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.

Operationalizing Whole-Person Postpartum Care: Health Care Provider-Level Strategies.

Postpartum mothers report feeling unsupported and unprepared by their health care providers to meet the challenges of the postpartum period. This gap perpetuates a cycle of disappointment with and disengagement from postpartum care services. The need to revamp postpartum care has been recognized at the population level but implementing changes at the health care provider level is challenging without practical guidance.

Best Practices in Management of Postpartum Pain.

Pain has been documented as a major concern for women in the postpartum period. Management of postpartum pain, however, is a relatively neglected area of clinical research. As a result, evidence to support interventions to alleviate the discomforts associated with childbirth is sparse.

Impact Evaluation of PRONTO Mexico: A Simulation-Based Program in Obstetric and Neonatal Emergencies and Team Training.

Introduction: Most maternal deaths in Mexico occur within health facilities, often attributable to suboptimal care and lack of access to emergency services. Improving obstetric and neonatal emergency care can improve health outcomes. We evaluated the impact of PRONTO, a simulation-based low-cost obstetric and neonatal emergency and team training program on patient outcomes.

Team training in obstetric and neonatal emergencies using highly realistic simulation in Mexico: impact on process indicators.

Background: Ineffective management of obstetric emergencies contributes significantly to maternal and neonatal morbidity and mortality in Mexico. PRONTO (Programa de Rescate Obstétrico y Neonatal: Tratamiento Óptimo y Oportuno) is a highly-realistic, low-tech simulation-based obstetric and neonatal emergency training program. A pair-matched hospital-based controlled implementation trial was undertaken in three states in Mexico, with pre/post measurement of process indicators at intervention hospitals.

The recognition and management of intrapartum fetal heart rate emergencies: beyond definitions and classification.

The ongoing and well-documented debate about the value of electronic fetal monitoring has focused primarily on the fact that most variant fetal heart rate (FHR) patterns are poor predictors of fetal acid-base status. Most recently, much of this attention has been focused on the implications for clinical management of FHR patterns that the National Institute of Child Health and Human Development has classified as indeterminate: neither normal nor abnormal. Given that a majority of fetuses will have an FHR pattern considered indeterminate at some point in labor, this is an important and worthwhile discussion.

Understanding and meeting the needs of women in the postpartum period: the Perinatal Maternal Health Promotion Model.

A new model for the care of women in the postpartum focuses on the development of life skills that promote complete well-being. The year following childbirth is a time of significant transition for women. In addition to the physiologic changes associated with the postpartum period, a woman undergoes marked psychosocial changes as she transitions into a motherhood role, reestablishes relationships, and works to meet the physical and emotional needs of her infant and other family members.

Promoting cultural humility during labor and birth: putting theory into action during PRONTO obstetric and neonatal emergency training.

Maternal and neonatal mortality in Northern Guatemala, a region with a high percentage of indigenous people, is disproportionately high. Initiatives to improve quality of care at local health facilities equipped for births, and increasing the number of births attended at these facilities will help address this problem. PRONTO (Programa de Rescate Obstétrico y Neonatal: Tratamiento Óptimo y Oportuno) is a low-tech, high-fidelity, simulation-based, provider-to-provider training in the management of obstetric and neonatal emergencies.

PRONTO training for obstetric and neonatal emergencies in Mexico.

Objective: To evaluate the acceptability, feasibility, rating, and potential impact of PRONTO, a low-tech and high-fidelity simulation-based training for obstetric and neonatal emergencies and teamwork using the PartoPants low-cost birth simulator.

Methods: A pilot project was conducted from September 21, 2009, to April 9, 2010, to train interprofessional teams from 5 community hospitals in the states of Mexico and Chiapas. Module I (teamwork, neonatal resuscitation, and obstetric hemorrhage) was followed 3 months later by module II (dystocia and pre-eclampsia/eclampsia) and an evaluation.

Shoulder dystocia: using simulation to train providers and teams.

Shoulder dystocia is an obstetric emergency that requires immediate recognition and a well-coordinated response. This response must include effective application of the maneuvers proven to relieve the impaction of the fetal shoulder and timely hand-off of the newborn to the neonatology team. The rare frequency of shoulder dystocia, coupled with patient safety concerns and the medico-legal environment, limits the opportunity of providers to learn and practice the management of shoulder dystocia.

Clinical management of intra-amniotic infection and chorioamnionitis: a review of the literature.

Intra-amniotic infection (IAI), or chorioamnionitis, complicates up to 10% of all pregnancies and up to 2% of labors at term. There is a significant risk of complications for the mother and the neonate following IAI, including sepsis and pneumonia. In addition, there is a correlation between IAI and premature rupture of membranes, preterm premature rupture of membranes, preterm labor, and preterm birth.

Ectopic pregnancy.

The incidence of ectopic pregnancy in the United States has been reported to be as high as 20 per 1000 pregnancies, a more than 4-fold increase over the last 20 years. Clinical presentation can range from subtle, nonspecific abdominal complaints to acute onset pain or hemorrhagic bleeding. This article reviews the associated risk factors, pathophysiology, diagnosis, and management of ectopic pregnancy.