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200 papers
Mental Health Profile Relating to Suicide Crises Among Women in and Around Pregnancy and Surgical Termination of Pregnancy: A Data Linkage Study.
Meurk C, Roberts S, Lam M … +10 more , Wittenhagen L, Callaway L, Moss K, Lucke J, Barker R, Waterson E, Malmstrom N, Weaver E, Hoehn E, Heffernan E
Birth · 2025 Dec · PMID 40152338 · Full text
INTRODUCTION: This article presents an assessment of the mental health profile of women who were the subject of a suicide-related call to police or paramedics around the time of (i) pregnancy or (ii) surgical termination...
INTRODUCTION: This article presents an assessment of the mental health profile of women who were the subject of a suicide-related call to police or paramedics around the time of (i) pregnancy or (ii) surgical termination of pregnancy compared to (iii) other women of a similar age. METHODS: Findings are drawn from a population-wide linked dataset of approximately 70,000 individuals who were the subject of a suicide-related call to police or paramedics in Queensland, Australia. Mental health diagnoses were assessed based on the Diagnostic and Statistical Manual (fifth edition). Behavior, impairment, symptoms, and social functioning were assessed using Health of the Nation Outcome Scores (HoNOS). RESULTS: 32.7% of individuals had a record of one or more confirmed mental health diagnoses. The presence of a mental health diagnosis differed significantly across subgroups. Rates of clinically significant problems, as measured by HoNOS, differed significantly across groups for most items. CONCLUSION: Findings present a complex picture of the relationship between mental health diagnosis, pregnancy or termination of pregnancy, and other stressors experienced around the time of a suicide-related contact with police or paramedics.
Feasibility of a Community-Developed Survey Measuring Experiences of Pregnancy Care for LGBTQ2S+ Families.
Altman MR, van Winkle T, Ferrell B … +8 more , Lowik AJ, Soled KRS, Tarasoff LA, McCulloch J, Stoll K, Obedin-Maliver J, Vedam S, Birth Includes US Community Steering Council
Birth · 2025 Sep · PMID 40066909 · Full text
INTRODUCTION: Despite increased recognition of and support for family building among lesbian, gay, bisexual, transgender, queer, Two-Spirit, and other sexual and gender minoritized (LGBTQ2S+) populations, there is still...
INTRODUCTION: Despite increased recognition of and support for family building among lesbian, gay, bisexual, transgender, queer, Two-Spirit, and other sexual and gender minoritized (LGBTQ2S+) populations, there is still little evidence describing the experiences of pregnancy care within these populations in quantifiable ways. This paper describes our pilot study process and the feasibility of implementing a community-developed survey measuring respectful pregnancy care within LGBTQ2S+ communities. METHODS: Using a participatory action research approach, a Community Steering Council developed and piloted the Birth Includes Us survey. To assess the feasibility of the survey, recruitment was assessed through how participants heard about the study, and enrollment and survey completion were tracked in the REDCap survey platform. We used descriptive statistics to report the demographics of the pilot sample. RESULTS: Recruitment through social media, predominantly Facebook, was an effective route to reach the target population, accounting for over 60% of the sample. Of the 404 eligible participants who opened the survey, 91% completed the survey. The pilot study sample represented 41/50 states in the USA and 5/13 provinces and territories across Canada. While only 17% of the sample were members of racially minoritized communities, there was wide representation across genders and sexualities. CONCLUSION: The findings of this feasibility pilot study will inform the implementation of the Birth Includes Us survey to ensure the recruitment, enrollment, and retention of diverse participants. Lessons learned from this process will also support researchers in developing mitigating strategies to minimize the harm incurred during the process of LGBTQ2S+ family building.
Intrapartum Care Experiences Associated With Postpartum Visit Attendance.
Weeks F, Myerson R, Gangnon R … +3 more , Dykema J, Cornelius C, Green T
Birth · 2025 Dec · PMID 40066908 · Full text
INTRODUCTION: The postpartum visit is an important opportunity to prevent pregnancy-related morbidity and mortality; however, about 1 in 10 birthing people do not attend this visit. Intrapartum care experiences are an un...
INTRODUCTION: The postpartum visit is an important opportunity to prevent pregnancy-related morbidity and mortality; however, about 1 in 10 birthing people do not attend this visit. Intrapartum care experiences are an understudied factor that may contribute to postpartum healthcare engagement. MATERIALS AND METHODS: We analyze data from a novel survey supplement on intrapartum care experiences administered to a probability-based population sample of people who have recently given birth through the Wisconsin Pregnancy Risk Assessment Monitoring System. RESULTS: In regression models adjusting for a robust set of individual characteristics and birth hospital clustering, we find that lower provider responsiveness during intrapartum care is associated with increased odds of forgoing the postpartum visit (aOR 1.4, 95% CI 1.0-2.0). DISCUSSION: The quality of care received during the birth hospitalization may shape how birthing people feel about health care providers and their willingness to attend future visits. Experiences of care during the intrapartum period may contribute to future health care utilization. Improving these experiences is an opportunity to promote long-term health.
The Efficacy of Psycho-Educational Interventions to Optimize Women's Sleep in Pregnancy: An Integrative Review.
Visvanathan V, Pollock W, Zisin Y … +1 more , Willey S
Birth · 2025 Jun · PMID 40062448 · Full text
BACKGROUND: Poor sleep in pregnancy is associated with several adverse maternal and infant outcomes. Psychoeducational interventions may offer a safe and acceptable first-line intervention to help with sleep disturbances...
BACKGROUND: Poor sleep in pregnancy is associated with several adverse maternal and infant outcomes. Psychoeducational interventions may offer a safe and acceptable first-line intervention to help with sleep disturbances. AIM: To identify and review studies that examined the effect of psycho-educational interventions on sleep in pregnancy and to identify moderators in the treatment effects of the interventions. METHODS: An integrative review methodology was used. A comprehensive search in five electronic databases retrieved 1250 articles. Eligible studies (n = 12) were assessed for methodological quality according to the "QualSyst" rapid appraisal tool. Data were extracted and recorded using a modified Covidence form. Quantitative data were summarized in a meta-analysis or narrative synthesis. Qualitative data were narratively reported. FINDINGS: Twelve studies with three different sleep interventions: Cognitive Behavioral Therapy for Insomnia (CBT-I), Sleep Healthy Education (SHE) and relaxation training were included. Given the variation in study methodologies and interventions, only quantitative results from RCT trials using CBT-I were summarized in the meta-analysis. CBT-I was found to be statistically significant in improving sleep quality in pregnancy (Standard Mean Difference = -0.78; 95% CI = -1.01, -0.54, p < 0.001). Few studies reported the efficacy of SHE and relaxation training. Potential moderators had no effect on the measured sleep quality outcome. Overall, psychoeducational interventions were acceptable to participants during pregnancy. CONCLUSION: There is insufficient evidence on which to base the recommendations about the effectiveness of all psychoeducational interventions to improve sleep. Based on the available literature, CBT-I is an evidence-based intervention to improve sleep quality in pregnancy.
Impolite Birth: Provider Perspectives on Vocalization During Childbirth.
Roosevelt L, Danford K, Zielinski R
Birth · 2025 Dec · PMID 40062445 · Full text
BACKGROUND: Childbirth is a pivotal event marked by diverse vocalizations, yet scant research examines healthcare providers' perspectives on vocalization during birth. This study seeks to address this gap by exploring th...
BACKGROUND: Childbirth is a pivotal event marked by diverse vocalizations, yet scant research examines healthcare providers' perspectives on vocalization during birth. This study seeks to address this gap by exploring the attitudes and practices of various healthcare professionals regarding vocalization during labor and birth. METHODS: This study used a qualitative comparison approach, grounded in Organizational Cultural Phenomenon of Humanized Childbirth. Five discipline specific focus groups were conducted with doulas, nurses, community midwives, hospital midwives, and obstetricians to explore provider perceptions and experiences with vocalization during childbirth. RESULTS: Analysis of the focus groups indicated five overarching themes: (1) Shame and apologies, (2) Providers inhibiting or facilitating vocalization of gendered norms, (3) Affirmations or "Mantras," (4) Right and wrong sounds, and (5) Developing comfort with vocalization. DISCUSSION: The findings underscore the need for education on supporting vocalization during childbirth. The tension between provider expectations and birthing individuals' autonomy highlights broader issues of paternalism in Western childbirth practices. Addressing these dynamics can foster a more respectful and empowering birth environment, promoting positive birth experiences.
From Midwife to Lead Perinatal Practitioner: A Utopian Vision.
Pendleton J, Pezaro S
Birth · 2025 Sep · PMID 40062427 · Full text
The professional title "midwife" is predicated on the understanding that people who access their services have a normative relationship between their gender and assigned sex. As trans and non-binary people increasingly r...
The professional title "midwife" is predicated on the understanding that people who access their services have a normative relationship between their gender and assigned sex. As trans and non-binary people increasingly require access to midwifery services, this paper proposes an alternative professional title that is inclusive and liberates midwives from continuously reinscribing the sex/gender binary in their nomenclature. We work with Levitas's Utopia as Method framework to propose the title of Lead Perinatal Practitioner. Working through the archaeological, ontological and architectural modes, we explain the rationale for each component part of the title. "Lead" foregrounds the profession's relationship with autonomy, which is considered foundational but threatened by encroaching medicalization. "Perinatal" encompasses not just the birthing person but also the neonate and the physiological process and timeframe encapsulating pregnancy and birth currently absent. "Practitioner" captures the reflexivity, skill, and active engagement already inscribed in allied healthcare professions that use this title. We argue that when combined, they signal a trailblazing contribution towards the eradication of gender inequalities in the reproductive arena by uncoupling the profession from patriarchal oppression inscribed in the sex/gender binary, which has hitherto been positioned as the sine qua non of midwifery.
Changes in Fear of Childbirth and Its Predictors Over Three COVID-19 Pandemic Waves in Poland.
Ilska M, Kołodziej-Zaleska A, Brandt-Salmeri A … +2 more , Preis H, Lobel M
Birth · 2025 Dec · PMID 40052635 · Publisher ↗
BACKGROUND: The COVID-19 pandemic posed new and unpredictable challenges worldwide, having a particular effect on vulnerable groups, including pregnant women. The occurrence of these stressful circumstances likely increa...
BACKGROUND: The COVID-19 pandemic posed new and unpredictable challenges worldwide, having a particular effect on vulnerable groups, including pregnant women. The occurrence of these stressful circumstances likely increased women's fear of childbirth, a critical issue in pregnancy with consequences for various outcomes. METHODS: This cross-sectional study investigated fear of childbirth in pregnant women during three waves of the COVID-19 pandemic in Poland and identified factors predicting severe fear. Participants were recruited through social media platforms. In total, 2462 pregnant women completed the study questionnaire during the first (n = 1079), second (n = 1119), or third (n = 264) waves of the pandemic. Fear of childbirth was measured with the Fear of Birth visual analog scale (FOBS) using a cut-off score of ≥ 54 to indicate clinically relevant fear of childbirth. COVID-19-related stress was assessed using the Pandemic-Related Pregnancy Stress Scale (PREPS). RESULTS: Fear of childbirth was present in 51.5%, 61.9%, and 56.8% of participants at the three waves, respectively. Women who were pregnant during the first and third waves had lower fear of childbirth scores than those who were pregnant during the second wave. This could be explained by changes in infection rates and the severity of the disease, restrictions in maternity care, and the availability of vaccinations. In successive pandemic waves, predictors of severe fear of childbirth (FoC), especially related to COVID-19, differed. Across waves, the most powerful predictor was stress originating from feeling unprepared for birth. DISCUSSION: Fear of childbirth differed across pandemic time points. Pandemic waves should be considered in future review studies and meta-analyses.
Women's Experiences of Induction of Labor and Birth After Prolonged Medical Induction: A Qualitative Study From Denmark.
Mejdahl CT, Hvidman L, Helmig RB … +5 more , Boie S, Larsen AH, Lundbo M, Ziska J, Lou S
Birth · 2025 Dec · PMID 40052630 · Full text
BACKGROUND: The increasing frequency of induction of labor (IOL) prompts explorations into women's experiences. To inform individualized obstetric care, this study aimed to investigate the experiences of Danish pregnant...
BACKGROUND: The increasing frequency of induction of labor (IOL) prompts explorations into women's experiences. To inform individualized obstetric care, this study aimed to investigate the experiences of Danish pregnant women who underwent out-patient medical IOL and were not in active labor 48 h after IOL initiation. METHODS: A qualitative interview study with 28 women who had experienced prolonged IOL (all indications). The women were recruited at two obstetric departments approximately 48 h after IOL initiation and telephone interviewed 2-6 weeks after birth (average of 37 min duration). Interviews were recorded, transcribed, and analyzed using thematic analysis. RESULTS: The first theme describes the underlying rationale in the women's description of IOL and birth: 'Motivated by the birth of a healthy baby.' The results show how the women accepted medical indications for IOL, found comfort in the out-patient regimen, and felt secure about the health of their baby, even if the prolonged IOL was frustrating. The results show how 'progress' became a primary motivator for suggesting and accepting interventions. The second theme describes four 'Situations of discouragement' that are clusters of events during IOL and birth that could challenge the women's expectations and boundaries, for example, experiencing excessive pain or not feeling heard. Despite challenges, most women viewed their experiences positively, remaining open to future IOL. DISCUSSION: The findings underscore the complexity of women's experiences during IOL and birth, emphasizing the need for healthcare professionals to navigate diverse, individual preferences while prioritizing maternal and fetal well-being.
Birthing With Others: Exploring the Efficacy of One-On-One Professional Support on Physiological Birth and Flow State.
Dahan O, Goldberg A
Birth · 2025 Dec · PMID 40040573 · Full text
BACKGROUND: One-on-one professional support during labor is recognized for its role in promoting physiological birth, reducing interventions, and enhancing women's birthing experiences. Throughout physiological birth, ma...
BACKGROUND: One-on-one professional support during labor is recognized for its role in promoting physiological birth, reducing interventions, and enhancing women's birthing experiences. Throughout physiological birth, many women encounter an altered state of consciousness. This state not only facilitates the normal birth process but also empowers women during and after childbirth. Recently, the flow-a mental state of complete absorption and energized focus in an activity, with a sense of control and high motivation-has been identified as a measure of this experience during physiological birth. This study aimed to discover whether one-on-one continuous professional support would improve the childbirth experience by increasing the likelihood of physiological birth and a heightened state of flow during childbirth. METHODS: Women with childbirth experience were recruited through social media. Participants (n = 788) completed an online survey: the Flow State Scale (FSS) and a demographic questionnaire, including details about the professional support received during childbirth. RESULTS: One-on-one professional support was significantly associated with natural childbirth (midwife: 80.9%, doula: 65.7%) and lower medical interventions (midwife: 19.1%, doula: 34.3%) compared to conventional professional assistance (natural birth: 44.4%, interventions: 55.6%). A MANCOVA analysis revealed significant differences in flow state levels, with women receiving one-on-one support experiencing the highest flow state. CONCLUSIONS: This research validates the significant correlation between one-on-one support-provided by midwives or doulas-and physiological birth. It also establishes for the first time a correlation between women in childbirth receiving continuous one-on-one professional support and heightened flow state levels, signifying a positive and empowering birthing experience.
Do Antenatal Interventions Improve Maternal and Perinatal Outcomes for Migrant Women Living in High-Income Countries and What Guidelines Exist for Migrant Women? A Systematic Review and Meta-Analysis.
Weerasingha S, Tindal K, Palmer K … +2 more , Ellery SJ, Davies-Tuck M
Birth · 2025 Dec · PMID 40028818 · Full text
BACKGROUND: Given the rise in migrant women giving birth in high-income countries (HICs) there is a need to identify and evaluate the efficacy of existing interventions that address disparities in adverse pregnancy outco...
BACKGROUND: Given the rise in migrant women giving birth in high-income countries (HICs) there is a need to identify and evaluate the efficacy of existing interventions that address disparities in adverse pregnancy outcomes experienced by migrant women. OBJECTIVE: This review aims to identify any antenatal interventions offered to migrant women living in HICs, evaluate their efficacy at improving perinatal and maternal adverse outcomes, and to identify and evaluate pregnancy management guidelines relating to migrant status or ethnicity-specific practices or recommendations. SEARCH STRATEGY: Medline, Embase, CINAHL, Scopus, TRIP, ProQuest, and the International Guidelines Library were searched from January 2010 to March 2023. SELECTION CRITERIA: English-language randomized controlled trials, mixed-methods, and observational studies reporting perinatal and maternal outcomes in women living in HICs receiving a migrant-specific antenatal intervention. An additional search of any pregnancy management guidelines relating to migrant status or ethnicity-specific practices or recommendations was completed. DATA COLLECTION AND ANALYSIS: Two authors independently conducted data extraction. Outcomes of interest included perinatal (stillbirth, neonatal death, 5-min post-delivery Apgar score < 7, NICU admission, small for gestational age, large for gestational age, low birth weight, and preterm birth) and maternal outcomes (mortality, gestational diabetes, gestational hypertension, pre-eclampsia, caesarean birth, instrumental birth, and induction of labour). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated and pooled for meta-analysis using a random-effects model. All studies and guidelines were assessed using relevant risk assessment tools. MAIN RESULTS: Six studies met the inclusion criteria for this review. Meta-analysis showed that infants born to women offered a migrant-specific antenatal intervention had lower odds of stillbirth (OR 0.60 95% CI 0.37-0.97, p = 0.04, I = 0%) when compared to those in the standard care group. However, the use of migrant-specific interventions increased the odds of labor induction (OR 1.38 95% CI 1.27-1.49, p = < 0.01, I = 0%). Additionally, we identified 18 guidelines; however, no migrant or ethnicity-specific recommendations were supported by high-level evidence. CONCLUSION: Several migrant-specific antenatal interventions exist for migrant women living in HICs. These include fetal monitoring, group antenatal care programs, and a cultural training program for midwives. Despite heterogeneity between interventions, together they reduced the odds of stillbirth. Of the pregnancy management guidelines identified, most recommendations were largely based on findings from systematic reviews of observational and cohort studies, highlighting the lack of higher-quality evidence from clinical trials currently available.
Racial Disparities in Nulliparous Singleton Term Vertex Cesarean Deliveries: Rates, Reasons, and Time to Delivery.
McCloskey K, Woodard A, Gregory C … +3 more , Lipscomb L, Clarke N, Neilsen J
Birth · 2025 Dec · PMID 40028817 · Full text
BACKGROUND: Non-Hispanic Black individuals have the highest odds of having a nulliparous term singleton vertex (NTSV) cesarean birth out of all racial and ethnic groups, but this disparity is not well understood. This st...
BACKGROUND: Non-Hispanic Black individuals have the highest odds of having a nulliparous term singleton vertex (NTSV) cesarean birth out of all racial and ethnic groups, but this disparity is not well understood. This study assesses the factors associated with overall rates of NTSV cesarean delivery, differences in reasons for cesarean births, and door-to-delivery time among individuals who had an NTSV cesarean delivery. METHODS: Retrospective analyses assessed n = 31,826 NTSV births from January 1, 2016 to December 31, 2021 at 11 medical centers in North Carolina. For each outcome variable, multivariate regression estimated Black-White disparities while controlling for clinical and social covariates. Models included random intercepts for facility and delivery provider. RESULTS: After accounting for covariates, non-Hispanic Black patients were more likely to have an NTSV cesarean delivery compared to non-Hispanic White patients (AOR = 1.48, 95% CI 1.47, 1.69). Among those who had an NTSV cesarean delivery, non-Hispanic Black patients were more likely than non-Hispanic White patients to have a cesarean delivery due to fetal intolerance of labor (AOR = 2.10, 95% CI 1.87, 2.42). Non-Hispanic Black patients had a shorter door-to-delivery time for unscheduled NTSV cesarean deliveries than non-Hispanic White patients (b = -1.80, 95% CI -2.50, -1.11). CONCLUSIONS: We confirmed the persistence of a racial disparity in cesarean delivery rates after controlling for multiple social and clinical factors. As fetal intolerance of labor has been described as a subjective indicator, and faster door-to-delivery time for cesarean deliveries may indicate faster decision making, our findings indicate a need to better understand decision making around cesarean deliveries.
Effect of Maternity Units' Organizational Levels on Maternal Birth Satisfaction: A Multicentric Cohort Study.
Fumagalli S, Nespoli A, Panzeri M … +25 more , Antolini L, Colciago E, Adami A, Canepa MM, Del Bo E, Ferrara R, Mauri PA, Cagnacci A, Ceccaroni M, Dattolo C, Esposito G, Franchi MP, Gorlero F, Grisolia G, Grosso F, Lecis A, Mazzeo Melchionda M, Michelerio V, Mogavino L, Ogliari C, Ramunno M, Spinillo A, Valletta S, Vergani P, Locatelli A
Birth · 2025 Dec · PMID 40028807 · Full text
INTRODUCTION: Maternal birth satisfaction is correlated to long-term outcomes and is influenced by the place of birth. In Italy, most births occur in hospitals. Our study aimed to assess whether the organizational level...
INTRODUCTION: Maternal birth satisfaction is correlated to long-term outcomes and is influenced by the place of birth. In Italy, most births occur in hospitals. Our study aimed to assess whether the organizational level (I vs. II) of the Maternity Unit (MU) had any impact on birth satisfaction. METHODS: A multicentric cohort study was conducted in 11 Italian MUs, classified as Level I (for low-risk pregnancies or with minor complications) or Level II (for low and high-risk women) according to organizational, structural, and technical standards. Birth satisfaction was measured using the Italian version of the BSS-R, composed of three sub-scales. Data analysis was performed using Stata/MP18.0. RESULTS: Among 1642 participants, maternal satisfaction was similar in I and II level MUs (27.7 vs. 27.2; p-value 0.096). Women who gave birth in an I level MU were found to have a greater Quality of care sub-scale score compared to participants who gave birth in a II level MU (14.28 vs. 13.87; p-value < 0.001). The three sub-scales contributed differently to the total score, with a minor contribution given by the Stress Experienced (8.65/16) and the Women's Attributes sub-scales (4.72/8). CONCLUSION: This study contributes to understanding how the level of the MU might impact women's birth satisfaction. Factors affecting the Women's Attributes and the Stress Experienced sub-scales' scores should be considered to increase maternal satisfaction with birth, improving the quality of maternity services.
Abuse and Disrespect in Obstetric Care in the United States: A Qualitative Descriptive Study of Nurse Experiences.
Darilek U, Gill SL
Birth · 2025 Dec · PMID 40028783 · Full text
BACKGROUND: This qualitative descriptive study of the experiences of US labor and delivery nurses follows the World Health Organization's call to address abuse and disrespect of women in maternity care. The majority of r...
BACKGROUND: This qualitative descriptive study of the experiences of US labor and delivery nurses follows the World Health Organization's call to address abuse and disrespect of women in maternity care. The majority of research about abuse and disrespect for childbearing women has been conducted in Africa, Asia, and Europe, but the US is unique as a high-income country with largely capitalist or privatized health care. The objective of this study was to gain knowledge about abuse and disrespect in hospital-based maternity care in the US from the perspective of labor and delivery nurses. METHODS: Using a qualitative descriptive methodology, online data collection followed by optional interviews, we solicited the experiences of labor and delivery nurses regarding their experiences with patients being treated unethically in obstetric care. Content analysis was used to interpret the data into themes. RESULTS: One hundred sixty-eight (N = 168) participants provided written examples of unethical treatment they had witnessed in their professional experience, and 7 interviews were conducted. Four major themes were identified: Violation of the Trust that We are Going to Keep You and Your Baby Safe; Assault; Stripping a Patient of Autonomy; and Failure of the Hospital to Provide Safe Conditions for Birth. DISCUSSION: People within the healthcare system are aware of abuse and disrespect, but it is often hidden by stakeholders who have conflicting interests. Perpetrators of abuse and disrespect are people and systems. More research is necessary to quantify and address the problems from within the healthcare system.
The Cost of Untreated Perinatal Mood and Anxiety Disorders (PMADs) in Montana: An Economic Analysis of Perinatal Mental Health in a Rural State.
Liddell JL, Monroe A, Carlson TA … +1 more , Mullan K
Birth · 2025 Dec · PMID 39932108 · Full text
BACKGROUND: Although extremely common, and with a broad range of associated negative outcomes for both parents and infants, the full impact and cost of perinatal mood and anxiety disorders (PMADs) is under-researched. Ru...
BACKGROUND: Although extremely common, and with a broad range of associated negative outcomes for both parents and infants, the full impact and cost of perinatal mood and anxiety disorders (PMADs) is under-researched. Rural states, such as Montana, in particular experience gaps in access to mental healthcare and high rates of PMADs, emphasizing a need for an economic analysis of untreated PMADs. To address this gap, a cost analysis of the impact of untreated PMADs in Montana was conducted using 2021 birth data. METHODS: A cost-of-illness analysis was conducted to estimate the incremental costs of untreated PMADs in Montana. Secondary data sources and peer-reviewed literature were utilized to provide baseline estimates of the prevalence of maternal and birth outcomes in Montana and to estimate the impact of PMADs on these outcomes from the perinatal period through the first year postpartum. RESULTS: Using 15% as the PMAD prevalence rate in Montana, the total estimated incremental cost of untreated perinatal mood and anxiety disorders for births in 2021 is about $21.7 million. This is about $12,897 per impacted mother-child pair. DISCUSSION: This study provides needed insight into the economic impact of untreated PMADs and highlights the broad range of negative impacts PMADs have on the well-being of parents and infants. This study highlights the importance of providing effective treatment to people experiencing PMADs to improve the health of both parents and their infants and has important policy implications for increased funding and workforce development for the detection and treatment of PMADs.
Childbirth Experience, Mistreatment, and Migrant Status: A Retrospective Cross-Sectional Study.
Mangindin EL, Gottfreðsdóttir H, Stoll K … +3 more , Cadée F, Lárusdóttir EI, Swift EM
Birth · 2025 Dec · PMID 39891471 · Full text
INTRODUCTION: Childbirth experience can affect women's long-term health and well-being. However, there is limited knowledge on whether migrant status affects woman's experience during childbirth. We aimed to answer the f...
INTRODUCTION: Childbirth experience can affect women's long-term health and well-being. However, there is limited knowledge on whether migrant status affects woman's experience during childbirth. We aimed to answer the following research questions: (1) Is there a difference in childbirth experience between migrant and native-born women in Iceland; and (2) Are migrant women more likely to experience mistreatment in childbirth compared to native-born women in Iceland? METHODS: An online survey was developed including the Childbirth Experience Questionnaire 2 to assess overall childbirth experience, and descriptive analysis and linear regression were conducted to determine differences between migrant and native-born women in Iceland. The mistreatment by care providers in childbirth indicators were used to evaluate mistreatment in childbirth, and frequencies and logistic regression were conducted. Both regression models were adjusted for sociodemographic and obstetric factors. RESULTS: A total of 1365 women participated. Migrant women reported statistically significantly lower scores for birth experience compared to native-born women (F [12, 1352] = 23.97, p < 0.001). There was no statistical difference between groups regarding mistreatment in childbirth. One in four of all women reported at least one form of mistreatment. CONCLUSION: This study suggests that there are areas in maternity care that can be improved upon, particularly in providing care for migrant women and addressing mistreatment in childbirth for all. Our results suggest further research in this area as well as evaluation of maternity systems, training in cultural competency and effective communication.
The Benefits of Licensed Midwifery and Community Birth Among BIPOC Birthing People in New Mexico.
Rivera RZ, Cadena ML, Gutfreund JF … +1 more , Dodge E
Birth · 2025 Jun · PMID 39670916 · Full text
BACKGROUND: Black, Indigenous, and people of color (BIPOC) families comprise a disproportionately low percentage of home and freestanding birth center births in New Mexico (NM), despite NM Medicaid coverage of care by Li...
BACKGROUND: Black, Indigenous, and people of color (BIPOC) families comprise a disproportionately low percentage of home and freestanding birth center births in New Mexico (NM), despite NM Medicaid coverage of care by Licensed Midwives (LMs) in these settings. The purpose of this study was to examine why low income BIPOC seek out LM care, how they benefit from this model of care, and which factors facilitate and obstruct access. METHODS: We conducted 7 focus groups with 55 low income BIPOC individuals who had birthed in New Mexico in the past 5 years. Participants in four of the groups intended to birth with an LM in the community setting; participants in three of the groups intended to birth in a hospital. RESULTS: Prior negative birthing experiences at hospitals were the most-often discussed reason for choosing LM care. The aspects of LM care most commonly described as beneficial were: (1) the high quality of one-to-one individualized and holistic care offered by LMs, as well as (2) the respectfulness of care received. Medicaid coverage of LM care and special payment allowances made by LMs were cited as two important facilitators of access to LM care. Barriers to care included the lack of general awareness of LM care, the persisting stigma against community birth, the small number of LMs, and payment and insurance coverage challenges. CONCLUSION: LM care is beneficial for many families seeking respectful and accessible care, especially in underserved areas. BIPOC birthing individuals' reflections on their experiences with LM care provide valuable information that should be considered when designing and revising perinatal care systems and policies with the intent of increasing access to high-quality maternal and newborn care in New Mexico and, more generally, the United States.
Facilitators and Barriers to Access to Midwife-Led Birth Settings for Racialized Women in the UK: A Scoping Review.
Melamed A, Rocca-Ihenacho L, Horn A … +3 more , McCourt C, Rivers F, Daniele MAS
Birth · 2025 Sep · PMID 39654410 · Full text
BACKGROUND: In UK maternity care, racialized women have worse experiences and clinical outcomes than White women. Midwife-led birth settings (MLBS), including home births and midwife-led units, both freestanding and alon...
BACKGROUND: In UK maternity care, racialized women have worse experiences and clinical outcomes than White women. Midwife-led birth settings (MLBS), including home births and midwife-led units, both freestanding and alongside hospitals, are all available as choices for low-risk women in the UK. MLBS deliver optimal outcomes for low-risk women with uncomplicated pregnancies, including for racialized women, and can offer culturally specific care, possibly mitigating existing social inequalities. Evidence suggests that racialized women access MLBS less than White women. AIM: To map existing literature on facilitators and barriers to accessing MLBS for racialized women and to identify emerging themes. METHOD: A scoping review of UK literature over the last 10 years using OVID, Ebsco Host, and gray literature. Search, selection, and data extraction were performed using PRISMA and JBI guidelines. Data were analyzed using inductive thematic analysis. RESULTS: Fourteen articles met the inclusion criteria, only one addressing the research question directly and others containing some relevant material. Six themes were identified: admission criteria, information giving, the role of antenatal groups, bias and assumptions, beliefs about birth, and MLBS as empowering. CONCLUSIONS: There is a lack of research on racialized women's access to MLBS. Community outreach, having midwifery services embedded in the community, defaulting to MLBS for women categorized as low risk, continuity of carer, and interventions achieving a reduction in care-giver bias may improve access and outcomes.
Men as Midwifery Professionals: A Scoping Review.
Abdul Hamid Alhassan R, Baumann S, Fapohunda A … +6 more , Tiah JAY, Laari TT, Narbey L, Niemczyk NA, Bam V, Anto-Ocrah M
Birth · 2025 Sep · PMID 39654408 · Full text
BACKGROUND/INTRODUCTION: Midwives provide skilled, primary, reproductive, and sexual health care to women, adolescent girls, and infants throughout the perinatal period, promoting health and safeguarding against obstetri...
BACKGROUND/INTRODUCTION: Midwives provide skilled, primary, reproductive, and sexual health care to women, adolescent girls, and infants throughout the perinatal period, promoting health and safeguarding against obstetric emergencies and maternal and infant mortality. In many cultures, midwifery has been a predominantly female profession. However, in emerging research, the proportion of male midwives is growing to augment shortages of female midwives, prompting a need for further research that explores the contributions of male midwives in maternal and child health. The objective of this scoping review was to synthesize key findings from the literature regarding the growing, global workforce of male midwives. Specifically, we aimed to evaluate (1) the temporal nature of the publications, (2) the geographic distributions of the emerging literature, and (3) the key findings regarding male midwives' training and work experiences. METHODS: We used Semantic Scholar and Google Scholar to identify relevant, peer-reviewed articles using the keywords "gender," "male," "men," "midwifery," and "nurse midwives," that met the inclusion criteria: (1) primary research papers, (2) published in the English language (for ease of understanding by the multinational, interdisciplinary authorship team), (3) explored male midwives' experiences during training/education and working, and (4) published between 2000 and 2023. Papers were excluded if they exclusively focused on females or nurses or other health professionals. RESULTS: Our initial search yielded 57 articles, with an additional nine obtained by reviewing the references. After excluding duplicates and reviewing based on inclusion criteria, 26 papers were included in the scoping review. All 26 articles were published between 2011 and 2023, with the majority (65%, n = 17) of articles focused on populations in the African region (Aims 1 and 2). Key findings (Aim 3) were as follows: 1. Training experiences of male midwives: Compared to other regions, male midwifery students in African, Middle Eastern, and Asian settings reported challenging training conditions, possibly influenced by sociocultural factors and gendered expectations of men in these settings. 2. Pregnant/birthing persons' delivery experiences and gendered preferences for their attending midwife: A significant number of birthing persons would choose female midwives over male midwives for their care, despite acknowledging similar skill sets. However, younger clients, urban residents, and non-traditional men expressed a need for gender equity and greater acceptance of men as midwifery professionals. 3. Professional work environment: Many of the male midwives faced professional challenges, often stemming from societal and professional prejudices, leading to feelings of alienation and marginalization within the midwifery profession. Despite these challenges, they remained dedicated to the profession and felt supported by their family, friends, and coworkers. CONCLUSION: Male midwives represent a growing proportion of the global obstetric workforce and provide an important contribution to addressing maternal morbidity and mortality. Further attention to providing equitable training opportunities, navigating caregiving within settings with strong cultural and religious influences, integrating cultural, geographic, and religious diversity into the midwifery curriculum, and providing male midwives with mentorship and role model support to grow and sustain their careers are urgently needed for improving maternal and infant health outcomes.
A History of Cesarean Birth as a Risk Factor for Postpartum Hemorrhage Even After Successful Planned Vaginal Birth.
Boujenah J, Belabbas M, Tigaizin A … +4 more , Benbara A, Hensienne I, Fermaut M, Carbillon L
Birth · 2025 Jun · PMID 39526670 · Publisher ↗
BACKGROUND: It is unclear if a history of cesarean birth (CB) is a risk factor for postpartum hemorrhage (PPH) even after a successful planned vaginal birth. METHODS: A historical retrospective cohort study from all deli...
BACKGROUND: It is unclear if a history of cesarean birth (CB) is a risk factor for postpartum hemorrhage (PPH) even after a successful planned vaginal birth. METHODS: A historical retrospective cohort study from all deliveries (42,456) between 2004 and 2019. Inclusion criteria were as follows: (i) women with only one previous CB; (ii) liveborn cephalic singleton pregnancy and term spontaneous labor; (iii) successful planned vaginal birth; (iv) no operative vaginal delivery; and (v) no history of PPH. Women who experienced intrapartum uterine rupture leading to CB were excluded. Those who experienced uterine rupture diagnosed after vaginal birth were not excluded. The labor after cesarean (LAC) group (109 women with previous CB and current vaginal birth) were compared with 2 control groups to consider the parity: control group 1 (1633 nulliparous women) and control group 2 (4197 parous women). The main outcome was the rate of PPH (> 500 mL). Multivariate analysis was performed to investigate whether previous CB was an independent risk factor for PPH. Bivariate analysis and causal framework was used to determine the relation between variables of clinical interest. RESULTS: The PPH rates in the LAC group, control group 1, and control group 2 were 12.8%, 5.3%, and 6.4%, respectively. Irrespective of the group control (1 or 2), a history of CB was associated with an increased risk of PPH: adjusted odds ratio (aOR) 2.38 [95% confidence interval (CI) 1.28-4.44] (adjusted with maternal age, overweight, hyperthermia, and use of oxytocin) and aOR 2.16 [95% CI 1.20-3.87] (adjusted with maternal age and overweight) for Groups 1 (parous) and 2 (nulliparous), respectively. CONCLUSION: A history of cesarean birth could be a risk factor for PPH even after successful planned vaginal delivery.
Pregnant Women's Care Needs During Early Labor-A Scoping Review.
Mueller AN, Grylka-Baeschlin S
Birth · 2025 Jun · PMID 39526645 · Full text
INTRODUCTION: Pregnant women face the challenge of managing early labor on their own until they feel the need to seek professional support. However, professional support during such a vulnerable stage of labor may someti...
INTRODUCTION: Pregnant women face the challenge of managing early labor on their own until they feel the need to seek professional support. However, professional support during such a vulnerable stage of labor may sometimes be insufficient. This study aims to understand pregnant women's care needs during early labor in order to improve the quality of care provided at the onset of labor. METHODS: A scoping review was conducted following a systematic search strategy in May 2021 and in August 2022 concentrating on pregnant women in early labor with spontaneous onset of labor. A sensitive search strategy was used with five different databases. The articles were screened by two independent researchers. Data were extracted and mapped to answer the research question. RESULTS: 52 articles were included. Major reasons for seeking professional help are to receive reassurance and get advice and information on how to cope with early labor. Furthermore, many women express the need for professional guidance. Several articles demonstrated women's preferences for hospital admission or a continuous care model. While some women want empowerment and empathy from a midwife, others require clear instructions on helpful measures or even clinical interventions within the process. CONCLUSIONS: Managing early labor without professional support creates a major challenge for pregnant women and nurtures insecurities and anxiety. Protecting women from unnecessary interventions is a well-intentioned plan, yet a lack of support in early labor may sometimes jeopardize a positive birth experience. New ways need to be elaborated to support women-centred and individualized approaches to providing early labor care.
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