Journal of midwifery & women's health最新文献

{"title":"Supporting Labor After 2 Cesarean Births","authors":"Bridget Forte RN, BSN,&nbsp;Stephanie Welsh CNM, DNP, MSN,&nbsp;Jenna A. LoGiudice CNM, PhD, RN","doi":"10.1111/jmwh.13721","DOIUrl":"10.1111/jmwh.13721","url":null,"abstract":"<p>Labor after cesarean (LAC) is a safe alternative for pregnant persons who have had 1 or 2 previous cesarean births (CBs) and have no contraindication to vaginal birth. When compared with repeat CB, vaginal birth after cesarean (VBAC) reduces short- and long-term health complications and morbidity and should therefore be presented as an option. Despite recommendations from the American College of Nurse-Midwives and the American College of Obstetricians and Gynecologists in support of LAC, not all pregnant persons who are candidates have access to this option. In some areas, provider hesitancy and institutional guidelines limit the availability of LAC, especially after more than one CB. Midwives are uniquely positioned to advocate for this birthing option through the use of shared decision-making. In the antepartum period, birth decision aids, VBAC calculators, and continued dialogue allows for pregnant persons to make informed choices meeting their unique health needs and goals. This clinical rounds article highlights the safety of labor in a pregnant person with a history of 2 prior CBs. As presented in this case, when LAC includes the need for induction of labor, the use of a transcervical balloon catheter for cervical ripening and judicious use of oxytocin are safe, evidence-based options. Ultimately, LAC can offer pregnant persons an increased sense of autonomy and control over their labor and birth, which improve both satisfaction and outcomes, consistent with the family- and person-centered hallmarks of midwifery care.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 2","pages":"350-355"},"PeriodicalIF":2.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13721","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815405","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":"Preserving the Midwifery Model of Care on a High Acuity Labor and Delivery Unit: Midwives’ Perspectives Working in a US Tribal Health System","authors":"Anjali Madeira CNM, DNP, MPH,&nbsp;Kimberly Fleming CNM, MA/MSN, MPH,&nbsp;Megan Webb CNM,&nbsp;Heather Wheelock CNM, WHNP-BC","doi":"10.1111/jmwh.13716","DOIUrl":"10.1111/jmwh.13716","url":null,"abstract":"<p>Today nearly 9 out of 10 certified nurse-midwives/certified midwives (CNMs/CMs) attend births in hospitals. As the demand for hospital midwifery care has increased over the last quarter century, CNM/CMs' scope of practice has expanded to include care for high-risk patients. Hospital CNMs/CMs are faced with the challenge of balancing support for physiologic birth with an increasingly complex pregnant population cared for in a medicalized ecosystem. Varied perceptions of patient risk and unique philosophies of care can lead to complex discussions between midwives and physicians on the most appropriate care plan for patients. This article shares the experiences and successes of a hospital midwifery practice in the Alaska Native Tribal Health System and explores strategies for promoting the midwifery model of care (MMOC). Midwives in this Tribal Health System experience robust interprofessional collaboration and an organizational focus on patient-centered relationship-based care. Interprofessional collaboration is noted to be among the most critical elements for protecting a MMOC in a hospital setting. Although distinct from one another, the medical and midwifery models can be complementary in the care of high-risk patients, and the Indigenous concept of Two-Eyed Seeing is offered as an approach to integrating the 2 models of care to achieve optimal care for birthing people and their families.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 2","pages":"336-342"},"PeriodicalIF":2.1,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13716","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796646","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":"Challenges in Antenatal Care (2024-002JMWH)","authors":"","doi":"10.1111/jmwh.13718","DOIUrl":"10.1111/jmwh.13718","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"985-987"},"PeriodicalIF":2.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788219","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":"A Qualitative Study of Postpartum Women's Lived Experiences During COVID-19","authors":"Christine Toledo PhD, MSN, APRN, FNP-C,&nbsp;Narciso Quidley-Rodriguez PhD, BSN, RN,&nbsp;Rosina Cianelli PhD, MPH, RN, IBCLC,&nbsp;Natalia Villegas Rodriguez PhD, MSN, RN, IBCLC","doi":"10.1111/jmwh.13704","DOIUrl":"10.1111/jmwh.13704","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>According to the Centers for Disease Control and Prevention, the state of Florida became the epicenter of the COVID-19 delta variant during the summer of 2021. There is limited knowledge on how the pandemic impacted postpartum women's lived experiences in the United States. The purpose of the study was to explore the lived experiences of postpartum women living in South Florida during the COVID-19 pandemic and their responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A descriptive qualitative study design was used. Study participants included 26 postpartum women living in South Florida who had given birth to a live newborn from March 2020 to May 2022. We used purposeful sampling and social media recruitment methods. Sociodemographic information was collected using REDCap, and live face-to-face in-depth interviews were conducted on Webex using a semistructured questionnaire. Content analysis was used to analyze the research data and develop themes and subthemes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The first central theme, raising an infant during a pandemic, included 3 subthemes: (1) protecting the infant, (2) feeling isolated, and (3) food for thought. The second central theme, maternal needs during a pandemic, included 3 subthemes: (1) mental health needs, (2) support needs, and (3) health care needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings suggest women experienced significant challenges in caring for themselves and their infants during the COVID-19 pandemic. Findings highlight the need for policy reform that secures comprehensive and quality postpartum health care for women that includes mental health screenings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 2","pages":"308-314"},"PeriodicalIF":2.1,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13704","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775786","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":"An Integrative Review of Exclusive Breast Milk Expression","authors":"Kimberly Rosenbaum MSN, RN, RNC-OB, C-EFM, IBCLC,&nbsp;Barbara McAlister CNM, PhD, RN","doi":"10.1111/jmwh.13713","DOIUrl":"10.1111/jmwh.13713","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A growing number of families are using exclusive breastmilk expression to feed their newborns. They need accurate information and support from their providers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The purpose of this integrative review was to explore the prevalence, characteristics, practices, and outcomes of families who fed exclusively expressed breastmilk to their infants. The electronic databases of CINAHL, Scopus, PubMed, Web of Science, and article reference lists for articles on expressing human milk for infants were searched. Results were filtered to glean published studies between 2012 and 2022, academic journals, human studies, and English language journals while excluding secondary reviews and expert opinions. Both authors screened records within Covidence systematic review management software. Selected studies were evaluated for quality of evidence using the Johns Hopkins Research Evidence Appraisal Tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-seven studies were included in this review. Most families who exclusively expressed originally planned to directly breastfeed their newborns and only began pumping after encountering problems. The most frequently recurring theme was that advice from health care personnel was inconsistent. Women described a knowledge deficit and received more help with exclusive expression from informal social media groups than their providers. Prevalence of exclusive breastmilk expression is highest in Asian countries and in the neonatal intensive care unit environment. These women had a shorter duration of human milk feeding and higher likelihood of cessation compared with women who both fed expressed milk and directly breastfed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Only recently have breastfeeding researchers begun distinguishing the type of milk (human milk or artificial formula) from the feeding method in their publications. This approach allows clinicians to provide better guidance on the outcomes of each feeding method. As clinicians, we can help families by encouraging them and providing consistently accurate information. Solely feeding expressed human milk is a valid option when the lactating person is unable or unwilling to directly breastfeed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 2","pages":"325-335"},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13713","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775730","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":"Challenges for Antepartum Care of the Individual with Perinatal Substance Use: An Empirical Integrative Review of Novel Approaches to Improve Care","authors":"Lauren Taylor Narbey CNM, MSN, WHNP-BC,&nbsp;Alice Curtis Cline CNM, MSN","doi":"10.1111/jmwh.13714","DOIUrl":"10.1111/jmwh.13714","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Perinatal substance use continues to rise across the United States presenting unique challenges to providing antepartum care. Polysubstance use, limited and late engagement in health care, co-occurring mood disorders, and several social barriers are well documented. This review seeks to summarize these barriers and present novel approaches to caring for this high-risk population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Inclusion criteria for this study focused on peer-reviewed articles that explicitly detailed a direct impact on the provision or receipt of antenatal care in the setting of substance use within the United States that were published in the last 5 years. PubMed and Web of Science were used to find applicable articles. Of the 156 articles found, 10 relevant articles were selected for the final empirical integrative review that entailed data evaluation using the Mixed Methods Appraisal Tool (MMAT) and thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>10 review articles met inclusion; 3 were qualitative, 6 were quantitative and nonrandomized, and one was quantitative descriptive. Six articles met MMAT quality criteria, and there were significant limitations in every article. Topics included opioid use disorder (n = 6), general substance use (n = 3), and tobacco use (n = 1). Themes included integrated models of prenatal care, colocated care, resource coordination, and peer support along with the role of the perinatal health care professional and consistent use of a substance use screening tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>A comprehensive and multidisciplinary care model is necessary to meet the complex and urgent needs of individuals with perinatal substance use that not only meets recommendations for opioid maintenance therapy or substance use cessation but the important areas of accessibility and interpersonal support. Future research should focus on the development, implementation, and evaluation of new models of care for this vulnerable population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"863-874"},"PeriodicalIF":2.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741897","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":"Center M Pilot Trial: Integrating Preventive Mental Health Care in Routine Prenatal Care","authors":"Ellen L. Tilden CNM, PhD,&nbsp;Taylor Shank PhD,&nbsp;Catherine Polan Orzech MA LMFT,&nbsp;Leah R. Holmes BA,&nbsp;Ravyn Granados BA,&nbsp;Sayehsadat Moosavisahebozamani MS,&nbsp;David Starr MBA,&nbsp;Aaron B. Caughey PhD, MD,&nbsp;Alice M. Graham PhD,&nbsp;Kristen L. Mackiewicz Seghete PhD","doi":"10.1111/jmwh.13709","DOIUrl":"10.1111/jmwh.13709","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Perinatal depression is a leading cause of preventable US maternal morbidity and mortality. Although Mindfulness-Based Cognitive Therapy for Perinatal Depression (MBCT-PD) is highly effective, it faces significant scalability challenges. Center M, a brief, group-based, mindfulness-based cognitive behavioral therapy (CBT) intervention, is an adaptation of MBCT-PD designed to overcome these challenges. The purpose of this pilot study was to evaluate Center M's preliminary acceptability, feasibility, mechanisms of action, and efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this mixed-methods pilot study, data were collected from 99 pregnant people at 3 time points: preintervention, postintervention, and 6-weeks postpartum (Clinical Trials no. NCT06525922). Participants engaged in 4 one-hour, weekly group telehealth Center M sessions facilitated by social workers. Participants strengthened mindfulness CBT skills using home practice materials between group sessions. Data included self-report measures evaluating depressive symptoms, mindfulness skills, and emotion regulation. Satisfaction was assessed via focus groups or surveys.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Depressive symptoms significantly decreased preintervention to postintervention (Patient Health Questionnaire-8 score: preintervention mean [SD] 5.02 [3.52], postintervention mean [SD] 4.23 [2.84]; <i>P</i> = .03), and mindfulness capacity significantly increased preintervention to 6 weeks postpartum (Five Facets of Mindfulness Questionnaire score: preintervention mean [SD] 125.56 [18.68], 6 weeks postpartum mean [SD] 130.10 [17.15]; <i>P</i> = .004). Linear regression analyses indicate that higher mindfulness at 6 weeks postpartum significantly predicted fewer depression symptoms at 6 weeks postpartum (β, −0.07; 95% CI, −0.123 to −0.021, <i>R²</i> = 0.22; <i>P</i> = .006). Reduction in the use of maladaptive emotion regulation was significantly associated with decreased depressive symptoms at 6 weeks postpartum (β, 0.21; 95% CI, 0.048 to 0.376, <i>R²</i> = .21; <i>P</i> = .012). Qualitative themes indicated high Center M acceptability and appeal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings support the feasibility, acceptability, and appeal of Center M. Results suggest Center M may be effective in reducing depression and enhancing mindfulness skills. Future research must confirm these initial findings to more widely address Center M implementation capacity and sustainability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"906-916"},"PeriodicalIF":2.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735462","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":"Implementing Food Security Screening in all Pregnant Women: Call to Action","authors":"Jennifer Woo CNM, PhD, WHNP,&nbsp;Divya Parmar RN,&nbsp;Valeria Millinga MS,&nbsp;Tracie Kirkland PhD, DNP, ANP, PNP","doi":"10.1111/jmwh.13708","DOIUrl":"10.1111/jmwh.13708","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"826-831"},"PeriodicalIF":2.1,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717885","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 and Testing of the Comprehensive Prenatal Care Index: Relationship With Preterm Birth and Small for Gestational Age Across Racial and Ethnic Groups","authors":"Sueny P. Lima dos Santos MS,&nbsp;Eric E. Calloway PhD, RDN,&nbsp;Ilana R. A. Chertok PhD, MSN, RN, IBCLC,&nbsp;Zelalem T. Haile PhD, MPH","doi":"10.1111/jmwh.13707","DOIUrl":"10.1111/jmwh.13707","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Preterm birth and small for gestational age (SGA) are significant public health concerns in the United States, with pronounced disparities across racial and ethnic groups. Traditional prenatal care adequacy indices have limitations in fully capturing their multifaceted nature. Our study introduces the Comprehensive Prenatal Care Index (CPCI) to provide a more holistic assessment of prenatal care by integrating key elements of prenatal counseling and health promotion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study used the Pregnancy Risk Assessment Monitoring System 2016-2021 data. The CPCI was developed based on a comprehensive literature review, incorporating components such as timing, frequency, and content of prenatal visits. The index was validated using Item Response Theory (IRT) and compared with the Kotelchuck and Kessner Indices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 139,181 pregnant women. The CPCI demonstrated strong internal consistency (Cronbach's α, 0.75; ω total, 0.81). IRT analysis confirmed the index's ability to capture variability in the quality of prenatal care, with item difficulty parameters ranging from −2.93 to +2.10. CPCI scores were significantly associated with reduced odds of adverse birth outcomes. Adequate CPCI care was linked to a 63% reduction in the odds of preterm birth among non-Hispanic White women, with similar reductions observed in Hispanic women (odds ratio [OR], 0.59) and Asian women (OR, 0.38). For SGA, adequate care was protective among non-Hispanic White (OR, 0.86) and Hispanic women (OR, 0.82) but showed mixed results in other groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The CPCI provides a more inclusive measure of the quality of prenatal care compared with traditional indices. The study's findings suggest a significant role of comprehensive prenatal care in reducing adverse birth outcomes and addressing racial and ethnic disparities. Future research should focus on refining the CPCI and exploring its applicability in diverse populations to inform targeted and culturally sensitive prenatal care strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"917-928"},"PeriodicalIF":2.1,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734969","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":"Family-Centered Antenatal Care With a Life-Limiting Fetal Condition: A Developmental Theory-Guided Approach","authors":"Carrie J. Henry CNM, PhD, RN,&nbsp;Denise Côté-Arsenault PhD, RN, CPLC","doi":"10.1111/jmwh.13710","DOIUrl":"10.1111/jmwh.13710","url":null,"abstract":"<p>Trisomy 18 (T18) is the second-most common autosomal trisomy and includes multiple anomalies, growth restriction, and a severely shortened life span, often lasting only hours or days. Côté-Arsenault and Denney-Koelsch extended Reva Rubin's work, describing the psychosocial stages of pregnancy by describing the stages and developmental tasks for a pregnancy altered by a life-limiting fetal condition such as T18. When a diagnosis of T18 is made prenatally, the pregnancy changes dramatically, although it remains a psychosocial developmental process. The extended stages of pregnancy with T18 or another life-limiting fetal condition are: <i>Pre-Diagnosis, Learning the Diagnosis, Living With the Diagnosis, Birth and Death</i>, and <i>Post Death</i>. As they navigate these stages, parents must also address 7 developmental tasks of pregnancy, which are (1) <i>Navigating Relationships</i>, (2) <i>Comprehending Implications of the Condition</i>, (3) <i>Revising Goals of Pregnancy</i>, (4) <i>Making the Most of Time With Baby</i>, (5) <i>Preparing for Birth and Inevitable Death</i>, (6) <i>Advocating for Baby With Integrity</i>, and (7) <i>Adjusting to Life in Absence of Baby</i>. Knowledgeable health care providers can do much more than support parents through grief and facilitate discussions about birth planning. This case report highlights the importance of a knowledgeable provider who can help parents navigate the stages and tasks of pregnancy, empowering them to make choices consistent with their values so they have no regrets.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"958-962"},"PeriodicalIF":2.1,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717882","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}