Journal of Midwifery & Women's Health

INTRODUCTION: There are striking disparities in perinatal health outcomes for Black women in the United States. Although the causes are multifactorial, research findings have increasingly identified social and structural determinants of health as contributors to perinatal disparities. Maltreatment during perinatal care, which is disproportionately experienced by Black women, may be one such contributor. Qualitative researchers have explored Black women's perinatal care experiences, but childbirth experience data has yet to be analyzed in-depth across studies...

INTRODUCTION: Black women face poor maternal health outcomes including being over 3 times more likely to die from pregnancy complications than White women. Yet the lived experience of how these women self-advocate has not been clearly explored. The goal of this cross-sectional qualitative study was to describe the lived experiences of Black women advocating for their needs and priorities during the perinatal period. METHODS: Between January and October of 2022, we recruited Black women from obstetric clinics, research registries, and community advocacy groups who were either in their third trimester of pregnancy or within a year postpartum...

No abstract text is available yet for this article.

BACKGROUND: Recommended gestational weight gain (GWG) is crucial for health of women and their offspring. Food security status is hypothesized to influence diet quality and GWG. Therefore, we examined the relationship between diet quality and GWG by food security status. METHODS: Participants (n = 679) were enrolled in the Initial Vanguard Study of the National Children's Study. GWG was calculated as third trimester weight minus prepregnancy weight. Food security status and diet quality (Healthy Eating Index [HEI]-2015) were assessed using the Household Food Security Survey and a Diet History Questionnaire, respectively...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

INTRODUCTION: To be effective, pelvic floor muscle therapy (PFMT) exercises should be intense, be practiced consistently, and include clinical support. Many women do not adhere to a consistent PFMT program, compromising the resolution or prevention of urinary incontinence (UI). This study aimed to answer 2 key questions: What prevents women from performing PFMT long term, and what can health care providers do to support women to perform them? METHODS: Postpartum women from 4 sites in the United States completed a questionnaire about experiences with PFMT or Kegel exercises during and after pregnancy...

INTRODUCTION: Efforts to reduce primary cesarean birth may include supporting longer second stages of labor. Although midwifery-led care is associated with lower cesarean use, little has been published on associated outcomes of prolonged second stage (≥3 hours of pushing) for nulliparous individuals in US hospital-based midwifery care. Epidural analgesia and the role of passive descent in midwifery-led care are also underexplored in relation to the second stage. In this study, we report the incidence of prolonged second stage stratified by epidural analgesia and/or passive descent...

INTRODUCTION: Maternal health disparities based on race, ethnicity, and socioeconomic factors exist in the United States, with Black women experiencing significantly worse outcomes. With much of perinatal morbidity and mortality attributed to the postpartum period, attention to equitable postpartum care is necessary for addressing this disparity. PROCESS: A rapid-cycle quality improvement initiative was implemented in an urban clinic serving predominantly Black, Medicaid-insured clients...

INTRODUCTION: Weight bias toward individuals with higher body weights is present in health care settings. However, there has been limited quantitative exploration into weight bias among perinatal care providers and its potential variations based on demographic characteristics. The aim of this study was to examine if the direction and extent of weight bias among midwives certified by the American Midwifery Certification Board (AMCB) varied across age, years since certification, body mass index (BMI), race, ethnicity, and US geographic region...

INTRODUCTION: The aim of this integrative review is to understand (1) how parents in specific populations engage with online breastfeeding, chestfeeding, or lactation support groups, (2) how these support groups influence extended breastfeeding duration and other outcomes, and (3) whether the use of support groups by these specific populations has changed since the start of the COVID-19 pandemic. METHODS: Of the articles identified across 4 electronic databases, 10 studies met the inclusion criteria; they were published between 2013 and 2023, written in English, and focused on the use of online peer support groups for breastfeeding, chestfeeding, and lactation support in specific populations...

INTRODUCTION: Telemedicine use in prenatal care has greatly expanded without substantial research. Optimizing user experiences can increase telemedicine's utilization to support care access. The purpose of this study was to explore patient and provider experiences using telemedicine for routine prenatal care during the COVID-19 pandemic, identifying factors affecting its utilization and satisfaction. METHODS: In this mixed methods study, online surveys and semi-structured interviews with pregnant and postpartum patients and perinatal providers across the United States were used to explore experiences with telemedicine and prenatal care during the COVID-19 pandemic...

INTRODUCTION: This study was conducted to determine the effects of transcutaneous electrical nerve stimulation (TENS) applied in the early postpartum period after cesarean birth on incision site healing, postoperative recovery, pain, and comfort. METHODS: This randomized, single-blind, placebo-controlled study was conducted with 138 women (TENS group n = 46, placebo group n = 46, control group n = 46) who gave birth by cesarean between January and September 2023...

Over the last 6 years, the Pennsylvania Affiliate of the American College of Nurse-Midwives has worked to meet the needs of its diverse membership and increase the capacity of the affiliate board by taking a series of strategic steps. This article details the key components of this journey, which has culminated in a successful annual conference with over $118,000 in net revenue to help meet affiliate goals, including pursuing midwifery modernization legislation for Pennsylvania and an increase in our affiliate membership by almost 100 individuals...

INTRODUCTION: Weight bias toward individuals with higher body weights permeates health care settings in the United States and has been associated with poor weight-related communication and quality of care as well as adverse health outcomes. However, there has been limited quantitative investigation into weight bias among perinatal care providers. Certified nurse-midwives (CNMs)/certified midwives (CMs) attend approximately 11% of all births in the United States. The aims of this study were to measure the direction and extent of weight bias among CNMs/CMs and compare their levels of weight bias to the US public and other health professionals...

INTRODUCTION: Active-duty servicewomen and veterans make up nearly 20% of the United States military and may experience trauma specific to military service. Military-specific trauma includes combat deployment and military sexual trauma, exposure to which may result in posttraumatic stress disorder (PTSD). The purpose of this scoping review is to examine the extent to which military trauma exposures impact the pregnancy outcomes of active-duty servicewomen and women veterans. METHODS: A systematic search of OVID MEDLINE, OVID Embase, and OVID PsycINFO from inception to September 25, 2023, identified studies examining associations between military trauma exposures and perinatal outcomes...

INTRODUCTION: Black birthing people in the United States disproportionately endure inequitable experiences and outcomes during pregnancy and childbirth via structural, interpersonal, and obstetric racism. In this study, the researchers explore provider perspectives of how racism is perpetuated in institutional perinatal and reproductive health care. METHODS: Critical Race Theory, Reproductive Justice, and midwifery theory were operationalized through secondary thematic analysis of existing qualitative data from the Community Racial Equity and Training Interventions and Evaluation of Current and Future Healthcare Clinicians Study...

INTRODUCTION: Postgraduate fellowships are growing in midwifery and yet are poorly understood by the profession. These fellowships are optional for midwives interested in developing advanced skills, transitioning to specialty practice, or entering or re-entering professional practice. The purpose of this study was to explore the characteristics and outcomes of US postgraduate midwifery fellowships as described by midwifery fellowship program directors. METHODS: Postgraduate midwifery fellowship programs in the United States were identified through an environmental scan and snowball sampling...

INTRODUCTION: There is a misperception in society that individuals with visual impairment are asexual and cannot marry, have children, or take care of children. In addition, individuals with visual impairment face difficulties in many aspects of life due to accessibility issues. Although it is expected that visually impaired individuals experience difficulties when having children, very few studies have focused on understanding the challenges women with visual impairment face in the process of having children...

Unintentional overdose is a leading driver of maternal death in Colorado. The high volume of maternal deaths from preventable causes lends questions to failures in our clinical and community-based care for pregnant and postpartum people. The Colorado Maternal Mortality Review Committee identified 3 main contributors including stigma in the community and health care system, fragmentation of the health care system, and the need for more clinician training. The Colorado Perinatal Care Quality Collaborative led a 3-pronged intervention to address these challenges and improve perinatal care...