Nursing Midwifery Commons^™

Evaluating Referral Rates For Positive Postpartum Depression Screenings At Telehealth And Well-Child Visits: A Scoping Review, Rachel Macklin Barber, Mph, Bsn, Rn, Damaris Amber Brooks, Bsn, Rn, Ashli-Emeria Gary, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn, Kate Fouquier Phd, Aprn, Cnm, Pmh-C, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Postpartum depression (PPD) affects one in nine women. It has distressing impacts, including behavioral and attachment issues and toveruse of healthcare services. PPD occurs within 4 weeks to 12 months postpartum. A scoping review was conducted to compare referral rates to mental health providers after PPD screenings were conducted via telehealth versus those completed at well-child visits.

Methods

Peer-reviewed articles published within five years before the initial search, beginning September 2022 and ending November 2024, were selected. Articles were sourced from several publications using an online library database with various MeSH terms and Boolean operators. Search results were narrowed …

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 …

The Impact Of The Utilization Of Shared Decision-Making Tools In Contraceptive Counseling On Patient Satisfaction In Adolescents: A Scoping Review, Akaninyene Ruffin Msn,Fnp-C, Judith Tunney Bsn, Rn, Mary Katherine Fouquier Phd, Aprn, Cnm, Facnm, Margaret Harvey Phd, Aprn, Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Robust adolescent contraceptive counseling requires deep understanding of the specific context in which adolescents are receiving reproductive health care. As teen pregnancy rates rise, particularly in places across the Deep South, providers must find ways to engage their adolescent patients about their sexual and reproductive health. Professional organizations like the American College of Obstetricians and Gyencologists and the American Academy of Pediatrics both offirm the need for robust contraceptive counseling for adolescents. The purpose of this is to ascertain the impact of utilizing shared-decision making aids during contraceptive counseling on patient satisfaction in adolescent populations.

Methods

A systematic literature …

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 …

Perinatal Mood And Anxiety Disorders (Pmads): A Scoping Review, Christina Willis Bsn, Rn, Nia Wells Bsn, Rn, Miranda Smith Bsn, Rn, Kate Fouquier Cnm, Phd, Facnm

Doctor of Nursing Practice Projects

Purpose/Background Perinatal Mood and Anxiety Disorders (PMADs), including postpartum depression, anxiety, and psychosis, significantly impact maternal and infant health. This scoping review consolidates current literature on PMADs, emphasizing prevalence, risk factors, screening, and treatment. The primary aim is to identify research gaps and inform clinical guidelines to enhance perinatal care.

Methods A literature search followed PRISMA guidelines from August 2022 to November 2024. Databases searched included PubMed, CINAHL, Scopus, and Google Scholar, using terms such as "perinatal mood disorders" and "maternal mental health." Inclusion criteria were English-language studies from the past decade addressing PMADs during pregnancy and up to one …

Implementation Of The Modified Early Obstetric Warning System (Meows) In Obstetric Patients Within A Level Iv Maternal Care Facility, Mei M. Stalder

Student Scholarly Projects

Practice Problem: Incidences of increasing maternal morbidity and mortality are often preceded by a period of unrecognized deterioration. The lack of an obstetric early warning system in a high-risk Level IV Maternal Care Facility further contributed to delayed identification and intervention of deteriorating mothers.

PICOT: The PICOT question that guided this DNP project was, in obstetric patients, 18-years or older (P), does the Modified Early Obstetric Warning System (MEOWS) (I), compared to current standard practice (C), affect the number of patients transferred to the ICU (O) within a six-week time frame (T)?

Evidence: Nine evidence-based articles were included in this …

Prevalence And Risk Factors Associated With Postpartum Hemorrhage Among Postpartum Women In Selected Health Facilities In Machakos County - A Case-Control Study, Daniel Kyalo Muthiani

MSc in Advanced Practice Midwifery

Background: Postpartum hemorrhage (PPH) refers to blood loss ≥500mls after vaginal birth and ≥1000mls after cesarean section. PPH is of concern in low and middle-income countries and is estimated to cause maternal mortality every 10 minutes, with a prevalence of 25% and 34% in Uganda and Kenya, respectively. Despite efforts to address this issue, the prevalence of PPH remains high and is associated with maternal and fetal risk factors that can present along the continuum of birth. Understanding the risk factors is necessary in designing appropriate interventions for their prevention.

Objective: To determine the prevalence, maternal and fetal risk factors …

Confirming The Validity And Reliability Of The Placement Evaluation Tool To Evaluate Midwifery Practice Placements (Pet-Midwifery), Fiona Bogossian, Dianne Bloxsome, Angela Brown, Robyn Cant, Susan Hunter, Lauren Kearney, Lesley Kuliukas, Carolyn Ross, Simon Cooper

Research outputs 2022 to 2026

Problem: In Australia, program accreditation requirements include that education providers monitor and evaluate teaching and learning environments and provide evidence of outcomes being used to inform program quality improvement. Yet, closing this loop has proven challenging. Background: The Australian National Placement Evaluation Centre (NPEC) functions to measure the quality of placements through student evaluations. One measure the Placement Evaluation Tool (PET) had not been tested in midwifery student cohorts. Aim: To confirm the validity and reliability of the Placement Evaluation Tool (PET) for midwifery. Design: Survey instrument development. Methods: A three-phase, sequential study involving seven Australian universities and students enrolled …

Birth Planning, Audrey K. Gill, Kacie J. Easley

Student Scholarship & Creative Works

This is an informative presentation completed using evidence based practice regarding the importance of birth planning and the use of birth plans. It is used as a tool to educate nurses and healthcare providers about the benefits of implementing birth plan education into their patients portfolio. The birth plan is a written document that involves the collaborative efforts between nurses/healthcare providers and future mothers. It is used in order to personalize and improve the birthing experience for patients. This presentation uses qualitative research, quantitative research, and theoretical framework in order to deem positive results with the implementation of birth plans.

Midwives Experience Of Working With Maternity Assistants: A Qualitative Study, Carol Crevacore, Annie De Leo, Peta Fisher, Sara Bayes

Research outputs 2022 to 2026

Introduction: The midwifery workforce is essential for delivering safe, high-quality maternity care, however, global staffing shortages pose significant challenges. To address these issues, incorporating midwifery assistants, including undergraduate midwifery students into the model of care has been proposed as a strategy to support midwives and maintain effective service delivery. Aim: This study explores the Registered Midwives' experiences working with Midwifery Assistants (MAs) in an Australian tertiary maternity service. Methods: This study employed a qualitative exploratory design and was conducted using semi-structured interviews with 9 midwives who had experienced working with MAs in the tertiary maternity care setting. Results: The discussion …

A Qualitative Analysis Of Australian Midwifery Students’ Perspectives Of Midwifery Practice Experience: Characteristics That Enhance Or Diminish Clinical Education Placements, L. Kearney, Dianne Bloxsome, S. Hunter, A. Brown, Simon Cooper, F. Bogossian

Research outputs 2022 to 2026

Background: Midwifery education in Australia faces challenges in combining theoretical and practical experiences, with reports of inconsistent support and supervision during Midwifery Practice Experience (MPE), alongside significant financial and personal costs to students. National evaluation and improvement initiatives are essential to ensure that midwifery students receive effective and high-quality clinical learning opportunities. Aim: This study aimed to answer two research questions: 1) How do midwifery students describe their Midwifery Practice Experiences? 2) What are the characteristics of Midwifery Practice Experiences that enhance or diminish midwifery student learning? Methods: National midwifery student survey data, collected through the National Placement Evaluation Centre. …

How Valuable Is An Implementation Toolkit For Midwives? An Exploratory Study, Annemarie (Annie) De Leo, Linda Sweet, Peter Palamara, Dianne Bloxsome, Sara Bayes

Research outputs 2022 to 2026

Background: Incorporating evidence-based approaches in maternity care throughout the entire trajectory from pregnancy through to the postnatal phase is integral to good public health. Yet, despite developing theories, frameworks, and models to guide midwives’ implementation efforts, implementing new evidence-based practices in midwifery practice settings remains challenging. Methods: An exploratory study design was used to conduct an initial assessment of the appeal and suitability of an implementation ‘how to’ Toolkit for Australian change-leader midwives. We aimed to determine the effectiveness of the intervention by evaluating midwives’ experience of using the Toolkit, and report on the usability of the Toolkit in maternity …

Correlation Of Physical Activity With Vasomotor, Psychosocial, And Physical Symptoms Of Menopausal Women In A Rural Area Of Pati Regency, Indonesia, Shovia Nurul Hidayati, Winarni Winarni

Journal of Asian Midwives (JAM)

Background: Menopause often brings vasomotor, psychosocial, and physical symptoms that challenge women's well-being, yet physical activity offers a promising avenue for relief. Physical activity can improve a person's quality of life. Menopausal women in Pegandan village have varying physical activity and menopausal symptoms but it is currently unknown whether they are correlated. This study investigated the correlation between physical activity and vasomotor, psychosocial, and physical symptoms among menopausal women.
Methods: The study employed a cross-sectional design involving 47 menopausal women from Posyandu Lansia in Pegandan village, Pati regency, Indonesia. They were selected by simple random sampling. Participants' measurements for physical …

The Role Of Maternal Position During The Second Stage Of Labor On Reducing Perineal Injury: An Integrative Review, Ericka L. Dalton, Tabatha Ruth Erlandson

All Electronic Theses and Dissertations

Introduction: Perineal lacerations remain a common occurrence amongst vaginal deliveries. While there are some recommendations for supportive techniques throughout the literature, position is typically not included in these. Perineal trauma can have a lasting effect on the individual and increase health care costs. The purpose of this review is to identify what birthing positions are most effective at preventing perineal injury.

Methods: A formalized search of the literature was conducted via PubMed, CINAHL, Google Scholar, and SCOPUS databases. Of the 344 articles identified, 22 original studies met the inclusion and exclusion criteria for this review. A literature matrix and quality …

Facilitators And Barriers To Interprofessional Collaboration Between Physicians And Midwives: An Integrative Review, Kathy D. Lambright, Anesha E. Martin

All Electronic Theses and Dissertations

Introduction: Early models of interprofessional collaborative care suggest that when there is a collaboration between midwives and physicians, the outcomes for mothers and babies are improved. The purpose of this integrative review of the relevant literature is to identify the facilitators and barriers to collaborative relationships between physicians and midwives.

Methods: A keyword search was done using the Science Direct, PubMed, and CINAHL databases. Inclusion criteria were that they must be original research, identify facilitators and barriers in interprofessional collaborative relationships, and include healthcare professionals involved in maternity care. The database search yielded a total of 348 articles, which were …

Freestanding Birth Centers-Safety And Efficacy Related To Maternal And Neonatal Outcomes: An Integrative Review, Nicole Lynn Muzik, Casey Renee Workman

All Electronic Theses and Dissertations

Introduction: The goal of this literature review is to determine the safety of community birth by evaluating if low-risk pregnant women at term, who deliver in the community setting, specifically at freestanding birth centers, have comparable or lower maternal and neonatal morbidity and mortality outcomes, than low-risk women who deliver at an in-hospital birthing facility.

Methods: The authors of this integrative review retrieved original research articles from computerized databases (Nursing and Allied Health, PubMed, and CINAHL), as well as online journal hand searching, followed by cited reference searching. A total of 48 articles underwent a full-text review, and a total …

The Ethical Justification Of Application Of Long-Acting Reversible Contraception In Patients With Intellectual Disabilities, Kelly Savitri

Journal of Health Ethics

This paper explores the ethical justification for the use of Long-Acting Reversible Contraception (LARC) in patients with intellectual disabilities, particularly in scenarios where patients cannot provide informed consent. The tension between respecting autonomy and ensuring beneficence presents a complex challenge for healthcare providers. Drawing on historical context, current reproductive justice issues, and evolving societal attitudes towards individuals with intellectual disabilities, this essay argues for a semi-discrete model that recognizes the need to prioritize patient health and safety while valuing their autonomy. By examining the implications of both past and present practices, this study highlights the necessity for healthcare providers to …

The Impact Of Having A Native Spanish-Speaking Nurse In Labor And Delivery For Latina Mothers, Lesvia Muñoz Mazariegos

Nursing | Senior Theses

Labor and Delivery is the physiological process in which a pregnant woman gives birth to a baby. With an increase of the Hispanic/Latinx population, the need for Spanish-speaking nurses also increases. Specifically in labor and delivery, language barriers play a critical role for a Latina mother’s laboring experience. However, according to the research, there is limited data on the effects of language concordance/discordance for laboring Latina mothers. To investigate, primary research articles were reviewed focusing on patient experiences with language concordance and discordance, childbirth experiences across different races, and nurses' perceptions of patient experiences related to language barriers. This proposed …

Telehealth In The Postpartum Period: An Integrative Review, Ann Elizabeth Niedermayer, Laura Orrock

All Electronic Theses and Dissertations

Introduction: Improving postpartum care by addressing the steep decline in postpartum care utilization is important to maternal and newborn health. This integrative review explores the use of telehealth in the postpartum period and its impact on improving health outcomes and access to care.

Methods: A literature search identified original studies published between 2018 and 2025 in PubMed, CINAHL, Scopus, and ScienceDirect to learn about the use of telehealth in postpartum care. Reference lists of included articles were screened, and a hand search of three applicable journals was also conducted. The search identified 1187 studies after duplicates were removed, of which …

Genetic Insights Into Methylenetetrahydrofolate Reductase Polymorphisms And Inherited Thrombophilia: Advancing Precision Screening And Therapeutic Interventions To Optimize Perinatal Outcomes, Taylar Hash

All Electronic Theses and Dissertations

Introduction: Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and inherited thrombophilia, such as Factor V Leiden and Prothrombin G20210A, have been implicated in adverse pregnancy outcomes, including recurrent pregnancy loss, preeclampsia, fetal growth restriction, and preterm birth. This integrative review explores how genetic insights into MTHFR polymorphisms and inherited thrombophilia can guide precision medicine, including both screening and therapeutic intervention, to optimize perinatal outcomes. Methods: An integrative literature review was conducted following Whittemore and Knafl’s methodology. Research databases including PubMed, CINAHL, Scopus, and ScienceDirect were searched for studies published or translated to English within the last twenty years that examined MTHFR polymorphisms, …

Facilitators And Barriers To Reducing Maternal Mortality Rates In Non-Hispanic Black Women: An Integrative Review, Melissa Marie Andersson, Elizabeth L. Goes

All Electronic Theses and Dissertations

Introduction - Black maternal mortality remains a crucial public health crisis in the United States despite a plethora of research on the incidence. This presents in the persistent disparities in health outcomes between Black and White mothers and newborns. While numerous studies have explored isolated factors contributing to this issue, few have synthesized the full scope of barriers and facilitators influencing Black maternal health outcomes in the United States specifically.

Research Aim - This integrative review aims to identify and organize the key facilitators and barriers to reducing Black maternal mortality in the United States using the socio-ecological model as …

A Brief History Of Antenatal Colostrum Expression, And Where To From Here, Therese A. O’Sullivan, Connie N. Ihlein

Research outputs 2022 to 2026

The practice of antenatal colostrum expression (ACE), or the extraction of colostrum from the breasts during pregnancy, has an interesting history and continues to evolve. This narrative review aims to describe how perception and practices of ACE have changed over time, summarise the evidence on ACE in maternal and infant care, and highlight areas for future research. The literature demonstrates that ACE is safe for low-risk women when done from around 36 weeks’ gestation. Women should be reassured that the skill of hand expressing is a valuable tool post-birth, regardless of whether they are able to collect colostrum antenatally or …

Intrapartum Hydration Assessment And Management: A Cross-Sectional Survey Of Australian And New Zealand Maternity Units, Brianne G. Mcintyre, Debbie Massey, Nigel Lee, Lauren Kearney

Research outputs 2022 to 2026

Background: Hydration assessment and management during labour play an important role in maternal and newborn outcomes. Studies indicate that clinical practice is inconsistent, with limited consensus evident in clinical guidelines. Current practices in fluid management across public and private maternity units within Australia and New Zealand remain unknown. Respondents highlighted the importance of maternal hydration assessment and management to well-being. However, inconsistencies were noted in the documentation, medication use and adherence to clinical protocols. Aim: Our study aimed to investigate unit-level clinical practice regarding intrapartum hydration assessment and management across Australian and New Zealand private and public hospitals. The scope …

Emotional Safety In Maternity Care: An Evolutionary Concept Analysis, Elliesha O'Reilly, Kate Buchanan, Sara Bayes

Research outputs 2022 to 2026

Background: Safety in maternity care is a priority, and a broadened view of safety (e.g., emotional, psychological, cultural) is evident in scientific literature and in lay discourse. ‘Emotional safety’ is being referred to with increasing frequency in this context; however, there is a lack of clarity in its use and meaning. Aim: The aim of this concept analysis was to examine the concept of emotional safety in maternity care. Methods: The evolutionary approach was used for this concept analysis. Data sources: This concept analysis was literature-based, with a systematic search conducted of CINAHL, MIDIRS, and MEDLINE databases. Ten articles published …

Through The Looking Glass; Midwifery Students' Experience Of Ethical Issues: A Feminist Explanatory Case Study, D. Bygraves, K. Wissemann, K. Buchanan

Research outputs 2022 to 2026

Background: The ethical component in midwifery education is governed by international professional values, codes, and ethical principles. The aim of midwifery education is to encourage students to develop a lifelong commitment to ethical practice within their midwifery role and scope. However, little evidence is available on the experiences of midwifery students and how they navigate ethical issues in maternity systems. Aim: To present a case study from a midwifery students' perspective that demonstrates observed ethical issues and to provide analysis of the ethical issues identified. Design: A Single explanatory case study design with a feminist lens applied. Explanatory case studies …

Fostering A Resilient Healthcare System: Supportive Practice Environment Initiatives To Support Nurse And Midwives A Scoping Review, Gemma Doleman, Dianne Bloxsome, Rong Wang, Lisa Whitehead

Research outputs 2022 to 2026

Aim: This scoping review aimed to explore supportive practice environment initiatives that support novice and expert nurses and midwives. Design: Scoping review. Methods: Studies were identified through the electronic databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsychInfo, Scopus, and Web of Science. Grey literature was searched using GreyNet, National Grey Literature Collection, ProQuest Dissertation and Theses, and Google Scholar. Results: Thirty-one papers met the criteria for inclusion and data extraction. The key concepts identified were the need for adequate staffing and resources, clear and regular communication, managerial presence and engagement in committees and relationship building, celebration …