Journal of midwifery & women's health最新文献

{"title":"Contemporary Issues in Contraception and Abortion Care (2023-005JMWH)","authors":"","doi":"10.1111/jmwh.13594","DOIUrl":"https://doi.org/10.1111/jmwh.13594","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138679066","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":"Ethics, Abortion Access, and Emergency Care Post-Dobbs: The Gray Areas","authors":"Stephanie Tillman CNM, MSN,&nbsp;Meghan Eagen-Torkko CNM, PhD, ARNP,&nbsp;Amy Levi CNM, PhD, WHNP-BC","doi":"10.1111/jmwh.13598","DOIUrl":"10.1111/jmwh.13598","url":null,"abstract":"<p>Clinical management of emergency pregnancy care, such as ectopic pregnancy or heavy bleeding with pregnancy of unknown location, includes upholding legal and ethical standards. For health care providers unwilling to provide evidence-based life-saving abortion care due to personal beliefs, clear guidance dictates disclosure of these limitations to the patient and colleagues, followed by immediate referral for appropriate care. However, this decision-making pathway may not be engaged due to a variety of factors: providers’ beliefs preclude adherence to referral responsibilities, political discourse confuses patients as to their options and rights, and a constantly changing state and national legal landscape leads providers to question their ability to practice to their full scope of clinical care. Although this disruption of evidence-based standard of care existed pre-Dobbs, the moral disorder is now heightened. This Clinical Rounds highlights a patient vignette describing the risks of abortion restrictions for patients and providers alike, particularly when an individual provider's concerns for violating institutional guidelines sets a precedent for nursing response and forecloses on collaborative input or ethics consultation. The history of physician-only abortion exceptionalism and exclusion of nurses and midwives despite a significant history of nurses and midwives in abortion care grounds an argument for focusing on the impact of unethical and substandard care on the interprofessional care team leading to moral distress and negative patient outcomes. Patient-centered models of care, such as frameworks common in nursing and midwifery, offer opportunities to consider how all providers practicing to their full scope in interprofessional and collaborative ways, such as in emergency rooms and labor departments, might mitigate obstructions to abortion care that risk pregnant people's lives.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138628945","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":"Research and Professional Literature to Inform Practice, November/December 2023","authors":"Rebecca R. S. Clark CNM, PhD, MSN, WHNP-BC,&nbsp;Noelle Burwell,&nbsp;Mirabelle Jean Louis,&nbsp;Jasmine A. Philips","doi":"10.1111/jmwh.13593","DOIUrl":"https://doi.org/10.1111/jmwh.13593","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138678973","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":"Mitigating Weight Bias in the Clinical Setting: A New Approach to Care","authors":"Signey M. Olson CNM, WHNP-BC, DNP,&nbsp;Elizabeth G. Muñoz CNM, DNP,&nbsp;Ellen C. Solis CNM, DNP,&nbsp;Heather M. Bradford CNM, PhD","doi":"10.1111/jmwh.13578","DOIUrl":"10.1111/jmwh.13578","url":null,"abstract":"<p>Weight bias toward patients in larger bodies is pervasive among health care providers and can negatively influence provider-patient communication, as well as patients’ behavior and health outcomes. Weight bias has historical roots that perpetuate thinness and Whiteness as the cultural norm. Although weight bias remains socially acceptable in US culture, contributing factors to an individual's body size are complex and multifactorial. Providers and health care systems also consistently use body mass index (BMI) as an indicator of health status, despite its limitations and harmful effects in the clinical setting. This state of the science review presents 8 evidence-based strategies that demonstrate how to mitigate harm from weight bias and improve quality of care and health outcomes for patients living in larger bodies. Person-centered approaches to care include (1) eliminating clinical recommendations to lose weight; (2) shifting from a focus on weight to health; (3) implementing a size and weight-inclusive approach; (4) engaging in weight bias self-evaluation; (5) creating a welcoming environment for patients of all sizes; (6) seeking permission and learning the patient's story; (7) using weight-inclusive language; and (8) re-evaluating clinical guidelines and policies based on BMI. Midwives and other health care providers may benefit from training that re-imagines the delivery of health care to patients in larger bodies.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138628947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midwifery and APRN Scope of Practice in Abortion Care in the Early Post-Roe Era: Everything Old Is New Again","authors":"Julie Jenkins DNP, APRN, WHNP-BC,&nbsp;Christie Pitney CNM, MS, WHNP-BC,&nbsp;Morgan Nuzzo CNM, MSN,&nbsp;Meghan Eagen-Torkko CNM, PhD, ARNP","doi":"10.1111/jmwh.13599","DOIUrl":"10.1111/jmwh.13599","url":null,"abstract":"<p>Over the past 10 years, there has been a rapid expansion of legal and legislative changes in abortion care provision for advanced practice clinicians (APCs), including nurse practitioners, midwives, and physician associates (formerly physician assistants), with most of that expansion occurring in the last several years. This expansion has occurred via several routes (eg, legislative, popular vote, court decision, attorney general opinion), and the patchwork of legal statuses nationally creates confusion for clinicians who are unclear on current regulations. This review explores the historical context of abortion practice for APCs, as well as the primary philosophical and legal concepts relevant to this role development. Since 2012, the number of states permitting abortion practice by APCs has more than quintupled, and the changes to abortion law in the United States in the wake of the 2022 Supreme Court decision in the case of Dobbs v. Jackson Women's Center creates a new imperative to understand the role of APCs in accessing abortion care. Additionally, although the research on abortion safety for APC abortion providers is well-established, the physician-centered paradigm of abortion care has limited the ability of APCs to develop expertise in this essential public and clinical health service.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138628621","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":"Toward Opt-In Consent for Pregnancy Testing","authors":"Stephanie Tillman CNM, MSN,&nbsp;B. A. Goodrum CNM, FNP,&nbsp;Angel Shae Street CNM, WHNP-BC,&nbsp;Ashish Premkumar MD, PhD,&nbsp;Kim D. Ricardo JD,&nbsp;Jonah Fleisher MD, MPH","doi":"10.1111/jmwh.13597","DOIUrl":"https://doi.org/10.1111/jmwh.13597","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138678938","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 Provision of Abortion Care via Telehealth in the United States: A Rapid Review","authors":"Camille Brown PhD, RN,&nbsp;Carrie E. Neerland CNM, PhD,&nbsp;Elizabeth V. Weinfurter MLIS,&nbsp;Melissa A. Saftner CNM, PhD","doi":"10.1111/jmwh.13586","DOIUrl":"10.1111/jmwh.13586","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The recent Supreme Court decision Dobbs v. Jackson Women's Health that has overruled Roe v. Wade has resulted in severe limitations of abortion access throughout the United States. Telehealth has been put forth as one solution for improving access for reproductive health care, including abortion services. Telehealth has demonstrated safety and efficacy in several health care disciplines; however, its use for abortion care and services has not been explored and synthesized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>As part of a larger review on telehealth and general reproductive health, our team identified a moderate amount of literature on telehealth and abortion care. We conducted a rapid review searching for eligible studies in MEDLINE, Embase, and CINAHL. Information was extracted from each included study to explore 4 key areas of inquiry: (1) clinical effectiveness, (2) patient and provider experiences, (3) barriers and facilitators, and (4) the impact of the coronavirus disease 2019 (COVID-19) pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-five studies on the use of telehealth for providing abortion services published between 2011 and 2022 were included. Telehealth for medical abortion increased during the COVID-19 pandemic and was found to be safe and clinically effective, with high patient satisfaction. Overall, telehealth improved access and removed barriers for patients including lack of transportation. Legal restrictions in certain states were cited as the primary barriers. Studies contained limited information on the perspectives and experiences of health care providers and diverse patient populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Abortion care via telehealth is safe and effective with high satisfaction and may also remove barriers to care including transportation and fear. Removing restrictions on telehealth for the provision of abortion services may further improve access to care and promote greater health equity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13586","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138560168","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 Mediating Role of Physical Activity Self-Efficacy in Predicting Moderate-Intensity Physical Activity in Pregnant People at High Risk for Gestational Diabetes","authors":"Xiao Yang MSc, RN,&nbsp;Rongrong Han MSc, RN,&nbsp;Yingli Song BSN, RN,&nbsp;Ji Zhang MSc, RN,&nbsp;Hui Huang BSN, RN,&nbsp;Jing Zhang BSN, RN,&nbsp;Yan Wang BSN, RN,&nbsp;Lingling Gao PhD, MSc, RN","doi":"10.1111/jmwh.13589","DOIUrl":"10.1111/jmwh.13589","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. Moderate-intensity physical activity during pregnancy can lower the risk of GDM. However, the relationship between moderate-intensity physical activity and correlated factors among pregnant people at high risk for GDM remains unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted in China. Two hundred fifty-two participants completed the Pregnancy Physical Activity Questionnaire, Pregnancy Physical Activity Self-Efficacy Scale, Physical Activity Knowledge Questionnaire, Physical Activity Social Support Scale, 7-item Generalized Anxiety Disorder Scale, Edinburgh Postnatal Depression Scale, and a sociodemographic data sheet. Structural equation modeling was used to explore the direct and indirect associations between the study variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 51.6% of the participants did not meet the current physical activity guidelines. Only physical activity self-efficacy was significantly correlated with moderate-intensity physical activity. Physical activity self-efficacy mediated the relationship between moderate-intensity physical activity and knowledge of physical activity, social support for physical activity, and anxiety symptoms. Furthermore, knowledge of physical activity was also associated with improved moderate-intensity physical activity mediated by reduced anxiety symptoms and increased physical activity self-efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study revealed a high prevalence of not meeting current physical activity guidelines among pregnant people at high risk for GDM. Physical activity self-efficacy played an important mediating role in predicting moderate-intensity physical activity. Future studies should focus on enhancing self-efficacy to improve moderate-intensity physical activity for pregnant people at high risk for GDM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138560344","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":"Cervical Lacerations: A Review of Risks","authors":"Susan Salazar CNM, PhD,&nbsp;Kaitlyn Grayson MD,&nbsp;Harris Tsamolias MD","doi":"10.1111/jmwh.13579","DOIUrl":"10.1111/jmwh.13579","url":null,"abstract":"<p>Cervical laceration (CL), although infrequent, is an often-unrecognized complication of vaginal birth and can cause significant blood loss in the immediate postpartum period. The rate of clinically significant CL ranges from 0.14% to 0.2% of births. Nulliparity, operative vaginal birth, occiput posterior position of the fetus, induction of labor, and episiotomy have been cited as possible risk factors. Much of the available literature regarding CL, however, is dated or anecdotal, and there are varying and inconsistent risk associations with its occurrence. Given this unpredictability, CL should be considered in all women with immediate postpartum hemorrhage when there is difficulty obtaining hemostasis. Although midwives receive training about CLs, the low incidence may lead to delay in diagnosis and management. This Clinical Rounds case presents a composite case of postpartum hemorrhage caused by a CL. Risk factors, diagnosis and midwifery management are discussed.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138489324","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":"Respectful Care for All: A Midwifery Practice and Policy Imperative","authors":"Melissa D. Avery CNM, PhD","doi":"10.1111/jmwh.13591","DOIUrl":"10.1111/jmwh.13591","url":null,"abstract":"<p>A recent research report from the Centers for Disease Control and Prevention (CDC) caught my attention and spurred further reading and reflection.<span>¹</span> This report should push all of us to action to assure that all recipients of perinatal care feel well cared for and able to discuss any topic with their care providers.</p><p>The authors of this CDC study described overall maternity care experiences using survey data from more than 2000 mothers who are part of an opt-in community panel. The study revealed that 1 in 5 women (20%) reported mistreatment during childbirth in the United States.<span>¹</span> That rate was close to 30% for Black, Hispanic, and multiracial respondents. In addition, nearly 30% of respondents reported discrimination of some type, including age, weight, and income. Furthermore, nearly half of respondents reported not asking a question or addressing a concern with their provider.<span>¹</span></p><p>The CDC report is only the latest study to address this problem. Other recent research, including research led by midwives, reports the existence of mistreatment in perinatal care in the United States and offers additional information by birth location and provider type. A survey of more than 2000 women, using patient-designed items, revealed that 1 in 6 (17%) identified some type of mistreatment. Only 5% of those who gave birth in community settings (home or freestanding birth center) identified mistreatment compared with 28% who gave birth in hospitals. As in the CDC study, mistreatment was reported more often by women of color. Mistreatment was less common when midwives were the main prenatal care provider.<span>²</span> A secondary analysis of the same study focused on place of birth and intrapartum provider type among participants who gave birth in their planned location. For this subset of 1290 respondents, mistreatment was less likely for those giving birth in community settings with midwives compared with physicians in hospital settings. Although autonomy was greater for respondents cared for by midwives in hospitals, reported mistreatment was not different compared with those cared for by physicians in hospitals.<span>³</span></p><p>Authors of a qualitative analysis of nearly 100 birth stories from 61 participants, analyzed using previously determined domains of mistreatment, found descriptions of mistreatment in 42.7% of narratives. Most instances were classified as poor rapport, such as poor communication, loss of autonomy, and lack of supportive care; none were physical or sexual abuse.<span>⁴</span> In an effort to identify health care clinician behaviors that exemplify respectful maternity care, researchers examined the literature within a combined set of rights for respectful care during labor and birth. Specific examples of identified clinician respectful behaviors included providing only clinically indicated and evidence-based care, avo","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13591","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138447626","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}