Despite high breastfeeding initiation rates, few families are able to meet the breastfeeding recommendations set by the American Academy of Pediatrics. Mothers require breastfeeding support immediately following birth an...Despite high breastfeeding initiation rates, few families are able to meet the breastfeeding recommendations set by the American Academy of Pediatrics. Mothers require breastfeeding support immediately following birth and at points of contact in the postpartum months. Just as breastfeeding is multifactorial with numerous potential barriers, the concept of breastfeeding support is dynamic. The purpose of this concept analysis is to clarify what constitutes breastfeeding support. Using the Walker and Avant approach, this concept analysis reveals the uses, antecedents, attributes, model cases, borderline cases, contrary cases, consequences, and empirical referents of breastfeeding support. Breastfeeding support consists of an intervention, positive perception by the mother, and timeliness and effectiveness of implementation. For interventions to be received positively, they must be communicated sensitively, consistent with a mother's emotional needs. Effectiveness relies upon health care professionals seeking education to ensure sufficient expertise in lactation. Nurses, nurse practitioners, physicians, lactation support specialists, and any health care professionals who interact with breastfeeding women can make use of this concept analysis to guide attitudes and actions in breastfeeding support.
BACKGROUND: Almost 6% of new mothers will experience postpartum depression (PPD) during the 12-month postpartum period. PROBLEM: PPD is often undiagnosed, underdiagnosed, and untreated, increasing the risk for maternal m...BACKGROUND: Almost 6% of new mothers will experience postpartum depression (PPD) during the 12-month postpartum period. PROBLEM: PPD is often undiagnosed, underdiagnosed, and untreated, increasing the risk for maternal mortality, which is highest in the second half of the postpartum period. METHODS: This quality improvement project started with educating a pediatric clinic team about a PPD Screening and Referral Pathway and then applying it to their practice when seeing new mothers and their infants during the first 12 months postpartum. INTERVENTIONS: The PPD Pathway has instructions for the clinic team to give mothers the Edinburgh Postnatal Depression Scale (EPDS), complete the Receptionist Tracking Form, evaluate the EPDS, refer mothers who screen positive for PPD to behavioral health services, scan the EPDS into the mother's medical record, and complete the Referral Tracking Form. RESULTS: The clinic team screened 112 mothers in 15 weeks from July to October 2024. Overall EPDS scores indicated possible distress (n = 112, m = 5.79±5.83). Over 15 weeks, 25% (n = 28) of mothers screened positive and received a referral to behavioral health services. The average infant age at the time of positive screen was 18 weeks (m = 4.2±3.49). Positive screens were steady during the first 9 months of the postpartum year with 22.4% at 0-3 months, 21.2% at 3.5-6 months, and 25% at 6.5-9 months. However, positive screens peaked with 80% at 9.5 to 12 months. Results from the Normalization Measure Development (NoMAD) questionnaire indicate that the clinic team wants to continue the PPD Pathway, which became a clinic quality measure. CONCLUSION: Pediatric nurse practitioners and physicians can fill a gap in maternal care by screening for PPD, which can begin or intensify after the final postpartum obstetric visit. A standardized PPD Pathway is effective, feasible, and sustainable within the pediatric clinic setting.
BACKGROUND: Pregnancy is typically considered to be a joyous time, but complications during birth can be traumatizing for patients and their families, affecting their mental health and well-being. Traumatic births are li...BACKGROUND: Pregnancy is typically considered to be a joyous time, but complications during birth can be traumatizing for patients and their families, affecting their mental health and well-being. Traumatic births are linked to postpartum mental health conditions like depression and post-traumatic stress disorder, leading to significant consequences for mothers, infants, and families. PURPOSE: This quality improvement project sought to evaluate whether addressing perinatal trauma through debriefing mitigates the effects of perinatal trauma. METHODS: A program was implemented at a high-risk level IV maternal care hospital that focused on providing comprehensive mental health support to women experiencing significant complications during their birth. Structured debriefs with a registered nurse, optional mental health and pastoral care consultations, impact of event mental health screening, and follow-up assessments were conducted with these mothers. Surveys were administered at the end of the program to determine the effectiveness of the project and the impact of event scoring compared at birth, and 2 and 4 weeks. RESULTS: Most mothers (84%) found the opportunity to discuss their experience with a registered nurse beneficial. During the clinical debriefs with mothers, a major influence on the mother's perception of her birth was the effectiveness of communication between her and her health care team. CLINICAL IMPLICATIONS: When labor and birth include traumatic events, debriefing with the patient and follow-up after hospitalization can be helpful to patients and their families in answering questions and understanding what happened and why. Communication with the patient and her family by members of the health care team is critical to patient satisfaction.
PURPOSE: The purpose of this study was to examine the association of maternity nurse education provided by the hospital with exclusive breastmilk feeding (EBF) and, secondarily, to evaluate the mediating role of in-hospi...PURPOSE: The purpose of this study was to examine the association of maternity nurse education provided by the hospital with exclusive breastmilk feeding (EBF) and, secondarily, to evaluate the mediating role of in-hospital breastfeeding education for mothers on this relationship. STUDY DESIGN METHODS: We used a cross-sectional analysis of the 2022 Maternity Practices in Infant Nutrition and Care (mPINC) survey, which included hospital-level practices related to breastfeeding support, nurse education by the hospital about breastfeeding, and patient education in U.S. hospitals and territories. Data from 1,994 of the 2,779 eligible U.S. hospitals (72% response rate) that participated in the mPINC survey were analyzed. RESULTS: Hospitals without all required hands-on breastfeeding skills reported significantly lower EBF rates (β = -3.995, 95% CI [-6.37, -1.62]). A lack of all hands-on breastfeeding skills was associated with lower maternal breastfeeding education (β = -0.266, 95% CI [-0.32, -0.22]), and higher maternal breastfeeding education was associated with higher EBF scores (β = 3.244, 95% CI [1.16, 5.33]). CLINICAL IMPLICATIONS: Hospitals should prioritize hands-on breastfeeding skills for nurses and breastfeeding education for mothers to increase EBF rates.
PURPOSE: To explore the personal meanings of being diagnosed with cancer while pregnant in the context of becoming a mother. STUDY DESIGN AND METHODS: Using a longitudinal, interpretive phenomenological design, women par...PURPOSE: To explore the personal meanings of being diagnosed with cancer while pregnant in the context of becoming a mother. STUDY DESIGN AND METHODS: Using a longitudinal, interpretive phenomenological design, women participated in three in-depth, semi-structured interviews. Data were analyzed using interpretive hermeneutic analysis. RESULTS: Ten women were interviewed twice during pregnancy and once within 8 weeks postpartum. Three major themes with nine subthemes were identified: The Embodied Understandings of Cancer and Pregnancy (I Still Can, I No Longer Can, I Must); Pregnancy Disrupted (All I Heard was Cancer, Mom Guilt, Meanings of the Pregnancy); and Early Motherhood Disrupted (Birth as a Finish Line or a New Starting Point, The Balancing Act, Mothering Intentions) . Participants described varying degrees of collision they experienced as their mothering identities, intentions, and capabilities collided with cancer. Cancer forced many participants to confront disrupted expectations they held for pregnancy, birth, and early motherhood. CLINICAL IMPLICATIONS: Nurses and other health care professionals can provide anticipatory guidance and skillful clinical care that recognizes the complexities of disrupted mothering expectations and intentions in all those with cancer during pregnancy. Meeting these needs through tailored support, education, and interventions can balance pregnancy, birth, and postpartum care with cancer management.
PURPOSE: The purpose of this study was to describe US nurses' perspectives and practices on maternal position changes during labor. STUDY DESIGN: We conducted a national survey of nurses working in labor and delivery uni...PURPOSE: The purpose of this study was to describe US nurses' perspectives and practices on maternal position changes during labor. STUDY DESIGN: We conducted a national survey of nurses working in labor and delivery units in the past year. METHODS: The survey was disseminated through social media and email with snowball sampling. Our primary objective was to characterize the proportion of nurses using position changes during labor and nurses' reported indications for position changes. Secondary outcomes included the use of position change circuits and reasons position changes were not initiated. We used descriptive statistics to characterize responses and bivariate analyses to compare respondents who reported circuit use in their practice to those who did not. RESULTS: Among 498 respondents, 99% reported using maternal position changes during labor and 96% believed labor maneuvers are effective and improve outcomes. Nurses routinely reported using positional maneuvers for indications of slow labor progress, suspected occiput posterior, and suspected asynclitic fetal position. Commonly reported reasons for not using position changes included patient BMI, patient preference, fetal monitoring, and a lack of knowledge. Approximately two-thirds of nurses using maneuvers included a circuit of positions. Of the 20 listed maneuvers in the survey, seven were used by >50% of respondents and most likely to be used in a circuit of position changes. Use of circuits was more common among younger nurses. Region of the country was not a factor in use of circuits. CLINICAL IMPLICATIONS: Position changes are a frequently used intrapartum intervention with limited high-quality supporting evidence linking specific positions or circuits of positions to specific labor and birth outcomes. Further research is needed on the effectiveness of circuit-based position changes in labor, especially in cases of prolonged first stage of labor.
Renbarger KM, Place JM, Hess C
… +1 more, Burkhart L
MCN Am J Matern Child Nurs
· 2026 Jan-Feb 01 · PMID 41335563
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PURPOSE: The purpose of this study is to describe the experiences of women with symptoms of perinatal mental health disorders who recently gave birth and participated in a virtual peer support specialist program for mate...PURPOSE: The purpose of this study is to describe the experiences of women with symptoms of perinatal mental health disorders who recently gave birth and participated in a virtual peer support specialist program for maternal mental health during the COVID-19 pandemic. STUDY DESIGN AND METHODS: A qualitative descriptive design was used to describe the experiences of six women with symptoms of perinatal mental health disorders who participated in a peer support specialist program. Participants were recruited from online Indiana-based Facebook parenting groups targeted to women with young children. Semi-structured interviews were conducted, and data were analyzed using a basic inductive content analysis. RESULTS: We identified three main themes: 1) Seeking help for mental health symptoms, 2) Receiving unbiased peer support, and 3) Improving mental health symptoms. CLINICAL IMPLICATIONS: Implications for nursing practice include developing strategies to increase peer networks for women in the perinatal period, increasing the screening of women for symptoms of perinatal mental health disorders, and conducting more research on the efficacy of a peer support specialist programs for improving maternal mental health.