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Despite clinical recommendations, only 24.9% of infants in the United States are exclusively breastfed at 6 months of age, and women who use formula report facing stigma and feeling like a failure. Individual experiences are often influenced by master narratives such as “breast is best,” and stories can reveal how the discourse may manifest unintended effects, potentially eliciting guilt and shame, which are known to result in negative maternal mental outcomes, including depression and anxiety. The purpose of this research was to use a narrative framework to analyze the stories of women who used formula and determine how they interpreted the master narrative of “breast is best.” We conducted interviews with 20 women who had used formula within the first 6 months after giving birth and had an infant no older than 12 months at the time of the interview. Qualitative analysis revealed that women integrated “breast is best” into their stories, and that the master narrative influenced conceptions of themselves as mothers including the bonded mother, the good mother, the shameful mother, and, ultimately, the multitudinous mother. Participants who used formula within the first six months desired that messaging about breastfeeding, particularly in online spaces, move away from all-or-nothing framing and instead show the diversity of infant feeding experiences. It is important to consider how breastfeeding discourse evolves online, considering the unintended effect of stigma, its impact on mental health, and the potential for individuals interacting in these spaces to curate more nuanced narrative messaging about breastfeeding to improve maternal and infant health. [ABSTRACT FROM AUTHOR]

Few life events are as profound as the birth of a child. Yet for those who gave birth during the COVID-19 pandemic, the birth experience and the care of their newborn child were altered in significant ways. In this study, we examined the stories of women who gave birth during the COVID-19 pandemic using expectations violations theory and communication privacy management theory. Based on focus group interviews with 65 women from 19 states across the U.S., we found that policies imposed by institutions and visitation rules negotiated by women were prominent in women's birth stories. Policies that affect territorial access to mothers and babies shaped communication to manage health and safety, resulted in intense emotional responses, and affected relationships with women's partners and families. Our findings offer practical implications for both health care systems and health care providers. Systems must communicate proactively to offer compassionate patient care, and physicians should offer guidance to help new parents manage visitors. [ABSTRACT FROM AUTHOR]

Women who gave birth in the spring and summer of 2020 contended with a host of challenging factors. In addition to facing pregnancy, labor, and delivery during an emerging global pandemic, women grappled with health care restrictions that altered their birth experience. To explore how women made sense of their birth during COVID-19, we analyzed written narratives from 71 women who gave birth in the United States from March to July 2020. Based on tenets of communicated narrative sense-making, the themes that emerged from our data suggest that women framed the role of the pandemic as either completely overshadowing their birth experience or as an inconvenience. Women also wrote about threats to their agency as patients, mothers, and caregivers, as well as the evolving emotional toll of the pandemic that often prompted feelings of fear and sadness, along with self-identified anxiety and depression. We discuss these findings in light of the literature on birth stories as essential sites of narrative sense-making for women and their families. [ABSTRACT FROM AUTHOR]

Changes in cervical cancer screening guidelines and persistent disparities indicate a need to identify communication preferences for receiving a positive HPV test result to ensure appropriate follow-up care. We conducted a directed content analysis guided by the tenets of self-determination theory of 575 written responses derived from a national sample of women > 18 in the United States. Biologically female women responded to a prompt about communication preferences for a positive HPV test result. Pearson chi-square analyses were conducted to discover differences in communication preferences. Individuals with health insurance (p = 0.044), those with >$29,999 in annual household income (p = 0.040), and White participants (p = 0.026), more frequently indicated a preference for communication related to autonomy compared to other groups. Hispanic/Latino participants more frequently indicated a preference for relatedness in communication (p = 0.003). Implications include that communication should (a) focus on the meaning of results and HPV's relationship to cancer (i.e., competence) and what a woman can specifically do to follow up (i.e., autonomy); (b) incorporate elements that build autonomy to encourage clinical follow-up in populations that less frequently mention autonomy-based communication; and (c) build culturally competent communication by embodying the concept of "personalismo," or friendliness, for Hispanic/Latino patients. [ABSTRACT FROM AUTHOR]

New guidelines for cervical cancer screening (CCS) incorporate both HPV and Pap tests, and there is a need to understand communication of these cotesting results to patients, especially in at-risk populations disproportionally affected by cervical cancer. This study used computer-assisted telephone interviews in 2017 at 51 federally qualified health centers (FQHCs) in Indiana to evaluate the characteristics of clinical communication CCS results to women. Results revealed that clinical communication practices varied on channel, timing, and content. Almost half of the clinics (n = 23, 45%) communicate results to patients by phone. Most clinics (n = 47, 92%) notify patients of results in two weeks or less. For cotesting, 70% (n = 36) always communicate Pap/HPV results at the same time. The majority of clinics (n = 42, 82%) explain the type of abnormal Pap test, while only 43% (n = 22) discuss the cervical cancer risk as indicated by the HPV test result. Even though 98% (n = 48) of participants rated their communication strategy as effective, qualitatively participants acknowledged difficulties in communicating cotesting results with their often transient and low health literate patients populations. These results indicate considerable variation and potential deficits in clinical communication of cotesting results in FQHCs, but several promising communication strategies were identified that may inform improved screening communication for other clinics. [ABSTRACT FROM AUTHOR]

Miscarriage is one of the most common pregnancy complications health care providers discuss with patients. Previous research suggests that women's distress is compounded by ineffective communication with providers, who are usually not trained to deliver bad news using patient-centered dialogue. The purpose of this study was to use a patient-centered approach to examine women's experiences with and perspectives of communication during a miscarriage to assist in the development of communication training tools for health care providers. During focus groups, 22 women who had experienced miscarriage discussed video-recorded standardized patient-provider interactions and recalled communication during their own miscarriages. Results of a pragmatic iterative analysis of the transcripts suggest training techniques and communication behaviors that should guide education for providers to deliver the diagnosis of and treatment options for early pregnancy loss, such as demonstrating empathy, creating space for processing, checking for understanding, and avoiding medical jargon and emotionally charged language. [ABSTRACT FROM AUTHOR]