Journal of midwifery & women's health最新文献

{"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":"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}

{"title":"Self-Compassion and Psychosocial Well-Being After Traumatic Births: Caring for the Midwife.","authors":"Yael Musseri Navon, Chani Malakov, Anna Woloski Wruble, Wiessam Abu Ahmad, Nurit Zusman, Michal Liebergall Wischnitzer","doi":"10.1111/jmwh.13733","DOIUrl":"https://doi.org/10.1111/jmwh.13733","url":null,"abstract":"<p><strong>Introduction: </strong>Midwives report high rates of exposure to traumatic births that can negatively affect their psychosocial well-being. Self-compassion can be considered as a tool to promote psychosocial well-being. The aim of this study was to assess the prevalence of midwives' exposure to traumatic births and explore midwives' self-compassion and its correlation to their psychosocial well-being in relation to experiences of traumatic births.</p><p><strong>Methods: </strong>In a cross-sectional correlational study, data were collected using an electronic questionnaire by way of social networks and the website of the Israel Midwives Association. Inclusion criteria were certified Israeli midwives working in a hospital delivery room and able to read and write Hebrew. The questionnaire was composed of 4 parts: a demographic section, a traumatic events in perinatal care list, a self-compassion scale-short form, and a psychosocial health and well-being tool (short form of Copenhagen Psychosocial Questionnaire).</p><p><strong>Results: </strong>The most common traumatic event reported was death. Self-compassion and psychosocial health and well-being were found to be at a medium-high level (mean [SD], 40.66 [6.5]; 38.33 [13.03]), and correlated significantly (r = 0.339; P < .001). There was a significant interaction effect between low self-compassion (mean, ≤3.17) and exposure to traumatic birth in the last year on psychosocial well-being compared with those who were not exposed to traumatic birth in the last year (F_2,103 = 3.25; P = .043). No significant effect was found in those women with medium (mean, 3.18-3.67) or high (mean, ≥3.68) self-compassion.</p><p><strong>Discussion: </strong>Self-compassion is related to the psychosocial health and well-being of midwives exposed to traumatic birth. Self-compassion can be learned and should be considered for inclusion in midwives' basic and continuing education.</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":"143019003","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":"Financial Barriers to Expanded Birth Center Access in New Jersey: A Qualitative Thematic Analysis.","authors":"Rebecca H Ofrane, Slawa Rokicki, Leslie Kantor, Julie Blumenfeld","doi":"10.1111/jmwh.13732","DOIUrl":"https://doi.org/10.1111/jmwh.13732","url":null,"abstract":"<p><strong>Introduction: </strong>Birth centers are an underused care setting with potential to improve birth experience and satisfaction. Both hospital-based and freestanding birth centers operate with the midwifery model of care that focuses on safe, low-intervention physiologic birth experiences for healthy, low-risk pregnant people. However, financial barriers limit freestanding birth center sustainability and accessibility in New Jersey, especially for traditionally marginalized populations. This qualitative study explores the financial barriers faced by freestanding birth centers in order to expand access and choice for pregnant people in New Jersey.</p><p><strong>Methods: </strong>Semistructured interviews were conducted with participants from 4 sectors: (1) birth center or health system, (2) policy-adjacent philanthropy or research, (3) state departments, and (4) health insurance. Coding and analysis followed a reflexive thematic analysis process, resulting in the identification of 4 financial barriers to birth center access.</p><p><strong>Results: </strong>Facility Medicaid reimbursement rates are a primary barrier for birth centers, along with startup and operating costs and, more indirectly, low supply of midwives and low patient demand for birth center care.</p><p><strong>Discussion: </strong>New Jersey is well-positioned to enact critical policies and programs that can improve out-of-hospital birth center access, based on the findings and recommendations from this research. Other states can follow suit in pursuit of solutions to improve maternal health access and equitable birth center sustainability.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960778","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":"Mandala as a New Intervention for Reducing Fear of Childbirth: A Randomized Controlled Trial.","authors":"Tuğba Topcu, Fadime Bayri Bingöl","doi":"10.1111/jmwh.13722","DOIUrl":"https://doi.org/10.1111/jmwh.13722","url":null,"abstract":"<p><strong>Introduction: </strong>Fear of childbirth is common in nulliparous women. More accessible and less costly interventions such as mandala are needed to reduce fear of childbirth. The purpose of this study was to test the efficacy of mandala coloring added to antenatal education to reduce fear of childbirth.</p><p><strong>Methods: </strong>An open, randomized controlled trial with a parallel group design was conducted at a tertiary care hospital in Turkey (ClinicalTrials.gov registration NCT05217368). Nulliparous pregnant women without pregnancy complications, between 24 and 32 weeks' gestation, and with increased fear of childbirth were included in the study. A total of 140 pregnant women were allocated to the intervention (mandala coloring plus antenatal education) and control (antenatal education alone) groups, and 100 participants completed the study. Fear before childbirth was measured with the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) version A at baseline and after completion of antenatal education with or without mandala coloring. Fear during childbirth was measured with the W-DEQ version B retrospectively within one week of giving birth.</p><p><strong>Results: </strong>At baseline, the intervention and control groups experienced similar fear of childbirth (57.1 vs 57.0; P = .978). After completing antenatal education, the mean fear of childbirth decreased more in the intervention group than in the control group (42.6 vs 50.1; P = .018). In the postpartum period, the intervention group reported less fear during childbirth than the intervention group (68.5 vs 58.0; P = .030). Perinatal outcomes were statistically similar between the 2 groups.</p><p><strong>Discussion: </strong>Adding mandala coloring to antenatal education significantly reduced fear of childbirth before and during birth. More studies examining the effects of mandala coloring on perinatal mental health should be conducted.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815402","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":"Music and Sleep Hygiene Interventions for Pregnancy-Related Insomnia: An Online Randomized Controlled Trial.","authors":"Nadia Flensted Hoegholt, Camilla Eva Krænge, Peter Vuust, Morten Kringelbach, Kira Vibe Jespersen","doi":"10.1111/jmwh.13699","DOIUrl":"https://doi.org/10.1111/jmwh.13699","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately 50% to 60% of all pregnant women suffer from insomnia during pregnancy. Pregnancy-related insomnia has been associated with severe outcomes for both mother and child postnatally. Currently, the treatment of pregnancy-related insomnia is often neglected due to a lack of suitable treatments. This online assessor-masked randomized controlled trial aimed to evaluate the effectiveness of music listening and sleep hygiene for treating pregnancy-related insomnia.</p><p><strong>Methods: </strong>We recruited first-time pregnant women at the end of the second trimester with a report of poor sleep. Participants in the music and sleep hygiene (MSH) group received standard sleep hygiene advice and were instructed to listen to music daily at bedtime for 4 weeks. They could choose from 6 sleep playlists of different genres. Participants randomized to the sleep hygiene alone (SH) group received standard sleep hygiene only. Primary outcomes were sleep quality measured with the Pittsburgh Sleep Quality Index (PSQI) and insomnia severity measured with the Insomnia Severity Index.</p><p><strong>Clinicaltrials: </strong>gov Identifier: NCT04633395.</p><p><strong>Results: </strong>Among the 98 participants receiving the online intervention, 31 participants in the MSH group (62%) and 40 participants in the SH group (80%) completed the postintervention measurements. Both groups experienced improved sleep quality during the intervention period (PSQI change, -2.10; 95% CI, -3.27 to -0.93; P < .001), with no significant difference between the groups. Similarly, insomnia symptoms were reduced (Insomnia Severity Index change, -3.42; 95% CI, -5.02 to -1.83; P < .001) with no significant difference in the effect between groups. There was a significant difference in adherence to sleep hygiene between the MSH and SH groups (42% vs 8%; P = .007).</p><p><strong>Discussion: </strong>Sleep quality and insomnia severity can be improved in pregnant women with relatively simple interventions like music listening and sleep hygiene advice. These results align with previous research, but larger trials are recommended to support introduction into clinical practice.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484394","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}