Journal of midwifery & women's health最新文献

{"title":"Solidarity, Justice, and the Future of Midwifery at the International Confederation of Midwives 34th Triennial Congress","authors":"Melissa D. Avery CNM, PhD, Melicia Escobar CNM, WHNP-BC, DNP, Mari-Carmen Farmer CNM, WHNP-BC, MSN","doi":"10.1111/jmwh.70165","DOIUrl":"10.1111/jmwh.70165","url":null,"abstract":"<p>The 34th International Confederation of Midwives (ICM) Congress wrapped on June 18, 2026. A March for Midwives along the banks of the Tagus River welcomed midwives to Lisbon. Representing more than 120 countries, midwives processing with their colorful flags marked the official opening of the congress. Hallway greetings and conversations with friends new and old bookended formal sessions. Imagine a week of celebration, connection, education, and protest, filled with sharing of ideas and strategic organizing to strengthen midwifery around the world. More than 250 US midwives, including approximately 40 midwives of color, represented the American College of Nurse-Midwives (ACNM) and the National Association of Certified Professional Midwives (NACPM). As your eyes and ears on the proceedings at the ICM Congress, each author has shared a summary of their individual reflections.</p><p>The Congress theme was <i>One Million More Midwives</i><span><sup>1</sup></span> to increase autonomous midwifery practice worldwide by educating 1,000,000 more midwives to ICM standards. This goal also includes building on the strong record of research showing the positive impact of midwifery models of care, urged by the World Health Organization (WHO), in advancing the health of families and communities, preventing stillbirths, and using fiscal resources more effectively.<span><sup>2</sup></span></p><p>ICM is an organization of midwifery associations, representing more than 130 midwifery associations in 116 countries. ACNM and NACPM are the 2 US member associations. ICM promulgates formal statements and develops resources under the Professional Framework for Midwifery to support midwifery associations, regulation, and education. For example, in the United States, the ACNM Core Competencies for Basic Midwifery Practice are consistent with the ICM Competencies.<sup>3</sup> ICM also provides resources for midwifery advocacy, education program development, and a commitment to gender equality, justice, equity, diversity, and inclusion.</p><p>As an ICM member association, ACNM appoints 2 voting delegates to attend a 3-day preconference council meeting. The council is part of the ICM governing body and provides guidance on strategic priorities, debates key issues, and votes on motions and resolutions. The ACNM delegates were Jessica Brumley, Immediate Past President, and Pandora Hardtman, Vice President. A precouncil meeting vote had resulted in passing a motion to temporarily rescind the ICM Statement on Indigenous Midwifery. During the Americas region meeting, it became clear that this topic had not received sufficient opportunity for dialogue or debate. Many council delegates from the Americas region and beyond were prepared to support the Indigenous midwives in their protest of this ICM action. This moment of protest and solidarity was one of the most memorable and meaningful of this Triennial Congress.</p><p>So, let's return to the Congress! Attending the ICM congress","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"503-505"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611653","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":"Establishment of an Early Pregnancy Care Clinic","authors":"Megan E. V. Mussell CNM, DNP, APRN,&nbsp;Julie A. Lamppa CNM, MSN, APRN,&nbsp;Rebecca M. Smith CNM, PhD, APRN","doi":"10.1111/jmwh.70123","DOIUrl":"10.1111/jmwh.70123","url":null,"abstract":"<p>Early pregnancy loss can have a profound impact on the lives of women and their families, but the experience is often underacknowledged, with the diverse and complex needs of these women not always being met. Health care providers are in a unique position to provide support, helping each woman navigate through what is often a significant event in her lifetime.</p><p>In response to these gaps, a large academic medical center in the upper Midwest established the Early Pregnancy Care (EPC) Clinic in 2019 as a subclinic of the Department of Obstetrics and Gynecology. The goal of the EPC Clinic is to standardize the management of early pregnancy loss and related concerns to ensure each woman receives timely, holistic, and patient-centered care that fully encompasses the physical and emotional needs of the patient and her family.</p><p>The EPC Clinic is run by a small, dedicated team of certified nurse-midwives and registered nurses in collaboration with a multidisciplinary team, providing comprehensive care to women with a confirmed early pregnancy loss, first trimester bleeding, pregnancy of unknown location, inconclusive viability, or a history of a prior early pregnancy loss, including ectopic and molar pregnancies. Team members coordinate timely visits and evaluation, offer comprehensive management options, and provide bereavement care and resources. Follow-up care is arranged to monitor each woman's physical and emotional recovery following a loss, including check-ins with consistent members of the team to maintain continuity of care.</p><p>Anecdotal evidence as well as Press-Ganey surveys obtained from patients and their families have demonstrated the exceptional value of the EPC Clinic. In this article, we outline our EPC Clinic's components and processes and discuss strategies that may benefit other health care systems aspiring to develop similar programs to improve early pregnancy loss care and the patient experience.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"652-656"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694441","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 Neonatal Transfer from Birth Center to Hospital with a Postpartum Hemorrhage During Transport","authors":"Lorraine M. Garcia CNM, PhD, WHNP-BC,&nbsp;Marsha Matsunaga-Kirgan MD","doi":"10.1111/jmwh.70098","DOIUrl":"10.1111/jmwh.70098","url":null,"abstract":"<p>There is increasing interest from women and birthing people for midwifery-led care with community birth options in birth centers and for home birth. Birth centers are a high-value and high-quality option for place of birth and also address the increasing need to provide access to perinatal care for women in maternity care deserts. This case report reviews the transfer of a postpartum patient and her newborn from an accredited, freestanding birth center to the designated hospital. The reasons for transfer were neonatal respiratory distress with hypoxemia and an emergent postpartum hemorrhage that was initially reported as a stable maternal transfer to be admitted with the neonate. The newborn was treated for meconium aspiration syndrome in the neonatal intensive care unit while the patient was treated for uterine atony and a cervical laceration as the causes of the postpartum hemorrhage. This case review demonstrates the importance of efficient hospital transfers with skilled care for perinatal emergencies during transport, effective interprofessional collaboration, and quality improvement actions for complications that required transfer to the hospital for treatment. This case review emphasizes the importance of accurate and prioritized communication within the birth center team and between emergency services and receiving hospital clinicians as dynamic changes in patient status occur. The clinical reasons for transfer, along with the transfer process, must be examined for areas of improvement when emergent medical complexity necessitates a hospital transfer for medically matched treatment.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"663-667"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492364","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":"Integrating Hepatitis C Treatment in the Postpartum Setting: A Call for Practice Innovation","authors":"Daisy Goodman CNM, DNP, MPH, CARN-AP,&nbsp;Taylor Cooper BA,&nbsp;Micah Ulrich MD,&nbsp;Meagan Adams CHW,&nbsp;David de Gijsel MD, MSc, MPH","doi":"10.1111/jmwh.70124","DOIUrl":"10.1111/jmwh.70124","url":null,"abstract":"<p>Hepatitis C virus (HCV) affects an estimated 50 million people worldwide. Prevalence among persons who are pregnant has increased 161% between 2009 and 2017, largely driven by increasing maternal injection drug use. Although the American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention now recommend universal prenatal HCV screening, diagnosis during pregnancy too often does not result in timely treatment postpartum. Consistent with research at other institutions, internal review at our medical center revealed that referrals to gastroenterology or infectious disease specialists resulted in low follow-through, with few patients receiving curative therapy. To address this gap, we implemented a patient-centered program integrating HCV care into the outpatient prenatal and postpartum service at our rural academic medical center. This article describes a practice innovation which streamlines the process from confirmatory testing during pregnancy to the initiation and follow-up for direct-acting antiviral treatment postpartum. Embedding postpartum HCV treatment within routine perinatal services reduces barriers to cure and is well within the scope of midwifery and other obstetric practice. Adoption of this patient-centered approach accelerates progress toward regional and global HCV elimination goals.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"657-662"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793295","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":"Perceptions of Traditional Postpartum Practices With Hmong Women in the United States","authors":"Rachael Koch PharmD,&nbsp;Asia Kerchia Lee PharmD,&nbsp;Celena Ho PharmD,&nbsp;Kajua Betsy Lor PharmD, BCACP","doi":"10.1111/jmwh.70101","DOIUrl":"10.1111/jmwh.70101","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Postpartum care varies widely across cultures, yet research on ethnic minorities, especially Asian American Pacific Islanders subgroups, often masks meaningful differences among ethnic subpopulations. The Hmong, an ethnic minority originating from Southeast Asia, faces cultural shifts since immigrating to the United States. This study examined the perceptions of traditional postpartum practices among Hmong women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional electronic survey was distributed to Hmong women and professional organizations. Participants were included in the study if they were aged at least 18 years, self-identified as Hmong, were female, and were living in the United States. Data on postpartum knowledge and experiences were analyzed using SPSS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 323 respondents (average age 33.5 years), 89% were women who practiced postpartum traditions, with most having 0 to 5 children. Over 65% reported their health care providers were unaware of traditional Hmong practices, and 77.8% were willing to educate them. Common practices included the chicken diet (95.8%) and belly binding (40.9%) for an average confinement period of 25 days. Knowledge of traditional postpartum practices was moderate; participants correctly answered about 45% of knowledge questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Although many Hmong women in the United States continue to practice postpartum customs, traditional knowledge appears to be eroding across generations. There is a clear gap between patient practices and provider awareness. These findings highlight the need for culturally competent postpartum care and suggest that health care providers incorporate respectful, informed discussions about traditional practices to support maternal health among Hmong women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"519-525"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583544","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":"#GroupBStrepTest on TikTok: What Social Media Reveals About Patient Experiences and Expectations","authors":"Brooke E. Schroeder BS,&nbsp;Sarah J. Kuehn BS,&nbsp;Joelle Sills BS,&nbsp;Sarah K. Dotters-Katz MD, MMHPE,&nbsp;Jenny Wu MD","doi":"10.1111/jmwh.70106","DOIUrl":"10.1111/jmwh.70106","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Nearly half of the US population uses TikTok, influencing patient perceptions of public health measures, including group B streptococcus (GBS), a known cause of neonatal sepsis and mortality. This study examines TikTok content on GBS testing/treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>After institutional review board exemption, we evaluated the top 100 videos tagged with #gbs, #groupbstrep, #gbstest, and #groupbstreptest. Video information was downloaded via Apify. Two reviewers coded videos, with a third resolving discrepancies. We used the modified 5-point DISCERN scale to assess information reliability and the Patient Education Materials Assessment Tool (PEMAT) for understandability and actionability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 773 videos, 176 unrelated to GBS or in non-English languages were excluded. The top 100 videos had 17 million views, averaging 66.4 seconds. Most content creators were female (97.0%) and based in the United States (89.0%); fewer were health care professionals (21.1%). Video types included patient experiences (41.0%), educational videos (28.0%), and humorous content (22.0%). Video tone was more often negative (40%) than positive (22%). Nearly half of patient videos (49.3%) emphasized anxiety, although only 10.3% reported test discomfort. Concerns centered on the rectal swab, with some patients being unaware of this procedure until after the test. Distrust of health care professionals was emphasized in 6.5% of videos. Five videos (360,600 views, 1273 shares) promoted alternative GBS treatments (eg, probiotics, garlic, fermented foods). Videos scored poorly on quality (DISCERN: mean, 1.8; SD, 1.1) and actionability (PEMAT: mean, 18.3%; SD, 35.6%) but had better understandability (PEMAT: mean, 75.8%; SD, 19.7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Significant anxiety and misinformation about GBS testing/treatment exist in popular content, highlighting the importance of anticipatory counseling. Health care professionals can use these insights to guide patient education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"570-575"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517864","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":"Using the Lived Experience From Traditional Midwives in Remote Guatemala to Guide Improvement in Maternal Outcomes","authors":"Kimberly Garcia CNM, DNP, WHNP,&nbsp;Cheryl Armstrong DNP, MSN, RN,&nbsp;Jill Johnson MSN, RN,&nbsp;Kayla Madsen SN,&nbsp;Emily Flynn RN,&nbsp;Ashlee Taft Nelson SNM, BS, RN","doi":"10.1111/jmwh.70125","DOIUrl":"10.1111/jmwh.70125","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Preeclampsia is the second leading cause of maternal death and accounts for 25% of infant deaths in Guatemala, where maternal and infant mortality rates are among the highest in Central America. One contributing factor is that most women give birth at home with traditional midwives (TMs) with limited reading and writing skills who lack training about obstetric emergencies, such as preeclampsia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Guided by the World Health Organization's Quality of Care Theory of Change, authors conducted a qualitative study using thematic analysis of focus groups as the data collection method. The study was held in Spanish at 11 locations in the remote Petén department with 179 TMs to explore their knowledge, skills, and practices regarding preeclampsia. Audio recordings of the focus groups were transcribed verbatim and translated into English. Braun and Clark's thematic analysis was used to determine categories from focus group transcripts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six categories emerged: (1) knowledge of signs and symptoms, (2) awareness of risk factors, (3) expressions of maternal and fetal risks, (4) position for measuring blood pressure (BP), (5) differentiation between normal and abnormal BP readings, and (6) recognition of patient precautions during hospital transfers</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>In remote communities, informal knowledge transfer and experience-based learning play important roles, even in the absence of formal training. This existing foundation provides an important basis for developing structured education programs and promoting greater integration of TMs into the health care system—specifically, to address issues associated with hospital transfer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"628-635"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663499","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":"Exploring the Experiences of Newly Certified Midwives and Women's Health Nurse Practitioners in Medically Underserved Populations","authors":"Monica Ketchie CNM, DNP, ANP,&nbsp;Karen Schwartz DNP, WHNP-BC,&nbsp;Sallie Coke PhD, FNP-C, CPNP-PC, PMHS","doi":"10.1111/jmwh.70120","DOIUrl":"10.1111/jmwh.70120","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Maternal health care disparities persist in the Southern areas of the United States because of limited perinatal providers and scarce resources. Certified nurse-midwives (CNMs), certified midwives (CMs), and women's health nurse practitioners (WHNPs) can improve outcomes in these settings and the experiences of newly graduated clinicians as they transition into practice need further exploration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This qualitative study used a phenomenological approach to explore the lived experiences of 9 newly graduated CNMs and WHNPs practicing in medically underserved communities in the Southern United States. Participants were recruited and interviewed using a semistructured guide. Interviews were transcribed, coded, and thematically analyzed by a team of researchers. Field notes and reflexive journaling were used to enhance interpretive depth and rigor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four themes emerged: community ties, lack of resources, tailoring communication to patient context, and challenges transitioning from novice to competent practice characterized by limited mentorship and professional isolation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Newly graduated CNMs and WHNPs bring unique strengths to medically underserved practices, including cultural familiarity and a commitment to community care. However, resource constraints, insufficient support, and restrictive practice environments hinder their ability to thrive. Structured mentorship, comprehensive orientation, full practice authority, and education about the new role are essential strategies to improve retention, provider satisfaction, and, ultimately, patient outcomes in underserved regions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"610-617"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793302","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":"Reimagining Perinatal Care in Alabama Through Innovative Partnerships","authors":"Allison Shorten PhD, RN,&nbsp;Elizabeth G. Muñoz CNM, DNP,&nbsp;Christian Ketel DNP, RN,&nbsp;Candace C. Knight PhD, RN,&nbsp;Michele H. Talley PhD, ACNP-BC,&nbsp;Cynthia S. Selleck PhD, RN","doi":"10.1111/jmwh.70100","DOIUrl":"10.1111/jmwh.70100","url":null,"abstract":"<p>Childbearing families in the United States, especially in rural communities, face inconsistent access to high-quality maternity care, with many experiencing sparse and fragmented services. In response to long-standing disparities in Alabama, we created the Women and Children Health Initiative (WACHI), a coordinated hub that advances midwifery workforce growth, expands practice partnerships, and catalyzes policy change to support collaborative, risk-appropriate care. Central to WACHI is integrating certified nurse-midwives (CNMs) within systems that have historically imposed practice barriers. Grounded in the belief that Alabama can do better, WACHI convenes academic fields, health systems, public health sectors, and community partners to codesign and implement evidence-informed interventions. Program pillars include (1) reopening and expanding the state's nurse-midwifery education pathway, (2) embedding Nurse-Family Partnership home visiting with integrated behavioral health, (3) launching the Moms and Kids Mobile Health Clinic to reach underserved rural areas, and (4) building durable CNM-physician collaborations and standardized protocols for team-based care. These coordinated strategies align workforce development, health care delivery, and policy to increase first-trimester prenatal entry, improve postpartum follow-up, and reduce preventable complications. Early results include growth in the CNM workforce, new rural practice partnerships, and health-system engagement with respectful, team-based models that prioritize patient preferences and cultural safety. In this article we describe the WACHI model and early outcomes to inform adaptation and support replication by diverse regional coalitions and systems nationwide.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"644-651"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596995","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 Intersectional Examination of How Class, Marital Status, and Age Shape Discrimination Among Black Women Who Are Postpartum","authors":"Sarah C. Haight PhD, MPH,&nbsp;Karen Sheffield-Abdullah CNM, PhD, RN,&nbsp;Aryana Daye IBCLC, BA,&nbsp;Kayla Blades BS,&nbsp;E. Nicole Teal MD, MPH","doi":"10.1111/jmwh.70127","DOIUrl":"10.1111/jmwh.70127","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Intersectionality posits that multiple social categories (eg, race, gender, class) interact to create systems in which people experience discrimination differently. Among Black women, limited work has explored intersections beyond race, pregnancy status, and gender. This study compares experiences of racism and discrimination by multidimensional social category, inclusive of socioeconomic status (SES), marital status, and age, among Black women who are postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed cross-sectional survey data from 197 self-identified Black women aged 18 years or older with a live birth at a university hospital system from 2019 to 2021. Surveys included information on demographics, the Perceived Racism Scale, and the Perceived Discrimination Scale. Demographics included SES (low: education less than a bachelor's degree or &lt;$20,000 annual income), marital status, and age (young: &lt;26 years). Latent class analysis identified 3 groups: no additional marginalized social categories, 2 additional marginalized social categories (low SES and unmarried), and 3 additional marginalized social categories (low SES, unmarried, and young)—hereafter, groups 1, 2, and 3. Kruskal-Wallis tests determined group differences in median scores on the racism and discrimination scales, and modified Poisson regression estimated prevalence ratios (PRs) and 95% CI for scoring in the top quartile of each scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among Black women who were postpartum (3-32 months), the median perceived racism score was 101 (IQR, 71-138; possible range, 0-430) and did not differ by group (<i>P</i> = .40). The median perceived discrimination score was 29 (IQR, 22-35; possible range. 9-47) and differed by group (<i>P</i> = .02). Compared with group 1, group 2 was 2.5 times as likely to report top-quartile discrimination (PR, 2.5; 95% CI, 1.3-4.7), indicating heightened discrimination among Black women who were postpartum, low SES, and unmarried.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>In this sample of Black women who were postpartum, additional marginalized social categories, such as being lower SES and a single mother, heightened experiences of discrimination. Findings support the need for perinatal health care providers and researchers to consider an intersectional lens.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"636-643"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701043","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}