Journal of midwifery & women's health最新文献

{"title":"Community-Based Initiatives to Improve Maternal and Newborn Health in High-Income Settings: A Mixed-Methods Systematic Review.","authors":"Elise Robinson, Aradhna Kaushal, Joanna Drazdzewska","doi":"10.1111/jmwh.70023","DOIUrl":"https://doi.org/10.1111/jmwh.70023","url":null,"abstract":"<p><strong>Introduction: </strong>Although community-based interventions, including Participatory Learning and Action (PLA) groups, have demonstrated significant success in improving maternal and newborn health outcomes and promoting equity in low to middle-income countries, the evidence in high-income settings remains limited. This systematic review, carried out in collaboration with Women and Children First (a UK-based charity focusing on improving the lives of women and children globally), explores community-based initiatives that are currently used in high-income countries (HICs) to enhance maternal and newborn health, as well as the effectiveness of these initiatives in improving maternal and newborn health outcomes. Additionally, the review aims to examine the relationship between community-based initiatives and PLA methodology.</p><p><strong>Methods: </strong>This is a mixed-method systematic review with a narrative synthesis of results. MEDLINE, Embase, CINAHL, and MIDIRS databases were searched for community-based initiatives for any maternal and neonatal health outcome between 2000 and 2023. Both quantitative and qualitative studies were included and assessed for methodological quality using the Mixed-Methods Appraisal Tool. A convergent results-based synthesis approach was used.</p><p><strong>Results: </strong>A total of18 studies were included for review. Three main types of community-based interventions were identified: peer support, social support, and health education. Most interventions had beneficial effects on their maternal and neonatal health outcomes of interest. Qualitative analysis revealed 4 main aspects of peer support-connectedness, emotional validation, self-efficacy, and information sharing-which helps to explain the positive effects of peer support, particularly for breastfeeding and maternal mental health. The community-based initiatives linked to PLA methodology in some ways but were lacking in promoting community mobilization since the majority were aimed at the individual or group level, as opposed to engaging whole communities.</p><p><strong>Discussion: </strong>Community-based initiatives can be effective in HICs for improving aspects of maternal and neonatal health, particularly maternal mental health and breastfeeding. There is very limited research on more participatory community-based initiatives, such as PLA, in HICs that promote community-wide engagement and mobilization. Further research is needed in this area.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's Interest in Midwifery Continuity of Care During and After Pregnancy and Childbirth in Sweden:\"As a Matter of Course\".","authors":"Hanna Fahlbeck, Ingegerd Hildingsson, Birgitta Larsson, Margareta Johansson","doi":"10.1111/jmwh.70035","DOIUrl":"https://doi.org/10.1111/jmwh.70035","url":null,"abstract":"<p><strong>Introduction: </strong>The midwifery continuity of care model is well-established internationally, but it is rarely offered in Sweden. Pregnant women's interest in midwifery continuity of care has not been investigated in recent years. This study aimed to investigate the interest of pregnant women and new mothers in Sweden regarding midwifery continuity of care and to identify factors associated with this interest.</p><p><strong>Methods: </strong>A national longitudinal digital questionnaire was conducted to collect background information, pregnancy-related variables, and childbirth-related variables, as well as to measure interest in midwifery continuity of care among women in Sweden. Odds ratios with 95% CIs and logistic regression analyses were used.</p><p><strong>Results: </strong>Of 1697 women who responded, 68.1% expressed a strong interest in midwifery continuity of care during pregnancy, and 74.2% during postpartum. Fear of childbirth was associated with a higher interest in midwifery continuity of care during pregnancy (adjusted odds ratio [aOR] 1.75; 95% CI, 1.34-2.27). Women who had mixed or negative experiences with the care they received were also more likely to be interested in the model (aOR, 2.33; 95% CI, 1.43-3.97).</p><p><strong>Discussion: </strong>Pregnant women and new mothers in Sweden show a high level of interest in midwifery continuity of care. However, current maternity services do not adequately meet these preferences, indicating a need to scale up continuity of care models, particularly for women who experience fear of childbirth and dissatisfaction with their care. Therefore, antenatal, intrapartum, and postpartum care in Sweden should be enhanced to better align with the needs and preferences of pregnant women and new mothers.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, Implementation, and Evaluation of Implicit Bias Skill Building Sessions for Maternal Health Care Professionals.","authors":"Nicole Warren, Briana E Kramer, Cheri Wilson, Nikki Akparewa, Kelly M Bower","doi":"10.1111/jmwh.70027","DOIUrl":"https://doi.org/10.1111/jmwh.70027","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal mortality and morbidity in the United States are marked by gross disparities linked to individual bias and systems-level factors. Implicit bias training is one strategy to address these disparities, and several states now require such education. Although evidence-based strategies to mitigate bias exist, these are not commonly integrated into training opportunities in clinical settings or evaluated for their impact on learners. We designed and evaluated an implicit bias skill building training program to address this gap.</p><p><strong>Methods: </strong>We used a quasiexperimental, multimethod evaluation to assess the outcomes of our program: reach, participant satisfaction, knowledge and acknowledgment of bias and its impacts, as well as behaviors to mitigate one's own and others' biases. Survey and qualitative data from internal hospital facilitators provided added details about program satisfaction.</p><p><strong>Results: </strong>People who participated in didactic implicit bias training reported being more aware of their own and others' biases and reported using more mitigation strategies than those who did not participate in any such training. Participants in the didactic training and at least one implicit bias skill building session reported using more mitigation strategies than people who completed the didactic training alone. Participants agreed that the training was relevant and motivated them to change their behavior.</p><p><strong>Discussion: </strong>Our results suggest there is potential value in adding skill building activities to maximize the impact of implicit bias training efforts.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Appraisal on \"Person-Centered Perinatal Health Care and Empowerment During Pregnancy, Birth, and Postpartum: A Cross-Sectional Mixed-Methods Analysis\".","authors":"Amiya Das, Moumita Das","doi":"10.1111/jmwh.70032","DOIUrl":"https://doi.org/10.1111/jmwh.70032","url":null,"abstract":"","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midwifery's Moment: Medicaid Partnerships Open Doors for Expansion and Integration.","authors":"Melissa D Avery, Amy M Kohl","doi":"10.1111/jmwh.70034","DOIUrl":"https://doi.org/10.1111/jmwh.70034","url":null,"abstract":"","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"Critical Appraisal on 'Person-Centered Perinatal Health Care and Empowerment During Pregnancy, Birth and Postpartum: A Cross-Sectional Mixed-Methods Analysis'\".","authors":"Rebecca Woofter, Renee Clarke, Prisca C Diala, Molly R Altman, Patience A Afulani","doi":"10.1111/jmwh.70031","DOIUrl":"https://doi.org/10.1111/jmwh.70031","url":null,"abstract":"","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The CHOICES Black Midwifery Fellowship: An Innovative Model for Training Midwives in Reproductive Justice and Community-Centered Care.","authors":"Nikia D Grayson, Nicole Quinones, Kemetra King, Kiara Norman, Talita Wells Oseguera, Nekea Smith, Miajenell Peake, Alexis Dunn Amore","doi":"10.1111/jmwh.70028","DOIUrl":"https://doi.org/10.1111/jmwh.70028","url":null,"abstract":"<p><p>The CHOICES Black Midwifery Fellowship Program is an exemplar of a transformative postgraduate model in midwifery education that extends beyond traditional training frameworks. The program is designed around 5 core pillars: full-scope reproductive health services education and training, Black feminist thought, leadership and mentorship, neonatal and postnatal care, and community and patient-centered care. By embedding these frameworks into the curriculum, the fellowship challenges the prevailing medicalized approach to birth that often neglects the unique needs of marginalized communities. This perspective equips fellows with a critical understanding of the social, political, and economic factors that influence health outcomes, enabling them to advocate effectively for their patients and communities. In addition to improving clinical outcomes, the fellowship has also played a crucial role in restoring trust between Black birthing people and the health care system. Historical injustices and ongoing systemic racism have led to deep-seated mistrust of mainstream health care institutions among many Black communities. By training Black midwives who understand and share the cultural and lived experiences of their patients, the CHOICES fellowship helps to bridge this trust gap. Fellows are taught to adopt a patient-centered approach that prioritizes informed consent, shared-decision-making, and respect for cultural practices. In this article we outline the structure, curriculum, and training activities of the CHOICES Black Midwifery Fellowship. Additionally, we review the challenges encountered and lessons learned during the implementation process.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Nurse-Midwifery Education: A Quality Improvement Initiative for Competency-Based Intrapartum Skills Laboratories.","authors":"Deanna Womack, Melissa Stec","doi":"10.1111/jmwh.70029","DOIUrl":"https://doi.org/10.1111/jmwh.70029","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal morbidity and mortality rates in the United States and Georgia remain alarmingly high, exceeding those of many low-resource regions despite extensive interventions. Research highlights the role of competent midwifery care in addressing key contributing factors, such as limited health care access, insufficient prenatal care, and adverse social determinants of health. To expand the pool of qualified certified midwives and certified nurse-midwives, there is a pressing need for robust midwifery education programs, reliable and valid evaluation tools for student assessment, and documentation of skill development and confidence improvement among trainees.</p><p><strong>Process: </strong>To evaluate preparedness and competency, a quality improvement project was initiated to assess the effectiveness and efficiency of the intrapartum simulation laboratory. A modified version of the National League for Nursing Student Satisfaction and Self-Confidence in Learning tool was used. Third-semester midwifery students at Emory University School of Nursing in Atlanta, Georgia, completed pre- and postlaboratory surveys, which included a Likert scale to measure confidence in the simulation laboratory's ability to meet their educational needs. Qualitative questions were incorporated to identify suggestions for laboratory improvements.</p><p><strong>Outcomes: </strong>Statistically significant improvements were observed in midwifery students' pre- and postlaboratory assessments, particularly in their confidence regarding the skills reviewed, the alignment of simulation and laboratory time with their learning styles, and their trust in faculty members' ability to effectively teach essential midwifery practices.</p><p><strong>Discussion: </strong>The findings validate the effectiveness of intentional teaching strategies and innovative simulation technologies in enhancing midwifery education. Increasing the number of competent midwives in practice represents a critical step in addressing the persistently high maternal morbidity and mortality rates in the United States. These teaching approaches and technologies can also be applied to other midwifery simulation laboratories and adapted for use in other advanced practice registered nursing specialties.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing a Statewide Hospital Equity Initiative: A Qualitative Formative Evaluation.","authors":"Kelly M Bower, Briana E Kramer, Nicole Warren","doi":"10.1111/jmwh.70026","DOIUrl":"https://doi.org/10.1111/jmwh.70026","url":null,"abstract":"<p><strong>Introduction: </strong>Implicit bias training for health professionals is widely recommended as a strategy to mitigate maternal health inequities; however, evidence to support its efficacy is limited. Furthermore, experts recommend that bias training be embedded in a program of systems-level equity interventions. Although frameworks and broad recommendations for hospitals exist, there is limited actionable guidance for operationalizing effective maternal health equity programs in hospitals. This study aimed to gather data to inform the design and implementation of a statewide offering of implicit bias training and systems-level maternal health equity-focused interventions responsive to hospital needs and preferences, and expert input.</p><p><strong>Methods: </strong>This qualitative formative evaluation consisted of in-depth interviews with maternal health leaders from Maryland birth hospitals and experts in maternal health equity to understand current maternal health equity work, recommended strategies, barriers, and facilitators of hospital-based implicit bias training and systems-level maternal health equity initiatives.</p><p><strong>Results: </strong>Seventeen interviews were conducted with birth hospital representatives and experts in maternal health equity. Hospital representatives reported limited prior work providing implicit bias training or implementing systems-level interventions. Participants recommended equity-focused interventions that align with existing health care improvement and maternal health equity recommendations. They also suggested implementation approaches aimed at leveraging facilitators and overcoming barriers of hospital-based settings.</p><p><strong>Discussion: </strong>Formative work in the design of maternal health equity initiatives can offer an expanded understanding of the actual barriers and needed support for hospitals and could improve effectiveness of these interventions.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Raynaud's Phenomenon of the Nipple: A Case Report of Postpartum Recurrence and Treatment.","authors":"Jennifer Trebbin, Tara A Singh","doi":"10.1111/jmwh.70012","DOIUrl":"https://doi.org/10.1111/jmwh.70012","url":null,"abstract":"<p><p>Raynaud phenomenon is a well-known condition that is characterized by episodic vasoconstriction of the extremities leading to pain and discoloration. It is more common among women than men and often results from exposure to cold or stress. Raynaud phenomenon can also affect the nipple during breastfeeding, causing severe pain and distress for the lactating individual and newborn, leading to premature cessation of breastfeeding. Raynaud phenomenon of the nipple is often confused with other breastfeeding pain causes, which can result in treatment oversights. The etiology of Raynaud phenomenon of the nipple is complex and thought to be caused by an interplay of hormones and stress in the peripartum period. Literature on this condition is limited, mostly consisting of case reports, and there are very little data about its recurrence in subsequent peripartum periods. Treatment options are similar to those for Raynaud phenomenon and, if initiated in a timely fashion, can allow breastfeeding to continue uninterrupted. This clinical rounds article presents a case report of Raynaud phenomenon of the nipple after a first birth and a reoccurrence during a subsequent (second) postpartum period. Discussion of the pathophysiology, clinical presentation, diagnostic tips, and appropriate treatment options are included.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}