Dramatic perinatal outcomes in birth center where nurse midwives and traditional midwives work together in community. Abstract Background Mothers and infants continue to die at alarming rates throughout the Global South. Evidence suggests that high-quality midwifery care significantly reduces preventable maternal and neonatal morbidity and mortality. This paper uses a case study approach to describe the social and institutional model at one birth center in Northern Uganda where, in over 20,000 births, there have been no maternal deaths and the neonatal mortality rate is 11/1000—a rate that i ..read more

Abstract Background The impact of midwifery, and especially Indigenous midwifery, care for Indigenous women and communities has not been comprehensively reviewed. To address this knowledge gap, we conducted a mixed-methods systematic review to understand Indigenous maternal and infant outcomes and women's' experiences with midwifery care. Methods We searched nine databases to identify primary studies reporting on midwifery and Indigenous maternal and infant birth outcomes and experiences, published in English since 2000. We synthesized quantitative and qualitative outcome data using a con ..read more

Abstract Understanding the impacts of bias, and how to mitigate these impacts, on clinical care is critically important for all healthcare team members. However, the concerns and needs in our current system are likely even more fundamental, as we are continuing to hear about the experiences of patients who are struggling to seek care that contains even the most basic tenants of respect and decency. Creating inclusive and diverse environments requires constant proactive evaluation, commitment, and energy. This piece shares the experiences of a Black birth mom and a White adoptive dad (who is al ..read more

The Family & Pregnancy Pop-Up Village: Developing a one-stop-shop of services to reduce pregnancy care-related inequities in San Francisco. Abstract Introduction Centering affected individuals and forming equitable institutional–community partnerships are necessary to meaningfully transform care delivery systems. We describe our use of the PRECEDE-PROCEED framework to design, plan, and implement a novel care delivery system to address perinatal inequities in San Francisco. Methods Community engagement (PRECEDE phases 1–2) informed the “Pregnancy Village” prototype, which would unite key ..read more

Abstract Objective To evaluate the association of labor induction on cesarean delivery and other maternal and neonatal outcomes in low-risk, full-term patients in community hospitals during a period of concerted effort to safely prevent cesarean delivery. Methods We performed a retrospective cohort study using the California Maternal Data Center comprised linked discharge diagnoses and birth certificate data for all low-risk, nulliparous, term, singleton, vertex (NTSV) individuals between 39 and 41 weeks from three Sacramento Valley community hospitals from 2016 to 2022 (N = 10,821) during a p ..read more

Gender, power, structure and, culture can make women more vulnerable to obstetric violence. Figure 3 shows various aspects of these four cross-cutting domains. For instance, women’s lack of choice is gender-based and deep rooted in the cultural conditioning in and about women in the patriarchal post-colonial societal structure, which sustains the powerlessness by keeping them in a lower position in the society. Abstract Background Evidence suggests that obstetric violence has been prevalent globally and is finally getting some attention through research. This human rights violation take ..read more

Separation between mother and baby shortly after birth due to safeguarding concerns is a deeply distressing and traumatising event, for all involved. We investigated the prevalence and incidence of infant separation and its impact on mothers and babies. Building on principles of Reproductive Justice Theory, Intersectionality and Standpoint Midwifery, we critically reviewed the role of midwives in this complex issue. Abstract Separation at birth due to safeguarding concerns is a deeply distressing and impactful event, with numbers rising across the world, and has devastating outcomes for birt ..read more

A recent focus in reproductive healthcare on “sexed language” reflects an ideology of unchangeable sex-binary and fear of erasure, from both cisgender women and the profession of midwifery. In this paper, we highlight how privileging sexed language causes harm to all who birth—including pregnant cisgender women, trans, gender diverse, and non-binary people—and is therefore unethical and incompatible with the principles of midwifery. Abstract Effective communication in relation to pregnancy and birth is crucial to quality care. A recent focus in reproductive healthcare on “sexed language” ref ..read more

An interrupted time series analysis of repeated cross-sectional data from province-wide screening at the time of postpartum hospital discharge assessed changes associated with the pandemic. Concerns about ability to parent or care for children were infrequent and did not substantively change in the first year of the pandemic. Significant improvements were observed in the likelihood of being unable to identify a support person to assist with care, need of newcomer support, and concerns about money over time. Adverse impacts of the pandemic may have been mitigated by accommodations for remote w ..read more

We considered 92 randomized controlled trials (RCTs) and 126 observational studies for our exploratory review on the quality of reporting and analyzing labour duration. Mean was the preferred summary measure, followed by the median, which more appropriately summarizes inherently skewed data. Only a handful of studies reported both mean and median. Most studies did not specify the statistical analysis. However, when specified, linear regression and interval-censoring regression were most commonly applied for statistical analysis, followed by Cox regression and binary logistic regression. Our s ..read more