Journal of midwifery & women's health最新文献

{"title":"Gender and Sex Inclusive Approaches for Discussing Predicted Fetal Sex: A Call for Reflection and Research","authors":"Hannah Llorin MS, CGC, Tiffany Lundeen CNM, MSN, Elizabeth Collins MD, MPH, Claudia Geist PhD, Kyl Myers PhD, MS, Susanna R. Cohen CNM, DNP, Kimberly Zayhowski MS, CGC","doi":"10.1111/jmwh.13663","DOIUrl":"10.1111/jmwh.13663","url":null,"abstract":"<p>Technology has rapidly transformed the centuries-old practice of fetal sex prediction, and significant social and medical progress is changing the way prenatal health care providers (HCPs) address the often-asked question, “Am I having a boy or a girl?” Access to prenatal cell-free fetal DNA (cfDNA) screening is expanding broadly, and medical societies recommend cfDNA screening for all pregnancies.<span><sup>1, 2</sup></span> Prenatal cfDNA screening offers sex chromosome assessment for sex chromosome aneuploidy (sex chromosome complements other than XX or XY), along with other aneuploidy screening (for trisomies 13, 18, and 21), as early as 10 weeks’ gestation. Patients may have a limited understanding of the prevalence of aneuploidy in the general population, the implications of these differences, and the purpose of screening for them. This gap in understanding could lead patients to believe the test is solely about gender determination.</p><p>There is increased awareness that gender and sex diversity are essential components of health, health care, and social reality.<span><sup>3</sup></span> In this commentary, we posit that many prenatal HCPs are currently underprepared to talk to parents about fetal sex prediction and sex chromosome variation during the course of prenatal care in a manner that is accurate and inclusive of gender and sex diversity, which would promote family function and individual well-being for gender- and sex-diverse children and adults. This skill is relevant to midwives, nurses, genetic counselors, physicians, physician associates, radiologists, and radiology technicians. Of note, in this commentary, we have largely chosen to use the term <i>parents</i> to align with the focus on childhood gender socialization, presupposing a context of desired pregnancies leading to birth and parenting.</p><p>When prenatal HCPs tell patients, “It's a girl!” or “It's a boy!” they reinforce an erroneous bioessentialist framework: people with XX chromosomes or an apparent vulva are assigned female and socialized as girls, and people with XY chromosomes or an apparent penis are assigned male and socialized as boys. (See Table 1 for relevant terms and definitions.) However, a person's own construct of gender identity is the result of interactions between biological and social factors and relies on cognitive development across the life span. Misconceptions about both sex and gender that are often enacted during the prenatal period among HCPs and pregnant people include: (1) sex and gender are determined by sex chromosomes alone, (2) a person's sex chromosomes can only be XX or XY, and that sex is strictly binary, and (3) there are only 2 gender categories: boy or girl.<span><sup>4, 5</sup></span> These incorrect assumptions jeopardize the child's autonomy<span><sup>6</sup></span> and contribute to the inflexible binary social model and dimorphic biological model that underlie bigotry, erasure, phobias, and discrimination against gender-di","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"821-825"},"PeriodicalIF":2.1,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Reviews to Inform Practice, July/August 2024","authors":"Nena R. Harris CNM, PhD, FNP-BC, CNE","doi":"10.1111/jmwh.13671","DOIUrl":"10.1111/jmwh.13671","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 4","pages":"606-614"},"PeriodicalIF":2.1,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antenatal Care Visits, Institutional Births, and Associated Risk Factors in Afghanistan: Insights from the Multiple Indicator Cluster Survey 2022-2023","authors":"Jahar Bhowmik PhD,&nbsp;Lakma Gunarathne BSc,&nbsp;Sunil Bhar PhD,&nbsp;Udayan Bhowmik,&nbsp;Raaj Kishore Biswas PhD","doi":"10.1111/jmwh.13666","DOIUrl":"10.1111/jmwh.13666","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Insufficient use of antenatal care (ANC) services and institutional births services can elevate the maternal mortality risk in limited resource settings. Hence, the key objective of this study was to evaluate the potential association between the frequency of ANC visits and institutional birth services in Afghanistan, while also identifying other sociodemographic factors that may exert influence. Furthermore, we explored factors associated with the attendance of women at ANC visits during their pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We employed data from the most recent Multiple Indicator Cluster Survey conducted in Afghanistan in 2022 to 2023 with a total of 8096 women aged 15 to 49. A complex survey weight-adjusted logistic regression model was used to examine factors related to institutional births, and a multinomial logistic regression model was fitted to assess the relationships between sociodemographic factors and ANC visits, adjusting for survey weights, cluster effects, and strata.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Approximately 40% of the sample (n = 3247) had undergone 4 or more ANC visits, and 74.4% (n = 6,022) had opted for institutional birth. Women's higher education was found to be associated with ANC visits. The area of residence, wealth index, education levels of women, ownership of mobile phones, number of children, and number of ANC visits were associated with institutional births. Compared with women with no or one ANC visit, those with more than 3 visits had 31% higher odds (adjusted odds ratio, 1.31; 95% CI, 1.10-1.57) of accessing institutional births.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings indicate a significant association between ANC visits and use of institutional birth care. These findings carry implications for advancing safe motherhood and childbirth by enhancing women's social status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 1","pages":"147-156"},"PeriodicalIF":2.1,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13666","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602384","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":"Midwives’ and Obstetric Physicians’ Practices Related to Pregnancy Nutrition Counseling: A Scoping Review","authors":"Katherine Erbe CNM, PhD, MS,&nbsp;Kylea Liese CNM, PhD,&nbsp;Lisa Tussing-Humphreys PhD, MS, RD,&nbsp;Elizabeth Lerner Papautsky PhD, MS,&nbsp;Julienne Rutherford PhD,&nbsp;Mary Dawn Koenig CNM, PhD","doi":"10.1111/jmwh.13661","DOIUrl":"10.1111/jmwh.13661","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Dietary intake during pregnancy impacts short- and long-term maternal and fetal health outcomes. Dietary habits are highly individualized and influenced by contextual factors and social determinants of health within each person's lived environment. Midwives and other health care providers are well positioned to facilitate nutrition conversations and interventions with patients related to recommendations and modifications before and during pregnancy. This scoping review synthesizes the literature on perinatal care providers’ attitudes and practices related to antenatal nutrition counseling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An electronic database literature search was conducted in March 2023 using the following inclusion criteria: English language, published between 1990 and 2023, completed in high-income countries, and evaluated provider practices related to educating pregnancy patients on nutrition. Exclusion criteria included comparison or interventional studies as well as those focused on patient perspectives, specialty diets, comorbidities, or pregnancy complications. Thematic analysis was completed to identify common themes and subthemes across studies related to perinatal care providers’ perspectives of pregnancy nutrition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-six articles were included in the final review. Although providers acknowledged the importance of nutrition for pregnancy outcomes, few reported being able to cover the topic in-depth during antenatal visits. Counseling was usually generalized, limited in scope, and lacked consideration of patient-specific contextual factors such as dietary restrictions, preferences, or access to resources needed to follow recommendations. Provider barriers to comprehensive nutrition counseling included lack of training and time during clinic visits and limited availability of guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Multiple gaps in current pregnancy nutrition counseling practices exist. Despite nutrition being viewed by perinatal care providers as an important part of pregnancy, multiple barriers lead to it being overlooked during patient-provider interactions. Contextual factors for both providers and patients contribute to failure of current interventions to consistently and significantly impact dietary habits of pregnant people.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 1","pages":"61-76"},"PeriodicalIF":2.1,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13661","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Midwives in US Perinatal Palliative Care: A Scoping Review","authors":"Robyn Schafer CNM, PhD,&nbsp;Jenna A. LoGiudice CNM, PhD,&nbsp;Pamela Hargwood MLIS, AHIP,&nbsp;Abigail Wilpers PhD, WHNP-BC","doi":"10.1111/jmwh.13664","DOIUrl":"10.1111/jmwh.13664","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Perinatal palliative care (PPC) is a rapidly growing and essential reproductive health care option for pregnant persons with a diagnosed life-limiting fetal condition who continue their pregnancy. The provision of PPC is within the scope of basic midwifery competencies, and midwives are well-positioned to make unique and valuable contributions to interprofessional PPC teams. However, little is known about midwives’ past or current involvement in PPC in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This scoping review of the literature investigated what is known about the role of midwives in PPC in the United States. Multiple databases of published literature were used for this review: PubMed, CINAHL, Embase, Web of Science, ProQuest, Google Scholar, and relevant citations from identified studies. All types of English language publications addressing midwives’ involvement in PPC in the United States were included, without any limitations on publication date.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The role and contributions of midwives in PPC is not well represented in existing literature. Of the 259 results identified, 7 publications met criteria for inclusion. These included 5 case reports, one quantitative research article, and one conference abstract. Midwives are involved in PPC through the provision of direct clinical care (including antepartum, intrapartum, postpartum, neonatal, bereavement, postmortem, and follow-up care) and care planning and coordination as part of an interprofessional team.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Despite midwives being uniquely positioned to provide holistic, family-centered, and person-centered care in situations of pregnancy with life-limiting fetal conditions, there is limited literature about their involvement in PPC in the United States. PPC should be incorporated into midwifery education and training programs. Midwives should play a central role in shaping future research and policies to ensure the accessibility and quality of PPC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"875-887"},"PeriodicalIF":2.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise in Pregnancy","authors":"","doi":"10.1111/jmwh.13672","DOIUrl":"10.1111/jmwh.13672","url":null,"abstract":"&lt;p&gt;Most exercise is safe in a healthy pregnancy. Daily exercise can help you and your baby be healthier and decrease your chance of some problems during pregnancy. Exercise in pregnancy does not increase your chance of miscarriage, low birth weight, or early delivery. If you had a medical problem before you became pregnant or have had complications during your pregnancy, you should talk about the safety of exercise with your health care provider before you start any activity.&lt;/p&gt;&lt;p&gt;Exercise in pregnancy can help you in many ways. It can help you feel better and have less back pain, constipation, and tiredness. Exercise can also help you sleep better and improve your mood. Your body will be better prepared for labor. You may have a shorter labor with less chance of having a cesarean birth. You may gain less weight in pregnancy, which will help you get back to your pre-pregnancy weight more quickly after the baby comes. Exercise in pregnancy lowers your chance of gestational diabetes or high blood pressure during pregnancy. Your baby is more likely to be born with a healthy birth weight. Exercise can also lower the chance of having postpartum depression after the baby is born.&lt;/p&gt;&lt;p&gt;You should try to do moderate exercise for at least 150 minutes a week. Moderate exercise means you should start to sweat and your heart rate should increase, but you are still able to talk while you are exercising. You can divide your exercise into whatever amounts work best in your life. Some find 30 minutes a day at one time works. Others prefer 10–15 minutes a few times a day. If you exercised before pregnancy, you can probably continue the same physical activities and intensity of exercise. If you are not currently exercising, pregnancy is a good time to start. You want to start slow and gradually increase your exercise.&lt;/p&gt;&lt;p&gt;Walking or swimming are good exercises to start with. You will get moving and have less strain on your joints. Biking, yoga, Pilates, and low-impact aerobics are also good choices. Light weight training is okay, too. Being creative with your exercise will help you stay motivated. Hiking, dancing, and rowing can be fun activities to try. You do not need to pay money for an exercise class or activity. Walking up and down stairs or doing exercises at home are all good, free activities.&lt;/p&gt;&lt;p&gt;Be sure to stretch your muscles first and warm up and cool down each time you exercise. Drink water throughout your exercise so you can stay well hydrated. Make sure you don't get too hot, and don't overdo your exercise especially on a hot day. During pregnancy, your balance changes as the baby grows so it is important to move carefully and always make sure you are not in danger of falling. Pregnancy hormones cause your joints to be more relaxed. They can be injured easier especially with jerky, bouncy, or high-impact movements. You have more oxygen needs in pregnancy. This can make it harder to breath, especially with hard exercise or for people with obesit","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 4","pages":"619-620"},"PeriodicalIF":2.1,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Provider Trust as a Key Component of Prenatal Screening for Adverse Childhood Experiences (ACES): A Concept Analysis","authors":"Paige D. Gilliland BS,&nbsp;Jennifer E. Phipps PhD,&nbsp;Breän Derret MD,&nbsp;Indira D'Souza BS,&nbsp;Stephanie Ha BS,&nbsp;Shwetha Patil BS,&nbsp;Leigh Ann Simmons PhD, MFT","doi":"10.1111/jmwh.13660","DOIUrl":"10.1111/jmwh.13660","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The concept of patient-provider trust in prenatal adverse childhood experiences (ACEs) screening remains unexplored. This concept analysis illuminates the role of trust in prenatal ACE screening to improve patient-provider relationships, increase patient uptake of ACE screening, and ensure that ACE screening is implemented in a strengths-based, trauma-informed way.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A concept analysis was conducted using the Rodgers’ evolutionary method to define the antecedents, attributes, and consequences of this construct. The databases searched were PubMed, PsychInfo, and Scopus between 2010 and 2021. A total of 389 articles were retrieved using the search terms <i>prenatal, adverse childhood experiences screening, adverse childhood experiences</i>, and <i>adverse childhood experiences questionnaire</i>. Included articles for detailed review contained prenatal screening, trauma screening (ACE or other), trust or building trust between patient and health care provider, patient engagement, and shared decision making. Excluded articles were those not in the context of prenatal care and that were exclusively about screening with no discussion about the patient-provider relationship or patient perspectives. A total of 32 articles were reviewed for this concept analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We define trust in prenatal ACE screening as a network of evidence-based attributes that include the timing of the screening, patient familiarity with the health care provider, cultural competence, demystifying trauma, open dialogue between the patient and health care provider, and patient comfort and respect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This concept analysis elucidates the importance of ACE screening and provides suggestions for establishing trust in the context of prenatal ACE screening. Results give insight and general guidance for health care providers looking to implement ACE screening in a trauma-informed way. Further research is needed to evaluate pregnant patients' attitudes toward ACE screening and how a health care provider's trauma history might influence their care. More inquiry is needed to understand the racial, ethnic, and cultural barriers to ACE screening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 1","pages":"88-95"},"PeriodicalIF":2.1,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13660","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474019","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":"Economic, Psychological, and Emotional Well-Being of Pregnant Women During the COVID-19 Pandemic","authors":"Kamal M. Eldeirawi PhD, MSN, RN,&nbsp;Victoria W. Persky MD,&nbsp;Cameron Zielke MS,&nbsp;Ellen Goldstein PhD, MFT,&nbsp;Olivia Bimbi BSN, RN,&nbsp;Jennifer Saenz BA,&nbsp;Zane Mustafa BS,&nbsp;Tamara A. Jumah BS,&nbsp;Xavier R. Ramirez AM, LCSW,&nbsp;Ali Aldirawi MSN, RN,&nbsp;Laurie Quinn PhD, RN, CDCES,&nbsp;Rosalba Hernandez PhD","doi":"10.1111/jmwh.13659","DOIUrl":"10.1111/jmwh.13659","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The intersection between perinatal mental health and the coronavirus disease 2019 (COVID-19) pandemic remains of significant public health importance. The current study examined the emotional and financial well-being and predictors of elevated depressive symptoms among pregnant women during the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This online survey was conducted with 2118 women ≥18 years old who were pregnant at the time of the survey and living in the United States or Puerto Rico. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale, with scores ≥10 indicative of elevated depressive symptoms. The final logistic regression model included housing insecurity, financial distress, COVID-19 diagnosis, exposure to COVID-19, and demographic covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More than half the sample (53.8%) had elevated depressive symptoms. In logistic regression analyses, the odds of having elevated depressive symptoms were significantly higher for participants reporting housing insecurity (adjusted odds ratio [aOR], 1.56; 95% CI, 1.22-2.01), financial distress (aOR, 1.57; 95% CI, 1.17-2.12), COVID-19 diagnosis (aOR, 2.53; 95% CI, 1.53-4.17), and COVID-19 exposure (aOR, 1.41; 95% CI, 1.07-1.86), after adjusting for covariates. The association of elevated depressive symptoms with housing insecurity was especially strong among those who experienced COVID-19 (aOR, 6.04; 95% CI, 2.15-17.0).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings are consistent with previous literature revealing that diagnosis, exposure, concerns about family, and effects on financial stability were related to depressive symptoms during the pandemic. The relationships between financial and housing concerns with elevated depressive symptoms, independent of concerns about infection in family members, suggest that there may be direct and indirect effects of the pandemic on mental health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 1","pages":"111-123"},"PeriodicalIF":2.1,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13659","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Integrated Approach to Address Perinatal Mental Health Within an Obstetrics Practice","authors":"Christina L. Felten CNM, DNP, WHNP, PMH-C,&nbsp;Kayla S. Smith MSN, CRNP, PMH-C,&nbsp;Melissa B. Aylesworth MMS, PA-C, PMH-C","doi":"10.1111/jmwh.13658","DOIUrl":"10.1111/jmwh.13658","url":null,"abstract":"<p>Outpatient perinatal care providers (one certified nurse-midwife, one nurse practitioner, and one physician assistant) at a high-volume, suburban health system in southeastern Pennsylvania developed and implemented a care model to identify and care for patients at risk for perinatal and postpartum mental health conditions. The program, Women Adjusting to Various Emotional States (WAVES), was created to bring the most up-to-date, evidence-based treatment recommendations to patients while addressing the increased demand placed on the health care system by pregnant and postpartum patients in need of psychiatric services. WAVES is a specialized program offered for anyone who is pregnant or up to one year postpartum who is struggling with mental health symptoms or concerns. Perinatal mood and anxiety disorders have become one of the most prevalent pregnancy ailments, yet mental health is not always addressed during routine prenatal care visits. Common obstacles to patients obtaining mental health care during pregnancy include lack of access, clinician gaps in knowledge, and stigma surrounding diagnoses. WAVES offers a method to empower perinatal providers with the education and tools to address this need. The model outlines how to appropriately assess, diagnose, manage, or refer patients for mental health services. Patient feedback has been overwhelmingly positive, and this novel care model shows great promise for the future of perinatal care. The development of integrated programs like WAVES may be a valuable resource to help combat the perinatal mental health epidemic.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 5","pages":"778-783"},"PeriodicalIF":2.1,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Postpartum Pregnancy Prevention Behaviors Among Women Experiencing Homelessness: A Mixed-Methods Analysis","authors":"Annalynn M. Galvin PhD, RN,&nbsp;Rebecca E. Bergh CNM, PhD, RN,&nbsp;Scott T. Walters PhD,&nbsp;Melissa A. Lewis PhD,&nbsp;Erika L. Thompson PhD","doi":"10.1111/jmwh.13657","DOIUrl":"10.1111/jmwh.13657","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Women experiencing homelessness are at higher risk of unintended pregnancy than women who are stably housed and may have unique reasons for not engaging in postpartum pregnancy prevention. This sequential explanatory mixed-methods study aimed to examine reasons women experiencing homelessness may not engage in pregnancy prevention during the postpartum period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Quantitative 2016-2019 Pregnancy Risk Assessment Monitoring System data regarding postpartum pregnancy prevention among recently pregnant women experiencing homelessness and women stably housed (n = 99,138) were analyzed with complex survey-weighted bivariate analysis. Primary outcomes included whether women engaged in postpartum contraception and key reasons for not engaging in postpartum contraception. Qualitative data from semistructured interviews with north Texas women (n = 12) recently pregnant and homeless were coded and thematically analyzed. Findings were triangulated using a woman-centered conceptual framework that facilitates meeting reproductive goals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Women experiencing homelessness reported several statistically significant (<i>P</i> &lt; .05) reasons for not using postpartum pregnancy prevention: currently pregnant, currently abstinent, cannot afford contraception, and partner not liking contraception. Key themes from interviews were related to internal factors (eg, perceived risk of pregnancy is high, current situation not good for having children); external factors (eg, my partner wants to have another child); perceptions of pregnancy (eg, children would be joyful, I want to get pregnant soon after I get housing), and salience of planning (eg, doesn't matter if we plan).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Findings highlight several key reasons for not engaging in postpartum pregnancy prevention among women experiencing homelessness. Findings lay the groundwork for interventions seeking to support individualized and evolving sexual and reproductive health goals within the context of needed housing and family resources.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 1","pages":"77-87"},"PeriodicalIF":2.1,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141507340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}