Maternal, Child Health and Neonatal Nursing Commons^™

Internet Use And Decision-Making Processes Among Pregnant Women: A Cross-Sectional Study, Ayça Balmumcu, Endam Çetinkaya Ak, Sabriye Uçan Yamaç

Makara Journal of Health Research

Background: The coronavirus disease 2019 (COVID-19) pandemic restricted access to in-person health services, especially in rural areas. This increased reliance on the internet for health information and decision-making was particularly notable among pregnant women. This study aimed to investigate the role of internet use in decision-making among pregnant women.

Methods: This analytical, cross-sectional study examined 384 pregnant women living in a rural district of Turkey who attended family health centers for prenatal care. Data were collected using the Internet Decision-Making Scale in Pregnancy and a questionnaire assessing internet use patterns during the pandemic.

Results: Pregnant women demonstrated …

Integrating Matrescence Into Birth Worker Practice: A Practice Improvement Project, Kelsey B. Green

Doctor of Nursing Practice (DNP) Projects

Background: Perinatal mood and anxiety disorders (PMADs) affect 20–25% of mothers worldwide and are a leading cause of maternal complications. Stigma, fragmented care, and limited provider training leave families vulnerable, while birth workers offer trusted, continuous support.

Problem: Birth workers' maternal mental health (MMH) training is minimal and often excludes matrescence, the developmental transition to motherhood, limiting their ability to distinguish normal adjustment from clinical PMADs and delaying intervention.

Methods: A single-group, pre-/post-test design evaluated a matrescence-informed workshop at Roots Community Health's 2nd Annual Symposium. Anonymous surveys measured knowledge, attitudes, and confidence, analyzed with Mann–Whitney U, Wilcoxon signed-rank tests, and …

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

Community Perceptions Of A Hospital-Based Doula Program In Mobile, Alabama, Sarah Laney

Honors Theses

Background: The maternal mortality ratio in the United States is much higher than the mortality rate for women who live in other countries with similar Human Development Index scores. Black women are more likely to die than their white counterparts. Most of these deaths are preventable. Patients feel like they are being ignored, or that they are not being seen. Doula care is a possible solution to these problems.

Purpose: The purpose of this study was to assess patient understanding and perception of doulas as well as comparing desire for doulas to demographics and past experiences to search for relationships. …

Clinical Pathway For Rhogam Administration In The Emergency Department, Lauren Kyzar, Amy Bigham

Appalachian Student Healthcare Research Review

Background: Clinical pathways in emergency departments (ED) are designed to standardize patient care and reduce variability in clinical practice. In a rural hospital setting, the ED management of RhoGAM administration in pregnant patients with vaginal bleeding varied by provider with no standard of care achieved. This approach raised concerns about potential patient safety issues.

Methods: In response, the local emergency department medical director, in conjunction with local perinatal providers developed a clinical pathway to standardize care and optimize RhoGAM administration. The clinical pathway was implemented to the local ED providers over a three-month period. Retrospective chart review for Type and …

A Historical Analysis Of The Development Of Prenatal Care In The U. S., Kristen Montgomery Phd, Cnm, Aprn, Shelby Greene Bsn, Rn, Lauren Griffin Bsn, Rn, Destiny Lewis Bsn, Rn, Lauryn Lewis Bsn, Rn, Bryleigh Newberry Bsn, Rn, Brittany Scott Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: This paper examines the historical development of prenatal care in the United States, tracing its evolution from informal, home—based management to structured, evidence-based systems that are central to maternal and fetal health.

Aims: The specific aim of this project was to determine how prenatal care evolved in the United States.

Methods: A historical methods approach was used. Historical documents were reviewed using PubMed, CINAHL, and Google Scholar to find relevant resources. Relevant articles were reviewed by the research team and analyzed for components regarding the development of prenatal care. All members of the research team reviewed the articles and …

A Historical Analysis Of The Development Of Childbirth In The U. S., Kristen Montgomery, Kayleigh Berg Bsn, Rn, Emily Greer Bsn, Rn, Marsha Hedgecough Bsn, Rn, Emma Holden Bsn, Rn, Halle Ingle Bsn, Rn, Alexis Tolbert Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: The purpose of this project is understand the historical development of childbirth from early documentation of birth in the home to modern day obstetrics, where most deliveries occur in the hospital. Approximately 3.5 to 4 million births occur each year in the U. S.

Aims: The aim of this study is to understand the historical development of childbirth in the U.S. with a particular emphasis on maternal autonomy. Depending on the amount of materials available, the research may be limited to the Appalachian Region.

Methods: Using a historical method, materials were located that traced the trajectory of childbirth from …

Comparing Nurse-Led Holistic Pain Relief Strategies And Sole Pharmacological Use In Enhancing Maternal Satisfaction, Reducing Pain, And Lowering Obstetric Interventions During Childbirth, Jessica C. Moore

Nursing | Senior Theses

Background: Childbirth has become heavily reliant on pharmacological management and obstetric interventions such as epidural use, labor induction, and cesarean deliveries (C-sections) even among low-risk pregnancies. While necessary in some cases, excessive reliance on pharmacological interventions can negatively impact the experience of birthing as a whole. Non-pharmacological interventions (NPIs) such as breathing techniques, positioning, hydrotherapy, massage, aromatherapy and continuous support have shown to be effective in reducing pain and supporting physiologic labor. The gaps in education and lack of standard implementation result in inconsistent application in practice. Purpose: This research proposal aims to evaluate the effectiveness of nurse-led NPIs compared …

Socioeconomic Influences On Doula Access And Perceived Care Quality Among Black Women Experiencing Severe Maternal Morbidity, Deborah Esene

2026 Spring Honors Capstones Projects

Black women experience disproportionately high rates of maternal morbidity and mortality, making it essential to examine access to and the perceived impact of doula support. This study examines whether socioeconomic status influences access to and the perceived benefits of doula support among Black women who experienced severe maternal morbidity (SMM). Researchers surveyed Black women ages 18-49 who had a live birth within the past two years and experienced SMM. Participants were recruited and completed an online survey in late 2020. Key variables included income, education, doula use, and perceived quality of prenatal, intrapartum, and postpartum care. Among 188 participants, 12.2% …

The Knowledge, Experiences, And Attitudes Of Nurses Regarding Trauma-Informed Care For Sexually Abused Intrapartum Patients, Kayleigh Mcgraw

Honors Undergraduate Theses

Labor and delivery nurses care for women from diverse backgrounds who are preparing for a life-changing event, often marked by fear, excitement, sadness, and joy. However, 1 in 5 women in the United States have experienced rape or attempted rape, and for these survivors, labor can become re-traumatizing. Many report flashbacks, dissociation, and a sense of “being back in the rape” during childbirth. Research further links prior sexual assault to unplanned cesareans, traumatic births, and childbirth-related PTSD. Trauma-informed care (TIC) provides a framework to reduce these risks by encouraging providers to understand trauma, recognize signs of distress, and act to …

Evaluating The Effectiveness Of Nurse-Led Prenatal Education On Maternal Outcomes And Labor Satisfaction, Alexis Boris

Honors Undergraduate Theses

Prenatal education has been a long-time major component of maternal healthcare, which has been known to impact expectant mothers and their level of preparedness during the labor and birthing process. Nurses have historically been key educators in the maternity field, due to their accessibility, education, and holistic approach in the healthcare system. Despite their recognition as vital educators in this field and the importance of maternal prenatal education, maternal healthcare is still affected by many modern-day factors, such as access to healthcare and education, health disparities, and negative childbirth experiences. This integrative literature review aims to evaluate the overall effectiveness …

Yoga And Breathing Techniques For Fear Of Childbirth (Foc) And Quality Of Sleep Among Antenatal Women During Pregnancy – A Systematic Review Protocol, Anjana Sharma, Sonia R B D’Souza Dr., Shripad Hebbar Dr., Govardhan Reddy G Dr.

Manipal Journal of Nursing and Health Sciences

Abstract

Objectives: The objective of this study was to determine the effectiveness of Yoga and breathing techniques in decreasing Fear of Childbirth (FOC) and improving the quality of sleep among antenatal women. Introduction: Pregnancy, labor, and childbirth experiences for women are diverse. One of the issues faced by pregnant women is FOC, which can be stressful for mothers and their families. The global prevalence of FOC among women is 14%, while in India it is 17.7%. Fearful mothers may lack confidence in their ability to give birth, be swayed by unfavorable stories about the process, fear getting hurt during delivery, …

Climate Change Anxiety Related To Women’S Health Among Health Sciences Students, Derya Kaya Şenol, Semiha Aydın Özkan, Durdu Cennet Omuş

Makara Journal of Health Research

Background: Climate change impacts are unequally distributed globally, with children, women, pregnant women, the elderly, marginalized populations, and refugees bearing a disproportionate burden. This study aims to determine the levels of related anxiety among female students and to examine the relationship between the anxiety and their perceptions, knowledge levels, and health behaviors related to women’s health.

Methods: The study has a descriptive cross-sectional design. The study population included women students enrolled in the fall semester of the 2023–2024 academic year at the Faculty of Health Sciences of a university between October and December 2023. Personal Information Form and …

Improving Interdisciplinary Communication And Collaboration With The Standardization Of Doula Care Through An Informatics Tool, Shela Le

Master's Projects and Capstones

Objective: The 22-bed Labor and Delivery (L&D) unit lacks a standardized model to introduce doulas, clarify their scope of practice, or communicate the value of the services they provide. To address this gap, the team implemented a standardized doula awareness poster that included each doula’s name, photo, years of experience, and personal interests. Aim: The goal is to enhance visibility and promote integration of doula support to strengthen team collaboration and patient engagement. Methods: A pre- and post-implementation survey was distributed exclusively to the volunteer doulas. After the doula awareness poster was displayed for a month, a post-survey assessed these …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Code Crimson Ob: A Lifeline For Maternal Health, Colleen Cowie, Elizabeth Barrera, Leah Williams-Jones, Mercy R. Banaszak, Leonor Ruiz, Arvinder Singh

Nursing & Health Sciences Research Journal

Introduction: Postpartum hemorrhage (PH) accounts for 12% of maternal deaths in the U.S. and affects approximately 5% of obstetric individuals. Despite available treatments, delays in recognition and response can lead to severe complications or death. The purpose of this evidence-based practice project was to improve maternal outcomes by implementing Code Crimson OB, a specialized obstetric rapid response team (RRT) for managing maternal hemorrhage.

Methods: An unannounced maternal hemorrhage drill revealed critical delays in mobilizing appropriate personnel. In response, the RRT protocol was revised to include Code Crimson OB, ensuring rapid, coordinated intervention. Hospital-wide education was conducted, and the protocol officially …

Exploring Factors Informing The Choice Of Caesarean Sections Among Couples, And Healthcare Workers: A Case Of The Nairobi Hospital, Kenya, Mercy Mukubwa

MSc in Advanced Practice Midwifery

Background: A caesarean section (C/S) is a lifesaving procedure to reduce maternal and newborn morbidity and mortality. It is associated with more risks compared to a vaginal birth. The rates of C/S have been on an upward trend globally and are expected to continue to rise further. C/S predisposes neonates to poor outcomes, some of which could be life-threatening compared to vaginal birth. Similarly, C/S mothers are at greater risk for serious complications.

Objective: The primary objective of this study was to investigate the factors influencing the decision to undergo a caesarean section among couples and healthcare workers …

Economic Factors Influencing Utilization Of World Health Organisation-Recommended Anc Visits Among Women In Jordan: An Analysis Of Jordan Population And Family Health Survey 2023, Lilian Nuwabaine, Joseph Kawuki, John Baptist Asiimwe, Benjamin Betunga, Mathius Amperiize, Angella Namulema, Imelda Namatovu, Shamim Nabidda, Patience Annet Nakalega, Quraish Sserwanja

School of Nursing & Midwifery, East Africa

Background: Antenatal care (ANC) is crucial for reducing maternal and neonatal mortality by identifying and managing complications early during pregnancy. In 2016, the World Health Organization (WHO) updated its guidelines, recommending a minimum of eight ANC visits to improve maternal health outcomes. Despite Jordan’s efforts to enhance maternal healthcare, disparities in ANC utilization persist, particularly among vulnerable populations such as refugees. This study aimed to assess the economic factors influencing utilization of the WHO-recommended eight ANC visits among women in Jordan.

Methods: The study used data from the 2023 Jordan Population and Family Health Survey (JPFHS). A two-stage sampling technique …

Ready Or Not? An Autoethnography Of A Midwife’S Preparedness And Readiness Journey, Kristen Graham

The Qualitative Report

This emotive autoethnography explores my experiences working as an Australian midwife in low- and middle-income countries, which led to a Doctor of Philosophy journey exploring primary care midwives' preparedness and readiness in rural and remote communities in this context. I use the midwifery tradition of storytelling to explore personal experiences of preparedness and readiness as a way towards researcher reflexivity, understanding and meaning. Emerging themes of preparation for practice, resource limitations, heartache, and emotional resilience offer insights to inform midwifery education, research, and practice.

Association Of Covid-19 Status With Maternal And Neonatal Outcomes Among Pregnant Women At Mombasa County Referral Hospital, Kenya, Salome Mghoi Rajab

MSc in Advanced Practice Midwifery

Background: COVID-19 pandemic has raised global concern regarding maternal and neonatal health owing to physiological and immunological changes that may heighten disease severity. Despite the global evidence linking COVID-19 infection with unfavorable pregnancy outcomes, data from Sub-Saharan Africa remain limited. This leaves an essential vacuum in our understanding of how COVID-19 status affects maternal and neonatal outcomes in counties like Mombasa, where health-care system problems may alter risks. Vertical transmission remains a puzzle to be solved.

Aim: To assess the association of COVID-19 status on maternal and neonatal outcomes between March 2020 to March 2022.

Methodology: A …

Reducing Nulliparous, Term, Singleton, Vertex Cesarean Birth Rate, Roseanna Juarez

Master's Projects and Capstones

Abstract

Problem: Cesarean birth rates for nulliparous, term, singleton, vertex (NTSV) pregnancies in the United States continue to exceed the Healthy People 2030 goal of 23.6%, resulting in preventable maternal and neonatal complications and higher healthcare costs.

Context: This quality improvement (QI) initiative was conducted in a high-acuity labor and delivery unit in California’s Central Valley, an area characterized by maternal health disparities, high rates of comorbidities, and limited access to prenatal care. The goal was to reduce the NTSV cesarean rate to 18.0% by July 31, 2025.

Interventions: Guided by Kotter’s 8-Step Change Theory and the Plan-Do-Study-Act (PDSA) framework, …

The Lived Experiences Of Fathers With Postpartum Depression: A Qualitative Study, Rachael Elizabeth Schmitz

Nursing and Health Sciences

Background:

Although parents may joyfully anticipate the birth of a child, it's impossible for them to know ahead of time just how profoundly their lives will change. Postpartum depression (PPD) can result. While there is a substantial body of research regarding maternal PPD, paternal PPD has received far less attention and is neither adequately understood nor diagnosed. This is exacerbated by outdated but persistent sociocultural masculinity norms and the stigmas around mental health issues.

Purpose:

This study sought to explore the lived experiences of new fathers with PPD in order to provide greater insight into their experiences.

Methods:

This qualitative …

Exploration Of Advanced Practice Registered Nurses’ Perception Of Barriers To Promoting And Supporting Breastfeeding In Primary Care, Devon L. Stubblefield, Allison L. Scott, Carmel Kruse, Marilou D. Shreve, Hope A. Ballentine

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: Breastfeeding is the biological way to provide active and passive immunity, as well as necessary nutrients, to infants while concurrently providing multiple health benefits for mothers. Even though evidence is readily available to support the argument to breastfeed, United States’ breastfeeding rates fall below Healthy People 2030 goals. Advanced practice registered nurses (APRNs) in primary care settings are in a prime position to give education and create care plans to support breastfeeding mothers to improve breastfeeding rates but literature supports APRNs lack confidence to do so. An APRN is likely to defer care to another provider to address …

Experiences Of Women In The Labour Room: The Untold Story, Emmanuel Dziwornu, Belinda Kpodo, Ophelia Anarfi, Enyonam Afi Adzato, Anita Fafa Dartey

Patient Experience Journal

Background: Childbirth experiences are some of the most sensitive indicators of the utilisation of health facilities. Women who go through the child-birthing process are reported to be faced with a range of experiences. Aim: This study described women's experiences in the labour room. Methods: The study employed a qualitative research approach with a descriptive design. Purposive sampling was used in this study and data saturation was reached after the 18^th participant. In-depth interviews were used to obtain information from recently delivered women. Interviews were audio recorded and transcribed verbatim. Thematic content analysis (TCA) was done and the results were …

Assessing The Efficacy Of Tranexamic Acid In Adjunct To Oxytocin In Reducing Blood Loss During Cesarean Deliveries: A Scoping Review, Hilary Clair Ray Bsn, Rn, Shelbie Freeman Hendrix Bsn, Rn, Lauren Elizabeth Hubbard Bsn, Rn, Helen Maisen Conley Bsn, Rn, Dwayne Accardo Dnp, Ccrn, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Globally, postpartum hemorrhage (PPH) is the leading cause of morbidity and mortality during the peripartum and postpartum period in delivering people. Emerging evidence suggests that combining second-line uterotonics with tranexamic acid (TXA) improves maternal outcomes, reduces blood loss, and lowers morbidity and mortality related to PPH (Jones et al., 2023; Al-dardery et al., 2023). TXA, an antifibrinolytic, enhances clotting, reduces blood loss, transfusion needs, hemoglobin drop, and the use of additional uterotonics (Bellos & Pergialiotis, 2021). This review highlights the benefits of TXA.

Methods

A scoping review required a literature search conducted from August 2023 to February 2024 using …

Evaluating The Efficacy Of The Implementation Of A Food Insecurity Screening Tool In Identifying Risk Amongst Nicu Families, Jessica Daniels Bsn, Rn, Sahtiah Williams Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background

Infants admitted to the Neonatal Intensive Care Unit (NICU) are critically ill and at risk of increased infections, developmental delays, and higher readmission rates after discharging due to complex health needs when compared to healthy term newborns. Nutrition has been widely recognized as an important predictor of readmission and developmental delay. However, current practice often does not provide any screening for food insecurity (FI) in NICU families, which assumes security and displays a gap in care surrounding discharge planning. This quality improvement project implements the use of an FI screening tool for NICU families to help practitioners identify FI …

Capturing Women's Birth Experiences Through Photos, Kristen Montgomery, Betsy Crabtree, Samantha Grayson, Alyssa Harmon, Rachael Robbins, Sarah Shelton, Hannah Sobas, Alexis Taliaferro, Nolan Willard

Epsilon Sigma at-Large Research Conference

Purpose: Each year 3.5 to 4 million women give birth in the United States. Childbirth is a life-changing event that induces various emotions in women. Many women report having a negative experience due to short staffing, inadequate care, and a loss of autonomy. Aims: The aim of the study was to understand what factors contribute to a positive or negative birth experience.

Methods: A descriptive qualitative study was conducted using photo elicitation. Photos were collected from participants and included a description of how the photo represented the participant’s experience. Demographic data were collected through a survey. Participants …

A Jewel In The Crown Is Better Than Money In The Pocket": Historical Data On The Role Of Midwives In Caring For Families In Southern Appalachia, Kristen Montgomery

Epsilon Sigma at-Large Research Conference

Background: Midwives have provided care to women since the beginning of time. Early midwives had little training but learned their craft from experienced women. Later, formal training became available. Midwives have a rich history in Appalachia.

Purpose: to explore the rich history of all types of midwives in Appalachia.

Methods: Materials from the Archives of Appalachia were reviewed. Both written and oral materials were evaluated. This included a review of the document, identification of themes, and then comparing those themes with previously identified themes. Documents were reviewed in a random order by two researchers who met to discuss results.

Results: …

Quality Of Perinatal Care: Experiences Of Clients And Providers In Three District Hospitals Of Western Uganda– A Mixed Methods Study, Mercy Muwema, Joaniter Nankabirwa, Dan K. Kaye, Gorrette Nalwadda, Joanita Nangendo, Gloria Odei Obeng-Amoako, Jean Claude Nkurunziza, Wilson Mwanja, Elizabeth N. Ekong, Joan N. Kalyango, Grace Edwards, Emmanuel Otieno, Robert Basaza

School of Nursing & Midwifery, East Africa

Background: It is anticipated that closing the quality gap through provision of effective antenatal, intrapartum and postnatal care for mothers and newborns in facilities will reduce morbidity and mortality. Mothers’ and health care providers’ experiences play a vital role in achieving quality care during the perinatal periods.

Purpose: To assess the health care providers’ (HCPs) and clients’ experiences on quality of perinatal care at three district hospitals in Bunyoro region, Western Uganda.

Methods: A convergent parallel mixed methods study design was utilized to explore experiences of 1) mothers as they sought antenatal, intrapartum, and postnatal care; and 2) …

Scoping Review Of Algorithms For Electronic Fetal Monitoring, Katherine Sabatier, Kate Fouquier Cnm, Phd, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

The purpose of this scoping review is to review the use of an algorithm in evaluating continuous external fetal heart rate (FHR) monitoring in labor as opposed to clinician judgment for improved fetal outcomes, including earlier recognition of abnormal tracings (Clark et al., 2017). FHR monitoring was created to evaluate for fetal hypoxia in labor and has become standard practice (Gyllencreutz et al., 2018). One of the goals of the use of cardiotocography is to decrease hypoxia-induced fetal metabolic acidemia and neurologic injury. There are multiple options for individual or computer-based algorithms in evaluating FHR to reduce fetal acidemia …