The Role of Trust in CenteringPregnancy: Building Interpersonal Trust Relationships in Group-Based Prenatal Care in The Netherlands.

BACKGROUND: CenteringPregnancy (CP) is a specific model of group-based prenatal care for women, implemented in 44 midwifery practices in The Netherlands since 2011. Women have evaluated CP positively, especially in terms of social support, and improvements have been made in birthweight and preterm-birth outcomes; however, there is limited understanding as to why. The purpose of this study was to examine the mechanisms that create trusting relationships within CP to better understand CP outcomes and effectiveness.

METHODS: A qualitative study was conducted using in-depth interviews with 26 (former) CP participants, alongside observations of CP sessions. All interviews were transcribed and analyzed following open, axial, and selective coding.

RESULTS: Most women characterized trust as a positive expectation about how others would respond to sensitive information that was shared within the group. Trust emerged within the data as a multidimensional concept and several preconditions seemed crucial in building trusting relations: vulnerability, communication, reciprocity, chemistry, and atmosphere. The facilitating of interpersonal trust among CP participants enhanced group processes, especially as a basis for social support by which women said they were more eager to share sensitive information in a trusting environment.

CONCLUSIONS: Processes of trust were interwoven within various CP group dynamics. Trust facilitated social support which in turn enabled reassurance and the building of women's self-confidence.