Journal of midwifery & women's health最新文献

{"title":"Curriculum Resources for Integrating Respectful Maternity Care Into Health Professions Education: A Rapid Scoping Review","authors":"Kendra L. Rieger PhD, RN,&nbsp;Lillian Ohene PhD,&nbsp;Tintswalo Victoria Nesengani PhD, RN,&nbsp;Eunice Siaity Pallangyo PhD,&nbsp;Ronell Leech PhD,&nbsp;Duncan Dixon MLIS, MEd,&nbsp;Meghann Buyco MSN, RN,&nbsp;Ingrid Watts MSN, RN,&nbsp;Tumisho Mokwele MNurs,&nbsp;Jessica Wilson MSN, RN,&nbsp;Kiel Mayich  ,&nbsp;Ikponwosa Ero JD,&nbsp;Ramadimetja Shirley Mooa PhD, RN,&nbsp;Barbara Astle PhD, RN,&nbsp;Sheryl Reimer-Kirkham PhD, RN","doi":"10.1111/jmwh.70129","DOIUrl":"10.1111/jmwh.70129","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Respectful maternity care (RMC) ensures that every childbearing woman is treated with dignity, safety, and respect. Health care professionals play a critical role in RMC but can also contribute to disrespectful and abusive practices, inflicting lasting trauma. Educating pre-service health care learners is one promising strategy for change. As part of our larger Mothering and Albinism research project, we sought timely evidence to develop educational resources supporting RMC for people impacted by albinism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our international team conducted a rapid scoping review to answer the question, “What curriculum resources are available for integrating RMC into the education of nursing, midwifery, medical, and other health care students, and what are their key pedagogical components and contextual factors shaping implementation?” We searched key databases and online sources for qualitative, quantitative, and mixed-methods studies of RMC education initiatives and curriculum resources relevant to teaching RMC to pre-service learners. Two reviewers screened abstracts/full texts, and data were charted and synthesized using descriptive statistics and content analysis. Our diverse author network was consulted to ensure rigor and relevance for a range of populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis of 25 research reports and 8 curriculum resources produced 5 synthesized categories. The first 4 categories illuminate how RMC education initiatives are conceptualized, their core content, effective pedagogical strategies, and how researchers studied the impact of RMC education. The fifth category addresses contextual influences and the need for taking a systems perspective within RMC education initiatives. Significant gaps remain with few initiatives addressing the unique needs of structurally disadvantaged groups or including trauma-informed, violence-informed, or equity-oriented approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>RMC education has potential, but it must be paired with systemic change and attention to equity for meaningful change. These findings lay the groundwork for developing context-specific, effective educational resources to support RMC for all women, including those impacted by albinism.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 5","pages":"717-731"},"PeriodicalIF":2.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulating Midwifery Through Manuals: Institutionalization and the Displacement of Traditional Midwives in the 20th-Century South","authors":"Sharon L. Holley CNM, DNP","doi":"10.1111/jmwh.70155","DOIUrl":"10.1111/jmwh.70155","url":null,"abstract":"<p>Efforts to standardize perinatal care in the early-mid 20th century led to the development of standardized midwifery training manuals produced by the US Children's Bureau and adapted by state health departments. This analysis examines how these manuals facilitated the institutionalization of midwifery education and contributed to the displacement of apprentice-trained Indigenous and Black midwives. Primary-source manuals from the US Children's Bureau and the Alabama and Mississippi departments of public health were examined through direct visual analysis, including a reproduced copy of the Alabama manual. Manuals were selected based on their publication following the Sheppard-Towner Maternity and Infancy Act, their documented use in state-supported programs, and the completeness of available editions. A comparative historical framework, informed by public health history and institutionalization theory, guided interpretation. The manuals codified competencies, literacy and documentation requirements, and supervisory oversight, shifting authority from community midwives to state-approved professionals. Alabama's implementation illustrates how federal guidance was operationalized locally through eligibility standards, record-keeping practices, inspections, and narrowing pathways into practice, measures that selectively advantage nurse-led models. Beyond procedural standardization, the manuals embedded racialized and classed assumptions, framing traditional midwives as problems to be corrected rather than knowledge-holders. These dynamics aligned with broader regulatory campaigns that restricted licensure, increased surveillance, and ultimately diminished traditional midwifery practice. Midwifery training manuals consequently functioned not only as instructional texts but also as tools of institutionalization that reshaped who was permitted to practice, under what authority, and to whose benefit. Understanding this history clarifies contemporary debates surrounding regulation, equity, and authority in midwifery care.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 5","pages":"848-853"},"PeriodicalIF":2.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Innovative Approach to Midwifery Education: The Bridge Clinical Experience","authors":"Jessica Pipitone CNM, MSN,&nbsp;Maria Mackeil DNP, MSN,&nbsp;Sascha James-Conterelli CNM, DNP, MSN,&nbsp;Erin Morelli CNM, PhD, MSN","doi":"10.1111/jmwh.70148","DOIUrl":"10.1111/jmwh.70148","url":null,"abstract":"<p>Enhancing preparedness for midwifery students who do not have prior experience as registered nurses (RNs) and are entering a graduate-entry nurse-midwifery program is crucial for their success. A graduate-entry program is an accelerated academic pathway designed for students who already hold a bachelor's degree in a different field, leading to a master of science in nursing (MSN) in 3 years. During the first year of the graduate-entry pathway, students complete undergraduate nursing education, take the National Council Licensure Examination and become RNs before beginning their master's coursework. This approach can be challenging for non-RN students who enter an MSN program with less clinical experience and potentially less comprehension of the nurse-midwife's professional role. The aim of the Bridge Clinical Experience is to strengthen the readiness of graduates by improving their RN clinical experience during their first year of study. By leveraging students’ enthusiasm for their chosen field of midwifery, this curriculum redesign fosters interprofessional relationships and introduces advanced concepts early in the program, thereby enhancing their student experience and setting them up for success.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 5","pages":"854-861"},"PeriodicalIF":2.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Black Doula Support in US Jails and Prisons: Caring for Those Confined","authors":"Denae L. Bradley PhD","doi":"10.1111/jmwh.70150","DOIUrl":"10.1111/jmwh.70150","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>As patient advocates, Black community-based doulas aim to address disparities in perinatal health care within both community and carceral settings. Yet, little is known about how they interpret their work with people who are pregnant and incarcerated. The purpose of this study was to examine Black doulas’ perspectives on providing care in carceral systems and the institutional constraints of this work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study draws on interviews with 19 Black doulas who provided services in US jails and prisons. Using a directed content analysis and the reproductive justice framework, their care practices are examined to understand how they provide care in systems structured by punishment, surveillance, and perinatal health care disparities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants framed their work as relational and culturally grounded, which countered the punitive logics of incarceration. They described providing one-on-one support and education that people who are pregnant might not have otherwise received, given the precarious state of perinatal health care in carceral facilities. At the same time, they detailed various institutional constraints that influenced their model of care. Despite these constraints, doulas interpreted their work as a transformative intervention within carceral systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>By centering Black doulas’ perspectives, this study shows how their care work resists state-sanctioned reproductive oppression and affirms alternative visions of perinatal health care that are culturally grounded and rooted in dignity and respect. As such, it demonstrates how Black doulas’ insights are critical for informing institutional policies and practices and also for advancing reproductive justice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 5","pages":"761-768"},"PeriodicalIF":2.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Online Versus Group Prenatal Education on Breastfeeding Determinants and Outcomes in Nulliparous Women: A Prospective Cohort Study","authors":"Marie-Violaine Ponte MSc, RN,&nbsp;Alexandre Prud'homme BSc,&nbsp;Sonia Semenic PhD, N,&nbsp;Stéphane Turcotte MSc,&nbsp;Maude Laberge PhD,&nbsp;Nils Chaillet PhD,&nbsp;Geneviève Roch PhD, RN","doi":"10.1111/jmwh.70156","DOIUrl":"10.1111/jmwh.70156","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Prenatal education is key to promoting breastfeeding. To address equity and access challenges, health care facilities are increasingly offering online prenatal education in addition to in-person sessions. This study aimed to estimate the influence of online and group prenatal education services, used separately or together, on breastfeeding determinants (intentions, self-efficacy) and outcomes (initiation, exclusivity) among nulliparous pregnant persons, compared with standard prenatal care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective cohort study was conducted from June 2018 to September 2020 in Québec, Canada with 863 nulliparous pregnant persons from 2 adjacent regions. Prior to the COVID-19 pandemic, 358 participants completed questionnaires at 3 time points about their use of prenatal education services in which breastfeeding-related content was optional. Based on their self-reported use, participants were divided into 5 categories: (1) face-to-face group prenatal education, (2) asynchronous online prenatal education, (3) both (with breastfeeding), (4) either group/online/both (opted out of breastfeeding content), and (5) standard prenatal care only. Repeated-measures analysis of variance, generalized linear mixed models, mixed-effects logistic regression, χ², and Fisher's exact test were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 53.3% of participants chose the prenatal education services with breastfeeding information. When compared with standard prenatal care only, exposure to breastfeeding information from the online option alone or from both services was associated with breastfeeding intentions and initiation. No prenatal education services were associated with self-efficacy or exclusivity; however, higher prenatal breastfeeding self-efficacy predicted exclusivity 4 weeks after childbirth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Study findings highlight the complementary contribution of asynchronous online and in-person group prenatal education services to breastfeeding, adding to the scant literature comparing these educational options. This can help health care providers, decision-makers, and policy makers identify avenues to strengthen equity in the administration of breastfeeding education, thereby providing expectant persons with better strategies for choosing and maintaining breastfeeding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 5","pages":"771-781"},"PeriodicalIF":2.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Hereditary Cancer Risk Assessment and Genetic Testing Workflow in Interprofessional Women's Health Practice: A Multicenter Survey of Advanced Practice Providers","authors":"Elaine Mielcarski CNM, MS, NP,&nbsp;Dana Karanik RN, BSN,&nbsp;Heather Bagley MMSc, CGC,&nbsp;Edith Smith CNM, DNP, WHNP-BC,&nbsp;Amanda Steele PhD,&nbsp;Logan Schneider MS,&nbsp;Lauren Lenz MS,&nbsp;Royce T. Adkins MD","doi":"10.1111/jmwh.70134","DOIUrl":"10.1111/jmwh.70134","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Advanced practice providers (APPs), including certified nurse-midwives (CNMs)/certified midwives and nurse practitioners, are well positioned to meet the growing demand for women's health care services. In interprofessional obstetric and gynecologic settings, APPs’ scope of practice includes performing hereditary cancer risk assessments (HCRAs) and genetic evaluations, comparable with physicians. However, time constraints, limited confidence, and inadequate resources may hinder APPs’ ability to routinely and effectively incorporate HCRA and genetic testing into practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Process</h3>\u0000 \u0000 <p>This prospective, single-arm health care quality improvement initiative introduced workflow innovations and tools to improve HCRA workflow. This intervention included training on using online family history screening and virtual patient education tools within a standardized HCRA. Metrics related to genetic evaluation and testing completion and the experiences of women and APP respondents were recorded preintervention and postintervention. Data were analyzed using descriptive statistics and univariate conditional logistic regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes</h3>\u0000 \u0000 <p>Following workflow standardization, APPs noted increases of 27.1 percentage points in the proportion of women offered genetic testing and 26.4 percentage points in the genetic testing completion rate (26.4%). APPs agreed or strongly agreed that the workflow modification improved their confidence in performing HCRA (91.7%) and meeting the standard of care (91.7%) and supported guideline adherence (83.3%) and ease of practice integration (66.7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>APPs care for women with similar risk profiles as physicians and are equally capable of implementing novel tools and processes to provide evidence-based, personalized HCRA consistent with their scope of practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 5","pages":"754-760"},"PeriodicalIF":2.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Synthesis of Principles and Approaches From the Field of Implementation Science for Studying Midwifery Integration in the United States","authors":"E. Brie Thumm CNM, PhD, MBA,&nbsp;Denise Colter Smith CNM, PhD,&nbsp;Katie Page CNM, MSN,&nbsp;Amy G. Huebschmann MD, MSc","doi":"10.1111/jmwh.70136","DOIUrl":"10.1111/jmwh.70136","url":null,"abstract":"<p>Midwifery care has not been widely or equitably implemented in the United States despite a large body of evidence supporting its effectiveness in improving health outcomes. Implementation science is an emerging field that rigorously studies how to translate evidence-based models of care, like midwifery, into practice to improve population health outcomes. Principles and approaches from implementation science can be applied to midwifery care integration to understand how midwifery care is provided and functions effectively across different settings. This state of the science review provides a primer in implementation science and its application to midwifery care. Using theories, models, and frameworks from implementation science across all stages of the research process promotes shared language across studies, thereby increasing generalizability and reproducibility. Theories, models, and frameworks also help to elucidate mechanisms for successful implementation. Developing a catalog of implementation strategies with associated implementation outcomes can bring uniformity and efficiency to efforts to implement midwifery care in different settings. Successful midwifery care implementation is largely dependent on organizational-level context; therefore, utilizing implementation frameworks and strategies that center on the organization is encouraged. Midwifery-integration researchers can leverage study designs from implementation science, such as hybrid approaches that simultaneously study implementation and effectiveness, use positive deviance approaches that study exemplar cases, and apply lessons learned to under-performing settings. Implementation science also provides methods for systematically studying adaptation and equitable implementation that are particularly relevant for midwifery care in the US context.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 5","pages":"740-753"},"PeriodicalIF":2.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Labor Control Among Latinas: Examining the Role of Pregnancy Loss, Prenatal Depression, and Childbirth Pain Severity","authors":"Sandraluz Lara-Cinisomo PhD,&nbsp;Biniyam Melesse PhD","doi":"10.1111/jmwh.70145","DOIUrl":"10.1111/jmwh.70145","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Prenatal mental health, perception of pain, and pregnancy histories can affect a birthing person's sense of control during labor. Although recent research has focused on cesarean births, less attention has been given to the role those factors play in perceived control during vaginal births. These gaps are particularly critical for Latinas, who experience health care intrapartum disparities in the United States. This study addresses these gaps by examining how prenatal depression symptoms, history of pregnancy loss, and pain severity are related to perceived control during labor among Latinas birthing vaginally. The findings may inform intrapartum care for a patient population at increased risk of health care inequities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This secondary data analysis included 119 self-identified Latina women who had a vaginal childbirth in North Carolina. Hierarchical linear regressions tested associations between prenatal depressive and anxiety symptoms, history of pregnancy loss, labor pain severity, and perceived control of labor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A history of pregnancy loss was associated with lower perceived control during labor across all models, even after controlling for covariates, mental health, and perinatal variables (<i>B =</i> −0.450; <i>P</i> =  .024). Prenatal depressive symptoms were also a robust predictor, showing an inverse association with perceived control of labor in the final model with all predictors (<i>B</i> = −0.076; <i>P</i> =  .014). Lastly, there was a significant and negative association between pain severity and perceived control of labor, even after controlling for covariates, histories of pregnancy loss, prenatal depressive symptoms, and analgesia use in labor (<i>B =</i> −0.355; <i>P</i> &lt;  .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Latinas in the United States encounter health care inequalities during and after childbirth. The findings underscore the need for clinicians to screen for depressive symptoms, discuss patients’ pregnancy histories, support pain management during labor, and implement shared decision-making protocols.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 5","pages":"799-807"},"PeriodicalIF":2.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Midwifery Students’ Communication and Counseling Skills in Maternal Nutrition: A Quality Improvement Educational Initiative","authors":"Martina Caglioni PhD, RM,&nbsp;Vanessa Odelli RM,&nbsp;Paolo Ghisleni MSc,&nbsp;Viola Marostica RM,&nbsp;Elena Celi RM,&nbsp;Sara Trapani RM,&nbsp;Barbara Cigoli RM,&nbsp;Stefania Rinaldi RM,&nbsp;Stefano Salvatore MD,&nbsp;Massimo Candiani MD, PhD","doi":"10.1111/jmwh.70132","DOIUrl":"10.1111/jmwh.70132","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Maternal nutrition is a key determinant of pregnancy, birth, and child health outcomes, yet many women who are pregnant do not meet dietary guidelines. Midwives play a central role in providing nutritional counseling, but gaps persist in students’ preparedness. Opportunities for structured, immersive practice in nutrition-focused communication are limited within midwifery degree programs in Italy. This quality improvement (QI) project aimed to implement an integrated educational intervention designed to strengthen midwifery students’ communication and counseling skills in maternal nutrition and to evaluate students’ perceptions of its relevance, effectiveness, and impact on their learning experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Process</h3>\u0000 \u0000 <p>The Perinatal Education and Agro-food Counseling and Communication initiative included 3 components: (1) foundational theoretical seminars, (2) an online knowledge-sharing repository, and (3) an off-site residential training weekend. Twenty-three second-year and third-year students were selected based on academic criteria and motivational interviews. The intervention employed participatory, experiential teaching strategies. A qualitative descriptive approach was used, with all participants taking part in a postintervention focus group. Data were analyzed through qualitative content analysis using ATLAS.ti.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes</h3>\u0000 \u0000 <p>Analysis revealed 6 interconnected thematic areas: (1) agro-food integration, (2) clinical influence, (3) communication skills, (4) counseling challenges, (5) knowledge gain, and (6) perception of effectiveness. Students reported enhanced clarity, empathy, and confidence in communication; improved understanding of the role of nutrition in antenatal care; and appreciation for experiential group activities and the residential setting. The program fostered teamwork, reflection, and deeper engagement. However, challenges in conducting independent nutrition counseling persisted, highlighting the need for further structured practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This QI initiative demonstrated that combining targeted nutrition content with experiential communication training can improve midwifery students’ confidence and perceived readiness to provide nutritional counseling. Embedding similar approaches within midwifery curricula may enhance competency development and support high-quality antenatal care. Future work should include longitudinal follow-up and expanded implementation across cohorts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 5","pages":"877-886"},"PeriodicalIF":2.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Postpartum Mental Health and Healthy Lifestyle Behaviors in Women of Color Who Are Pregnant and Experiencing Depression, Anxiety, and Stress Through Group Prenatal Care: A Randomized Controlled Trial","authors":"Bernadette Mazurek Melnyk PhD, APRN-CNP,&nbsp;Susan Gennaro PhD, RN,&nbsp;Laura A. Szalacha EdD,&nbsp;Anne M. Gibeau CNM, PhD,&nbsp;Jacqueline Hoying PhD, RN,&nbsp;Caitlin M. O'Connor MSN, CPNP,&nbsp;Andrea Cooper CNM, MS, WHNP-BC,&nbsp;Melanie M. Aviles BS","doi":"10.1111/jmwh.70154","DOIUrl":"10.1111/jmwh.70154","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A mental health epidemic exists in women of color who are pregnant, with alarming rates of depression and anxiety. Furthermore, the majority of these women do not receive treatment because of inadequate screening, mental health stigma, and lack of access to mental health care professionals. The purpose of this study was to evaluate the 6-week and 6-month postpartum effects of the Creating Opportunities for Personal Empowerment (COPE)-Pregnancy (COPE-P) program, administered by midwives, compared with a health promotion education program on mental health and healthy lifestyle behaviors and beliefs of Black and Hispanic women experiencing depression, anxiety, or stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was a longitudinal, 2-group randomized controlled trial with 299 Black and Hispanic participants who screened high on depression, anxiety, or stress scales. In total, 41% of women screened met study eligibility criteria. Two 6-session group prenatal care interventions—the COPE-P cognitive-behavioral skills-building (CBSB) program and a health promotion with discussion attention control—were evaluated. Valid and reliable measures included the General Anxiety Disorder-7 scale, Edinburgh Postnatal Depression Scale, Perceived Stress Scale, Healthy Lifestyle Beliefs Scale, and Healthy Lifestyle Behaviors Scale, which were assessed at baseline, postintervention, 6 weeks postpartum, and 6 months postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two-way analyses of variance and longitudinal multilevel growth models assessed outcomes. Both groups demonstrated rapid, significant decreases in depression, anxiety, and stress (<i>P</i> &lt;.001) over time through 6 months postpartum. Only the COPE-P group's significant improvement in healthy lifestyle behaviors was sustained through 6 weeks postpartum (<i>P</i> &lt;.001). Participants who completed more CBSB activities showed greater improvements in outcomes than all other participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>CBSB and health promotion content provided in group prenatal care by midwives decreased depression, anxiety, and stress that persisted through 6 months postpartum. CBSB programming sustained longer-term improvements in healthy lifestyle beliefs and behaviors. Performing more CBSB activities led to greater improvements in outcomes. The study was registered at the US National Institutes of Health (ClinicalTrials.gov) (NCT03416010).</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 5","pages":"808-819"},"PeriodicalIF":2.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}