Publications by authors named "Haywood L Brown"

Having been afforded many opportunities throughout my academic career, I took on the challenges that chronicled my path to leadership. In many instances, I was the first person of color to enter that educational and leadership environment. I am grateful to many mentors who have guided and supported me over the 4 decades since the time of my residency through fellowships and the various institutions to which I have been affiliated.

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Article Synopsis
  • * The scientific statement reviews preventive strategies using the American Heart Association's Life's Essential 8 framework, focusing on blood pressure management and lifestyle changes for better cardiovascular health.
  • * There is a need for future trials to improve screening and interventions during the fourth trimester (the 12 weeks after delivery) to enhance cardiovascular health in those affected by adverse pregnancy outcomes.
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There is limited research that specifically explores paternal involvement during pregnancy and childbirth. To address this gap, we completed a series of focus groups with fathers to examine social, cultural, and environmental factors that influence behaviors among new fathers while also providing community perspectives on men's experiences seeking care pre- and postdelivery. We used a phenomenological thematic approach to analyze data from 10 focus groups from five of the six Alliance for Innovation on Maternal Health-Community Care Initiative pilot sites collected between November 2021 and April 2022.

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Introduction: Protests and the call to action in the aftermath of the deaths of Black citizens at the hands of police officers have reawakened the consciousness of American society on policing and the need for reforms. Racism in policing has a long history dating back to slave patrols following the Civil War. Criminal anti Black police behavior violates the police oath to "protect and defend" all individuals.

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Black enslaved women endured sexual exploitation and reproductive manipulation to produce a labor workforce on the southern plantations during the Antebellum Period. Health care inequity has continued from slavery and into the 21th century primarily due of racial segregation, poverty, access, poor quality of care, eugenics and the assault of forced sterilizations. Racial disparity in maternal and infant mortality is an outcome rooted in racial injustice, social and economic determinants as well as the stresses during pregnancy throughout the generations of Black births.

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Telehealth in Maternity Care.

Obstet Gynecol Clin North Am

September 2020

The use of telehealth is gaining momentum in providing obstetric care. Telehealth through various platforms provides obstetricians and gynecologists and other providers of obstetric and postpartum care with the tools to better facilitate prenatal, intrapartum, and postpartum encounters. Telehealth helps facilitate consultation with specialists and subspecialists in maternal-fetal medicine in a team-based fashion to improve quality and safe obstetric practices in a fragmented obstetric care delivery system, especially in rural access communities.

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Heart disease is the leading cause of mortality in adult women. Beyond the traditional risk factors of obesity, diabetes, and hypercholesterolemia, women with the pregnancy complications of preeclampsia, gestational diabetes, prematurity, and low birth weight for gestational age (fetal growth restriction) are at higher risk for later development of cardiovascular disease. Education of women and providers about the association of pregnancy complications and cardiovascular disease should begin in the postpartum period.

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Post-traumatic stress disorder (PTSD) accompanies miscarriage, intrauterine fetal demise, and preterm birth. Levels of PTSD may be higher for women who experience acute, life-threatening events during labor and delivery. Severe maternal morbidities or near misses for maternal death disproportionately impact African American, Hispanic, American Indian, and women in rural communities.

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Opioid Management in Pregnancy and Postpartum.

Obstet Gynecol Clin North Am

September 2020

Pregnant and postpartum women with opiate use disorder present a challenge in perinatal care. It is important for health care teams to provide sensitive and compassionate evidence-based care for these women, who often are stigmatized during the prenatal, delivery, and postpartum periods. Women with opiate use disorder are at risk for inadequate prenatal and postpartum care and for complications.

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Objective: This study evaluated the influence of early gestational weight gain (GWG) on neonatal outcomes among women with class III obesity.

Study Design: Retrospective cohort of women with class III obesity who gained more than the Institute of Medicine (IOM) guidelines (>20lbs). Women gaining ≥75% of total gestational weight prior to 28 weeks (EWG) were compared to women gaining <75% of their total weight prior to 28 weeks (SWG).

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Objective: This study explores OB/GYN providers' knowledge about published health and healthcare disparities in women's reproductive health.

Method: We collected demographic and health disparities knowledge information from OB/GYN providers who were members of ACOG District IV using an online survey (n = 483). We examined differences across groups using statistical tests and regression analyses in a structural equation modeling approach.

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Objective: Obesity in the USA continues to be a prominent medical and public health concern. Due to increasing rates of maternal obesity, the current Institute of Medicine (IOM) guidelines recommend 11-20 pounds of total weight gain during pregnancy in women with a BMI ≥30 kg/m. The impact of maternal obesity on adverse perinatal outcomes has been well documented however, there is minimal data on the effect of gestational weight gain on neonatal outcomes.

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Objective: The aim of this study is to describe the impact of maternal weight gain on infant birth weight among women with Class III obesity.

Study Design: Retrospective cohort of women with body mass index (BMI) ≥40 kg/m at initial prenatal visit, delivered from July 2013 to December 2017. Women presenting 14/0 weeks of gestational age (GA), delivering preterm, or had multiples or major fetal anomalies excluded.

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Objective: Excessive gestational weight gain (GWG) increases risk of postpartum weight retention in normal and overweight women but little is known about weight retention in morbidly obese women. We evaluated the impact of GWG on postpartum weight retention in women with class-III obesity.

Study Design: This is a retrospective cohort of pregnancies at a single institution from July 2013 to December 2017 complicated by body mass index (BMI) ≥ 40 at entry to care.

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Objective: We investigated the association between gestational weight gain (GWG) and postpartum depression (PPD) in women with class III obesity.

Study Design: This is a retrospective cohort of women with body mass index (BMI) ≥ 40 kg/m at entry to care, first prenatal visit ≤14 weeks gestation, with singleton, nonanomalous pregnancies who delivered at term from July 2013 to December 2017. Women missing data regarding PPD were excluded.

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The Centers for Disease Control and Prevention have demonstrated continuous increased risk for maternal mortality and severe morbidity with racial disparities among non-Hispanic black women an important contributing factor. More than 50,000 women experienced severe maternal morbidity in 2014, with a mortality rate of 18.0 per 100,000, higher than in many other developed countries.

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Objective: To identify the current challenges in obstetrics and gynecology residency education and propose solutions to overcome these obstacles.

Methods: The American College of Obstetricians and Gynecologists (ACOG) hosted the first National Summit on Women's Health on May 31 and June 1, 2017, with a follow-up meeting December 20-21, 2017, at ACOG headquarters in Washington, DC. Invitees from 20 related societies briefly presented their organizations' perspectives and discussed focused questions about specific challenges, proposed solutions, and anticipated obstacles.

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Objective: To quantitate the contribution of various demographic factors to the U.S. maternal mortality ratio.

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At the 36th Annual meeting of the Society for Maternal-Fetal Medicine (SMFM), leaders in the field of maternal-fetal medicine (MFM) convened to address maternal outcome and care inequities from 3 perspectives: (1) education, (2) clinical care, and (3) research. Meeting attendees identified knowledge gaps regarding disparities within the provider community; reviewed possible frameworks to address these knowledge gaps; and identified models with which to address key clinical issues. Collaboration and communication between all stakeholders will be needed to gain a better understanding of these prevailing disparities and formulate strategies to eliminate them.

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Unlabelled: Objective To review fetal and infant deaths from women enrolled in Indianapolis Healthy Start using the National Fetal and Infant Mortality Review (FIMR) methods to provide strategies for prevention.

Methods: Marion County Public Health Department (MCPHD) FIMR staff identified and reviewed 22 fetal and infant deaths to Indianapolis Healthy Start program participants between 2005 and 2012. Trained FIMR nurses completed 13 of 20 maternal interviews and compiled case summaries of all deaths from the MCPHD FIMR database.

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Article Synopsis
  • The field of obstetrics and gynecology has been at the forefront of ensuring quality and safety in women's health for many years.
  • Over 4 million hospitalizations occur each year for childbirth, making obstetrics the primary reason for hospital admissions and discharges.
  • Implementing safety initiatives and quality measures is crucial for improving patient satisfaction and providing safe, effective, evidence-based care in this discipline.
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