Maternal and Child Health Commons^™

Addressing The Increased Prevalence Of Gestational Diabetes Among Hispanic/Latino Pregnant Persons In The Central Valley Of California, Kathleen Janise Farrell Wardell

Master's Projects and Capstones

Gestational Diabetes (GDM) is a preventable noncommunicable disease that has been on the rise over the last 60 years. Pregnant persons with gestational diabetes are 10 times higher of acquiring Type 2 Diabetes after pregnancy (Ionannou et al., 2024). There is an urgent need to address this public health threat because of its increase in mortality. To address this complex chronic disease, this literature review explored multi-level interventions using the socioecological model to mitigate GDM in the Central Valley’s, Tulare County. Tulare County is disproportionately affected by chronic diseases like diabetes especially among the Hispanic and Latinx communities. Therefore, it …

Ob Deserts Remain Public Health Concern For New Mexico, Dustin Roberto

HSC Newsroom

As of 2022, one in three New Mexico counties were "OB deserts," places where pregnancy and childbirth care is limited. Distance, hospital closures, and staff shortages make care especially hard to reach for rural, low-income, and Indigenous communities. To help, the University of New Mexico offers a minor and certificate in maternal and child health leadership.

The Precise-Dyad Neurodevelopmental Substudy Protocol: Neurodevelopmental Risk In Children Of Mothers With Pregnancy Complications, Dorcas Magai, Jaya Chandna, Marie-Laure Volvert, Rachel Craik, Hawanatu Jah, Agnes Msoka, Amina Abubakar, Angela Koech, Grace Mwashigadi, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Over 250 million children are not reaching their developmental potential globally. The impact of prenatal factors and their interplay with postnatal environmental factors on child neurodevelopment, is still unclear—particularly in low- and middle-income settings. This study aims to understand the impact of pregnancy complications as well as environmental, psychosocial, and biological predictors on neurodevelopmental trajectories. Open Peer Review Approval Status 1 2 version 2 (revision) 05 Aug 2024 view view version 1 09 Nov 2023 view view Kimford Meador, Stanford University School of Medicine, Palo Alto, CA,, USA 1. Page 1 of 21 Wellcome Open Research 2024, 8:508 Last …

Scaling Up, Sustaining, And Enhancing School-Based Sexuality Education Programs In Resource-Constrained And Conservative Contexts: Replicable Lessons From Positive-Deviant Countries, Chandra Mouli, Michielsen Kristien, Gogoi Aparajita, Nair M, Ziauddin Mohammed, Hadi S, Ijaz A, Rubio Auriolesh, Marleen Temmerman

Centre of Excellence in Women and Child Health

Despite considerable efforts, progress in the implementationof sexuality education (SE) has been uneven. This study identi-fied six “positive-deviant” low- and middle-income countries,i.e., countries that had scaled up, sustained and enhancedtheir SE programs when many others—in similar social, cul-tural and economic circumstances—were not able to do so. Inother words, they were significantly and consistently moresuccessful than the norm. Countries were shortlisted using avalidated framework and were analyzed using three other vali-dated frameworks on political priority setting, scaling up, andstakeholder engagement. The study found that India, Pakistan,Nigeria, Senegal, Mexico, and Uruguay had scaled up (eithernationwide or in some states/provinces), sustained andenhanced their …

Effect Of Male Partners' Involvement And Support On Reproductive, Maternal And Child Health And Well-Being In East Africa: A Scoping Review, Richard Fletcher, Faye Forbes, Abel Fekadu Dadi, Getachew Mullu Kassa, Casey Regan, Anna Galle, Addisu Beyene, Rebecca Liackman, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background and Aims: East African countries have high rates of maternal and childmortality and morbidity. Studies have shown that the involvement of male partners inreproductive health can benefit maternal and child health (MCH). This scoping reviewaims to provide an overview of the evidence across East Africa that describes malepartner involvement and its effect on maternal, reproductive, and child well‐being.

Methods: Ten databases were searched to identify quantitative data on male'sinvolvement in East Africa. Studies reporting qualitative data, “intention to use” dataor only reporting on male partner's education or economic status were excluded.Studies were organized into five a priori categories: antenatal …

Enhancing Vaginal Delivery In Greece Through Educational And Behavioral Interventions Among Maternity Care Providers Regarding Labor Management: The Engage Stepped-Wedge Randomized Prospective Trial Protocol, Nikolaos Vrachnis, Nikolaos Antonakopoulos, Peter Von Dadelszen, Marianne Vidler, Georgios Maroudias, Jeffrey Bone, Ash Sandhu, Nikolaos Loukas, Laura Magee, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: There is an emerging need to systematically investigate the causes for the increased cesarean section rates in Greece and undertake interventions so as to substantially reduce its rates. To this end, the ability of the participating Greek obstetricians to follow evidence-based guidelines and respond to other educational and behavioral interventions while managing labor will be explored, along with barriers and enablers. Herein discussed is the protocol of a stepped-wedge designed intervention trial in Greek maternity units with the aforementioned goals in mind, named ENGAGE (ENhancinG vAGinal dElivery in Greece).

Methods: Twenty-two selected maternity units in Greece will participate in …

Preeclampsia In The Context Of Covid-19: Mechanisms, Pathophysiology, And Clinical Outcomes, Guilherme M Nobrega, Brittany R Jones, Indira U Mysorekar, Maria Laura Costa

Center on Aging Staff Publications

The emergence of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to the global COVID-19 pandemic, significantly impacting the health of pregnant women. Obstetric populations, already vulnerable, face increased morbidity and mortality related to COVID-19, aggravated by preexisting comorbidities. Recent studies have shed light on the potential correlation between COVID-19 and preeclampsia (PE), a leading cause of maternal and perinatal morbidity worldwide, emphasizing the significance of exploring the relationship between these two conditions. Here, we review the pathophysiological similarities that PE shares with COVID-19, with a particular focus on severe COVID-19 cases and in PE-like syndrome cases related with …

Breastfeeding As Co-Occupation: Occupational Therapy’S Role In Promoting Health And Well-Being, Lisa Joelle Sutton, Julie D. Kugel, Dragana Krpalek, Arezou Salamat

The Open Journal of Occupational Therapy

Background: Even with efforts to encourage mothers to breastfeed exclusively for the first 6 months, the majority of women are not able to undertake breastfeeding as the sole means of infant nutrition provision for various reasons. The role of occupational therapists working with mothers who breastfeed is complex and not strongly supported in the literature. Therefore, this qualitative study was designed to examine the role that occupational therapists may engage in supporting mothers and infants in the co-occupation of breastfeeding.

Method: A qualitative phenomenological study design was applied and included 11 occupational therapists working with breastfeeding dyads. The …

Multicountry Spread Of Influenza A(H1n1)Pdm09 Viruses With Reduced Oseltamivir Inhibition, May 2023-February 2024, Mira C Patel, Ha T Nguyen, Philippe Noriel Q Pascua, Rongyuan Gao, John Steel, Rebecca J Kondor, Larisa V Gubareva

Faculty, Staff and Student Publications

Since May 2023, a novel combination of neuraminidase mutations, I223V + S247N, has been detected in influenza A(H1N1)pdm09 viruses collected in countries spanning 5 continents, mostly in Europe (67/101). The viruses belong to 2 phylogenetically distinct groups and display ≈13-fold reduced inhibition by oseltamivir while retaining normal susceptibility to other antiviral drugs.

A Landscape Evaluation Of Caffeine Citrate Availability And Use In Newborn Care Across Five Low- And Middle-Income Countries, Osayame Ekhaguere, Olufunke Bolaji, Helen Nabwera, Andrew Storey, Nicholas Embleton, Stephen Allen, Zelalem Demeke, Olufunke Fasawe, Betty Wariari, Mansharan Seth

Centre of Excellence in Women and Child Health

Apnoea of prematurity (AOP) is a common complication among preterm infants (< 37 weeks gestation), globally. However, access to caffeine citrate (CC) that is a proven safe and effective treatment in high-income countries is largely unavailable in low- and-middle income countries, where most preterm infants are born. Therefore, the overall aim of this study was to describe the demand, policies, and supply factors affecting the availability and clinical use of CC in LMICs. A mixed methods approach was used to collect data from diverse settings in LMICs including Ethiopia, Kenya, Nigeria, South Africa, and India. Qualitative semi-structured interviews and focus group discussions were conducted with 107 different health care providers, and 21 policymakers and other stakeholders from industry. Additional data was collected using standard questionnaires. A thematic framework approach was used to analyze the qualitative data and descriptive statistics were used to summarize the quantitative data. The findings indicate that there is variation in in-country policies on the use of CC in the prevention and treatment of AOP and its availability across the LMICs. As a result, the knowledge and experience of using CC also varied with clinicians in Ethiopia having no experience of using it while those in India have greater knowledge and experience of using it. This, in turn, influenced the demand, and our findings show that only 29% of eligible preterm infants are receiving CC in these countries. There is an urgent need to address the multilevel barriers to accessing CC for managing AOP in Africa. These include cost, lack of national policies, and, therefore, lack of demand stemming from its clinical equivalency with aminophylline. Practical ways to reduce the cost of CC in LMICs could potentially increase its availability and use.

Implementation Of Specific Nutrition Interventions To Prevent Stunting In Pregnant Women In The Oesapa Community Health Center Area East Nusa Tenggara, Septa Katmawanti, Oktavia Sri Wahyuni, Farah Paramita, Agung Kurniawan, Siti Khuzaimah

Preventia: The Indonesian Journal of Public Health

Policies related to stunting prevention have been in place since 2013. However, the prevalence of stunting in East Nusa Tenggara Province is still the highest in Indonesia from 2013 to 2022. One of the areas in the province where the prevalence decreased from 2021 to 2022 is Kupang City. Oesapa Community Health Centre was appointed by the Indonesian Ministry of Health as a pilot health centre representing Kupang City. The purpose of this study is to describe the implementation of specific nutritional interventions for handling stunting based on the variables of communication, bureaucratic structure, resources, and disposition in the target …

Determinants Of Utilization Of Covid-19 Vaccination Services For Pregnant Women, Risa Septi Astutik, Ayun Sriatmi, Eka Yunila Fatmasari

Preventia: The Indonesian Journal of Public Health

The COVID-19 pandemic has caused an increase in the death rate of pregnant women. The government is taking preventive action by providing COVID-19 vaccination to pregnant women in accordance with the Circular Letter of the Ministry of Health of the Republic of Indonesia HK.02.01/I/2007/2021. Even though it has been carried out for 2 months, vaccination coverage is still low, especially in Temanggung Regency. This study aims to determine behavioral determinants in the use of COVID-19 vaccination services for pregnant women. This research uses an analytical survey method with a quantitative approach through a cross-sectional study. Taking 200 samples using the …

A Comparison Of Menstrual Health And Well-Being Among Adolescent Girls In Urban And Rural Areas Of The Belegavi District: A Crossectional Study, Arati Mahishale, Nagma Khan

Internet Journal of Allied Health Sciences and Practice

Background: Due to their relationship with several health hazards, menstrual hygiene management (MHM) and awareness are major public health concerns in both urban and rural settings. This study examined the awareness of MHM among adolescent girls in Belagavi and assessed their knowledge and understanding of menstruation and related taboos.

Methods: In the Belagavi District of Karnataka, India, a cross-sectional, community-based observational study was carried out. About 380 (as 8 were excluded) menstruating adolescent girls between the ages of 12 and 18 who attended different convent and government schools were included in the study. IBM SPSS version 20 was used to …

Prenatal Maternal Depression In Canada: Are Current Protocols Adequate?, Britney A. Glasgow-Osment, Farah Wahib, Madeleine Zanin, Shama Kassam

Master's in Interdisciplinary Medical Sciences Graduate Program

Throughout pregnancy, maternal and fetal health are influenced by a multitude of factors. Prenatal maternal depression is one such factor. It is well documented that prenatal maternal depression causes negative pregnancy outcomes for both the mother and baby, including irregular placental function, psychological distress, and pre-term birth, among others. In Ontario, the incidence of prenatal maternal depression is alarmingly high, at 10.3%.As such, the current tools for managing prenatal maternal depression must be effective, efficient, and comprehensive. We hypothesized that the current protocols for screening and treating prenatal maternal depression in Canada are inadequate. To investigate this, a literature review …

“I Had To Go There For My Own Safety” Negotiations Of Access And Autonomy Among Dc Birth Settings, Elizabeth Avery Borgmann

Geography Undergraduate Senior Theses

Childbirth experiences are shaped by spatial context. This study considers the relationships between access to, selection of, and experiences with labor and delivery care among Black birthing people in Washington, DC. Informed by Reproductive Justice and reproductive geographies frameworks, I employ a mixed methods GIS design that integrates mapping of potential spatial access with qualitative analysis of community members’ lived experiences. On the quantitative side, nearest-neighbor and 2-step floating catchment area analyses reveal an east-west gradient of potential spatial access to labor and delivery wards, with low access concentrated in predominantly Black and low-income census tracts of Wards 5, 7, …

Investigating The Association Between Metabolic Syndrome Conditions And Perinatal Mental Illness: A National Administrative Claims Study, Cecilia Ganduglia Cazaban

Faculty, Staff and Student Publications

BACKGROUND: Although the association between mental disorder and metabolic syndrome as a bidirectional relationship has been demonstrated, there is little knowledge of the cumulative and individual effect of these conditions on peripartum mental health. This study aims to investigate the association between metabolic syndrome conditions (MetS-C) and maternal mental illness in the perinatal period, while exploring time to incident mental disorder diagnosis in postpartum women.

METHODS: This observational study identified perinatal women continuously enrolled 1 year prior to and 1 year post-delivery using Optum's de-identified Clinformatics® Data Mart Database (CDM) from 2014 to 2019 with MetS-C i.e. obesity, diabetes, high …

Well-Child Visits For Early Detection And Management Of Maternal Postpartum Hypertensive Disorders, Farah H Amro, Kim C Smith, Syed S Hashmi, Michelle S Barratt, Rachel Carlson, Kristen Mariah Sankey, Michal Fishel Bartal, Sean C Blackwell, Suneet P Chauhan, Baha M Sibai

Faculty, Staff and Student Publications

IMPORTANCE: Innovative approaches are needed to address the increasing rate of postpartum morbidity and mortality associated with hypertensive disorders.

OBJECTIVE: To determine whether assessing maternal blood pressure (BP) and associated symptoms at time of well-child visits is associated with increased detection of postpartum preeclampsia and need for hospitalization for medical management.

DESIGN, SETTING, AND PARTICIPANTS: This is a pre-post quality improvement (QI) study. Individuals who attended the well-child visits between preimplementation (December 2017 to December 2018) were compared with individuals who enrolled after the implementation of the QI program (March 2019 to December 2019). Individuals were enrolled at an academic …

Postpartum Recovery After Severe Maternal Morbidity In Kilifi, Kenya: A Grounded Theory Of Recovery Trajectories Beyond 42 Days, Ursula Gazeley, Marvine Ochieng, Onesmus Wanje, Angela Koech, Grace Mwashigadi, Nathan Barreh, Alice Kombo, Mwanajuma Bakari, Grace Maitha, Marleen Temmerman

Centre of Excellence in Women and Child Health

Introduction The burden of severe maternal morbidity is highest in sub-Saharan Africa, and its relative contribution to maternal (ill) health may increase as maternal mortality continues to fall. Women’s perspective of their long-term recovery following severe morbidity beyond the standard 42-day postpartum period remains largely unexplored.

Methods This woman-centred, grounded theory study was nested within the Pregnancy Care Integrating Translational Science Everywhere (PRECISE) study in Kilifi, Kenya. Purposive and theoretical sampling was used to recruit 20 women who experienced either a maternal near-miss event (n=11), potentially life-threatening condition (n=6) or no severe morbidity (n=3). Women were purposively selected between 6 …

Fetal Brain-Derived Exosomal Mirnas From Maternal Blood: Potential Diagnostic Biomarkers For Fetal Alcohol Spectrum Disorders (Fasds), Nune Darbinian, Monica Hampe, Diana Martirosyan, Ahsun Bajwa, Armine Darbinyan, Nana Merabova, Gabriel Tatevosian, Laura Goetzl, Shohreh Amini, Michael E Selzer

Faculty, Staff and Student Publications

Fetal alcohol spectrum disorders (FASDs) are leading causes of neurodevelopmental disability but cannot be diagnosed early in utero. Because several microRNAs (miRNAs) are implicated in other neurological and neurodevelopmental disorders, the effects of EtOH exposure on the expression of these miRNAs and their target genes and pathways were assessed. In women who drank alcohol (EtOH) during pregnancy and non-drinking controls, matched individually for fetal sex and gestational age, the levels of miRNAs in fetal brain-derived exosomes (FB-Es) isolated from the mothers’ serum correlated well with the contents of the corresponding fetal brain tissues obtained after voluntary pregnancy termination. In six …

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 …

Pregnancy-Related Maternal Deaths In The State Of Georgia According To Timing And Causes Of Death, Anthony Kondracki, Wei Li, Mitch Mokhtari, Bhuvaneshwari Muchandi, John A. Ashby, Jennifer L. Barkin

Georgia Public Health Association Annual Meeting & Conference

BACKGROUND: This study examines pregnancy-related maternal deaths in the State of Georgia according to timing and causes of death in association with maternal sociodemographic characteristics. METHODS: Maternal mortality data from 2016 to 2019 were obtained from the Georgia Department of Public Health and the study sample was restricted to pregnancy-related deaths. Descriptive analyses compared timing and six leading underlying causes of maternal death in association with basic sociodemographic characteristics. A distribution of the leading underlying causes of death was conducted among the four time-points, i.e., during pregnancy, 0 to 60 days, 61 to 180 days, and 181 to 365 days …

A Case Study On The Effects Of Pregnancy On Expiratory Flow Limitation (Efl) And Operating Lung Volumes During Exercise, Hannah Young

Masters Theses, 2020-current

The purpose of this study was to examine the effects of pregnancy on expiratory flow limitation (EFL) and operating lung volumes (end expiratory lung volume and end inspiratory lung volume; EELV and EILV) during exercise, with an exploratory aim to assess differences in the above measures between exercise modalities. EFL has been shown to occur in several other subgroups but has never been studied in pregnant individuals. We followed one 35-year-old pregnant subject throughout her pregnancy, completing exercise and pulmonary testing every other week from 8 weeks gestation to 38 weeks gestation, and once again ~8 weeks postpartum. Testing was …

Use Of Point-Of-Care Ultrasound In The Diagnosis Of Postpartum Cardiomyopathy, Muhammad Noman, Frank A. Wheeler, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Postpartum cardiomyopathy (PPCM), also known as peripartum cardiomyopathy is a rare form of heart failure (HF) that occurs in the late stages of pregnancy or in the early postpartum period. For it to be classified as PPCM, it must occur in the absence of another identifiable cause for HF and have left ventricular (LV) systolic dysfunction with an LV ejection fraction (LVEF) less than 45%. Here we present the case of a 46-year-old female G3P2 presented 5 days postpartum cesarean section delivery in acute respiratory distress where point of care ultrasound was used for assessment of the lungs to visualize …

Maternal Health Outcomes Of The Least And Most Vulnerable Counties In Nj, Nayarith Lopez

Rowan-Virtua Research Day

- Maternal health continues to be of great concern in the United States.

-The maternal mortality rate for 2021 was 32.9 deaths per 100,000 live births, an increase from both 2020 and 2021.1

-The leading causes of pregnancy-related death are mental health, hemorrhage, and cardiovascular conditions. Most are preventable.2

-New Jersey ranks 27th, with 24.1 deaths occurring within 42 days of the end of a pregnancy per 100,000 live births.3

-While rates for the entire state show a need for improvement, in comparison to northern and central regions, rates in the southern region of NJ are approximately twice the state …

Management Strategies For Traumatic Injuries In Pregnant Women: A Comprehensive Literature Review, Jaylyn D. Thompson, Jenna Zappetti, Clarence Julian Clark Ii

Rowan-Virtua Research Day

Introduction: Traumatic injuries in pregnant women are the leading cause of non-obstetric death and affect 6% to 8% of all pregnancies. Therefore, it is imperative to maintain updated guidelines to construct a framework for the optimal management strategies for traumatic injuries in pregnant women, considering the perspectives of obstetrics/gynecology, emergency medicine, and orthopedics.

Methods: To conduct this study, research was done via a database search through the Rowan-Virtua School of Osteopathic Medicine’s research library. PubMed was the sole database used to review 8 peer-reviewed sources. Articles that were published within the last 10 years were chosen.

Results: Every woman with …

Insurance Status And Its Effect On Mothers With Postpartum Depression (Ppd) In The United States, Nikita Paranjape, Sanjana Davuluri, Alexander Youssef, Lillian J. Alonzo, Akshad Thirugnanam, Cara Fogarty

Rowan-Virtua Research Day

Postpartum depression (PPD) is a significant health issue in the US today: 1 in 8 new mothers experience symptoms of PPD. Understanding how social determinants of health impact the short and long-term health outcomes of patients with PPD is key to providing interventions that are effective, efficient, equitable, and patient-centered. In this literature review, we aimed to shed light on the association between discrepancies in health outcomes of mothers with PPD and their insurance status. A search was conducted across PubMed and ProQuest Central databases focusing on literature from 2014 onwards. Studies that explored factors contributing to PPD, the impact …

Barriers In Health Care Leading To High Maternal Mortality Rates In Southern New Jersey, Katarina Rusinak, Muznah Khan, Ava Dinardo, Nayarith Lopez

Rowan-Virtua Research Day

Maternal mortality remains a significant issue in New Jersey, particularly in the Southern counties where rates are alarmingly high. This study investigates barriers faced by mothers in these areas, utilizing data from state health departments, as well as the CDC. Findings reveal clear disparities in healthcare access and resources, exacerbated by high poverty and rural settings. Proposed interventions include educational posters and community workshops to empower expecting mothers and families. However, challenges such as low attendance and limited effectiveness of interventions underscore the need for comprehensive, sustainable solutions to tackle maternal mortality in Southern New Jersey.

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 …

A Review Of Risk Factors, Adverse Outcomes, And Counseling Strategies Among Pregnant Individuals With Eating Disorders, Alexandra Fontaine, Emily Meale

Rowan-Virtua Research Day

Background: Eating disorders (EDs) among women of childbearing age have become more prevalent on the global level. Identifying at-risk populations of women having EDs before, during, or after pregnancy is essential for clinicians to improve treatment and decrease the likelihood of negative maternal and/or fetal outcomes. Purpose: The purpose is to determine risk factors for women who have EDs throughout pregnancy, to identify negative pregnancy outcomes of women suffering from EDs, and to explore treatment and counseling options through the postpartum period. Methods: This literature review mainly utilizes sources from PubMed and the National Institute of Health databases. An expansive …

Addressing The Black Maternal Mortality Rate, Kennedy Sanders, Venkateswar Venkataraman, Kate Whelihan

Rowan-Virtua Research Day

Introduction: As of 2021, the Black maternal mortality rate in the United States was 69.9 deaths per 100,000 live births as compared to the national average of 32.9 and the White American average of 26.61. It has been demonstrated that this discrepancy is not fully explained by socioeconomic status. Doulas are professionals who provide support and guidance throughout pregnancy, birth, and early parenthood. Encouraging the use of doulas may be an effective approach to improve the birth experience for Black mothers. Methods: A literature review was performed using PubMed and the following search strings: maternal mortality rate (+race, +race +ethnicity, …