Maternal and Child Health Journal最新文献

{"title":"\"Like I Wasn't There, Except They Knew I Was\": A Qualitative Analysis of Latina Perinatal and Postpartum Experiences in Support of Self-care.","authors":"Airia S Papadopoulos, Katherine D Preftes, Melissa Destrampe, Maya Singh, Ariana Buterbaugh, Pablo Rodríguez, Dharma Cortes, Anna Cano Morales, Allison Bryant, Lisa Marceau","doi":"10.1007/s10995-026-04291-y","DOIUrl":"10.1007/s10995-026-04291-y","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this qualitative study was to understand the perinatal experiences of Latinas from pregnancy through the first year postpartum to inform the creation of a web-based tool to support postpartum self-care. This study is the second of a two-phase effort to gain insights into women's experiences and challenges with self-care and their recommendations for improving the perinatal and postpartum experience for other women.</p><p><strong>Methods: </strong>Twenty-one Latinas (N = 21) between six months pregnant and six months postpartum participated in one of 10 conversations conducted in English or Spanish. A deductive thematic analysis was performed to identify themes across conversations.</p><p><strong>Results: </strong>Seven primary themes emerged: reasons for participating, childbirth experiences, challenges after childbirth, challenging stereotypes, social support, information on pregnancy and postpartum, and web-based tool features and content. Study results demonstrate that participants struggled with childbirth and postpartum experiences due to lack of information about maternal health and varying levels of understanding, support, and treatment.</p><p><strong>Conclusions for practice: </strong>Results highlight difficulties Latinas experience during and after childbirth without access to information, resources that support self-care, or opportunities for self-advocacy. Findings also inform the practices of health care professionals who treat perinatal Latinas, including doctors, midwives, nurses, lactation specialists, therapists, social workers, and doulas with a call to mitigate unconscious bias and foster collaborative dialogue that bridges the gap between patient experience and clinical practice.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1028-1037"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608806","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":"Pregnancy Ambivalence, History of Pregnancy, Condom Use, and Contraceptive Use Among U.S. Youth Experiencing Homelessness.","authors":"Annalynn Galvin, Jennifer Jones, Utsav Arandhara, Mary Lingwall, Nikhil Padhye, Adeline Nyamathi, Marguerita Lightfoot, Mary Paul, Yasmeen Quadri, Michael Businelle, Diane Santa Maria","doi":"10.1007/s10995-026-04307-7","DOIUrl":"10.1007/s10995-026-04307-7","url":null,"abstract":"<p><strong>Objectives: </strong>Youth experiencing homelessness (YEH) are 5-8 times more likely than housed peers to become pregnant. A more nuanced examination of YEH pregnancy desire may better inform pregnancy and pregnancy prevention guidance. This study examined pregnancy ambivalence, pregnancy history, condom use, and contraceptive use among sexually active YEH.</p><p><strong>Methods: </strong>We utilized baseline data of YEH aged 16-25 from a randomized controlled trial published elsewhere (Santa Maria et al., 2021). Pregnancy desire was categorized as ambivalence (43%) and non-ambivalence: desiring pregnancy (10%) and not desiring pregnancy (47%). We calculated adjusted prevalence ratios (aPRs) and 95% confidence intervals (95% CI) between pregnancy ambivalence with three outcomes (pregnancy history, condom, and any contraceptive use), stratified by male/female participants, controlling for demographics (e.g., gender, sexual orientation).</p><p><strong>Results: </strong>Among YEH (n = 446, 44% female, 50% male, 6% another gender; mean age 21.1 years), 39% reported pregnancy history, 41% reported recent condom use, and 15% reported contraceptive use. Adjusted prevalence ratios stratified by male/female participants indicated that pregnancy ambivalence was notsignificantly associated with pregnancy history, recent condom use, and reported contraceptive use.</p><p><strong>Conclusions for practice: </strong>By characterizing YEH pregnancy ambivalence, condom and contraceptive use, and the pregnancy history, providers may develop tailored policies and programs that respond to the preferences and sexual decision-making needs of YEH who are more vulnerable to undesired pregnancy, regardless of pregnancy desire.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"1001-1007"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686469","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":"Determinants and Caste-Based Disparities in Very Early Pregnancy Awareness Among Indian Women: Evidence from NFHS-5.","authors":"Subhajeet Singh Sardar, Mridul Mandal, Subhasis Bhattacharya, Shubhra Singh Sardar","doi":"10.1007/s10995-026-04304-w","DOIUrl":"10.1007/s10995-026-04304-w","url":null,"abstract":"<p><strong>Objectives: </strong>This study examines the determinants and caste-based disparities of very early pregnancy awareness among Indian women using data from the National Family Health Survey-5 (NFHS-5, 2019-21).</p><p><strong>Methods: </strong>Data were obtained from NFHS-5, a nationally representative survey of women aged 15-49 years in India. The analysis included 172,871 women. Very early pregnancy awareness was defined as awareness of pregnancy within the first month of gestation. Survey-weighted logistic regression models accounting for clustering, stratification, and sampling weights were employed to examine associations between very early pregnancy awareness and demographic, socioeconomic, and healthcare access-related factors. Additional caste-stratified analyses were conducted for Scheduled Tribes (ST), Scheduled Castes (SC), and Other caste groups. Supplementary analysis assessed the association between very early pregnancy awareness and timely antenatal care initiation within the first trimester.</p><p><strong>Results: </strong>Higher educational attainment, household wealth, and perceived geographic access to health facilities were significantly associated with greater odds of very early pregnancy awareness. Compared with Scheduled Tribe women, Scheduled Caste women (AOR = 1.277, 95% CI: 1.202-1.356) and women belonging to Other caste groups (AOR = 1.390, 95% CI: 1.314-1.471) had significantly higher odds of becoming aware of pregnancy within the first month. Women with higher education had substantially greater odds of very early pregnancy awareness compared with women having no formal education (AOR = 1.764, 95% CI: 1.661-1.874). Women with very early pregnancy awareness were significantly more likely to initiate antenatal care within the first trimester (AOR = 1.406, 95% CI: 1.355-1.459).</p><p><strong>Conclusions for practice: </strong>Substantial caste-based and socioeconomic disparities persist in very early pregnancy awareness among Indian women. Improving female education and reducing geographic barriers to healthcare may enhance timely pregnancy awareness and antenatal care utilization.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"899-911"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473607","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":"When Adolescents Become Dads: A Clinical-Qualitative Study on the Experience of Male Adolescents Attending a Prenatal Care Service.","authors":"Juliana Vasconcellos Freitas-Jesus, Fernanda Garanhani Surita, Débora Bicudo Faria-Shutzer, Rodrigo Almeida Bastos, Egberto Ribeiro Turato","doi":"10.1007/s10995-026-04302-y","DOIUrl":"10.1007/s10995-026-04302-y","url":null,"abstract":"<p><strong>Objectives: </strong>Adolescent pregnancy has garnered public interest due to its implications for health, social dynamics, and economic outcomes. Fatherhood contributes to the formation of the identity of young men, particularly during their transition to adulthood. Prenatal care presents a valuable opportunity to involve adolescent fathers in parenting and supporting their pregnant partners. This study aims to investigate how adolescent fathers perceive fatherhood while attending a specialized prenatal clinic.</p><p><strong>Methods: </strong>This qualitative study focused on 14 expectant adolescent fathers aged up to 19 years, recruited from a specialized prenatal care clinic at a tertiary hospital in Brazil. Employing a purposive sampling strategy, we utilized in-depth interviews, sociodemographic questionnaires, and field diaries for data collection. Data analysis involved content analysis, contextualized within the framework of Health Psychology.</p><p><strong>Results: </strong>We raised four categories: (1) \"Myself, a dad?!\": reactions to a positive pregnancy test and the young men's concepts of fatherhood; (2) The imagined relationship with the baby and expectations for the future; (3) The new dynamics in the relationship with the female adolescent during pregnancy; and (4) The influence of the social circles on the development of fatherhood: the family of origin and the friends.</p><p><strong>Conclusions: </strong>The findings underscore the importance of integrating adolescent fathers into healthcare initiatives, addressing critical life-course topics such as family planning, bonding with the child, social support networks, and assistance for adolescent women. These insights highlight the potential for prenatal care settings to offer comprehensive support and guidance to young men navigating their parental roles.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"912-922"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537169","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":"Massachusetts Paid Family Medical Leave and its Relationship with Breastfeeding Duration and Exclusivity.","authors":"Katie Godere Davidson, Aimee J Palumbo, Sarah Lederberg Stone","doi":"10.1007/s10995-026-04299-4","DOIUrl":"10.1007/s10995-026-04299-4","url":null,"abstract":"<p><strong>Objectives: </strong>This study analyzes how the Massachusetts Paid Family Medical Leave (PFML) program impacts parental leave utilization and breastfeeding duration and exclusivity. Multiple organizations recommend exclusive breastfeeding for the first six months of life to protect against disease and promote cognitive growth.</p><p><strong>Methods: </strong>We used data from the Massachusetts Pregnancy Risk Assessment Monitoring Surveillance System to calculate prevalence and duration of parental leave and breastfeeding. The sample included 3,480 Massachusetts residents who gave birth in state between 2016 and 2022, oversampled by race and Hispanic ethnicity. We used survival analysis to identify how parental leave and other factors affect breastfeeding duration and exclusivity.</p><p><strong>Results: </strong>In 2021-2022, an additional 3.7 weeks of leave were taken on average in comparison to prior years (14.4 weeks vs. 10.7 weeks, p < 0.05), and 73.3% of women reported taking paid leave, compared to 46.2% in 2019 (p < 0.05). Those utilizing only unpaid leave were 48% more likely to stop breastfeeding compared with the paid leave group [HR 1.48, 95% CI (1.25-1.75)]. After adjusting for confounders such as race, education and marital status, there was no association between type of leave and breastfeeding duration (p > 0.05).</p><p><strong>Conclusions: </strong>These results suggest that PFML in Massachusetts may have contributed to increased utilization and duration of parental leave, but there was no identifiable impact on breastfeeding duration and exclusivity after controlling for confounders. Future research should review socioeconomic factors as barriers to breastfeeding and the long-term effects of PFML on maternal and child health.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"923-933"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521289","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":"Multiple Output Gaussian Process Model for Predicting Low Birth Weight in Medellín, Colombia: An Alternative to Conventional Machine Learning Models.","authors":"Diego Alejandro Salazar Blandon, Hernán Felipe García Arias, Juan José Giraldo Gutiérrez","doi":"10.1007/s10995-026-04284-x","DOIUrl":"10.1007/s10995-026-04284-x","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the methodological feasibility of a heterogeneous multi-output Gaussian process model for jointly handling a continuous birth outcome and its clinically used binary representation in routinely collected perinatal data, and to compare its predictive performance with that of conventional single-output models.</p><p><strong>Methods: </strong>Routinely collected live-birth certificate data from Medellín, Colombia, covering births from 2012 to 2021, were analyzed. After cleaning and class balancing, the analytic dataset included 32,110 records. A heterogeneous multi-output Gaussian process model was trained to jointly model birth weight in grams with a Gaussian likelihood and low birth weight status with a Bernoulli likelihood. Predictive performance was compared with that of conventional single-output regression and classification models.</p><p><strong>Results: </strong>The heterogeneous multi-output Gaussian process model achieved acceptable predictive performance (R² = 0.67 for birth weight and accuracy = 0.845 for low birth weight classification), with results comparable to those of models fitted separately for each task. These findings support the practical feasibility of modeling heterogeneous outputs within a single probabilistic framework.</p><p><strong>Conclusions: </strong>In this application, the heterogeneous multi-output Gaussian process model was a viable methodological alternative for jointly modeling birth weight in grams and its binary low-birth-weight classification. This study should be interpreted primarily as a methodological demonstration of a flexible multi-output framework in perinatal data that may be extended in future studies to jointly model other outcomes of greater direct relevance to public health.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"875-883"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346872","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":"Association of Food Insecurity with Mental Health and Clinical Outcomes Among Women Living with HIV/AIDS: A Cross-Sectional Study of Southwestern Iran.","authors":"Hassan Joulaei, Zohre Foroozanfar, Maryam Riasatian, Mohammadali Mohsenpour","doi":"10.1007/s10995-026-04285-w","DOIUrl":"10.1007/s10995-026-04285-w","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to investigate the prevalence of food insecurity and its association with health outcomes among Women Living with HIV/AIDS (WLHIV).</p><p><strong>Methods: </strong>This was a cross-sectional study in 452 WLHIV between 2021 and 2022 in Shiraz, Iran. Data were collected via face-to-face interviews and the patients' files. Participants were assessed for food insecurity based on the Household Food Insecurity Access Scale (HFIAS), quality of life, mental health, resilience, social support, and socioeconomic status. A logistic regression model was used to analyze the data.</p><p><strong>Results: </strong>Of 452 WLHIV, 297 (66.0%) were food secure, 50 (11.0%) mildly, 53(12.0%) moderately, and 52 (11.0%) severely food insecure. Food insecurity were significantly associated with CD4 < 500 (OR = 1.03; 95% CI 1.01-1.06), detectable HIV Viral load (OR = 1.03; 95% CI 1.01-1.07), and clinical symptoms (OR = 1.04; 95% CI 1.01-1.08). Food-insecure WLHIV had significantly higher depression, stress, and anxiety scores and lower QOL and resilience scores(P = 0.001).</p><p><strong>Conclusions: </strong>results indicated that food insecurity is associated with various adverse outcomes including poorer clinical indicators and worse mental health status. These findings highlight the importance of addressing food insecurity within HIV care to enhance both clinical and psychosocial health status.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"959-969"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260229","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":"Awareness and Attitudes of Health Professionals on Endocrine Disruptors in Pregnancy.","authors":"Mukaddes Turan Miral, Rojjin Mamuk, Nevin Hotun Şahin","doi":"10.1007/s10995-026-04283-y","DOIUrl":"10.1007/s10995-026-04283-y","url":null,"abstract":"<p><strong>Objective: </strong>Given the limited evidence on the awareness and attitudes of health professionals who educate pregnant women about endocrine disruptors, alongside growing concern regarding their adverse effects during pregnancy, this study was conducted to assess these factors.</p><p><strong>Methods: </strong>The study, which was carried out according to cross-sectional, descriptive, and correlational methods, was implemented during an antenatal education conference held in Izmir between October 27-30, 2023. The sample consisted of 178 health professionals, including midwives, nurses, and obstetricians, who attended the congress and provided education to pregnant women. Data were collected with the Introductory Information Form (IIF), Endocrine Disruptors Attitude Scale (EDAS), and Endocrine Disruptor Chemicals Awareness Scale for Health Professionals (EDCAS).</p><p><strong>Results: </strong>A total of 83.7% of the participants had not received training on endocrine disruptors. The mean EDAS score of the participants was 80.87±11.39, and the mean EDCAS score was 84.93±13.34. There is a weak correlation between the EDCAS score and the EDAS score and a moderately significant relationship between the general awareness sub-dimension of EDCAS and EDAS (p < 0.05). Participants who received training on endocrine disruptors had higher EDCAS and EDAS scores (p < 0.01).</p><p><strong>Conclusion: </strong>These findings are relevant to perinatal health as they show that many prenatal health professionals lack formal training despite moderate awareness and positive attitudes. Since training is associated with higher awareness and attitudes, improving education may enhance counseling, reduce harmful exposures, and support better maternal and fetal outcomes.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"970-978"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206278","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":"Linking Experiences of Interpersonal Racism and Pandemic Worries to Postpartum Symptoms of Anxiety and Depression Among Asian Birthing Individuals.","authors":"Tiffany Tieu, Deiriai Myers, Kristin A Murtha, Sara L Kornfield, Ran Barzilay, Sydney Sun, Chinyelu I Ojukwu, Megan M Himes, Julia Parish-Morris, Raquel E Gur, Lauren K White, Rebecca Waller, Wanjiku F M Njoroge","doi":"10.1007/s10995-026-04287-8","DOIUrl":"10.1007/s10995-026-04287-8","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic was disruptive to birthing individuals' peripartum experiences. This study examined associations between interpersonal racism experiences, pandemic worries, and mental health of Asian and Non-Hispanic white birthing individuals receiving prenatal care in a large northeastern healthcare system.</p><p><strong>Methods: </strong>The sample (N=122; Age, M = 33.6, SD = 3.73) was n=61 Asian and n=61 white individuals who were propensity matched on age at childbirth, gestational age, relationship status, income, and educational attainment. Participants completed self-report surveys on discrimination experiences, pandemic worries, and general mental health at 10-15 weeks postpartum.</p><p><strong>Results: </strong>Asian individuals reported experiencing significantly more interpersonal racism compared to matched white individuals. Pandemic worries were associated with anxiety and depressive symptoms in the entire sample. Among Asian individuals, the association between pandemic worries and anxiety was stronger among those who reported more interpersonal racism.</p><p><strong>Discussion: </strong>While postpartum birthing individuals experienced heightened worry during the pandemic, which may have increased risk for anxiety, this association was pronounced among Asian individuals who experienced interpersonal racism.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"884-892"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498287","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 Clinician Autonomy Support Before and After the COVID-19 Pandemic Onset in a Pregnancy Cohort.","authors":"Mark Fedyk, Katherine B Glaser, Andrea Millman, Saher Daredia, Charles P Quesenberry, Assiamira Ferrara, Susan D Brown","doi":"10.1007/s10995-026-04286-9","DOIUrl":"10.1007/s10995-026-04286-9","url":null,"abstract":"<p><strong>Background: </strong>Patient autonomy - the ability to form intentions and undertake actions based upon one's values - is essential to patient-centered care. However, little research has examined patients' perceptions of autonomy support, defined as clinician behaviors that help patients understand options, ask questions, feel heard, and make decisions aligned with their values. This is a critical gap, particularly for pregnant and postpartum populations.</p><p><strong>Methods: </strong>Our objective was to examine a measurable aspect of the patient-clinician relationship that could provide a window into perceived autonomy, specifically, whether patients reported clinician behaviors consistent with autonomy-supportive care. Measured using a subset of responses to the 6-item short-form of the validated Healthcare Climate Survey, we examined whether perceived autonomy support from clinicians shifted from pre- to post-onset of the COVID-19 pandemic and descriptively explored whether patterns appeared to vary by participant characteristics. We analyzed a diverse subset of participants in the Pregnancy, Lifestyle and Environment Study-2 (PETALS-2), a prospective longitudinal cohort study. Participants completed validated surveys at baseline during pregnancy (2017-2019, pre-pandemic onset) and at a study follow-up at 24-36 months postpartum (2020-2021, post-pandemic onset).</p><p><strong>Results: </strong>In the analytic sample (N = 278), perceived autonomy support decreased over time, both overall (baseline 95% CI = 5.3-5.8 and follow-up 95% CI = 4.8-5.3, p < 0.001). Descriptive subgroup analyses suggested similar directional patterns across several racial/ethnic groups, but subgroup results were interpreted cautiously because the study was not powered to test differences by race/ethnicity. These data therefore do not provide sufficient evidence to draw conclusions about whether changes in perceived autonomy support differed by sociodemographic characteristics or recent perceived discrimination.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"952-958"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158576","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}