Matern Child Health J [JOURNAL]
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200 papers
Maternal Characteristics and U.S. Prenatal Care: Associations with Neonatal Health and Postpartum Maternal Wellbeing.
Nordgren I, Duncan RJ, Moding KJ … +1 more , Posada GE
Matern Child Health J · 2025 Sep · PMID 40624320 · Full text
Prenatal care provides an opportunity for the promotion of healthy parent and neonatal outcomes, but there are gaps in understanding the consequences and antecedents of prenatal care experiences during pregnancy. The obj...
Prenatal care provides an opportunity for the promotion of healthy parent and neonatal outcomes, but there are gaps in understanding the consequences and antecedents of prenatal care experiences during pregnancy. The objective of the current study was to provide insight into the mediational processes of sociodemographic and pregnancy characteristics on neonatal health and postpartum maternal wellbeing outcomes through prenatal care experiences. Data were analyzed from the publicly available Listening to Mothers III dataset comprised of 2,400 online-survey participants (ages 18-45) who gave birth to singleton infants in hospitals between July 2011 and June 2012 in the U.S. Primary analyses were conducted using two separate path analysis models examining maternal characteristics (i.e., sociodemographic and pregnancy factors) and the mediation of prenatal care experiences (i.e., responsive provider behavior, week of first prenatal visit, and attendance in group prenatal care) on infant health (i.e., preterm, low birthweight, NICU stays) and postpartum maternal wellbeing (i.e., social support, depression, confidence). The perceived need for treatment of depression and smoking during pregnancy resulted in 0.15 and 0.20 larger proportions of infants admitted into the NICU, respectively. Women who reported responsive provider behavior indicated higher social support (b = 0.29, p <.001), less depressive symptomology (b = -0.20, p <.001), and felt more confident (b = 0.07, p =.005). While maternal characteristics were related to neonatal health, the interpersonal experiences during prenatal care related to postpartum maternal wellbeing, indicating a need for providers to bolster their responsiveness to women during prenatal visits.
Health Care Utilization and Family Frustration: Do Health Insurance Coverage and Medical Homes for US Children Matter?
Mehmood G, Giannouchos TV
Matern Child Health J · 2025 Sep · PMID 40615749 · Full text
OBJECTIVE: To examine the association of health services utilization and family frustration in getting health care services with the intersection of consistent and adequate health insurance coverage and access to medical...
OBJECTIVE: To examine the association of health services utilization and family frustration in getting health care services with the intersection of consistent and adequate health insurance coverage and access to medical home care among children in the US. METHODS: We conducted a pooled, cross-sectional data analysis using the 2016-2023 National Survey of Children's Health data. Survey-weighted multivariable logistic regressions were used to estimate the association of emergency department (ED) visits, preventive care utilization, and family frustration in getting services with the intersection of having consistent and adequate health insurance coverage and comprehensive access to medical home care. RESULTS: Of 279,789 children representing 61.9 million children from 2016 to 2023, 79.0% had one or more preventive care visits, 17.9% had at least one ED visit, and 18.7% of families reported being frustrated in efforts to get care for their children in the past 12 months. Overall, 33.1% of children were consistently and adequately insured and had access to medical home care, while 21.0% had neither. Compared to children with consistent and adequate health insurance coverage and access to a medical home, children without either or both consistent and adequate health insurance coverage and access to medical home care were less likely to have at least one preventive care visit and, their families were more likely to report frustration in obtaining services. CONCLUSION FOR PRACTICE: Improving access to medical home care is critical to minimize disparities in preventive care use and to improve health outcomes for children, beyond comprehensive health insurance coverage.
Exploring the Multilevel Determinants of Suboptimal Maternal and Child Continuum of Care in Indonesia.
Widyaningsih V, Mohanty I, Mulyaningsih T … +6 more , Gebremedhin TA, Miranti R, Zaen NA, Nugroho SD, Azmiardi A, Probandari A
Matern Child Health J · 2025 Jul · PMID 40613953 · Full text
OBJECTIVE: Understanding the multilevel factors associated with completeness of care across the continuum of maternal and child health is needed in order to reduce maternal and child mortality and morbidity in Indonesia....
OBJECTIVE: Understanding the multilevel factors associated with completeness of care across the continuum of maternal and child health is needed in order to reduce maternal and child mortality and morbidity in Indonesia. This study aims to assess the multilevel determinants of continuum of care (CoC) and its contextual factors in Indonesia. METHODS: Data from the 2017 Indonesian Demographic and Health Survey were analyzed. A total of 14,398 women aged 15-49 years who had live births 5 years preceding the survey were analyzed for maternal CoC, while data from 9,206 women and their children (aged < 36 months) were analyzed for maternal CoC and vaccination. Maternal CoC include antenatal care visits, safe facility delivery, and postnatal care. Vaccination includes the 10 recommended dosages of vaccination adjusted for age. Multilevel logistic regression was used to analyse variations in maternal CoC at the individual, household and community levels. RESULTS: Our findings showed that only half of the women in our study had the complete maternal CoC, and only one-third had both the complete CoC and vaccination for their children. The odds of completing CoC and vaccination are lower among women aged < 20 years, have ≥ 4 children, have low socioeconomic status, and live in rural areas or outside Java-Bali. Pregnancy-related factors were also associated with CoC completeness. CONCLUSIONS FOR PRACTICE: Targeted interventions to improve awareness and increase access that go beyond the individual factors should be developed. In addition to awareness campaigns, interventions aimed at reducing disparities across the different regions in Indonesia should be implemented to improve completeness of maternal CoC and vaccination.
The Origins and Evolution of the Maternal and Child Health Journal, 1991-2025.
Kotelchuck M, Petersen DJ, De Ver Dye T
Matern Child Health J · 2025 Aug · PMID 40593434 · Publisher ↗
The Maternal and Child Health Journal, a preeminent peer-reviewed scientific and practice journal of the MCH field, was established 25 years ago to showcase research and practice in MCH and to provide a forum that enhanc...
The Maternal and Child Health Journal, a preeminent peer-reviewed scientific and practice journal of the MCH field, was established 25 years ago to showcase research and practice in MCH and to provide a forum that enhances and reflects our ever-expanding field. The three surviving editors reflect on the history, evolution, and future of the MCH Journal-with special emphasis on the MCH Journal's origins, and on the lived experience of the editors. APHA's MCH section formed a committee in Nov 1991 to explore creation of a journal. This effort culminated in March 1997 with the publication of the first issue of the MCH Journal, which has since published over 240 subsequent issues. The MCH Journal evolved from a small quarterly print journal to a large monthly, abstracted, print and digital Journal that publishes over 200 + articles and receives almost 1,000,000 downloads annually. Milt Kotelchuck (1997-2003) helped create and sustain the culture of the Journal in its earliest most precarious stage of development, secured Medline abstraction and digital publication, and fostered MCH Epidemiology and Social Determinants of Health (SDOH) initiatives. Greg Alexander and Donna Petersen (2004-2012) expanded the frequency and size of the Journal, implemented its Editorial Manager System, expanded author and reviewer writing capacity and quality, strengthened ties with MCH practitioners, and increased the MCH Journal's use as a pedagogic tool. Tim Dye (2013-present) continued expanding and globalizing the Journal introducing a monthly format; broadened the scope of disciplines and types of articles published; and-through aligning publication policies-uplifted voices of communities traditionally marginalized by academic presses. The MCH Journal continues to provide a critical platform for the publication of MCH research, practice, policy, and professional development, helping to define, strengthen, and forcefully advocate for our MCH field and advance MCH population health, social justice, and equity.
Intimate Partner Violence Against Indigenous Women and Association with Stunting and Anemia in Children: A Mixed Approach in Chimborazo-Ecuador.
Rivadeneira MF, Naranjo MD, Barrera MF … +5 more , Trujillo P, Montaluisa MA, Moncayo AL, Grijalva D, Torres AL
Matern Child Health J · 2025 Jul · PMID 40580271 · Full text
OBJECTIVES: This study aimed to describe intimate partner violence in Indigenous women and assess its association with stunting and anemia among children less than five years of age in Chimborazo, Ecuador. METHODS: This...
OBJECTIVES: This study aimed to describe intimate partner violence in Indigenous women and assess its association with stunting and anemia among children less than five years of age in Chimborazo, Ecuador. METHODS: This study used a mixed-methods research design with two components: A cross-sectional study was conducted among 317 children under 5 years of age and their mothers. Structured questionnaires were used to collect data on Spousal Index Abuse, family socioeconomic characteristics, and alcohol consumption. Data on children's anthropometric measurements and hemoglobin were quantified. Bivariate and multivariate Poisson regressions were performed to determine the association of stunting and anemia with intimate partner violence. Additionally, a qualitative study was conducted with focus groups in 28 indigenous women from rural communities in Chimborazo. RESULTS: 31.5% (n = 100) of women were exposed to nonphysical IPV and 18% (n = 57) to physical IPV. Spousal alcohol consumption frequency of twice a month or more was associated with a probability 4.2 times greater of being a victim of IPV (95% CI 1.14-12.6). Physical and non-physical IPV was 2.71 (95% CI 1.36-5.39) and 3.48 times (95% CI 1.4-8.6) more prevalent in households without drinking water supply or sewerage network, respectively. There was not a statistically significant association between IPV and stunting in children. Maternal physical and nonphysical IPV was associated with a higher prevalence of anemia, 2.1 times higher for physical (95% CI 1.8-5.0) and 2.6 for nonphysical IPV (95% CI 1.1-5.8). The focus group discussions revealed a relationship between violence, age, religion, poverty, lack of education, and limited access to public services. For mothers, violence is related to sadness, which affects the health and nutrition of their children. CONCLUSIONS: This study suggests that children of women exposed to IPV are at greater probability of suffering from anemia. Therefore, an integral approach to IPV prevention is required, through social protection and healthcare policies for mothers and children, considering the intercultural context.
Global Maternal Child Health Initiatives and Programs 1974 to 2023.
Jackson D
Matern Child Health J · 2025 Aug · PMID 40579684 · Full text
AIM: This review paper aims to review Global MCH initiatives and note trends across the last five decades (1974-2023). METHODS: As an organizing framework, MCH initiatives and programs have been classified into five cate...
AIM: This review paper aims to review Global MCH initiatives and note trends across the last five decades (1974-2023). METHODS: As an organizing framework, MCH initiatives and programs have been classified into five categories: Global Health Conferences, Declarations or Strategies; Global Health Surveys; Global MCH Programs; Global MCH related Data Initiatives or Working/Advisory Groups; and Global MCH Partnerships or Networks. RESULTS: Over 50 Global MCH initiatives and programs have been implemented during this period. The first International Conference on Primary Health Care and the Alma Ata Declaration in 1978 initiated a new era of global public health. International conferences building on Alma Ata with a focus on population health and MCH, along with global surveys to measure the health status of populations across countries and global working groups to analyze these data, emerged over the next decades. Global MCH partnerships also emerged for advocacy and coordination of an increasing number of efforts to improve maternal, newborn, child and adolescent health and well-being-towards achieving the Millennium (2000-2015) and Sustainable (2016-2030) Development Goals. CONCLUSION: Four trends were noted across these five decades: (1) MCH Mortality decreased but unacceptable inequities persist with COVID-19, ongoing conflicts and climate change threatening these gains. (2) Implementation of primary health care (PHC) as envisioned by Alma Ata in 1974 continues to see a debate about selective versus comprehensive programs. (3) As mortality declined (Survive), the field expanded focus to child well-being (Thrive) and across preconception through adolescents (Transform). (4) Global MCH issues are relevant across high-income (HIC) and low-middle income (LMIC) settings to achieve health and well-being of all women and children everywhere.
Improving Access to Mental Health Care among Children who Receive Subspecialist Care.
Gigli KH, Graaf G
Matern Child Health J · 2025 Jul · PMID 40571849 · Publisher ↗
OBJECTIVES: Children and Youth with Special Healthcare Needs (CYSHCN) have high rates of unmet health care need, particularly mental health. To increase access to mental health care, policymakers support pediatric subspe...
OBJECTIVES: Children and Youth with Special Healthcare Needs (CYSHCN) have high rates of unmet health care need, particularly mental health. To increase access to mental health care, policymakers support pediatric subspecialists providing mental health care. Yet it is unclear how great the need for this role might be. This study described mental health care needs among CYSHCN who needed pediatric subspeciality care, and rates at which needs go unmet. METHODS: We conducted a retrospective cohort study of 20,335 CYSHCN who needed subspecialist care from 2016 to 2021 using pooled National Survey of Children's Health data. Analysis described rates of mental health care need and unmet need. RESULTS: 40% (N = 8,538) of CYSHCN who needed subspecialist care had mental health care needs. CYSHCN receiving care from a specialist had a significantly lower unmet need for mental health care, compared to those who did not receive specialist care (12.5% vs. 43.5%). Receiving subspecialist care was associated with a 24-percentage point decrease in unmet mental health need. CONCLUSIONS FOR PRACTICE: CYSHCN who receive subspecialist care have high rates of mental health care need, most need is met. Future work should explore strategies to support subspecialists in the provision of holistic, physical, and mental, health care without assuming roles as mental health care providers.
The Relationship Between Adherence to the MIND Diet and Maternal Anxiety and Sleep Disorders.
Bahrami A, Zamaninasab Z, Khorasanchi Z … +4 more , Zarban A, Asadian AH, Ferns GA, Karbasi S
Matern Child Health J · 2025 Jul · PMID 40562986 · Publisher ↗
OBJECTIVES: Maternal diet is essential for the mother's and infant's health. Our Study aimed to evaluate the relationship between breastfeeding mothers' psychological distress and the Mediterranean diet and Dietary Appro...
OBJECTIVES: Maternal diet is essential for the mother's and infant's health. Our Study aimed to evaluate the relationship between breastfeeding mothers' psychological distress and the Mediterranean diet and Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet. METHODS: The data were collected in a cross-sectional survey conducted by the authors in 2021. Psychological parameters were assessed in 350 breastfeeding mothers using the Quality of Life (QL) Questionnaire, Depression Scale, Anxiety Questionnaire, and Pittsburg Sleep Quality Index (PSQI). A Food Frequency Questionnaire (FFQ) assessed adherence to the MIND diet. RESULTS: Mothers in the highest tertile of the MIND diet had significantly lower maternal sleep disturbance scores (3.71 ± 3.61 vs. 5.28 ± 3.89; P < 0.001), lower anxiety scores (30.86 ± 7.49 vs. 32.89 ± 7.90; P-value = 0.01) and better maternal mental health (21.58 ± 3.68 vs. 20.76 ± 3.15) compared to those in the lowest tertile. After controlling for potential confounders, adherence to the MIND pattern was associated with less maternal sleep disturbance (β = 0.89; 95%CI: 0.82-0.96). CONCLUSIONS: for practice. Adherence to the MIND diet is potentially associated with less sleep disturbance in breastfeeding mothers.
Association of Chronic Diabetes with 42-Day Readmission after Delivery Hospitalization.
Boyd M, DuBois D, Tilford JM … +3 more , Rezaeiahari M, Goudie A, Brown CC
Matern Child Health J · 2025 Jul · PMID 40553363 · Full text
OBJECTIVES: To evaluate the impact of chronic diabetes on 42-day hospital readmission rates and hospitalization costs following hospital delivery discharge. METHODS: Using 2016-2019 data from the Hospital Cost and Utiliz...
OBJECTIVES: To evaluate the impact of chronic diabetes on 42-day hospital readmission rates and hospitalization costs following hospital delivery discharge. METHODS: Using 2016-2019 data from the Hospital Cost and Utilization Project Nationwide Readmissions Database, we conducted a propensity score matched analysis comparing individuals with and without chronic diabetes. Given the strong relationship between severe maternal morbidity and readmission, we used an exact match for severe maternal morbidity during the delivery hospitalization. The study evaluated three outcomes: (1) readmission rates within 42 days of discharge from the delivery hospitalization, (2) total hospitalization costs during the delivery and readmissions within 42 days, and (3) total hospitalization costs for readmission hospitalizations. RESULTS: Adjusted analyses showed 61% [adjusted Odds Ratio: 1.61; Confidence Interval: (1.52, 1.71)] higher rates of postpartum hospital readmission within 42 days (4.49% vs. 2.85%; p < 0.001) and 24% higher total delivery hospitalization costs plus the cost of readmission among individuals with chronic diabetes relative to individuals without diabetes ($9,047 vs. $7,296; p < 0.001). Hospital readmissions costs were higher for individuals with diabetes compared with individuals without diabetes at the time of delivery ($9,136 vs. $8,363; p = 0.03). CONCLUSIONS FOR PRACTICE: Continued efforts to prevent and control chronic diabetes may be important for prevention of postpartum hospital readmissions and increased associated costs.
Experiences of Lactation in GME: Are there Benefits Beyond the Parent and Infant?
Sheffield V, Tomlinson S, McCaffery H … +1 more , McCormick AD
Matern Child Health J · 2025 Jul · PMID 40536654 · Full text
INTRODUCTION: Although lactating graduate medical education trainees often encounter barriers when returning to work-such as perceived challenges on clinical teams-the potential benefits arising from their lactation expe...
INTRODUCTION: Although lactating graduate medical education trainees often encounter barriers when returning to work-such as perceived challenges on clinical teams-the potential benefits arising from their lactation experiences remain understudied. In particular, no prior research has examined whether working alongside lactating trainees enhances knowledge and patient care. The purpose of this study was to assess trainee perceptions of how experiences with lactation impacted their knowledge of lactation and ability to care for lactating patients. METHODS: In 2022, all residents and fellows at a large academic medical center were eligible to participate in an anonymous electronic survey. Data analyses included chi-squared testing of lactation experiences and trainee self-perceived ability to care for lactating patients. RESULTS: 133/1319 (10%) of trainees representing 31 programs completed the survey. 87% of participants disagreed that they felt uncomfortable about a co-resident pumping in their presence. Personal experience with lactation was associated with perceived increase in knowledge of lactation (p = 0.012) as well as perceived ability to better care for a lactating patient (p < 0.001) when compared with no experience with lactation, or experience through others. Among those without personal lactation experience, 71% felt their knowledge of lactation improved and 42% believed their ability to care for lactating patients was better due to their experiences working with lactating teammates. CONCLUSIONS: Lactation does not disrupt other residents on the team and may positively impact the care of lactating patients. The benefits of lactation may extend beyond the lactating parent and their infant.
Exploring Determinants of Exclusive Breastfeeding among Mothers in Jiangsu, China.
Wu Q, Wacharasin C, Tang Y
Matern Child Health J · 2025 Jul · PMID 40536653 · Publisher ↗
OBJECTIVES: The World Health Organization (WHO) recommends exclusive breastfeeding (EBF) for infants under 6 months, but EBF practices in China face significant challenges. This study aimed to evaluate EBF duration and i...
OBJECTIVES: The World Health Organization (WHO) recommends exclusive breastfeeding (EBF) for infants under 6 months, but EBF practices in China face significant challenges. This study aimed to evaluate EBF duration and its determinants among Chinese mothers in Jiangsu Province. METHODS: This prospective study recruited 374 mothers from postnatal wards of hospitals. On the day of discharge, a face-to-face survey was conducted, utilizing a demographic record form, the Breastfeeding (BF) Knowledge Questionnaire, the BF Attrition Prediction Tool, the Perception of Insufficient Milk (PIM) Questionnaire, and the Infant Feeding Intention Scale. After discharge, 3 follow-up calls were conducted with an EBF record form. AMOS 23.0 software were employed to perform structural equation modelling. RESULTS: Only 12.30% of the participants sustained EBF until 6 months postpartum. BF intention, maternity leave, and perceived control had direct positive effects on EBF. Subjective norm, perceived control and PIM had indirect positive effects on EBF through BF intention. BF knowledge indirectly influenced EBF through BF attitude, subjective norm, perceived control, and PIM, all in positive directions. Additionally, BF attitude had an indirect positive effect on EBF through subjective norm. CONCLUSIONS: Predictors of EBF for the first 6 months were successfully identified in this study, highlighting the importance of a multi-faceted approach. To support EBF, nurses, employers, and governments must collaborate. Providing lactation facilities, time off for milk expression, and comprehensive maternity leave, along with targeted nursing interventions, can extend EBF durations and improve maternal and infant health.
Obstetric Unit Closure Effects on Child Academic Achievement, Infant Health, and Maternal Care.
Wehby GL
Matern Child Health J · 2025 Jun · PMID 40506613 · Full text
OBJECTIVE: To examine effects of obstetric unit closures on children's academic achievement, infant health, and maternal care outcomes. METHODS: This retrospective cohort study employs 1994-2009 birth certificate data fr...
OBJECTIVE: To examine effects of obstetric unit closures on children's academic achievement, infant health, and maternal care outcomes. METHODS: This retrospective cohort study employs 1994-2009 birth certificate data from Iowa linked to school test scores for grades 2-11 through 2017-2018. Regressions based on two-way fixed effects (TWFE) and Callaway and Sant'Anna (C&S) difference-in-differences models estimate the effects of maternal residence in counties that had obstetric unit closures within 5 years before birth year. Outcomes are national percentile rankings (NPRs) on math and reading, gestational age, preterm birth, birthweight, low birthweight, prenatal visits, cesarean delivery, and labor induction. RESULTS: The sample included 2,414,393-2,424,184 child-grade observations and 379,772-381,228 children depending on the outcome. TWFE estimates were - 0.66 (95% CI: - 1.48, 0.15) NPRs for math and - 0.86 (95% CI: - 1.93, 0.21) NPRs for reading. C&S estimates were - 0.88 (95% CI: - 4.48, 2.72) NPRs for math and 0.30 (95% CI: - 4.93, 5.52) NPRs for reading. Closure associations with gestational age were - 0.1 (95% CI: - 0.17, - 0.028) and - 0.09 weeks (95% CI: - 0.28, 0.09) in the TWFE and C&S models, respectively; associations with birthweight were - 33 g (95% CI: - 59, - 7) and - 2 g (95% CI: - 57, 54), respectively. Associations with other infant health and maternal outcomes were small and not statistically significant. CONCLUSIONS: There is overall little evidence that obstetric unit closure within 5 years before birth impact children's math and reading scores and infant health and maternal care outcomes. Future research can evaluate how closures affect care continuity and access and potential heterogeneity including by maternal health risks and pregnancy complications.
Caring for A Child with Autism Spectrum Disorder: A Metaphor Study.
Uncu B, Gokcek AI, Aras N
Matern Child Health J · 2025 Jul · PMID 40465190 · Publisher ↗
OBJECTIVE: It aims to explore the language used by women about their experiences of caring for their child with autism spectrum disorder through metaphor, and to provide a valuable source of insight for midwives and othe...
OBJECTIVE: It aims to explore the language used by women about their experiences of caring for their child with autism spectrum disorder through metaphor, and to provide a valuable source of insight for midwives and other clinicians. METHODOLOGY: The study was a prospective qualitative study with a phenomenological approach based on semi-structured, individual and in-depth interviews and observations of the participants. Data saturation was achieved after 11 participants were interviewed. Data were collected in a private clinic between January and May 2024. RESULTS: This metaphor analysis revealed ten metaphors that mothers used to describe their experience of caring for their child with an autistic spectrum disorder. These metaphors were described as a treasure, a maze, a boat trip, a tangled knot, a newly discovered planet, a late bearing tree, a mountaintop, a new day, an alien and a newly sprouted flower. CONCLUSIONS: In conclusion, paying attention to the metaphors that women with children on the autistic spectrum use to describe their caring situation can provide midwives and other clinicians with rich insights into understanding women.
Inequality in Utilization of Maternal Healthcare Services in Low‑ and Middle‑Income Countries: A Scoping Review of the Literature.
Misu F, Gasbarro D, Alam K
Matern Child Health J · 2025 Jun · PMID 40461773 · Full text
BACKGROUND: Inequality in maternal healthcare service (MHS) utilization is a significant global health challenge in low- and middle-income countries (LMICs). Recently, the literature on MHS inequality in LMICs has expand...
BACKGROUND: Inequality in maternal healthcare service (MHS) utilization is a significant global health challenge in low- and middle-income countries (LMICs). Recently, the literature on MHS inequality in LMICs has expanded. We conducted a scoping review to synthesize existing evidence and identify knowledge gaps. METHODS: Following PRISMA-ScR guidelines, we systematically searched PubMed, Scopus, and CINAHL Ultimate in June 2023 for literature published since January 1, 2015. We included empirical studies using nationally representative data to measure inequality in at least one of five MHS indicators: antenatal care (ANC), skilled birth attendance (SBA), facility-based delivery (FBD), caesarean-section (C-section) delivery, and postnatal care (PNC). Our review encompassed 132 peer-reviewed articles on MHS inequality in LMICs. RESULTS: ANC, FBD, and SBA were more frequently analyzed indicators for inequality measurement compared to PNC and C-section delivery. None of the 132 studies assessed all five MHS indicators together. The concentration index was the most frequently used inequality measure across all MHS indicators. Included studies were predominantly focused on economic (wealth) and geographic (residence, region) inequalities, while sociocultural factors (e.g., religion, ethnicity) remain underexplored. Inequality was most pronounced in low-income (LICs) and lower-middle-income countries (LwMICs). The extant literature mainly concentrates on India and Ethiopia as research settings. CONCLUSION: Our review highlights significant gaps in health inequality research, particularly in LICs and upper-middle-income countries (UMICs), with a heavy reliance on cross-sectional data, limited assessment of PNC and C-section delivery and lack of comprehensive analysis across all five common MHS indicators. Future research in LMICs should address the gaps identified in this review.
MCH and Abortion: Towards a Stronger Relationship.
Allen D, Sable MR, Bennett T
Matern Child Health J · 2025 Aug · PMID 40437266 · Publisher ↗
The history of abortion rights in the US is long and contentious. Women have always had abortions, legal or not, and the legalization fight in recent history has been led by feminists. This paper tracks the course of tha...
The history of abortion rights in the US is long and contentious. Women have always had abortions, legal or not, and the legalization fight in recent history has been led by feminists. This paper tracks the course of that history through the Progressive Era of the first wave feminists, second wave feminism from the 1960s to the 1973 Roe v. Wade Supreme Court decision, the reactive period of trying to minimize the harm of abortion restrictions, and the consequences of the 2022 Dobbs v. Jackson Women's Health Organization decision overthrowing Roe v. Wade. For each time period we ask who was leading the fight, how they framed their advocacy, who were their opponents and what arguments they used, and the extent to which maternal and child health (MCH) professionals and institutions engaged in the struggle. We offer recommendations for MCH practice going forward to (1) embrace women's health and health care as inseparable from infant, child, and family health, and abortion as central to women's physical and mental health; (2) build partnerships and coalitions among entities identified with MCH and those advocating reproductive rights, particularly abortion; (3) become voices for abortion as an essential part of MCH and public health; and (4) framing abortion as an equity issue. Women's judgment about the timing of their own childbearing and women's ability to act on that judgment improves maternal and child survival and wellbeing.
Interventions Initiated Before and After Pregnancy for Women who Experience Severe Nausea and Vomiting of Pregnancy: A Scoping Review.
El-Dirani Z, Araz K, Bazzi O … +7 more , O'Leary N, Kent G, Nana M, Williamson C, Devin J, O'Brien E, Flynn AC
Matern Child Health J · 2025 Jun · PMID 40423907 · Full text
INTRODUCTION: Nausea and vomiting of pregnancy (NVP) affects up to 90% of women, while hyperemesis gravidarum (HG), a severe form of NVP, impacts quality of life, and ability to eat and drink normally, with reported recu...
INTRODUCTION: Nausea and vomiting of pregnancy (NVP) affects up to 90% of women, while hyperemesis gravidarum (HG), a severe form of NVP, impacts quality of life, and ability to eat and drink normally, with reported recurrence rates up to 89% in subsequent pregnancies. Severe NVP has a profound impact on maternal physical and mental health, impairing daily functioning and quality of life, and is associated with anxiety and depression. AIMS: To conduct a scoping review to identify and characterise interventions initiated before and after pregnancy that aim to mitigate the impact and consequences of severe NVP on maternal health. METHODS: A comprehensive search was conducted across seven electronic databases and included grey literature without restrictions on language or date. Eligible studies were identified according to a prespecified criteria. All references were screened independently by two reviewers. FINDINGS: Three studies were included; two utilised pre-emptive counselling and antiemetic treatment beginning before pregnancy or in early pregnancy/upon recognition of pregnancy, while one focused on post-pregnancy writing therapy. Both pre-emptive interventions reported a reduction in NVP symptom severity and a lower recurrence rate of HG, while writing therapy was beneficial in aiding recovery from severe NVP and allowed women an opportunity to externalise and process the experience. DISCUSSION: This study revealed a paucity of interventions initiated before and after pregnancy for women with severe NVP. The included studies showed some benefits of pre-emptive treatment and writing therapy. CONCLUSION: Tailored pre-pregnancy and postpartum interventions for women with previous severe NVP are urgently needed to address the physical and mental health burden of the condition.
A Systematic Review of the Use of Doulas to Support Rural Perinatal People in the United States.
Liddell JL, Garnsey A, Glover A … +1 more , Piskolich E
Matern Child Health J · 2025 Jun · PMID 40418422 · Publisher ↗
INTRODUCTION: Maternal health outcomes are frequently worse for individuals living in rural and remote communities due to the distance people must travel for healthcare, higher rates of poverty, and higher risk factors f...
INTRODUCTION: Maternal health outcomes are frequently worse for individuals living in rural and remote communities due to the distance people must travel for healthcare, higher rates of poverty, and higher risk factors for related health conditions, such as mental illness and substance use. Doulas, non-medical childbirth companions, provide emotional, informational, physical, and advocacy support to people during pregnancy, birth, and postpartum. Research has documented doulas' positive impact on birth outcomes, including lower rates of induction and cesarean birth. The benefits of doulas may be especially important for marginalized and underserved populations who experience disparate health outcomes, including rural residents. This scoping review was conducted to describe and assess the landscape of doula-focused research that focuses on the unique contextual challenges faced by rural communities. METHODS: We conducted a scoping review of research exploring the use of doulas in rural contexts. Peer-reviewed articles presenting original research using both quantitative and qualitative methods were included. Target populations for the included studies were rural perinatal people receiving doula support or doulas in rural contexts. All definitions of rurality were included. Database index terms were searched as well as keyword search terms: "rural" AND "doula" OR "labor coach" OR "birthing coach" OR "childbirth coach" OR "birth attendant" AND "United States" OR "U.S.A."12 peer-reviewed journal databases and Google Scholar were searched May 2022- September 2023. Data was synthesized using tabular and narrative methods to capture (a) study design and type, b) study purpose, c) population, d) study location, e) analysis, d) definition of rurality, and e) reported results and gaps in the literature. RESULTS: 2,195 articles were identified. After removing duplicates and ineligible studies, 3 articles were included in the final results. These articles included quantitative (1), qualitative (1), and mixed methods (1) studies exploring access to and perceptions of doulas in rural areas. CONCLUSION: Findings demonstrate limited scholarship on the use of doulas in rural settings. This area of research warrants further attention.
Factors Associated with Positive Toxicology at Delivery: Insights From the University of Maryland Medical System.
Habersham LL, Woolfolk CL, Taylor KJ … +2 more , Terplan M, Mark K
Matern Child Health J · 2025 Jun · PMID 40402351 · Full text
OBJECTIVE: To explore factors associated with positive toxicology tests during birthing admissions within a hospital system employing universal toxicology testing. METHODS: A retrospective cross-sectional study from 2019...
OBJECTIVE: To explore factors associated with positive toxicology tests during birthing admissions within a hospital system employing universal toxicology testing. METHODS: A retrospective cross-sectional study from 2019 to 2022, within a health system where toxicology tests are performed routinely during the birth admission. Substance use was defined as a positive toxicology test and race was self-reported. The association between substance use with race and insurance was analyzed. Assessments were made using descriptive statistics, chi-squared tests, and logistic regression models, controlling for maternal age, gestational age, birth year, insurance, and birth hospital. Separate analyses were conducted excluding cannabis from the toxicology evaluations. RESULTS: Of 37,438 deliveries, 97% (36,323) underwent toxicology testing. Unadjusted odds for positive toxicology tests (including amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, fentanyl, methadone, opioids (all), phencyclidine) were: Black (OR 1.91), Hispanic (OR 0.36), and Other (OR 0.56), compared with White. After adjusting for confounders, all groups showed decreased odds: Black (aOR 0.75), Hispanic (aOR 0.15), and Other (aOR 0.36). For insurance, the unadjusted odds were compared to private insurance: Public (OR 4.18) and Other (OR 1.81). When excluding cannabis, unadjusted odds for Black individuals increased (OR 1.21) while adjusted odds for Black, Hispanic, and 'Other' groups decreased relative to White individuals. CONCLUSION: Substance use during pregnancy exhibits sociodemographic variations. Initial unadjusted findings indicated racial disparities in substance use. However, adjusted models shifted these initial observations. Findings highlight the intertwined nature of sociodemographic factors in toxicology test results. Study findings underscore the need for comprehensive research to inform interventions, focusing on racial and socioeconomic inequities.
Assessing the Knowledge, Practices and the Associated Factors Among Postpartum Mothers Concerning Neonatal Umbilical Cord Care in Pakistan: A Cross-Sectional Study.
Atta M, Xie Y, Qin H
Matern Child Health J · 2025 Jun · PMID 40381154 · Publisher ↗
OBJECTIVE: The objective of this study is to estimate the maternal knowledge and practice levels regarding neonatal umbilical cord care and their associated factors in different provinces of Pakistan. METHODS: A descript...
OBJECTIVE: The objective of this study is to estimate the maternal knowledge and practice levels regarding neonatal umbilical cord care and their associated factors in different provinces of Pakistan. METHODS: A descriptive cross-sectional study design was used to collect data from the respondents. Multistage sampling techniques were carried out for this study. Semi-structured questionnaire was designed for collection of data after acquiring ethical approval and informed consent. Descriptive statistics were carried out by taking frequencies and percentages of the collected data and associated factors were analyzed by applying chi-square test at the p value of < 0.05. RESULTS: 245 (65.3%) of the respondents had poor knowledge levels about umbilical cord care and 220 (58.7%) respondents practiced poor cord care. More than half of the respondents had poor knowledge. 285 (76%) about the usage of chlorhexidine (CHX) on the cord for seven consecutive days. Some conventional and unhygienic practices were also recorded in this study. More than half of the mothers used cord clamps for tying the cord 245 (65.3%) followed by tailor's threads 77 (20.5%). The associated factors including parity, occupation and income were not showing statistically significant results at the p value of < 0.05 except for place of delivery (*p = 0.01), (*p = 0.005) and educational status (*p = 0.04), (*p = 0.03), which are showing statistically significant results. CONCLUSION: Paucity in both knowledge and practices of umbilical cord care were observed among mothers attending postnatal care in the hospitals. Programs need to be initiated for the improvement of knowledge of UCC and discouragement of unhygienic practices.
Content Analysis of Maternal Toxicology Testing Policies to Inform Equity in Substance Use Disorder Identification.
Habersham LL, Choi S, Gelband M … +5 more , Wilcox W, Bianco A, Bernstein PS, Taylor KJ, Mohamed NE
Matern Child Health J · 2025 Jun · PMID 40377768 · Full text
OBJECTIVE: Analyze existing hospital-level policies in New York City (NYC) regarding substance use and substance use disorders (SUDs) during the perinatal period to provide a comprehensive guide for hospital-level policy...
OBJECTIVE: Analyze existing hospital-level policies in New York City (NYC) regarding substance use and substance use disorders (SUDs) during the perinatal period to provide a comprehensive guide for hospital-level policy development, ensuring equitable maternal screening for substance use and SUDs. METHODS: Maternal toxicology policies were collected from eight NYC health systems between 1/1/2021 and 12/31/2022. One policy focused exclusively on neonate toxicology testing and thus was excluded. The remaining seven policies were de-identified and underwent a qualitative thematic content analysis using the Health Equity Impact Assessment framework. Two researchers conducted the thematic analysis, and two others reviewed identified themes for distinctions between policies. RESULTS: Seven hospital-level policies identified four distinct policy approaches (Types A, B, C, and D). The policies varied in their approach to prenatal substance use and SUD identification, highlighting gaps in knowledge and lack of standard guidelines. The different approaches involved combinations of standardized screening tools, toxicology tests, social service referrals, and patient consent procedures, among others. Researchers found that some policies may inadvertently reinforce stigma and bias due to a focus on high-risk characteristics not necessarily indicative of substance use or SUDs. CONCLUSION: Multidisciplinary-informed evidence-based guidelines are needed to address substance use and SUDs during pregnancy. Our findings support the integration of evidence-based screening, brief intervention, and referral to treatment (SBIRT) into policies, and discourage sole reliance on toxicology tests for SUD identification. The study's findings can potentially guide the development of equitable and clinically useful maternal substance use and SUD policies, thereby improving dyad outcomes.
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