Journal of midwifery & women's health最新文献

{"title":"The Relationship Between Women's Disaster Preparedness, Genital Hygiene Behaviors, and Menstrual Hygiene Measures.","authors":"Ayça Demir Yıldırım, Ebru Özcan, Arzu Akdemir","doi":"10.1111/jmwh.70197","DOIUrl":"https://doi.org/10.1111/jmwh.70197","url":null,"abstract":"<p><strong>Introduction: </strong>Disasters disrupt access to water, sanitation, privacy, and menstrual hygiene products, thereby increasing women's risk of genital and urinary tract infections and posing a threat to reproductive health. Despite the importance of disaster preparedness, limited evidence exists on the relationship between women's disaster preparedness, genital hygiene behaviors, and menstrual hygiene measures.</p><p><strong>Methods: </strong>This study aimed to investigate the relationship between women's disaster preparedness and menstrual hygiene practices in relation to general genital hygiene. It was a cross-sectional online study in Istanbul from April to July 2025. A total of 385 women participated, and data were collected using the Introductory Information Form, the Genital Hygiene Behavior Scale, and the Disaster Preparedness Scale.</p><p><strong>Results: </strong>Among the participants, 41.8% had experienced at least one natural disaster in the past. Most women had made no preparations for basic needs (77.7%) or had not made a disaster bag (78.2%). In terms of disaster preparedness, the proportion of those who kept a product specifically intended for menstrual hygiene was limited to 17.7%. The mean (SD) scores for the Genital Hygiene Behavior Scale and the Disaster Preparedness Scale score were 84.74 (6.9) and 30.63 (6.5), respectively. Correlation analysis indicated a low-level yet statistically significant positive association between Genital Hygiene Behavior Scale scores and Disaster Preparedness Scale scores (r = 0.162; P =  .001).</p><p><strong>Discussion: </strong>Most participants reported limited preparedness for menstrual hygiene within the disaster preparedness process despite the high educational attainment and favorable income status of the sample. Menstrual hygiene-related preparedness was higher among women with higher Genital Hygiene Behavior Scale scores.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120957","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":"Severe Maternal Morbidity in the Rural United States: State of the Science.","authors":"Kathryn Lenhart Usedom, Florence M Weierbach, Pi-Ming Yeh","doi":"10.1111/jmwh.70198","DOIUrl":"https://doi.org/10.1111/jmwh.70198","url":null,"abstract":"<p><p>Severe maternal morbidity (SMM) is a pervasive adverse health outcome in the United States, affecting 50,000 to 60,000 pregnant individuals annually. Rural communities experience a convergence of factors that place them at higher risk of SMM. This state of the science review synthesizes current evidence regarding SMM in the rural United States, using an intersectional lens to critically evaluate the complex dynamics influencing SMM in these communities. We reviewed 32 studies published in the last 10 years, from which 3 broad themes emerged. First, rural residency is an independent risk factor for SMM, with risk increasing alongside greater geographic remoteness, even after adjusting for sociodemographic factors and medical comorbidities. Second, racial and ethnic disparities in SMM are wider in rural communities compared with their urban counterparts, indicating that geographic isolation and structural racism interact to create unique pressures on minoritized populations. Third, the pattern of SMM attributable to specific health risks and conditions diverges between rural and urban communities. Rural residents experience a greater proportion of SMM due to hypertensive disorders, chronic condition-related decompensation, severe hemorrhage, and mental health conditions. These findings highlight a significant measurement gap, wherein current national surveillance may systematically undercount SMM indicators most prevalent in rural communities. Future perinatal health research must validate rural metrics, use intrarural classifications to explore the nuance of place-based outcomes, and prioritize intersectional investigations viewing rurality as a structural driver with complex and nonuniform effects. Theory-guided research of rural communities is critically needed to build a comprehensive understanding of rural SMM, address persistent inequities, and create effective perinatal health interventions.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083373","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":"Social Media Recruitment to Increase Participation Among Hard-to-Reach Populations: Experiences From a Breastfeeding Study of African American Women.","authors":"Nicole G Moody, Rebecca C Robert, Amira A Roess","doi":"10.1111/jmwh.70179","DOIUrl":"https://doi.org/10.1111/jmwh.70179","url":null,"abstract":"<p><strong>Introduction: </strong>Among racial and ethnic groups, African American women experience some of the lowest breastfeeding rates, yet they remain underrepresented in breastfeeding research. Social media has the potential to increase their participation, but practical examples of its use are needed to accompany existing guidelines.</p><p><strong>Methods: </strong>We used Facebook to recruit African American, breastfeeding women for our cross-sectional survey research designed to explore breastfeeding and human milk expression behaviors. We describe the steps undertaken and challenges faced with our recruitment efforts.</p><p><strong>Results: </strong>The steps included (1) identifying relevant Facebook groups, (2) contacting administrators, (3) posting and sustaining visibility, and (4) addressing the challenges encountered related to survey completion, including bots, discordant answers, missing data, and sample size, and how we addressed each. Of the private Facebook groups contacted, 21.6% permitted recruitment, resulting in a final sample of 133 African American women who completed the survey.</p><p><strong>Discussion: </strong>Many challenges were encountered in social media recruitment. We offer practical guidance for researchers contemplating similar platforms to recruit participants for breastfeeding or other maternal health research, especially those recruiting hard-to-reach or underrepresented populations.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083391","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":"Neonatal Mortality Risk in Planned Home Birth, 2014-2024.","authors":"Lauren Hoehn-Velasco, Diana R Jolles, Raka Datta","doi":"10.1111/jmwh.70195","DOIUrl":"https://doi.org/10.1111/jmwh.70195","url":null,"abstract":"<p><strong>Introduction: </strong>Planned home birth increased sharply in the United States after 2019. This study examined the evolution of neonatal mortality risk in planned home births compared with hospital births from 2014 to 2024.</p><p><strong>Methods: </strong>This is a retrospective observational analysis using US natality detail files from 2014 to 2024. The primary outcome was neonatal death. This study used a pooled logistic regression to estimate the overall odds ratio (OR) for home birth versus hospital birth, interacting home birth with period indicators (2014-2016, 2017-2019, 2020-2021, 2022-2024). The sensitivity analyses also considered how much the individual \"low-risk\" sample restrictions contributed.</p><p><strong>Results: </strong>Planned home birth was associated with a higher OR for neonatal death relative to hospital birth (OR, 1.71; 95% CI, 1.23-2.37), but the adjusted OR (aOR) was not statistically significant (aOR, 1.30; 95% CI, 0.92-1.83) from 2014 to 2024. Joint Wald tests indicated that the prepandemic aORs (2014-2016 and 2017-2019) were not statistically different from the 2020-2021 reference period (P = .234), whereas the 2022-2024 aOR was weakly significant (P = .055). In the sensitivity analyses, re-including pregnancies with higher-risk conditions increased the aOR. Adding back noncredentialed midwives to the sample had the largest effect on the aOR (aOR, 1.70; P < .001; q < .001). Adding back breech presentations (aOR, 1.46; P = .014; q = .060), congenital abnormalities (aOR, 1.37; P = .030; q = .087), postterm births (aOR, 1.37; P = .056; q = .125), and missing controls (aOR, 1.36; P = .068; q = .129) increased the aOR as well.</p><p><strong>Discussion: </strong>For low-risk births attended by certified nurse-midwives/certified midwives or physicians, the neonatal mortality differential between planned home and hospital settings was modest from 2014 to 2024. However, relaxing clinical risk criteria or including less-regulated provider types increased the estimated risk of neonatal mortality.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083398","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":"Identification and Treatment of Anorexia Nervosa in Women With Perimenopause.","authors":"Janell Senda, Sarah Carpenter, Mary Carter-Orbke","doi":"10.1111/jmwh.70189","DOIUrl":"https://doi.org/10.1111/jmwh.70189","url":null,"abstract":"<p><p>Disordered eating is a common problem that midwives will encounter as frontline primary care providers. Anorexia nervosa (AN) is a form of disordered eating that results in chronic starvation state, creating significant risk of morbidity and mortality to the patient. AN is traditionally considered a disorder of adolescence and young adulthood; however, recurrence and new-onset eating disorders (EDs) also occur during midlife, particularly during the menopausal transition. Hormonal changes, psychosocial stressors, and body image concerns may contribute to symptom emergence or relapse, yet EDs in this population frequently remain underrecognized. This case highlights the importance of considering EDs in the differential diagnosis of amenorrhea, weight loss, and menopausal symptoms in midlife adults. Certified nurse-midwives and certified midwives are uniquely positioned to identify EDs through longitudinal, relationship-based care and routine preventive visits. Early recognition, appropriate screening, comprehensive health evaluation, and timely multidisciplinary referral are essential in reducing morbidity and improving long-term outcomes for patients experiencing recurrent EDs across the life span.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083413","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":"Interprofessional Collaboration Between Certified Nurse-Midwives/Certified Midwives and Obstetrician-Gynecologist Physicians: A State of the Science Review.","authors":"Myra DeLuca, Diane Berish, Erin Kitt-Lewis, Kelly Gallagher","doi":"10.1111/jmwh.70196","DOIUrl":"https://doi.org/10.1111/jmwh.70196","url":null,"abstract":"<p><p>Interprofessional collaboration (IPC) occurs when autonomous professionals work together to achieve shared system-level or patient-centered goals and is a promising strategy to improve perinatal care. Prior research suggests that when midwives and physicians collaborate, there is increased access to perinatal services, improved care outcomes, and more efficient use of limited health care resources. However, it is not always clear how IPC is defined, operationalized, demonstrated, or hindered. This state of the science review examines how IPC between certified nurse-midwives or certified midwives and obstetrician-gynecologist physicians is described in current US literature and highlights gaps to guide future practice, policy, and research. Smith's conceptual model of midwife-physician collaboration guided the synthesis and organization of findings from 14 publications. The publications were organized into 5 areas: (1) professional roles and expectations, (2) relational and communication processes that build collaboration, (3) structural and relational barriers to IPC, (4) interprofessional education and IPC, and (5) the impact and evaluation of IPC. IPC was associated with practice environments that included clear clinical roles, shared goals, and structured guidelines supported by organizational leadership. Other relational dynamics such as mutual respect, trust, and clear, consistent communication were found to strengthen IPC. Institutional hierarchies and regulatory restrictions on midwives' autonomy were identified as barriers to IPC. Very few studies used objective measures of IPC, linked IPC to outcomes, or examined rural settings. These findings highlight the need for policy reform, improved measurement strategies, and intentional efforts to strengthen clinician relationships to advance IPC and support a sustainable perinatal care workforce.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070917","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":"Transportation Is Not Just a Ride: How Transportation Shapes Prenatal Care Experiences Among Black Women.","authors":"Lucinda Canty, Lindiwe Sibeko, Ruth Appiah Kubi, Favorite Iradukunda, Isabelle Coppa Wandenkolk, Shannon C Roberts","doi":"10.1111/jmwh.70190","DOIUrl":"https://doi.org/10.1111/jmwh.70190","url":null,"abstract":"<p><strong>Introduction: </strong>Prenatal care improves maternal and infant outcomes; however, transportation as a social determinant of health influences both access to care and the conditions under which care is experienced. Transportation is often conceptualized as a barrier to appointment attendance, limiting understanding of its broader role in prenatal care. This study examined how transportation shapes prenatal care experiences among Black women.</p><p><strong>Methods: </strong>We used a concurrent triangulation mixed-methods design with 8 Black women who completed 2 semistructured interviews (preprenatal and postprenatal visit) and a ride-along observation. Qualitative data explored transportation, care experiences, interactions with health care providers, and emotional well-being. Quantitative data examined mode of transportation, travel time, and road conditions. Data were analyzed concurrently and integrated through triangulation.</p><p><strong>Results: </strong>Five themes emerged: (1) Not every ride is a good option; (2) driving while pregnant; (3) it takes a village to feel safe in my care; (4) roads matter: infrastructure as a determinant of prenatal care; (5) I would expect them to give me some grace. Transportation was multidimensional, encompassing safety, cost, reliability, physical discomfort, and emotional burden. Structural factors-including institutional policies, scheduling inflexibility, parking challenges, and road conditions-influenced both access to care and experiences within care. Despite these challenges, participants consistently prioritized prenatal care.</p><p><strong>Discussion: </strong>Transportation is a structural determinant that shapes both access to and experiences of prenatal care. Findings challenge deficit-based narratives by highlighting how Black women actively navigate complex systems to obtain care. Efforts to improve maternal health equity should integrate transportation considerations into health care delivery, health system design, and community-informed strategies that address structural barriers to person-centered care.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070912","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":"Design, Assembly, and Implementation of Low-Cost Suture Knot-Tying Practice Models.","authors":"Hannah C McGrew, Hannah L Diaz, Samantha Swift, Julia C Phillippi","doi":"10.1111/jmwh.70184","DOIUrl":"https://doi.org/10.1111/jmwh.70184","url":null,"abstract":"","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972805","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":"Three Deadly Delays: How Medicaid Policy in Iowa Is Risking the Lives of Childbearing People.","authors":"Joan Combellick, Megan Sloat, Sophia Breitag, Eugene Declerq","doi":"10.1111/jmwh.70181","DOIUrl":"https://doi.org/10.1111/jmwh.70181","url":null,"abstract":"","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901770","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":"Neonatal Mortality Risk Among Births in Freestanding Birth Centers, 2015 to 2024.","authors":"Lauren Hoehn-Velasco, Diana R Jolles, Raka Datta","doi":"10.1111/jmwh.70177","DOIUrl":"https://doi.org/10.1111/jmwh.70177","url":null,"abstract":"<p><strong>Introduction: </strong>Births in freestanding birth centers have grown over the past decade, particularly during the COVID-19 pandemic. Whether the safety profile of birth center births has remained stable as volumes have grown is an open question. This study examines neonatal mortality risk among births in freestanding birth centers compared with births in hospitals over the period 2015 to 2024.</p><p><strong>Methods: </strong>This is a retrospective observational study using public-use US Natality Detail Files from 2015 to 2024. The primary outcome is neonatal death. The sample is restricted to term, singleton, and vertex births without major medical risk factors. Logistic regressions are used to consider the odds of neonatal death by setting (freestanding birth centers relative to birth in hospitals) for each year (2015 to 2024).</p><p><strong>Results: </strong>Across all 10 years in the sample, the adjusted odds ratio for neonatal death in freestanding birth centers fluctuated around 1.0, and no year showed a statistically significant difference in neonatal death between births in freestanding birth centers and hospitals. During the pandemic years (2020-2021), when birth center volumes increased, odds ratios were below 1.0 (0.43 in 2020; 0.78 in 2021), providing no evidence that higher use of freestanding birth centers raised the risk of neonatal death. The relative safety pattern of birth centers was consistent and stable throughout the study period.</p><p><strong>Discussion: </strong>Freestanding birth centers continue to demonstrate neonatal safety comparable with that of hospitals for low-risk pregnancies. This pattern held through a period of substantial growth in birth center use during the COVID-19 pandemic. These findings reinforce birth centers as a safe, evidence-based option for well-qualified low-risk births and support policies that integrate birth centers into mainstream maternity care systems.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901742","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}