Medicine and Health Sciences Commons^™

Impact Of The Maternity Care Changes Of The Covid-19 Pandemic On Pregnant Women And Their Birth Partners: An Integrative Literature Review, Rebekah Kemp

Master of Science in Nursing Final Projects

Introduction: In March 2020, the novel coronavirus originating out of Wuhan in China and spreading rapidly worldwide, became known as the COVID-19 pandemic. Patients with pre-existing conditions, such as the elderly and pregnant women, are among those most vulnerable to severe infection due to COVID-19. Increased pulmonary expansion in the respiratory tract make pregnant women more susceptible to viral respiratory infections and exacerbation of illnesses like COVID-19. Another major concern correlated with the pandemic and pregnancy is its effect on pregnant women’s mental health. Unique physiological and psychological changes place pregnant women at an increased risk for experiencing mental health …

Decreasing Black Maternal Mortality Rate, Gabriella J. Bermeo, Kate Bragg, Jessica Duranko, Susannah Gaines

Non-Thesis Student Work

Abstract

The drastic difference in Black maternal mortality rates (MMR) compared to White MMR has begged the question: For pregnant Black women, how does access to quality prenatal care and screenings for common pregnancy complications, such as pregnancy induced hypertension (PIH), affect the maternal mortality rate compared to pregnant Black women of childbearing age that do not receive quality prenatal care and screenings? Studies have shown the Black MMR to be 3.55 times that of the White MMR, with three in five maternal deaths being preventable. A correlation exists between poor use of prenatal care services and adverse maternal outcomes. …

Adherence To Screening And Management Guidelines Of Maternal Group B Streptococcus Colonization In Pregnancy, Sabine Pangerl, Deborah Sundin, Sadie Geraghty

Research outputs 2022 to 2026

Aims: To investigate Group B Streptococcus (GBS) colonization in pregnancy; adherence to antenatal GBS screening and adherence to the intrapartum antibiotics protocol within two models of care (midwifery and non-midwifery led). Design: This retrospective quantitative study has employed a descriptive design using administrative health data. Methods: Data from five maternity hospitals in metropolitan and regional Western Australia that included 22,417 pregnant women who gave birth between 2015 and 2019 were examined, applying descriptive statistics using secondary data analysis. Results: The study revealed an overall GBS colonization rate of 21.7% with similar rates in the different cohorts. A lower adherence to …

The Global Network Socioeconomic Status Index As A Predictor Of Stillbirths, Perinatal Mortality, And Neonatal Mortality In Rural Communities In Low And Lower Middle Income Country Sites Of The Global Network For Women's And Children's Health Research, Archana B. Patel, Carla M. Bann, Cherryl S. Kolhe, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Lester Figueroa, Nancy F. Krebs, Fabian Esamai, Sarah Saleem

Community Health Sciences

Background: Globally, socioeconomic status (SES) is an important health determinant across a range of health conditions and diseases. However, measuring SES within low- and middle-income countries (LMICs) can be particularly challenging given the variation and diversity of LMIC populations.
Objective: The current study investigates whether maternal SES as assessed by the newly developed Global Network-SES Index is associated with pregnancy outcomes (stillbirths, perinatal mortality, and neonatal mortality) in six LMICs: Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan, and Zambia.
Methods: The analysis included data from 87,923 women enrolled in the Maternal and Newborn Health Registry of the NICHD-funded …

The Eat Sleep Console Approach: An Evaluation Of Impact, Outcomes And Continuation Of Care, Stefanie Disilvio

Doctor of Nursing Practice (DNP) Manuscripts

Neonatal Opioid Withdrawal Syndrome (NOWS), a subgroup of Neonatal Abstinence Syndrome (NAS), is a constellation of postnatal symptoms that occurs due to the abrupt cessation of intrauterine opioid exposure. Historically, these infants have been evaluated and treated by the Finnegan Neonatal Abstinence Scoring Tool (FNAST) (Appendix A). Recent evidence supports the use of the Eat Sleep Console Approach (ESC) (Appendix B) as an alternative to the FNAST. The ESC model focuses on the comfort and care of these infants by maximizing nonpharmacologic methods and increasing family involvement in the treatment of their infant. The purpose of this project was to …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Development Of A Project To Improve Prenatal Education At A Rural Medically Assisted Treatment Center Focused On Neonatal Abstinence Syndrome And Parenting Skills., Tracey Brink

Doctor of Nursing Practice Papers

Abstract

Background: Many women who suffer from substance use disorder syndrome (SUDS) have low self-esteem and can be labeled as “unfit parents” which can impede infant bonding and maternal sobriety. Parent and self-efficacy are associated with improved maternal-infant attachment and sobriety (Adams, et.al. 2021). The earlier prenatal education is implemented, the more empowered the mothers will feel to be able to help their infants and themselves.

Setting: A medically assisted treatment center (MAT) for pregnant women who presents with SUDS. The six-bed inpatient facility is in a rural county in central Kentucky.

Purpose: To create an educational program about parent …

Understanding Perinatal Patient’S Health Preferences And Patient-Provider Relationships To Prevent Congenital Syphilis In California And Louisiana, Jennifer A. Wagman, Eunhee Park, Gloria P. Giarratano, Pierre M. Buekens, Emily W. Harville

School of Nursing Faculty Publications

Background: Congenital syphilis (CS) has reemerged as a global maternal and child health crisis. Kern County, California and East Baton Rouge Parish, Louisiana are among the highest CS morbidity regions in the United States. We previously reported on social-ecological and structural barriers to prenatal care and maternal syphilis testing and treatment in these two regions. The aim of this study was to examine perinatal patient’s health preferences and perceptions of patient-provider relationships in the prenatal care clinic setting. Methods: Between May 2018 and January 2019 we conducted 20 in-depth qualitative interviews with prenatal providers and 8 focus group discussions with …

Implicit Bias Training For Perinatal Nursing, Racheal Lakine-Harden

Dissertations

Problem: Maternal and fetal morbidity and mortality is a rising health care crisis in the United States. Black women are disproportionately affected. Clinician implicit bias and medical racism have been named as factors in this crisis. Recommendations to address this public health peril include; educating and raising awareness among front-line perinatal nursing staff on implicit bias and its consequences for Black women. The purpose of this project is to evaluate the impact of implicit bias training on nurses’ awareness of implicit bias, attitudes, and beliefs about disparities, and the likelihood to engage in behaviors to reduce or address racial bias …

Implementation Of Quantitative Blood Loss Tool To Detect Postpartum Hemorrhage After Vaginal Delivery, Rachael Williams

Dissertations

Problem Maternal deaths and comorbidities related to postpartum hemorrhage (PPH) continue to be high despite being quite preventable. The delay in recognition and treatment of PPH due to the use of imprecise estimated blood loss (EBL) instead of precise measurement using quantitative blood loss (QBL) attributes to this issue.

Methods For this quality improvement (QI) project, a descriptive, observational design was used to gather quantitative data regarding QBL implementation instead of EBL as well as the number of PPH’s identified. A pilot cohort of staff nurses participated by documenting QBL two hours after each delivery. The nurses were given an …

Community Health Worker Program - Substance Use Disorder In Pregnancy, Alicia Claire Kletter Dnp

Doctor of Nursing Practice (DNP) Projects

Background Substance use disorder (SUD) in pregnancy is a concern for mother, baby and community. Healthcare policies are increasingly calling for diversification of the workforce to meet healthcare needs. Community health workers (CHWs) are understood from the literature to be effective at bridging the gap between patient and healthcare provider, especially for vulnerable populations. Local Problem California’s Central Valley is majority Latinx and faces challenges from poverty, lack of medical resources, unemployment and SUD at rates which are higher than other communities. Combine SUD with pregnancy and the need for robust social connections, psychological support, and physical healthcare become even …

Intimate Partner Violence Disclosure And Associated Factors Among Pregnant Women Attending A City Hospital In South-Western Uganda: A Cross-Sectional Study, Eve Katushabe, John Baptist Asiimwe, Vincent Batwala

School of Nursing & Midwifery, East Africa

Background: Intimate partner violence (IPV) during pregnancy is a public health problem in Uganda that negatively impacts maternal and newborn health outcomes. However, IPVdisclosure and associated factors among pregnant women have remained poorly documented in southwestern Uganda. Therefore, this study determined IPV disclosure and associated factors among pregnant women attending a large City hospital.

Methods: In a cross-sectional design, 283 women attending Mbarara City Hospital Antenatal care (ANC) clinic were consecutively recruited into the study. Data was collected using a semi-structured questionnaire. This was administered by the research team and the exercise took over a month. That is; from 7th …

Pregnancy Education In Rural Areas, Kayla Tinsley

Doctor of Nursing Practice Scholarly Project

Educating of the pregnancy population before, during and after pregnancy can help to ensure a healthy pregnancy and in turn reduce maternal mortality. The purpose of this research project was to understand education provided in the clinic and hospital setting in a rural area by those who take care of and talk to pregnant women and their support persons. A descriptive research design was utilized to discover the important education topics that are discussed, and the routine tests that are done throughout the pregnancy, during labor and at delivery, and even ask how prepared they feel they are equipped to …

Utilizing Community Health Workers To Support Latinx Women With Substance Use Disorder During Pregnancy, Alicia Claire Kletter

DNP Qualifying Manuscripts

Community health workers in the Latinx community, sometimes called promotores de salud, are employed in a variety of medical settings to help increase access to health promoting services such as awareness, education, and screening. Given their deep understanding of the culture and community in which they work, community health workers in Latinx communities are increasingly included in the healthcare team for their cultural sensitivity and versatility with hard- to-reach populations, including the support of pregnant women and children. An integrative review of the literature seeks to understand if community health workers can improve outcomes for pregnant women who also suffer …

Perinatal Care In Western Uganda: Prevalence And Factors Associated With Appropriate Care Among Women Attending Three District Hospitals, Mercy Muwema, Dan K. Kaye, Grace Edwards, Gorrette Nalwadda, Joanita Nangendo, Jaffer Okiring, Wilson Mwanja, Elizabeth N. Ekong, Joan N. Kalyango, Joaniter I. Nankabirwa

School of Nursing & Midwifery, East Africa

Background: Perinatal mortality remains high globally and remains an important indicator of the quality of a health care system. To reduce this mortality, it is important to provide the recommended care during the perinatal period. We assessed the prevalence and factors associated with appropriate perinatal care (antenatal, intrapartum, and postpartum) in Bunyoro region, Uganda. Results from this study provide valuable information on the perinatal care services and highlight areas of improvement for better perinatal outcomes.

Methods: A cross sectional survey was conducted among postpartum mothers attending care at three district hospitals in Bunyoro. Following consent, a questionnaire was …

Benefits Of Exercise In Pregnant Women, Jenna Renee Barretto

Nursing | Senior Theses

Exercise is an important lifestyle habit to include in one's daily routine. Remaining physical activity during pregnancy is important. According to the CDC, pregnant women should, “Get at least 150 minutes of moderate-intensity aerobic activity during pregnancy and the postpartum period.” (Centers for Disease Control and Prevention, 2021). This paper will encompass a range of topics that highlight the benefits of exercise from a physiological as well as a mental health standpoint. Although more research needs to be conducted to solidify the benefits of exercise, the articles that were collected demonstrate how it can help mothers have a healthy pregnancy. …

Opioid Use Disorder And Infant Health Outcomes: A Literature Review, Shayln Russell-Fritch

Epsilon Sigma at-Large Research Conference

Introduction and background

Opioid use disorder (OUD) is an epidemic in the U.S. OUD affects both the mother’s and infant’s health. Substance-exposed infants suffer from decreased health outcomes relative to non-exposed infants.

Purpose

The aim is to identify infant health outcomes when pregnant women are prescribed medication-assisted treatment (MAT) for OUD. Among pregnant women with OUD in the U.S., is medication-assisted therapy as compared to no therapy associated with decreased negative infant health outcomes?

Literature review

Five studies on OUD and infant outcomes in the U.S. were reviewed. CINAHL and PubMed were searched using terms opioid use disorder, pregnancy, and …

Comparing An Evidence-Based Screening Tool To Standard Substance Abuse Screening Questions In Identifying Pregnant Women At Risk For Substance Abuse, Nicole Y. Romero

Doctor of Nursing Practice Scholarly Projects

The purpose of the study project was to compare a nonspecific substance screening questionnaire with a well validated, evidence-based substance screening tool designed specifically for the pregnant population Evidence has shown use of an evidence-based screening tool improves maternal and fetal outcomes and reduces the risk of missed cases, stereotyping, and stigma. This study project utilized the social learning theory model, which defines human behavior as a reciprocal, continuous interaction among cognitive, behavioral, and environmental determinants. A pilot observational study project was conducted within a focal organization in a specified women’s health clinic over a 12-week period comparing their currently …

Placental Lesions And Differential Expression Of Pro-And Anti-Angiogenic Growth Mediators And Oxidative Dna Damage Marker In Placentae Of Ghanaian Suboptimal And Optimal Health Status Pregnant Women Who Later Developed Preeclampsia, Enoch Odame Anto, David Antony Coall, Emmanuel Akomanin Asiamah, Osei Owusu Afriyie, Otchere Addai-Mensah, Yaw Amo Wiafe, W. K. B. A. Owiredu, Christian Obirikorang, Max Efui Annani-Akollor, Nicholas Akinwale Titiloye, Eric Adua, Emmanuel Acheampong, Evans Asamoah Adu, Stephen Opoku, Agartha Odame Anto, Augustine Tawiah, Youxin Wang, Wei Wang

Research outputs 2022 to 2026

Background Angiogenic growth mediators (AGMs) and oxidative stress (OS) both play essential roles in normal placental vascular development and as such, placental alterations in these factors contribute to pre-eclampsia (PE). Suboptimal health status (SHS), an intermediate between health and disease, has been associated with imbalanced AGMs and OS biomarkers. Thus, SHS pregnant women may be at increased risk of developing PE and may present abnormal placental alteration and expression of AGMs and OS compared to optimal health status (OHS) pregnant women. We examined the histopathological morphology, immunohistochemical expression of AGMs antibodies and oxidative DNA damage marker in the placentae of …

Maternal-Fetal Attachment And Its Relationship To Quality Of Life In Pregnant Women With Diabetes, Cheryl Ann Angel

Dissertations

Background: Maternal-fetal attachment (MFA) is the bond between a mother and her unborn child during pregnancy. Pregnant women with diabetes are considered high-risk and their numbers are expected to increase as levels of obesity rise and women wait longer to have children. This researcher has observed health care providers instructing pregnant women with diabetes about diabetes self-management (DSM) activities such as “dietary management” and encouraging the women to make those changes for their baby. However, some women remained unable to successfully engage in DSM behaviors despite having exhibited signs of MFA, e.g., expressing “thoughts of the fetus” to health care …

Online Support For Families Affected By Opioid Use Disorder, Sharonda Hill

Doctor of Nursing Practice Projects

Families who care for children with neonatal abstinence syndrome (NAS) face many challenges and may be lacking support. The purpose of this project was to provide evidence-based information to families caring for NAS children through an established online support group, To the Moon and Back. Nola Pender’s Health Promotion Model was the theoretical model used to guide this project. An intervention to deliver support and information was implemented through three sessions. During these sessions participants were educated on evidenced-based tools to help their children with behavioral self- regulation and communication with providers. Data was collected through pre and post assessments …

Evaluating Providers’ Knowledge, Attitudes And Intentions Toward Assessing Pregnancy Desires In Women Of Childbearing Age, Sydney Hahn

DNP Projects

Abstract

Background: Unintended pregnancies account for over half of all pregnancies in the United States. Unintended pregnancies can lead to abortion, socioeconomic difficulties, medical complications, psychological issues, and political issues. Unintended pregnancies are potentially harmful to both the mother and the baby. Healthy People 2030 listed reducing the number of unintended pregnancies as one of their family planning objectives.

Purpose: The purpose of this DNP project was to evaluate providers’ knowledge, attitudes, and intentions toward assessing pregnancy desires in women of childbearing age. Methods: The study was a one-group pre/post intervention design. The data was gathered via a convivence sample …