Journal of midwifery & women's health最新文献

{"title":"Trauma Exposure and Posttraumatic Stress Disorder in a Rural Perinatal Population","authors":"Michelle L. Miller PhD,&nbsp;Emma N. Cleary BA,&nbsp;Mahogany A. Monette MS,&nbsp;Rachel E. Emery MSN, FNP-BC, PMH-C,&nbsp;Anushay Ansari BA,&nbsp;Rilyn Wonnell,&nbsp;David M. Haas MD","doi":"10.1111/jmwh.70051","DOIUrl":"10.1111/jmwh.70051","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There is very limited information on the rates of trauma exposure and posttraumatic stress disorder (PTSD) symptoms for perinatal individuals who live in rural settings. Increasing understanding of traumatic experiences among rural-dwelling pregnant individuals may be an important avenue through which midwives can help address the care disparities and poor outcomes in this population. This study aimed to implement screening and estimate prevalence rates of trauma exposure and perinatal PTSD symptoms among individuals at a Midwestern rural obstetric clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants completed a brief screening measure that assessed demographics, trauma exposure, mental health knowledge and experience, and PTSD symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 421 patients screened, the mean age was 26.8 years, and 69.6% identified as White and 11.9% identified as Latina. Over half endorsed trauma exposure (53.0%). The most common types of traumatic events were death of a close family member or friend (36.1%) and childhood sex abuse (14.3%). About 1 in 4 trauma-exposed patients (25.6%) scored above the clinical threshold for probable PTSD (≥3 on the Primary Care PTSD Screen for DSM-5). The most endorsed PTSD symptom type was internal and external avoidance of trauma-related stimuli (32.4%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>A history of trauma exposure and perinatal PTSD symptoms were more common than expected when compared with both overall perinatal and rural population PTSD prevalence rates. Specific considerations were identified that facilitated successful screening in our rural population. Future clinical research with rural populations should consider: (1) broad implementation of PTSD symptom screening of perinatal patients and creation of a workflow that establishes follow-up steps for patients who screen positive; (2) development of training and psychoeducational materials for health care providers and patients to facilitate connection with brief trauma interventions; and (3) support of trauma-informed, stepped care models with a range of disciplines and provider types to help manage perinatal PTSD symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 1","pages":"87-94"},"PeriodicalIF":2.3,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145498120","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":"Masaje Perineal En El Embarazo","authors":"","doi":"10.1111/jmwh.70047","DOIUrl":"https://doi.org/10.1111/jmwh.70047","url":null,"abstract":"&lt;p&gt;El perineo es la zona entre la abertura vaginal y el recto. Esta zona se estira al dar a luz y, en ocasiones, el perineo o la vagina se desgarran durante el nacimiento del bebé. Si su proveedor médico realiza una episiotomía durante el parto, es esta zona la que corta. Es posible que necesite puntos de sutura después del nacimiento del bebé si tiene un desgarro o si se le realiza una episiotomía.&lt;/p&gt;&lt;p&gt;Aproximadamente entre 4 y 8 de cada 10 mujeres que dan a luz por vía vaginal presentan algún desgarro en el perineo. Aproximadamente dos tercios de estas mujeres necesitarán puntos de sutura.&lt;/p&gt;&lt;p&gt;La mayoría de las mujeres no necesitan una episiotomía. Aunque eran comunes antes de la década de 1990, hoy en día rara vez se realizan. Sin embargo, en ocasiones, el profesional de la salud puede recomendar una episiotomía justo cuando nace el bebé. Por ejemplo, una episiotomía puede ser útil si es necesario que un bebé nazca pronto. Puede pedirle a su proveedor de atención médica que hable con usted sobre la episiotomía durante una visita prenatal.&lt;/p&gt;&lt;p&gt;Se han realizado numerosas investigaciones acerca la prevención del desgarro perineal durante el parto. Diversos estudios de investigación han demostrado que el masaje perineal durante las últimas semanas del embarazo puede reducir la probabilidad de un desgarro en las mujeres primerizas. Este masaje, en el que se utilizan dos dedos para estirar los tejidos perineales, se realiza por la mujer o su pareja en casa una o dos veces por semana durante las últimas 4 a 6 semanas del embarazo. En la siguiente página se explica cómo realizarlo. Por cada 15 mujeres que se realizan un masaje perineal, una evitará una episiotomía y un desgarro perineal que requiera puntos de sutura. Mientras se masajea, puede practicar la relajación de los músculos del perineo. Esto puede ayudarla a prepararse para la sensación de estiramiento y ardor que podría sentir cuando nazca la cabeza de su bebé. Relajar esta zona durante el parto puede ayudar a prevenir el desgarro.&lt;/p&gt;&lt;p&gt;El masaje parece funcionar mejor en algunas mujeres que en otras. Las mujeres primerizas, las mayores de 30 años y las que se han sometido a episiotomías presentan menos desgarros y desgarros menos graves cuando se realiza el masaje perineal durante las últimas semanas del embarazo.&lt;/p&gt;&lt;p&gt;¡Sí! A muchas mujeres les resulta más fácil que sus parejas les realicen este masaje. Consulte las instrucciones para el masaje perineal a continuación para obtener más información.&lt;/p&gt;&lt;p&gt;No que sepamos. Es gratis. No duele. Es fácil de hacer. Y a la mayoría de las mujeres no les molesta hacerlo. No se debe estirar el perineo hasta el punto de que duela ni masajearlo con demasiada frecuencia ya que puede lastimar la piel de esa zona. No se realice el masaje perineal más de una o dos veces por semana. Las mujeres que lo realizan con más frecuencia no tienen un menor riesgo de desgarro perineal. Consulte con su médico antes de comenzar el masaje perineal. Y si cree que ","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 6","pages":"987-988"},"PeriodicalIF":2.3,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792425","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":"Policy Knowledge and Abortion Access for US Active-Duty Servicewomen: A Mixed-Methods Study","authors":"Caitlin Russell PhD, MBE, MSHP, WHNP-BC,&nbsp;Tiara Walz PhD, MHA, MBA, MSEd, FACHE,&nbsp;Laura Manzo PhD, MBA, MSN, CCRN,&nbsp;Shelby Mueller BSN,&nbsp;Sharon Messina,&nbsp;Sharon Arana,&nbsp;Keira Feng,&nbsp;Holly Harner PhD, MBA, MPH, RN, WHNP-BC, FAAN","doi":"10.1111/jmwh.70049","DOIUrl":"10.1111/jmwh.70049","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>More than 80,000 US military servicewomen are stationed in states enforcing abortion bans. US Department of Defense (DOD) policies must adhere to the Hyde Amendment, which restricts abortion coverage. Little research exists regarding active-duty servicewomen's (ADSW) knowledge of these policies or their experiences accessing abortion care. This study examines the reproductive health policy knowledge and lived experiences of ADSW who have accessed abortion care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 24-item questionnaire was designed to measure reproductive health policy knowledge and explore reproductive health experiences among ADSW. Via secondary analysis, a subset of 178 participants self-reported obtaining an abortion while on active duty. A convergent mixed-methods design (quantitative and qualitative) was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most participants (65%; n = 115) did not know TRICARE covered abortion costs in cases of rape or incest; 77% (n = 137) erroneously believed they required leadership permission to get an abortion; and 87% (n = 155) did not know they were entitled to convalescent leave to recover after an elective abortion. More than half (53%; n = 94) took personal leave to access abortion care; 46% (n = 82) traveled more than one hour; 48% experienced financial difficulties; 31% (n = 55) experienced negative professional repercussions; 16% (n = 29) received convalescent leave; 92% (n = 164) were not offered mental health counseling; and 77% (n = 137) felt they would have benefited from mental health counseling postabortion. Qualitative themes included a systemic lack of DOD abortion policy knowledge and lived experiences of accessing abortion care (eg, financial burdens, stigma).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Given the systemic lack of policy knowledge reported among study participants, the DOD should develop and implement a standardized abortion policy and access training for military health care professionals, leadership, and service members. Policies ensuring access to abortion should be adopted, codified, and implemented uniformly across all branches of service.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 1","pages":"46-53"},"PeriodicalIF":2.3,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454399","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":"Strengthening Perinatal Services Through Social Care: Outcomes of a Quality Improvement Initiative for a Health Center-Based Perinatal Care Program","authors":"Rebecca L. Emery Tavernier PhD, LP, PMH-C,&nbsp;Peyton Rogers MPH,&nbsp;Mia Shenkman,&nbsp;Aaliyah Moore BA,&nbsp;Briana Sailor BA,&nbsp;Veena Channamsetty MD,&nbsp;Yvette Highsmith MM,&nbsp;Margaret Flinter PhD, NP","doi":"10.1111/jmwh.70042","DOIUrl":"10.1111/jmwh.70042","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Given the prevalence and consequences of unmet social needs in perinatal populations, there is a critical demand for perinatal care that addresses social needs. To better support health systems in providing comprehensive social and perinatal care services, this quality improvement initiative uses the Donabedian model for care quality to describe the structure, process, and outcomes of embedding an innovative perinatal care program with integrated social care into an established primary care center.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Process</h3>\u0000 \u0000 <p>The Improving Maternal Outcomes Now! (IMON) program was designed to address the clinical and health-related social needs of patients at highest risk of maternal health disparities. The IMON program offers holistic prenatal and postpartum care through the provision of midwifery services, obstetrician support, intensive social needs support, and around-the-clock virtual care. Program implementation began in June 2023 at a federally qualified health center.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes</h3>\u0000 \u0000 <p>During the first 18 months of implementation, 102 pregnant patients received prenatal care. Forty-four percent of patients identified as Hispanic, with more than half (54%) reporting Spanish as their preferred language. Patients were highly engaged with program services. Nearly two-thirds of IMON patients (65%) initiated prenatal care in their first trimester, and most (91%) were assisted with social needs during or after pregnancy. A majority (88%) enrolled to receive adjunctive virtual care services. Among the 61 patients who gave birth, 77% did so vaginally, whereas the remaining 23% did so via cesarean birth. On average, patients gave birth at 39 weeks’ gestation, with only 5% giving birth preterm and 3% having a newborn that was small for gestational age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Preliminary findings suggest that IMON can be implemented within a safety-net setting, with high patient engagement and social needs support. Early outcomes show promising maternal and neonatal health indicators.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 1","pages":"135-142"},"PeriodicalIF":2.3,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395959","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 Facilitators to Colposcopy Follow-up After Abnormal Cervical Cancer Screening: Qualitative Insights From an Urban Health Care Setting","authors":"Jaqueline Serrano Aguilar MD,&nbsp;Hunter K. Holt MD, MAS,&nbsp;Caroline Beshers MD,&nbsp;Kelley Baumann MPH,&nbsp;Maria Valle Coto MD,&nbsp;Gelila Goba MD, MPH,&nbsp;Priyanka Gokhale MD","doi":"10.1111/jmwh.70041","DOIUrl":"10.1111/jmwh.70041","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Delays to colposcopy increase the risk for cervical cancer development. Our study sought to understand the barriers and facilitators to follow-up after an abnormal cervical cancer screening test result.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>English-speaking adult patients who did not attend at least one of their scheduled appointments at an urban academic colposcopy clinic between June 2021 and June 2023 were eligible. Semistructured interviews were conducted, and thematic analyses using inductive and deductive coding were completed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty women were interviewed. The mean (SD) age was 34 (10) years, and participants mainly identified as non-Hispanic Black (60%). The mean (SD) time to colposcopy was 12.5 (11.9) months. Seven participants did not have a follow-up colposcopy at the time of the interview. Five categories of themes emerged at the individual, interpersonal, clinic, and system level, including (1) fear of pain and/or pelvic examinations, (2) patient-provider communication (including result communication), (3) clinic interactions (including presence of trainees and lack of continuity), (4) scheduling difficulties, and (5) system-level barriers such as loss of insurance coverage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Barriers to follow-up care exist across multiple levels. A one-size-fits-all approach may be ineffective for facilitating follow-up; rather, a multipronged approach may be needed to improve adherence and reduce delays to follow-up care after an abnormal cervical cancer screening test result.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 1","pages":"39-45"},"PeriodicalIF":2.3,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395945","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":"Development of the Preparation for Community-Based Labor and Birth Instrument Centering Black Perspectives in the United States: A Participatory Adaptation","authors":"Ashley Mitchell MPH, CPE,&nbsp;Nikia Grayson CNM, DNP, MSN, MPH, MA, FNP-C,&nbsp;Patience A. Afulani PhD, MBChB, MPH,&nbsp;Kimberly Baltzell RN, PhD, MS,&nbsp;Carrie Neerland CNM, PhD, APRN,&nbsp;Alden Hooper Blair PhD, MS,&nbsp;Alexis Dunn Amore CNM, PhD","doi":"10.1111/jmwh.70040","DOIUrl":"10.1111/jmwh.70040","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Community-based birth supported by midwives and nurses is increasing in the United States amid stark racial disparities in maternal outcomes and worsening access to pregnancy care. Although studies examining prenatal confidence have shown that persons with higher confidence are more likely to give birth vaginally, reporting less pain, anxiety, and dissatisfaction, existing measurement tools have focused on hospital births. Accordingly, we adapted the previously validated Preparation for Labor and Birth (P-LAB) instrument, which measures third-trimester confidence for physiologic birth, for community-based births, centering the perspectives of Black populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Expert stakeholders (N = 5) including practicing midwives and maternal health researchers assessed the relevance and completeness of the P-LAB. Following individual reviews, stakeholders adapted the tool during a group review session. Virtual cognitive interviews were then conducted with community stakeholders (N = 10), prenatal and newly postpartum persons, to test comprehensibility, informing further adaptation of P-LAB items. Findings were summarized and analyzed using an abbreviated framework method. A subset of community stakeholders (N = 5) pretested the final instrument for redundancy and appropriateness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The iterative adaptation process informed removal of irrelevant items (N = 6), further clarification of existing items (N = 12), and the generation of additional items (N = 7). The final instrument, the Preparation for Community-Based Labor and Birth (P-CLAB), is a 23-item, Likert-response survey. Expert stakeholder engagement resulted in replacing medication-focused measures with items related to safety, dignity, and racial concordance while incorporating language aligning with the midwifery model of care. Community stakeholder engagement highlighted unclear items and opportunities to improve relevance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>In addition to promising utility for research, measuring prenatal confidence may equip midwives and nurses to further engage in person-centered care by addressing maternal fears and empowering patients according to their specific needs. The participatory P-CLAB adaptation enhances the instrument's utility and applicability to community-based care settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 1","pages":"76-86"},"PeriodicalIF":2.3,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395957","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":"Journal Award Winners Ad 2025","authors":"","doi":"10.1111/jmwh.70045","DOIUrl":"https://doi.org/10.1111/jmwh.70045","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145297435","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":"What Indigenous Women Want in Pregnancy and Birth: Perspectives on Care Preferences Across the United States","authors":"Karina Bañuelos MA,&nbsp;Mona Zuffante PhD,&nbsp;Paul Masotti PhD,&nbsp;Cheyenne Seneca MA,&nbsp;Shannon Maloney PhD","doi":"10.1111/jmwh.70037","DOIUrl":"10.1111/jmwh.70037","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although awareness of respectful maternity care is increasing, international maternal and newborn care standards often overlook culture as a key component of respectful care. Indigenous communities may have unique pregnancy care needs due to cultural and lived experience differences from the broader US population, yet little is known about Indigenous preferences for pregnancy care. We must articulate a vision for positive pregnancy care among Indigenous people in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In partnership with Indigenous academic researchers, a Tribal Health Department, and a Native-serving health center, the research team conducted a qualitative descriptive study informed by Indigenous research methodologies to explore the care preferences of Indigenous persons throughout pregnancy. We recruited participants from all 12 Indian Health Service regions, including Hawai'i. The senior author conducted semi-structured interviews with 27 Indigenous women to gather insights on their aspirations related to place, people, and the provision of pregnancy care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 3 overarching themes that describe Indigenous women's preferences for pregnancy care: rights and validity; safety, dignity, and humanity; and pregnancy care options. Although we identified common themes that Indigenous women share with the broader population, there are specific and unique preferences for comprehensive wraparound services, for the ability to incorporate Indigenous birthing practices, and for health systems to reposition themselves to be emotionally, spiritually, and physically safe institutions for Indigenous women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings highlight the need for a culturally centered approach to maternity care, urging health systems to adopt policies and practices that better support Indigenous women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 1","pages":"8-16"},"PeriodicalIF":2.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294948","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":"Plan de Parto","authors":"","doi":"10.1111/jmwh.70003","DOIUrl":"https://doi.org/10.1111/jmwh.70003","url":null,"abstract":"<p>Un plan de parto es una declaración escrita de sus metas y de lo que es importante para usted durante su trabajo de parto y cuando esté dando a luz. Un plan de parto describe la experiencia que espera tener y cómo desea recibir apoyo de quienes le atienden.</p><p>Durante una de las consultas de seguimiento prenatal puede compartir y revisar su plan de parto con su partera u otro proveedor de atención prenatal. Cuando el plan esté completo, es posible que su proveedor querrá colocar una copia en su expediente prenatal. Usted también debería conservar una copia para compartirla con los proveedores que la cuiden cuando esté en trabajo de parto.</p><p><i>Ventajas</i>: Desarrollar un plan de parto le permite aprender acerca de sus opciones antes de estar en trabajo de parto y comunicar con sus proveedores y familia sus objetivos e ideas acerca de estas opciones. El revisar con su partera/proveedor de atención medica el plan de parto durante una visita prenatal le brinda la oportunidad de informarse acerca de los procedimientos de rutina en el lugar donde dará a luz antes del parto, lo cual le permite estar mejor preparada.</p><p><i>Desventajas</i>: Puede sentirse decepcionada si las cosas que enumera en su plan de parto no suceden. No hay certeza que su plan se llevará a cabo en todos los aspectos porque muchas cosas inesperadas pueden suceder durante el trabajo de parto y el nacimiento. Si su trabajo de parto se complica, puede necesitar intervenciones que quizás esperaba evitar.</p><p>Asistir a clases de preparación al parto, hablar con familiares o amigos que hayan dado a luz en el lugar donde usted dará a luz, hablar con una doula (persona de apoyo durante el embarazo y el parto), leer libros y buscar información en sitios web sobre el embarazo son algunas de las maneras de informarse acerca de las opciones disponibles para usted. También puede platicar con su proveedor y con amigos o familiares que tengan valores similares a los suyos mientras considera sus opciones. Puede visitar el hospital o centro de parto donde planea dar a luz para que le puedan explicar los procedimientos de rutina que puede anticipar.</p><p>Approved July 2025.</p><p>This handout may be reproduced for noncommercial use by health care professionals to share with patients, but modifications to the handoutare not permitted. The information and recommendations in this handout are not a substitute for health care. Consult your health careprovider for information specific to you and your health.</p><p>La información y las recomendaciones en este documento no sustituyen la atención médica. Consulte con su proveedor de atención médicapara obtener información específica para usted y su salud.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"833-834"},"PeriodicalIF":2.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145297108","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":"Community-Based Initiatives to Improve Maternal and Newborn Health in High-Income Settings: A Mixed-Methods Systematic Review","authors":"Elise Robinson RM, MPH,&nbsp;Aradhna Kaushal PhD, MSc, BSc,&nbsp;Joanna Drazdzewska MSc, BA","doi":"10.1111/jmwh.70023","DOIUrl":"10.1111/jmwh.70023","url":null,"abstract":"<p><b>Introduction</b>: Although community-based interventions, including Participatory Learning and Action (PLA) groups, have demonstrated significant success in improving maternal and newborn health outcomes and promoting equity in low to middle-income countries, the evidence in high-income settings remains limited. This systematic review, carried out in collaboration with Women and Children First (a UK-based charity focusing on improving the lives of women and children globally), explores community-based initiatives that are currently used in high-income countries (HICs) to enhance maternal and newborn health, as well as the effectiveness of these initiatives in improving maternal and newborn health outcomes. Additionally, the review aims to examine the relationship between community-based initiatives and PLA methodology.</p><p><b>Methods</b>: This is a mixed-method systematic review with a narrative synthesis of results. MEDLINE, Embase, CINAHL, and MIDIRS databases were searched for community-based initiatives for any maternal and neonatal health outcome between 2000 and 2023. Both quantitative and qualitative studies were included and assessed for methodological quality using the Mixed-Methods Appraisal Tool. A convergent results-based synthesis approach was used.</p><p><b>Results</b>: A total of18 studies were included for review. Three main types of community-based interventions were identified: peer support, social support, and health education. Most interventions had beneficial effects on their maternal and neonatal health outcomes of interest. Qualitative analysis revealed 4 main aspects of peer support—connectedness, emotional validation, self-efficacy, and information sharing—which helps to explain the positive effects of peer support, particularly for breastfeeding and maternal mental health. The community-based initiatives linked to PLA methodology in some ways but were lacking in promoting community mobilization since the majority were aimed at the individual or group level, as opposed to engaging whole communities.</p><p><b>Discussion</b>: Community-based initiatives can be effective in HICs for improving aspects of maternal and neonatal health, particularly maternal mental health and breastfeeding. There is very limited research on more participatory community-based initiatives, such as PLA, in HICs that promote community-wide engagement and mobilization. Further research is needed in this area.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 1","pages":"54-69"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194295","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}