Journal of midwifery & women's health最新文献

{"title":"Barriers to Birth Center Integration Into the Perinatal Health System in New Jersey: A Qualitative Analysis","authors":"Rebecca H. Ofrane DrPH,&nbsp;Slawa Rokicki PhD,&nbsp;Julie Blumenfeld CNM, DNP,&nbsp;Leslie Kantor PhD","doi":"10.1111/jmwh.70010","DOIUrl":"10.1111/jmwh.70010","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>When compared with hospitals, evidence has shown that freestanding birth centers are a high-value but underused birth setting offering midwifery care for individuals with low-risk pregnancies. However, systemic barriers limit birth center accessibility, especially for pregnant people of color, who fear bias and disempowerment in the hospital setting. This qualitative study is an expansion of previous research exploring the financial barriers facing birth centers in New Jersey. The aim of this study is to further describe barriers to improved birth center integration into the broader health system in New Jersey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semistructured interviews were conducted with professionals from 4 sectors: birth center or health system, policy-adjacent philanthropy or research, statewide departments, and health insurance. Coding and reflexive thematic analysis resulted in 4 systemic barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The identified systemic barriers to birth center access are (1) widespread lack of understanding of birth center care, (2) workforce and care network integration concerns, (3) state-related licensure and Medicaid process burdens, and (4) geographic and transportation infrastructure limitations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This research provides further analysis and insights on the barriers to birth center access and suggests important areas for systemic policy and practice improvements. Results align with limited national studies and can spur a well-integrated perinatal system of care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"757-763"},"PeriodicalIF":2.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983551","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":"Taking Care of Your Health","authors":"","doi":"10.1111/jmwh.70000","DOIUrl":"https://doi.org/10.1111/jmwh.70000","url":null,"abstract":"<p>Taking care of your health is one of the most important things that you can do for yourself. If you are in good health, then you can take care of those who need your help. The more we know about our health, the better we can prevent certain health conditions or find them early. This handout reviews the health screenings and vaccines that are recommended for adults of all ages.</p><p>You can discuss how often you should be seen for a health check-up and which tests would be helpful for you with your health care provider. Screening tests give you information about your overall health. Vaccinations recommended for healthy people who have received the recommended childhood vaccinations are also listed. Your health care provider may offer some screening tests earlier than recommended, depending on your health history, family history, or if you are having symptoms of a health problem.</p><p>The recommendations in this chart are general suggestions. It is important to discuss the tests and vaccines with your health care provider. Recommendations by your health care provider depend on your personal health history. Your health care provider may suggest more frequent testing or more tests if you have a family history or personal health history that suggests you have a higher chance of getting cancer or other diseases.</p><p><b>Health Screenings and Immunizations for Women</b>\u0000 \u0000 </p><p>Flesch-Kincaid Grade Level: 8.8</p><p>Approved June 2025. This handout replaces “Taking Care of Your Health” published in Volume 62, Issue 3, May/June 2017.</p><p>This handout may be reproduced for noncommercial use by health care professionals to share with patients, but modifications to the handout are not permitted. The information and recommendations in this handout are not a substitute for health care. Consult your health care provider for information specific to you and your health.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 4","pages":"681-682"},"PeriodicalIF":2.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869182","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":"Staying Healthy While You Are Pregnant","authors":"","doi":"10.1111/jmwh.70001","DOIUrl":"https://doi.org/10.1111/jmwh.70001","url":null,"abstract":"<p>If you are pregnant or thinking of becoming pregnant soon, you have a great opportunity to start making healthy lifestyle changes. Eating a well-balanced diet, setting a healthy weight gain goal, avoiding harmful substances, getting 7–8 hours of sleep, exercising regularly, taking a daily prenatal vitamin and having regular prenatal checkups all help keep you healthy in pregnancy. Staying healthy in pregnancy helps your baby have a healthy start. It also decreases your chance of complications in pregnancy and increases the chance you will have a healthy birth.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 4","pages":"683-684"},"PeriodicalIF":2.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869183","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":"Barriers and Equity in Paid Parental Leave: Insights from Diverse Postpartum Experiences in Connecticut","authors":"Kortney Floyd James PhD, RN,&nbsp;Dana C. Beck PhD, MSN, FNP-BC,&nbsp;Emily Diep,&nbsp;Channelle Ndagire BA,&nbsp;Judit Vega BA,&nbsp;Lucinda Canty CNM, PhD, RN","doi":"10.1111/jmwh.70007","DOIUrl":"10.1111/jmwh.70007","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Paid parental leave (PPL) is a critical yet unevenly distributed support that can shape postpartum recovery and maternal mental health. Even in states with comprehensive PPL programs, families often face barriers shaped by job type, income, language, and limited awareness. This study provides a nuanced, qualitative exploration of diverse postpartum individuals’ lived experiences with PPL, addressing critical gaps in understanding barriers and inequities beyond quantitative data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used a phenomenological approach to capture participants’ lived experiences with PPL following the implementation of Connecticut's state program in January 2022. In-depth interviews were conducted with 25 postpartum women between December 2023 and March 2024. Participants were recruited through parent-focused events and social media, and eligibility included giving birth since 2022 and having used or attempted to use PPL. The sample was racially, linguistically, and socioeconomically diverse, with a range of employment types.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four themes emerged: (1) rest and recovery, highlighting PPL's role in healing and bonding; (2) internal struggles and family guilt, reflecting pressures to return to work; (3) external barriers, including workplace stigma and policy awareness gaps; and (4) paving the way forward, including when participants offered suggestions to improve PPL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>PPL supports maternal recovery, but persistent barriers limit its impact, even in Connecticut for those with broad PPL eligibility. Equitable wage replacement, expanded access, and integrated PPL education in health care settings are critical for promoting equity and public health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"707-716"},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857286","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 Descriptive Study of Career Satisfaction and Professional Trajectories of Certified Midwives and Certified Nurse-Midwives","authors":"Karen Jefferson CM, DM,&nbsp;Abigail Bella CM, MPH,&nbsp;Suzanne Schechter CNM(ret), MS,&nbsp;Lauren Buscarino MPH,&nbsp;Barbara Hackley CNM, PhD,&nbsp;Ronnie Lichtman CNM, PhD","doi":"10.1111/jmwh.13787","DOIUrl":"10.1111/jmwh.13787","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Certified Midwife (CM) credential was introduced by the American College of Nurse-Midwives in 1996 to increase the midwifery workforce and provide an equivalent direct entry pathway to midwifery practice without prior nursing education. No research has compared the professional experiences of certified nurse-midwives (CNMs) and CMs. This study compared the career trajectories and experiences of CNMs and CMs who graduated from the State University of New York Downstate Health Sciences University Midwifery Program between 1997 and 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a cross-sectional design, a survey was sent to 237 alumni. The survey included items on satisfaction with chosen education pathways, role transition from student to midwife, and professional experiences. Mann-Whitney U tests and Pearson's χ² tests of independence were used to assess group differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 237 individuals invited to participate in the survey, 131 completed the survey in sufficient detail to be included in the analysis. Participants reported similar career trajectories, satisfaction with their education preparation, measures of job performance, longevity as a midwife, and overall satisfaction with their careers. CMs were significantly more likely to express dissatisfaction with their education route, largely due to a lack of geographic mobility. CMs and CNMs experienced significantly different levels of respect from professional colleagues in their first and current or most recent positions. There were no significant differences in reported clinical competence or perceived success between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study demonstrates that CNMs and CMs have equal career success and satisfaction. Expanding the geographic mobility of CMs by expanding state licensure could enhance career satisfaction and potentially increase the number of students interested in becoming CMs. Because both the CNM and CM pathways produce qualified midwives, the American College of Nurse-Midwives and state affiliates should continue to seek CM licensure with an identical scope of practice to CNMs in all 50 states.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"764-770"},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736419","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":"Systematic Reviews to Inform Practice, July/August 2025","authors":"Nena R. Harris CNM, PhD, FNP-BC, CNE,&nbsp;Abby Howe-Heyman CNM, PhD","doi":"10.1111/jmwh.70002","DOIUrl":"https://doi.org/10.1111/jmwh.70002","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 4","pages":"664-679"},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869640","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":"Development of an Online Question Bank for Midwifery and Women's Health Nurse Practitioner Comprehensive and Certification Examination Preparation","authors":"Heather M. Bradford CNM, PhD,&nbsp;Melicia Escobar CNM, WHNP-BC, DNP,&nbsp;Kathryn Atkin WHNP-BC, ANP-BC, DNP,&nbsp;Ella T. Heitzler WHNP-BC, FNP-BC, RNC-OB, PhD","doi":"10.1111/jmwh.13784","DOIUrl":"10.1111/jmwh.13784","url":null,"abstract":"&lt;p&gt;Pass rates on national certification examinations (NCEs) vary by health care profession and specialty.&lt;span&gt;&lt;sup&gt;1-3&lt;/sup&gt;&lt;/span&gt; Pass rates serve as critical indicators for both the student and the graduate education program. Improving pass rates is a challenge because ensuring examination success requires not only quality education, but critical thinking and test-taking skills. There is extensive research indicating that well-designed practice tests can serve as valuable tools in preparing for health care professional NCEs.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Students of Accreditation Commission for Midwifery Education (ACME)-accredited midwifery and accredited women's health nurse practitioner (WHNP) education programs must successfully pass a comprehensive exam during their last term and meet program requirements to take the American Midwifery Certification Board (AMCB) and National Certification Corporation (NCC) WHNP NCEs, respectively, to become certified nurse-midwives/certified midwives (CNMs/CMs) or board certified WHNPs. AMCB overall certification pass rates have decreased from 91.8% in 2015 to 73.0% in 2024, and NCC WHNP overall certification pass rates have decreased from 94% in 2020 to 79.0% in 2024.&lt;span&gt;&lt;sup&gt;1, 6, 7&lt;/sup&gt;&lt;/span&gt; Consistent with national trends, AMCB and NCC pass rates among graduates of one large, distance-based education program also decreased.&lt;/p&gt;&lt;p&gt;In response to the pass rate trend and a goal to bolster students’ confidence, readiness, and knowledge, program leadership identified a critical need for an additional study resource. Consequently, over the course of 2 years, nurse-midwifery and WHNP faculty developed an online question bank of 600 multiple choice (MC) questions titled the &lt;i&gt;Review Portal&lt;/i&gt;. Practice review of MC questions has been found to be an effective study technique, assisting with recall and requiring active, engaged learning rather than passively absorbing information from textbooks.&lt;span&gt;&lt;sup&gt;8, 9&lt;/sup&gt;&lt;/span&gt; The &lt;i&gt;Review Portal&lt;/i&gt; was constructed in Canvas, a learning management system, and launched in 2018. It is a free resource to program students to assist with preparation for their comprehensive examinations and NCEs.&lt;/p&gt;&lt;p&gt;The design and development of the &lt;i&gt;Review Portal&lt;/i&gt; was unique in many ways (see Table 1). First, to promote optimal review of midwifery content, the percentage of items was mapped to the AMCB examination proportionally by content area (see Table 2). It was not originally mapped to the NCC WHNP certification examination since pass rates among program graduates were higher on the NCC WHNP examination compared with the AMCB examination. However, except for intrapartum and newborn care, the content for both examinations is similar, so the resource was offered to students preparing for both examinations. Second, specific topics within each content area were determined using the AMCB and NCC WHNP Candidate Handbook blueprints.&lt;span&gt;&lt;sup&gt;6, 10&lt;/sup&gt;&lt;/span&gt; Altho","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"812-814"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13784","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621618","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":"Qualitative Evaluation of a Statewide Implicit Bias Training for Maternal Health Professionals","authors":"Briana E. Kramer CNM, MS, MPH,&nbsp;Amy Ushry RN, MPH,&nbsp;Andreea A. Creanga MD, PhD,&nbsp;Nicole Warren CNM, PhD, MSN,&nbsp;Cheri Wilson MA, MHS,&nbsp;Kelly M. Bower RN, PhD, MSN","doi":"10.1111/jmwh.13783","DOIUrl":"10.1111/jmwh.13783","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In response to alarming and persistent perinatal health inequities, policymakers, professional organizations, researchers, and advocates have called for the widescale dissemination of implicit bias training (IBT) for health care professionals. However, evaluations of such trainings are lacking. This study examines maternal health care professionals’ self-reports of knowledge, awareness, and skills changes after completing an IBT developed specifically for this audience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a secondary analysis of qualitative responses to a posttest-only evaluation of a one-hour online IBT delivered to 2760 maternal health care professionals, 2257 (81.8%) of whom completed the evaluation survey. We applied reflexive thematic analysis to responses to 2 open-ended questions that directly addressed learning outcomes: (1) What did you learn that will help you in your practice? and (2) Please explain how this activity improved your competence. We then assessed the themes for alignment with Sukhera and Watling's conceptual framework for the integration of implicit bias recognition and management into training for health professionals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five themes identified were foundational knowledge, general awareness, self-awareness, skills and strategies, and practice change. These themes mapped onto 5 of the 6 domains of the conceptual framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>A one-hour online IBT can lead to intended learner outcomes that align with a theorized framework reflecting an individual-level progression from increasing knowledge about implicit bias to building sensitivity to the experiential effects of one's bias on others. Learner responses indicate that building awareness of structural drivers and fostering a sense of acceptance and personal responsibility to address implicit bias may be additional key training components.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"749-756"},"PeriodicalIF":2.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577455","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":"Development of a Community- and Patient-Engaged Maternal Health Equity Toolkit for Hospitals","authors":"Kelly M. Bower PhD, MSN, MPH, RN,&nbsp;Lauren A. Arrington CNM, DNP,&nbsp;Briana E. Kramer CNM, MPH, MS, RN,&nbsp;Noelene K. Jeffers CNM, PhD, IBCLC,&nbsp;S. Michelle Ogunwole PhD, MD,&nbsp;Tanay Lynn Harris","doi":"10.1111/jmwh.13771","DOIUrl":"10.1111/jmwh.13771","url":null,"abstract":"<p>Inequities in maternal health outcomes are persistent, widespread, and unacceptable. Despite growing awareness that health care organizations play a critical role in addressing the maternal health crisis and eliminating racial inequities in outcomes, hospitals report barriers and limitations in implementing policy changes. We developed a Maternal Health Equity Toolkit and provided hospital maternal care units and departments with a comprehensive systems-level approach to advance health equity. The toolkit offers hospitals access to curated guidance from leading professional, quality and safety, and advocacy organizations. Detailed action steps for operationalizing change ideas are included. This article describes the development process and the final toolkit structure and content.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"800-806"},"PeriodicalIF":2.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13771","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556289","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":"Research and Professional Literature to Inform Practice, July/August 2025","authors":"Amy Alspaugh CNM, PhD, MSN","doi":"10.1111/jmwh.13785","DOIUrl":"https://doi.org/10.1111/jmwh.13785","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 4","pages":"658-663"},"PeriodicalIF":2.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870071","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}