Maternal and Child Health Commons^™

Reframing Nutrition Policy For Under-Five Children In Thailand: Beyond The First 1,000 Toward 2,500 Days, Saipin Chotivichien, Waraporn Jitaree, Wareethip Phuengpan, Saiyed M. Hyder

Indonesian Journal of Public Health Nutrition (IJPHN)

Malnutrition continues to threaten child health globally, with Thailand mirroring this trend: in 2022, 12.4% of children under five were stunted, 7.2% wasted, and 10.9% obese. While the country’s First 1,000 Days initiative—targeting pregnancy to age two—yielded early success in reducing undernutrition, emerging gaps among 3–5-year-olds prompted a policy shift toward a broader 2,500-day framework. This approach, launched in 2022, extends care from preconception through age five and integrates multisectoral action involving five key ministries. Anchored in the “Power of Three Pillars”—policy, partnerships, and resources—the initiative strengthens local governance, enhances service delivery, and fosters family and community engagement through sub-district …

Birth Outcomes In The Hispanic Population In The United States: Trends, Variation, And Determinants (2011–2021), Yanchao Yang, Thinh Nguyen, Sota Fuji

Annual Student Research Poster Session

Infants born to mothers who self-identify as Hispanic account for a substantial and growing share of births in the United States, yet limited research has examined disparities in birth outcomes across Hispanic origin subgroups. This study aims to document trends and identify important factors associated with Cesarean section (C-section), low birthweight, and prematurity within the Hispanic population. We use data from the National Vital Statistics System (2011–2021), covering nearly all U.S. births. We compare outcomes across Hispanic, non-Hispanic White, and non-Hispanic Black mothers and further disaggregate by Hispanic origin (Mexican, Puerto Rican, Cuban, Central/South American, and Other/Unknown). We use logistic …

Spatiotemporal Modeling Of Maternal Mortality In South Carolina 2018-2023, Leah Wood, Ray Bai, Emily Mann

Senior Theses

Maternal death serves as a public health indicator due to fact that it is considered preventable with the availability of modern biomedicine, however, it persists broadly throughout the United States. Current literature outlines national trends in maternal mortality with complicating, preexisting conditions, and structural upstream factors often cited as being the largest contributors to increased risk. This study utilizes publicly available, county-level data for maternal death in addition to demographic and descriptive data in order to estimate maternal mortality rates in each of South Carolina’s 46 counties from 2018 to 2023. In order to address sparsity in the outcome variable …

Determinants Of Uptake Of Breast Cancer Screening Among Women Of Reproductive Age In Makueni County, Lola Ndirangu

MSc in Advanced Practice Nursing

Background: Breast cancer is the most diagnosed cancer in all women worldwide, with women in low and middle-income countries dying of the disease in disproportionate numbers because of late diagnosis and access to screening services. Sub-Saharan Africa is an under-researched area, and the level of screening uptake in Kenya, especially in rural and semi-arid areas, including Makueni County, is low. This research assessed the factors that determine the reproductive age women's screening uptake of breast cancer in Makueni County.

Methodology: The cross-sectional design was analytical and was conducted in Makueni County Referral Hospital, where 301 randomly chosen women …

Regain Confidence Postpartum: A Guide For Pelvic Floor Health​, Taylor Jackson, Mary Jan Greer, Donna Carver

Fall 2025 OTD Capstone Symposium

Postpartum pelvic floor dysfunction can disrupt daily occupations such as toileting, hygiene, mobility, sexual health, sleep, and infant care. These challenges often reduce confidence and limit participation. Although pelvic floor issues are common, occupational therapy has not been widely recognized in this emerging area, leaving a gap in functional, client-centered support.

This capstone project developed Regain Confidence Postpartum: A Guide for Pelvic Floor Health, an occupation-focused resource designed to help postpartum individuals understand pelvic floor dysfunction and return to meaningful routines. A needs assessment was completed through clinical observation, discussions with providers at Purely Pelvic Floor, and a review …

Low Unintended Dural Puncture Rate Using A Flush-Measure-Check-Advance Technique To Perform Combined Spinal-Epidural Anesthesia In Parturients: A Quality Improvement Clinical Series, James Riopelle, Julie Gayle, Zubaer Anwar, Jeff Burton

School of Medicine Faculty Publications

Background: Reported rates of unintended dural puncture during performance of continuous epidural anesthesia (CEA) or combined spinal-epidural anesthesia (CSEA) have remained steady at approximately 0.5% to 1% since the 1970s. Methods: A modified method of inserting the Tuohy epidural catheterization needle was used during performance of CSEA in 393 parturients. A single staff/faculty anesthesiologist performed or supervised resident use of a flush-measure-check-advance Tuohy needle insertion algorithm. Results: The rate of evident Tuohy needle dural puncture during the series was 0%. One parturient experienced a post-dural puncture headache possibly because of intentional subarachnoid puncture with a very small diameter (25 gauge) …

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 ( …

Material Hardship And Postpartum Depression: The Moderating Role Of Social Support Across Family Structures, Christine Pham, Chantal Uzoma, Monica Perez

Research Colloquium

Background: Economic hardship is a significant risk factor for postpartum depression (PPD), a condition with lasting impacts on maternal and child well-being (Agrawal et al., 2022). Although social support is theorized to buffer stress, little is known about whether its protective effects on PPD differ by family structure (Wang et al., 2023).

Objective: The objective of the current study is to examine whether higher social support moderates the association between material hardship and postpartum depression among new mothers and whether this relationship varies across marital status groups (married, cohabiting, single).

Methods: Data will be drawn from Wave 1 of the …

Sex-Specific Associations Between Early Life Unpredictability And Trajectories Of Body Mass Index From Infancy To Adolescence, Emily M. Melnick, Lilybelle K. Deer, Jenalee R. Doom, Hal S. Stern, Curt A. Sandman, Laura M. Glynn, Elysia P. Davis

Psychology Faculty Articles and Research

Objective:

Unpredictability in early life is an understudied aspect of early life adversity that provides important signals to the child about their environment. Recent work shows the predictability of patterns of parental signals on a moment-to-moment timescale sculpts the developing brain during sensitive windows, offering a potential pathway through which early life experiences shape child development. Both experimental non-human animal models and observational human research show sex-specific links between early life exposure to unpredictable patterns of parental sensory signals and aberrant offspring development. The impact of predictability of sensory signals on physical health outcomes, such as BMI, remains unknown. Here …

Medical Students’ Perspectives On Dobbs V Jackson Women’S Health Organization, Victoria Lazarov, Cecilia Mastrogiacomo, Mikaela Koch, Kirsten Wohlars, Tova Ablove, Student Perspectives On Reproductive Rights Research Group

Cooper Rowan Medical Journal

Background: In June 2022, the Dobbs v Jackson Women’s Health Organization ruling overturned the previously upheld constitutional right to abortion. The resulting impact on medical training and student decision-making remains uncertain. This study aims to assess the nationwide impact of the Dobbs decision on medical students’ geographic residency preferences, specialty selection, and level of concern regarding civil and criminal charges for physicians providing abortion and fertility care.

Methods: An anonymous IRB-approved REDCap survey was distributed to American accredited medical schools across the United States and Israel between December 2022 and May 2023. Participants indicated specialty interests and geographic preferences for …

Neonatal Striatal Volume Is Associated With Infant Anhedonia, Melissa Nevarez-Brewster, Catherine H. Demers, Jessica L. Irwin, Laura M. Glynn, Martin A. Styner, Mercedes Hoeflich Haase, M. Camille Hoffman, Diego A. Pizzagalli, Benjamin L. Hankin, Elysia Poggi Davis

Psychology Faculty Articles and Research

Anhedonia is increasingly recognized as a transdiagnostic risk factor for psychopathology. New evidence demonstrates that anhedonia is present in infancy and early childhood. Structural variability in striatal regions involved in reward processing and pleasure seeking is concurrently linked to anhedonia, yet few studies have examined whether striatal differences presage anhedonia, and none have examined prospective associations before middle childhood. The present study examined whether neuroanatomical markers that confer risk for anhedonia can be detected as early as the neonatal period. Specifically, we tested whether the volume of striatal regions in neonates predicted the emergence of infant anhedonic behaviors at six …

Appearance Over Function - The Impact Of Long-Term Oral Contraceptive Use On Brain Development, Breast Tissue Composition, And Future Lactation Outcomes, Fiona M. Wang

Dissertations

This integrative review examines the long-term effects of combined oral contraceptive (COC) use beginning in puberty on brain development, breast tissue composition, and future breastfeeding outcomes. Puberty is a critical developmental stage during which hormonal changes significantly impact the neurological and reproductive systems. The introduction of synthetic estrogen and progestin through COC use during this time may disrupt natural hormonal pathways, potentially altering neuroendocrine signaling and breast tissue maturation. Such changes may have lasting consequences, including impaired milk production, a weakened milk ejection reflex, disrupted maternal-infant bonding, and reduced overall breastfeeding success. The review synthesizes findings from endocrinology, neuroscience, and …

The Psychosocial Impact Of Covid-19 Mitigation Measures On Frontline Staff Providing Sexual Health And Family Planning Services In Kenya: A Mixed-Methods Study, Ferdinand Okwaro, Abdu Mohiddin, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background The recognition of the unintended impact of COVID-19 mitigation measures to the availability of sexual and reproductive health (SRH) services led to the initiation of mitigation and health systems support mechanisms within public health facilities by the Ministry of Health (MoH) in Kenya to maintain pre-Covid-19 levels of SRH service provision. These recovery mechanisms however concentrated on policy and infrastructural elements of service provision with limited attention given to the psychosocial impacts of COVID-19 on health care workers (HCWs). This paper examines the psychosocial impact of COVID-19 on front line family planning (FP) and sexually transmitted infections (STI) management …

Routine Antenatal Ultrasound By Nurse-Midwives In Rural Kenya: A Pragmatic Trial Assessing Feasibility And Effects Of The Mimba Yangu (My Pregnancy) Project, Claudia Hanson, Lucy Nyaga, Nidhi Leekha, Michaela Mantel, Sarah Kedenge, Caroline Gitonga, Violet Naanyu, Jasmit Shah, Marleen Temmerman

Centre of Excellence in Women and Child Health

Introduction: Task-sharing of obstetric ultrasound between nurse-midwives and doctors has the potential to operationalize the World Health Organization’s recommendation of at least one ultrasound before 24 weeks of gestational age for every pregnant woman. Here, we report on the feasibility, acceptability, and effects of the Mimba Yangu (My Pregnancy) task-sharing approach in rural Kenya.

Methods: We conducted a pragmatic trial including 28 primary care facilities between April 2021 and March 2022, selected based on feasibility criteria. Fourteen facilities received the ultrasound intervention composed of (i) task-sharing with nurse-midwives, (ii) the use of portable ultrasound devices (Lumify™) connected to a tablet, …

Women's Unique Health Needs And The Sustainable Development Goals: A Meeting Report From The 79th United Nations General Assembly Science Summit, Irene Aninye, Sarah Chew, Nicole Althaus, Michele Barry, Ru-Fong Cheng, Carolyn Harris, Eleanor Nwadinobi, Beth Battaglino, Aisha Brooks, Marleen Temmerman

Centre of Excellence in Women and Child Health

Biological sex, hormones, and gender uniquely affect health and disease, often resulting in disparities for women across the lifespan and from different racial and ethnic groups, geographical locations, and socio economic backgrounds. Without intentional investment and infrastructure to support good health and wellbeing for women,half of the world’s population remains vulnerable to preventable morbidity and mortality. The Society for Women’s Health Research and ECHAlliance–The Global Health Connector convened a women’s health programas part of the 10th Annual Science Summit during the United Nations 79th General Assembly. This hybrid event was held in New York, NY, (USA) and virtually in September …

Improved Obstetric Hemorrhage Care Through Toolkit Revision: A Quality Improvement Project, Samantha Kalkstein, Amber Woodring

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric hemorrhage (OBH) remains a leading cause of preventable maternal morbidity and mortality in the United States. Accurate risk identification is critical for initiating timely interventions; however, current risk assessment practices vary significantly. This quality improvement (QI) project aimed to implement the California Maternal Quality Care Collaborative (CMQCC) OBH Risk Assessment Tool on the labor and delivery (L&D) unit of a community-based hospital to standardize risk stratification and improve interdisciplinary communication. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, the project involved a gap analysis, staff education, and the introduction of a paper-based CMQCC tool formatted for visibility and …

Hubungan Kualitas Pemeriksaan Kehamilan Terhadap Kejadian Stunting Pada Anak Usia 6-23 Bulan Di Indonesia (Analisis Ski 2023), Hanna Audila, Helda Helda, Sudarto Ronoatmodjo

Jurnal Epidemiologi Kesehatan Indonesia

Stunting is still a nutritional problem and remains a major public health issue. Especially in Indonesia, the prevalence of stunting among children under two years old (toddlers) remains high, at 18.50%. The annual average rate of reduction of stunting among toddlers has been relatively slow for over the past 10 years. Therefore, optimizing stunting interventions-particularly during the first 1000 days of life is essential, including through antenatal care (ANC). This study aims to analyze the relationship between the quality of antenatal care and the incidence of stunting among children aged 6-23 months-old in Indonesia, after being controlled by the other …

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.

A Qualitative Analysis Of The Lived Experience Of Active-Duty Servicewomen Receiving Perinatal Care Within The Military Health System., Caitlin Russell, Emily Balog, Anne Teitelman, Rosemary Polomano

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVES: We explored the lived experiences of active-duty servicewomen (ADSW) accessing and receiving care during the perinatal period (from discovery of pregnancy to 1 year postpartum) within the Military Health System.

STUDY DESIGN: Using qualitative methods, we conducted semi-structured interviews between September 2022 and February 2023 with 23 ADSW participants who were pregnant or within their first year postpartum. Data were analyzed using inductive coding and thematic analysis techniques.

RESULTS: Participants reported bureaucratic hurdles and long wait times for accessing care, too little choice in providers, and inadequate coordination between civilian and military care providers. Those who experienced perinatal complications …

Kind Kids, Healthy Teens: Child Prosociality And Fruit And Vegetable Intake, Farah Qureshi, Krista P. Woodward, Laura D. Kubzansky, Julia K. Boehm

Psychology Faculty Articles and Research

Introduction

Methods