Birthing parent and companion verbal reactions following interactions with inpatient postpartum health care team members: an observational study using naturalistic filming.

Background: Respectful, equitable, and supportive health care team interactions with patients and their companions are a key part of quality health care services. Despite the importance of communication and other aspects of engagement during inpatient postpartum care, little is known about how care is experienced during this period from families' perspectives.

Methods: This study collected video and audio data with 15 birthing families (n = 9 English-speaking and n = 6 Spanish-speaking) and their health care team members during inpatient postpartum care in a southeastern United States academic medical center.

HPA axis dysregulation and postpartum depression and anxiety symptoms in breastfeeding vs bottle-feeding parents.

Objective: Hypothalamic-pituitary-adrenal (HPA) axis dysregulation has been implicated in the pathogenesis of perinatal mood disorders. Further, HPA axis response is known to be blunted during breastfeeding. We hypothesized that 1) postpartum depression/anxiety symptoms would be associated with HPA axis dysregulation, indexed by loss of expected adrenocorticotropic hormone (ACTH)-cortisol coupling, and 2) this association would vary by method of infant feeding.

Postpartum Acute Care Utilization in a Health Care System in the Southeastern United States.

Postpartum acute care utilization (PACU), including visits to an emergency department, obstetric triage, or urgent care ("outpatient"), and hospital readmissions, may indicate medical complications and signal unmet health needs. We estimated the incidence of PACU and examined patterns by sociodemographic factors, pregnancy and birth characteristics, time since discharge from the birth hospitalization, and medical indications. We constructed a retrospective cohort of people aged ≥18 years who delivered ≥1 liveborn infant >20 weeks of gestation from July 1, 2021, to December 31, 2022, using electronic health record data from a quaternary maternity hospital in the Southeastern United States PACU data throughout the health care system were collected through March 31, 2023.

Postpartum menstrual equity: Video and audio analysis of vaginal bleeding counseling during postpartum inpatient care at a southeastern US tertiary hospital.

Background: Despite the universal nature of postpartum vaginal bleeding after childbirth and the importance of managing vaginal bleeding in the postpartum period to monitor health status, little is known about the information or products that birthing individuals are provided. Investigating current practices may offer insights to enacting more supportive and equitable postpartum care.

Objective: To evaluate the patterns and content of vaginal bleeding counseling provided to birthing parents while on a postnatal inpatient unit.

Birthing parent postpartum acute care use: Multilevel opportunities for strengthening healthcare.

Background: Two-thirds of pregnancy-related deaths occur from 1 day to 1 year after birth, and medical complications frequently occur after birth. Postpartum health concerns are often urgent, requiring timely medical care, which may contribute to a reliance on acute care. One approach to improving postpartum health is to investigate birthing parents' accounts of acute care use in the months after birth, which is what we did in this study.

Lupus nephritis kidney biopsy characteristics and preterm birth.

Individuals with lupus nephritis (LN) are at high risk of adverse maternal and fetal outcomes in pregnancy. Outside of pregnancy, proliferative lesions on kidney biopsies are associated with disease progression, but these have not been consistently associated with increased risk in pregnancy. This retrospective, single-center study examines how histologic findings, the timing from kidney biopsy to pregnancy, and the clinical features in the first trimester are associated with preterm birth among individuals with LN.

Birthing Parent Experiences of Postpartum at-Home Blood Pressure Monitoring Versus Office-Based Follow up After Diagnosis of Hypertensive Disorders of Pregnancy.

Hypertensive disorders of pregnancy are a leading cause of pregnancy-related morbidity and mortality. The primary objective of this study was to compare the frequency of documentation of postpartum blood pressure through remote blood pressure monitoring with text-message delivered reminders versus office-based follow-up 7-10 days postpartum. The secondary objective was to examine barriers and facilitators of both care strategies from the perspectives of individuals who experienced a hypertensive disorder of pregnancy.

Identification of postpartum symptom informedness and preparedness typologies and their associations with psychological health: A latent class analysis.

Background: Birthing parents, defined as postpartum women and people with various gender identities who give birth, commonly experience challenging postpartum symptoms. However, many report feeling uninformed and unprepared to navigate their postpartum health.

Objective: To identify typologies of postpartum symptom informedness and preparedness using latent class analysis (LCA) and to examine the associated patient and healthcare characteristics.

Setting the Agenda for Patient-Centered Research in Infant and Young-Child Feeding: Results from the Academy of Breastfeeding Medicine and Reaching Our Sisters Everywhere.

Breastfeeding is critically important for optimal health of both birthing people and their infants. Shared, patient-centered goals of how health care team members, community groups, and families can help facilitate breastfeeding success are needed, as are ways to define and measure what breastfeeding success looks like from the patient's perspective. The Academy of Breastfeeding Medicine and Reaching Our Sisters Everywhere's collaborated in a multi-methods approach to identify breastfeeding priorities most important to parents.

Cultivating Vital Conditions For Perinatal Well-Being And A Sustained Commitment To Reproductive Justice.

Perinatal mental illness is a leading cause of death during pregnancy and the first postpartum year in the United States. Although better acute care services for mental health conditions are desperately needed, urgent services alone cannot create the conditions to thrive. Cultivating well-being requires a sustained commitment to reproductive justice, "the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.

Perinatal Mental Health: The Need For Broader Understanding And Policies That Meet The Challenges.

Perinatal mental health is gaining recognition as a key antecedent of adverse maternal and child outcomes as the United States experiences a maternal mortality and morbidity crisis. Recent policy efforts have attempted to mitigate adverse outcomes through legislation such as the Taskforce Recommending Improvements for Unaddressed Mental Perinatal and Postpartum Health (TRIUMPH) for New Moms Act of 2021 and postpartum coverage through Medicaid expansion. Even with progress, perinatal mental health policy continues to grapple with a basic truth: The United States lacks an overarching health care system capable of meeting the mental health care needs of perinatal people and their families.

Postpartum Hospital Discharge: Birthing Parent Perspectives on Supportive Practices and Areas for Improvement.

Background: Postpartum hospital care and individualized discharge preparedness should be part of person-focused health services. Yet, there are limited descriptions of birthing parents' experiences to identify clinical practice strengths and opportunities to improve systems of care.

Objective: To explore birthing parents' perspectives on supportive healthcare practices and areas for improvement around postpartum hospital discharge.

Postpartum care in a cardio-obstetric clinic after preterm preeclampsia: patient and healthcare provider perspectives.

Background: Despite the significant disruption and health implications of preterm preeclampsia with severe features for birthing people, little is known about how the system of postpartum care might be strengthened for affected families. Multidisciplinary cardio-obstetric clinics are emerging; however, there is limited research on patient and healthcare provider perspectives.

Objective: To describe patient and healthcare provider perspectives of services in a cardio-obstetric clinic following preterm preeclampsia with severe features.

Anthropometric Changes During Pregnancy and Their Association with Adequacy of Gestational Weight Gain.

Background: Gestational weight gain (GWG) is an expected component of a healthy pregnancy. Gaining weight within the recommended range helps support the mother's health by providing energy reserves and nutrients to meet the increased metabolic demands during pregnancy. Too much or too little GWG has been associated with adverse health outcomes for the mother and child.

Hemoglobin on Admission for Childbirth and Postpartum Acute Care Use in a Southeastern Health Care System.

Objective: Our objective was to evaluate whether hemoglobin on admission for childbirth is associated with postpartum acute care use (ACU).

Study Design: We conducted a retrospective cohort study of patients giving birth at a southeastern quaternary care hospital from January 2018 through June 2021 using electronic health records. Predelivery hemoglobin was categorized as <9, 9- < 10, 10- < 11, 11- < 12, and ≥12 g/dL.

Standardized Order Sets Do Not Eliminate Racial or Ethnic Inequities in Postpartum Pain Management.

Objective: To quantify the extent to which a standardized pain management order set reduced racial and ethnic inequities in post-cesarean pain evaluation and management.

Methods: We conducted a retrospective cohort study to quantify racial and ethnic differences in pain evaluation and management before (July 2014-June 2016) and after implementation of a standardized post-cesarean order set (March 2017-February 2018). Electronic medical records were queried for pain scores >7/10, number of pain assessments, and opioid, nonsteroidal anti-inflammatory drug (NSAID), and acetaminophen doses.

The Mood, Mother and Child Study: Protocol for a Prospective Longitudinal Study and Randomized Controlled Trial.

Background: Perinatal depression affects >400,000 mother-child dyads in the United States every year and is associated with numerous adverse maternal and child developmental outcomes. Previous research implicates the dysregulation of oxytocin and the hypothalamic-pituitary-adrenal (HPA) axis functioning in mothers and children as potential mechanisms mediating or moderating the transmission of risk associated with maternal depression.

Objective: The Mood, Mother and Child study will examine the psychobiological sources of risk and resilience within mother-child dyads affected by maternal depression.

Reducing Opioid Prescribing after Cesarean Delivery by Utilizing a Tailored Opioid Prescribing Algorithm.

Objective: There are increasing efforts among health care systems to promote safe opioid prescribing; however, best practice for minimizing overprescription is not established. Our study aimed to evaluate the effect of a tailored opioid prescribing algorithm on opioid prescription quantities.

Study Design: A tailored opioid prescribing algorithm was developed to provide a recommended prescription quantity based on inpatient opioid use.

Delivery Strategies for Postpartum Care: A Systematic Review and Meta-analysis.

Objective: To systematically review the effects of postpartum health care-delivery strategies on health care utilization and maternal outcomes.

Data Sources: We searched Medline, EMBASE, CENTRAL, CINAHL, and ClinicalTrials.gov for studies in the United States or Canada from inception to November 16, 2022.

Postpartum Home Blood Pressure Monitoring: A Systematic Review.

Objective: To assess the effectiveness of postpartum home blood pressure (BP) monitoring compared with clinic-based follow-up and the comparative effectiveness of alternative home BP-monitoring regimens.

Data Sources: Search of Medline, Cochrane, EMBASE, CINAHL, and ClinicalTrials.gov from inception to December 1, 2022, searching for home BP monitoring in postpartum individuals.

Health Insurance Coverage and Postpartum Outcomes in the US: A Systematic Review.

Importance: Approximately half of postpartum individuals in the US do not receive any routine postpartum health care. Currently, federal Medicaid coverage for pregnant individuals lapses after the last day of the month in which the 60th postpartum day occurs, which limits longer-term postpartum care.

Objective: To assess whether health insurance coverage extension or improvements in access to health care are associated with postpartum health care utilization and maternal outcomes within 1 year post partum.

An equitable, community-engaged translational framework for science in human lactation and infant feeding-a report from "Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)" Working Group 5.

Human milk is the ideal source of nutrition for most infants, but significant gaps remain in our understanding of human milk biology. As part of addressing these gaps, the Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN) Project Working Groups 1-4 interrogated the state of knowledge regarding the infant-human milk-lactating parent triad. However, to optimize the impact of newly generated knowledge across all stages of human milk research, the need remained for a translational research framework specific to the field.