Maternal and Child Health Commons^™

Implementation Of A Doula-Supported Postpartum Wellness Toolkit In A Black Community-Based Maternal Wellness Program, Janice Luethje, Leslie Torres

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to expand the areas of focus within a maternal wellness program at a Black community center and to evaluate the satisfaction levels of the doulas who utilized the material during postpartum home visits. The toolkit covers a range of postpartum topics in the areas of nutrition, exercise, sexual health, mindfulness, and social support as well as a postpartum mental health screening tool.

Design: This quality improvement project included three distinct phases: The pre-implementation phase, the implementation phase, and the post-implementation phase.

Setting: The project location was a Black community center in Lincoln, Nebraska. …

Improving Patients’ Perception Of Provider Trust And Communication With Birth Plans, Christelle Reeves, Nicole Tenzel, Timothy Kremer

North Texas Research Forum 2024

Objective: Birth plans are an effective tool for a pregnant person to express their desires and expectations for labor and postpartum. Shortcomings of birth plans can be found whenever there is a lapse in communication between provider and patient. In the management of labor and emergent situations, it has been observed by patients that obstetric providers can communicate in authoritarian and dismissive manners. In response to this, birth plans were developed to serve as a guide in these scenarios. Birth plans allow a pregnant person to design a thoughtful plan of action with their healthcare provider before giving birth, rather …

Protocols For Postpartum Hemorrhage, Nicole A. Mitchell, Wilbur Greene, Samantha Claxton, Lydia Lester

Student Scholar Showcase

The purpose of this study was to examine the relationship between the protocols for postpartum hemorrhage and lack of implementation, how race may play a role in care, the different effect on maternal lives; physically and mentally, and more effective treatment options. Many women all over the world struggle with postpartum hemorrhaging as it is a life-threatening complication that can follow giving birth. There are standard protocols set in place for different facilities that relay how the healthcare professionals should act in that situation. The PICOT question, “In child-bearing women, how do protocols for postpartum hemorrhage compared with a lack …

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

Spring 2024 Virtual OTD Capstone Symposium

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

Pharmacologic Management Of Postpartum Hemorrhage In An Urban Hospital, Jessica Summer Martin Bsn, Rn, Alison Brubaker Doyle Bsn, Rn, Lacey Camille Ballard Bsn, Rn, Stephanie Marie Maupin Bsn, Rn, Kate Fouquier Phd, Aprn, Cnm, Facnm

Doctor of Nursing Practice Projects

This retrospective chart review examined female patients (N=25) who had a postpartum hemorrhage. Electronic medical records from Regional One Health were queried for ICD-10 072 related codes from January 1, 2021-October 31, 2023. Of those, a maximum of 25 charts were identified and the information was deidentified. All data was de-identified, coded, encrypted, housed, and locked securely. Selected records that met the above criteria were then queried for the following: Baseline demographics, gravida, para, amount of blood loss, pharmacological and non-pharmacological interventions, and timing of tranexamic acid (TXA) administration. Data was imported into MS Excel and statistical analysis was conducted …

Impact Of Fads Genotype On Polyunsaturated Fatty Acid Content In Human Milk Extracellular Vesicles: A Genetic Association Study, John J. Miklavcic, Natalie Paterson, Jennifer Hahn-Holbrook, Laura M. Glynn

Food Science Faculty Articles and Research

Background

Extracellular vesicles in human milk are critical in supporting newborn growth and development. Bioavailability of dietary extracellular vesicles may depend on the composition of membrane lipids. Single-nucleotide polymorphisms (SNPs) in the fatty acid desaturase gene cluster impact the content of long-chain polyunsaturated fatty acids in human milk phospholipids. This study investigated the relation between variation in FADS1 and FADS2 with the content of polyunsaturated fatty acids in extracellular vesicles from human milk.

Methods

Milk was obtained from a cohort of mothers (N = 70) at 2–4 weeks of lactation. SNPs in the FADS gene locus were determined using …

Effect Of Russian Current And Structured Exercise Program On Postpartum Diastasis Recti Abdominis: A Case Series, Nagma Khan, Ashwini Bulbuli

Internet Journal of Allied Health Sciences and Practice

Background: Diastasis recti abdominis (DRA) is the most common complication occurring post-delivery that limits the functional well-being of the affected individuals. Management of diastasis recti can include an abdominal binder, core strengthening, taping, and various surgical procedures. There is limited evidence to support the Russian current and structured exercise intervention in managing patients with DRA. Methodology: Three patients identified with DRA underwent a multi-modal treatment regimen including a hot moist pack, Russian current, abdominal binder, transverse abdominus activation exercises, treadmill training, and stationary cycling training. Outcomes were assessed using the visual analogue scale, abdominal girth, Ranney DRA scale, Oswestry …

The Koolungar Moorditj Healthy Skin Project: Elder And Community Led Resources Strengthen Aboriginal Voice For Skin Health, Bernadette M. Ricciardo, Jacinta Walton, Noel Nannup, Dale Tilbrook, Heather-Lynn Kessaris, Carol Michie, Brad Farrant, Roni Forrest, Annette Garlett, Joanne Hill, Larissa Jones, Natasha Kickett, Sally Smith, Delys Walton, Taleah Ugle, Nadia Rind, Richelle Douglas, Jodie Ingrey, Brenda Carter, Ainslie Poore, Ingrid Amgarth-Duff, Hannah Thomas, Prasad S. Kumarasinghe, Jonathan R. Carapetis, Asha C. Bowen

Journal of the Australian Indigenous HealthInfoNet

In partnership with local Aboriginal Community Controlled Health Organisations, the Elder-led co-designed Koolungar Moorditj Healthy Skin project is guided by principles of reciprocity, capacity building, respect, and community involvement. Through this work, the team of Elders, community members, clinicians and research staff have gained insight into the skin health needs of urban-living Aboriginal koolungar (children); and having identified a lack of targeted and culturally appropriate health literacy and health promotion resources on moorditj (strong) skin, prioritised development of community-created healthy skin resources. Community members self-appointed to Aboriginal Community Advisory Groups (CAG) on Whadjuk (Perth) …

Birth Defect Trends Within Texas Public Health Region 11, 2000-2019: An Analysis Of Texas Department Of State Health Services Public Data., Miguel A. Lopez, Jonathan M. Hebert, Padmanabhan Rengasamy

Research Symposium

South Texas is a predominantly Hispanic region with high rates of chronic illness, poor healthcare access, and a history of birth defect clusters. Between 1986 and 1991, 47 cases of anencephaly in Cameron County were linked to elevated fumonisins in the region’s corn-based diet, prompting a series of ongoing public health efforts. This paper aims to identify changes in prevalence for CNS defects, in addition to cardiac, circulatory, gastrointestinal, and genitourinary defects in South Texas within the last two decades. Public data on 20 birth defects from the Texas Department of State Health Services were obtained for decades 2000-2010 and …

Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki

Medical Student Research Symposium

In 2019, the Academy of Breastfeeding Medicine issued a revised set of educational objectives for medical trainees at various stages of education. In this statement, objectives for medical school were broken down into preclinical and clinical training objectives. In this project, our goal is to assess the degree to which medical training at Wayne State University School of Medicine is addressing these aims.

The assessment of breastfeeding education is accomplished by surveying medical students at various stages of training (M1-M4) and eliciting their level of confidence in and understanding of the topics outlined in the objectives by the Academy of …

A Systematic Review Of Measures Of Healthcare Workers’ Vaccine Confidence, Kofoworola Akinsola, Ayobami Bakare, Elisa Gobbo, Carina King, Claudia Hanson, Adegoke Falade, Sibylle Herzig Van Wees

Centre of Excellence in Women and Child Health

Healthcare workers (HCW) perceptions toward vaccines influence patient and community vaccine decision making. In an era of rising vaccine hesitancy, understanding HCW vaccine confidence is critical. This systematic review aims to review instruments that have been validated to measure HCW vaccine confidence. We conducted a search in five databases in June 2023. Data was descriptively synthesized. Twelve articles describing 10 different tools were included. Most tools included dimensions or items on vaccine knowledge (n = 9), safety (n = 8), vaccine usefulness (n = 8), recommendation behavior (n = 8), and self-vaccination practice (n = 7). All, except one study, …

Dhea: A Neglected Biological Signal That May Affect Fetal And Child Development, Natasha A. Bailey, Elysia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

The stress-sensitive maternal hypothalamic–pituitary–adrenal (HPA) axis through the end-product cortisol, represents a primary pathway through which maternal experience shapes fetal development with long-term consequences for child neurodevelopment. However, there is another HPA axis end-product that has been widely ignored in the study of human pregnancy. The synthesis and release of dehydroepiandosterone (DHEA) is similar to cortisol, so it is a plausible, but neglected, biological signal that may influence fetal neurodevelopment. DHEA also may interact with cortisol to determine developmental outcomes. Surprisingly, there is virtually nothing known about human fetal exposure to prenatal maternal DHEA and offspring neurodevelopment. The current study …

Identifying Rural Health Clinics Within The Transformed Medicaid Statistical Information System (T-Msis) Analytic Files, Katherine Ahrens Mph, Phd, Zachariah Croll, Yvonne Jonk Phd, John Gale Ms, Heidi O'Connor Ms

Rural Health Clinics

Researchers at the Maine Rural Health Research Center describe a methodology for identifying Rural Health Clinic encounters within the Medicaid claims data using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files.

Background: There is limited information on the extent to which Rural Health Clinics (RHC) provide pediatric and pregnancy-related services to individuals enrolled in state Medicaid/CHIP programs. In part this is because methods to identify RHC encounters within Medicaid claims data are outdated.

Methods: We used a 100% sample of the 2018 Medicaid Demographic and Eligibility and Other Services Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files for 20 states …

Enhancing Pastoralist Women's Knowledge Of Danger Signs Through Home-Based Life-Saving Skills Intervention In Northern Kenya: A Quasi Experimental Study, Dabo Galgalo Halake, Elijah Isinta Maranga, Japheth Mativo Nzioki, John Gachohi

Faculty Publications

Background: Maternal recognition of obstetric danger signs is crucial for reducing maternal mortality and delays in seeking emergency care. However, there is insufficient knowledge about obstetric danger signs among women in rural Kenya, especially in the hard-to-reach pastoralist communities. This study aimed to determine whether home-based life-saving skills intervention improves knowledge about obstetric danger signs among women in Marsabit County, Kenya. Methods: We conducted a quasi-experimental study with pre-posttests among 256 pregnant women, allocated to intervention and control groups. We implemented sensitization of pregnant women on obstetric danger signs and basic life-saving actions as components of home-based life-saving skills intervention. …

Covid-19 Prevalence And Trends Among Pregnant And Postpartum Persons In Maine By Rurality And Pregnancy Conditions, Charlie O. Grantham, Christina M. Ackerman-Banks Md, Heather S. Lipkind Md, Ms, Kristin Palmsten Scd, Katherine A. Ahrens Mph, Phd

Journal of Maine Medical Center

No abstract provided.

Infant Mortality Rates Vary Substantially Across Regions Of The United States, Marissa Merrifield

Population Health Research Brief Series

Infant mortality rates are higher in the United States than in its high-income peer countries. Additionally, infant mortality rates vary within the U.S., with much higher rates in some geographic regions compared to others. This data slice uses data from the U.S. Centers for Disease Control and Prevention to compare infant mortality rates by geographic region in the U.S. between 2017-2021. The results show that the infant mortality rate was the highest in the South and lowest in the Northeast and West.

Black Women Have The Highest Maternal Mortality Rate In The United States, Tori-Ann Haywood

Population Health Research Brief Series

The U.S. maternal mortality rate is consistently higher than its high-income peer countries. Since 2018 maternal mortality rates in the U.S. have steadily increased for all ethnoracial groups. This data slice uses data from the U.S. National Center for Health Statistics to describe U.S. maternity mortality rates for women ages 15-45 across different ethnoracial groups between 2018-2022. Results show that, except for non-Hispanic (NH) Asian women, ethnoracial minority women have higher maternal death rates than NH White women.

Women In Health And Their Economic, Equity And Livelihood Statuses During Emergency Preparedness And Response (Wheeler) Protocol: A Mixed Methods Study In Kenya., Evaline Chepchirchir Langat, Bilali Yusuf Mazoya, Pauline Oginga, Ferdinand Okwaro, Norah Matheka, Irene Kibara, Rhoda Otieno, Michaela Mantel, Robert Lorway, Marleen Temmerman

Centre of Excellence in Women and Child Health

Introduction: Kenya reported its first COVID-19 case on 13 March 2020. Pandemic-driven health system changes followed and unforeseen societal, economic and health effects reported. This protocol aims to describe the methods used to identify the gender equality and health equity gaps and possible disproportional health and socioeconomic impacts experienced by paid and unpaid (community health volunteer) female healthcare providers in Kilifi and Mombasa Counties, Kenya during the COVID-19 pandemic.

Methods and analysis: Participatory mixed methods framed by gender analysis and human-centred design will be used. Research implementation will follow four of the five phases of the human-centred design approach. Community …

Challenges And Opportunities For Improving Access To Adolescent And Youth Sexual And Reproductive Health Services And Information In The Coastal Counties Of Kenya: A Qualitative Study., Evaline Chepchirchir Langat, Abdu Mohiddin, Flaura Kidere, Anisa Omar, Job Akuno, Violet Naanyu, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Globally, adolescents and youth experience high unmet need for sexual and reproductive health (SRH) information and services. In Kenya, evidence shows that more than half of teenage pregnancies are unintended and that half of all new HIV infections occur in people ages 15-24-year-olds, with the majority of those being female. The coastal counties in Kenya record a relatively high adolescent pregnancy rate and higher rates of unmet need for contraception for all women of reproductive age compared to the national average. This study focused on gaining a deeper understanding of the existing challenges to and opportunities for accessing SRH …

The Contradictory Nature Of U.S. Laws And Nutrition Programs And Their Effects On Infant Feeding, Lily Patel

Journal of Food Law & Policy

The contradictory nature of U.S. laws, including the laws concerning infant feeding, though supposedly aligned with policies to promote wellness in Americans, can exacerbate gender and race inequality and work against the National Strategy. The overarching goal of U.S. laws concerning infant feeding is to ensure that infants are fed, nourished, and receive proper nutrition. However, the laws often appear to be directly contradictory to one another in the priorities they are promoting.