Birth-Issues in Perinatal Care最新文献

{"title":"Neonatal morbidity and mortality in birth centers in the United States 2018–2021: An observational study of low-risk birthing individuals","authors":"Lauren Hoehn-Velasco PhD,&nbsp;Lisa Ross DNP,&nbsp;R. David Phillippi PhD,&nbsp;Nancy A. Niemczyk PhD,&nbsp;Dominic Cammarano DO,&nbsp;Steven Calvin MD,&nbsp;Julia C. Phillippi PhD,&nbsp;Jill Alliman DNP,&nbsp;Susan Rutledge Stapleton DNP,&nbsp;Jennifer Wright MA,&nbsp;Stanley Fisch MD,&nbsp;Diana Jolles PhD","doi":"10.1111/birt.12823","DOIUrl":"10.1111/birt.12823","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many studies reporting neonatal outcomes in birth centers include births with risk factors not acceptable for birth center care using the evidence-based CABC criteria. Accurate comparisons of outcomes by birth setting for low-risk patients are needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the public Natality Detailed File from 2018 to 2021 were used. Logistic regression, including adjusted and unadjusted odds ratios, compared neonatal outcomes (chorioamnionitis, Apgar scores, resuscitation, intensive care, seizures, and death) between centers and hospitals. Covariates included maternal diabetes, body mass index, age, parity, and demographic characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sample included 8,738,711 births (8,698,432 (99.53%) in hospitals and 40,279 (0.46%) in birth centers). There were no significant differences in neonatal deaths (aOR 1.037; 95% CI [0.515, 2.088]; <i>p</i>-value 0.918) or seizures (aOR 0.666; 95% CI [0.315, 1.411]; <i>p</i>-value 0.289). Measures of morbidity either not significantly different or less likely to occur in birth centers compared to hospitals included chorioamnionitis (aOR 0.032; 95% CI [0.020, 0.052]; <i>p</i>-value &lt; 0.001), Apgar score &lt; 4 (aOR 0.814, 95% CI [0.638, 1.039], <i>p</i>-value 0.099), Apgar score &lt; 7 (aOR 1.075, 95% CI [0.979, 1.180], <i>p</i>-value 0.130), ventilation &gt;6 h (aOR 0.349; [0.281,0.433], <i>p</i>-value &lt; 0.001), and intensive care admission (aOR 0.356; 95% CI [0.328, 0.386], <i>p</i>-value &lt; 0.001). Birth centers had higher odds of assisted neonatal ventilation for &lt;6 h as compared to hospitals (aOR 1.373; 95% CI [1.293, 1.457], <i>p</i>-value &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Neonatal deaths and seizures were not significantly different between freestanding birth centers and hospitals. Chorioamnionitis, Apgar scores &lt; 4, and intensive care admission were less likely to occur in birth centers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 3","pages":"659-666"},"PeriodicalIF":2.8,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12823","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midwifery continuity of care for women with perinatal mental health conditions: A cohort study from Australia","authors":"Allison Cummins RM, PhD,&nbsp;Alison Gibberd PhD,&nbsp;Karen McLaughlin RM, RN, PhD,&nbsp;Maralyn Foureur RM, RN, PhD","doi":"10.1111/birt.12838","DOIUrl":"10.1111/birt.12838","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Perinatal mental health (PMH) conditions are associated with adverse outcomes such as maternal suicide, preterm birth and longer-term childhood sequelae. Midwifery continuity of care (one midwife or a small group of midwives) has demonstrated benefits for women and newborns, including a reduction in preterm birth and improvements in maternal anxiety/worry and depression.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To determine if midwifery care provided through a Midwifery Group Caseload Practice model is associated with improved perinatal outcomes for women who have anxiety and depression and/or other perinatal mental health conditions. An EPDS ≥ 13, and/or answered the thought of harming myself has occurred to me and/or women who self-reported a history compared to standard models of care (mixed midwife/obstetric fragmented care).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A retrospective cohort study using data routinely collected via an electronic database between 1 January 2018 31st of January 2021. The population were women with current/history of PMH, who received Midwifery Caseload Group Practice (MCP), or standard care (SC). Data were analysed using descriptive statistics for maternal characteristics and logistic regression for birth outcomes. One-to-one matching of the MCP group with the SC group was based on propensity scores.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;7,359 births were included MCP 12% and SC 88%. Anxiety was the most common PMH with the same proportion affected in MCP and SC. Adjusted odds of preterm birth and adverse perinatal outcomes were lower in the MCP group than the SC group (aOR (95%CI): 0.77 (0.55, 1.08) and 0.81 (0.68, 0.97), respectively) and higher for vaginal birth and full breastfeeding (aOR (95% CI): 1.87 (1.60, 2.18) and 2.06 (1.61, 2.63), respectively). In the matched sample the estimate of a relationship between MCP and preterm birth (aOR (95% CI): 0.88 (0.56, 1.42), adverse perinatal outcomes (aOR (95% CI): 0.83 (0.67, 1.05)) and breastfeeding at discharge (aOR (95% CI): 1.82 (1.30, 2.51)), stronger for vaginal birth (aOR (95% CI): 2.22 (1.77, 2.71)).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study supports positive associations between MCP and breastfeeding and vaginal birth. MCP was also associated with lower risk of adverse perinatal outcomes, though in the matched sample with a smaller sample size, the confidence interval included 1. The dir","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 4","pages":"728-737"},"PeriodicalIF":2.8,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12838","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Birth \"outside of guidance\"-An exploration of a Birth Choices Clinic in the United Kingdom.","authors":"Sophie McAllister, Claire Litchfield","doi":"10.1111/birt.12827","DOIUrl":"https://doi.org/10.1111/birt.12827","url":null,"abstract":"<p><strong>Background: </strong>Decision-making around birthplace is complex and multifactorial. The role of clinicians is to provide unbiased, evidence-based information to support women and birthing people to make decisions based on what matters to them. Some decisions may fall outside of clinical guidance and recommendations. Birth Choices Clinics can provide an opportunity for extended discussion and personalized birthplace planning. This study aimed to explore the rationale behind choosing birthplace \"outside of guidance\" and examine the outcomes for women who attended a Birth Choices Clinic.</p><p><strong>Methods: </strong>The study was descriptive using data extracted from clinical documentation and consultation. The data included demographic information, maternal characteristics, reason for choosing a midwifery-led birth setting, birthplace preference, and outcome.</p><p><strong>Results: </strong>Eighty-two women used the Birth Choices Clinic between April 2022 and February 2023 in one large maternity unit in the UK. Reasons for choosing birth in a midwifery-led setting included having access to a birthing pool, to reduce the chance of obstetric interventions and pragmatic reasons. Sixty-five percent of women experienced a spontaneous vaginal birth, 10% experienced an assisted vaginal birth, and 23% experienced a cesarean birth. Of the 33 women who ultimately commenced labor care in a midwifery-led setting, 76% (n = 25/33) birthed in this setting without complications. Transfer rates in labor were similar to those in a \"low-risk\" pregnant population.</p><p><strong>Discussion: </strong>Birth choice clinics may facilitate an understanding of material risk and support individualizing birth planning. There is evidence that women changed their planned birthplace, possibly in recognition of a move along the risk spectrum.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and reliability of an Arabic-language version of the postpartum specific anxiety scale research short-form in Jordan","authors":"Heba H. Hijazi MSc, PhD,&nbsp;Main N. Alolayyan MSc, PhD,&nbsp;Rabah M. Al Abdi MSc, PhD,&nbsp;Ahmed Hossain MSc, PhD,&nbsp;Victoria Fallon BSc (Hons), PhD,&nbsp;Sergio A. Silverio MPsycholSci (Hons), MSc","doi":"10.1111/birt.12840","DOIUrl":"10.1111/birt.12840","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The English-language Postpartum Specific Anxiety Scale (PSAS) is a valid, reliable measure for postpartum anxiety (PPA), but its 51-item length is a limitation. Consequently, the PSAS Working Group developed the PSAS Research Short-Form (PSAS-RSF), a statistically robust 16-item tool that effectively assesses PPA. This study aimed to assess and validate the reliability of an Arabic-language version of the PSAS-RSF in Jordan (PSAS-JO-RSF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a cross-sectional methodological design, a sample of Arabic-speaking mothers (<i>N</i> = 391) with infants aged up to 6 months were recruited via convenience sampling from a prominent tertiary hospital in northern Jordan. Factor analysis, composite reliability (CR), average variance extracted (AVE), McDonald's ω, and inter-item correlation measures were all examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Explanatory factor analysis revealed a four-factor model consistent with the English-language version of the PSAS-RSF, explaining a cumulative variance of 61.5%. Confirmatory factor analysis confirmed the good fit of the PSAS-JO-RSF (<i>χ</i>²/<i>df</i> = 1.48, CFI = 0.974, TLI = 0.968, RMSEA = 0.039, SRMR = 0.019, <i>p</i> &lt; 0.001). The four factors demonstrated acceptable to good reliability, with McDonald's ω ranging from 0.778 to 0.805, with 0.702 for the overall scale. The CR and AVE results supported the validity and reliability of the PSAS-JO-RSF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study establishes an Arabic-language version of the PSAS-JO-RSF as a valid and reliable scale for screening postpartum anxieties in Jordan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 4","pages":"708-718"},"PeriodicalIF":2.8,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy experiences of transgender and gender-expansive individuals: A systematic scoping review from a critical midwifery perspective.","authors":"Elias G Thomas, Bahareh Goodarzi, Hannah Frese, Linda J Schoonmade, Maaike E Muntinga","doi":"10.1111/birt.12834","DOIUrl":"https://doi.org/10.1111/birt.12834","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that transgender and gender-expansive people are more likely to have suboptimal pregnancy outcomes compared with cisgender people. The aim of this study was to gain a deeper understanding of the role of midwifery in these inequities by analyzing the pregnancy experiences of transgender and gender-expansive people from a critical midwifery perspective.</p><p><strong>Methods: </strong>We conducted a systematic scoping review. We included 15 papers published since 2010 that reported on pregnancy experiences of people who had experienced gestational pregnancy at least once, and were transgender, nonbinary, or had other gender-expansive identities.</p><p><strong>Results: </strong>Three themes emerged from our analysis: \"Navigating identity during pregnancy,\" \"Experiences with mental health and wellbeing,\" and \"Encounters in the maternal and newborn care system.\" Although across studies respondents reported positive experiences, both within healthcare and social settings, access to gender-affirmative (midwifery) care and daily social realities were often shaped by trans-negativity and transphobia.</p><p><strong>Discussion: </strong>To improve care outcomes of transgender and gender-expansive people, it is necessary to counter anti-trans ideologies by \"fixing the knowledge\" of midwifery curricula. This requires challenging dominant cultural norms and images around pregnancy, reconsidering the way in which the relationship among \"sex,\" \"gender,\" and \"pregnancy\" is understood and given meaning to in midwifery, and applying an intersectional lens to investigate the relationship between gender inequality and reproductive inequity of people with multiple, intersecting marginalized identities who may experience the accumulated impacts of racism, ageism, and classism. Future research should identify pedagogical frameworks that are suitable for guiding implementation efforts.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cesarean reduction efforts undercut by not attempting vaginal birth","authors":"Ellen Kauffman MD","doi":"10.1111/birt.12826","DOIUrl":"10.1111/birt.12826","url":null,"abstract":"&lt;p&gt;Cesarean birth (CB) is likely overused&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; as no evidence of benefit to newborn morbidity or mortality and increasing maternal morbidity and mortality have spurred national and global efforts to reduce its use.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; The increasing risks to the birthing person are “a significant maternal health safety issue.”&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; While potentially lifesaving, CB does have both short- and long-term risks for both mother and newborn.&lt;span&gt;&lt;sup&gt;5-7&lt;/sup&gt;&lt;/span&gt; In the United States (US), the CB rate has risen from 16.5% in 1980,&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; to 20.7% in 1996,&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; to &gt;30% from 2005 to the present&lt;span&gt;&lt;sup&gt;10&lt;/sup&gt;&lt;/span&gt; with a rate of 32.2% reported for 2022 and the first quarter of 2023.&lt;span&gt;&lt;sup&gt;11&lt;/sup&gt;&lt;/span&gt; Since 2012, labor management guidelines&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; have been a core tool designed to help lower the CB rate in the United States. In January 2024, the American College of Obstetrics and Gynecology (ACOG) reaffirmed labor management guidelines as the principal mechanism for reducing CB.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;And yet, publicly available data&lt;span&gt;&lt;sup&gt;12&lt;/sup&gt;&lt;/span&gt; show that 72% of all CB between 2016 and 2021 in the United States occurred among women and birthing people with no trial of labor in pursuit of vaginal birth. Because the ACOG guidelines &lt;i&gt;by definition&lt;/i&gt; only reduce CB among individuals who labor, they necessarily exclude the majority of CBs. As such, the ability of these guidelines to reduce CBs is significantly diminished.&lt;/p&gt;&lt;p&gt;The purpose of this commentary is to describe the disconnect between where cesarean reduction efforts are focused and where the majority of cesareans are actually occurring in the United States. Next, I propose a strategy for collecting and reporting data that would enable a more thorough analysis of this disconnect and that might also indicate ways to eliminate it. I close with some reflections on associated issues surrounding the provision of maternity care in the United States today.&lt;/p&gt;&lt;p&gt;Centers for Disease Control and Prevention (CDC) national vital statistics natality records distinguish between two clinical circumstances for CB: (i) CB that interrupts labor and (ii) CB without a trial of labor. The CDC data for the 6 years between 2016 and 2021&lt;span&gt;&lt;sup&gt;12&lt;/sup&gt;&lt;/span&gt; indicate that of the 21,821,747 women who gave birth, 21,727,755 (99.6%) have data on whether vaginal birth was attempted or not. Most women (77%, &lt;i&gt;n&lt;/i&gt; = 16,757,753) attempted a vaginal birth (the labor group), while 23% (&lt;i&gt;n&lt;/i&gt; = 4,970,002) did not attempt a vaginal birth (the no-labor group). Figure 1 shows the percentage of the population in each group.&lt;/p&gt;&lt;p&gt;Of the 21,727,755 women who gave birth between 2016 and 2021, 6,847,320 did so by cesarean, with 72% of CBs occurring in the group of women who did not attempt a vaginal birth (no labor, &lt;i&gt;n&lt;/i&gt; = 4,970,002). This means that only 28% of CBs (&lt;i&gt;n&lt;/i&gt; ","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 3","pages":"471-474"},"PeriodicalIF":2.8,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12826","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When facts become feelings.","authors":"Alice M Abernathy","doi":"10.1111/birt.12830","DOIUrl":"10.1111/birt.12830","url":null,"abstract":"<p><p>I have long maintained that equipoise between empathy and the rational, decisive nature of obstetric care is central to good doctoring. I had exacting standards for how to communicate facts with feeling while shielding my own. Then, after experiencing my own obstetric emergency and preterm birth, this changed. In this reflection, I explore how recognizing the intersections between facts and feelings has made me a better physician.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Client-centered flexible planning of home-based postpartum care: A randomized controlled trial on the quality of care","authors":"Fleur J. Lambermon PhD,&nbsp;Noortje T. L. van Duijnhoven PhD,&nbsp;Christine Dedding PhD,&nbsp;Jan A. M. Kremer PhD","doi":"10.1111/birt.12824","DOIUrl":"10.1111/birt.12824","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Standardization of health systems often hinders client-centered care. This study investigates whether allowing more flexibility in the planning range of the Dutch home-based postpartum care service improves its quality of care, as innovative approach to client-centered care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized controlled trial was conducted (2017–2019), in which pregnant women who intended to breastfeed were assigned into two groups (1:1). The intervention group was allowed to receive care up to the 14th-day postpartum, instead of the first 8–10 consecutive days (“usual care”). Primary outcome measure was the proportion of newborns still receiving exclusively breastmilk on final caring day of the service. This so-called <i>successful breastfeeding rate</i> is currently used by the Dutch health sector to measure the quality of care. Secondary outcome measures were <i>self-care experience</i>, <i>overall care experience</i>, and <i>exclusive breastfeeding duration rate</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Based on data from 1275 participants, there was no difference in exclusive breastfeeding on final caring day (86,7% intervention group vs. 88,9% control group, RR: 1.03, 95% CI: 0.98–1.07). Both groups showed similar <i>self-care experiences</i>. Women in the intervention group had slightly poorer <i>overall care experience</i> and lower <i>exclusive breastfeeding duration rates</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study found no effect on the quality of care when allowing more flexibility in the planning range of home-based postpartum care. Women can, therefore, be offered more flexibility to suit them. Given the confusion in interpreting the sector's current main quality indicator, we call for an inclusive dialogue on how to best measure the quality of home-based postpartum care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 3","pages":"649-658"},"PeriodicalIF":2.8,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12824","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of devaluing Women of Color: stress, reproduction, and justice","authors":"Gabriella B. Mayne MA,&nbsp;Luwam Ghidei MD, MSCI","doi":"10.1111/birt.12825","DOIUrl":"10.1111/birt.12825","url":null,"abstract":"<p>This commentary is in response to the Call for Papers put forth by the Critical Midwifery Studies Collective (June 2022). We argue that due to a long and ongoing history of gendered racism, Women of Color are devalued in U.S. society. Devaluing Women of Color leads maternal healthcare practitioners to miss and even dismiss <i>distress</i> in Women of Color. The result is systematic underdiagnosis, undertreatment, and the delivery of poorer care to Women of Color, which negatively affects reproductive outcomes generally and birth outcomes specifically. These compounding effects exacerbate distress in Women of Color leading to greater distress. Stress physiology is ancient and intricately interwoven with healthy pregnancy physiology, and this relationship is a highly conserved reproductive strategy. Thus, where there is disproportionate or excess stress (<i>distress</i>), unsurprisingly, there are disproportionate and excess rates of poorer reproductive outcomes. Stress physiology and reproductive physiology collide with social injustices (i.e., racism, discrimination, and anti-Blackness), resulting in pernicious racialized maternal health disparities. Accordingly, the interplay between <i>stress</i> and <i>reproduction</i> is a key social <i>justice</i> issue and an important site for theoretical inquiry and birth equity efforts. Fortunately, both stress physiology and pregnancy physiology are highly plastic—responsive to the benefits of increased social support and respectful maternity care. <i>Justice</i> means valuing Women of Color and valuing their right to have a healthy, respected, and safe life.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 2","pages":"245-252"},"PeriodicalIF":2.5,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12825","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum care for parent–infant dyads: A community midwifery model","authors":"Ariana Thompson-Lastad PhD,&nbsp;Jessica M. Harrison PhD, LCSW,&nbsp;Tanya Khemet Taiwo CPM, PhD, MPH,&nbsp;Chanda Williams PhD,&nbsp;Mounika Parimi MSc,&nbsp;Briana Wilborn CNM,&nbsp;Maria T. Chao DrPh, MPA","doi":"10.1111/birt.12822","DOIUrl":"10.1111/birt.12822","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Postpartum health is in crisis in the United States, with rising pregnancy-related mortality and worsening racial inequities. The World Health Organization recommends four postpartum visits during the 6 weeks after childbirth, yet standard postpartum care in the United States is generally one visit 6 weeks after birth. We present community midwifery postpartum care in the United States as a model concordant with World Health Organization guidelines, describing this model of care and its potential to improve postpartum health for birthing people and babies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted semi-structured interviews with 34 community midwives providing care in birth centers and home settings in Oregon and California. A multidisciplinary team analyzed data using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 24 participants were Certified Professional Midwives; 10 were certified nurse-midwives. A total of 14 midwives identified as people of color. Most spoke multiple languages. We describe six key elements of the community midwifery model of postpartum care: (1) multiple visits, including home visits; typically five to eight over six weeks postpartum; (2) care for the parent–infant dyad; (3) continuity of personalized care; (4) relationship-centered care; (5) planning and preparation for postpartum; and (6) focus on postpartum rest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The community midwifery model of postpartum care is a guideline-concordant approach to caring for the parent–infant dyad and may address rising pregnancy-related morbidity and mortality in the United States.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 3","pages":"637-648"},"PeriodicalIF":2.8,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12822","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140583167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}