Introduction: The US maternity care system achieves worse outcomes for birthing people identifying as Black versus White. Assessment of fetal well-being in labor is an area of perinatal care subject to significant interobserver variability and therefore may be at particular risk of medical racism influencing care.
Methods: Statewide collaborative quality initiative data, focused on decreasing the nulliparous, term, singleton, vertex (NTSV) cesarean birth rate, were used to conduct a retrospective cohort study to assess differences in cesarean birth for nonreassuring fetal status between birthing people identifying as Black compared with White.
Background: Bladder health encompasses total bladder well-being and not merely the absence of urinary symptoms. While much is known about the prevalence of urinary symptoms in women, little is known about the distribution of bladder health (eg, optimal to poor).
Objective: We report the distributions of multiple dimensions of bladder health and function in a population-based sample of community-dwelling women, overall and separately in women without urinary symptoms to begin to explore bladder health dimensions that may precede the onset of symptoms.
Womens Health Rep (New Rochelle)
September 2024
J Pediatr Adolesc Gynecol
October 2024
Objective: Financial strain and unmet social needs are associated with greater risk for lower urinary tract symptoms. Little research has examined financial strain and unmet social needs in relation to the more holistic concept of bladder health. This study utilizes baseline data from RISE FOR HEALTH: A U.
View Article and Find Full Text PDFJ Community Engagem Scholarsh
January 2024
Community engagement has been named a research priority by the National Institutes of Health, and scholars are calling for community engagement as an approach to address racism and equity in science. Robust community-engaged research can improve research quality, increase inclusion of traditionally marginalized populations, broaden the impact of findings on real-life situations, and is particularly valuable for underexplored research topics. The goal of this paper is to describe lessons learned and best practices that emerged from community engagement in a multi-institution population health research consortium.
View Article and Find Full Text PDFImportance: Although parturients report few postpartum symptoms, birth is clearly associated with future symptom development. The ability to identify asymptomatic at-risk women would facilitate prevention.
Objective: The aim of the study was to develop a model predicting abnormal recovery in women at risk for childbirth-associated pelvic floor injury.
Aims: To describe women's experiences with a range of bladder self-care practices.
Design: We conducted a secondary, directed content analysis of qualitative data from the Study of Habits, Attitudes, Realities and Experiences, a multisite focus group study designed to explore adolescent and adult women's experiences, perceptions, beliefs, knowledge and behaviours related to bladder health. This study was conducted by the National Institute of Diabetes and Digestive and Kidney Diseases' Prevention of Lower Urinary Tract Symptoms Research Consortium.
Purpose: We aimed to estimate the prevalence of a wide range of lower urinary tract symptoms (LUTS) in US women, and explore associations with bother and discussion with health care providers, friends, and family.
Materials And Methods: We analyzed baseline data collected from May 2022 to December 2023 in the RISE FOR HEALTH study-a large, regionally representative cohort study of adult female community members. LUTS and related bother were measured by the 10-item Symptoms of Lower Urinary Tract Dysfunction Research Network Symptom Index, and discussion was assessed by a study-specific item.
Purpose: Although maternal depression is associated with adverse outcomes in women and children, its relationship with lower urinary tract symptoms (LUTS) in offspring is less well-characterized. We examined the association between prenatal and postpartum maternal depression and LUTS in primary school-age daughters.
Design: Observational cohort study.
Background: We describe variation in postpartum opioid prescribing across a statewide quality collaborative and assess the proportion due to practitioner and hospital characteristics.
Methods: We assessed postpartum prescribing data from nulliparous, term, singleton, vertex births between January 2020 and June 2021 included in the clinical registry of a statewide obstetric quality collaborative funded by Blue Cross Blue Shield of Michigan. Data were summarized using descriptive statistics.
J Womens Health (Larchmt)
October 2023
The purpose of this analysis was to explore adolescent and adult women's preferences for the content and delivery of public health messaging around bladder health. This was a directed content analysis of focus group data from the Study of Habits, Attitudes, Realities, and Experiences, which explored adolescent and adult women's experiences, perceptions, beliefs, knowledge, and behaviors related to bladder health and function across the life course. This article reports an analysis of the "Public Health Messaging" code, which includes participants' views on what information is needed about bladder health, attributes of messaging, and preferred locations and delivery methods.
View Article and Find Full Text PDFIntroduction: The current gold standard instrument used to measure fear of childbirth is the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ). However, the existing scale is long, has translational challenges, and lacks data specific to experiences of a diverse population in the United States, making it challenging to assess how fear of childbirth impacts perinatal health care disparities. The objective of this study was to revise the WDEQ and analyze its reliability and validity for use in the United States.
View Article and Find Full Text PDFObjective: This article evaluates the impact of adopting a practice of elective induction of labor (eIOL) at 39 weeks among nulliparous, term, singleton, vertex (NTSV) pregnancies in a statewide collaborative.
Study Design: We used data from a statewide maternity hospital collaborative quality initiative to analyze pregnancies that reached 39 weeks without a medical indication for delivery. We compared patients who underwent an eIOL versus those who experienced expectant management.
Purpose: We examined how antecedent sexual health factors affect lower urinary tract symptoms (LUTS) in adolescent women.
Methods: We analyzed 1,941 adolescent women from the Avon Longitudinal Study of Parents and Children at age 19. At ages 15 and 17, participants reported use of oral contraceptives (OCs), history of sexual intercourse, number of sexual partners, and condom use.
Objective: The Prevention of Lower Urinary Tract Symptoms (PLUS) research consortium launched the RISE FOR HEALTH (RISE) national study of women's bladder health which includes annual surveys and an in-person visit. For the in-person exam, a standardized, replicable approach to conducting a pelvic muscle (PM) assessment was necessary. The process used to develop the training, the products, and group testing results from the education and training are described.
View Article and Find Full Text PDFBackground: Existing bladder-specific measures lack the ability to assess the full range of bladder health, from poor to optimal health.
Objective: This study aimed to report evidence of validity of the self-administered, multidimensional bladder health scales and function indices for research in adult women.
Study Design: A cross-sectional population-based validation study with random assignment to paper or electronic administration was conducted using national address-based probability sampling supplemented by purposive sampling of women with lower urinary tract symptoms in 7 clinical research centers.
J Midwifery Womens Health
November 2022
J Womens Health (Larchmt)
February 2023
Introduction: Our aim was to evaluate variation in opioid prescribing rates and prescription size following childbirth across providers and hospitals.
Methods: This retrospective cohort study analyzed claims data from a single-payer Preferred Provider Organization from June 2014 to May 2019 in 84 hospitals in a statewide quality collaborative. All patients aged 12-55 years, undergoing childbirth, with continuous enrollment in pregnancy were included.
Objective: To develop and test the psychometric properties of a shared decision-making tool: Childbirth Options, Information, and Person-Centered Explanation (CHOICEs).
Design: Multiphase instrument development study beginning with item development through a cross-sectional postpartum survey.
Setting: The cross-sectional postpartum survey was distributed online through convenience and snowball sampling methods.