Journal of midwifery & women's health最新文献

{"title":"Research and Professional Literature to Inform Practice, November/December 2024","authors":"Rebecca R. S. Clark CNM, PhD, MSN, RN","doi":"10.1111/jmwh.13712","DOIUrl":"10.1111/jmwh.13712","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"963-968"},"PeriodicalIF":2.1,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712234","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":"Building Integrity and Trust in Clinical Trials","authors":"Melissa D. Avery CNM, PhD, Linda A. Hunter CNM, EdD, Ira Kantrowitz-Gordon CNM, PhD","doi":"10.1111/jmwh.13719","DOIUrl":"10.1111/jmwh.13719","url":null,"abstract":"<p>The <i>Journal of Midwifery & Women's Health</i> (<i>JMWH</i>) leadership strives to ensure the highest level of scholarly publication, including consistency with national and international guidance related to scientific integrity and excellence. Since July 1, 2005, the International Committee of Medical Journal Editors (ICMJE) has recommended registration of all clinical trials.<span><sup>1</sup></span> Clinical trial registration is necessary for study results to be published in journals that adhere to the ICMJE guidelines. Thus, investigators are responsible for ensuring their trials have been appropriately registered. <i>JMWH</i> has a long history of commitment to following these recommendations.<span><sup>2</sup></span> Some authors, however, may be unaware of the requirements. Therefore, the background and current standards are reviewed here.</p><p>What is clinical trial registration and why is it important? The purposes of registration of clinical trials in a national or international database are transparency and reporting integrity. When clinical trial information is publicly available before participant enrollment, individuals interested in trial participation can search opportunities in available registry databases. Researchers can search ongoing trials in their area of study to avoid unnecessary duplication. Clinical trial registration aims to prevent bias in the reporting of research such as only reporting selected outcomes. Trial registries can also be helpful to institutional review boards that are examining newly proposed studies.<span><sup>3</sup></span></p><p>Clinical trials are defined by ICMJE as “any research project that prospectively assigns people or a group of people to an intervention, with or without concurrent comparison or control groups, to study the relationship between a health-related intervention <i>and</i> a health outcome.”<span><sup>3</sup></span><sup>(p 1)</sup> The treatment or intervention may be pharmacologic, surgical, behavioral, dietary, educational, or changes in care processes. Feasibility type studies that assign participants to a single treatment without a control or comparison group are also considered clinical trials for the purpose of trial registration.<span><sup>3</sup></span> Examination of the clinical trial registration date can assure the public that information was provided to the registry before enrollment of participants, which is essential to preventing bias in reporting.</p><p>Registration of a clinical trial involves investigators providing specific information about the trial to an approved registry.<span><sup>4</sup></span> For example, Clinicaltrials.gov is a trial registry database maintained by the National Library of Medicine and contains information about trials conducted in the United States and many other countries. The World Health Organization (WHO) requires a specific set of items about trials to be included, such as a unique trial identifier (assigned by the regis","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"819-820"},"PeriodicalIF":2.1,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13719","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693985","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":"Alcohol Use in Pregnancy","authors":"","doi":"10.1111/jmwh.13717","DOIUrl":"10.1111/jmwh.13717","url":null,"abstract":"<p>Prenatal alcohol exposure is a leading cause of preventable birth defects and developmental problems. There is no known safe amount of alcohol you can drink during pregnancy or while trying to get pregnant. Too many people continue to drink during pregnancy. About 1 in 10 pregnant people in the United States drank alcohol in the past 30 days. About 1 in 22 pregnant people in the United States had 4 or more drinks at one time (binge drinking) in the past 30 days. These problems are completely preventable if a person does not drink alcohol during pregnancy. Why take the risk?</p><p>Drinking alcohol during pregnancy can cause miscarriage, stillbirth, preterm birth, and sudden infant death syndrome (SIDS) and a range of physical, behavioral, and intellectual disabilities for the baby that can last a lifetime. These disabilities are known as fetal alcohol spectrum disorders (FASDs). Some of the health and other problems of people with FASDs include learning disabilities, hyperactivity, difficulty with attention, speech and language delays, intellectual disabilities, and poor reasoning (thinking) and judgment skills. People born with FASDs can also have problems with their organs, including the heart and kidneys. Some babies with FASDs can have a smaller head, weigh less than other babies, and have parts of their faces that look different than other babies.</p><p>There is no known safe amount of alcohol use during pregnancy or when you are trying to get pregnant. Alcohol is passed through the placenta and the fetus is exposed to the same amount as the pregnant person. All exposure to any drinks with alcohol can affect a baby's growth and development and cause FASDs. A 5-ounce glass of wine has the same amount of alcohol as a 12-ounce can of beer or a 1.5-ounce shot of straight liquor. All types of alcohol—even wine, wine coolers, seltzers, hard cider and beer—can harm your developing baby. The Chart on the following page shows when your baby is developing different parts of its body that may be harmed by drinking alcohol.</p><p></p><p>It is best to stop drinking alcohol when you start trying to get pregnant. Many people become pregnant and do not know it right away. It may be up to 4 to 6 weeks before you know for sure that you are pregnant. This means you might be drinking and exposing your developing baby to alcohol without meaning to. If you think you have a problem with alcohol, it's best to get treatment before you try to get pregnant.</p><p>If you drank before you knew you were pregnant or before you knew it could harm your baby, stop now. The less exposure, the better for your baby. If you are having trouble quitting drinking, ask your health care provider for help. There are many treatment options that can help and are safe in pregnancy. Together, you can develop a plan to quit drinking.</p><p>Flesch Kincaid 7.3</p><p>Approved October 2024. This handout replaces “Alcohol in Pregnancy” published in Volume 60, Issue 1, January/February 2015.</","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"983-984"},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13717","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678101","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":"Congenital Cytomegalovirus (CMV)","authors":"","doi":"10.1111/jmwh.13715","DOIUrl":"10.1111/jmwh.13715","url":null,"abstract":"<p>Cytomegalovirus <i>(sy-toh-mega-loh-virus</i>), or CMV, is a common virus that causes cold-like symptoms. It does not harm most people and may cause a few days of sore throat and feeling tired. CMV stays silent in the body and can become active from time to time. There are different types of CMV. If a person catches CMV right before becoming pregnant or during pregnancy, or a previous infection becomes active, their fetus may get CMV. Babies that get CMV during pregnancy are referred to as having congenital CMV, or cCMV.</p><p>About one in every 200 babies born in the United States has cCMV.</p><p>Most babies with cCMV have no signs you can see at birth. About 10–20% of babies born with cCMV will have more serious problems. At birth they may have a low birth weight and/or small head size (microcephaly). They may also have other signs at birth such as hearing loss, feeding difficulties, jaundice, and a purple spotted rash. Congenital CMV can also lead to long-term health problems, like later hearing loss and developmental delay. Common health problems associated with cCMV are listed in the box, below.</p><p>CMV is transmitted through body fluids, like saliva, urine, and semen. People who catch CMV can pass the virus to others for months. Young children, especially those in daycare or preschool, often have CMV in their body fluids. If a pregnant person gets those infected body fluids in their body (e.g. by kissing), they may get CMV and their baby may develop cCMV.</p><p>People who spend time with young children are at a higher risk of catching CMV and having a baby with cCMV. This includes people with young children, and those who work with young children such as daycare workers, teachers, and other health care providers. People who have had CMV can catch it again and pass it to their baby during pregnancy.</p><p>Only one-third of people who catch CMV while pregnant pass it to their baby. Most people who catch CMV while pregnant do not have babies with cCMV.</p><p>Some health care providers may offer routine testing for CMV antibodies at the beginning of the pregnancy. This is to find out if you have ever had a CMV infection, or if you have a current infection. Others may offer testing if you think you may have been exposed, or for those who spend time with young children. Your health care provider may also recommend CMV testing if certain results are seen on ultrasound, such as slow growth, smaller head size, or other signs of infection.</p><p>Your health care provider may recommend some blood tests for antibodies or discuss testing your amniotic fluid.  This is to see if your baby has the virus. Ultrasounds can monitor the baby's growth and look for other signs of congenital CMV, like slow growth or small head size.</p><p>There are no known treatments for cCMV during pregnancy. In the United States, anti-viral medication or treatment with immunoglobulins are not recommended. Research has not found these treatments safe or effective for the ba","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"981-982"},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13715","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678105","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, November/December 2024","authors":"Nena R. Harris CNM, PhD, FNP-BC, CNE, Abby Howe-Heyman CNM, PhD","doi":"10.1111/jmwh.13711","DOIUrl":"10.1111/jmwh.13711","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"969-980"},"PeriodicalIF":2.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635170","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":"Prenatal and Postpartum Care Experiences Among Black Birthing People in the United States: An Integrative Review","authors":"Laura M. Segovia CNM PhD,&nbsp;Emily Neiman CNM MS,&nbsp;Shannon L. Gillespie RN PhD,&nbsp;McKenzie K. Jancsura RN PhD,&nbsp;Cindy M. Anderson PhD, APRN-CNP","doi":"10.1111/jmwh.13705","DOIUrl":"10.1111/jmwh.13705","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Among Black birthing people, high-quality, respectful care throughout pregnancy and postpartum is hindered by distrust, racial discrimination, and unsatisfactory care. The purpose of this integrative review was to examine prenatal and postpartum care experiences among Black birthing people in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature search, spanning from inception through October 6, 2022, across 4 research databases, used a combination of keywords to capture reports on care experiences among Black birthing people. We included quantitative and qualitative studies in the United States with people who self-identified as Black or African American and reported prenatal or postpartum health care experiences. Intrapartum experiences were excluded. All studies were evaluated with the Mixed-Methods Appraisal Tool, National Institutes of Health Study Quality Assessment tool, or Joanna Briggs Institute critical appraisal checklist. Data were analyzed and synthesized using the Joanna Briggs Institute convergent integrated approach to incorporate quantitative and qualitative research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 16 studies published over 27 years met the inclusion criteria. All studies examined the health care experiences of Black birthing people during prenatal or postpartum care. None of the studies focused solely on postpartum care experiences. The 2 most prominent themes were models of care and patient-provider interactions, encompassing both positive and negative experiences. Positive care experiences included collaborative patient-provider interactions, continuity of care, and culturally centered care. Adverse experiences were more frequently noted and involved discriminatory treatment during patient-provider interactions, fragmented care models, and a lack of cultural awareness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Black birthing people in the United States report some positive but more negative health care experiences during pregnancy and postpartum care, which may play an important role in health inequities. Promoting prenatal and postpartum care models that provide continuity and are high-quality, collaborative, and culturally centered were identified as high-priority targets to foster patient safety and improve clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 2","pages":"235-246"},"PeriodicalIF":2.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13705","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635169","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":"Perinatal Care Provider Perspectives on Integrating Clinical Research Into the Clinical Infrastructure","authors":"Yanqiao Li BSN, RN,&nbsp;Kylea L. Liese CNM, PhD,&nbsp;Lacey Pezley PhD, RDN,&nbsp;Arissara Sawatpanich MSN, RN,&nbsp;Gloria Elam MD,&nbsp;Katherine Erbe CNM, PhD, MS,&nbsp;Lisa Tussing-Humphreys PhD, RD, MS,&nbsp;Mary Dawn Koenig CNM, PhD, RN","doi":"10.1111/jmwh.13703","DOIUrl":"10.1111/jmwh.13703","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study explored perinatal health care providers’ perspectives on the recruitment of pregnant participants and integrating clinical research into their practice, with a particular emphasis on the complexities introduced by the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From May to September 2021, semistructured interviews were conducted with 10 perinatal health care providers from an urban US health center. The interview transcripts were analyzed using Braun and Clarke's thematic analysis framework, a rigorous method for analyzing qualitative data by identifying, coding, and reporting themes. This approach allowed us to systematically code the data and identify key themes related to recruitment strategies and integration of clinical trials during prenatal care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Barriers to integrating clinical trials into the perinatal infrastructure included pandemic-related restrictions, heavy workloads, time constraints, ineffective communication and coordination, and maintaining the relevance of the research among providers. Facilitators included the use of communication tools, collaboration with multidisciplinary teams and stakeholders, creation of detailed study information for clinic staff, and fostering commitment to supporting research among providers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The perspectives of perinatal health care providers uncover barriers and facilitators regarding the recruitment of pregnant individuals for clinical trials and shed light on the unprecedented challenges of research in this population during the COVID-19 pandemic and lessons learned postpandemic. This information can support the development of evidence-based solutions and strategies to improve the recruitment of pregnant individuals, as well as enhance clinical research integration into infrastructure in perinatal health clinics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 2","pages":"301-307"},"PeriodicalIF":2.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13703","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635146","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":"Polycystic Ovary Syndrome as a Key Risk Factor in Pregnancy Outcomes: A Midwifery Perspective from the International Guideline","authors":"Mahnaz Bahri Khomami BMid, MMid, PhD","doi":"10.1111/jmwh.13706","DOIUrl":"10.1111/jmwh.13706","url":null,"abstract":"<p>Risk factor identification at preconception and in pregnancy is critical for preventing both short term and long-term morbidity and mortality in women and their offspring.<span>¹</span> The World Health Organization recommends midwifery-led prenatal care starting before 12 weeks of pregnancy for timely nutrition intervention, proper assessments including risk factor identification, preventive measures, and management of pregnancy specific features.<span>²</span> Effective and timely identification and management of risk factors can guide interventions, prevent complications, and optimize the health of both women and offspring in the short and long-term.<span>³</span> Polycystic Ovary Syndrome (PCOS) is one such risk factor that significantly influences maternal and offspring pregnancy outcomes.<span>^4-6</span> However, PCOS is often underrecognized and under-addressed in preconception and prenatal education and care.<span>^{7, 8}</span> Currently, only about half of women with PCOS receive counseling about the implications of PCOS for their pregnancy outcomes at preconception, and the majority are not satisfied with the information they receive.<span>⁹</span> Midwives, as frontline health care providers, play a pivotal role in identifying and managing PCOS in pregnant women. This commentary aims to underscore the importance of health care professionals, particularly midwives, in recognizing and managing PCOS as a critical risk factor during pregnancy. It also addresses the broader challenges of early identification and management of PCOS in prenatal care. Furthermore, this commentary explores opportunities for improvement through research, education, collaboration, and practice change to enhance both maternal and offspring health outcomes. The <i>2023 International Evidence-based Guideline for the Assessment and Management of PCOS</i> offers comprehensive, evidence-based recommendations to address these challenges.<span>¹⁰</span></p><p>PCOS affects approximately 17 million pregnancies annually and poses a significant risk for adverse pregnancy outcomes. The <i>2023 International Evidence-based Guideline for the Assessment and Management of PCOS</i><span>¹⁰</span> highlights key recommendations for identification, early screening, prevention, and intervention strategies to improve these outcomes. Despite its prevalence, PCOS remains underrecognized in perinatal care, with challenges such as knowledge gaps, lack of standardized identification and management protocols, underreporting, and inconsistent practice guidelines. Addressing these gaps through a multifaceted approach will enhance both basic and continuing midwifery education, ultimately improving care and health outcomes for women and their newborns.</p><p>The author has no conflicts of interest to disclose.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 2","pages":"200-203"},"PeriodicalIF":2.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13706","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635168","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":"Perinatal Loneliness and Isolation Early in the COVID-19 Pandemic in New York City: A Qualitative Study","authors":"Brooke S. West PhD,&nbsp;Lida Ehteshami BA,&nbsp;Clare McCormack PhD,&nbsp;Beatrice Beebe PhD,&nbsp;Ginger D. Atwood BA,&nbsp;Judy Austin PhD,&nbsp;Vitoria Chaves BA,&nbsp;Violet Hott BA,&nbsp;Yunzhe Hu BA,&nbsp;Maha Hussain MS,&nbsp;Margaret H. Kyle BA,&nbsp;Georgia Kurman BA,&nbsp;Marissa Lanoff MA,&nbsp;Andréane Lavallée RN, PhD,&nbsp;Jeremiah Q. Manning BA,&nbsp;Mary T. McKiernan RN,&nbsp;Nicolò Pini PhD,&nbsp;Grace C. Smotrich BA,&nbsp;William P. Fifer PhD,&nbsp;Dani Dumitriu MD, PhD,&nbsp;Sylvie Goldman PhD","doi":"10.1111/jmwh.13695","DOIUrl":"10.1111/jmwh.13695","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>During the COVID-19 pandemic, birthing parents were identified as a high-risk group with greater vulnerability to the harms associated with SARS-CoV-2. This led to necessary changes in perinatal health policies but also to experiences of maternal isolation and loneliness, both in hospital settings, due to infection mitigation procedures, and once home, due to social distancing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, we qualitatively explored birthing and postpartum experiences in New York City during the early days of the pandemic when lockdowns were in effect and policies and practices were rapidly changing. Using thematic analysis, our focus was on experiences of isolation, navigating these experiences, and the potential impacts of isolation and loneliness on maternal health for 55 birthing people.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants described numerous stressors related to isolation during the birthing process, including reconciling their hopes for their birth with the realities of the unknown and separation from partners, family, and friends in the hospital. During the postpartum period, loneliness manifested as having limited or no contact with family and friends, which led to feelings of a need for strengthened social support systems. The impact of these negative experiences shaped mental health. Overall, we found that solitary experiences during birthing and postpartum isolation were major sources of stress for participants in this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>To support impacted families and prepare for future crisis events, clinicians and researchers must prioritize the development of strong clinical and social support structures for perinatal people to ensure both maternal and child health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 1","pages":"124-130"},"PeriodicalIF":2.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13695","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635162","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":"Adapting Group Prenatal Care for Telehealth: A COVID-Era Innovation to Address Barriers to Care for Latinx Clients","authors":"Catherine Daily CNM, DNP,&nbsp;Ashley Gresh CNM, PhD,&nbsp;Elizabeth R. Hamilton MPH, CPHQ,&nbsp;Christina X. Marea CNM, PhD, MA, MSN","doi":"10.1111/jmwh.13701","DOIUrl":"10.1111/jmwh.13701","url":null,"abstract":"<p>The use of telehealth prenatal care increased exponentially during the coronavirus disease 2019 (COVID-19) pandemic, but there is no literature describing its use for group prenatal care during this time. The COVID-19 pandemic also exacerbated structural barriers to care that disproportionately affect Black and Latinx people. Telehealth enabled pregnant people to access health care and minimize infectious risks. Telehealth group prenatal care (T-GPNC) incorporated the essential elements of CenteringPregnancy with telehealth is an innovative care delivery method borne out of necessity during the COVID-19 pandemic that has potential to mitigate structural barriers to care.</p><p>Mary's Center is a federally qualified health center (FQHC) in Washington, DC, and Maryland that rapidly pivoted to individual telehealth prenatal care early in the pandemic. Mary's Center used our experience with group care and guidance from the Centering Healthcare Institute on virtual Centering to launch T-GPNC. This new model included home self-monitoring equipment and video classrooms, mixed with in-person individual care visits. We used a team-based approach with nurses, midwives, and community health workers to provide holistic care to pregnant people. Our robust care coordination team also connected them to home visiting, mental health services, and nutrition counseling.</p><p>The purpose of this article is to describe how Mary's Center modified the CenteringPregnancy model of group prenatal care for telehealth, following the hallmarks of CenteringPregnancy, and met the needs of Spanish-speaking clients, henceforth Latinx clients. A secondary purpose is to demonstrate how telehealth can expand access to health care and remove structural barriers that may prevent pregnant people from attending in-person appointments. We also discuss the structural inequities in digital access and literacy in the context of program implementation.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"945-951"},"PeriodicalIF":2.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515451","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}