Maternal and Child Health Journal最新文献

{"title":"Amplifying Youth Voices in Public Health: Assessing the Sustained Impact of PATCH Youth Engagement Programs on Adolescent Health, Well-Being and Leadership Development.","authors":"Tess I Jewell, Chelsea J Aeschbach","doi":"10.1007/s10995-026-04293-w","DOIUrl":"10.1007/s10995-026-04293-w","url":null,"abstract":"<p><strong>Introduction: </strong>For over 10 years, the Wisconsin-based Providers and Teens Communicating for Health (PATCH) Program has worked alongside youth ages 14-19 to enhance adolescent health programs, policies, and practices. This evaluation explores the lasting effects on those who participated in the PATCH program as an adolescent.</p><p><strong>Methods: </strong>All former Wisconsin PATCH participants were invited to complete a retrospective pre-post survey that asked them to reflect on their attitudes, actions, and knowledge before and after participating in PATCH. The survey used 5-point Likert scales and open-ended questions to comprehensively assess themes such as job exploration and readiness, relationships and connectedness, advocacy, self-worth, stigma, and health- and healthcare-related knowledge, confidence, and behaviors.</p><p><strong>Results: </strong>A total of 104 past participants completed the survey. All 11 scales showed significant changes (p < .001), and qualitative analysis yielded 6 key themes, including the program's impact on sense of community and interpersonal relationships, advocacy, and workforce development.</p><p><strong>Conclusions: </strong>These findings contribute to the understanding of the long-term benefits of youth engagement in health programs and provide valuable insights for practitioners aiming to develop and enhance similar initiatives. Furthermore, they underscore the critical role of sustained, structured youth involvement in achieving meaningful and lasting improvements in adolescent health.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1103-1110"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889147","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":"Women's Quality-of-Life Trajectories During Pregnancy and Postpartum Periods by Mode of Birth: A Prospective Cohort Study.","authors":"Alayna Carrandi, Yanan Hu, Maria Forslund, Jenny Gamble, Debra Creedy, Emily Callander, Valerie Slavin","doi":"10.1007/s10995-026-04298-5","DOIUrl":"10.1007/s10995-026-04298-5","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the quality-of-life scores of women during pregnancy and postpartum and compare the differences by mode of birth.</p><p><strong>Methods: </strong>A secondary analysis of a prospective, observational cohort study comprising 2866 pregnant women in Queensland, Australia. Women's quality-of-life scores were collected at 36 weeks of gestation and 6- and 12-week postpartum and converted into utility values.</p><p><strong>Results: </strong>On average, quality-of-life utility scores increased from 36 weeks of gestation to 12 weeks postpartum, regardless of birth type. After adjusting for socioeconomic characteristics, women who went on to have a planned caesarean section had a significantly lower utility score at 36 weeks of gestation compared to women who went on to have a spontaneous vaginal birth (adjusted mean difference =  - 0.07; 95% CI - 0.11, - 0.02); women who did not have select birth type had a statistically significantly lower utility score at 36 weeks of gestation compared to women who had a select birth type (adjusted mean difference =  - 0.05; 95% CI - 0.08, - 0.02). No significant differences were observed for other birth types at 6- and 12-week postpartum.</p><p><strong>Conclusions for practice: </strong>Women's quality of life improves from late pregnancy to postpartum. Further research is needed to develop targeted interventions to improve quality of life among women at higher risk of low quality of life and adverse pregnancy and birth outcomes, however we did not identify any differences by mode of birth.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1131-1140"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819927","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":"Growing CAPITOL 4 Life: A Case Study of Co-designed Material for the First 1000 Days Using a Modified Double Diamond Approach.","authors":"Andrew P Hills, Sisitha Jayasinghe, Kylie Mulcahy, Kylie Burgess, Lisa Dalton, Kiran D K Ahuja, Roger Hughes, Nuala M Byrne","doi":"10.1007/s10995-026-04320-w","DOIUrl":"10.1007/s10995-026-04320-w","url":null,"abstract":"<p><strong>Introduction: </strong>Growing CAPITOL 4 Life is a place-based public health initiative focused on the first 1000 days (F1D), from conception to a child's second birthday. It sought to strengthen community capacity for early-childhood health by leveraging local knowledge, assets and partnerships, while moving beyond one-way information provision towards sustained learning, empowerment and collective action. This study retrospectively examined the co-design process through the lens of the Double Diamond.</p><p><strong>Methods: </strong>Parents, educators, service providers and community stakeholders across Burnie, Circular Head and Devonport, Tasmania, participated in co-design workshops. Engagement spanned government, local government, Aboriginal organizations, libraries and community services. The process was facilitated by a place-based systems-change organization and supported by the University of Tasmania. Community members contributed lived experience alongside professional and academic knowledge, with decision-making remaining largely community-led and guided by the principle of \"for the community, by the community.\"</p><p><strong>Results: </strong>Across the four phases, communities moved from sharing experiences and identifying strengths and challenges (Discover), to refining priorities (Define), developing locally relevant resources and learning approaches (Develop), and shaping feasible delivery models (Deliver). The process centered on the F1D domains of Connection, Nutrition, Caring and Moving and resulted in community-informed Evidence Briefs, workshops and playgroup-based learning. Importantly, the Double Diamond was reflected not as a prescribed sequence, but as a recurring pattern of opening outward to explore and narrowing inward to make sense, prioritize and act. Discussions moved organically between what was working, what was missing, what an ideal future might look like and how communities could move towards it.</p><p><strong>Discussion: </strong>The findings suggest that the value of the Double Diamond in public health lies less in adherence to predefined stages than in providing sufficient structure for purposeful exploration while preserving community agency. This flexible approach may support locally relevant, acceptable and trusted solutions, particularly in complex regional settings where effective public health responses must emerge from, rather than be imposed upon, communities.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1111-1121"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867376","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":"Correction: Perceived Tobacco Smoking Risk and Predictors of Smoking During Pregnancy: A Cross-Sectional Predictive Correlational Study.","authors":"Teresa Gulley, Denise Hammer, Melissa Jarvill, MyoungJin Kim, Sheila Jesek-Hale","doi":"10.1007/s10995-026-04315-7","DOIUrl":"10.1007/s10995-026-04315-7","url":null,"abstract":"","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1151"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766450","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":"Perceived Tobacco Smoking Risk and Predictors of Smoking During Pregnancy: A Cross-Sectional Predictive Correlational Study.","authors":"Teresa Gulley, Denise Hammer, Melissa Jarvill, MyoungJin Kim, Sheila Jesek-Hale","doi":"10.1007/s10995-026-04301-z","DOIUrl":"10.1007/s10995-026-04301-z","url":null,"abstract":"<p><strong>Objective: </strong>To examine the strength of perception of tobacco smoking risk, maternal-fetal attachment, and perceived stress as factors for predicting pregnant women's smoking status, after controlling for socioeconomic variables.</p><p><strong>Methods: </strong>This is a cross-sectional, predictive correlational study with a convenience sample recruited from a private prenatal clinic and a federally funded community health clinic in one central Illinois county. Women 18 years or older, at 24 weeks gestation or greater, were surveyed during their prenatal appointments, utilizing the Maternal Antenatal Attachment Scale, the Perceived Stress Scale, the Modified Perception of Pregnancy Risk Questionnaire (MPPRQ), and obstetric, demographic and socioeconomic questions to determine if maternal-fetal attachment, perceived stress, and perceived risks from smoking tobacco (smoking) predict smoking status during pregnancy.</p><p><strong>Results: </strong>We found higher perceived smoking tobacco risk predicted women were likely to not currently use tobacco [p = .004, Exp(B) = 0.96, 95% CI (0.94, 0.99)]. Specifically, for each increase of 1 out of 100 on the MPPRQ scale, a woman is 4% less likely to currently smoke (smoke) tobacco. Maternal-fetal attachment and perceived stress did not predict smoking status.</p><p><strong>Conclusion: </strong>A woman's choice to continue to smoke during pregnancy is complex and personal. Understanding the impact of her personal perception for risk of smoking can assist providers with conversations and improve interventions, leading to increased cessation success and subsequently improve pregnancy and neonatal health outcomes.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1141-1150"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521285","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 Effect of An Integrated Accountable Model on Healthcare Utilization During Pregnancy Among Low-Income Women with Comorbid Mental and Physical Conditions: Evidence from Oregon's Coordinated Care Organizations.","authors":"Mandana Masoumirad, S Marie Harvey, Linh N Bui, Jangho Yoon","doi":"10.1007/s10995-026-04312-w","DOIUrl":"10.1007/s10995-026-04312-w","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of chronic conditions continues to increase in the United States, disproportionately affecting low-income women and Medicaid beneficiaries. This study examined whether an accountable care approach implemented in Oregon Medicaid, known as Coordinated Care Organizations (CCOs), which integrates the delivery of physical and mental health services, may improve high-value healthcare utilization during pregnancy among female Oregon Medicaid beneficiaries with chronic mental-physical comorbidities (MPCs).</p><p><strong>Methods: </strong>We performed a retrospective analysis of Oregon Medicaid data from 2008 to 2016, linked with birth certificates and hospital discharge records. Measures of high-value utilization included timely and adequate prenatal care visits, preventable hospitalizations, and preventable emergency department (ED) visits. We utilized a quasi-experimental difference-in-differences approach, comparing the pre-post changes in the outcomes between CCO enrollees and other Medicaid beneficiaries.</p><p><strong>Results: </strong>CCO enrollment was associated with greater odds of having the first prenatal care visit in the first trimester of pregnancy (OR 1.51, CI 1.21, 1.88) and the adequacy of prenatal care (OR 1.40, CI 1.10, 1.78) among women with MPCs. However, no statistically discernible associations were found for preventable hospitalization and ED visits.</p><p><strong>Discussion: </strong>CCOs are effective in improving timely and adequate utilization of prenatal care among women with MPCs. Further research is needed to understand whether and how CCOs may reduce preventable costly healthcare utilization among women with MPCs during and beyond pregnancy.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1181-1190"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725658","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":"Association between High-Risk Pregnancy History and High-Efficacy Postpartum Contraception Use in North Carolina.","authors":"Maya E Cox-Terry, Elizabeth D Enright, Godwin Y Dogbey, James M Edwards","doi":"10.1007/s10995-026-04297-6","DOIUrl":"10.1007/s10995-026-04297-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate factors associated with postpartum use of high-efficacy contraception among postpartum individuals in North Carolina and to assess whether a history of high-risk pregnancy was associated with increased use of WHO Tier 1 contraceptive methods.</p><p><strong>Study design: </strong>North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2012 to 2020 were analyzed. The analytic sample included 6,993 postpartum respondents. A composite high-risk pregnancy history index was created using self-reported and birth certificate variables including preterm birth, low birth weight, obesity, hypertension, diabetes, depression, and inadequate prenatal care. Multivariable logistic regression was used to evaluate factors associated with postpartum use of WHO Tier 1 contraception.</p><p><strong>Results: </strong>A cumulative sample of 13,866 postpartum persons were selected and invited to complete the survey; 6,993 responded and were considered participants. History of high-risk pregnancy was associated with slightly increased odds of postpartum Tier 1 contraception use (aOR 1.18, 95% CI 1.00-1.39, p < 0.05), although the association was modest. Other significant factors associated with high-efficacy contraception use included multiparity (aOR = 2.00, 95% CI 1.70 to 2.36), planned conception (aOR = 0.72, 95% CI 0.62 to 0.85), living infant (aOR = 2.85, 95%CI 1.42 to 5.72), postpartum contraception counseling (aOR = 0.36, 95% CI 0.28 to 0.45), postpartum depression screening (aOR = 1.40, 95% CI 1.05 to 1.89), Black and Asian races (aOR = 0.78, 95% CI 0.64 to 0.95 and aOR = 0.36, 95% CI 0.23 to 0.59, respectively), a bachelor's or master's degree (aOR = 0.64, 95% CI 0.50 to 0.82 and aOR = 0.66, 95% CI 0.48 to 0.89, respectively), and age groups 30-34 and 35-39 year-olds (aOR = 1.31, 95% CI 1.08 to 1.59 and aOR = 1.50, 95% CI 1.19 to 1.89, respectively).</p><p><strong>Conclusion: </strong>In this North Carolina population, high-risk pregnancy history was only modestly associated with postpartum use of high-efficacy contraception. Other findings of this study suggest that high efficacy postpartum contraception use is influenced by demographic, reproductive, and healthcare interaction factors beyond pregnancy risk status alone. Interventions focused on equitable, patient-centered counseling and access to postpartum contraception may improve reproductive planning among patients with high-risk pregnancies who desire pregnancy spacing or prevention.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1122-1130"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819995","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":"Maternal Mental Health After Stillbirth: Associations With Autopsy Decisions, Cause of Death Knowledge, and Psychosocial Risk Factors.","authors":"Rana Jawish, Emily DiBlasi, Amanda A Allshouse, Renee Martin-Willett, Becky Kinkead, Matthew Moench, Paul J Carlson, Marcela C Smid, Adam J Gordon, Robert M Silver, Mark H Rapaport","doi":"10.1007/s10995-026-04314-8","DOIUrl":"10.1007/s10995-026-04314-8","url":null,"abstract":"<p><strong>Purpose: </strong>Stillbirth is a traumatic event with potentially lifelong effects on maternal mental health, but there are few clinical guidelines or resources for supporting families. Additionally, the effects of parental autopsy decision-making and knowledge of cause of death effect on maternal mental health is unclear.</p><p><strong>Methods: </strong>We evaluated associations between autopsy decision, cause of death determination, and maternal mental health in data from the multi-center, five region Stillbirth Collaborative Research Network (2006-2008). Secondarily, we examined psychosocial risk factors associated with adverse MMH outcomes. Maternal mental health was assessed at single time point within 6-36 months after stillbirth delivery. Exposures included autopsy decision (none, partial, full) and knowledge of cause of death (known, unknown). Adverse maternal mental health was defined as abnormal scores on one or more validated instruments assessing depression, grief, distress, post-traumatic growth, and change in substance use. Psychosocial risk factors included childhood trauma and perceptions of support or blame. Logistic regression identified associations with maternal mental health outcomes.</p><p><strong>Results: </strong>Among 272 participants (44% response rate), 54% reported one adverse maternal mental health outcome 6-36 months postpartum. Autopsy decision and knowledge of cause of death did not impact maternal mental health. Knowledge of cause of death was associated with less feeling of blame (OR 2.02, 95% CI 1.05-3.88). Childhood trauma (OR 4.10, 95% CI 1.60-10.70) and low income (OR 2.32, 95% CI 1.34-4.02) were associated with poorer maternal mental health.</p><p><strong>Conclusions: </strong>Despite the impact of stillbirth on maternal health, our understanding of factors impacting mental health is limited, and the clinical guidelines for providing psychological care are limited. In the current study, autopsy decision and knowledge of cause of death did not impact mental health outcomes 6-36 months postpartum, while childhood trauma, feeling blamed for the loss, and socioeconomic disadvantage were significantly associated with adverse mental health. This important, early data from the Stillbirth Collaborative Research Network may help inform screening for psychosocial risk factors and updating guidelines for providing trauma-informed support following stillbirth.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1191-1204"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799634","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":"Exploring Parental Factors in Autism Spectrum Disorder Risk: A Case-Control Study.","authors":"Mahmoud A Bashtawi, Ayah A Al-Zgool, Dima A Al Sharman, Mohammad Y Alsmadi, Fares M Issa","doi":"10.1007/s10995-026-04310-y","DOIUrl":"10.1007/s10995-026-04310-y","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) is a complex neurodevelopmental condition. Diagnosis is based on developmental history and behavioral observation. Parental age has been identified as a potential risk factor for ASD.</p><p><strong>Objectives: </strong>This study aimed to assess the association between maternal age, paternal age, parental education level, smoking history, and ASD risk.</p><p><strong>Methods: </strong>This case-control study included 154 individuals with ASD and 335 controls. Demographic, clinical, and familial data were collected through structured questionnaires and interviews. Statistical analysis included descriptive statistics and chi-square tests for categorical variables.</p><p><strong>Results and discussion: </strong>A total of 489 participants were included (154 ASD cases and 335 controls). The ASD group was predominantly male (77%), compared with the control group (68%). Mothers in both groups most commonly held a bachelor's degree (40%), while fathers showed more variable educational backgrounds. A family history of ASD was significantly more frequent in the ASD group (23%) compared with controls (5.4%), whereas a family history of psychiatric disorders showed no significant difference (15% vs. 11%). NICU admission (11% vs. 2.4%) and preterm delivery (7.3% vs. 1.8%) were more common in the ASD group. In multivariable analysis, paternal age (adjusted OR = 1.08, 95% CI: 1.03-1.14), maternal age (adjusted OR = 1.09, 95% CI: 1.03-1.15), male sex (adjusted OR = 4.13, 95% CI: 2.38-7.16), and family history of ASD (adjusted OR = 2.40, 95% CI: 1.09-5.30) were independently associated with ASD.</p><p><strong>Conclusions: </strong>ASD risk was independently associated with parental age, male sex, and family history of ASD, highlighting the role of genetic and demographic factors. Prospective longitudinal studies are needed to further clarify ASD risk trajectories.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1161-1166"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680579","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":"Key Determinants of Delivery Choices at Healthcare Facilities in Rural Indonesia: Insights from Riskesdas.","authors":"Nilam Sari, Haerawati Idris","doi":"10.1007/s10995-026-04305-9","DOIUrl":"10.1007/s10995-026-04305-9","url":null,"abstract":"<p><strong>Objective: </strong>Maternal delivery in non-healthcare facilities remains high in rural Indonesia, contributing to increased maternal mortality. Understanding the determinants influencing delivery choices is crucial for policy intervention. This study investigates the determinants influencing delivery at healthcare facilities in rural Indonesia.</p><p><strong>Methods: </strong>A cross-sectional data analysis of the 2018 Basic Health Research or Riset Kesehatan Dasar (Riskesdas) was conducted, involving 34,012 mothers meeting inclusion criteria. Data were analyzed using univariate, bivariate (Chi-square test), and multivariate (multiple logistic regression) methods.</p><p><strong>Results: </strong>Among rural mothers, 69.3% delivered at healthcare facilities. Significant determinants included maternal age, education, parity, antenatal care (ANC) visits, labor complications, travel time, and health insurance. Health insurance was the strongest predictor (OR = 4.5, 95% CI: 4.152-4.869). Employment status of mothers and husbands showed no significant association.</p><p><strong>Conclusions: </strong>Health insurance ownership strongly predicts healthcare facility delivery. Policymakers should prioritize awareness campaigns and accessible health insurance for uninsured rural mothers.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1061-1068"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632327","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}