Low birthweight rate differences associated with distinct perinatal staffing mixes at federally funded health centers.

Health centers (sometimes referred to as "federally qualified health centers") can play an important role in addressing perinatal inequities. However, there is limited information on how different staffing models in health centers contribute to perinatal outcomes, including the availability of certified nurse midwives (CNMs). Using 2011-2021 Uniform Data System files, we examined 4 staffing models in 1385 health centers: those with no CNMs or obstetricians-gynecologists (OBs) ("non-CNM/OB"), CNM-only, OB-only, and both CNMs and OBs ("CNM/OB").

Providers' Experiences Discussing Care for Patients with Kidney Failure Who Forgo KRT: A National Qualitative Study.

Background: Many nephrology providers express difficulty in discussing care options for patients who forgo KRT, which hampers their ability to help patients make decisions about their current and future treatment of kidney disease.

Methods: We conducted a qualitative study using interviews with a national sample of nephrology providers (i.e.

Health Workforce Challenges Impact the Development of Robust Doula Services for Underserved and Marginalized Populations in the United States.

Evidence of doulas' positive impacts on maternal health outcomes, particularly among underserved populations, supports expanding access. Health workforce-related barriers challenge the development of robust doula services in the United States. We investigated organizations' barriers regarding training, recruitment, and employment of doulas.

Financial Instability of Federal Navigator Program Challenges Organizations to Help Uninsured Enroll in Health Insurance Coverage.

Under the Affordable Care Act, the federal Health Insurance Navigator Program aims to reduce the rate of uninsured in the United States. Under this program, navigators help people obtain insurance coverage through federally facilitated Marketplaces. However, the program's financial instability and substantial budget cuts created a severe shortage of navigator assistance for the uninsured and underserved.

"This work that we're doing is bigger than ourselves": A qualitative study with community-based birth doulas in the United States.

Context: Community-based birth doulas support pregnant women, transgender men, and gender non-binary individuals during the perinatal period and provide essential services and expertise that address health inequities, often taking on additional roles to fill systemic gaps in perinatal care in the United States (US). Despite the benefits that community-based birth doulas provide, there is little research exploring the work-related conditions and stressors community-based doulas experience. To address this gap, we examined the work experiences, related stressors, and stress management strategies of individual community-based birth doulas.

Addressing Systemic Racism in Birth Doula Services to Reduce Health Inequities in the United States.

Birth doulas support pregnant people during the perinatal period. Evidence of doulas' positive impacts on pregnancy and birth outcomes, particularly among underserved populations, supports expanding access. However, health workforce-related barriers challenge the development of robust doula services in the United States.

Lack of Consistent Investment in Federal Insurance Navigator Program Undermines Navigators' Equity Work in Vulnerable Communities.

Context: Navigators in the federal Insurance Navigator Program ("Navigator Program"), who are employed by organizations in states with Federally Facilitated Marketplaces, provide enrollment assistance, outreach, and education to individuals who are eligible for health insurance coverage. Such work is central to public health efforts to address inequities but continues to be poorly understood and undervalued. More information is needed to understand the components of navigators' equity work and how decreases in program funding have affected their service provision.