Community Midwifery Postpartum Care Model. Abstract Introduction Postpartum health is in crisis in the United States, with rising pregnancy-related mortality and worsening racial inequities. The World Health Organization recommends four postpartum visits during the 6 weeks after childbirth, yet standard postpartum care in the United States is generally one visit 6 weeks after birth. We present community midwifery postpartum care in the United States as a model concordant with World Health Organization guidelines, describing this model of care and its potential to improve postpartum health fo ..read more

Abstract Objective We sought to understand the lived experiences of Black women diagnosed with severe maternal morbidity (SMM) in communities with high maternal mortality to inform practices that reduce obstetric racism and improve patient outcomes. Methods From August 2022 through December 2022, we conducted a phenomenological, qualitative study among Black women who experienced SMM. Participants were recruited via social media and met inclusion criteria if they self-identified as Black cisgender women, were 18–40 years old, had SMM diagnosed, and lived within zip codes in the United States t ..read more

Women over three generations in a single family in Iraq were interviewed to capture shifts in attitudes to childbirth in modern times. Each generation experienced a paradigm shift in childbirth, from exclusive home births, to hospital-directed maternity care, to a trend to favor or accept planned caesarean births. The emerging themes were social influences, changing technology, and medical profession impacting attitudes to childbirth and pregnancy. A drive to improve women’s experiences in labor, as well as maternal and neonatal outcomes, must consider these wider issues in order to be succes ..read more

Abstract Background Small for gestational age (SGA) and large for gestational age (LGA) are designations given to neonates based solely on birthweight, with no distinction made for maternal height. However, there is a possibility that maternal height is significantly correlated with neonatal birthweight, and if so, SGA and LGA cutoffs specific to maternal height may be a more precise and useful tool for clinicians. To explore this possibility, we analyzed the association between maternal height and ethnicity and neonate birthweight in women with low-risk, 37- to 40-week gestation, singleton pr ..read more

Abstract Introduction To describe and compare intervention rates and experiences of respectful care when Hungarian women opt to give birth in the community. Methods We conducted a cross-sectional online survey (N = 1257) in 2014. We calculated descriptive statistics comparing obstetric procedure rates, respectful care indicators, and autonomy (MADM scale) across four models of care (public insurance; chosen doctor or chosen midwife in the public system; private midwife-led community birth). We used an intention-to-treat approach. After adjusting for social and clinical covariates, we used logi ..read more

Birth, Volume 51, Issue 1, Page 1-2, March 2024 ..read more

Abstract Background In an Australian randomized controlled trial (RCT), two techniques for intrapartum fetal surveillance were compared: ST analysis (STan) as an adjunct to cardiotocography (CTG), compared with CTG alone. The aim was to determine whether CTG + STan could reduce emergency cesarean birth rates while maintaining or improving neonatal outcomes. Secondary aims were to compare clinical, economic, and psychosocial outcomes. The purpose of this paper was to present psychosocial outcomes from one cohort enrolled in the trial. Methods The study was conducted at one tertiary referral hos ..read more

The extent of tissue trauma within the second-degree perineal tear category varies widely. There is a need for a better understanding of the occurrence and risk factors for larger second-degree tears, as second-degree tears of greater severity may impact post-partum pelvic floor health. In this study, a subclassification system for second-degree tears was used. The overall occurrence of second-degree tear subcategories was 16.3% for 2A tears, 9.1% for 2B tears, and 6.6% for 2C tears. Differences in perineal anatomy, primiparity, and factors associated with a more complicated birth significant ..read more

Abstract Background To prevent the spread of SARS-CoV-2, hospitals around the world adopted protocols that, in varying ways, resulted in the exclusion of partners from hospital postnatal care wards. The objective of this study was to examine the effect this exclusion had on partners' satisfaction with postnatal care. Methods An online survey (the Swedish Pregnancy Panel) including free-text comments was conducted before and during the first wave of the COVID-19 pandemic; partners of pregnant women were recruited at an early ultrasound appointment and followed until 2 months after childbirth ..read more

Abstract Background Pregnant women involved in decisions about their care report better health outcomes for themselves and their children. Shared decision-making (SDM) is a priority for health services; however, there is limited research on factors that help and hinder SDM in hospital-based maternity settings. The purpose of this study was to explore barriers and facilitators to SDM in a large tertiary maternity care service from the perspectives of multiple stakeholders. Methods Qualitative semi-structured interviews were undertaken with 39 participants including women, clinicians, health ser ..read more