Medicine and Health Sciences Commons^™

Preparatory Program For Women During Pregnancy/Postpartum And Transitioning Back To Work Or School, Bria Runnels, Rebecca King

Spring 2024 Virtual OTD Capstone Symposium

Despite the importance of maternal health during the prenatal, postnatal, and parenting stages, there is a lack of research on the role of occupational therapists (OTs) in addressing the occupational challenges faced by women during this transitional phase. This dissertation aims to develop a program that raises awareness of the role of occupational therapy in maternal health and promotes occupational therapists as part of an interdisciplinary team within the scope of maternal health care. By adapting co-occupation for mothers, occupational therapists can play an important role in individualizing occupations for enhanced transitioning and overall quality of life. The study highlights …

A Call To Action: Person-Centered Care Aligned With Reproductive Justice For Incarcerated Pregnant People With Substance Use Disorder, Essence Hairston, Aunchalee El Palmquist, Andrea K. Knittel, Kevin Mensah-Biney, Crystal M. Hayes, Amelia Mack, Hendrée E. Jones

School of Social Work Faculty Publications

Although research has proven that jails and prisons are ineffective in preventing or reducing substance use among pregnant people, the USA continues to rely heavily on the criminal legal system as its intervention. Pregnant people with an opioid use disorder are more likely to experience incarceration than pregnant people without an opioid use disorder. In some states, pregnant people are transported from jail to prison through the process of safekeeping in order to receive physical or mental health care that the jail does not provide, despite conviction status. When pregnant and postpartum safekeepers with an opioid use disorder experience incarceration, …

Association Of Prenatal Depression With New Cardiovascular Disease Within 24 Months Postpartum., Christina M Ackerman-Banks, Heather S Lipkind, Kristin Palmsten, Mariah Pfeiffer Rn, Mph, Catherine Gelsinger Rn, Katherine Ahrens Mph, Phd

Population Health

No abstract provided.

Relationships Among Pregnancy, Substance Use, Social Determinants Of Health And Assessment, Referral, And Utilization Of Treatment: A Secondary Analysis Of Nsduh Data, Heather Lynn Coddington

Graduate Theses, Dissertations, and Problem Reports

ABSTRACT

Relationships Among Pregnancy, Substance Use, Social Determinants of Health and Assessment, Referral, and Utilization of Treatment: A Secondary Analysis of NSDUH Data

Heather Coddington

Background: Assessment and referral for substance use disorder during pregnancy is crucial to improving outcomes for mothers and newborns during the antepartum and postpartum period. Healthcare professionals are essential during the entirety of the pregnancy during each trimester to provide effective communication when assessing for substance use early and throughout each trimester of pregnancy. The purpose of this study was to determine if there was a relationship between assessment, referral, and utilization of treatment …

Cerebral Venous Thrombosis In Pregnancy : A Case Report, Dr Sumuk M S Sr, Dr Anupama Marnal B A Sr, Dr Mamatha S Professor And Head Of The Department, Poornima M Associate Professor

Digital Journal of Clinical Medicine

Cerebral venous thrombosis (CVT) is a rare complication encountered in pregnancy. Symptoms of CVT include headache, limb paresis, seizures , disturbed consciousness , visual disturbances. We present our 25 years old pregnant patient who presented with unsteadiness of gait , weakness and numbness of all four limbs, vomiting headache , giddiness due to which it was difficult for her to perform her daily activities. After the differential diagnostic examinations, we recognised cerebral venous thrombosis. After anti-coagulant treatment , the symptoms resolved. We would like to convey that such symptoms in pregnant women we should always think of CVT.

Access To Prenatal Care And Mental Health In Pregnant Women During Covid-19: A Systematic Review, Chloe Feezel, Marin Kahoun, Kaija Kunttu

Williams Honors College, Honors Research Projects

COVID-19 affected the world in many ways. Pregnant women were greatly impacted by a change in their access to prenatal care, from in-person care to telehealth methods, and social support being limited by social isolation. Compared with prevalence of anxiety and depression in pregnant women pre-COVID-19, pregnant women during COVID-19 reported higher levels of anxiety and depression symptoms due to the stress of circumstantial changes. The purpose of this systematic review is to review and critically appraise the evidence about access to prenatal care and mental health in pregnant women during the COVID-19 pandemic. The following PICOT formatted question will …

Time-Out For Well-Being: A Mixed Methods Evaluation Of Attitudes And Likelihood To Engage In Different Types Of Online Emotional Well-Being Programmes In The Perinatal Period, Jacqueline A. Davis, Amy L. Finlay-Jones, Natasha Bear, Susan L. Prescott, Desiree T. Silva, Jeneva L. Ohan

Research outputs 2022 to 2026

Background: Positive maternal mental health during the perinatal period contributes to general well-being and positive emotional bonds with the child, encouraging an optimal developmental trajectory. Online interventions to enhance maternal well-being and develop coping skills, such as meditation-based interventions, can be a low-cost way to improve mother and child outcomes. However, this depends on end-user engagement. To date, there is limited evidence about women’s willingness to engage and preferences for online programmes. Objectives: This study explored pregnant women’s attitudes towards and likelihood to undertake minimal online well-being training programmes (mindfulness, self-compassion, or general relaxation), engagement barriers and enablers, and programme …

A Reasoned Action Approach To Pregnant Smokers’ Intention To Switch To E-Cigarettes: Does Educational Attainment Influence Theory Application?, Eric D. Schisler, Paul Branscum, Lydia Buckley, Rebecca Mccann, Emily Richardson, Abbie Luzius, Page D. Dobbs

Health Behavior Research

Social determinant research has noted educational attainment to be among the strongest influencing factors for tobacco use during pregnancy. Concurrently, maternal e-cigarette use has doubled in recent years, with some citing it as a safer alternative to combustible cigarettes. To better understand the decision-making practices of pregnant persons based on educational attainment, the reasoned action approach (RAA) was used to evaluate factors that may be associated with the intention to switch from cigarettes to e-cigarettes. A sample of U.S. pregnant persons (n = 267) between 18-40 years of age, who smoked at least one cigarette in the past 30 …

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 …

The Role Of Occupational Therapy In Unplanned Motherhood, Cierra Stewart, Karen Park

Summer 2022 Virtual OTD Capstone Symposium

For women experiencing unplanned pregnancy, the thought of becoming a mother can increase stress and affect the mother’s mental health. Maternal adjustment can include depression, anxiety, worry, stress, and happiness (Mihelic et al., 2016). The impact that this new role has effects daily demands, leading to a disruption in occupational engagement, environmental changes, and overall less time for the mother (Horne et al., 2005). There is currently not a well-defined role for occupational therapy within pregnancy medical clinics to support women experiencing unplanned pregnancy and their transition to motherhood. The purpose of this project is to provide care to new …

Opioid Usage In Pregnant Women, Sheron Mehak, Karen Krieg

Rowan-Virtua Research Day

Women have a heightened sense of health during pregnancy, especially first pregnancies. They often pay closer attention to taking medications (both over the counter and prescribed). Some discontinue smoking and choose healthier diet choices. The question or hypothesis of this research is to examine if this heightened sense of health during pregnancy has any effect on the choice to use recreational drugs during pregnancy.

Development And Management Of Depression During And After Pregnancy, Alexa Bouts, Maria Patnella, Jourdan Ujlaki, Emily Wells, Hannah Lamb, Michelle Musser

Pharmacy and Wellness Review

Depression during pregnancy is common, whether it is a new onset of the disease or emerging symptoms of the already existent disease. Due to patient and prescriber concerns with antidepressant use during pregnancy, approximately three-quarters of those diagnosed with depression remain untreated. Furthermore, up to half of pregnant women with depression remain undiagnosed due to lack of recognition. As a result, both mother and fetus are at risk for negative health outcomes including substance abuse, functional impairment, increased risk of postnatal depression and poor pregnancy outcomes. Benefits must be balanced against the risks when considering pharmacologic treatment options to manage …

Treating A Public Health Crisis For Rural Moms – A Comparative Analysis Of Four Rural States Addressing Maternal Opioid Misuse With Medicaid Innovation Models, Jason Semprini

Online Journal of Rural Research & Policy

Objective As we enter the third decade of the opioid crisis, opioid misuse continues its devastating toll on young women, specifically mothers on Medicaid in rural areas. The evolving Medicaid policy landscape has led to coverage and benefit expansion, yet gaps remain for pregnant women with opioid misuse. Further, the myriad of state specific policy decisions related to maternal eligibility and substance abuse benefits have created a seemingly disjoint policy arena for tackling a specific subgroup’s unmet needs. This policy scan aims to investigate the newly implemented 1115 demonstration model for Maternal Opioid Misuse by comparing the approaches of four …

Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd

Electronic Theses and Dissertations

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical …

Pregnancy And Substance Use, Elise Withers, Krista Thompson, Emily Hamilton, Maren Wright Voss

All Current Publications

The use of alcohol and other harmful substances, such as cocaine, opioids, and marijuana during pregnancy has increased over the last decades (Sebastiani et al., 2018). Using these substances can be very harmful to the unborn baby and mother (Viteri et al., 2015). This fact sheet covers (1) the consequences of substance use and (2) the current recommendations for substance use during pregnancy.

Mindfulness-Based Interventions For Prenatal Stress, Anxiety, And Depression, Fiona Kate Rice

Expressive Therapies Capstone Theses

Pregnant people in the United States (US) face myriad barriers to resource accessibility when seeking support, including financial gatekeeping, discrimination, and cis-gendering of the process. Commodification of prenatal support is exhaustive and contributes to a growing exclusivity of traditionally accessible interventions designed to reduce stress, anxiety, and depression, and to promote positive fetal outcomes and parent-child bond. Mindfulness-based interventions are particularly appropriate for reducing stress, anxiety, and depression in pregnancy. Mindfulness-based interventions are intersectional, accessible means of pregnancy and childbirth support with evidence-based outcomes of positive birth experiences and results. Mindfulness is defined as nonjudgmental awareness of the present moment. …

Caesarean Section Versus Vaginal Birth In The Perception Of Woman Who Gave Birth By Both Methods, Octavian Gabriel Olaru, Anca Daniela Stanescu, Cristina Raduta, Liana Ples, Adriana Vasilache, Nicolae Bacalbasa, Andrei Vasilache, Oana Denisa Balalau

Journal of Mind and Medical Sciences

The increase in the number of births by Caesarean section is a phenomenon whose global expansion is generated by numerous factors and especially by the contemporary perceptions of women regarding childbirth meeting the interests of the professionals in the field. However, the opinion of many women towards the benefits of Caesarean delivery is often not based on the experience or information from reliable sources. This study aimed at sharing the experience of women who gave birth both vaginally and by Caesarean section, focusing on their perception of these events. The study included 26 women and the conclusion of the vast …

Maternal Stress And Breastfeeding Intention In Pregnant Women With Opioid Use Disorder, Yassamin Jamshidian, Vanessa Short, Phd, Mph, Diane J. Abatemarco

Phase 1

Introduction: Breastfeeding rates are low among women in treatment for opioid use disorder (OUD). Information on determinants of breastfeeding intention can help inform the design of breastfeeding promotion interventions for this population. The objective of the study was to examine associations between maternal characteristics, including stress, and breastfeeding intention among pregnant women in treatment for OUD.

Methods: Fifty-six pregnant women who were receiving treatment for OUD at Thomas Jefferson University’s Maternal Addiction Treatment Education & Research (MATER) program completed a survey, which included questions on demographics, psychosocial characteristics, breastfeeding history, and breastfeeding intention. Maternal stress was measured using the Perceived …

Beyond The Bump: Reconceiving The Philosophy Of Pregnancy, Hazel T. Bianas, Leni Dlr Garcia, Ninotchka Mumtaj B. Albano

Philosophy Department Faculty Publications

French philosopher Hélène Cixous (1976) stressed the importance of feminine writing. She believes that women should take part in sharing their experiences from their own novel points-of-view. We discuss that while pregnancy is an experience unique to women; it has been misappropriated by patriarchal structures throughout the years. The pregnancy bump; which is more than just evidence of the uterus stretching to accommodate the fetus; is a symbol of a woman's triumphs and struggles all throughout conception; pregnancy and childbirth. We show that women have already gone beyond the bump and challenged existing patriarchal systems through different means; as Cixous …

Mothers Know Best: Guidance For Healthcare Providers On Early Identification Of Perinatal Mental Health Disorders, Klarissa I. Garcia Orellana

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Introduction: The perinatal period has been associated with an increased risk of developing psychiatric disorders among women. Perinatal mental health disorders (PMHD) are highly prevalent, yet highly underrecognized and untreated. The involvement of medical providers, especially obstetrics/gynecology and pediatric providers, in the early identification of PMHD is critical to ensure women with PMHD receive appropriate supports. However, providers lack the education, training, and ability to identify and screen for PMHD as well as the knowledge of appropriate referrals. Objective: This study explores the existing issues with healthcare providers’ early identification practices of PMHD from the perspective of ten mothers and …

Behavioral And Enhanced Perinatal Intervention (B-Epic): A Randomized Trial Targeting Tobacco Use Among Opioid Dependent Pregnant Women, Amanda Fallin-Bennett, Michelle R. Lofwall, Teresa M. Waters, Paul Nuzzo, Janine Barnett, Letitia Ducas, Andrea Mccubbin, Niraj R. Chavan, Lisa Blair, Kristin Ashford

Nursing Faculty Publications

Background

Opioid use during pregnancy is a significant public health issue. The standard of care for treating opioid use disorder during pregnancy includes medications for opioid disorder (MOUD). However, tobacco use often goes unaddressed among pregnant women on MOUD. In 2018, our team received a National Institute on Drug Abuse (NIDA) funded R34 to conduct a three year-randomized trial to test the feasibility of a novel tobacco intervention for pregnant women receiving MOUD.

Aims

The aims of this study are: (1) to determine the impact of the B-EPIC intervention on maternal tobacco use and stage of change; (2) to determine …

A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso

Electronic Theses and Dissertations

Legal induced abortion is a safe option for terminating a pregnancy for women of reproductive age in the United States (U.S.), though access has varied since the Roe v. Wade and Doe v. Bolton cases in 1973. Information is lacking on women’s attitudes toward and perceptions of abortion as well as on related constructs such as pregnancy attitudes and contraceptive use. Exploring these constructs is important in that it can provide much needed context to women’s reproductive life planning. This research aimed to explore perceptions of abortion access and safety and examine the potential associations between attitudes toward abortion access …

Barriers And Facilitators To Opioid Use Treatment And Recovery Services During Pregnancy, Loralie Woods

Dissertations

Purpose: To identify barriers and facilitators to opioid use treatment and recovery services among pregnant and nonpregnant women who misuse opioids.

Background: Over 130 Americans die daily after overdosing on opioids. Women have not been immune from opioid use disorders (OUDs), with a 4-fold increase from 1999-2010. The prevalence of opioid use among pregnant women increased from 1.5 per 1,000 hospital deliveries to 6.5. Although the annual National Surveys on Drug Use and Health (NSDUH) has provided information on risk factors for OUD related to socioeconomic and demographic factors, no studies using this data have identified barriers to opioid use …

An Examination Of The Association Between State Medicaid Perinatal Services And Birth Outcomes, Joy Morgan Myers

Honors Theses

This thesis investigated the connection between socioeconomic status, healthcare coverage, and birth outcomes. The research question that was posed specifically looked at twenty perinatal services that states covered under Medicaid to varying degrees to see their association, if any, with premature birth rates and low birthweight rates. State-level and Mississippi county-level data were compiled regarding preterm birth rates, low birthweight rates, presumptive eligibility adoption, and coverage of twenty different perinatal services. Using these data, the correlation between state Medicaid expansion status and birth outcomes was first calculated in order to determine if variation in birth outcomes was associated with expanded …

Polybrominated Diphenyl Ether (Pbde) And Poly- And Perfluoroalkyl Substance (Pfas) Exposures During Pregnancy And Maternal Depression, Ann M. Vuong, Kimberly Yolton, Joseph M. Braun, Andreas Sjodin, Antonia M. Calafat, Yingying Xu, Kim N. Dietrich, Bruce P. Lanphear, Aimin Chen

Environmental & Occupational Health Faculty Publications

Background: Experimental studies in rodents suggest that polybrominated diphenyl ethers (PBDEs) and poly- and perfluoroalkyl substances (PFAS) may contribute to depressive symptoms. Few studies have examined the impact of these chemicals on depression in adults. Objective: To examine the associations between serum PBDE and PFAS concentrations during pregnancy and repeated measures of depressive symptoms in women assessed from pregnancy to 8 years postpartum. Methods: This study was based on 377 women from the Health Outcomes and Measures of the Environment Study, a birth cohort in Cincinnati, OH (USA). PBDEs (BDE-28, -47, -99, -100, -153, and ∑PBDEs) and PFAS (perfluorooctanoate [PFOA], …

Consciousness Level Determination Of Red Meat Consumption Of Pregnant Women, Giresun/Turkey Province, Duygu Balpetek Külcü, Özge Cağcağ Yolcu

Journal of Mind and Medical Sciences

In this study, meat consumption and the nutritional status of pregnant women living in Giresun province of Turkey were investigated. The study was carried out at Giresun University, the Maternity and Pediatrics Training and Research Hospital between February-March 2019. The study group consisted of 218 pregnant women aged 18 to 49 years, who benefited from polyclinic services and agreed to participate in the survey. A questionnaire consisting of 12 questions was used, and the findings were evaluated using SPSS to generate descriptive statistics and t-tests or ANOVAs. The majority of participants stated that red meat is beneficial during pregnancy (71.1%) …

Medicaid Home Visitation And Maternal And Infant Care And Health: A Reassessment Of Program Effectiveness, Cristian Meghea, Zhiying You, Jennifer E. Raffo, Lee Anne Roman

Michigan Journal of Public Health

Introduction: The Maternal Infant Health Program, MIHP, is Michigan's largest home visiting program for Medicaid-eligible pregnant women and infants. Prior quasi-experimental propensity score matched MIHP evaluations were limited by the possibility of selection bias due to the limited available baseline characteristics. The purpose of this study was to assess the effectiveness of MIHP including previously unobserved baseline characteristics to mitigate the possibility of selection bias.

Methods: We analyzed health care and outcomes of mothers and their infants using linked administrative and screening data. All Medicaid pregnant women with a singleton birth in Michigan between 2009 and 2012 who were prenatally …

Prevalence Of Illicit Tobacco Use And Tobacco Tax Avoidance In Pregnancy, Brendan P. Mcdonnell, Robert Mccausland, Sheila Keogan, Luke Clancy, Carmen Regan

Articles

Background Smoking during pregnancy is associated with adverse maternal and fetal outcomes. Tobacco tax avoidance and tax evasion undermine the effectiveness of tobacco tax policies, resulting in cheaper prices for smokers and increased tobacco usage. Aims The purpose of this study was to explore the purchasing habits of pregnant smokers with regard to tobacco expenditure and
use of illicit tobacco. Methods Prospective cohort study. Face to face interviews were conducted with 90 attendees (age range 18–42 years; mean age
28 years) of a smoking cessation antenatal clinic in a large Irish tertiary level maternity hospital. Information regarding smoking habits, quantity …

Non-Pharmacological Interventions For Alcohol, Marijuana, And Opioid Use During Pregnancy: A Systematic Review, Hannah Safranek, Madeline Frausto, Amy King, Stoneking Madison

Williams Honors College, Honors Research Projects

The purpose of this review is to analyze evidence on prevalence of opioid, alcohol and marijuana use during pregnancy and answer the PICOT question: In pregnant women addicted to or using marijuana, opioids, and alcohol, how do non-pharmacological interventions, compared to standard care of pharmacological interventions alone, affect health outcomes in mothers and neonates between birth to hospital discharge? Diagnosis of substance use disorder is increasing and with it comes increased risk of complications to mother and neonate including neonatal abstinence syndrome (NAS), fetal alcohol syndrome (FAS) and other negative neonatal and maternal outcomes. Evidence was identified on the online …

Addressing Postpartum Smoking Relapse Among Low-Income Women: A Randomized Control Trial, Kristine Alaniz, Bruce Christiansen, Tingting Sullivan, Lisette Khalil, Michael C. Fiore

Journal of Patient-Centered Research and Reviews

Purpose: Smoking during pregnancy can have dire consequences for both the baby and mother. Low-income pregnant women smoke at particularly high rates. Among women who quit during pregnancy, postpartum relapse is high. This randomized control trial tested the effect of adding postpartum assistance to an existing smoking cessation program (First Breath) designed for low-income women.

Methods: Of 185 study participants, 94 women were randomly assigned to the standard First Breath program (control) and 91 to an enhanced program. First Breath consisted of evidence-based smoking cessation counseling provided at every prenatal visit. The enhanced program included all First Breath services plus …