Fear of Childbirth Among Pregnant People Facing Anti-Fat Bias.

Explicit and implicit anti-fat biases are widespread among healthcare providers, leading to significant negative consequences for pregnant people, including poorer health outcomes. Fear of childbirth (FOC) can affect the length of labor, increase the risk of cesarean delivery, and negatively influence a new parent's perception of infant bonding. This study investigated the impact of perceived anti-fat bias on FOC among pregnant people.

Effect of Group Antenatal Care on Breastfeeding Knowledge and Practices Among Pregnant Women in Ghana: Findings from a Cluster-Randomized Controlled Trial.

The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months after birth to ensure child health and survival. Antenatal care provides an opportunity to educate pregnant women on optimal breastfeeding practices. A cluster-randomized control trial in Ghana examined the impact of group antenatal care on breastfeeding knowledge and practice.

The impact of group antenatal care on newborns: Results of a cluster randomized control trial in Eastern Region, Ghana.

Background: Maternal recognition of neonatal danger signs following birth is a strong predictor of care-seeking for newborn illness, which increases the odds of newborn survival. However, research suggests that maternal knowledge of newborn danger signs is low. Similarly, maternal knowledge of optimal newborn care practices has also been shown to be low.

Knowledge, Acceptance, and Uptake of Family Planning: A Cluster Randomized Controlled Trial of Group Antenatal Care in Ghana.

The use of family planning (FP) methods significantly contributes to improved outcomes for mothers and their offspring. However, the use of FP remains low, particularly in low- and middle-income countries. A cluster randomized controlled clinical trial was implemented in Ghana, comparing group antenatal care (ANC) with routine care.

Effect of group antenatal care versus individualized antenatal care on birth preparedness and complication readiness: a cluster randomized controlled study among pregnant women in Eastern Region of Ghana.

Background: As utilization of individual antenatal care (I-ANC) has increased throughout sub-Saharan Africa, questions have arisen about whether individual versus group-based care might yield better outcomes. We implemented a trial of group-based antenatal care (G-ANC) to determine its impact on birth preparedness and complication readiness (BPCR) among pregnant women in Ghana.

Methods: We conducted a cluster randomized controlled trial comparing G-ANC to routine antenatal care in 14 health facilities in the Eastern Region of Ghana.

Implementation of Virtual Antenatal and Postnatal Urgent Midwifery Visits: Evaluation of a Quality Improvement Initiative.

Women seeking care during the perinatal period often face delays or long waits at healthcare facilities due to lack of providers and/or resources, leading to sub-optimal outcomes. We implemented a program whereby patients with concerns could receive same-day care virtually from a midwife rather than presenting to the clinic or hospital for care. Implementation strategies included virtual training, a staged increase in patient volume, and frequent communication between the midwives via text, email, and monthly meetings.

Social Media and Nutritional Guidelines in Pregnancy.

Introduction: Nutrition impacts health outcomes of pregnant people and their fetuses. Discussing nutrition with patients may be challenging for health care providers. In this vacuum, patients use social media for health information during pregnancy.

Implementation of Healthy Men Healthy Communities: A Health Promotion and Gender-Based Violence Prevention Program for Male South Sudanese Refugees in Uganda.

Men living in refugee settings are often exposed to violence, poverty, and social instability, which impacts physical and mental health and increases the risk of perpetrating sexual and gender-based violence. Healthy Men Healthy Communities was developed as a male-led health promotion program to address men's physical and mental health and their role in creating healthy relationships and families. Three community leaders from the settlements were trained to facilitate the program, which was implemented among six groups consisting of twelve men in each group.

Improving respectful maternity care through group antenatal care: findings from a cluster randomized controlled trial.

Background: Disrespect and patient mistreatment are identified as barriers to care-seeking and low uptake of facility-based deliveries. These mitigating factors have led to slow progress in the achievement of maternal and child health targets, especially in Ghana. Group antenatal care, as an alternative to individual antenatal was implemented to explore the impact on outcomes, including mothers' perception of respectful care.

Improving health literacy through group antenatal care: results from a cluster randomized controlled trial in Ghana.

Background: Although the majority of Ghanaian women receive antenatal care (ANC), many exhibit low health literacy by misinterpreting and incorrectly operationalizing ANC messages, leading to poor maternal and newborn health outcomes. Prior research in low-resource settings has found group antenatal care (G-ANC) feasible for women and providers. This study aims to determine the effect of G-ANC on increasing maternal health literacy.

"With group antenatal care, pregnant women know they are not alone": The process evaluation of a group antenatal care intervention in Ghana.

Background: An essential component to improving maternal and newborn outcomes is antenatal care. A trial of group antenatal care was implemented in Ghana where 7 health care facilities were randomized to be intervention sites and 7 control sites continued traditional antenatal care. Group antenatal care, where 10-14 women with similar due dates meet together for visits, includes traditional components such as risk assessment with increased opportunity for education and peer support.

Knowledge, attitudes, and practices of healthcare professionals on oral care of pregnant women in Brunei Darussalam.

Objective: To examine nationwide the knowledge, attitudes, and practices of healthcare professionals on oral/dental care of pregnant women in Brunei Darussalam.

Materials And Methods: A descriptive cross-sectional study conducted using an online survey of eligible healthcare professionals in all Government Maternal and Child Health Care Clinics, Dental Clinics and Obstetrics and Gynecological Clinics in four hospitals covering the whole of Brunei Darussalam. Participants were given seven days to complete the survey.

Measuring Fear of Childbirth Among a Diverse Population in the United States: A Revised Wijma Delivery Expectancy/Experience Scale (WDEQ-10).

Introduction: 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.

Group Antenatal Care in Ghana: Protocol for a Cluster Randomized Controlled Trial.

Background: While group antenatal care (ANC) has been delivered and studied in high-income countries for over a decade, it has only recently been introduced as an alternative to individual care in sub-Saharan Africa. Although the experimental design of the studies from high-resource countries have been scientifically rigorous, findings cannot be generalized to low-resource countries with low literacy rates and high rates of maternal and newborn morbidity and mortality. The Group Antenatal Care Delivery Project (GRAND) is a collaboration between the University of Michigan in the United States and the Dodowa Health Research Centre in Ghana.

Perspectives of Doulas of Color on their Role in Alleviating Racial Disparities in Birth Outcomes: A Qualitative Study.

Introduction: The purpose of this study was to explore how doulas of color conceptualize both their work and how their racial and ethnic identities influence their work within the context of racial disparities in birth outcomes in the United States.

Methods: We conducted semistructured qualitative interviews with doulas of color who had attended at least 3 births as doulas. Participants were recruited from across the United States.

A pilot study to evaluate the effect of classroom-based high-fidelity simulation on midwifery students' self-efficacy in clinical lactation and perceived translation of skills to the care of the breastfeeding mother-infant dyad.

Background: Midwives are expected to provide timely and skilled support to breastfeeding mothers, yet it is not clear whether and how midwifery students receive training in clinical lactation. The primary objective of this pilot study was to evaluate the impact of a classroom-based breastfeeding simulation on nurse-midwifery students' self-efficacy in lactation skills. The secondary objective was to describe students' exposure to breastfeeding patients in the classroom and in clinical settings.

Outcomes of Expectant Management of Term Prelabor Rupture of Membranes.

Objective: To assess rates of induction/augmentation of labor, maternal infection, neonatal outcomes, and time to birth when women were expectantly managed after term prelabor rupture of membranes (PROM) at home or in the hospital.

Design: Retrospective, descriptive study based on a review of data from a hospital midwifery service database and chart review.

Setting: A large Midwest hospital with 4,700 births annually.

Relational Decision-Making in the Context of Life-Limiting Fetal Anomalies: Two Cases of Anencephaly Diagnosis.

Life-limiting fetal diagnoses such as anencephaly require families to make decisions in which no options offered will lead to the desired outcome of a healthy newborn. Although informed choice and shared decision-making are important aspects of ethics regarding care choices, they have limitations. In this article, 2 cases of anencephaly diagnosis are presented, and a relational decision-making model of care is proposed as an alternative for aiding pregnant people and their families in making challenging choices in the context of perinatal care.

Midwifery students better approximate their self-efficacy in clinical lactation after reflecting in and on their performance in the LactSim OSCE.

Background: Midwives are expected to support women with lactation initiation and maintenance. Midwifery students engaged in a simulation-based exercise (LactSim OSCE) where they role-played the clinician and the breastfeeding patient by wearing a high-fidelity breast model. We provided participants opportunities for reflecting in and on practice to compare their perceived self-confidence in clinical lactation skills to actual clinical performance.

Development and evaluation of a high-fidelity lactation simulation model for health professional breastfeeding education.

Background: A key reason for premature cessation of breastfeeding is inadequate support from healthcare providers. Most physicians and nurses do not feel confident in their ability to support families with breastfeeding initiation or maintenance. Increasing health professional confidence in clinical lactation skills is key to improving maternal and child health outcomes.

A retrospective comparison of waterbirth outcomes in two United States hospital settings.

Background: Water immersion during labor is an effective comfort measure; however, outcomes for waterbirth in the hospital setting have not been well documented. Our objective was to report the outcomes from two nurse-midwifery services that provide waterbirth within a tertiary care hospital setting in the United States.

Methods: This study is a retrospective, observational, matched comparison design.

Certified Nurse-Midwives' Experiences With Provision of Prenatal Genetic Screening: A Case for Interprofessional Collaboration.

Prenatal genetic screening (GS) for the most common autosomal aneuploidies encompasses maternal serum screening (MSS) and noninvasive prenatal testing (NIPT, or cell-free fetal DNA testing). In the United States, most maternity care is provided by obstetrician-gynecologists; however, women are increasingly utilizing the services of certified nurse-midwives (CNMs). Currently, limited research exists on midwives' experiences with providing prenatal GS.

Timing and Outcomes of an Indication-Only Use of Intravenous Cannulation During Spontaneous Labor.

Introduction: In the United States, most women presenting in spontaneous labor undergo intravenous (IV) cannulation on admission to hospital labor and birth units. There is limited evidence for this routine practice in pregnant women at low risk for adverse outcomes during labor or birth.

Methods: A retrospective, exploratory, descriptive study of an indication-only practice of IV cannulation on admission for women presenting in spontaneous labor and cared for by a nurse-midwife service was performed.

Determinants of postnatal care utilization in Tigray, Northern Ethiopia: A community based cross-sectional study.

Introduction: Globally, 289,000 women die from complications related to pregnancy, childbirth, or the postnatal period every year. Two-thirds of all maternal deaths occur during the first six weeks following birth and more than two thirds of newborn deaths occur during the first week of life, These statistics underscore the importance of postnatal care, an often neglected service according to the World Health Organization (WHO). The purpose of this study was to assess the factors associated with postnatal service utilization in the Tigray region of Ethiopia.