Journal of midwifery & women's health最新文献

{"title":"Women's Interest in Midwifery Continuity of Care During and After Pregnancy and Childbirth in Sweden: “As a Matter of Course”","authors":"Hanna Fahlbeck PhL, RN, RM,&nbsp;Ingegerd Hildingsson PhD, RN, RM,&nbsp;Birgitta Larsson PhD, RN, RM,&nbsp;Margareta Johansson PhD, RN, RM","doi":"10.1111/jmwh.70035","DOIUrl":"10.1111/jmwh.70035","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The midwifery continuity of care model is well-established internationally, but it is rarely offered in Sweden. Pregnant women's interest in midwifery continuity of care has not been investigated in recent years. This study aimed to investigate the interest of pregnant women and new mothers in Sweden regarding midwifery continuity of care and to identify factors associated with this interest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A national longitudinal digital questionnaire was conducted to collect background information, pregnancy-related variables, and childbirth-related variables, as well as to measure interest in midwifery continuity of care among women in Sweden. Odds ratios with 95% CIs and logistic regression analyses were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1697 women who responded, 68.1% expressed a strong interest in midwifery continuity of care during pregnancy, and 74.2% during postpartum. Fear of childbirth was associated with a higher interest in midwifery continuity of care during pregnancy (adjusted odds ratio [aOR] 1.75; 95% CI, 1.34-2.27). Women who had mixed or negative experiences with the care they received were also more likely to be interested in the model (aOR, 2.33; 95% CI, 1.43-3.97).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Pregnant women and new mothers in Sweden show a high level of interest in midwifery continuity of care. However, current maternity services do not adequately meet these preferences, indicating a need to scale up continuity of care models, particularly for women who experience fear of childbirth and dissatisfaction with their care. Therefore, antenatal, intrapartum, and postpartum care in Sweden should be enhanced to better align with the needs and preferences of pregnant women and new mothers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 1","pages":"95-103"},"PeriodicalIF":2.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182456","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, Implementation, and Evaluation of Implicit Bias Skill Building Sessions for Maternal Health Care Professionals","authors":"Nicole Warren CNM, PhD, MPH,&nbsp;Briana E. Kramer CNM, MS, MPH,&nbsp;Cheri Wilson MA, MHS, CPHQ,&nbsp;Nikki Akparewa MSN, MPH, RN,&nbsp;Kelly M. Bower PhD, MSN, MPH","doi":"10.1111/jmwh.70027","DOIUrl":"10.1111/jmwh.70027","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Maternal mortality and morbidity in the United States are marked by gross disparities linked to individual bias and systems-level factors. Implicit bias training is one strategy to address these disparities, and several states now require such education. Although evidence-based strategies to mitigate bias exist, these are not commonly integrated into training opportunities in clinical settings or evaluated for their impact on learners. We designed and evaluated an implicit bias skill building training program to address this gap.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used a quasiexperimental, multimethod evaluation to assess the outcomes of our program: reach, participant satisfaction, knowledge and acknowledgment of bias and its impacts, as well as behaviors to mitigate one's own and others’ biases. Survey and qualitative data from internal hospital facilitators provided added details about program satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>People who participated in didactic implicit bias training reported being more aware of their own and others’ biases and reported using more mitigation strategies than those who did not participate in any such training. Participants in the didactic training and at least one implicit bias skill building session reported using more mitigation strategies than people who completed the didactic training alone. Participants agreed that the training was relevant and motivated them to change their behavior.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our results suggest there is potential value in adding skill building activities to maximize the impact of implicit bias training efforts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"740-748"},"PeriodicalIF":2.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182444","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":"Midwifery's Moment: Medicaid Partnerships Open Doors for Expansion and Integration","authors":"Melissa D. Avery CNM, PhD,&nbsp;Amy M. Kohl","doi":"10.1111/jmwh.70034","DOIUrl":"10.1111/jmwh.70034","url":null,"abstract":"&lt;p&gt;The Centers for Medicare &amp; Medicaid Services (CMS) has officially launched new funding to assist a group of state Medicaid agencies in improving maternal and newborn health for individuals enrolled in Medicaid and the Children's Health Insurance Program (CHIP). Announced in December 2023, proposals were submitted in Fall 2024. The Transforming Maternal Health (TMaH) Model has opportunities for midwives and freestanding birth centers right at the top of the list.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The 15 states selected to receive funding were announced in January 2025. Those selected are Alabama, Arkansas, California, District of Columbia, Illinois, Kansas, Louisiana, Maine, Minnesota, Mississippi, New Jersey, Oklahoma, South Carolina, West Virginia, and Wisconsin. The 10-year, $17,000,000 funding provided to each of these states and the District of Columbia includes a 3-year preimplementation period for states to develop their model followed by 7 years of implementation.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The overall goal of the TMaH project is to help states improve perinatal outcomes while supporting health equity to reduce maternal and newborn health disparities within the Medicaid program. The project also aims to improve access, quality, and the experience for patients while reducing costs. It is well known that the United States spends more on perinatal and newborn health care than any other developed country and yet ranks at the bottom on health outcomes. It is also well known that countries with a well-integrated and robust midwifery workforce as part of their care system demonstrate better outcomes than the United States. Experts have commented that it will take much more funding plus coordination nationally and among states to make the strides needed for meeting the full TMaH objectives.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Others have offered a formal &lt;i&gt;Playbook&lt;/i&gt; to support state Medicaid agencies in working toward the TMaH goals and implementing proposed solutions.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Why should midwives be excited about this project? The TMaH program is centered around 3 pillars: (1) access, infrastructure, workforce; (2) quality improvement and safety; and (3) whole-person care delivery. The proposed solution to the lack of access to all care providers identified in pillar 1 is to increase access to midwives and freestanding birth centers. The pillars provide many opportunities for midwives in the 15 states to engage the project teams in their state Medicaid offices and take actions to remove barriers to midwifery practice and birth centers.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Midwives, birth centers, and midwifery-led care models are central to the success of the TMaH program. Midwives must promote midwifery-led care into the broader, whole-person approach to pregnancy and postpartum care. Related to pillar 1, reimbursement for all licensed midwives at the same rate as physicians for the same type of care is essential. Paying freesta","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"693-694"},"PeriodicalIF":2.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152260","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":"Designing a Statewide Hospital Equity Initiative: A Qualitative Formative Evaluation","authors":"Kelly M. Bower PhD, MSN, MPH, RN,&nbsp;Briana E. Kramer CNM, MPH, MS, RN,&nbsp;Nicole Warren CNM, PhD, MPH, RN","doi":"10.1111/jmwh.70026","DOIUrl":"10.1111/jmwh.70026","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Implicit bias training for health professionals is widely recommended as a strategy to mitigate maternal health inequities; however, evidence to support its efficacy is limited. Furthermore, experts recommend that bias training be embedded in a program of systems-level equity interventions. Although frameworks and broad recommendations for hospitals exist, there is limited actionable guidance for operationalizing effective maternal health equity programs in hospitals. This study aimed to gather data to inform the design and implementation of a statewide offering of implicit bias training and systems-level maternal health equity-focused interventions responsive to hospital needs and preferences, and expert input.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This qualitative formative evaluation consisted of in-depth interviews with maternal health leaders from Maryland birth hospitals and experts in maternal health equity to understand current maternal health equity work, recommended strategies, barriers, and facilitators of hospital-based implicit bias training and systems-level maternal health equity initiatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen interviews were conducted with birth hospital representatives and experts in maternal health equity. Hospital representatives reported limited prior work providing implicit bias training or implementing systems-level interventions. Participants recommended equity-focused interventions that align with existing health care improvement and maternal health equity recommendations. They also suggested implementation approaches aimed at leveraging facilitators and overcoming barriers of hospital-based settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Formative work in the design of maternal health equity initiatives can offer an expanded understanding of the actual barriers and needed support for hospitals and could improve effectiveness of these interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"733-739"},"PeriodicalIF":2.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088242","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":"Raynaud's Phenomenon of the Nipple: A Case Report of Postpartum Recurrence and Treatment","authors":"Jennifer Trebbin CNM,&nbsp;Tara A. Singh MD","doi":"10.1111/jmwh.70012","DOIUrl":"10.1111/jmwh.70012","url":null,"abstract":"<p>Raynaud phenomenon is a well-known condition that is characterized by episodic vasoconstriction of the extremities leading to pain and discoloration. It is more common among women than men and often results from exposure to cold or stress. Raynaud phenomenon can also affect the nipple during breastfeeding, causing severe pain and distress for the lactating individual and newborn, leading to premature cessation of breastfeeding. Raynaud phenomenon of the nipple is often confused with other breastfeeding pain causes, which can result in treatment oversights. The etiology of Raynaud phenomenon of the nipple is complex and thought to be caused by an interplay of hormones and stress in the peripartum period. Literature on this condition is limited, mostly consisting of case reports, and there are very little data about its recurrence in subsequent peripartum periods. Treatment options are similar to those for Raynaud phenomenon and, if initiated in a timely fashion, can allow breastfeeding to continue uninterrupted. This clinical rounds article presents a case report of Raynaud phenomenon of the nipple after a first birth and a reoccurrence during a subsequent (second) postpartum period. Discussion of the pathophysiology, clinical presentation, diagnostic tips, and appropriate treatment options are included.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"807-811"},"PeriodicalIF":2.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076934","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":"Omega-3 Fatty Acids During Pregnancy","authors":"","doi":"10.1111/jmwh.70030","DOIUrl":"https://doi.org/10.1111/jmwh.70030","url":null,"abstract":"&lt;p&gt;During pregnancy, your baby gets most of their food from the foods you eat and vitamins you take. Omega-3 fatty acids (omega 3s) are an important family of building blocks needed during pregnancy and breastfeeding. The two most important omega-3s are DHA and EPA. Our bodies cannot make these fatty acids so we have to get them from food.&lt;/p&gt;&lt;p&gt;Omega-3s are important to health. They can lower blood pressure and reduce heart diseases and other health problems. Omega-3s improve your baby's eye and brain growth and early development. Taking in enough omega-3s can lower your baby's chances of being born to soon, or getting asthma and other allergic conditions. They also may lower your risk of depression after you have your baby (postpartum depression).&lt;/p&gt;&lt;p&gt;Only a few foods contain omega-3s. Fatty fish like salmon, sardines, and trout are the best sources. Omega-3s are also now added to certain foods (fortified) like some brands of eggs, milk, juice, and yogurt. Walnuts, flaxseed, chia seeds, seaweed and grass-fed beef all have DHA, just in lower amounts.&lt;/p&gt;&lt;p&gt;Because of mercury contamination of our oceans, rivers and lakes, almost all fish contain some mercury. Some fish contain too much mercury. Some fish may also have PCBs (polychlorinated biphenyls) and dioxin from industrial pollution. High amounts of mercury and PCBs in your body can cause problems with your baby's brain growth, so fish with high levels of these toxins should not be eaten during pregnancy. Check local advisories on the safety of fish from local waters. Fish advisories are available from your local health department and online from state agencies. The health benefits of eating low mercury fish during pregnancy outweigh the risks, so &lt;b&gt;DO&lt;/b&gt; eat safe fish during pregnancy and while you are breastfeeding your baby.&lt;/p&gt;&lt;p&gt;Choose fish low in mercury. Remove skin and fat before cooking. Baking, broiling, steaming, or grilling fish lets the fat drain away and reduces PCBs in fish. Do not eat raw fish or shellfish.&lt;/p&gt;&lt;p&gt;Pregnant women and women who are breastfeeding should get about 200–300 mg of omega-3s per day. Since omega-3s stay in the body for a few days, eating 2 to 3 servings of fatty fish per week can give you the 200–300 mg per day needed. One serving is a 4 ounce portion of cooked fish. If you do not eat fish, or do not want to eat it every week, you can get fish oil as a pill or liquid you can swallow. Purified fish oil in pills or liquid form have all PCBs and dioxin removed. Read the label carefully to make sure there are at least 200 mg of omega-3s. Fish oil pills generally do not have side effects. Some women do say they have a fishy aftertaste with burping. There are other foods that contain DHA. If you prefer get your DHA through these sources, you will need to eat more of them or buy food that has been fortified to get the amount of DHA you need. Eating less fried and processed foods in your diet will help your body's ability to use the omega-3s you are taking ","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"835-836"},"PeriodicalIF":2.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296970","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":"Precepting Through Perinatal Emergencies: A Simulation-Based Training for Midwifery Educators","authors":"Susanna R. Cohen CNM, DNP,&nbsp;Kimberly Calkins MA,&nbsp;Jennifer E. Kaiser MD, MA, MSCI,&nbsp;Heidi Breeze Harris MA,&nbsp;Elizabeth Auricchio CNM, DNP,&nbsp;Julie Blumenfeld CNM, DNP","doi":"10.1111/jmwh.70024","DOIUrl":"10.1111/jmwh.70024","url":null,"abstract":"<p>The growth of the midwifery model of care depends on the preparation of new midwives, which necessitates skilled midwifery clinical preceptors. The University of Utah, Rutgers University, and PRONTO International supported by the New Jersey Department of Health, created the <i>Precepting Through Perinatal Emergencies Workshop</i>. We developed this sustainable in-person and virtual preceptor educational content through iterative feedback and pilot testing with active New Jersey midwifery preceptors. The preceptor training centered around introducing preceptors to evidence-based educational tools like the Educational Time Out, a teaching strategy using guided discovery learning concepts, goal setting, peer coaching strategies, and adult learning theories to enhance communication and debriefing skills. The in-person, highly interactive workshops included didactic lessons, role-plays, and 2 high-fidelity person-centered simulation scenarios and debriefs using the model developed by PRONTO International. The initial workshop's success led us to create a facilitation workshop for preceptors to learn how to train others and 3 online asynchronous modules to augment the learning. Midwifery preceptors who completed the facilitator training were equipped with the requisite skills, knowledge, and supplies needed to repeat the training in their home facilities.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 6","pages":"910-916"},"PeriodicalIF":2.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056624","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, September/October 2025","authors":"Abby Howe-Heyman CNM, PhD,&nbsp;Nena R. Harris CNM, PhD, FNP-BC, CNE,&nbsp;Beth G. McManis CNM, PhD, MS","doi":"10.1111/jmwh.70025","DOIUrl":"https://doi.org/10.1111/jmwh.70025","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"819-832"},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296995","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 Generative Artificial Intelligence in Midwifery Education: Balancing Innovation, Ethics, and Academic Integrity","authors":"Megan Koontz MM, Postgrad Certificate in Instructional Design, CPM,&nbsp;Stefanie Podlog PhD, RN, CD, SBD, CCHW","doi":"10.1111/jmwh.70021","DOIUrl":"10.1111/jmwh.70021","url":null,"abstract":"<p>Applications driven by large language models (LLMs) are reshaping higher education by offering innovative tools that enhance learning, streamline administrative tasks, and support scholarly work. However, their integration into education institutions raises ethical concerns related to bias, misinformation, and academic integrity, necessitating thoughtful institutional responses. This article explores the evolving role of LLMs in midwifery higher education, providing historical context, key capabilities, and ethical considerations. Using insights from a US-based midwifery program, it highlights strategies for responsible LLM integration, including faculty development, classroom applications, and policy updates. The discussion addresses challenges such as mitigating bias, preventing plagiarism, and fostering critical thinking while ensuring that LLM-fueled applications remain a tool rather than a substitute for student learning. Practical approaches, including faculty training and student guidance, offer a replicable framework for leveraging LLM tools in professional health education while maintaining academic standards and equity.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 6","pages":"946-951"},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034941","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 Comparison of Synthetic Osmotic Dilators and Pharmacologic Agents for Cervical Ripening in Induction of Labor: A Systematic Review and Meta-Analysis","authors":"Gi Wook Ryu PhD, RN,&nbsp;Sun-Young Park PhD, RN","doi":"10.1111/jmwh.70017","DOIUrl":"10.1111/jmwh.70017","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Given the rising number of studies on synthetic osmotic dilators, there is a lack of comprehensive reviews for their use compared with other commonly used cervical ripening methods. This study aimed to examine the maternal and neonatal safety and efficacy in cervical ripening and labor induction using synthetic osmotic dilators compared with pharmacologic agents (prostaglandin E₁, prostaglandin E₂, oxytocin) for labor induction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis of randomized controlled trials (RCTs) and cohort studies was conducted, using MEDLINE, Embase, CINAHL, and Cochrane Library databases search. Two reviewers independently screened studies and assessed the risk of bias with Risk of Bias 2 and Risk Of Bias In Nonrandomized Studies - of Interventions tools. Relative risks (RRs) and mean differences (MDs) were calculated with 95% CIs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven studies (8 RCTs, 3 cohort; 2355 participants) showed no statistically significant differences in safety outcomes between synthetic osmotic dilators and pharmacologic agents, including maternal infection (RR, 1.27), postpartum bleeding (RR, 0.87), neonatal infection (RR, 1.19), low Apgar scores (RR, 0.74), and admission to neonatal intensive care unit (RR, 1.06) (all <i>P</i> &gt; .05). Efficacy outcomes were comparable for vaginal birth rates (RR, 0.98) and Bishop score changes (MD, 0.0) (both <i>P</i> &gt; .05). Synthetic osmotic dilators reduced uterine hyperstimulation (RR, 0.45) and digestive symptoms (RR, 0.15) but required more artificial rupture of membrane (RR, 1.57) (all <i>P</i> &lt; .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Synthetic osmotic dilators are a safe, effective, and viable option for labor induction, reducing maternal risks of uterine hyperstimulation. These findings have implications for incorporating the clinical use of synthetic osmotic dilators for cervical ripening into international guidelines. As evidence supports their efficacy and safety, educating nurses and midwives in the use of synthetic osmotic dilators for labor induction is required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 1","pages":"26-38"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016950","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}