Birth (Berkeley, Calif.)[JOURNAL]
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200 papers
Creative Health and the Impact on Mental Health Support for Women From Minoritized Backgrounds Experiencing Baby Loss: A Scoping Review.
Verdi E, Thampuran A, Marino LV
Birth · 2026 Jul · PMID 42402010 · Publisher ↗
INTRODUCTION: Women from minoritized backgrounds experience disproportionately higher perinatal mortality than white women, with stillbirth rates highest among Black women and elevated among some Asian ethnic groups. Des...
INTRODUCTION: Women from minoritized backgrounds experience disproportionately higher perinatal mortality than white women, with stillbirth rates highest among Black women and elevated among some Asian ethnic groups. Despite this, women from the global majority remain underrepresented in National Health Service Perinatal and Maternal Mental Health Services, United Kingdom (UK). This scoping review aims to: (i) examine the use of creative health approaches to support mental wellbeing following baby loss among minoritized women, and (ii) identify priorities for future research into culturally informed creative mental health interventions. METHOD AND DESIGN: This scoping review employed a structured methodology to identify qualitative, quantitative, and gray literature exploring creative health approaches for women from minoritized backgrounds following baby loss. RESULTS: A total of 1808 records were identified. Following deduplication, 507 records were screened and 22 full-text articles assessed for eligibility and eight included in the scoping review. A content analysis identified three overarching themes: (i) navigating the unseen-meaning, identity, and silence in perinatal loss; (ii) healing through creative expression; and (iii) holding on and moving forward-creative connection after baby loss. CONCLUSION: Creative approaches supported women in making sense of baby loss by fostering continuing bonds with their baby and facilitating reflection on identity and future direction. Group-based creative methods promoted belonging and helped counter silence surrounding baby loss within communities. However, there remains a significant lack of research in this area, particularly involving global majority women.
Changing From Midwife to Lead Perinatal Practitioner: Would It Afford the Profession More Authority, Value and Professional Identity Where It Currently Lacks Them?
Meyer Y, Lemay C
Birth · 2026 Jul · PMID 42389849 · Publisher ↗
Abstract loading — click title to view on PubMed.
Respectful Maternity Care and Postpartum Emotional Distress: The Mediating Role of Baby-Friendly Hospital Initiative Practices and Moderation by Support.
Oli C, Rhomberg M, Garvan C … +4 more , Varma DS, Evans V, Chen S, Louis-Jacques AF
Birth · 2026 Jun · PMID 42366836 · Publisher ↗
INTRODUCTION: Respectful maternity care (RMC) is a critical component of high-quality maternal care, yet its relationship with postpartum emotional distress remains underexplored. This study examined the mediating role o...
INTRODUCTION: Respectful maternity care (RMC) is a critical component of high-quality maternal care, yet its relationship with postpartum emotional distress remains underexplored. This study examined the mediating role of Baby-Friendly Hospital Initiative practices and moderating effects of support in the association between RMC and postpartum emotional distress. METHODS: We analyzed cross-sectional postpartum survey data from 207 women at a US based academic medical center. RMC was measured using the Mothers on Respect Index (MORi), and postpartum emotional distress was modeled as a latent construct comprising nervousness, sadness, anhedonia, and worry. We used Structural Equation Modeling with bootstrapped confidence intervals (n = 5000) to test for mediation and simple slope analysis to explore moderation by emotional and practical support. RESULTS: The median (SD) MORi score was 77 (12.0). RMC was associated with lower postpartum emotional distress [β = -0.224; 95% CI [-0.390, -0.059]], and was moderated by emotional support (β = 0.152, p = 0.014). Specifically, higher RMC was associated with lower distress among women with low emotional support (p = 0.002), but not among those with high emotional support (p = 0.968). However, practical support did not moderate the association. The indirect effect through Baby-Friendly Hospital Initiative practices was significant [β = -0.044; 95% CI [-0.102, -0.003]]. CONCLUSIONS: RMC may reduce postpartum emotional distress in part through the implementation of Baby-Friendly Hospital Initiative practices. The protective effect of RMC was strongest among women with lower emotional support. Our preliminary findings call for the need for longitudinal studies and replication in more diverse populations.
The Health, Wellbeing and Health Service Use of Women Attempting or Planning Pregnancy: A Nationwide Cross-Sectional Survey of Australian Women.
Steel A, Schoenaker D, Harnett J … +1 more , Adams J
Birth · 2026 Jun · PMID 42347819 · Publisher ↗
BACKGROUND: Health and wellbeing during the preconception period influence maternal and child health outcomes. We describe the sociodemographic and health characteristics of Australian women currently attempting pregnanc...
BACKGROUND: Health and wellbeing during the preconception period influence maternal and child health outcomes. We describe the sociodemographic and health characteristics of Australian women currently attempting pregnancy or planning to conceive in the next 12 months, compared with other women of reproductive age, to identify opportunities for preconception care. METHODS: A sub-analysis of survey data obtained in 2022 that included 874 responses from females aged 18-49 years was conducted. Socio-demographic characteristics, health and wellbeing status, and health service utilization data were described according to pregnancy intention. RESULTS: Of 874 women, 64 (7.4%) reported currently attempting pregnancy and 45 (5.2%) reported planning to become pregnant in the next 12 months. Both groups of women were married or in a de facto relationship. Women who were planning to become pregnant were aged 25-34 years (71.1%) compared to 18-24 years (20.0%) or aged 35 years or older (8.9%). They were also more likely to consult a chiropractor (OR 1.5). Women currently trying to conceive were less likely to not be in the paid workforce (OR 0.34) compared to working full time. They were also less likely to be using prescription-only pharmaceuticals (OR 0.30) and more likely to be consulting a Traditional Chinese medicine practitioner (OR 2.66) or a dietician (OR 2.11). CONCLUSION: The findings of this study can be used for informing health service planning and policy that takes a whole-of-health-system approach when designing preconception health primary care interventions.
Self-Reported Health Problems of Birthing Persons During the First and Second Postpartum Years: Scope and Correlates.
Sirithepmontree S, Palomares L, Walker LO
Birth · 2026 Jun · PMID 42347794 · Publisher ↗
BACKGROUND: Postpartum health-related problems are diverse, and some may extend beyond the first postpartum year. The purpose of this study was to describe women's postpartum health problems in the first and second postp...
BACKGROUND: Postpartum health-related problems are diverse, and some may extend beyond the first postpartum year. The purpose of this study was to describe women's postpartum health problems in the first and second postpartum years. METHODS: We analyzed data from an online survey (N = 427) conducted in 2024. Respondents gave birth within the past 2 to 22 months. Open-ended questions elicited women's health problems; physical and mental health ratings were also gathered. Data were analyzed by qualitative content analysis and non-parametric statistics. RESULTS: The three most frequently reported problems were depression/anxiety, musculoskeletal issues, and genitourinary disorders. The number of physical health problems did not differ between women 2-12 months and 13-22 months postpartum, p = 0.958. Similarly, mental health problems showed no difference between the time frames, p = 0.087. The number of physical and mental health problems was correlated with each other (r = 0.156, p < 0.01). The number of physical health problems was correlated with body mass index (r = 0.136, p < 0.01) and negatively correlated with physical (r = -0.218, p < 0.01) and mental health ratings (r = -0.175, p < 0.01). The number of mental health problems was negatively correlated with physical (r = -0.202, p < 0.01) and mental health ratings (r = -0.310, p < 0.01). DISCUSSION: Women reported a broad range of postpartum health problems, with no significant differences between the first and second years. Findings underscore postpartum care should be extended into the second year.
Adherence to Stillbirth Guidelines and Women's Psychological Well-Being: The CLASS (CiaoLApo Stillbirth Support) Cross-Sectional Study.
Ravaldi C, Roper F, Mosconi L … +1 more , Vannacci A
Birth · 2026 Jun · PMID 42322092 · Publisher ↗
BACKGROUND: The psychological impact of stillbirth on parents is profound, increasing the need for respectful care. Despite the existence of international guidelines, there has been no clinical confirmation of their effi...
BACKGROUND: The psychological impact of stillbirth on parents is profound, increasing the need for respectful care. Despite the existence of international guidelines, there has been no clinical confirmation of their efficacy in improving parental mental health outcomes. METHODS: This study is a web-based cross-sectional study and part of the OPALE (Observatory on PerinatAL hEalth) project. Participants were selected if they suffered a pregnancy loss after 20 weeks (including termination of pregnancy for medical reasons) in the last 10 years. The survey includes: the CiaoLapo Stillbirth Support (CLASS) checklist, the Perinatal Grief Scale (PGS), the National Stressful Events Survey PTSD Short Scale (NSESSS), and questions on satisfaction with care. RESULTS: 261 participants completed the survey. In a multivariate analysis, higher CLASS scores were correlated with lower PGS and NSESSS scores, suggesting a direct relationship between guideline adherence and better psychological outcomes. Specifically, satisfying over 40 of the 60 checklist items independently predicted greater care satisfaction (OR 2.0, CI 1.1-3.8), higher experiences of respectful care (OR 3.6, CI 1.9-7.0), lower grief (OR 0.08, CI 0.1-0.2), and reduced PTSD symptoms (OR 0.21, CI 0.1-0.5). CONCLUSIONS: This is the first study which identifies a correlation between adherence to stillbirth care guidelines and better psychological outcomes, indicating their importance in enhancing parents' mental health.
Physical Activity, Sitting Time, and Sleep Among Postpartum Women During the COVID-19 Pandemic.
Zhao L, Liu J, Whitaker KM … +4 more , Hung P, Hair N, Chen EL, Alberg AJ
Birth · 2026 Jun · PMID 42310930 · Publisher ↗
BACKGROUND: Little is known about the negative impacts of the COVID-19 pandemic on health behaviors among postpartum women. We aimed to assess self-reported changes in physical activity, sitting time, and sleep among pos...
BACKGROUND: Little is known about the negative impacts of the COVID-19 pandemic on health behaviors among postpartum women. We aimed to assess self-reported changes in physical activity, sitting time, and sleep among postpartum women early in the pandemic. METHODS: We conducted an online survey of postpartum women in the United States (n = 809) during May and June of 2020. Multiple logistic regression models were used to examine associations between socio-demographic, medical, and COVID-19-related factors (e.g., COVID-related worries and stressors) and self-reported changes in health behaviors. RESULTS: The prevalence of being less physically active, sitting for longer times, and sleeping less since the pandemic started were 57.4%, 64.9%, and 26.3%, respectively. Medicaid-insured recipients reported more reduced physical activity and longer sitting time than privately insured women. Breastfeeding was associated with higher odds of being less physically active. Worse health status was strongly associated with adverse changes in the three behaviors (All P < 0.05). A higher score on social connection with family members was associated with reduced physical activity and longer sitting time, while those with a higher social connection score with community/neighbors/friends were more physically active. COVID-19-related worries were associated with lower odds of being less physically active but greater likelihood of sitting longer and sleeping less. COVID-19-related stressors were associated with higher odds of sleeping less. CONCLUSIONS: Early in the COVID-19 pandemic, adverse changes in health behaviors were prevalent among US postpartum women. Intervention programs optimizing multiple health behaviors among postpartum women and high-risk groups are needed during pandemic situations.
"A Total Paradigm Shift": Interviews With Australian Maternity Care Providers Who Practice Weight-Inclusive Care.
Jenkinson B, Gill S, Kearney L … +11 more , Griffiths A, Mackinnon B, Hill B, Tome R, Siale T, Barrow K, Hewett L, Cawthorne T, Hocking J, Boyle JA, Callaway L
Birth · 2026 Jun · PMID 42273976 · Publisher ↗
BACKGROUND: Weight stigma is pervasive in maternity care, contributing to negative health outcomes and disengagement among larger-bodied women. To reduce weight stigma and promote respectful, individualized care, a weigh...
BACKGROUND: Weight stigma is pervasive in maternity care, contributing to negative health outcomes and disengagement among larger-bodied women. To reduce weight stigma and promote respectful, individualized care, a weight-inclusive approach prioritizes overall well-being rather than focusing on weight as a key health indicator. How maternity care providers adopt weight-inclusive approaches remains underexplored. This study aimed to investigate the perspectives and practices of weight-inclusive maternity care providers. METHODS: Semi-structured interviews were conducted online with medical, midwifery, and allied health maternity care providers, nominated by consumers or peers for their weight-inclusive practice. Interviews were audio recorded, transcribed, and analyzed thematically. RESULTS: Twenty-four professionals were interviewed, with three themes generated to describe their weight-inclusive approaches: (1) Time and space for reflection-participants described a gradual shift from weight-centric to weight-inclusive care, often prompted by personal or professional experiences of weight stigma; (2) Questioning weight science-participants questioned the value of body mass index or weight as indicators of individual health, favoring holistic assessments; and (3) Taking action to make change-participants had made specific changes to their practice, including to clinical environments, communication, and in responding to weight-centric systems. DISCUSSION: Our findings map how some maternity care providers describe enacting weight-inclusive maternity care. Despite systemic barriers such as weight-centric education and clinical guidelines, maternity care providers made meaningful change through deliberate reflection and compassionate practice. Reform in education and clinical guidelines is needed. Extending existing frameworks, our study describes maternity-specific enactments to address weight stigma and support broader adoption of weight-inclusive approaches.
From Guideline to Practice: Variation in Late-Term Pregnancy Management Across the Netherlands.
de Deugd CEA, Verhoeven CJM, van Dillen J … +1 more , Seijmonsbergen-Schermers AE
Birth · 2026 Jun · PMID 42272054 · Publisher ↗
INTRODUCTION: Introduced in 2021, the Dutch national guideline on late-term pregnancy management aims to standardize care, reduce regional variation, and optimize maternal and perinatal outcomes. This study aimed to eval...
INTRODUCTION: Introduced in 2021, the Dutch national guideline on late-term pregnancy management aims to standardize care, reduce regional variation, and optimize maternal and perinatal outcomes. This study aimed to evaluate the extent to which regional protocols adhere to this Dutch national guideline and assess variation in the content of protocols for late-term pregnancy management. METHODS: In this cross-sectional study, content analysis of 60 Dutch regional late-term pregnancy protocols was performed to assess alignment with the Dutch national guideline. Key variables included protocol characteristics, integration of guideline recommendations, use of shared decision-making tools, and regional policy choices. RESULTS: The integration of guideline recommendations varied largely among regional protocols. Induction of labor at 41 weeks alongside the option of expectant management was incorporated into 72% of the protocols, while the recommendation to facilitate shared decision-making was adopted in only 45%. The two recommendations regarding fetal monitoring and the recommendation on increased risk for nulliparous women were infrequently implemented (43%, 37%, and 30%). The implementation of late-term choices varied considerably in terms of shared decision-making conversation timing, additional monitoring, and available alternatives. CONCLUSION: Substantial variation was found in protocol content and the integration of guideline recommendations. Although the guideline highlights the importance of shared decision-making, a lack of clarity remains regarding the content, purpose, and scope of regional protocols. Restructuring the current system of protocol development from regional working groups to a centralized organization may help reduce practice variation and improve the quality of care.
Maternal Satisfaction With Childbirth and the Associated Factors: A Systematic Review and Meta-Analysis.
Mirghafourvand M, Alizadeh-Dibazari Z, Zarezadeh M … +2 more , Abbasalizadeh S, Najmi LA
Birth · 2026 Jun · PMID 42272044 · Publisher ↗
BACKGROUND: Maternal satisfaction with childbirth is a key indicator of intrapartum care quality and is linked to improved maternal and neonatal outcomes, continued use of maternity services, and psychological well-being...
BACKGROUND: Maternal satisfaction with childbirth is a key indicator of intrapartum care quality and is linked to improved maternal and neonatal outcomes, continued use of maternity services, and psychological well-being. Despite growing research attention, a consistent and comprehensive synthesis of global evidence on childbirth satisfaction and its determinants is still lacking. METHODS: A systematic review and meta-analysis of observational studies published in English between 2015 and 2025 was conducted. Eligible studies assessed maternal satisfaction using validated instruments. Searches were performed in PubMed, Scopus, and Google Scholar. Two reviewers independently screened, extracted data, and assessed study quality using the JBI Critical Appraisal Checklist. RESULTS: Thirty-two studies comprising 16,967 women met the inclusion criteria. The pooled prevalence of childbirth satisfaction was 71.0% (95% CI: 65%-77%), with substantial heterogeneity (I = 99.17%, p < 0.001). Satisfaction was 64.0% following vaginal birth and 63.0% after cesarean delivery. Regionally, satisfaction was highest among the five European countries (83.0%), moderate among the four Asian countries (74.0%), and lowest among the four African countries (62.0%). Substantial heterogeneity was observed across all analyses. The most commonly reported associated factors included maternal age, education, parity, respectful care, and mode of delivery. DISCUSSION: Differences in birth satisfaction may reflect variations in the quality of delivery services, women's expectations and experiences, socio-demographic characteristics, and cultural factors shaping perceptions of maternity care. LIMITATIONS: Significant heterogeneity across studies-arising from variations in methodological rigor, measurement approaches, and contextual conditions-limits the precision and generalizability of pooled estimates. The exclusion of non-English studies may have introduced language bias, and potential publication bias cannot be excluded, as suggested by observed funnel plot asymmetry. CONCLUSIONS: Approximately seven in ten women report satisfaction with childbirth, though estimates vary by region and study design. Standardized, culturally sensitive tools and high-quality research are needed to enhance understanding and improve women's childbirth experiences. REGISTRATION AND PROTOCOL: The systematic review protocol was registered in PROSPERO.
Correction to "The Prevalence of Perinatal Mental Health Disorders and Psychosocial Characteristics of Women in Malta: A Cross-Sectional Study".
Birth · 2026 Jun · PMID 42265844 · Publisher ↗
Abstract loading — click title to view on PubMed.
An Exploratory Qualitative Study of Screening, Testing, and Reporting Prenatal Cannabis Use by Recreational Legalization Status.
Iobst SE, Fendish Y, Skelton KR
Birth · 2026 Jun · PMID 42260941 · Publisher ↗
BACKGROUND: In recent years, state-level recreational cannabis legalization has bourgeoned throughout the United States, which may explain increasing rates of cannabis use among pregnant women. OBJECTIVE: Our objectives...
BACKGROUND: In recent years, state-level recreational cannabis legalization has bourgeoned throughout the United States, which may explain increasing rates of cannabis use among pregnant women. OBJECTIVE: Our objectives were to: (1) comprehensively explore policies and practices related to screening, testing, and reporting prenatal cannabis use across a multi-state sample, and (2) describe variations in policies and practices by state-level recreational cannabis legalization. METHODS: We conducted an exploratory, multiple-case qualitative case study of perinatal nurses using a combination of convenience and snowball sampling. Interviews were analyzed using content analysis. RESULTS: Of the 22 registered nurses from 15 states of mixed recreational cannabis legalization statuses (legal: n = 6, illegal: n = 9), universal verbal screening was reported in all but one state, which had recreational cannabis legalization. Nurses from nearly one-quarter of states described universal maternal toxicology testing, which is inconsistent with current clinical recommendations. Although discouraged as a standard practice, nurses from most states described policies in which positive toxicology results were reported to social work and/or child protective services. In response to positive toxicology results, changes in clinical practice reported by nurses included discouragement of breastfeeding, which may have concerning health equity implications. CONCLUSION: In contrast to clinical guidelines, nurses in one-third of states reported universal maternal toxicology testing. Nurses reported ethical concerns about testing practices, including biased rationales for testing, failure to conduct informed consent, and threatening with punitive consequences to accomplish testing.
Episiotomy Decision-Making and Perceived Consequences: A Qualitative Study From Two Public Hospitals in Mexico.
Jaimes-Jiménez I, Valtierra-Gutiérrez ES, González-De Ita RA … +7 more , Caballero-Torres LE, González-Ledesma A, Dominguez-Hernandez L, Mimiaga-Morales JM, Lumbreras-Marquez MI, Obrador GT, Monroy-Ramírez de Arellano LE
Birth · 2026 Jun · PMID 42249683 · Publisher ↗
INTRODUCTION: Episiotomy remains a widely performed procedure in many countries, despite international recommendations favoring a restrictive approach. In Mexico, high rates persist in several settings, including public...
INTRODUCTION: Episiotomy remains a widely performed procedure in many countries, despite international recommendations favoring a restrictive approach. In Mexico, high rates persist in several settings, including public hospitals. Understanding the factors that sustain this practice is key to designing evidence-based respectful birth care strategies. This study aimed to explore healthcare professionals' perspectives on the decision-making process, performance, and perceived consequences of episiotomy, and to engage them in the co-design of behavioral science-informed interventions to promote its restrictive use. METHODS: A two-phase qualitative study was conducted in two public hospitals in Mexico, as part of a broader project aimed at promoting the restrictive use of episiotomy. In Phase 1, we conducted 22 semi-structured interviews with maternal health care workers, selected through purposive sampling. Interviews were analyzed inductively using iterative coding and thematic grouping. In Phase 2, group interviews were conducted to discuss findings and collaboratively design interventions for a future pilot quasi-experimental study. RESULTS: Episiotomy decisions are often guided by clinical and preventive considerations. Non-clinical factors, including productivity burdens and training, also contributed to the high rates of episiotomy. Despite the absence of formal institutional monitoring of episiotomy rates, professionals expressed a strong interest in receiving feedback and training. CONCLUSION: Episiotomy practices in this setting are influenced by clinical, systemic, and educational factors. Addressing potential overuse of episiotomy requires institutional feedback systems, evidence-based training, and strategies to improve dignity in care. Engaging stakeholders through a participatory approach helps ensure that potential interventions are contextually relevant and feasible to implement.
Toward Labour-Care Tools That Survive Low-Resource Realities: Reflections From the PartoMa Group on the WHO Labour Care Guide Implementation Strategy.
Kujabi ML, Housseine N, Dmello BS … +3 more , Skovdal M, van den Akker T, Maaløe N
Birth · 2026 Jun · PMID 42240097 · Publisher ↗
Abstract loading — click title to view on PubMed.
Analysis of Burnout Risk Factors in Midwives in Times of Pandemic: An International Study.
Rodríguez-Puente Z, Arias-Gundín O, Andina-Díaz E … +1 more , Pérez-Rivera FJ
Birth · 2026 Jun · PMID 42220274 · Publisher ↗
BACKGROUND: Burnout and job satisfaction among midwives have been studied extensively but not in the context of global pandemics. Given the effects of pandemics and similar crises on the experiences and working condition...
BACKGROUND: Burnout and job satisfaction among midwives have been studied extensively but not in the context of global pandemics. Given the effects of pandemics and similar crises on the experiences and working conditions of midwives, as well as the increasing incidence of such events, it is necessary to evaluate their impact. The dual aims of this study were to analyze whether there were differences in the levels of burnout and job satisfaction experienced during the pandemic between midwives in Spain and the United Kingdom, and to identify risk factors for high levels of burnout during this period. METHODS: We conducted a cross-sectional study using a questionnaire based on validated burnout and job satisfaction scales between October 2020 and March 2021. We recruited a total sample of 599 midwives, 170 in the UK and 429 in Spain. Data were analyzed using logistic regression models in SPSS 20.0. RESULTS: Moderate and high levels of burnout were found in both countries, although UK midwives reported significantly higher levels of burnout than Spanish midwives (p > 0.000). Spanish midwives had higher job satisfaction scores in all variables except benefits received (salary, promotion, and training) (p > 0.000). Age, hospital care units, and rotating work shifts were the main factors related to high levels of burnout (p > 0.000). CONCLUSIONS: During the pandemic, midwives in Spain and the United Kingdom experienced high levels of burnout and job dissatisfaction. Strategies need to be developed to reduce the impact of pandemic-related stressors in order to minimize attrition in the profession without compromising quality of care.
Women, Infants and Children (WIC) Participation and Breastfeeding Behavior: Comparing Foreign-Born to US-Born Mothers.
Campbell AG
Birth · 2026 May · PMID 42216442 · Publisher ↗
BACKGROUND: This cross-sectional study compared rates of breastfeeding initiation and exclusive breastfeeding among foreign-born mothers who utilized the Women, Infants and Children (WIC) program with foreign-born non-pa...
BACKGROUND: This cross-sectional study compared rates of breastfeeding initiation and exclusive breastfeeding among foreign-born mothers who utilized the Women, Infants and Children (WIC) program with foreign-born non-participants and US-born WIC participants. METHODS: Sample children from the nationally representative dataset, the National Survey of Children's Health 2016-2022, ages 6 months to 1 year were included. Descriptive statistics and logistic regressions were executed for analysis. RESULTS: 91.8% of foreign-born women who utilized WIC initiated breastfeeding and 34.8% exclusively breastfed for 6 months. By comparison, 68.2% of US-born women who utilized WIC initiated breastfeeding and 10.4% exclusively breastfed for 6 months. Foreign-born women who utilized WIC had 4.04 times the odds [95% CI (1.49, 10.97)] of initiating breastfeeding relative to foreign-born women who did not utilize WIC. Foreign-born women who utilized WIC also had 7.42 times the odds [95% CI (3.22, 17.11)] of initiating breastfeeding and 3.47 times the odds [95% CI (1.52, 7.95)] of exclusive breastfeeding for 6 months relative to US-born women who utilized WIC (adjusted for household federal poverty level, preterm birth, birth order of sample child, sample child's race and mother's age, education, and marital status). CONCLUSION: Foreign-born women who utilized WIC had increased breastfeeding behavior relative to both foreign-born women who did not utilize WIC and US-born women who utilized WIC. This suggests that, rather than WIC contributing to lower breastfeeding rates, there is an unobserved characteristic that is correlated with lower breastfeeding rates among US-born women who utilize WIC that also encourages selection into the program.
Association Between Maternal Progesterone Use and Body Weight of Offspring in the US Collaborative Perinatal Project: A Retrospective Cohort Study.
Hu B, Wu Y, Xie Q … +4 more , Chen Q, Huang L, Zhang J, Zhang X
Birth · 2026 May · PMID 42198804 · Publisher ↗
INTRODUCTION: This study aimed to evaluate whether and to what extent progesterone use during pregnancy influences offspring's body weight in a large sample, drawn from 1959 to 1976. METHODS: We used the data from the Na...
INTRODUCTION: This study aimed to evaluate whether and to what extent progesterone use during pregnancy influences offspring's body weight in a large sample, drawn from 1959 to 1976. METHODS: We used the data from the National Collaborative Perinatal Project, which retrospectively collected information on maternal progesterone use and offspring weight from birth to 7 years of age. Multivariable linear regression models were used to evaluate the association between maternal progesterone use and offspring weight, and to verify whether early pregnancy progesterone use, total duration of pregnancy, and duration of pregnancy use affect offspring weight. RESULTS: Among 49,507 mothers, 952 (1.92%) used progesterone during pregnancy. Birth weight of those who used progesterone was significantly lower than that of nonusers after adjusting for potential confounders. We found that the weight gaps were -135 g (95% CI: -163 to -106 g) at birth and -92.6 g (95% CI: -149 to -35.7 g) at 4 months. When progesterone use was first initiated in the second or third trimester, lower weight in offspring of users could persist to 8 months and 1 year, respectively. If the total duration of progesterone use during the entire pregnancy was longer than 20 days, the weight gap between offspring of users and those of nonusers could last for 1 year after birth. CONCLUSIONS: Maternal progesterone use during pregnancy might be associated with lower birth weight of offspring in this population from 1959 to 1976, which suggests that further, updated research to in other populations is warranted.
"There Was no Break": A Qualitative Analysis of Mothers' Experiences With Labor Induction.
Mackessy JA, Philogene AJ, Thompson AL … +1 more , Martin SL
Birth · 2026 May · PMID 42175649 · Publisher ↗
BACKGROUND: Labor induction, the artificial start of labor using pharmacological or mechanical methods, has been associated with more negative birth experiences, including higher rates of poor maternal mental health, low...
BACKGROUND: Labor induction, the artificial start of labor using pharmacological or mechanical methods, has been associated with more negative birth experiences, including higher rates of poor maternal mental health, lower rates of breastfeeding self-efficacy, and shorter breastfeeding duration. However, few studies have used qualitative interviews to examine women's experiences with labor induction and why this intervention may lead to more negative birth experiences. METHODS: This study used a descriptive phenomenological approach. We analyzed 15 semi-structured interviews using coding and matrix analysis. Interview questions centered around mothers' birth experiences, the feeling of contractions, and differences between multiple birth experiences when applicable. RESULTS: Mothers with a labor induction stated their contractions were more intense, closer together, or had no break compared to their non-induced births or the coaching they received prenatally from doulas or childbirth educators. A desire for induction and levels of provider support also contributed to mothers' experiences with labor induction. Mothers expressed that this altered contraction patterning increased anxiety and motivated their use of pain medication. DISCUSSION: Our findings suggest that induced labor may lead to more negative birth experiences through altered contraction patterns, not wanting the induction, and lacking trust and support from care providers. Hospital policies should ensure that healthcare providers and clinicians have time to understand mothers' desires for induction and other medical interventions and should provide extra support for mothers who need this intervention. Further research is needed on the possible physiologic effects this altered contraction patterning has on mothers and infants.
Obstetrical and Neonatal Outcomes of Term Pregnancies Complicated by Unstable Fetal Lie.
Zrake AA, Odeh M, Kaiyal RS … +3 more , Aiob A, Lowenstein L, Sgayer I
Birth · 2026 May · PMID 42144909 · Publisher ↗
BACKGROUND: Unstable fetal lie, characterized by frequent changes in fetal presentation during late pregnancy, poses challenges in pregnancy management and delivery planning. We aimed to examine the obstetrical and neona...
BACKGROUND: Unstable fetal lie, characterized by frequent changes in fetal presentation during late pregnancy, poses challenges in pregnancy management and delivery planning. We aimed to examine the obstetrical and neonatal outcomes associated with term pregnancies complicated by an unstable fetal lie. METHODS: This retrospective cohort study included data recorded during 2012-2022 of women with term singleton pregnancies with an unstable fetal lie who attempted vaginal delivery after stabilizing to vertex. We compared their obstetrical and neonatal outcomes in a 1:2 ratio to those of women without a history of unstable fetal lie who had a singleton fetus in vertex presentation at delivery. RESULTS: Of 67,360 deliveries, 174 (0.25%) were with an unstable fetal lie. For women who attempted vaginal delivery (n = 116, 66.7%) compared to women with spontaneous vertex presentation who delivered vaginally (n = 232), the intrapartum cesarean delivery (CD) rate was higher (31.0% vs. 10.3%, p < 0.001). Also higher were the CD rates attributed to fetal distress (12.9% vs. 6.0%, p = 0.038) and labor dystocia (11.2% vs. 4.7%, p = 0.041), and the nuchal cord incidence rate (17.2% vs. 5.6%, p < 0.001). Multivariate logistic regression identified unstable fetal lie as an independent risk factor for emergent CD (OR 4.1, 95% CI 2.1-8.2, p < 0.001). Birth trauma, cord prolapse, and perinatal death were not reported. CONCLUSIONS: Vaginal delivery attempts in women with an unstable fetal lie did not show similar progression of labor and obstetrical outcomes as spontaneous vertex presentation. This emphasizes the need for tailored management.
Prevalence of Episiotomy Practice and Associated Factors in Brazil: A Systematic Review.
Dos Santos Rodrigues AC, de Sousa Gomes ML, da Silva RR … +5 more , Rafael EV, Azevedo PR, Rios CTF, de Brito Lima JF, Oriá MOB
Birth · 2026 May · PMID 42077041 · Publisher ↗
INTRODUCTION: Although routine episiotomy is not recommended, it remains widely performed during childbirth, with rates varying substantially across countries. This systematic review synthesizes evidence on the prevalenc...
INTRODUCTION: Although routine episiotomy is not recommended, it remains widely performed during childbirth, with rates varying substantially across countries. This systematic review synthesizes evidence on the prevalence and associated factors of episiotomy in Brazil. METHODS: This is a systematic review of prevalence, conducted in accordance with the recommendations of the Joanna Briggs Institute (JBI). The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the identification number CRD42024621526. Seven electronic databases were searched with no restrictions regarding publication period or language: MEDLINE/PubMed (via the National Library of Medicine), Web of Science, SCOPUS, CINAHL (EBSCO), Cochrane, EMBASE (Elsevier), and the Latin American and Caribbean Health Sciences Literature (LILACS). The JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data was used by two authors to assess the quality of the selected studies. RESULTS: A total of 65 studies were included. The prevalence of episiotomy practice among women varied from 0.5% to 94%. Only 16 studies (24.6%) reported episiotomy rates close to the recommended benchmark of 10%. Thirty-three studies (50.8%) analyzed factors associated with the practice, with the most frequently reported factors being: primiparity, primigravidity, nulliparity, adolescence, youth, higher education, higher income, delivery in private healthcare settings, physician-assisted births, use of oxytocin, instrumental delivery, absence of previous vaginal birth, prematurity, newborn weight over 4000 g, and horizontal delivery position. CONCLUSIONS: A limited number of studies have met recommended episiotomy rates, underscoring the challenge of translating evidence into practice. Lower rates were seen in births attended by nurse midwives. Continuous professional training focused on evidence-based care is essential to reduce unnecessary interventions and align rates with recommended targets.
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