Nursing Midwifery Commons^™

Trying To Cover The Sun With Your Thumb: A Critical Ethnography Of Maternity Care Provision In Rural Northern New Mexico, Abigail Reese

Nursing ETDs

Access to maternity care is disappearing for women across rural America. In the state of New Mexico, women often travel long distances to access hospitals and providers that offer childbirth services, as these resources are concentrated primarily in metropolitan areas. Although data on provider distribution is available, very few studies have explored the maternity care access crisis from the perspectives of the midwives and physicians who work in rural areas. The purpose of this critical ethnographic study was to explore barriers and facilitators to the provision of childbirth services from providers’ perspectives with the intent of informing policy debates around …

Trying To Cover The Sun With Your Thumb: A Critical Ethnography Of Maternity Care Provision In Rural Northern New Mexico, Abigail Reese

Shared Knowledge Conference

Access to maternity care is disappearing for women across rural America. In New Mexico, women often travel long distances in order to access hospitals and providers that offer childbirth services, as these resources are primarily concentrated in metropolitan areas. Although data on provider distribution is available, very few studies have explored the maternity care access crisis from the perspectives of the midwives and physicians who work in rural areas. The purpose of this study was to explore barriers and facilitators to the provision of childbirth services from providers’ perspectives with the intent of informing policy debates around the maintenance of …

A Preliminary Study Of Intergenerational Differences In Masxha Regarding Practice And Attitudes Towards Zulu Traditions During Pregnancy And Birth, Momoko Oyama

Independent Study Project (ISP) Collection

In the Zulu culture, several traditions and rituals are practiced during a woman’s pregnancy and perinatal period. However, as urbanization spreads and western influences strengthen, these rituals risk being lost. This project aims to capture existing knowledge of these traditions and to assess the intergenerational changes in practice and attitudes towards practicing the rituals.

Information on Zulu traditions practiced during a woman’s pregnancy and perinatal period was collected through two interviews and a focus group consisting of three elderly women in Masxha, a Black township in KwaZulu-Natal. Following the interviews and focus group, 32 Masxha residents were recruited to complete …

Maternal Healthcare In Eastern Uganda: The Three Delays, Mothers Making Empowered Choices, And Combatting Maternal Mortality, Emma Gier

Independent Study Project (ISP) Collection

Maternal and child health has been noted as an international concern and issue. While access to maternal healthcare has improved in Uganda since 2000, maternal mortality rates have remained high in the country as of 2015. However, maternal and child healthcare are inherently important in promoting sustainable and positive development. For that reason, I have explored maternal healthcare in Uganda’s Eastern region, specifically in Mbale Town and surrounding rural areas including Kween and Manafwa districts. Specifically I have looked at what factors influence women’s decision to give birth in a health centre or hospital, versus at home. I have also …

The Changing Roles And Reputations Of Dais In Rural Uttarakhand: An Investigation Into The Maternal Health Services Of Villages In Okhalkanda Block In Nainital, Jenna Davis

Independent Study Project (ISP) Collection

The dai, once a prominent figure in Indian maternal health, now faces marginalization as the government of India adopts the goal of universal institutional delivery. Under pressure from international discourse that Skilled Birth Attendants (SBAs) were more effective at lowering Maternal Mortality Rate (MMR) than Traditional Birth Attendants (TBAs) like dais (World Health Organization), dai training was discontinued and left in the hands of NGOs, while concurrently women and ASHAs were monetarily incentivized for every institutional birth (Park, 419). Yet in rural, isolated, or hilly areas like Okhalakanda block in Uttarakhand, institutional delivery is a long way from universal—only …

Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam

Dissertations

Mississippi continues to have one of the lowest rates and the weakest support in respect to breastfeeding in the nation (Centers for Disease Control and Prevention, 2014a). Hospital practices supporting breastfeeding such as the Ten Steps to Successful Breastfeeding (TSSB) can dramatically increase breastfeeding rates and duration (Rosenberg, Stull, Adler, Kasehagen, & Crivelli-Kovach, 2008). The aim of this study was to explore breastfeeding practices in Mississippi hospitals based on two levels of the Socio-Ecological Model: the organizational level (phase I) examined the hospital practices based on the level of implementation of the TSSB; the individual level (phase II) examined knowledge …

Caring For Women: A Profile Of The Midwifery Workforce In Massachusetts, Christa M. Kelleher, Dorothy Brewin

Publications from the Center for Women in Politics and Public Policy

This profile of the Commonwealth’s midwifery workforce provides state-level data on the demographic characteristics, employment context, and practice scope of midwives. It also offers a snapshot of populations served by mid-wives and public policy issues that affect midwives and midwifery care in Massachusetts. The report is based on a survey administered to midwives living and/or working in the state supplemented by in-depth interviews with five midwives, one obstetrician, and one state public health official. This report uniquely analyzes data collected from both certified nurse-midwives (CNMs) and directentry midwives (DEMs), including certified professional midwives (CPMs); this summary distinguishes between these two …

Women’S Health Disparities And Midwifery Care, Adeola Oni-Orisan, Dorothy Hiersteiner, Althea Swett

Publications from the Center for Women in Politics and Public Policy

This fact sheet was developed for the roundtables project “Midwifery Care in New England: Addressing the Needs of Underserved and Diverse Communities of Women.” Sponsored by the U.S. Department of Health and Human Services (HHS) Office on Women’s Health (Region I), this initiative addresses the challenges and opportunities related to the provision of midwifery care to underserved and vulnerable populations of women. The project aims to increase our understanding of regional midwifery workforce needs in the context of ensuring that all women living in New England have access to timely, affordable, and high-quality health care.

The September 2010 roundtables were …

Women’S Health Disparities And Midwifery Care: Spotlight On Connecticut, Dorothy Hiersteiner, Kaye Inandan

Publications from the Center for Women in Politics and Public Policy

Although Connecticut’s Medicaid programs, Husky A and B, are essential providers of coverage for maternity care, there are still major racial and ethnic disparities in access to, use of, and quality of prenatal care in Connecticut. The cesarean birth rate in the state is almost 9% higher than the US average. African American/black and Hispanic mothers experience comparatively high rates of low birth weight births. Furthermore, Connecticut is home to a substantial rural population which experiences unique challenges to accessing adequate health care. While 75% of the Connecticut population is non-Hispanic white, 9% is African American/black, 12% is Hispanic and …

Women’S Health Disparities And Midwifery Care: Spotlight On Maine, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

With a large percentage of its population living in rural areas, Maine faces obstacles to providing adequate prenatal and maternity care to many women. The vast majority (96.2%) of Maine residents are non-Hispanic white, 1.2% are African American/black, 1.4% are Hispanic and 1.2% have other racial/ethnic backgrounds.

Women’S Health Disparities And Midwifery Care: Spotlight On Massachusetts, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

As a result of Massachusetts’ 2006 health insurance coverage law, there has been a significant decrease in the uninsurance rate for women of color. Access to and use of health care for all women in the Commonwealth has also increased. Despite these coverage and access gains, major racial/ethnic disparities in health conditions and outcomes still exist among women, especially in the use and quality of prenatal care, the occurrence of preterm and low birth weight births, and infant mortality rates. The proportion of Massachusetts births that were cesarean deliveries in 2007 was 8% higher than the national rate. Compared to …

Women’S Health Disparities And Midwifery Care: Spotlight On New Hampshire, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

New Hampshire faces significant obstacles to serving the nearly 6% of the population living in medically underserved areas. In addition, many residents of New Hampshire are uninsured, limiting their access to vital medical care. According to 2007-8 data, the racial/ethnic breakdown of New Hampshire residents is: 1% African American/black, 2% Hispanic, 94% non-Hispanic white and 3% Other. In 2005, 5.9% of the total New Hampshire population was foreign born.1 Since 1996, New Hampshire has seen increases in low birth weight births, cesarean births2, and infant mortality with racial/ethnic disparities reflected in most maternal and infant indicators.

Women’S Health Disparities And Midwifery Care: Spotlight On Vermont, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

In Vermont, racial and ethnic dispariti es in low birth weight and preterm birth rates exist alongside racial and ethnic disparities in health insurance coverage and use of preventative care. As of 2005, the percentage of racial and ethnic minorities in Vermont was approximately 3.3%, compared to 25% for the nation as a whole. In 2005, 3.4% of the Vermont population was foreign born.

Women’S Health Disparities And Midwifery Care: Spotlight On Rhode Island, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

Rhode Islanders face unique health disparities based on race, ethnicity and location. Just over six percent (6.3%) of the Rhode Island population is living in Primary Care Health Professional Shortage Areas (HPSAs), according to 2008 data. Native American and African American/black communities face particular health disparities, specifically in the areas of reproductive and infant health. In 2008, 79% of the Rhode Island population was non-Hispanic white, while 5% was African-American/black, 11% was Hispanic and 5% had other racial/ethnic backgrounds. In 2005, 12.4% of the total Rhode Island population was foreign born.