Journal of midwifery & women's health最新文献

{"title":"Implementation of a Community Doula-Hospital Partnership to Improve Access to Linguistically and Racially Concordant Doula Care for Black Birthing People","authors":"Sarah L. Goff MD, PhD,&nbsp;Neena Qasba MD, MPH,&nbsp;Autumn Versace CNM, DNP,&nbsp;Carly Detterman CNM, MSN,&nbsp;Liza Winston CNM, MSN,&nbsp;Laura Gebhardt BA, CCRP,&nbsp;Tanita Council CBS, BS,&nbsp;Laconia Fennell CLC, BSN,&nbsp;Laura Attanasio PhD","doi":"10.1111/jmwh.70110","DOIUrl":"10.1111/jmwh.70110","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Racially and linguistically concordant doula care has reduced disparities in maternal morbidity and mortality rates for Black birthing people. This mixed-methods pilot implementation study assessed the feasibility of implementing and maintaining a novel partnership between a community doula organization led by 2 Black doulas and an urban academic tertiary care hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework was used to design and evaluate implementation. Black birthing people were recruited from the hospital's midwifery and general obstetrician-gynecology practices. Partnership members selected the implementation strategies. Implementation outcomes were assessed through periodic clinician surveys of midwives, labor and delivery nurses, and physicians and through doula monthly check-ins, postbirth debriefs, and patient visit logs. Descriptive and comparative quantitative analyses were conducted for surveys and doula logs. Rapid qualitative analyses were conducted for open-ended survey responses, doula check-ins, and debriefs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 51 of 55 patients enrolled in the study received doula services. Midwives expressed higher levels of acceptability and appropriateness of doula care on clinician surveys compared with labor and delivery nurses and physicians. Feasibility was high, but some clinicians demonstrated a lack of understanding of the doulas’ role in labor and birth. Fidelity for prenatal and postnatal visits was high (98% and 96.1%, respectively). A doula was physically present at 41 births and virtually present at 6 (N = 51). Reasons for not being present during the remaining 4 births included communication issues, precipitous births, and births at a facility other than the study site.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study demonstrates that implementation of a formal community doula-academic hospital partnership was largely feasible. Interprofessional education has the potential to improve physicians’ and labor and delivery nurses’ lower ratings of the appropriateness and acceptability of doula care compared with midwives’ ratings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"600-609"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641032","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 Patient, the Provider, and the TikTok Creator: Qualitative Analysis of the Content and Quality of Videos on Prenatal Genetic Screening","authors":"Erin P. Johnson PhD,&nbsp;Naomi O. Riches PhD,&nbsp;Stephanie Arceneaux BA,&nbsp;Emma Murdock MA,&nbsp;Caitlin Quade MPH,&nbsp;Susanna R. Cohen CNM, DNP,&nbsp;Robin E. Jensen PhD","doi":"10.1111/jmwh.70121","DOIUrl":"10.1111/jmwh.70121","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although providers may view the use of the noninvasive prenatal testing (NIPT) screen as an opportunity for patients to learn more about potential chromosomal variants of a fetus, research suggests that patients may view the genetic screening test primarily as an opportunity to learn about their fetus's sex chromosomes and may not understand the implications of a screening test, as compared with a diagnostic test. This study critically evaluates the informational quality of TikTok content related to NIPT, with a specific focus on the use and conflation of sex and gender terminology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 83 TikTok videos met our inclusion criteria. Two team members systematically coded the videos using a modified DISCERN instrument and content-specific codes to assess reliability and informational quality across 3 content creator categories: patients/nonexperts, health care professionals, and organizations. Many codes focused specifically on the use of gendered language in the videos.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patient-generated content exhibited the highest engagement metrics but frequently misrepresented NIPT as a confirmatory test and conflated sex with gender. Health care provider and organizational videos demonstrated higher informational reliability but were not immune to deterministic language around sex and gender and promotional framing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The findings underscore the influence of social media as a health information source and reveal significant gaps in public understanding of NIPT, particularly regarding its screening nature and limitations. Additionally, these results highlight the need for clinical protocols that address patient misconceptions and suggest that health care professionals should actively engage with digital platforms to familiarize themselves with what patients are seeing and hearing online. Recommendations include avoiding gendered mirroring, asking questions about patient knowledge, and leveraging social media for public health education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"618-627"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679932","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":"Evaluating the Impact of Telehealth Prenatal Care at a Federally Qualified Health Center","authors":"Catherine Daily CNM, DNP,&nbsp;Ashley Gresh CNM, PhD,&nbsp;Elizabeth R. Hamilton PhDc, MPH, CPHQ, CPPS,&nbsp;Nancy A. Crowell PhD,&nbsp;Germán Gustavo Alva Martinez BS,&nbsp;Christina X. Marea CNM, PhD, MA","doi":"10.1111/jmwh.70107","DOIUrl":"10.1111/jmwh.70107","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>During the COVID-19 pandemic, clinicians had to reimagine perinatal care. Mary's Center, a federally qualified health center, built an innovative telehealth group prenatal care (T-GPNC) program to ensure equitable and safe access to health care. T-GPNC includes an individual telehealth assessment and group education. We conducted a program evaluation to determine the adequacy of prenatal care for T-GPNC clients compared with individual prenatal care (IPC) clients and to describe client satisfaction with T-GPNC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This mixed-methods study included a retrospective chart review of electronic health records of Spanish-speaking midwifery clients at Mary's Center between July 1, 2021, and August 31, 2023, and client satisfaction surveys for T-GPNC. The T-GPNC intervention was offered only to Spanish-speaking clients in this timeframe. Our main outcome of interest was the adequacy of prenatal care, measured by generating an Adequacy of Prenatal Care Utilization Index. We conducted a thematic analysis of the surveys that included open-ended and categorical questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study sample for adequacy of prenatal care included 141 T-GPNC and 193 IPC clients. The majority of clients were Latinx, and 97.9% received public insurance or were uninsured. T-GPNC clients were significantly more likely to receive adequate or adequate-plus care at 67.9% compared to 39.1% for IPC clients (χ²(2) = 45; <i>P</i> &lt; .001). Among T-GPNC clients who completed the satisfaction survey (n = 47; 33% response rate), they reported a high level of satisfaction (mean [SD] 4.85 out of 5 [0.63]). Qualitative themes included gaining knowledge, shared experiences, and systems-level support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>T-GPNC provided critical support to Spanish-speaking clients during the COVID-19 pandemic, producing higher rates of adequate prenatal care for T-GPNC clients than for those receiving IPC and resulting in highly satisfied T‑GPNC clients. These statistically significant and clinically meaningful results indicate the value added by implementing T-GPNC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"538-548"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984904","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":"Career Pathways and Employment Experiences of Certified Nurse-Midwives Compared With Other Advanced Practice Registered Nurses in the United States","authors":"Paula M. Kett PhD, MPH, RN,&nbsp;Kyla F. Woodward PhD, RN,&nbsp;Shahida Shahrir PhD, MPH,&nbsp;Selina A. Mohammed PhD, MPH, RN","doi":"10.1111/jmwh.70104","DOIUrl":"10.1111/jmwh.70104","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite recent growth in the certified nurse-midwife (CNM) workforce and data showing better perinatal outcomes associated with their care, midwives continue to be underused in the United States. To facilitate targeted policies for integrating and sustaining this workforce, information is needed regarding the career pathways and employment experiences of CNMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this longitudinal study, we used the 2018 and 2022 National Sample Survey of Registered Nurses to examine how CNM demographics, career pathways, and job experiences changed over time and in comparison with other advanced practice registered nurses (APRNs). We used multivariable logistic regression to examine the odds of education, financing, and employment characteristics among CNMs compared with other APRNs, then used regression output to calculate predicted probabilities of each characteristic among CNMs compared with other APRNs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The size and racial diversity of the CNM workforce changed over time. CNMs had a 5.4% higher probability of working as a community health worker and a 9.5% higher probability of taking out a loan to finance their education than other APRNs. CNMs’ predicted mean annual salaries were up to $25,000 lower than other APRNs, and CNMs had up to a 6.3% higher probability of $60,000 or more in remaining debt compared with the other APRN groups. Finally, compared with other APRNs, CNMs were up to 15.0% less likely to report practicing to the full extent of their license and their education and training, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Although there was change in the size and diversity of the workforce, CNMs’ financial and employment situations may contribute to persistent challenges in entering and maintaining practice. Future research should explore additional factors related to CNM turnover and retention. Workforce policies should target barriers to practice and support more competitive salaries for CNMs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"556-569"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694491","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":"Outcomes for Labor Induction Compared With Expectant Management Among Women Receiving Hospital-Based, Midwifery-Led Care","authors":"Denise Colter Smith CNM, PhD,&nbsp;Jena Wallander Gemkow RN, BSN, MPH,&nbsp;Bethelhem A. Shiferaw MPH,&nbsp;Jessica Anderson CNM, DNP,&nbsp;Danielle Bulinski CNM, MSN,&nbsp;Mollie Gilbert Brody CNM, MSN,&nbsp;Suzanne Carrington CNM, DNP,&nbsp;Catherine Cherry CNM, MSN,&nbsp;Shannon M. Pirrie CNM, DNP,&nbsp;Ana Williams CNM, MSN,&nbsp;Heather L. Smyth PhD,&nbsp;Katherine J. Kissler CNM, PhD","doi":"10.1111/jmwh.70109","DOIUrl":"10.1111/jmwh.70109","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Use of labor induction has increased rapidly for medical and nonmedical reasons, raising questions about its impact on cesarean birth rates. With growing incidence of elective induction of labor (IOL) at 39 weeks, uncertainty remains about how care practices associated with IOL influence outcomes. Observational studies have reported varied cesarean birth rates following IOL. This issue is particularly relevant for midwives, who prioritize physiologic labor and recognize benefits of spontaneous labor in achieving vaginal birth. This study evaluated cesarean birth rates after labor induction in midwifery-led practice settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study (2017-2023) of term births (N = 7345) with midwifery-led intrapartum care in 4 practice groups across 3 hospitals. Outcomes were stratified by parity and gestational age. We compared cesarean birth rates between labor induction and expectant management (EM) for each week of gestation, replicating prior methodology. Logistic regression was used to calculate odds ratios for cesarean following IOL, adjusting for relevant covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall cesarean birth rate was 10.7%; the nulliparous, term, singleton, vertex cesarean birth rate was 18.4%. Labor induction occurred in 28.8% of births. Cesarean birth rates following IOL ranged from 10.5% at 39 weeks to 31.1% at 42 weeks. No significant differences in cesarean birth rates were observed between IOL and EM groups across gestational ages in adjusted analyses. Secondary outcomes, including postpartum hemorrhage, Apgar scores, and neonatal intensive care unit admission showed no significant differences across groups. Time from admission to birth was significantly longer following IOL, averaging 31.5 compared with 12.6 hours for spontaneous labor at 37 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Among patients receiving exclusive midwifery care, labor induction did not increase cesarean birth rates. Findings suggest that clinical context, including midwifery-led care and collaborative practice environments, may influence outcomes. Further research is needed to explore impact of IOL practices on risks for cesarean birth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"526-537"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640991","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":"Experiences and Perspectives of Perinatal Care for Women of Refugee Background, Interpreters, and Care Providers: A Scoping Review","authors":"Shadow Toke BH-BMED (Hons),&nbsp;Amita Tuteja PhD, MRCOG,&nbsp;Ignacio Correa-Velez PhD, MBBS,&nbsp;Elisha Riggs PhD, BAppSci Hons","doi":"10.1111/jmwh.70108","DOIUrl":"10.1111/jmwh.70108","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Women of refugee backgrounds who are pregnant continue to face significant challenges after migration, including barriers to accessing adequate perinatal care, resulting in higher risks for poor perinatal outcomes. To address these barriers and reduce these risks, it is imperative to understand the viewpoints of those involved in perinatal care. Thus, the aim of this scoping review is to identify and describe women of refugee backgrounds, interpreters, and care providers’ experiences with perinatal care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review of qualitative and mixed-methods studies was conducted. Publications were searched from CINAHL, MEDLINE (via OVID), Embase, and PubMed in August 2025. Peer-reviewed studies published in English since 2014 that reported women of refugee background, interpreters, and perinatal care providers’ experiences with perinatal care in high-income countries were considered for eligibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 57 studies from 12 high-income countries were identified for study inclusion. Of these, 40 studies included women of refugee background as participants, 19 included perinatal care providers who have provided care to women of refugee background, and 2 studies included interpreters who worked within perinatal care settings. Three overarching themes were identified: (1) women's health literacy, (2) language and communication, and (3) personal and sociocultural context. Addressing language barriers and the challenges they pose is vital in supporting women's health literacy and engagement with trauma-informed and culturally safe perinatal care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This review underscores the importance of understanding and navigating both women's and perinatal care providers’ sociocultural contexts within perinatal care. Perinatal care systems need to actively incorporate interpreters as integral members of the care team and provide training and support tailored to the complexities of working with refugee background populations. Additionally, future research should include interpreters’ voices on their perspectives and experiences in perinatal care to comprehensively understand and identify ways to improve interpreter-mediated perinatal care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"576-599"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517894","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":"Influences on Vaccine Decision-Making During Pregnancy","authors":"Shelly J. Reed CNM, PhD, DNP, MSN, APRN,&nbsp;McKinsey Owen MS, FNP-C,&nbsp;Cheryl A. Corbett MSN, APRN, FNP-C,&nbsp;Janelle L. B. Macintosh PhD, RN","doi":"10.1111/jmwh.70095","DOIUrl":"10.1111/jmwh.70095","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pregnant people are at greater risk for vaccine-borne illness yet are more vaccine hesitant than the general population. Hesitancy toward COVID-19 vaccination emerged among pregnant individuals during the COVID-19 pandemic, with vaccine hesitancy also reported in previous vaccine acceptors. With the clear benefits of vaccination for pregnant individuals and their neonates, it is essential to investigate vaccine hesitancy. Therefore, the purpose of this study was to explore the perceptions and decision-making processes of pregnant individuals regarding COVID-19 vaccination during pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative descriptive design with semistructured interviews was used for the study. A convenience sample of pregnant or recently pregnant individuals who spoke English or Spanish was obtained. Interviews were conducted until data saturation was achieved, and the interviews were translated (when necessary) and transcribed. Members of the research team analyzed interview transcripts separately, coded and organized the data into themes, and then collaborated to reach a consensus on the final themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 41 interviews conducted, with 10 participants self-identifying as Spanish, Hispanic, or Latino. Influences on decision-making included trust in health care providers, fear of complications from vaccination, fear of adverse effects from COVID-19 infection, perceived vaccine safety and efficacy, perceptions surrounding immunity, novelty of the COVID-19 vaccine, perceived positive health status, spiritual and religious influences, and influences from family members and friends. Information sources that participants described using in their vaccine decision-making included information obtained from family members who were health care professionals, the Centers for Disease Control and Prevention, and internet and social media sources that participants perceived as valid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The findings reveal the impact of health care providers’ recommendations on the COVID-19 vaccine decision-making process for pregnant individuals, highlighting the crucial role health care providers play in disseminating accurate vaccine information. Safety concerns regarding the vaccine and vaccination to prevent illness were described, showing that health care providers should address these concerns when providing vaccine information.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"511-518"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Analysis of Mental Well-Being in Postpartum Narratives Following a High-Risk Pregnancy: The Beautiful Agony","authors":"Kaitlyn K. Stanhope PhD, MPH,&nbsp;Morgan N. V. Buchanan MD, MPH,&nbsp;Margaret Master MPH, MBA,&nbsp;Anna Newton Levinson PhD, MPH,&nbsp;Taé Stallworth LPN,&nbsp;Anne L. Dunlop MD, MPH,&nbsp;Sarah C. Blake PhD, MA","doi":"10.1111/jmwh.70103","DOIUrl":"10.1111/jmwh.70103","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Mental health, at the opposite end of the spectrum from mental illness, is an important yet understudied aspect of maternal well-being. We sought to characterize aspects of emotional, social, and functional well-being in the postpartum period and perceived facilitators and barriers to mental health following a high-risk pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted 28 in-depth interviews with people 3 to 6 months postpartum who experienced a pregnancy complicated by hypertension or diabetes in Atlanta, Georgia. We conducted a thematic analysis to examine dimensions of mental health and prevalent challenges to attaining it.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants described how social well-being (including interpersonal relationships, functional support, and social support) facilitated positive functioning and emotional well-being. Challenges to well-being included difficulties with infant feeding and care, housing and financial insecurity, and personal health. Facilitators of well-being included robust and positive relationships with female relatives and male partners. Participants described a limited role of the perinatal care team in supporting mental well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Postpartum mental health is a distinct construct from mental illness that, when adequately supported through family networks and health care teams, can benefit both woman and infant.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 4","pages":"549-555"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825174","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":"Evaluation of a Shift Model Doula Program During Labor and Birth at a Large Volume, Safety-Net Teaching Hospital","authors":"Phoebe Montgomery CNM, APN,&nbsp;Stefka Fabbri MD, MPH,&nbsp;Laura Podewils PhD, MS,&nbsp;Abigail Steiner MS, MPH","doi":"10.1111/jmwh.70074","DOIUrl":"10.1111/jmwh.70074","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite documented benefits of doula support for patients and newborns, access remains limited. This evaluation examined patient and neonatal outcomes associated with a hospital-based, shift model of doula care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective analysis was conducted on eligible births at a single, safety-net teaching hospital between January 1 and December 31, 2022. Patients who received doula care during labor and/or birth were compared with those who did not. Doulas were volunteers who self-scheduled shifts and provided support when available. Primary outcomes included cesarean birth and neonatal intensive care unit (NICU) admission. Adjusted odds ratios were calculated to assess the association between doula presence and outcomes of interest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 3055 eligible patients, 375 (12.2%) were offered doula support, and 355 (11.6% of total; 94.7% of those offered) accepted. Most patients were 25 to 34 years old (53.6%), were multiparous (67.2%), identified as Hispanic (65.7%), and had public insurance (82.5%). Patients who received doula support were more likely to identify as Black non-Hispanic or multiracial (<i>P</i> = .005). Labor complications, including chorioamnionitis, shoulder dystocia, and arrest of labor, were more frequent among those with doula support (18.9% vs 14.6%; <i>P</i> = .034), as was oxytocin augmentation (54.9% vs 37.0%; <i>P</i> &lt;.001), and induction of labor (55.2% vs 37.1%, <i>P</i> &lt;.001). NICU admissions were lower among doula-supported births, although not statistically significant (2.8% vs. 5.1%, <i>P</i> = .058). Doula-supported patients had lower odds of cesarean birth (11.8% vs 16.5%; <i>P</i> = .024; adjusted odds ratio, 0.69; 95% CI, 0.48-0.97).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Doula care provided through a shift-based hospital model was associated with a decreased cesarean birth rate despite increased labor complications, induction of labor, and oxytocin use. These findings suggest that even intermittent doula support may improve outcomes. Additional studies are warranted to further evaluate the impact of shift-based doula care models on perinatal outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 3","pages":"412-421"},"PeriodicalIF":2.3,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807268","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":"Alignment of Midwifery Education in Nepal With Global Standards and Essential Competencies From the International Confederation of Midwives: A Mixed-Methods Study","authors":"Khim Bahadur Khadka MPH, MEd,&nbsp;Deepak Paudel PhD,&nbsp;Binod Bindu Sharma PhD,&nbsp;Ramesh Prasad Adhikari MPhil,&nbsp;Anju Poudel MN,&nbsp;Urmila Baral MN,&nbsp;Kamala Rana Magar MN,&nbsp;Bidhya Banstola MN,&nbsp;Guenter Froeschl MD, PD,&nbsp;Olena Ivanova MD, PhD, MPH","doi":"10.1111/jmwh.70096","DOIUrl":"10.1111/jmwh.70096","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Maternal and neonatal mortality rates in Nepal remain high, reflecting persistent gaps in the quality of maternal and newborn care. To address this issue, a national midwifery education program was initiated in 2016. This study assessed Nepal's preservice midwifery curricula against global standards and competencies defined by the International Confederation of Midwives (ICM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A mixed-methods study was conducted, comprising a desk review of national standards and curricula against ICM education standards (2021) and competencies (2024), 15 stakeholder interviews, 3 focus group discussions, and site visits to 4 hospitals and one midwifery school. Quantitative data were mapped using a 4-point alignment scale, and qualitative data were coded and thematically analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Nepal Nursing Council standards for the bachelor's in midwifery program aligned with 72% of the ICM education standards. The standards for the certificate in midwifery program covered 67%, whereas the certificate in midwifery curriculum from the Council for Technical Education and Vocational Training aligned with only 52%. The bachelor's in midwifery curriculum met 89% of the ICM essential competencies, the certificate in midwifery curriculum met 76%, and the certificate in nursing curriculum met 43%. These quantitative gaps were contextualized by qualitative findings, including theory-practice mismatches, shortages of qualified faculty members and training resources, and insufficient supervision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Stakeholders confirmed the absence of dedicated midwifery regulations and clear career pathways in the country as an issue. Without targeted reforms to standardize curricula, investment in infrastructure, and legally recognizing midwifery as a distinct profession, Nepal's ability to reduce preventable maternal and neonatal mortality will be compromised.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"71 3","pages":"367-378"},"PeriodicalIF":2.3,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625101","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}