that was scientifically validated by the Medical Sciences Campus between 2013 and 2015. Our goal is to empower patients so that they can be an integral part of their prenatal care successfully, while we position ourselves as a framework to follow for other medical institutions in Puerto Rico as well,” says Sánchez.
Group prenatal care is a framework based on scientific data that brings pregnant people together to receive prenatal care with their obstetrician-gynecologist (OB/GYN). The program addresses medical factors and social drivers in a flexible and relevant manner. During group sessions, participants take and record their own vital signs, receive a physical evaluation with their health care provider, support each other mutually, and acquire knowledge and skills related to pregnancy, childbirth, postpartum, and infant care. This framework will be developed for two years to serve groups of 8 to 12 pregnant people at a time, for a maximum of 200 participants per year. Participation is voluntary for all pregnant people and will be provided at no additional cost to their prenatal care.
People interested in participating in the program can visit the www.hospitalupr.org/aurora web page to fill out a request to receive orientation, or send an email to .