Maternal and Child Health Commons^™

Government Efforts And Personal Opinion Explain The Medicalization Of Pregnancy And Childbirth Through Time In Lower Mustang, Nepal, Ruth Baker

Independent Study Project (ISP) Collection

The way that women approach pregnancy and childbirth in rural Nepal has seen an amazing change in the past twenty to thirty years. The medicalization of this entire process, from pre-­‐ to post-­‐natal care, comes with government efforts for the increased education of women about family planning, nutrition, hygiene, and the proposed benefits of institutional versus in-­‐home delivery. In 9 villages of Lower Mustang, interviews conducted with Government Health Post workers, Female Health Volunteers, and women of different ages sought to discern personal experience and opinion about pregnancy and childbirth from the perspective of both local women and those with …

Premature Births And Maternal Health: An Analysis Of Risk Factors That Affect The Rate Of Prematurity / Los Nacimientos Prematuros Y La Salud Materna: Un Análisis De Los Factores De Riesgo Que Afecta La Tasa De Prematuridad, Alexandria Mickler

Independent Study Project (ISP) Collection

Research Question: What are the major socio-demographic risk factors influencing the rate of preterm birth in Valparaiso, Chile? Objectives: The objective of this study is to identify risk factors that influence the rate of preterm birth in an urban population of women living in Valparaiso, Chile. This study aims to understand whether a relationship exists between socio-demographic characteristics, such as economic level, education, lifestyle, access to medical attention and resources and the risk of prematurity. The outcomes of this study seek to determine the major biological, cultural, and social relationships and identify at-risk social groups. Additionally, this study considers the …

Perspectives From Community-Based Doulas And Mothers: Neighborhood Context And Pregnancy, Dara D. Mendez, Jessica Burke, Jennifer Jones, Cynthia Salter

Journal of Health Disparities Research and Practice

Objectives: Limited research explores the potential pathways by which neighborhoods influence pregnancy or how community members conceptualize and interpret how neighborhood contexts and living environments influence pregnancy and birth.

Study Design: We applied participatory Concept Mapping and a series of focused discussions with community-based doulas and mothers.

Methods: We collaborated with a community-based doula program to investigate how mothers and community doulas perceived the neighborhood to influence reproductive health. We conducted a series of focused discussions including ‘Brainstorming’ to uncover key themes related to how neighborhood context influenced pregnancy, ‘Sorting and Rating’ of key themes in association with pregnancy and …

A Community Conversation On Adolescent Pregnancy And Parenting Services: Networks Of Support, Gatekeepers To Care, And Non-Compulsory Fathering In A Black Urban Community, Tamara G.J. Leech, Elizabeth A. Adams, Marci Bounds Littlefield

Journal of Health Disparities Research and Practice

This study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serves as a …

Community Conversation Guide: How Can Our Community Support The Breastfeeding Experience In Brookings Businesses, Becky Kuehl, Jenn Anderson, Sara A. Mehltretter Drury, Charlotte Bachman, Marilyn Hildreth, Jamison Lamp, Mary Schwaegerl, Lois Tschetter, Julia Yoder

Communication Studies Publications

This forum is an opportunity for our community to come together and consider breastfeeding and support for our mothers and children with fresh eyes, fresh ideas, and a fresh conversation. Our conversation today will consider different approaches for increasing breastfeeding support in local businesses.
This guide introduces the issue, explains concerns with the breastfeeding experience in Brookings businesses, and presents three approaches to improving support. These approaches are not the only possible responses to the issue. Instead, they represent different ways that our community can take action based on our priorities.

Use Of Antenatal Corticosteroids And Tocolytic Drugs In Preterm Births In 29 Countries: An Analysis Of The Who Multicountry Survey On Maternal And Newborn Health, Joshua P. Vogel, João Paulo Souza, A Metin Gülmezoglu, Rintaro Mori, Pisake Lumbiganon, Zahida Qureshi, Guillermo Carroli, Malinee Laopaiboon, Bukola Fawole, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Despite the global burden of morbidity and mortality associated with preterm birth, little evidence is available for use of antenatal corticosteroids and tocolytic drugs in preterm births in low-income and middle-income countries. We analysed data from the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS) to assess coverage for these interventions in preterm deliveries.

Methods: WHOMCS is a facility-based, cross-sectional survey database of birth outcomes in 359 facilities in 29 countries, with data collected prospectively from May 1, 2010, to Dec 31, 2011. For this analysis, we included deliveries after 22 weeks’ gestation and we excluded births that …

Medicaid Pays For That? An Exploratory, Mixed-Methods Analysis Of Florida Home Birth, Nicole K. Demetriou

USF Tampa Graduate Theses and Dissertations

The overwhelming social norm for pregnant women in the U.S. is to receive prenatal care from an obstetrician and to give birth in a hospital setting. However, the incidence of midwifery care and out-of-hospital birth is increasing, particularly among White, non-Hispanic women. Florida has been considered a "model" state for home birth midwifery given legislative support that mandates coverage of all types of midwifery (e.g., Certified Professional Midwives and Certified Nurse-Midwives) care in all birth settings (e.g., hospital, home, birth center) and by all forms of insurance (e.g., commercial and Medicaid). Medicaid is the payer source for nearly half of …

Access To Comprehensive Perinatal Services Among Pregnant Women Enrolled In Both Medi-Cal And Covered California: Aligning And Integrating Care, Sara J. Rosenbaum, Carla Hurt, Mark Dorley, Sara Rothenberg, Nancy Lopez

Health Policy and Management Faculty Publications

Medi-Cal-enrolled women who are pregnant are entitled to coverage for enriched pregnancy-related care under Medi-Cal’s Comprehensive Perinatal Services Program (CPSP), a national landmark in the care and management of pregnant women with elevated health risks due to their low economic status. This entitlement applies to all pregnant women enrolled in Medi-Cal, including women who also are enrolled in subsidized health plans purchased through Covered California. The task that jointly faces Medi-Cal and Covered California is how best to align these two sources of pregnancy care financing in order to achieve a central goal of SB 857 – ensuring that dually …

A Review Related To Midwifery Led Model Of Care, Shahnaz Shahid, Rafat Jan, Rahat Najam Qureshi, Salma Rattani

School of Nursing & Midwifery

Background: Midwifery led care (MLC) is a model of care in which perinatal care is provided to women throughout different phases of childbirth by a midwife.
Objective: This paper aims to provide a literature review on MLC.
Methods: A variety of databases and reports were considered to do the literature review on MLC. The search was limited from 1991 to 2011 by using keywords. A total of 50 articles were critically appraised for this review.
Findings: The main theme that emerged was women ^’s satisfaction with MLC. Satisfaction was integrated with midwife ^’s presence throughout childbirth, experience to …

“In Light Of Real Alternatives”: Negotiations Of Fertility And Motherhood In Morocco And Oman, Victoria E. Mohr

Student Publications

Many states in the Arab world have undertaken wide-ranging family planning polices in the last two decades in an effort to curb high fertility rates. Oman and Morocco are two such countries, and their policies have had significantly different results. Morocco experienced a swift drop in fertility rates, whereas Oman’s fertility has declined much more slowly over several decades. Many point to the more conservative religious and cultural context of Oman for their high fertility rates, however economics and the state of biomedical health care often present a more compelling argument for the distinct differences between Omani and Moroccan family …

A Community Conversation On Adolescent Pregnancy And Parenting Services: Networks Of Support, Gatekeepers To Care, And Non-Compulsory Fathering In A Black Urban Community, Tamara Leech, Elizabeth A. Adams, Marci Littlefield

Department of Public Health Scholarship and Creative Works

This study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serve as a …

Syrian Refugee Families’ Awareness Of The Health Risks Of Child Marriage And What Organizations Offer Or Plan In Order To Raise Awareness, Rachel Fowler

Independent Study Project (ISP) Collection

The hypothesis of the study assumes: If Syrian refugee families understood the health risks involved with child marriage and the severity of these risks, they would be less likely to choose to marry off their daughter under the age of 18. If these families had more health educational programs and had more access to these programs, these programs would influence their decision towards avoiding child marriage for their daughter(s).

According to UNICEF, one-third of registered marriages among Syrian refugees in Jordan between January and March 2014 involved girls under the age of 18. Child marriage puts girls at risk of …

Approaches To Improve Quality Of Care (Qoc) For Women And Newborns: Conclusions, Evidence Gaps And Research Priorities, Zulfiqar Ahmed Bhutta, Rehana A. Salam, Zohra S. Lassi, Anne Austin, Ana Langer

Department of Paediatrics and Child Health

Despite progress in recent years, an estimated 273,500 women died as a result of maternal causes in 2010. The burden of these deaths is disproportionately bourne by women who reside in low income countries or belong to the poorest sectors of the population of middle or high income ones, and it is particularly acute in regions where access to and utilization of facility-based services for childbirth and newborn care is lowest. Evidence has shown that poor quality of facility-based care for these women and newborns is one of the major contributing factors for their elevated rates of morbidity and mortality. …

Childhood Obesity Fieldwork Summary Report: The Food Education Project, Maria De Rosario Vasquez

Master's Projects and Capstones

Childhood Obesity and diabetes is on the rise and the health risk for developing various diseases is a major public health issue. This paper examines the public health issue on childhood obesity and diabetes. This paper explains the importance and magnitude of this problem by providing statistics, research efforts, educational efforts and the importance of preventing childhood obesity and diabetes. The paper will summarize, explain observations and provide insight on fieldwork completed through a project called The Food Education Project. The project focuses on addressing the major public health problem through educating children and adolescents on health, nutrition, food and …

County Of San Mateo Adolescent Report 2014-2015 Youth And Adults Working Together For A Healthy Future, Vanessa D. Bolton

Master's Projects and Capstones

The purpose of this paper is to highlight my fieldwork experience with the County of San Mateo Health System’s Health Policy and Planning Unit. Under the guidance of a Community Health Planner, my scope of work was within the area of school wellness, ranging from an adolescent report publication to researching breakfast in the classroom models to attending district wellness policy meetings. The San Mateo County Adolescent Report took precedence over most of the school wellness projects and initiatives because it was seeking to identify the needs of the County’s youth using evidence from various data sources and to develop …

Fieldwork Summary Report: Reducing Repeat Teenage Pregnancy Through Program Planning And Evaluation, Winnie Y. Chan

Master's Projects and Capstones

This fieldwork summary report provides a synthesis of both my overall fieldwork experience at TAPP, Felton Institute’s Teenage Pregnancy and Parenting Program, and my Master of Public Health knowledge and skill sets. Since researching the huge social and economic impact that teenage pregnancy and parenting has not only on the teens and their children, but also the society at large, I strived to highlight prevention aspects to reduce repeat unwanted teenage pregnancy. So, I chose to intern at TAPP, focused my fieldwork project mainly on program development and evaluation, along with other aspects of improving wellness.

I begin this report …

Women's Empowerment And Contraceptive Use: The Role Of Independent Versus Couples' Decision-Making, From A Lower Middle Income Country Perspective, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque Sheikh, Ghazunfer Abbas, Marleen Temmerman, Bilal Iqbal Avan

Community Health Sciences

Introduction: There is little available evidence of associations between the various dimensions of women's empowerment and contraceptive use having been examined--and of how these associations are mediated by women's socio-economic and demographic statuses. We assessed these phenomena in Pakistan using a structured-framework approach.
Methods: We analyzed data on 2,133 women who were either using any form of contraceptive or living with unmet need for contraception. The survey was conducted during May - June 2012, with married women of reproductive age (15-49 years) in three districts of Punjab. The dimensions of empowerment were categorized broadly into: economic decision-making, household decision-making, and …

Herd Immunity And The Necessity Of Vaccinations: Modeling The Effects Of Mmr Vaccinations, Caitlyn Cardetti, Katie Groskreutz, Melissa Zins

Journal of Undergraduate Research at Minnesota State University, Mankato

The MMR vaccination is a two dose vaccine given to children between the ages of 12 – 15 months and the second dose between the ages of 4 – 6 years to prevent measles, mumps, and rubella. The objective was to mathematically model the effects of the MMR vaccinations in a hypothetical school through multiple compartment and spatial models. These models were based on each disease individually with their respective vaccine effectiveness and disease infection rates. These models demonstrated the limits of herd immunity. Herd immunity occurs when a high enough percentage of the population is immune or vaccinated to …

Policy Impact Assessment: The “Reasonable Break Time” Provision Of The Patient Protection And Affordable Care Act, Merritt Juliano

21st Century Social Justice

Breastfeeding continues to be the most optimal source of nutrition for infants under 6 months of age, and has been associated with a wide variety of infant and maternal health benefits, including protection against certain illnesses and diseases. Most health organizations recommend exclusive breastfeeding for at least the first 6 months post-birth. Despite these recommendations, breastfeeding women, especially those in lower socioeconomic groups face many challenges in our society. Moreover, maternal employment stands as a significant barrier to successful breastfeeding durations. To counter these problems, Section 4207 of the Patient Protection and Affordable Care Act [ACA] was enacted to offer …

Increasing Maternal Or Post-Weaning Folic Acid Alters Gene Expression And Moderately Changes Behavior In The Offspring, Subit Barua, Kathryn K. Chadman, Salomon Kuizon, Diego Buenaventura, Nathan W. Stapley, Felicia Ruocco, Umme Begum, Sara R. Guariglia, W. Ted Brown, Mohamad Junaid

Publications and Research

Background: Studies have indicated that altered maternal micronutrients and vitamins influence the development of newborns and altered nutrient exposure throughout the lifetime may have potential health effects and increased susceptibility to chronic diseases. In recent years, folic acid (FA) exposure has significantly increased as a result of mandatory FA fortification and supplementation during pregnancy. Since FA modulates DNA methylation and affects gene expression, we investigated whether the amount of FA ingested during gestation alters gene expression in the newborn cerebral hemisphere, and if the increased exposure to FA during gestation and throughout the lifetime alters behavior in C57BL/6J mice.

Methods …