Journal of midwifery & women's health最新文献

{"title":"Understanding Positionality and Reflexivity in Scholarly Writing","authors":"Lucinda Canty CNM, PhD, Ira Kantrowitz-Gordon CNM, PhD","doi":"10.1111/jmwh.13675","DOIUrl":"10.1111/jmwh.13675","url":null,"abstract":"<p>Midwifery, and by extension, midwifery research, exists within a complex social and political context. The ideation, construction, conduct, and presentation of midwifery scholarship are embedded in these structures, as well as the researchers and research participants who contribute, in varying ways, to the construction of the work. Positionality is understanding one's social identities and how these identities influence our interactions with others. Reflexivity can include examination of one's assumptions, biases, and blind spots.<span><sup>1</sup></span> Seeing things from multiple perspectives expands knowledge beyond the researcher's lived experience. Positionality and reflexivity are important in both qualitative and quantitative research.</p><p>Midwifery is built on the foundation of having the knowledge to address issues such as social determinants of health, racism, and other sources of inequity. Health care practitioners are increasingly aware of the societal structures that exist in our health care system and that influence health outcomes. Similarly, researchers need to be aware of the structures that exist within the research context to address health equity.</p><p>Our experiences shape who we are. Messages received since childhood shape our perception and understanding of the world. When generating knowledge to inform midwifery practice and education, it is important that we stay true to the realities of those we care for. The research findings should reflect their perceptions to inform how we understand the challenges and circumstances, and not be limited by our own perspectives.</p><p>Systems of power and oppression are built into the systems within which research is conducted. Underlying assumptions about value and importance that determine what is being studied (ie, what health conditions), who is being studied (what populations), and how it is studied (what methods) are determined by those who hold the most power (researchers, funders, authors, journals, and editors). These systems can be challenged only if we are aware and acknowledge that they exist. These include not just racism, but sexism, classism, and other forms of marginalization that can intersect within individuals. These oppressive structures are embedded so deep in our society that, as researchers, we may unknowingly become a part of these systemic issues and cause unintentional harm throughout the research process.</p><p>Qualitative research often involves direct contact between researchers and participants in dynamic data collection in the form of interviews. The researcher is the instrument of data collection when there is an interview. Similarly, the researcher is intricately part of the analysis and interpretation of findings. Interviews can be impacted by the lenses that interviewers and participants bring to the interaction from their social identities, past experiences with the topic of interest, and level of trust that the participant has in the research","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 4","pages":"453-454"},"PeriodicalIF":2.1,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13675","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753685","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":"The Availability of Midwifery Care in Rural United States Communities","authors":"Emily C. Sheffield MPH,&nbsp;Alyssa H. Fritz MPH,&nbsp;Julia D. Interrante PhD, MPH,&nbsp;Katy Backes Kozhimannil PhD, MPA","doi":"10.1111/jmwh.13676","DOIUrl":"10.1111/jmwh.13676","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Access to pregnancy-related and childbirth-related health care for rural residents is limited by health workforce shortages in the United States. Although midwives are key pregnancy and childbirth care providers, the current landscape of the rural midwifery workforce is not well understood. The goal of this analysis was to describe the availability of local midwifery care in rural US communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed and conducted a national survey of rural US hospitals with current or recently closed childbirth services. Maternity unit managers or administrators at 292 rural hospitals were surveyed from March to August 2021, with 133 hospitals responding (response rate 46%; 93 currently offering childbirth services, 40 recently closed childbirth services). This cross-sectional analysis describes whether rural hospitals with current or prior childbirth services had midwifery care with certified nurse-midwives available locally and whether rural communities with and without midwifery care differed by hospital-level and county-level characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among hospitals surveyed, 55% of those with current and 75% of those with prior childbirth services reported no locally available midwifery care. Of the 93 rural communities with current hospital-based childbirth services, those without midwifery care were more likely to have lower populations (37% vs 33%); majority populations that were Black, Indigenous, and people of color (24% vs 10%); and hospitals where at least 50% of births were Medicaid funded (77% vs 64%), compared with communities with midwifery care. Conversely, communities with midwifery care more often had greater than 30% of patients traveling more than 30 miles for hospital-based childbirth services (38% vs 28%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>More than half of rural hospitals surveyed reported no locally available midwifery care, and availability differed by hospital-level and county-level characteristics. Efforts to ensure pregnancy and childbirth care access for rural birthing people should include attention to the availability of local midwifery care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"929-936"},"PeriodicalIF":2.1,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753684","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":"Miscarriage","authors":"","doi":"10.1111/jmwh.13670","DOIUrl":"10.1111/jmwh.13670","url":null,"abstract":"<p>A miscarriage is the early loss of a pregnancy. Miscarriage can happen any time between your last menstrual period and 20 weeks of pregnancy. After 20 weeks, a pregnancy loss is called a stillbirth. Most miscarriages happen before 14 weeks of pregnancy.</p><p>Miscarriage happens in about 15% to 20% of pregnancies. The true number is unknown because many happen before the person knows they are pregnant.</p><p>Usually there is no known cause. About half of all miscarriages are caused by genetic problems. Pregnancy loss is more common in older people and those who have had a miscarriage before. Medical problems like diabetes or thyroid disease, smoking, or alcohol use can increase the chance of miscarriage. A miscarriage can happen to anyone.</p><p>The most common signs of miscarriage are vaginal bleeding, cramping, or pain in your lower abdomen or back. These symptoms don't always mean a miscarriage will happen. Sometimes a miscarriage can occur without any warning.</p><p>A miscarriage is diagnosed by ultrasound. The ultrasound will show that the fetus does not have a heartbeat. Blood tests can also be done to check your levels of the pregnancy hormone (HCG). This can be helpful if your health care provider thinks you are having a miscarriage.</p><p>When someone is having a miscarriage before 20 weeks, nothing can be done to stop it. There are several options after you know you are miscarrying. The best option depends on how far along the pregnancy is, how healthy you are, and if other problems are happening. Your desires and your health care provider's advice are important too.</p><p>If your pregnancy is more than 16 weeks, your health care provider may admit you to the hospital to induce labor. This process can take some time and may involve the use of several medications. You will receive care during the process to support you and answer questions. You may be asked if you want to see the fetus.</p><p>When you become pregnant again, be sure to tell your health care provider that you have a history of pregnancy loss. They will check you out and tell you about your specific chance of having another miscarriage.</p><p>Flesch Kincaid score 7.1</p><p>Approved June 2024. This handout replaces “Miscarriage” published in Volume 58, Number 4, July/August 2013.</p><p>This page may be reproduced for noncommercial use by health care professionals to share with clients. Any other reproduction is subject to the Journal of Midwifery &amp; Women's Health's approval. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, the Journal of Midwifery &amp; Women's Health suggests that you consult your health care provider.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 4","pages":"621-622"},"PeriodicalIF":2.1,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13670","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750135","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, 2024","authors":"Nancy A. Niemczyk CNM, PhD","doi":"10.1111/jmwh.13677","DOIUrl":"10.1111/jmwh.13677","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 4","pages":"615-618"},"PeriodicalIF":2.1,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731703","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":"Gender and Sex Inclusive Approaches for Discussing Predicted Fetal Sex: A Call for Reflection and Research","authors":"Hannah Llorin MS, CGC,&nbsp;Tiffany Lundeen CNM, MSN,&nbsp;Elizabeth Collins MD, MPH,&nbsp;Claudia Geist PhD,&nbsp;Kyl Myers PhD, MS,&nbsp;Susanna R. Cohen CNM, DNP,&nbsp;Kimberly Zayhowski MS, CGC","doi":"10.1111/jmwh.13663","DOIUrl":"10.1111/jmwh.13663","url":null,"abstract":"&lt;p&gt;Technology has rapidly transformed the centuries-old practice of fetal sex prediction, and significant social and medical progress is changing the way prenatal health care providers (HCPs) address the often-asked question, “Am I having a boy or a girl?” Access to prenatal cell-free fetal DNA (cfDNA) screening is expanding broadly, and medical societies recommend cfDNA screening for all pregnancies.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Prenatal cfDNA screening offers sex chromosome assessment for sex chromosome aneuploidy (sex chromosome complements other than XX or XY), along with other aneuploidy screening (for trisomies 13, 18, and 21), as early as 10 weeks’ gestation. Patients may have a limited understanding of the prevalence of aneuploidy in the general population, the implications of these differences, and the purpose of screening for them. This gap in understanding could lead patients to believe the test is solely about gender determination.&lt;/p&gt;&lt;p&gt;There is increased awareness that gender and sex diversity are essential components of health, health care, and social reality.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; In this commentary, we posit that many prenatal HCPs are currently underprepared to talk to parents about fetal sex prediction and sex chromosome variation during the course of prenatal care in a manner that is accurate and inclusive of gender and sex diversity, which would promote family function and individual well-being for gender- and sex-diverse children and adults. This skill is relevant to midwives, nurses, genetic counselors, physicians, physician associates, radiologists, and radiology technicians. Of note, in this commentary, we have largely chosen to use the term &lt;i&gt;parents&lt;/i&gt; to align with the focus on childhood gender socialization, presupposing a context of desired pregnancies leading to birth and parenting.&lt;/p&gt;&lt;p&gt;When prenatal HCPs tell patients, “It's a girl!” or “It's a boy!” they reinforce an erroneous bioessentialist framework: people with XX chromosomes or an apparent vulva are assigned female and socialized as girls, and people with XY chromosomes or an apparent penis are assigned male and socialized as boys. (See Table 1 for relevant terms and definitions.) However, a person's own construct of gender identity is the result of interactions between biological and social factors and relies on cognitive development across the life span. Misconceptions about both sex and gender that are often enacted during the prenatal period among HCPs and pregnant people include: (1) sex and gender are determined by sex chromosomes alone, (2) a person's sex chromosomes can only be XX or XY, and that sex is strictly binary, and (3) there are only 2 gender categories: boy or girl.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; These incorrect assumptions jeopardize the child's autonomy&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; and contribute to the inflexible binary social model and dimorphic biological model that underlie bigotry, erasure, phobias, and discrimination against gender-di","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"821-825"},"PeriodicalIF":2.1,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636349","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":"Systematic Reviews to Inform Practice, July/August 2024","authors":"Nena R. Harris CNM, PhD, FNP-BC, CNE","doi":"10.1111/jmwh.13671","DOIUrl":"10.1111/jmwh.13671","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 4","pages":"606-614"},"PeriodicalIF":2.1,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Midwives in US Perinatal Palliative Care: A Scoping Review","authors":"Robyn Schafer CNM, PhD,&nbsp;Jenna A. LoGiudice CNM, PhD,&nbsp;Pamela Hargwood MLIS, AHIP,&nbsp;Abigail Wilpers PhD, WHNP-BC","doi":"10.1111/jmwh.13664","DOIUrl":"10.1111/jmwh.13664","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Perinatal palliative care (PPC) is a rapidly growing and essential reproductive health care option for pregnant persons with a diagnosed life-limiting fetal condition who continue their pregnancy. The provision of PPC is within the scope of basic midwifery competencies, and midwives are well-positioned to make unique and valuable contributions to interprofessional PPC teams. However, little is known about midwives’ past or current involvement in PPC in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This scoping review of the literature investigated what is known about the role of midwives in PPC in the United States. Multiple databases of published literature were used for this review: PubMed, CINAHL, Embase, Web of Science, ProQuest, Google Scholar, and relevant citations from identified studies. All types of English language publications addressing midwives’ involvement in PPC in the United States were included, without any limitations on publication date.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The role and contributions of midwives in PPC is not well represented in existing literature. Of the 259 results identified, 7 publications met criteria for inclusion. These included 5 case reports, one quantitative research article, and one conference abstract. Midwives are involved in PPC through the provision of direct clinical care (including antepartum, intrapartum, postpartum, neonatal, bereavement, postmortem, and follow-up care) and care planning and coordination as part of an interprofessional team.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Despite midwives being uniquely positioned to provide holistic, family-centered, and person-centered care in situations of pregnancy with life-limiting fetal conditions, there is limited literature about their involvement in PPC in the United States. PPC should be incorporated into midwifery education and training programs. Midwives should play a central role in shaping future research and policies to ensure the accessibility and quality of PPC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"875-887"},"PeriodicalIF":2.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560582","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":"Exercise in Pregnancy","authors":"","doi":"10.1111/jmwh.13672","DOIUrl":"10.1111/jmwh.13672","url":null,"abstract":"&lt;p&gt;Most exercise is safe in a healthy pregnancy. Daily exercise can help you and your baby be healthier and decrease your chance of some problems during pregnancy. Exercise in pregnancy does not increase your chance of miscarriage, low birth weight, or early delivery. If you had a medical problem before you became pregnant or have had complications during your pregnancy, you should talk about the safety of exercise with your health care provider before you start any activity.&lt;/p&gt;&lt;p&gt;Exercise in pregnancy can help you in many ways. It can help you feel better and have less back pain, constipation, and tiredness. Exercise can also help you sleep better and improve your mood. Your body will be better prepared for labor. You may have a shorter labor with less chance of having a cesarean birth. You may gain less weight in pregnancy, which will help you get back to your pre-pregnancy weight more quickly after the baby comes. Exercise in pregnancy lowers your chance of gestational diabetes or high blood pressure during pregnancy. Your baby is more likely to be born with a healthy birth weight. Exercise can also lower the chance of having postpartum depression after the baby is born.&lt;/p&gt;&lt;p&gt;You should try to do moderate exercise for at least 150 minutes a week. Moderate exercise means you should start to sweat and your heart rate should increase, but you are still able to talk while you are exercising. You can divide your exercise into whatever amounts work best in your life. Some find 30 minutes a day at one time works. Others prefer 10–15 minutes a few times a day. If you exercised before pregnancy, you can probably continue the same physical activities and intensity of exercise. If you are not currently exercising, pregnancy is a good time to start. You want to start slow and gradually increase your exercise.&lt;/p&gt;&lt;p&gt;Walking or swimming are good exercises to start with. You will get moving and have less strain on your joints. Biking, yoga, Pilates, and low-impact aerobics are also good choices. Light weight training is okay, too. Being creative with your exercise will help you stay motivated. Hiking, dancing, and rowing can be fun activities to try. You do not need to pay money for an exercise class or activity. Walking up and down stairs or doing exercises at home are all good, free activities.&lt;/p&gt;&lt;p&gt;Be sure to stretch your muscles first and warm up and cool down each time you exercise. Drink water throughout your exercise so you can stay well hydrated. Make sure you don't get too hot, and don't overdo your exercise especially on a hot day. During pregnancy, your balance changes as the baby grows so it is important to move carefully and always make sure you are not in danger of falling. Pregnancy hormones cause your joints to be more relaxed. They can be injured easier especially with jerky, bouncy, or high-impact movements. You have more oxygen needs in pregnancy. This can make it harder to breath, especially with hard exercise or for people with obesit","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 4","pages":"619-620"},"PeriodicalIF":2.1,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Integrated Approach to Address Perinatal Mental Health Within an Obstetrics Practice","authors":"Christina L. Felten CNM, DNP, WHNP, PMH-C,&nbsp;Kayla S. Smith MSN, CRNP, PMH-C,&nbsp;Melissa B. Aylesworth MMS, PA-C, PMH-C","doi":"10.1111/jmwh.13658","DOIUrl":"10.1111/jmwh.13658","url":null,"abstract":"<p>Outpatient perinatal care providers (one certified nurse-midwife, one nurse practitioner, and one physician assistant) at a high-volume, suburban health system in southeastern Pennsylvania developed and implemented a care model to identify and care for patients at risk for perinatal and postpartum mental health conditions. The program, Women Adjusting to Various Emotional States (WAVES), was created to bring the most up-to-date, evidence-based treatment recommendations to patients while addressing the increased demand placed on the health care system by pregnant and postpartum patients in need of psychiatric services. WAVES is a specialized program offered for anyone who is pregnant or up to one year postpartum who is struggling with mental health symptoms or concerns. Perinatal mood and anxiety disorders have become one of the most prevalent pregnancy ailments, yet mental health is not always addressed during routine prenatal care visits. Common obstacles to patients obtaining mental health care during pregnancy include lack of access, clinician gaps in knowledge, and stigma surrounding diagnoses. WAVES offers a method to empower perinatal providers with the education and tools to address this need. The model outlines how to appropriately assess, diagnose, manage, or refer patients for mental health services. Patient feedback has been overwhelmingly positive, and this novel care model shows great promise for the future of perinatal care. The development of integrated programs like WAVES may be a valuable resource to help combat the perinatal mental health epidemic.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 5","pages":"778-783"},"PeriodicalIF":2.1,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461470","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 Postpartum Pregnancy Prevention Behaviors Among Women Experiencing Homelessness: A Mixed‐Methods Analysis","authors":"Annalynn M. Galvin, Rebecca E. Bergh, Scott T. Walters, Melissa A. Lewis, Erika L. Thompson","doi":"10.1111/jmwh.13657","DOIUrl":"https://doi.org/10.1111/jmwh.13657","url":null,"abstract":"IntroductionWomen experiencing homelessness are at higher risk of unintended pregnancy than women who are stably housed and may have unique reasons for not engaging in postpartum pregnancy prevention. This sequential explanatory mixed‐methods study aimed to examine reasons women experiencing homelessness may not engage in pregnancy prevention during the postpartum period.MethodsQuantitative 2016‐2019 Pregnancy Risk Assessment Monitoring System data regarding postpartum pregnancy prevention among recently pregnant women experiencing homelessness and women stably housed (n = 99,138) were analyzed with complex survey‐weighted bivariate analysis. Primary outcomes included whether women engaged in postpartum contraception and key reasons for not engaging in postpartum contraception. Qualitative data from semistructured interviews with north Texas women (n = 12) recently pregnant and homeless were coded and thematically analyzed. Findings were triangulated using a woman‐centered conceptual framework that facilitates meeting reproductive goals.ResultsWomen experiencing homelessness reported several statistically significant (<jats:italic>P</jats:italic> &lt; .05) reasons for not using postpartum pregnancy prevention: currently pregnant, currently abstinent, cannot afford contraception, and partner not liking contraception. Key themes from interviews were related to internal factors (eg, perceived risk of pregnancy is high, current situation not good for having children); external factors (eg, my partner wants to have another child); perceptions of pregnancy (eg, children would be joyful, I want to get pregnant soon after I get housing), and salience of planning (eg, doesn't matter if we plan).DiscussionFindings highlight several key reasons for not engaging in postpartum pregnancy prevention among women experiencing homelessness. Findings lay the groundwork for interventions seeking to support individualized and evolving sexual and reproductive health goals within the context of needed housing and family resources.","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"101 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141507340","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}