Maternal and Child Health Commons^™

Nourishing Births: A Program Evaluation Proposal For Community-Based Nutrition Education, Food Access, And Garden Engagement Among Black Birthing People, Naa Deedei-Vera Hammond

Master's Projects and Capstones

Black birthing people in the United States continue to experience unequal maternal health outcomes, shaped in part by racism and barriers to nutritious food, culturally relevant health education, and supportive community spaces. While prenatal nutrition education and food assistance programs can provide important resources, information alone cannot address the challenges many people face when trying to access healthy and affordable food during pregnancy. The Nourishing Births Initiative is a proposed community-based maternal health program designed to respond to these needs by bringing together prenatal nutrition education, help connecting to food resources, community gardening, and peer support for Black birthing people …

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Treatment And Interventions For Sexual Assault In Humanitarian Contexts: Addressing Gaps In Refugee And Idp Camp Care In Myanmar, Erin Nash

Capstone Experience: Master of Public Health

Sexual and gender-based violence (SGBV) remains a pervasive yet under-addressed issue in humanitarian settings. Refugee and internally displaced person (IDP) camps along the Thai– Myanmar border represent a complex nexus of protracted displacement, ethnic conflict, and limited access to medical and psychosocial care. Although the prevalence of sexual assault in these contexts is well-documented, there is a critical gap in the literature regarding effective, context-specific treatment and intervention strategies. This capstone project conducts a comprehensive review of existing research on sexual assault care in humanitarian crises worldwide and assesses its applicability to displaced ethnic minorities from Myanmar. The analysis considers …

Is Home Birth A Choice? Racial And Geographic Differences In Unintended Home Births In The U.S., Anna De La Paz

Population Health Research Brief Series

Home births that happen without planning or medical support (i.e., unintended home births) carry a higher likelihood of adverse outcomes, such as low birth weight, preterm birth, and hypothermia. This data slice summarizes findings using data from CDC WONDER (2017–2023) on racial, regional, and metropolitan status differences in home births among women ages 15–44 in the U.S. Findings show that unintended home births are disproportionately concentrated among non-Hispanic Black women, with rates varying substantially by region and metropolitan status.

M-O-M-S On The Bayou: Implementation Of An Intervention To Improve Mental Health After Disaster, E. W. Harville, Gloria Giarratano, M. Patterson, M. Schultheis, K. S. Dorans, S. Turner, S. Harris, S. Longo, K. Weis

School of Nursing Faculty Publications

Pregnant women are a vulnerable population after disaster. Their health may be improved through community-based support programs in addition to their standard prenatal care. We conducted a prenatal peer support program, Mentors Offering Maternal Support (M-O-M-S), focused on improving mental health in hurricane-affected areas in southern Louisiana. M-O-M-S consists of six biweekly sessions covering pregnancy acceptance, maternal role identification, family and partner relationships, preparation for labor/fears around labor, well-being/safety of self and baby, and post-delivery health and maternal-infant bonding. The program is led by a “mentor”, an experienced mother but not necessarily a clinician or social worker, who guides the …

Advancing Screening For Intimate Partner Violence In Pregnant Individuals Throughout The Perinatal Period To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Senior Theses

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of IPV …

Associations Between Individual And Structural Level Discrimination And Psychological And Physiological Stress Indicators During Pregnancy, Özlü Aran, Melissa Nevarez-Brewster, Kimberly D'Anna-Hernandez, Julia Dmitrieva, Curt A. Sandman, Laura M. Glynn, Elysia Poggi Davis

Psychology Faculty Articles and Research

In the United States (U.S.) pervasive health disparities in prenatal care disproportionately impact marginalized individuals. The present study investigates whether discrimination at the individual and structural levels are associated with indicators of psychological and physiological stress among pregnant Latinx people living in the U.S., including both U.S. and foreign-born individuals. Pregnant participants (n = 109) reported on birthplace, lifetime experiences of racial and ethnic discrimination, perceived levels of stress, acculturation, social support, and provided residential address data and hair samples for cortisol analysis. Regression analysis revealed that individual level discrimination was linked to higher psychological stress during pregnancy ( …

Is Health Insurance Related To Breastfeeding Duration?, Anna De La Paz

Population Health Research Brief Series

Breastfeeding duration, which plays an important role in shaping maternal and infant health, can be influenced by insurance type. This data slice uses data from the 2022-2023 National Survey of Family Growth (NSFG) to described differences in breastfeeding duration by insurance type among females ages 15-49 in the United States. Findings show that mothers with private insurance breastfeed longer than mothers with public insurance, such as Medicaid, net of controls for maternal age, race, education, and income.

Europe–Africa Collaboration: Working Together To Strengthen Health Research, Implementation, And Equitable Systems, Lara Pandya, Irene Norstedt, Martin Seychell, Emer Cooke, Isabel De La Mata Barranco, Niklas Blomberg, Marleen Temmerman, Michael Makanga

Centre of Excellence in Women and Child Health

In September 2024, key representatives from European Union (EU) directorates and agencies convened to enhance collaboration with Africa in strengthening health research, innovation, and implementation. The meeting focused on bolstering joint efforts to improve health outcomes and support wellbeing across all ages in Africa. Despite progress in addressing infectious diseases, the continent faces a dual burden with the rise of non-communicable diseases and emerging threats such as antimicrobial resistance, climate change, falsified medicines, and pandemic risks. These challenges are exacerbated by fragile health systems, rapid population growth, urbanisation, and limited access to affordable medical interventions.

To address these issues, the …

Born Too Soon: Every Story Counts: Lessons In Ethical, Inclusive Storytelling From Born Too Soon, Mary V. Kinney, Amy Reid, Mercy Juma, Anna Gruending, Olufunke Bolaji, Doris Mollel, Denise Suguitani, Silke Mader, Karen Walker, Marleen Temmerman, Joy Lawn

Centre of Excellence in Women and Child Health

Storytelling is increasingly recognized as a powerful tool in public health communication, particularly for addressing complex and stigmatized health issues. In the context of pregnancy and childbirth, personal narratives have proven effective in shaping perceptions, empowering women, complementing health education, and driving policy and legal reforms. Preterm birth remains a significant global challenge, and lived experiences of affected families offer critical insights that illuminate systemic gaps and advocate for the rights of babies, mothers, families, and healthcare workers. The Born Too Soon 2023 campaign placed people—especially women, families, communities, and healthcare workers—at the core of its advocacy efforts. This commentary …

Relationship Between Maternal Mortality And Zip Code In New Jersey, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality remains a pressing public health concern in the United States, with significant disparities influenced by geography and social determinants of health. This study investigates the relationship between zip code-level factors and maternal mortality rates (MMR) in New Jersey (NJ), a state with demographic and socioeconomic diversity. Using data from the NJ Department of Health, CDC, and recent literature, I identified patterns correlating higher MMR with areas experiencing poverty, limited access to healthcare, and predominantly minority populations. Counties such as Essex, Union, and Cumberland—classified as Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs)—exhibited particularly high vulnerability. These …

The Impact Of Environmental Deficiencies On Maternal Health Outcomes, Zahra Wallizadeh, Emiyah Bullock, Antoinette Jones, Katarina Rusinak

Rowan-Virtua Research Day

This study examines the environmental factors contributing to adverse maternal health outcomes in New Jersey, with particular focus on their disproportionate impact on minority women. Analysis of data from PubMed, Policy Map, NIH, CDC, EPA, and the New Jersey Department of Health reveals that women living in low-income areas face significant environmental challenges, including food deserts, air pollution, unsafe living conditions, inadequate infrastructure, and limited transportation options. These environmental determinants exacerbate maternal stress and contribute to complications such as preterm birth and hypertension. Black women are nearly three times more vulnerable to these adverse outcomes compared to white women, highlighting …

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …

The Importance Of Recruitment Of Low-Income Pregnant Persons In Interdisciplinary Research To Understand The Impact Of Social And Environmental Determinants: Lessons Learned About Implementation And Recruitment, Erika R. Marquez, Amanda Haboush-Deloye, Elizabeth M. Lawrence, Selam Ayele, Courtney Coughenour, Nora Doyle, Wynona Dizon, Lizbeth Perez Rodriguez, Chloe Bombara

Environmental & Global Health Faculty Research

Background: Prior research indicates that enrolling underrepresented populations in clinical research is challenging. Although research has identified some barriers to participation and strategies to overcome them, studies have made little progress in being inclusive and representative. There remains a great need for including racial/ethnic minorities, low-income families, and pregnant women in research. The purpose of this article is to describe the implementation of enrollment strategies used in our study to understand the feasibility of building a maternal cohort and better understand the relationship between environmental and social impacts on maternal exposure and child outcomes.

Methods: Working across multiple academic units, …

Risk Factors And Public Health Interventions Associated With Adolescent Pregnancy Prevention Among Females Aged 10–19 Years In Kenya: A Scoping Review Protocol, Kimbley Asaso Omwodo, Abdu Mohiddin, Danielle Denwood, Augustine N. Gitonga

Centre of Excellence in Women and Child Health

Background ; Adolescent pregnancy is associated with multifaceted challenges that impact countries’ health, education and economic stability. Despite ongoing interventions, in developing countries such as Kenya, adolescent pregnancy rates continue to be high. There is a need for more synthesised evidence on regional-specific risk factors to support tailored prevention strategies.

Objective; This scoping review aims to explore what is known about the risk factors and intervention strategies focused on adolescent pregnancy prevention in Kenya.

Methods and analysis; Using the Arksey and O’Malley framework combined with a three-step search strategy as recommended by the Joanna Briggs Institute, relevant articles will be …

"Our Vision Is That Black Mothers And Birthing People, Fathers, And Partners Are Safe, Honored, And Respected Throughout Pregnancy And Parenthood": Black Birth Workers' Agenda For Black Maternal Health In Oregon, Sarah Marguerite Applin

University Honors Theses

Black women and Birthing People (BWBP) face disproportionate rates of mortality within the United States healthcare system. BWBP are three times more likely to suffer a pregnancy-related death than White women. Therefore, addressing and consulting with BWBP about the birthing experience that BWBP sustains when they are bearing children is imperative. The inclusion and application of this key knowledge and understanding should be emphasized and at the root of further development toward reproductive justice. This participatory story was led by Dr. Roberta Hunte. Interviews and focus groups with Black birth workers, birthing people, and public health professionals were conducted in …

The Quic-Sp: A Spanish Language Tool Assessing Unpredictability In Early Life Is Linked To Physical And Mental Health, Sabrina R. Liu, Natasha A. Bailey, Sara Romero-González, Amy Moors, Belinda Campos, Elysia P. Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Accumulating evidence indicates that unpredictable signals in early life represent a unique form of adverse childhood experiences (ACEs) associated with disrupted neurodevelopmental trajectories in children and adolescents. The Questionnaire of Unpredictability in Childhood (QUIC) was developed to assess early life unpredictability, encompassing social, emotional, and physical unpredictability in a child’s environment, and has been validated in three independent cohorts. However, the importance of identifying ACEs in diverse populations, including non-English speaking groups, necessitates translation of the QUIC. The current study aims to translate and validate a Spanish language version of the QUIC (QUIC-SP) and assess its associations with mental and …

Barriers To Postpartum Depression Treatment: Availability And Accessibility Of Maternal Behavioral Health-Inclusive Support Groups For Low-Income Populations, Radhika S. Venkatesan

Honors Undergraduate Theses

The maternal health crisis is a prevalent and concerning issue in the United States. The lack of efficient availability and accessibility to health care services plays a significant role in augmenting this problem. One health care service that is often understudied is support groups, for prevalent issues like postpartum depression. Considering the socioeconomic burdens of low-income mothers, this paper analyzed the accessibility and availability of maternal health support groups across counties in Florida, with varying amounts of individuals below the federal poverty level (%BPL). Essentially, Florida counties were divided into one of four categories depending on their %BPL. A Fisher’s …

The Camden Study - A Pregnancy Cohort Study Of Pregnancy Complications And Birth Outcomes In Camden, New Jersey, Usa., Stephanie Shiau, Xinhua Chen, Ayana April-Sanders, Ellen C Francis, Shristi Rawal, Megan Hansel, Kehinde Adeyemi, Zorimar Rivera-Núñez, Emily S Barrett

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women.

METHODS: From 1985-2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White …

Disparities In The Pregnancy Experience: A Multi-Case Analysis, Tiffany C. Thomas, Lindsay Gietzen

Pacific Journal of Health

Racial disparities in maternal healthcare continue to be a significant issue, with Black women experiencing worse outcomes compared to White women. Despite improvements in healthcare, Black women are still 2.5 times more likely to die from pregnancy-related causes, and they face higher rates of preterm births, low birth weight, and insufficient prenatal care. This paper examines the experiences of three African American women from high socioeconomic backgrounds, focusing on where these negative experiences are most common throughout pregnancy, childbirth, and postnatal care. The study uses the Pregnancy and Maternity Care Patients' Experiences Questionnaire (PreMaPEQ) to explore different stages of care, …

Demographic Characteristics, Perinatal Smoking Patterns, And Risk For Neonatal Health Complications Among Pregnant Smokers In The United States Who Begin Using Electronic Cigarettes During Pregnancy: A Descriptive Study Using Population-Based Surveillance Data., Hui Nian, Rachel Odland, Samantha Mindlin, Lin Ammar, Hilary Tindle, Angela M Miller, Kelli K Ryckman, Ethan Xie, Tina V Hartert, Brittney M Snyder, Steven M Brunwasser, Pingsheng Wu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Health agencies have called for research evaluating e-cigarette (EC) use in supporting prenatal smoking cessation. This study aimed to describe (1) the characteristics of smokers who begin using electronic cigarettes (ECs) during pregnancy, (2) how frequently smokers reduce or eliminate pre- and post-natal combustible cigarette (CC) use, and (3) the risk for neonatal health complications among smokers who initiate ECs during pregnancy.

AIMS AND METHODS: Pregnant women using CCs exclusively during prepregnancy, who participated in a U.S. surveillance study, were classified by their reported late-pregnancy smoking behavior as CC-exclusive users, EC initiators, or quitters. EC initiators were further subclassified …

Credentialing Care: Covid-19 And The Bureaucratization Of Doulas, Ellen Block, Julie Johnson Searcy, Angela N. Castañeda

Sociology Faculty Publications

Doulas in the United States offer embodied, informational, and continuous one-on-one care to birthing people. Doulas have historically sought certification to gain knowledge through training and to gain legitimacy for healthcare providers and clients. During the COVID-19 pandemic, hospitals required doulas to provide proof of certification. The COVID-19 pandemic, and the proliferation of state-sponsored doula programs, has sparked a shift in how doulas are viewed and regulated, enabling new forms of bureaucratic oversight and control. Based on participant observation, surveys, and semi-structured interviews, we examine the connection between certification and care including motivations doulas have for certification, the perceived value …

Leveraging The Science Of Early Life Predictability To Inform Policies Promoting Child Health, Laura M. Glynn, Sabrina R. Liu, Candice Taylor Lucas, Elysia Poggi Davis

Psychology Faculty Articles and Research

Addressing the tremendous burden of early-life adversity requires constructive dialogues between scientists and policy makers to improve population health. Whereas dialogues focused on several aspects of early-life adversity have been initiated, discussion of an underrecognized form of adversity that has been observed across multiple contexts and cultures is only now emerging. Here we provide evidence for “why unpredictability?”, including: 1. Evidence that exposures to unpredictability affect child neurodevelopment, with influences that persist into adulthood. 2. The existence of a translational non-human animal model of exposure to early life unpredictability that can be capitalized upon to causally probe neurobiological mechanisms. 3. …

Strategic Advocacy: Doula Care, Liminality, And Reproductive Justice, Julie Johnson Searcy, Ellen Block, Angela N. Castañeda

Sociology Faculty Publications

No abstract provided.

Maternal Decision Making And Children’S Nutritional Status: Evidence From Indonesia, Nadia Roswita, Teguh Dartanto

Jurnal Ekonomi Kependudukan dan Keluarga

Indonesia is encountering consecutive health problems caused by malnutrition. The latter poses long-term effects on children’s development. As this issue continue its prominence, using linear regression and binary logistic with time lag to analyze data from Indonesia Family Life Survey (IFLS) in 2007 and 2014 shall support the analysis of issue. Previous results from the models indicated that maternal decision-making in their share of food expenditure has a weak correlation for stunted children's experience. However, this study revealed different results. It suggested that involvement in from men in nutritional knowledge, skills, and financial backing to advance women's roles contributes to …

Parenting Identity And Parental Mental Health In Chinese Parents In Mainland China, Zhenqiao Yang

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

In the modern context of mainland China, parents of young children face unique parenting stressors, making parental mental health during the early stages of parenting a significant public concern. Increasing awareness of the role of self-concepts in mental health underscores the importance of exploring the relationships between parenting identity concepts, parenting stress, parental mental health, and familial factors. This study aims to examine the relationship between parenting identity and parental mental health, specifically depression and anxiety, in the context of early childhood parenting stress. Data were collected from 456 parents at four daycare centers and public spaces in an Eastern …

Pediatric Obesity In The United States: Age–Period–Cohort Analysis, Ashley W. Kranjac, Dinko Kranjac, Roxanne I. Aguilera

Sociology Faculty Articles and Research

The rates of obesity among American children aged 2–5 years has reached a historic high. It is crucial to identify the putative sources of population-level increases in obesity prevalence among preschool-aged children because early childhood is a critical window for obesity prevention and thus reduction of future incidence. We used the National Health and Nutrition Examination Survey data and hierarchical age–period–cohort analysis to examine lifecycle (i.e., age), historical (i.e., period), and generational (i.e., cohort) distribution of age- and sex-specific body mass index z-scores (zBMI) among 2–5-year-olds in the U.S. from 1999 to 2018. Our current findings indicate that period effects, …

Impact Of The Department Of Defense Maternity Leave Policy Change On Retention And Postpartum Depression And The Air Force Postpartum Physical Fitness Policy Change On Physical Readiness Outcomes, Minette S. R. Herrick

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Understanding the implications of health policy is paramount to support continued execution and further wide-spread distribution. The Department of Defense has made many recent family friendly policy changes in effort to improve the health and morale of the force. Two such policies were analyzed in this study. The first was the change in maternity leave, in 2016, from allotting women six weeks time off to twelve weeks time off in the postpartum period. The second was executed by the Air Force to permit postpartum women a longer duration for their required physical fitness assessment (an increase from six months to …

Association Between Cultural Factors And Postpartum Depression, Usha Modukuru

Rowan-Virtua Research Day

Postpartum depression (PPD) is present in 17.22% of the world population. The negative physical and psychological impacts of PPD impact not only the mother, but also those around her. This raises the importance of identifying factors contributing to its onset. Studies have shown that PPD prevalence rates vary between non-Western and Western regions of the world. Cultural postpartum practices differed significantly region to region. Search terms including postpartum depression and cultures were used to find peer-reviewed articles, primary surveys, and patient interviews between 2013-2023. Qualitative analyses were performed on the results. Ethnokinship cultures, commonly present in non-Western countries, prioritized social …