Vancouver Clinic aims to relaunch CenteringPregnancy effort

Leaders at Vancouver Clinic want to revive a midwife-led group program to ensure mothers across Southwest Washington have access to adequate prenatal care.

Vancouver Clinic and PeaceHealth Southwest Medical Center previously offered the CenteringPregnancy program: a group prenatal care program that brought together women across Southwest Washington with similar pregnancy due dates for individual health assessments, group education sessions and community building.

The program — which was discontinued in March 2020 — aimed to reduce premature births, C-section rates and increase breastfeeding. Now, as access to prenatal care grows increasingly limited, particularly for Medicaid patients, Vancouver Clinic Chief Medical Officer Alfred Seekamp is working with PeaceHealth, Legacy Health and the Clark County Board of Health to relaunch the program by 2026 with a renewed focus on patient-centered, integrated care.

“For me, it really revolves around trying to do something better for the women of Clark County. It’s just not more of the same,” Seekamp said. “Group prenatal visits are really a better method of delivering care to women.”

The program will give women more one-on-one time with a midwife and allow them to connect with other mothers. It will come at no extra cost for expectant mothers.

Vancouver Clinic has about 2,000 deliveries a year, 600 of which are patients who receive Medicaid, Seekamp said.

In 2024, more than 2,000 births across Clark County were covered by Medicaid, and of those, about 31 percent received inadequate prenatal care. Among the more than 3,300 births covered by private insurance, about 22 percent received inadequate prenatal care, according to data from Clark County Public Health.

“Medicaid cuts may further limit access to care for pregnant patients on Medicaid,” Seekamp said. “Early prenatal care is critical, as it significantly improves outcomes for both mothers and babies.”

Midwifery

Allison Lawrence, a certified nurse-midwife at Vancouver Clinic, said midwifery’s distinct focus on autonomy, informed consent and lower intervention can lead to lower C-section rates and overall improved health outcomes for women.

Lawrence was one of the midwives who facilitated the CenteringPregnancy program before it ended.

She said she is excited for its revival.

“From a midwife perspective, and from what I saw through my patients’ eyes, it was not only higher quality care and more engaging, but it was more fun too,” Lawrence said. “Parents would come to the group and be really excited about their pregnancy and connecting with others.”

Parents who participated in the group would have more autonomy, Lawrence said.

They would complete their own vital signs and participate in group conversations to share their own knowledge with others. These aspects increased parents’ confidence moving through pregnancy, and in turn, built community, Lawrence said.

“If we could increase access to care with a program that we know also can nearly eliminate that disparity in maternal health, we would be doing wonderful things for our community,” Lawrence said.

Prenatal care

About 5,500 children are born in Clark County annually, according to the most recent data available from Clark County Public Health.

In 2023, 38 percent of all births in Clark County were covered by Apple Health, the state’s subsidized insurance program, while 57 percent of births were covered by private insurance. The highest rate of Apple Health births were among Pacific Islander, Hispanic, Native American and Black populations.

That same year, about 27 percent of those who gave birth in Clark County received inadequate prenatal care. This rate nearly doubled for the county’s Pacific Islander community, with 56 percent receiving inadequate prenatal care between 2018 and 2022, according to Public Health.

On Sept. 24, the Clark County Board of Health approved a resolution that commits to advancing efforts to increase pregnancy-related care for Medicaid clients in Clark County.

“Everyone deserves the very best care to ensure that moms and the new lives they are nurturing have the healthiest start possible,” Board of Health Chair Sue Marshall said in a news release. “The prospect of not being able to access prenatal care or not being able to access care until very late in one’s pregnancy is deplorable. That is why the Board of Health has directed Clark County Public Health to prioritize advancement of efforts to close the Medicaid gap. Breaking down barriers to quality prenatal care is our objective.”

Reviving the CenteringPregnancy program will require collaboration from multiple health care agencies, securing funding and ensuring health care insurers can refer eligible patients to the program.

Although still in the early stages, Seekamp said he hopes to see the program up and running again sometime in 2026.

“Sometimes, when there is a crisis, it encourages people to come together, think creatively,” Seekamp said. “So this is a good opportunity for us to share our strengths, put competition aside and really come together to create something that benefits the women of this community.”

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