Research

Doulas have been instrumental in providing breastfeeding support to nursing mothers before and during the COVID-19 pandemic, as they can significantly impact a mother's ability to initiate and maintain breastfeeding. However, the COVID-19 pandemic, subsequent lockdowns, and social isolation created challenges for nursing mothers to access doulas' services, usually provided in person. In this study, they examined the role of doulas in providing breastfeeding support during the COVID-19 pandemic, exploring adaptation to COVID-19 guidelines and the challenges doulas face in providing breastfeeding support during the pandemic.

In the United States, Black women are disproportionately impacted by inequities in maternal health. Community doula support may improve birth outcomes and experiences, including lower rates of preterm birth and low birthweight and increases in positive birthing experiences. This study conducted two rounds of qualitative interviews with doula clients who identified as Black or Pacific Islander between August 2019 and March 2020. Interviews explored clients’ knowledge of, experiences with, and motivations for seeking doula care and their perceptions of the services they received. This study utilized a Rapid Assessment Process to synthesize findings and thematic analysis.

This study aimed to investigate the effect of birth plan on maternal and neonatal outcomes. This study was a randomized controlled clinical trial performed on 106 pregnant women, 32–36 weeks of pregnancy, referring to Taleghani educational hospital in Tabriz city-Iran. 

While childbirth appears to be a potent trigger of severe mood disorders, the precise mechanisms by which postpartum psychosis occurs are poorly understood. This review examines the current evidence with respect to potential aetiology and childbirth-related triggers of postpartum psychosis. Findings to date have implicated neurobiological factors, such as hormones, immunological dysregulation, circadian rhythm disruption and genetics, to be important in the pathogenesis of this disorder.

The objective of this study was to tabulate adverse pregnancy outcomes among patients with SCD, comparing outcomes of deliveries among Black people with SCD with those of Black people without SCD and a control non-Black population, and to measure the association of racial disparities with adverse outcomes in SCD pregnancies. Its results suggest that the risk for SMM is higher in deliveries among people with SCD than those of Black or non-Black control populations with no SCD; nearly one-third of the increased risk may be attributable to racial disparities.

Most evidence for interpregnancy interval (IPI) and adverse birth outcomes come from studies that are prone to incomplete control for confounders that vary between women. Comparing pregnancies to the same women can address this issue.

There is ample evidence of associations between short birth interval and adverse maternal and child health outcomes, including infant and maternal mortality. Short birth interval is more common among women in low- and middle-income countries. Identifying actionable aspects of short birth interval is necessary to address the problem. This is a systemic review to systematize evidence on risk factors for short birth interval in low- and middle-income countries.

This study researches how the availability of contraceptive services was associated with a change in the abortion rate before and after Texas' legislative changes to the family planning budget in 2011 and abortion access in 2013.

For many women, breastfeeding their infant is an enjoyable experience. Some, however, have reported negative sensations such as an overwhelming need to unlatch while breastfeeding. This phenomenon is known as breastfeeding aversion response (BAR). The incidence of BAR is unknown and literature on this experience is limited. This study therefore aimed to expand the understanding of BAR using an online survey targeting those who have experienced feelings of aversion while breastfeeding.

Preparation for birthing has focused primarily on Caucasian women. No studies have explored African American women’s birth preparation. From the perceptions of 12 African American maternity health-care providers, this study elicited perceptions of the ways in which pregnant African American women prepare for childbirth. 

This review explores the impact of MCM on four perinatal outcome domains: pregnancy and obstetric; maternal mental health; infant; and the quality of the care-giving environment. Mechanisms identified in the included studies are discussed in relation to the maternal programming hypothesis and directions for future research.

The Mothers' Milk Tool was developed to make more visible the economic value contributed to society by women's unpaid care work through breastfeeding infants and young children. This article describes the development and display key features of the tool, and reports results for selected countries. 

This retrospective cohort study of 2556 women aimed to examine the relationship between childhood trauma and fear of childbirth (FOC). Childhood trauma was assessed retrospectively using the Trauma and Distress Scale (TADS) questionnaire completed at 14 weeks of gestation and diagnosis of FOC was obtained from the Finnish Medical Birth Register. The study found that emotional abuse, emotional neglect, and a higher total burden of childhood trauma (as measured by the TADS total score) increased the risk of FOC. However, there was no evidence of a significant association between physical abuse, physical neglect, sexual abuse, and FOC. 

This cross sectional study of 680 women aimed to investigate the childbirth experiences of immigrant and non-immigrant women, specifically focusing on perceived quality of care and the fulfillment of healthcare needs. The findings highlight the importance of further research to assess immigrant women's childbirth experiences and the need for healthcare providers to deliver optimal care that is sensitive to cultural backgrounds and individual expectations.

Preterm delivery is a stressful event for mothers, posing them at risk for post-traumatic stress reactions. This study examined the degree of depressive symptoms and post-traumatic stress in mothers of preterm infants born before 32 gestational weeks depending on whether the infant received music therapy in the neonatal intensive care unit (NICU) or not.

In this study, researchers aimed to conduct a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) dataset to examine self-identification of race/ethnicity and unplanned cesarean birth. The results indicated that the unplanned cesarean birth rate in percentage was about 19.6%. The cesarean birth rate was significantly higher in Black and Hispanic mothers in comparison to those who self-identified as White, even after controlling for pertinent clinical factors associated with cesarean birth.

This review aims to provide a broad overview of existing findings on the psychological effects of breastfeeding, highlighting the important role that breastfeeding plays across several dimensions of psychological functioning. We also discuss the potential mechanisms that may underpin the observed effects, provide a constructive commentary on the limitations of the existing work, and put forth some considerations when evaluating this line of research.

To address the research gap on comorbidity between psychiatric and reproductive system disorders, this study's objectives were to (1) systematically review the literature on associations between psychiatric and reproductive system disorders in women of reproductive age; (2) perform a meta-analysis on risk of psychiatric morbidity associated with disorders of the reproductive system, and vice versa; and (3) perform meta-analyses as in objective 2 but stratified by specific psychiatric-reproductive system disorder pairs.

This article uses the Afrocentric perspective to gain an understanding of the state of Black maternal mental health and supports for mental health.  The article also presents culturally centered recommendations aimed at addressing racial disparities in maternal and infant mental health and toward racial justice-oriented practice, policy, and research. 

Research shows there is a significant increase in gingival inflammation during pregnancy. This study was conducted to determine if an oral health intervention (OHI), including oral hygiene education delivered by nurse-led staff and an advanced over-the-counter (OTC) oral home care regimen, improved gingival inflammation in pregnant women with moderate-to-severe gingivitis compared with a standard oral hygiene control group.

This cross-sectional study sought to explore women's experience of maintaining breastfeeding after return to work, in all work sectors. In summary, this study reveals women who are confident in their rights to express breastmilk/breastfeed at work, are more likely to meet their own breastfeeding goals. Therefore, one important way to extend durations of breastfeeding is by creating more supportive workplace environments that foster increased confidence in maintaining milk supply.

This systematic review examines the research about programs that aim to support aspects of teen parents’ self-sufficiency by promoting their educational outcomes and healthy birth spacing. The review found rigorous evidence that programs can improve teen parents’ education, increase their contraceptive use, and decrease repeat pregnancies or births. It also found that these programs have diverse characteristics, but most provide intensive, one-on-one support to teen parents.

In the U.S., sudden unexpected infant deaths (SUID) due to accidental suffocation and strangulation in bed (ASSB) are increasing, with disparities by race/ethnicity. \Combining infant safe sleep (ISS) and breastfeeding promotion on the community level presents opportunities to address racial/ethnic disparities and associated socioeconomic, cultural, and psychosocial influences.

This study summarizes how postpartum depression (PPD) affects up to one in five mothers and birthing parents, yet as few as 10% access evidence-based treatments. One-day cognitive behavioral therapy (CBT)-based workshops for PPD have the potential to reach large numbers of sufferers and be integrated into stepped models of care.

This study aimed to provide reliable estimates of the incidence of stillbirth and neonatal death in three LMICs (Madagascar, Cambodia and Senegal) and to identify their main causes and associated risk factors, shedding light on the exact timing, causes, and circumstances of stillbirth and neonatal mortality in low- and middle-income countries (LMICs) which remains unknown. The authors identified that the peripartum period and the first day of life were the key periods of mortality. 

This nationwide retrospective cohort study aimed to evaluate delivery mode and fetal outcomes in a trial of labor after cesarean section (TOLAC). The authors conclude that further research is needed to identify those expecting women who are better suited for TOLAC to minimize the risk for a neonate, shedding light on the importance of evidence based counseling and shared decision making between expecting mothers and the healthcare team.

Exclusive breastfeeding is a public health priority in sub-Saharan Africa. However, systematic reviews on its determinants in Ghana remain scarce. Therefore, this study systematically reviewed the prevalence and determinants of exclusive breastfeeding in children 0–6 months in Ghana.

This study examines the effects of vitamin D supplementation on the physical growth and neurologic development of very preterm infants receiving nesting intervention in the neonatal intensive care unit (NICU).

This is a retrospective multicenter observational study. It is proposed that the development of parenteral nutrition-associated cholestasis (PNAC) was significantly associated with preterm birth, low birth weight, infection, etc.; however, the etiology and pathogenesis of PNAC are not fully understood. Most of the studies examining PNAC-associated risk factors were single-center studies with relatively small sample sizes.

Chorioamnionitis (CAM) is a common risk factor for preterm births, resulting in several adverse outcomes. The association between infertility treatment and CAM is unclear. This study examined the association between infertility treatment and CAM and described subsequent neonatal outcomes.

This study examined the prevalence and factors associated with postnatal depression, anxiety, post-traumatic stress (PTS), and comorbidity of these mental health problems for mothers of infants admitted to NNU, six months after childbirth.

Adolescent pregnancy is an important issue in terms of reproductive health. Adolescent mothers have to overcome two crises at the same time: motherhood and maturity. This cross-sectional study focuses on how the childbirth experience and posttraumatic stress disorder may influence the mother’s perception of her infant and postpartum care behaviors.

This study characterizes the barriers encountered by Black community-based doulas in Los Angeles, California. Black pregnant individuals endure a disproportionate burden of preventable morbidity and mortality due to persistent, racially mediated social and systemic inequities. As patient advocates, Black community-based doulas help address these disparities via unique services not provided by conventional doulas. However, Black doulas themselves may encounter obstacles when providing care to Black perinatal clients.

Mental health disorders during the post-partum period are a common morbidity, but parental leave might help alleviate symptoms by preventing or reducing stress. This research article aims to summarise available evidence on the effect of different types of parental leave on mental health outcomes among parents.

While home births rose an average of 2% from 1990 to 2019, they jumped 22% between 2019 and 2020, said Elizabeth Gregory, a researcher who co-authored the report. The findings offered another view of the pandemic’s effects on maternal health and how, of the nearly 52,000 home births recorded last year, the greatest increases were among Black and Hispanic women. 

This retrospective cohort study, published in March 2023, aimed to identify patient and hospital characteristics associated with postpartum ED visit rates. Findings suggest that Black and Hispanic patients experienced higher rates of postpartum ED visit rates across all hospital types, particularly at safety net hospitals and those serving racial and ethnic minority groups, suggesting structural changes are needed to reduce maternal health disparities.

There are many myths about the safety of dental care during pregnancy. As a result, pregnant women receive less dental care than when they are not pregnant. In our review, we tried to emphasize the importance and safety of routine dental care for pregnant women.

This study highlights the clinical differences between early versus late onset preeclampsia. The study concluded that gestational age at the onset of the disease should be taken as an important indicator of the severity of the disease with unfavorable maternal, fetal, and neonatal outcomes.

The Rural & Minority Health Research Center published this Findings Brief in August 2022 reporting disparities in geographic access to health services for places that have a relatively high proportion of residents from minoritized racial and ethnic groups. 

Researchers aimed to assess how race and ethnicity impact maternal and perinatal outcomes among U.S.-born and foreign-born women. The researchers found that compared to foreign-born women, U.S.-born women had a higher risk of adverse perinatal outcomes such as preterm birth, hypertensive disorders, low birth weight at term, and NICU admission. 

This study evaluated the influence of prenatal exercise on racial/ethnic disparities in gestational age, birthweight, and risks of preterm birth, cesarean section, and low-birthweight neonates. The study concluded that prenatal exercise may attenuate the racial/ethnic disparities observed.

This study by Lynn Rempel and John Rempel in 2004 examined the influence of partners on breastfeeding and found that despite not being directly involved in the act of breastfeeding, partners’ opinions of breastfeeding influence women’s breastfeeding intentions, initiation, and duration. The study recommends including partners in health education to improve breastfeeding outcomes.

This study assessed and compared prenatal care adequacy among women without disabilities and women with physical, sensory, and intellectual/developmental disabilities. The results demonstrate that among women with disabilities, there are differences in prenatal care adequacy based on disability status. They emphasize that inequitable access to prenatal care for women with disabilities, especially those with intellectual/developmental disabilities, must be addressed.

Researchers analyzed information from the Listening to Mothers in California Survey and found that perceived discrimination was related to lower postpartum visit attendance and a lower probability of discussing birth control, depression, and breastfeeding. 

This study provides a systematic review the impacts of breastfeeding interventions targeting ethnic/racial minority women in the U.S.

Irth - Birth without the Bias: A Mini-Manual to Pregnancy and Childbirth for Black People

Limited research has examined factors that impact access to postpartum mental healthcare. We investigated the predisposing, enabling, and need factors associated with postpartum consultation for mental health concerns in US mothers with or without depressive symptoms and examined potential disparities in access.

Despite general improvements, this study finds that severe maternal morbidity continues to contribute to excess maternal mortality among racial and ethnic minorities.

This study assessed the effectiveness of solution-focused counseling in terms of reducing violence and improving the quality of life of women who have previously experienced domestic violence.

The authors aimed to understand the effect of the COVID-19 pandemic on women's access to contraceptive services, desire for pregnancy, and economic conditions.

A comparative risk analysis of neonatal deaths averted by kangaroo mother care versus mortality due to SARS-CoV-2 infection

This quasi-experimental retrospective study aimed to assess whether participating in the Arizona Health Start Programme reduced rates of low birth weight (LBW), very LBW (VLBW), extremely LBW (ELBW), and preterm birth (PTB). 

The quality and quantity of families’ support systems during pregnancy can affect maternal and fetal outcomes. The support systems of expecting families can include many elements, such as family members, friends, and work or community groups. Emerging health information technologies (eg, social media, internet websites, and mobile apps) provide new resources for pregnant families to augment their support systems and to fill information gaps.

This research article, published in 2020, presents the findings of a qualitative study that explored the factors influencing women’s diet and physical activity during pregnancy, and aimed to identify the needs of these women with regards to lifestyle support. The authors concluded that lifestyle interventions in pregnancy should be adapted to meet the needs of individuals with different health identities, and encouraging a change in health identity may be one way of supporting sustained change in health behaviors. 

This study addresses this issue by estimating within-family models on a sample of 4.5 million births from 77 countries at various levels of development. We show that after unobserved maternal heterogeneity is controlled for, intervals shorter than 36 months substantially increase the probability of infant death. However, the importance of birth intervals as a determinant of infant mortality varies inversely with maternal education and the strength of the relationship varies regionally. 

Interpregnancy care aims to maximize a woman’s level of wellness not just in between pregnancies and during subsequent pregnancies, but also along her life course. Because the interpregnancy period is a continuum for overall health and wellness, all women of reproductive age who have been pregnant regardless of the outcome of their pregnancies (ie, miscarriage, abortion, preterm, full-term delivery), should receive interpregnancy care as a continuum from postpartum care. 

New Evidence from Linked Administrative Data: Health economists at Stanford University use linked administrative data that combines the universe of California birth records, hospitalizations, and death records with parental income from Internal Revenue Service tax records and the Longitudinal Employer-Household Dynamics file to provide novel evidence on economic inequality in infant and maternal health.

This survey was conducted by the United States Lactation Consultant Association in 2019 to better understand the demographics of the lactation profession in the United States.

New analysis of information on death certificates from 2016 to 2017 revealed that the maternal mortality rate among non-Hispanic Black women was 3.5 times higher than among non-Hispanic white women.

Researchers studied racial and ethnic disparities in maternal mortality in the United States. They found that the maternal mortality rate for non-Hispanic Black women was 3.55 times that of non-Hispanic white women. 

This study, published in October 2022, examined the impact of Arizona’s Health Start Program, a community health worker (CHW) home visiting intervention, on prenatal care utilization among an ethno-racially and geographically diverse cohort of women. It concluded that a CHW-led perinatal home visiting intervention operated through a state health department can improve prenatal care utilization among demographically and socioeconomically disadvantaged women and reduce maternal and child health inequity.

This study reinforces the case that doula involvement is a cost-effective method to improve outcomes for mothers and infants. The study also demonstrates that doulas can have an impact beyond the birth process itself and the mother’s experience of the birth.

Perinatal health is beginning to be recognized as an essential part of perinatal health. In this paper, an international team of paternal perinatal mental health experts summarize key findings in the field and provide an overview of paternal perinatal mental health, leading tools to assess paternal depression and anxiety, the impact of paternal mental health on mother and child health, and future directions for the field. 

Data from Maternal Mortality Review Committees in 36 US States, 2017-2019.

The article highlights the importance of educating women about adverse outcomes that can occur during pregnancy. Including increasing prevalence of cannabis-related diagnosis (CRD) from 2011 to 2017, increased risk of all maternal and infant outcomes assessed from CRD, strongest effects for prematurity and gastrointestinal malformations, and stronger effects when another substance-related diagnosis accompanied CRD.

This study concluded that interventions designed to raise breastfeeding rates in the study site community would ideally be grounded in tribal resources and involve a collaborative approach that engages the greater community, grandmothers, health care professionals, and scientific partners varying skills. 

This report provides an overview of maternity care in California, reviews the state’s performance by demographic groups, over time, and in comparison with national numbers.