Search

This report presents 2001 data on U.S. births according to maternal demographics (age, live-birth order, marital status, race, Hispanic origin, and educational attainment); maternal characteristics (medical risk factors, weight gain, and tobacco and alcohol use); pregnant women's medical care utilization (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and delivery method); and infant characteristics (gestation period, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Data are shown on mother's state of residence, month and day of birth, sex ratio, and father's age. Trends in fertility patterns and maternal and infant characteristics are noted. The number of births, birth rate, fertility rate, and total fertility rates all declined 1 percent in 2001. The teenage birth rate reached another historical low. Birth rates for women in their 20s declined slightly. Rates for women age 30-44 years continued to rise. Births to unmarried women changed very little. Smoking by pregnant women was down again. Women were more likely to begin care in the first trimester of pregnancy. The cesarean delivery rate rose for the 5th consecutive year to 24.4 percent. Preterm and low birthweight levels rose in 2001. (SM)

This document contains issues eight and nine of the 1999 Australian Early Intervention Network for Mental Health in Young People newsletters for health professionals. The newsletters disseminate information about the national and local initiatives for intervention and prevention of mental health problems in young children and youth. The issues feature information on the evaluation and effectiveness of several programs; consumer involvement in health care; available resources; and news on upcoming conferences. Guest editorials include: "Suicide Prevention: Changing the 'Tipping Point'" (Robert Goldney); "Indigenous Health and Early Intervention--Addressing and Acknowledging the Influences of the Past" (Shane Merritt); "Early Intervention and Perinatal Mental Health" (Stephen Matthey); and "Early Intervention: From Rhetoric to...?" (Cathy Davis). (Contains 19 references.) (JDM)

Recognizing the importance of health care during the perinatal period, the topic for this issue of "Children in the Tropics" is prenatal development; this issue is intended for health educators for use in educating their clients about prenatal development, health care during pregnancy, labor and delivery, and the needs of the mother and neonate during the perinatal period. The sections are: (1) "Gestation," focusing on considerations for health care providers, psychological, social, and environment risk factors; (2) "Intrauterine Development," presenting a day-by-day account of organ formation and development, functions of the placenta, the amniotic fluid, methods of intrauterine stimulation, medication, drugs, and maternal diet; (3) "Surveillance of Pregnancy," detailing health care procedures and the impact of the expectant mother's family and social environment; (4) "Pregnancy and Childbirth: A Psychological and Physiological Experience," describing psychological needs during pregnancy, the role of the health team, physical and psychological aspects of childbirth, examination of the neonate, identifying gestational age, and breastfeeding; and (5) "The Health Team--An Interdisciplinary Team," presenting the educational needs of expectant mothers and their families and health care procedures during the perinatal period. An appendix describes the effects of specific drugs taken at various points during prenatal development, during labor, or while breastfeeding. (KB)

This newsletter theme issue focuses on providing services to infants with special needs in rural areas. In "Old Threads, New Patterns: Reaching Out to Rural Families," Deborah Harris-Usner discusses bringing infant mental health care and parent-infant psychotherapy to rural New Mexico. In "The People of Kids Place: Creating and Maintaining Comprehensive Services for Young Children and Their Families in Small Rural Communities," Carolyn King describes the start-up and first 7 years of a comprehensive early childhood service center and considers the value of community input. In "Delivering Prenatal and Postpartum Care in Rural New York State," Richard Jones and others discuss issues related to transportation and access to care, hospitals in rural areas, and services at outreach sites. In "Elk in the Road, Chicks in the Foyer: Infant/Family Work in Rural Areas," Shelley Marie Windsor describes traveling to rural homes; case examples; and the need to connect rural early intervention providers with consultation, supervision, and training. In "Rural Early Intervention Training: Challenges and Strategies," Sue Forest discusses strategies for professional education as well as competencies needed for working with rural families and their infants and toddlers, child assessment, program planning and evaluation, and community service delivery. (SW)

This report describes the relationship between comprehensive prenatal care services and healthy babies, and examines the inclusion of social support services with medical care for women at-risk of problem pregnancies and unhealthy babies. The report notes that the United States trails many countries in indicators of maternal and child health. In 1989 Congress required states to expand Medicaid to pregnant women, and most states have established support services, such as home visiting. Although prenatal health services are vital, the most effective prenatal care programs include home visiting and other support services. Home visiting programs link high-risk pregnant women and infants to other important medical and social services. Examples of programs in Virginia, North Carolina, New York state, and Hawaii, which show promising results and cost savings are provided. Appendices give state-by-state information on Medicaid coverage for prenatal care and list key components of successful home visiting programs. (TM)

Tetanus remains a significant cause of mortality among undervaccinated mothers and their infants after unhygienic deliveries, especially in low-income countries. The strategies of the maternal and neonatal tetanus elimination (MNTE) initiative, which targets 59 priority countries, include strengthening antenatal vaccination of pregnant women with tetanus toxoid-containing vaccines (TTCVs), conducting TTCV supplementary immunization activities (SIAs) for women of reproductive age in high-risk districts, optimizing access to skilled birth attendants (SBAs) to ensure clean deliveries and clean umbilical cord care practices and identifying and investigating suspected cases of neonatal tetanus (NT). This report updates a previous report and describes progress towards achieving MNTE during 2000-2022. By December 2022, 47 (80%) of 59 priority countries were validated as having achieved MNTE. In 2022, of the 50 countries that reported coverage with ≥2 doses of TTCV (TTCV2+) among pregnant women, 16 (32%) reported coverage of ≥80%; and, of the 47 validated countries, 26 (55%) reported that ≥70% of births were assisted by SBAs. The number of NT cases reported worldwide decreased by 89%, from 17 935 in 2000 to 1995 in 2021, and the estimated number of deaths due to NT decreased by 84%, from 46 898 to 7719. Global disruption of routine vaccination due to the coronavirus disease 2019 (COVID-19) pandemic, however, slowed progress. Since 2020, the reported number of NT cases has increased in 18 (31%) priority countries. To achieve and sustain global elimination, MNTE strategies should be integrated into countries' national immunization programmes. [ABSTRACT FROM AUTHOR]

An interview with Rupal Sidhpura Faria, the celebrity trainer and founder of Rupal's Yogasthenics is presented. She discusses her expertise in pre-natal and post-natal yoga. She elaborates on the concept of biohacking during pregnancy, emphasizing how it involves creating optimal conditions for the baby's development, and also explains Garbh Sanskar as a practice to prepare the fetus for birth.

The article focuses on exploring the challenges of maternity care deserts in the U.S., highlighting the significant impact on maternal and infant health outcomes and the urgent need for equitable access to prenatal and postnatal care. It discusses the findings from a report by March of Dimes, revealing the increasing shortage of maternity care facilities and providers in certain areas, exacerbating the already high mortality rate for pregnant and postpartum patients.

The article discusses President Joe Biden's statement about third-trimester abortions and examines its accuracy. It explains that third-trimester abortions involve a three-day procedure where the baby is killed in the womb through lethal injection. The article argues that third-trimester abortions are not necessary to save the life of the pregnant person and can be replaced with induced delivery or cesarean section. It also mentions a study that found the reasons for third-trimester abortions are similar to earlier abortions, such as lack of knowledge about the pregnancy or difficulty arranging an abortion. The article concludes by highlighting an undercover video that shows third-trimester abortions being performed on healthy mothers with healthy babies. [Extracted from the article]

The article focuses on examining the association between cannabis use disorder (CUD) during pregnancy and neonatal outcomes, revealing increased risks of low birth weight, preterm birth, and higher infant mortality within the first year of life among babies born to mothers with CUD. It discusses the methodology of the study, findings indicating adverse neonatal outcomes associated with maternal CUD, and implications for prenatal care counseling regarding cannabis use.

2024 FEB 29 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- Investigators publish new report on Women's Health - Obstetrics and Gynecology. According to news [...]

2024 FEB 1 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- Researchers detail new data in hypertension. According to news originating from Melbourne, Australia, by [...]

The article comments on a study which examined the association of cannabis abuse during pregnancy with poor neonatal outcomes. It identifies features of cannabis use disorder (CUD) and study outcome measures. It points the failure of the study to clarify how hospitals chose to screen for CUD and to take into account whether the use of medical marijuana was record as CUD in medical charts. It recognizes the study's use of statistical modeling methodology known as propensity score matching.

Byline: admin Dr. Aakaar Kapoor, CEO and Lead Medical Advisor-City X-Ray and Scan Clinic Pvt Ltd, Founder and Partner - City Imaging & Clinical Labs LLP Prenatal care has come [...]

This document provides a list of 12 steps to reduce the infant mortality rate. The first five steps, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development, include preventing birth defects, addressing preterm birth and low birth weight, getting pre-pregnancy and prenatal care, creating a safe infant sleep environment, and using newborn screening to detect hidden conditions. The next four strategies, from nortonchildren.com, involve improving the physical environment, adopting healthy personal and eating habits, ensuring adequate prenatal care and emotional support, and addressing racial disparities. The final three steps, from betterhealth.vic.gov, suggest being a non-smoker, exercising regularly, and limiting alcohol consumption as ways to reduce the Black infant mortality rate. [Extracted from the article]

2023 JUL 13 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- Current study results on pregnancy complications have been published. According to news reporting out [...]

The article focuses on a study aimed to see if providing pregnant women and women with postponed major gynecological surgery with a mindfulness app Calm could prevent negative emotional responses during the COVID-19 pandemic and it showed decreasing stress and improved decision-making.

Objectives. To evaluate the cascade of care for the elimination of mother-to-child-transmission of human immunodeficiency virus (HIV) in Suriname and identify sociodemographic and clinical factors preventing transmission to exposed infants. Methods. A mixed-methods study design was used. Antenatal care data from the 2018 cross-sectional multi-indicator cluster survey on 1 026 women aged 15-49 years who had had a live birth in the previous 2 years were used. Furthermore, national data on a cohort of 279 mothers with HIV and their 317 infants born from 2016 to 2018 were evaluated. Additionally, 13 cases of mother-to-child-transmission of HIV were reviewed. Results. In 89.3% of cases, no mother-to-child HIV transmission occurred. Early cascade steps show that 28.4% of women had unmet family planning needs, 15% had no antenatal visits, 8% delivered outside a health facility, and 71.5% received an HIV test during antenatal care. Of the pregnant women with HIV, 84.2% received antiretroviral therapy, while 95.5% of their infants received HIV prophylactic treatment. Receiving antiretroviral therapy for the mother (odds ratio (OR) 45.4, 95% confidence interval (CI) 9.6-215.3) and the child (OR 145.7, 95% CI 14.4-1477.4) significantly increased the odds of a negative HIV test result in infants. Conversely, living in the interior decreased the odds (OR 0.2, 95% CI 0.4-0.7) compared with urban living. Conclusions. HIV medication for mothers with HIV and their infants remains key in the prevention of mother-to-child-transmission of HIV. Early prenatal care with follow-up should be strengthened in Suriname. [ABSTRACT FROM AUTHOR]

Objective. To understand the sexual and reproductive health (SRH) experiences of migrant women and girls of reproductive age (15-49 years) from the Northern Triangle of Central America (El Salvador, Guatemala and Honduras) during their journey to the United States. Methods. A descriptive, qualitative research design included 39 in-depth interviews with migrant women and unaccompanied migrant girls from El Salvador, Guatemala and Honduras from January to June 2022. Participants were recruited using purposive sampling. Interviews were transcribed, coded and analyzed using thematic analysis. Results. Migrant women and girls lack information and resources to manage their SRH during migration. The SRH of those traveling with smugglers is compromised due to their limited access to menstrual pads, water and sanitation services; the risks of transactional sex and sexual violence; the high risk of sexually transmitted infections; the inability to report sexual violence; the lack of access to SRH and prenatal services; and limited knowledge about their sexual and reproductive rights. Conclusions. There is a significant need for improved interventions during the predeparture phase of migration to inform migrant women and girls about the SRH risks they may encounter and to provide information and resources to support their SRH throughout their journey. Special attention should be directed towards trying to reach girls and women who will travel with smugglers. [ABSTRACT FROM AUTHOR]

Prenatal care is one of the most common preventive services in the United States--over 98% of the almost 4 million patients who give birth each year receive at least some [...]

The article discusses the Dobbs versus Jackson Women's Health Organization case focusing on the relative safety of abortion versus pregnancy due to the concern for maternal mortality. It emphasizes that women must receive quality health care before pregnancy, have access to quality prenatal and postnatal care, and be paid parental leave. The states need to invest in midwife-led care, which has proven to reduce maternal and neonatal mortality.

A study conducted in Cambodia examined the effect of health insurance coverage on antenatal care (ANC) utilization. The study utilized data from the 2021-2022 Cambodia Demographic and Health Surveys and included 3,162 women who gave birth within two years. The findings showed that women with health insurance coverage were statistically significantly associated with attending four or more ANC visits. Other factors that were significantly associated with attending four or more ANC visits included higher education, secondary education, and higher household wealth. The study suggests that providing health insurance coverage and improving women's economic and educational status may be essential to improving access to maternal health services in Cambodia. [Extracted from the article]

A recent study conducted at Arsi University in Ethiopia aimed to investigate the prevalence of urinary incontinence (UI) among pregnant women and its impact on their quality of life. The study found that UI affects approximately 18.6% of pregnant women, with stress UI being the most common type. Risk factors for UI included a history of UI, instrumental delivery, and alcohol intake. The study emphasizes the importance of advising pregnant women to avoid or reduce alcohol consumption and seek treatment for UI, as well as the need for follow-up throughout pregnancy and the postpartum period. [Extracted from the article]

A recent study conducted at Iranshahr University of Medical Sciences in Iran has found that elective caesarean section (C-section) deliveries at 37 weeks are associated with a higher risk of respiratory problems in newborns. The risk decreases as gestation advances, highlighting the importance of promoting natural labor and avoiding unnecessary C-sections. Adequate prenatal care and monitoring are crucial for identifying and managing potential risk factors for respiratory diseases in newborns. Healthcare professionals should educate expectant mothers about the risks of elective C-sections and the benefits of allowing labor to progress naturally. Transparent communication and collaborative decision-making between healthcare providers and pregnant women can lead to well-informed choices that prioritize the health of both the mother and the baby. Ongoing research and advancements in medical technology can further improve our understanding of how delivery methods affect newborn respiratory health. [Extracted from the article]

A recent study conducted by Teeside University in Rwanda has found a significant link between periodontitis (gum disease) and preterm deliveries. The study revealed that pregnant women in Rwanda have a high prevalence of periodontitis (60%) and that nurses working in antenatal clinics have insufficient knowledge about gum disease. The researchers recommend incorporating basic periodontal screening into existing antenatal care packages, along with nurse training and public awareness campaigns, to improve pregnancy outcomes and oral health. This policy brief aims to inform decision-making and contribute to a healthier future generation in Rwanda. [Extracted from the article]

A study conducted by the University of Tehran aimed to evaluate the effects of prenatal preparation classes on labor pain intensity, mother's satisfaction of delivery experience, and outcomes of normal vaginal delivery in nulliparous women. The study involved 100 nulliparous women who were divided into two groups: one group received prenatal training and the other group received usual pregnancy care. The results showed that prenatal education significantly reduced labor pain intensity, the need for episiotomy and perineal laceration, the need for augmentation with oxytocin, and increased mother's satisfaction of delivery experience, first minute Apgar score, and early onset of breastfeeding. The researchers suggest that prenatal preparation classes should be used more widely in pregnancy and childbirth care centers. [Extracted from the article]

A study conducted by researchers at Dalarna University in Sweden examined the prevalence and determinants of fetal macrosomia in Bangladesh. Fetal macrosomia, characterized by excessive birth weight, is a significant public health issue in developing countries. The study found that the prevalence of fetal macrosomia in Bangladesh was 11.6%. Factors associated with fetal macrosomia included higher maternal age, secondary level of mother's education, experienced physical attacks, hypertension during pregnancy, and rural residence. The study highlights the need for a comprehensive approach to address this issue, including improving maternal nutrition, promoting healthy lifestyles, enhancing access to quality prenatal care, and addressing socioeconomic and healthcare system challenges. [Extracted from the article]

A new report discusses research on the associations between in utero cannabis exposure and neonatal outcomes. The study, conducted by Kaiser Permanente Northern California, found that in utero cannabis exposure was associated with increased odds of low birthweight, small for gestational age, preterm birth, and neonatal intensive care unit admission. The research suggests that clinicians should counsel individuals who are pregnant or considering pregnancy about the potential adverse neonatal health outcomes associated with prenatal cannabis use. The study was peer-reviewed and published in the American Journal of Obstetrics and Gynecology. [Extracted from the article]

The article explores how neighborhood socioeconomic position impacts women's receipt of adequate prenatal care and their ability to fulfill postpartum permanent contraception. Topics discussed include the relationship between socioeconomic vulnerability and prenatal care adequacy, the influence of prenatal care on achieving permanent contraception, and the role of insurance type in moderating these relationships.

A recent study conducted by researchers from the Department of Disease Control found that bacterial vaginosis, a condition that increases the risk of preterm birth and low birthweight, is prevalent among pregnant women in low- and middle-income countries (LMICs). The study analyzed data from 74 studies conducted between 2000 and 2020, which included a total of 46,661 pregnant women. The overall pooled mean prevalence of bacterial vaginosis across LMICs was 15.7%, with regional variations ranging from 7.4% in Central and Southern Asia to 25.1% in sub-Saharan Africa. The researchers recommend screening and treatment for all pregnant women, including those with HIV infection, and call for further research to understand the biological mechanisms and develop interventions to prevent adverse pregnancy outcomes associated with bacterial vaginosis. [Extracted from the article]

A recent study conducted by researchers at the University of Leuven (KU Leuven) in Belgium explores the potential implementation of non-invasive prenatal testing (NIPT) in the Italian National Healthcare System. NIPT has revolutionized prenatal testing globally, and Italy is considering incorporating it into their publicly funded healthcare system. The study involved interviews with gynecologists, geneticists, bioethicists, health economists, and public health professionals, and found that a contingent implementation of NIPT for major chromosomal aneuploidies screening would be the most cost-effective and logical approach in the Italian context. However, there was no consensus on fetal sex and sex chromosome aneuploidies screening, and most interviewees disagreed with making whole-genome/whole-exome sequencing available through the public sector. The study highlights the potential benefits of NIPT and its compatibility with the Italian prenatal testing culture, but also acknowledges challenges such as high costs, regional differences, and lack of prioritization. The researchers suggest that with modest adjustments, the current prenatal testing structure and practice in Italy could accommodate NIPT. They recommend further research involving a broad range of stakeholders and investigation of different NIPT implementation strategies across Italian regions. [Extracted from the article]

A recent study conducted by researchers at Universitas Sebelas Maret in Indonesia examined the risk factors for stunting in low-income households. The study found that low birth weight and inadequate antenatal care visits were significantly correlated with stunting among children under five. However, there was no correlation between the mother's education level, mother's age, and children's breastfeeding status. The researchers concluded that low birth weight is the primary cause of stunting in children from low-income families. This information is important for understanding and addressing the high prevalence of stunting in Indonesia. [Extracted from the article]

A clinical trial, NCT06560099, has been launched to investigate the effectiveness of increasing the dose of oxytocin during cesarean sections to prevent postpartum hemorrhage in high-risk pregnancies. The trial aims to reduce maternal mortality and morbidity by controlling hemorrhage during and after the procedure. The study will compare the standard dose of oxytocin to a higher dose, and will also assess the use of additional uterotonics in the first 24 hours after the cesarean section. The trial is currently in the recruitment phase and is expected to be completed by April 2025. [Extracted from the article]

A recent study conducted at Hiwot Fana Comprehensive Specialized University Hospital in Eastern Ethiopia aimed to determine the determinants of preeclampsia among women who gave birth. The study found that living in rural areas, being younger than 20 years old, having a history of hypertensive disorders of pregnancy, and not receiving antenatal care were significant factors associated with preeclampsia. The researchers suggest that pregnant women with these characteristics should be given attention in preeclampsia screening and prevention. This information is important for understanding and addressing the causes of preeclampsia, which is a leading cause of maternal and perinatal mortality and morbidity. [Extracted from the article]

A recent study conducted by researchers at the University of Oslo explored the knowledge, attitudes, and perceptions of maternity care providers in three public hospitals in Buenos Aires, Argentina, regarding the use of calcium supplements during pregnancy for the prevention of preeclampsia. The study found that the providers' knowledge, attitudes, and practices regarding calcium supplementation were influenced by barriers to implementation. The researchers recommended that the government provide free calcium supplements and offer training to healthcare providers to ensure the adoption of calcium supplementation in antenatal care. Future studies should also assess the perceptions of pregnant women and policymakers and evaluate the local infrastructure for providing free calcium supplements. [Extracted from the article]

A study conducted by Madda Walabu University in Southeast Ethiopia explored the factors that influence delayed time to pregnancy among women with naturally planned conception. The study found that 18.6% of women experienced delayed time to pregnancy. Factors associated with delayed time to pregnancy included older maternal age, irregular menstrual cycles, frequency of sexual intercourse per week, and women's sexual dysfunction before pregnancy. The study suggests that addressing delayed time to pregnancy requires targeted approaches such as raising awareness, increasing sexual activity, and addressing challenges related to menstrual irregularity and sexual dysfunction. [Extracted from the article]

A recent study conducted by researchers at the Ghana Health Service compared the impact of group-based antenatal care (G-ANC) to routine antenatal care on birth preparedness and complication readiness (BPCR) among pregnant women in Ghana. The study found that participants in the G-ANC group were able to identify more pregnancy danger signs and had higher overall BPCR scores compared to those in the routine antenatal care group. The researchers concluded that G-ANC significantly increased BPCR among women in rural Eastern Region of Ghana and recommended prioritizing the implementation of G-ANC in future efforts. The study was registered on ClinicalTrials.gov and more information can be found in the BMC Pregnancy and Childbirth journal article. [Extracted from the article]

A recent study conducted by researchers at Kaiser Permanente Northern California has found that individuals with a greater number of adverse childhood experiences and low resilience are more likely to develop depression and anxiety during pregnancy. The study, which included 14,625 pregnancies, revealed that adverse childhood experiences and low resilience were independently associated with newly identified depressive disorders, depression symptoms, and anxiety disorders during pregnancy. The researchers suggest that routine screening for adverse childhood experiences and resilience may help identify individuals at risk and improve maternal and child outcomes. This research has been peer-reviewed and published in Obstetrics and Gynecology. [Extracted from the article]

A recent study conducted by researchers at Wayne State University School of Medicine highlights the safety and effectiveness of maternal vaccination in preventing infection in pregnant women, their fetuses, and infants after birth. Despite the availability of sufficient safety data, concerns about vaccine safety during pregnancy have led to underutilization of maternal immunization. However, the field of maternal vaccination is evolving to include more vaccines in the routine prenatal vaccination schedule, including the new RSV vaccine. This review provides an overview of the currently recommended vaccines in pregnancy, evidence for their use, and ongoing clinical trials investigating prospective vaccines for pregnant women. [Extracted from the article]

A recent study conducted by researchers from Kaiser Permanente Northern California examined the association between prenatal cannabis use and maternal health outcomes during pregnancy. The study included over 316,000 pregnancies in Northern California from 2011 to 2019. The results showed that prenatal cannabis use was associated with an increased risk of gestational hypertension, preeclampsia, abnormal weight gain, and placental abruption. However, further research is needed to understand the specific characteristics of prenatal cannabis use that may moderate these associations. [Extracted from the article]

A recent study conducted by researchers from Kaiser Permanente Northern California examined the association between prenatal cannabis use and maternal health outcomes during pregnancy. The study included over 316,000 pregnancies in Northern California from 2011 to 2019. The results showed that prenatal cannabis use was associated with an increased risk of gestational hypertension, preeclampsia, abnormal weight gain, and placental abruption. However, further research is needed to understand the specific characteristics of prenatal cannabis use that may moderate these associations. [Extracted from the article]

A recent study conducted by researchers from Kingston University explores the implementation of an educational film within antenatal care to reduce the risk of cytomegalovirus (CMV) infection in pregnancy. CMV infection is a leading cause of sensorineural hearing loss and neuro-disability in childhood. The study found that midwives were reluctant to discuss CMV as part of early pregnancy discussions due to lack of time, knowledge, and guidance. However, the educational intervention was seen as a useful tool to encourage conversations and empower women to manage risk. Successful implementation of CMV education in routine care will require increased awareness and knowledge among midwives. [Extracted from the article]