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PURPOSE Physically or psychologically distressing birth experiences can influence postpartum health, parenting efficacy, and future pregnancy plans. Communication deficits contribute to negative birth experiences. This qualitative analysis explored themes related to communication and negative birth experiences among Black birthing people who experienced preterm birth. METHODS We conducted qualitative interviews with non-Hispanic Black, English language-proficient birthing people with Medicaid-insured preterm infants. Interviews were designed to explore experiences with health care access and well-being after birth. Interviews were audio recorded, transcribed, and coded following an integrated approach where we applied a priori codes and captured emergent themes from the data. RESULTS We interviewed 30 participants from October 2018 to July 2021. Median gestational age at birth was 30 weeks (range 22-36 weeks). Interviews occurred a median of 7 months postpartum (range 2-34 months). Themes emerged related to negative birth experiences and communication: (1) communication gaps during urgent or emergent intrapartum procedures contributed to negative birth experiences; (2) postpartum opportunities to share birth experiences, particularly with peers, sometimes mitigated the psychological consequences of negative birth experiences; (3) participants did not consistently discuss concerns about future pregnancy risk related to negative birth experiences with clinical teams. CONCLUSIONS Themes from this sample of Black birthing people who experienced preterm birth suggest 3 ways health systems might intervene to improve communication to mitigate the consequences of negative birth experiences. Improvement efforts in these areas may improve postpartum health, future pregnancy outcomes, and long-term health. Key words: African American; birth trauma; Black; Black birthing people; interconception care; intrapartum care; negative birth experience; preconception care; reproductive justice; health communication; postpartum care, INTRODUCTION Birth experiences sometimes cause psychological distress, persistent feelings of anger or loss, or depression and posttraumatic stress disorder. (1-4) These negative birth experiences and their sequelae can influence women's [...]

Objectives To explore provider perspectives surrounding national guidelines proposing regionalization of maternal care. Methods An 18-item survey focused on provider attitudes and practices surrounding regionalized maternity care was administered to a national sample of practicing obstetricians. We classified respondants reporting less than 500 annual deliveries at their hospital as low-volume providers and those practicing at hospitals performing 500 or more annual deliveries as high-volume providers. We compared responses according to hospital delivery volume using univariate analysis. Results Of the 497 physicians surveyed, 278 people responded (56%) with 229 currently practicing obstetrics. The median annual delivery volume amongst respondents was 200 (interquartile range 100-1900) with 146 (63.7%) practicing in low-volume delivery centers. The need for medical or surgical expertise was the most commonly reported indication for maternal transfer (19.7%) and independent of practice setting. Ninety-six percent of providers agreed with the concept of regionalization, but respondents in high-volume centers reported higher familiarity with the levels of maternal care paradigm compared to their low-volume counterparts (81.9% v. 62.3%, p < 0.01). Financial factors (60.3%), geography (48.9%), and access to care (43.2%) were the most cited major barriers to regionalization. High-volume providers endorsed geography as a major barrier more often than low-volume providers (57.8% v. 43.8%, p = 0.04). Conclusions for Practice Obstetricians may agree with the concept of regionalized maternity care but also identify significant barriers to its implementation. Early and frequent engagement of providers reflecting the diversity of delivery centers in a region is a simple but necessary step in any attempts to designate levels of maternal care., Author(s): Sarah Rae Easter [sup.1] , Kelly C. Gilmore [sup.2] , Jay Schulkin [sup.2] , Julian N. Robinson [sup.1] Author Affiliations: (1) grid.38142.3c, 000000041936754X, Division of Maternal-Fetal Medicine, Brigham and [...]

Introduction Maternal depression, which includes depression in the prenatal and postpartum periods, is estimated to affect between 10 and 20% of women globally but the rate is higher in the Middle East. Research focused on maternal depression in Iraq is limited to one study focused on postpartum depression. This paper identifies the prevalence and factors associated with antenatal depression among pregnant Iraqi women. Methods Women seeking maternal health services at primary health centers were invited to participate. Data were collected by trained midwifery students in Erbil, Iraq. Responses to the PHQ-2 PRIME-MD depression questions were used to identify depressive symptoms. Chi-square and logistic regression analyses were used to analyze findings. Results Of the 179 participants, 86 (48%) reported depressive symptoms. In bivariate analysis, antenatal depression was associated with gestational age (p = 0.03), first prenatal visit in the second trimester (p = 0.003), loss of appetite (p = 0.003), not having help at home (p = 0.03), and use of prenatal vitamins (p = 0.002). Gravida approached significance (p = 0.07). In adjusted analysis, women reporting loss of appetite were more likely to report depressive symptoms (OR = 3.09, 95% CI: 1.47-6.51). Discussion Consistent with other research from the region, nearly half the women reported depressive symptoms. Because lack of appetite is associated with depressive symptoms, women reporting loss of appetite should be prioritized for depression screening in time-constrained settings., Author(s): Kathryn Mishkin [sup.1] , Shaymaa Samir Maqsood [sup.2] , Hamdia Mirkhan Ahmed [sup.2] Author Affiliations: (1) grid.265850.c, 0000 0001 2151 7947, Department of Health Policy, Management, Behavior, University at [...]

Objective To set up a global system for monitoring maternal and perinatal health in 54 countries worldwide. Methods The WHO Global Survey for Monitoring Maternal and Perinatal Health was implemented through a network of health institutions, selected using a stratified multistage cluster sampling design. Focused information on maternal and perinatal health was abstracted from hospital records and entered in a specially developed online data management system. Data were collected over a two- to three-month period in each institution. The project was coordinated by WHO and supported by WHO regional offices and country coordinators in Africa and the Americas. Findings The initial survey was implemented between September 2004 and March 2005 in the African and American regions. A total of 125 institutions in seven African countries and 119 institutions in eight Latin American countries participated. Conclusion This project has created a technologically simple and scientifically sound system for large-scale data management, which can facilitate programme monitoring in countries. Objectif Mettre en place dans 54 pays repartis dans l&apos;ensemble du monde un systeme mondial de surveillance de la sante maternelle et perinatale. Methodes L&apos;Enquete mondiale sur la surveillance de la sante maternelle et perinatale de I&apos;OMS s&apos;est operee par le biais d&apos;un reseau d&apos;etablissements de soins, selectionnes par echantillonnage en grappe stratifie a plusieurs niveaux. Une information ciblee sur la sante maternelle et perinatale a ete extraite des registres hospitaliers et entree dans un systeme de gestion des donnees en ligne, specialement developpe. Les donnees ont ete recueillies sur une periode de deux a trois mois dans chaque etablissement. Le projet a ete coordonne par I&apos;OMS et appuye par les bureaux regionaux de I&apos;OMS et par ses coordinateurs nationaux en Afrique et dans les Ameriques. Resultats L&apos;enquete initiale a ete realisee entre septembre 2004 et mars 2005 en Afrique et dans les Ameriques. Ont participe au total a l&apos;enquete 125 etablissements de sept pays africains et 119 etablissements de huit pays d&apos;Amerique latine. Conclusion Ce projet a cree un systeme technologiquement simple et scientifiquement rigoureux pour la gestion grande echelle des donnees, pouvant faciliter la surveillance programmatique dans les pays. Objetivo Establecer un sistema mundial de vigilancia de la salud materna y perinatal en 54 paises de todo el mundo. Metodos La Encuesta mundial OMS de vigilancia de la salud materna y perinatal se llevo a cabo a traves de una red de instituciones sanitarias seleccionadas mediante muestreo polietapico estratificado por conglomerados. La informacion focalizada y resumida sobre la salud materna y perinatal extraida a partir de las historias clinicas se introdujo en un sistema de gestion de datos en linea especialmente desarrollado. A lo largo de un periodo de dos a tres meses se reunieron datos en cada institucion. El proyecto fue coordinado por la OMS y respaldado por las oficinas regionales de la OMS y los coordinadores en los paises en Africa y las Americas. Resultados La encuesta inicial se llevo a cabo entre septiembre de 2004 y marzo de 2005 en las regiones de Africa y de las Americas. Participaron en total 125 instituciones de siete paises africanos y 119 instituciones de ocho paises latinoamericanos. Conclusion Este proyecto ha generado un sistema tecnologicamente sencillo y cientificamente solido para gestionar datos a gran escala, lo cual puede facilitar la vigilancia de los programas en los paises. [TEXT NOT REPRODUCIBLE IN ASCII], Introduction The WHO Global Survey on Maternal and Perinatal Health aims to develop a network of health institutions worldwide that collects up-to-date information on services provided and on how evidence-based [...]

CONTEXT: Although gender inequality is often cited as a barrier to improving maternal health in Nepal, little attention has been directed at understanding how sociocultural factors may influence the use [...]

CONTEXT: Because of high levels of early childbearing in developing countries, pregnancy and childbirth are the leading causes of death among women aged 15-19. Use of skilled antenatal and delivery [...]

Objective To determine the use of the active management of the third stage of labour in 15 university-based obstetric centres in ten developing and developed countries and to determine whether evidence-based practices were being used. Methods From March 1999 to December 1999, the Global Network for Perinatal and Reproductive Health (GNPRH) conducted an observational, cross-sectional survey to assess the use of the practice and its components. Prospective data on patient characteristics and the interventions used in the management of the third stage of labour were collected using standardized methods. Data on approximately 30 consecutive vaginal deliveries in each centre (452 in total) were included. Findings Significant intracountry and intercountry variation in the practice of the active management of the third stage of labour was found (111/452 deliveries used active management), which confirmed the existence of a large gap between knowledge and practice. Conclusion Areas identified for improvement are the urgent implementation of the evidence-based clinical management practice defined as the active management of the third stage of labour; increased accessibility to systematic reviews in developing countries; and the conduction of clinical trials that assess the impact of this intervention in other settings. Keywords Labor stage, Third/drug effects; Postpartum hemorrhage/drug therapy; Oxytocin/therapeutic use; Umbilical cord; Delivery, Obstetric/methods; Hospitals, University; Evidence-based medicine; Cross-sectional studies; Multicenter studies; Developed countries; Developing countries (source: MESH, MM), Mots cles Troisieme periode accouchement/action des produits chimiques; Hemorragie post partum/chimiotherapie; Oxytocine/usage therapeutique; Cordon ombilical; Delivrance, Obsterique/methodes; Hopital universitaire; Medecine factuelle; Etude section efficace; Etude multicentrique; Pays developpe; Pays en developpement (source: MESH, INSERM). Palabras clave Tercer periodo del trabajo de parto/efectos de drogas; Hemorragia posparto/quimioterapia; Oxitocina/uso terapeutico; Cordon umbilical; Parto obstetrico/metodos; Hospitales universitarios; Medicina basada en evidencia; Estudios transversales; Paises desarrollados; Paises en desarrollo (fuente: DeCS, BIREME). Bulletin of the World Health Organization 2003;81:286-291., Voir page 290 le resume en francais. En la pagina 291 un resumen en espanol. Introduction Post-partum haemorrhage (PPH) is the most common cause of maternal mortality and serious maternal [...]

DESPITE A PRECIPITOUS FALL during the past three decades, infant mortality for American Indians and Alaska Natives (AI) continues to exceed that for the general population (1, 2). Although in […]

Two recent studies conducted in Kenya suggest that voucher programs designed to subsidize poor women's access to maternal health care are associated with increases in facility-based deliveries and in skilled [...]

Priorities for antenatal care are discussed in relation to a survey of public antenatal clinics in Australia. Activities ranked as essential or desirable by nursing directors and by medical directors are detailed, with reference to recommendations of the National Health and Medical Research Council.

The Royal College of Midwives has welcomed a forthcoming survey that will be used to improve maternity services, but fears it will be pointless unless more midwives are employed. The [...]