Journal of midwifery & women's health最新文献

{"title":"The Effects of Interventions During Pregnancy to Improve Breastfeeding Self-Efficacy: Systematic Review and Meta-Analysis.","authors":"Fatma Koruk, Selma Kahraman, Zeliha Turan, Hatice Nur Özgen, Burcu Beyazgül","doi":"10.1111/jmwh.13742","DOIUrl":"https://doi.org/10.1111/jmwh.13742","url":null,"abstract":"<p><strong>Introduction: </strong>Breastfeeding self-efficacy can be increased through effective interventions to improve breastfeeding rates and promote maternal and infant health. Improving breastfeeding self-efficacy in the prenatal period is important for successful breastfeeding and sustainable breastfeeding practices after birth. Although randomized controlled trials have shown that antenatal and postnatal interventions can boost breastfeeding self-efficacy, evidence is lacking on which interventions are most effective and on the key characteristics of such interventions. The purpose of this review was (1) to examine the effects of various antenatal interventions on breastfeeding self-efficacy and (2) to identify the most effective intervention.</p><p><strong>Methods: </strong>In this meta-analysis, randomized controlled trials and experimental studies were searched using 5 search engines in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols declaration guidelines. In total, 34 studies were identified, which included 4698 participants. A random effects model, subgroup analysis, and meta-regression analysis were used to pool the results.</p><p><strong>Results: </strong>During pregnancy, all types of interventions except model-based counseling provided without prior education and simulation methods have been effective in increasing breastfeeding self-efficacy (P <.05). Intervention type was the only intervention characteristic that showed statistically significant differences in effect size using the between-group heterogeneity statistic (Q_B, 13.888; P = .016). A meta-regression analysis found a significant effect of differences in intervention types across studies (heterogeneity: τ², 0.672; Q value = 662.100; df = 33; P < .001; I² = 95.016%; test for overall effect: z, 7.020; P = .001), and this difference was found to be due to model-based education and counseling, which had the largest effect size in increasing breastfeeding self-efficacy. Intervention type explained 16% of the relationship between interventions to increase breastfeeding self-efficacy during pregnancy and breastfeeding self-efficacy (r² = 0.16).</p><p><strong>Discussion: </strong>There is a relationship between the types of interventions for breastfeeding during pregnancy and breastfeeding self-efficacy. To increase breastfeeding self-efficacy during pregnancy, it is recommended that health care professionals primarily develop programs that include model-based education and counseling.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702543","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":"Perinatal Health Care Preferences in a Rural Mennonite Community: A Mixed-Methods Study.","authors":"April E Ward, Barbara K Hackley, Emily C McGahey","doi":"10.1111/jmwh.13746","DOIUrl":"https://doi.org/10.1111/jmwh.13746","url":null,"abstract":"<p><strong>Introduction: </strong>A rapidly growing rural community of Old Order Mennonites in upstate New York abruptly lost midwifery services in 2018, causing a crisis in perinatal care access. A mixed-methods study was undertaken to explore health status, perinatal needs, and preferences in this culturally homogenous group.</p><p><strong>Methods: </strong>An anonymous survey mailed to 650 Mennonite families assessed demographic characteristics, general health, perinatal optimality, perinatal care characteristics, stress and anxiety related to rural childbearing, and preferences for a perinatal health care system. Voluntary follow-up telephone interviews explored recent perinatal experiences and desires for future care.</p><p><strong>Results: </strong>Surveys were returned by 218 Mennonite women, a 33.5% response rate. Home birth was preferred by 94.6% of participants. The mean (SD) Perinatal Background Index score was 86.7% (11.7), indicating a high level of optimality. Elevated levels of stress and anxiety, as measured by the Rural Pregnancy Experience Scale, were reported by 12 participants (6.6%). Qualitative descriptive analysis of 21 interviews revealed a strong desire to preserve home birth, receive care that was respectful of Mennonite cultural norms, and maintain a personal choice of birth attendants.</p><p><strong>Discussion: </strong>According to participants, an ideal perinatal care system would ensure locally available, skilled midwives willing to maintain the community's traditional childbearing practices. Despite rural remoteness, distance from inpatient perinatal services was not associated with increased stress and anxiety. Access to care could be improved by state-level initiatives to expand the licensure of midwives and to remove barriers to birth center development.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665738","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":"Preventing Type 2 Diabetes in Women With Gestational Diabetes: Three Theoretical Perspectives on Behavior Change.","authors":"Lotte Elton, Ann-Kristin Porth, Julie L O'Sullivan, Jan C Zoellick, Paul Gellert, Andy Guise, Alexandra Kautzky-Willer","doi":"10.1111/jmwh.13747","DOIUrl":"https://doi.org/10.1111/jmwh.13747","url":null,"abstract":"","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665739","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":"Variation in the Use of Guideline-Based Care by Prenatal Site: Decomposing the Disparity in Preterm Birth for Non-Hispanic Black Women.","authors":"Patricia McGaughey, Renata E Howland","doi":"10.1111/jmwh.13745","DOIUrl":"https://doi.org/10.1111/jmwh.13745","url":null,"abstract":"<p><strong>Introduction: </strong>Despite longstanding status as a public health priority, preterm birth rates continue to be higher among non-Hispanic Black women compared with other racial and ethnic groups. A growing body of literature highlights the site of care as a key factor in pregnancy outcomes. Although research shows that many individuals do not receive guideline-based prenatal care, little is known about site-level variation in the use of recommended prenatal services and its potential relationship with Black-White preterm birth disparities.</p><p><strong>Methods: </strong>In this cross-sectional cohort study, we analyzed variation in site-level use of 4 key prenatal services: tetanus, diphtheria, and pertussis (Tdap) vaccination, [per the CDC website] and screening for bacteriuria, diabetes, and group Beta streptococcus, using administrative data from New York State Medicaid and the American Community Survey. We used multivariable logistic regressions to estimate the odds of attending a low-use site (mean <2 services per patient) by race and ethnicity, controlling for age, high-poverty residential address, and low prenatal care attendance. We performed Fairlie decomposition analyses to quantify the contribution of individual and site-level factors to the observed difference in preterm birth rates among Black and White non-Hispanic women.</p><p><strong>Results: </strong>Site-level use of recommended prenatal services ranged from an average of 1 to 3.6 services per patient. Non-Hispanic Black women had more than twice the odds (adjusted odds ratio, 2.42; 95% CI, 2.32-2.52) of attending a low-use site compared with non-Hispanic White women. Among factors in the decomposition analysis, site-level screening for bacteriuria and diabetes accounted for the highest proportion of the explained variance in the observed preterm birth rates for non-Hispanic Black (10.7%) and non-Hispanic White (6.7%) women.</p><p><strong>Discussion: </strong>Results from this research support immediate improvement in guideline-based prenatal care to narrow the gap in preterm birth for non-Hispanic Black women. Research is needed to identify and correct site-level barriers to recommended prenatal services.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652894","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":"Feasibility of Remote Intensive Monitoring: A Novel Approach to Reduce Black Postpartum Maternal Cardiovascular Complications.","authors":"Michelle Villegas-Downs, Tara A Peters, Jared Matthews, Anne M Fink, Alicia K Matthews, Judith Schlaeger, Aiguo Han, William D O'Brien, Joan E Briller, Woon-Hong Yeo, Barbara L McFarlin","doi":"10.1111/jmwh.13743","DOIUrl":"https://doi.org/10.1111/jmwh.13743","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately 53% of maternal mortality occurs in the postpartum period, a time with little monitoring and health surveillance. The objective of this study was to test the feasibility, usability, appropriateness, and acceptability of remote low-burden physiologic monitoring of Black postpartum women, using a novel soft wearable patch and home vital sign monitoring for the first 4 weeks postpartum.</p><p><strong>Methods: </strong>A prospective longitudinal cohort feasibility study of 20 Black postpartum women was conducted using home monitoring equipment and a wearable patch with physiologic sensors measuring temperature, pulse oximetry, blood pressure, electrocardiogram (ECG), heart rate, and respiration twice daily during the first 4 weeks postpartum. Feasibility, acceptability, appropriateness, and usability were measured at the end of the study with the Feasibility of Intervention Measure, Acceptability of Intervention Measure, Intervention Appropriateness Measure, and System Usability Scale.</p><p><strong>Results: </strong>Twenty Black women were recruited and consented to participate in the study. Remote physiologic monitoring using a wearable patch and home monitoring equipment was rated as feasible (93%), acceptable (93%), appropriate (92%), and useable (80%). During the first 2 weeks postpartum, remote home monitoring detected that 60% of the women had blood pressures exceeding 140/90 mm Hg. The wearable patch provided useable data on ECG, heart rate, heart rate variability, pulse oximetry, and temperature.</p><p><strong>Discussion: </strong>Our research suggests that remote monitoring in the first 4 weeks postpartum has the potential to identify Black women at risk for postpartum complications.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517734","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":"Managing Bias in the Care of Pregnant and Parenting People with Substance Use Disorder.","authors":"Briana E Kramer, Nicole Warren, Mishka Terplan, Andreea A Creanga, Kelly M Bower","doi":"10.1111/jmwh.13744","DOIUrl":"https://doi.org/10.1111/jmwh.13744","url":null,"abstract":"<p><strong>Background: </strong>Unintentional overdose is the leading cause of pregnancy-associated death in Maryland and is preventable. Stigma contributes to birthing peoples' disengagement with the health care system, and health care professionals may participate in stigmatizing processes. We aimed to develop and evaluate a training on stigma and bias related to substance use disorder (SUD) for maternal health care professionals in Maryland.</p><p><strong>Methods: </strong>We used a community-engaged process to develop a training on stigma and bias related to SUD in pregnancy and implemented it with Maryland maternal health care professionals employed in birth hospital settings. We conducted a multimethod pre-post training evaluation, using a quantitative analysis of implementation reach, a pre-post knowledge test, a satisfaction survey, and a qualitative analysis of hospital facilitation meeting logs.</p><p><strong>Results: </strong>The training was completed by 1145 health care professionals. Knowledge test scores increased significantly after training, with the greatest change noted in the safety of medications for opioid use disorder during pregnancy. Over 90% of participants found the training relevant and planned to actively use what they learned. Qualitative feedback indicated the training may increase empathy with the patient population and contribute to practice changes.</p><p><strong>Discussion: </strong>Our evaluation suggests that this training is valuable, effective at increasing knowledge, and a potential catalyst for practice change among health care professionals working with pregnant and postpartum patients with SUD.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477275","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":"Exploring Midwives' Experiences Within Canada's First Alongside Midwifery Unit: Impacts and Implications for Midwifery Practice.","authors":"Beth Murray-Davis, Lindsay N Grenier, Anne M Malott, Cristina A Mattison, Carol Cameron, Eileen K Hutton, Elizabeth K Darling","doi":"10.1111/jmwh.13740","DOIUrl":"https://doi.org/10.1111/jmwh.13740","url":null,"abstract":"<p><strong>Introduction: </strong>Although midwifery-led units in hospitals are associated with positive outcomes, little is known about the experiences of the midwives who work within this model. Despite the increase in midwifery-led units globally, the first unit of this kind opened its doors in Canada in 2018. The Alongside Midwifery Unit (AMU) is staffed by a hospitalist midwife (a novel role in this country) and community midwives, working in a caseload model, who attend their clients' labor and birth on the unit. The AMU is a low-risk birthing unit located adjacent to the obstetric unit, offering midwifery-led care, in a homelike setting. Our aim was to explore and describe the experiences of midwives working in this model of care on the AMU.</p><p><strong>Methods: </strong>Qualitative semistructured interviews and one focus group with community and hospitalist midwives working at the AMU were conducted and analyzed using a grounded theory approach.</p><p><strong>Results: </strong>We identified that midwives were able to maintain the midwifery philosophy of care, strengthen relationships, amplify hospital integration, and grow midwifery leadership in this model.</p><p><strong>Discussion: </strong>Implementation of an AMU supports best practice, intra- and interprofessional relationships, and integration of midwives. Our findings demonstrate a positive impact of this model along with the absence of detrimental impact on midwifery values and philosophy. An improved understanding of the impact of the AMU on midwives and their practice is useful for refining the model of care and informing implementation in other settings. This research contributes to the growing evidence demonstrating the benefits of midwifery-led units.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392832","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 OptiBreech Trial Feasibility Study: A Qualitative Inventory of the Roles and Responsibilities of Breech Specialist Midwives.","authors":"Siân M Davies, Alice Hodder, Shawn Walker, Natasha Bale, Honor Vincent, Tisha Dasgupta, Alexandra Birch, Keelie Piper, Sergio A Silverio","doi":"10.1111/jmwh.13728","DOIUrl":"https://doi.org/10.1111/jmwh.13728","url":null,"abstract":"<p><strong>Background: </strong>The safety of vaginal breech birth is associated with the skill and experience of professionals in attendance, but minimal training opportunities exist. OptiBreech collaborative care is an evidence-based care bundle, based on previous research. This care pathway is designed to improve access to care and the safety of vaginal breech births, when they occur, through dedicated breech clinics and intrapartum support. This improved process also enhances professional training. Care coordination is accomplished in most cases by a key breech specialist midwife on the team. The goal of this qualitative inventory was to describe the roles and tasks undertaken by specialist midwives in the OptiBreech care implementation feasibility study.</p><p><strong>Methods: </strong>Semistructured interviews were conducted with OptiBreech team members (17 midwives and 4 obstetricians; N = 21), via video conferencing software. Template analysis was used to code, analyze, and interpret data relating to the roles of the midwives delivering breech services. Tasks identified through initial coding were organized into 5 key themes in a template, following reflective discussion at weekly staff meetings and stakeholder events. This template was then applied to all interviews to structure the analysis.</p><p><strong>Results: </strong>Breech specialist midwives functioned as change agents. In each setting, they fulfilled similar roles to support their teams, whether this role was formally recognized or not. We report an inventory of tasks performed by breech specialist midwives, organized into 5 themes: care coordination and planning, service development, clinical care delivery, education and training, and research.</p><p><strong>Discussion: </strong>Breech specialist midwives perform a consistent set of roles and responsibilities to co-ordinate care throughout the OptiBreech pathway. The inventory has been formally incorporated into the OptiBreech collaborative care logic model. This detailed description can be used by employers and professional organizations who wish to formalize similar roles to meet consistent standards and improve care.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076772","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":"Mothers' Experiences of Institutional Betrayal During Childbirth and their Postpartum Mental Health Outcomes: Evidence From a Survey of New Mothers in the United States.","authors":"Manali Kulkarni, Priya Fielding-Singh","doi":"10.1111/jmwh.13725","DOIUrl":"https://doi.org/10.1111/jmwh.13725","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this descriptive study was to explore the relationship between the experience of institutional betrayal (IB) during childbirth and postpartum mental health.</p><p><strong>Methods: </strong>Women who had given birth within the last 3 years in the United States as of June 2021 were recruited via Qualtrics to complete an online survey. Participants (N = 588) answered questions about their birth experiences, including adverse medical events and experiences of IB. Multiple logistic regressions examined whether experiencing one or more types of IB was associated with receiving a diagnosis of a postpartum mental health condition, controlling for other theoretically relevant covariates.</p><p><strong>Results: </strong>More than one-third (39%) of respondents experienced one or more types of IB during childbirth, with a mean (SD) of 1.7 (0.47) and maximum of 2. Experiencing IB increased the odds of a postpartum mental health condition diagnosis by 2.86 (95% CI, 1.63-5.05; P < .001).</p><p><strong>Discussion: </strong>The findings suggest that experiencing IB may be one mechanism driving negative postpartum mental health outcomes. Health care providers and policymakers should be aware of the role that IB can play in women's birth experiences and consider how strategies to decrease instances of IB during childbirth may improve postpartum mental health.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070388","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":"An Interprofessional Collaboration Between a Community-Based Doula Organization and Clinical Partners: The Champion Dyad Initiative.","authors":"Cassondra Marshall, Ashley Nguyen, Alli Cuentos, Alyana Almenar, Gabriella Mace, Jennet Arcara, Andrea V Jackson, Anu Manchikanti Gómez","doi":"10.1111/jmwh.13730","DOIUrl":"https://doi.org/10.1111/jmwh.13730","url":null,"abstract":"<p><p>As access to doula services expands through state Medicaid coverage and specific initiatives aimed at improving maternal health equity, there is a need to build and improve upon relationships between the doula community, hospital leaders, and clinical staff. Previous research and reports suggest rapport-building, provider education, and forming partnerships between community-based organizations and hospitals can improve such relationships. However, few interventions or programs incorporating such approaches are described in the literature. This article describes the development and 5 core components of the Champion Dyad Initiative (CDI), a novel program that uses bidirectional feedback between SisterWeb, a community-based doula organization, and 5 clinical sites (4 hospitals and one birthing center) to ensure pregnant and birthing people receive fair and equitable treatment. We also describe implementation challenges related to documentation, funding, and institutional support. The CDI is a promising model for community-based doula organizations and health care institutions to develop collaborative partnerships, build respectful doula-provider relationships, and work toward improving the pregnancy-related care that Black, Indigenous, and people of color receive in hospital and birth center settings. It is our hope that this innovative initiative can serve as a model that can be adapted for other locales, organizations, and hospitals.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018997","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}