Now Offering Centering for Pregnancy


The healthcare community is experiencing a shift toward value-based care with a focus on improving patient outcomes and experience. This includes prenatal care and birth outcomes. Premature birth (before 37 weeks gestation) and its complications are the largest contributors to infant death both in the United States and globally.

Alternative Approach to Prenatal Care

Each year, the March of Dimes issues a premature birth report card for each state and select counties. For 2018, North Carolina earned a D grade, with 10.5% of all live births having been born preterm. Although Wake County earned a B grade for the lowest preterm birth rate in the state for 2016 (8.9%), there is still significant opportunity for improvement.

One of the ways that Triangle Physicians for Women hopes to make a positive impact is by offering CenteringPregnancy® — an evidence-based model of group prenatal care that improves maternal and child health outcomes and reduces health disparities.

How Centering Works

  • Expectant mothers follow a recommended schedule of 10 prenatal visits with each visit lasting around two hours.
  • The schedule for Centering groups is the same as individual care, starting with four monthly groups followed by six bi-weekly groups. After 36 weeks, you will be seen weekly so every other week will be an individual appointment.
  • These Centering groups include your Midwife, a staff facilitator, and other women/couples of a similar gestational age. Each group includes an average of 8-12 women/couples with due dates around the same time.
  • Approximately 30 minutes will be spent measuring your own weight and blood pressure, and recording your own health data to encourage active engagement in your care.
  • Each mom meets individually for belly checks and fetal heart tone checks with the midwife, while the rest of the group has time to socialize, build relationships and enjoy refreshments.
  • After the health assessments are complete, the provider and support staff “circle-up” with moms and their support people and lead discussions and interactive activities about a variety of health topics including nutrition, common discomforts, stress management, labor and delivery, breastfeeding and infant care.
  • Once everyone delivers, the group will reunite for one more session.

Additional Benefits of Centering

  • Moms in Centering groups spend 10 times more time with their provider than women in traditional care resulting in increased patient satisfaction.
  • No waiting room time
  • CenteringPregnancy® often results in greater self-care because moms are more actively engaged in their own healthcare through the management of their own health information.
  • Research indicates that Centering moms have healthier babies and nearly eliminates racial disparities in preterm birth.
  • The cost of preterm birth and related conditions is more than 10x that of a healthy baby. Centering could save the healthcare system $8 billion each year by preventing preterm birth alone.
  • Centering moms are better prepared for labor, delivery and caring for their infant.
  • Practices that offer this type of care have reported fewer after-hours calls and emergency visits because expectant mothers are more knowledgeable about what is normal during pregnancy and what is cause for concern.
  • Women in the same group often create lasting friendships and are able to support one another as they go through similar experiences.

Who Can Participate

While all expectant mothers can benefit from this model of prenatal care, Centering can be especially beneficial for first-time moms, military families, those that do not have a strong support system nearby.

Although Centering is an alternative to traditional prenatal care, it is billed the same as traditional one-on-one prenatal visits so your insurance coverage will be the same as if you were having traditional care. The only additional cost to you is a nominal cost for the Centering materials.

How to Join a Centering Group

At Triangle Physicians for Women, we believe in empowering women to be active participants in their health throughout their pregnancy, labor and delivery, and beyond. By offering Centering, in addition to traditional prenatal care, our goal is to help families to have the labor and delivery experience that they desire.

Triangle Physicians for Women is currently the only practice in Holly Springs, North Carolina, and one of only a few in the Triangle, that is qualified to offer CenteringPregnancy. If you’re on the fence, we encourage you to attend the first two group meetings before deciding which approach to care fits you best. For more information about joining a group, call 919-678-6900.

I think Dr. Grana and her assistant (Mandy) are the best. I have been going to TP4W for years – at least 20, and I have never been disappointed with the level of care I have received. I can be a challenge as my level for pain tolerance is low and they put up with me! I can’t help but highly recommend the practice to anyone looking for exemplary women’s healthcare.

Love love love Dr. Grana and her crew. Love going to Holly Springs office. The girls are the best from Lisa at the front desk to all the girls in the back. Your music and atmosphere is great. Thanks for making these appointments fun!! Yes believe it or not, fun!!!

Dr V and the office staff were all very professional, understanding, caring and very efficient. I would be happy to recommend this practice to friends, family and associates. – Barbara M. Lucas

My visit was great! & my past visit have all been great.Kristy helped me even with me being a bit stressed & in a hurry because I had to be seen & my job is super strict. Her urgency to get me seen was phenomenal. I even got to see Heather, she’s awesome & amazing. She helped deliver my baby girl a year ago. My whole family loves her and Dr Sheshadri. We actually can’t wait to get pregnant again hahaha. Everyone treats you with respect and always makes sure your okay & answers whatever questions you have before you leave. Even leaving a message for the nurses,they get back to you so quickly.  This practice really makes you feel taken care of.  We appreciate you all!  – Erika Hooks

My experience with the TP4W staff has been top of the line.  They helped me through three pregnancies and coached me through every step of the way.  Eternally thankful I chose TP4W.  – Britney

TP4W have such amazing doctors, midwives and nurses.  I cannot say enough about Dr. Grana and the rest of the staff for all the help, advice, guidance and medical care they provided me with all of my kids.  She made me feel safe and calm through both c-sections.  My routine care and pregnancy care have always been top notch and I would recommend them to anyone looking for an OBGYN.  – Brooke

We were honored to receive a hand written note..

Dr. Grana, Angie, Jessica, Heather, April, Sarah and the rest of the staff –

Thank you all so much for taking such good care of me through both of my pregnancies and births, especially my latest one on 10/29! most of yall know how nervous I was from having gone through a lot (to say the least) with my first in 2016. You all made me feel so comfortable and at ease before, during and after. And going through a touch year with my dad, you guys always asked how he was doing at every appointment, which was so thoughtful and beyond your job description. I know that you all see many women go through what i did each and every day and deliver many babies and perform many c-sections. But I hope you know how special Ruby’s delivery was to me. You all have amazing jobs! I cannot thank you all enough. Merry Christmas!

Love, Lucy

I have been going to TP4W since 2010/11 and could not be happier.

The staff, nurses, midwives, and doctors are all amazing. I have 2 sons, both delivered via cesarean by Dr. V. Every visit and every provider did everything in their power to give me the birth experience I wanted, and also ensure that myself and my babies were safe and healthy. Dr. V even did everything in his power to help me avoid my first c-section and VBAC with the second, but that turned out to be out of his hands and he was the absolute best surgeon. With my two pregnancies, I experienced a few scares and some unusual circumstances that would be too long and too private to write in a review, but every single hurdle was handled with grace, honesty, and professionalism. I am so thankful for the recommendation from a friend to come to this office. I can’t imagine ever going to another practice.

TP4W is amazing and I am so very thankful I found them 9 years ago!! Amazing partnership between midwives and doctors, sweet nurses and front end staff, and relaxing environment. I literally recommend them to all my friends! I look forward to my appointments and feel like I’m going to catch up with old friends.

I’ve always had wonderful experiences at TP4W. Everyone is friendly, knowledgeable, and thorough in their care. April delivered my son and I can’t say enough wonderful things about her. She is patient and compassionate. I had the best labor and delivery experience thanks to her. I do and will continue to recommend them to my friends and family!