Risk and Protective Factors for Preterm Birth Among Racial, Ethnic, and Socioeconomic Groups in California.

Importance: Preterm birth (PTB) (gestational age <37 weeks) is a major cause of infant mortality and morbidity in the US and is marked by racial and ethnic and socioeconomic inequities. Further research is needed to elucidate the association of risk and protective factors with trends in PTB rates and with related inequities.

Objective: To describe the association of PTB rates with inequities as well as related risk and protective factors over the past decade in a US population-based cohort.

Disparities in Screening and Treatment Patterns for Depression and Anxiety During Pregnancy: An Integrative Review.

Introduction: Symptoms of untreated depression and anxiety during pregnancy are associated with serious adverse effects for the pregnant person, birth outcomes, and child development. However, pregnant persons are less likely to be screened and treated compared with nonpregnant people. In this systematic review, we aimed to explore individual, provider, and systems factors that impact screening, identification, and treatment patterns for depression and anxiety during pregnancy.

What do patients and families observe about pediatric safety?: A thematic analysis of real-time narratives.

Objectives: Data on inpatient safety are documented by hospital staff through incident reporting (IR) systems. Safety observations from families or patients are rarely captured. The Family Input for Quality and Safety (FIQS) study created a mobile health tool for pediatric patients and their families to anonymously report safety observations in real time during hospitalization.

Factors Associated with Family Functioning During Pregnancy by Adolescent and Young Adult Women.

Introduction: Pregnancy represents a stressful period for both women and their families. Whether the family maintains functioning during pregnancy could have significant implications on maternal and child health. In this study, we explored individual- and family-level factors associated with family functioning in adolescent and young adult mothers.

Understanding Food Insecurity as a Determinant of Health in Pregnancy Within the United States: An Integrative Review.

Background: Food insecurity is a major public health concern in the United States, particularly for pregnant and postpartum individuals. In 2020, ∼13.8 million (10.

Information Seeking Behavior and Strategies to Increase Milk Supply Among Breastfeeding Mothers in the United States.

Some breastfeeding mothers try to increase their milk supply through pharmaceutical, dietary, and behavioral strategies that vary in effectiveness. Information seeking behaviors may influence which strategies mothers use. To describe where mothers obtain information about increasing milk supply, describe the perceived influence of each information source on decision-making about strategies for increasing milk supply, and explore associations between information sources and mothers' use of galactagogues (i.

A Qualitative Study of Breastfeeding Experiences Among Mothers Who Used Galactagogues to Increase Their Milk Supply.

Objective: To qualitatively describe breastfeeding experiences among mothers who used galactagogues to increase their milk supply.

Design: One-time, semistructured phone interviews.

Setting: US.

Trends and Disparities in Severe Maternal Morbidity Indicator Categories during Childbirth Hospitalization in California from 1997 to 2017.

Objective: Severe maternal morbidity (SMM) is increasing and characterized by substantial racial and ethnic disparities. Analyzing trends and disparities across time by etiologic or organ system groups instead of an aggregated index may inform specific, actionable pathways to equitable care. We explored trends and racial and ethnic disparities in seven SMM categories at childbirth hospitalization.

Assessing the relationship between census tract rurality and severe maternal morbidity in California (1997-2018).

Purpose: Recent studies have demonstrated an increased risk of severe maternal morbidity (SMM) for people living in rural versus urban counties. Studies have not considered rurality at the more nuanced subcounty census-tract level. This study assessed the relationship between census-tract-level rurality and SMM for birthing people in California.

Use of Galactagogues to Increase Milk Production Among Breastfeeding Mothers in the United States: A Descriptive Study.

Background: Perceived insufficient milk is a primary reason for early breastfeeding cessation. Some breastfeeding mothers may use galactagogues (ie, foods, beverages, herbal supplements, and pharmaceuticals) to try to increase milk supply. However, milk production requires frequent and effective milk removal, and there is limited evidence on the safety and efficacy of galactagogues.

Examining respect, autonomy, and mistreatment in childbirth in the US: do provider type and place of birth matter?

Background: Analyses of factors that determine quality of perinatal care consistently rely on clinical markers, while failing to assess experiential outcomes. Understanding how model of care and birth setting influence experiences of respect, autonomy, and decision making, is essential for comprehensive assessment of quality.

Methods: We examined responses (n = 1771) to an online cross-sectional national survey capturing experiences of perinatal care in the United States.

Hospital characteristics associated with nurse staffing during labor and birth: Inequities for the most vulnerable maternity patients.

Background: Evidence is limited on nurse staffing in maternity units.

Purpose: To estimate the relationship between hospital characteristics and adherence with Association of Women's Health, Obstetric and Neonatal Nurses nurse staffing guidelines.

Methods: We enrolled 3,471 registered nurses in a cross-sectional survey and obtained hospital characteristics from the 2018 American Hospital Association Annual Survey.

Sources of stress and coping mechanisms: Experiences of maternal health care providers in Western Kenya.

The dynamic and complex nature of care provision predisposes healthcare workers to stress, including physical, emotional, or psychological fatigue due to individual, interpersonal, or organizational factors. We conducted a convergent mixed-methods study with maternity providers to understand their sources of stress and coping mechanisms they adopt. Data were collected in Migori County in western Kenya utilizing quantitative surveys with n = 101 maternity providers and in-depth interviews with a subset of n = 31 providers.

Neighborhood disinvestment and severe maternal morbidity in the state of California.

Background: Social determinants of health, including neighborhood context, may be a key driver of severe maternal morbidity and its related racial and ethnic inequities; however, investigations remain limited.

Objective: This study aimed to examine the associations between neighborhood socioeconomic characteristics and severe maternal morbidity, as well as whether the associations between neighborhood socioeconomic characteristics and severe maternal morbidity were modified by race and ethnicity.

Study Design: This study leveraged a California statewide data resource on all hospital births at ≥20 weeks of gestation (1997-2018).

Linking Patient Safety Climate With Missed Nursing Care in Labor and Delivery Units: Findings From the LaborRNs Survey.

Objective: This study aimed to explore the association of nurses' perceptions of patient safety climate with missed nursing care in labor and delivery (L&D) units.

Methods: We recruited nurse respondents via email distribution of an electronic survey between February 2018 and July 2019. Hospitals with L&D units were recruited from states with projected availability of 2018 state inpatient data in the United States.

Using medical expenditure panel survey data to explore the relationship between patient-centered medical homes and racial disparities in severe maternal morbidity outcomes.

Background: There are persistent racial/ethnic disparities in the occurrence of severe maternal morbidity. Patient-centered medical home care has the potential to address disparities in maternal outcomes.

Objectives: To examine (1) the association between receiving patient-centered medical home care and severe maternal morbidity outcomes and (2) the interaction of race/ethnicity on patient-centered medical home status and severe maternal morbidity.

Racial/ethnic disparities in severe maternal morbidity: An intersectional lifecourse approach.

Despite long-existing calls to address alarming racial/ethnic gaps in severe maternal morbidity (SMM), research that considers the impact of intersecting social inequities on SMM risk remains scarce. Invoking intersectionality theory, we sought to assess SMM risk at the nexus of racial/ethnic marginalization, weathering, and neighborhood/individual socioeconomic disadvantage. We used birth hospitalization records from California across 20 years (1997-2017, N = 9,806,406) on all live births ≥20 weeks gestation.

Nurse-Reported Staffing Guidelines and Exclusive Breast Milk Feeding.

Background: Nursing care is essential to overall quality of healthcare experienced by patients and families-especially during childbearing. However, evidence regarding quality of nursing care during labor and birth is lacking, and established nurse-sensitive outcome indicators have limited applicability to maternity care. Nurse-sensitive outcomes need to be established for maternity care, and prior research suggests that the initiation of human milk feeding during childbirth hospitalization is a potentially nurse-sensitive outcome.

Antidepressant use During Pregnancy: Knowledge, Attitudes, and Decision-Making of Patients and Providers.

Introduction: Despite the risks associated with untreated perinatal depression and anxiety, both patients and clinicians are less likely to follow evidence-based guidelines including the use of antidepressants during pregnancy. The aim of this integrative review was to describe the perspectives of both patients and prescribing health care providers regarding the use of antidepressants during pregnancy.

Methods: We performed a literature search in PubMed, CINAHL, ProQuest Central, and PsychINFO.

Risk Factors for Dual Burden of Severe Maternal Morbidity and Preterm Birth by Insurance Type in California.

Objectives: Among childbearing women, insurance coverage determines degree of access to preventive and emergency care for maternal and infant health. Maternal-infant dyads with dual burden of severe maternal morbidity and preterm birth experience high physical and psychological morbidity, and the risk of dual burden varies by insurance type. We examined whether sociodemographic and perinatal risk factors of dual burden differed by insurance type.

Psychometric properties of the perinatal missed care survey and missed care during labor and birth.

Aim:: To evaluate the psychometric characteristics of the Perinatal Missed Care Survey and assess the prevalence of nurse-reported missed care during labor and birth.

Background:: Nursing care during labor and birth differs from other nursing care. Empirical evidence is scant regarding nursing quality and missed nursing care during labor and birth, which are important aspects of quality in maternity care.

Social Construction of Target Populations: A Theoretical Framework for Understanding Policy Approaches to Perinatal Illicit Substance Screening.

Perinatal illicit substance use is a nursing and public health issue. Current screening policies have significant consequences for birthing individuals and their families. Racial disparities exist in spite of targeted and universal screening policies and practices.