Browsing by Subject "maternal health"

Now showing 1 - 6 of 6
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    Developmental origins of disease highlight the immediate need for expanded access to comprehensive prenatal care
    (Frontiers, 2022-11-23) McDonald, Chloe R.; Weckman , Andrea M.; Wright , Julie K.; Conroy, Andrea L.; Kain, Kevin C.; Pediatrics, School of Medicine
    The prenatal environment plays a critical role in shaping fetal development and ultimately the long-term health of the child. Here, we present data linking prenatal health, via maternal nutrition, comorbidities in pregnancy (e.g., diabetes, hypertension), and infectious and inflammatory exposures, to lifelong health through the developmental origins of disease framework. It is well-established that poor maternal health puts a child at risk for adverse outcomes in the first 1,000 days of life, yet the full health impact of the in utero environment is not confined to this narrow window. The developmental origins of disease framework identifies cognitive, neuropsychiatric, metabolic and cardiovascular disorders, and chronic diseases in childhood and adulthood that have their genesis in prenatal life. This perspective highlights the enormous public health implications for millions of pregnancies where maternal care, and therefore maternal health and fetal health, is lacking. Despite near universal agreement that access to antenatal care is a priority to protect the health of women and children in the first 1,000 days of life, insufficient progress has been achieved. Instead, in some regions there has been a political shift toward deprioritizing maternal health, which will further negatively impact the health and safety of pregnant people and their children across the lifespan. In this article we argue that the lifelong health impact attributed to the perinatal environment justifies policies aimed at improving access to comprehensive antenatal care globally.
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    ‘Had I gone into the office, they would have caught it a little bit sooner’: Narrative problematics in U.S. pandemic birth stories
    (T&F, 2022) Scott, Susanna Foxworthy; Johnson, Nicole L.; Brann, Maria; Bute, Jennifer J.; Communication Studies, School of Liberal Arts
    Individuals who gave birth during the COVID-19 pandemic experienced an increased risk for premature births, stillbirths, depression, and lower access to care. Their stories provide valuable information that can inform clinical care, particularly due to loss of in-person support resulting from visitor restrictions in hospitals. Grounded in a theory of narrative problematics, we explored how elicited birth narratives were affected by COVID-19 and how stories can be used as material evidence to inform healthcare systems. We facilitated seven focus group discussions with 65 women from 19 states who had given birth between March and July 2020. Three themes emerged from our qualitative thematic analysis: (1) navigating disrupted access to healthcare; (2) experiencing loss of co-construction of birth experience; and (3) recognizing fissures in the mask-wearing master narrative. Practical implications for improving healthcare include developing spaces for individuals to process birth stories for cathartic benefit due to significant disruption, improving hospital policies about in-person support to avoid loss of co-construction of experience, and centering hospitals and the providers that work within them as audiences for interventions around preventive measures during a disease outbreak.
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    Narrative Sense-Making During COVID-19: Using Stories to Understand Birth in a Global Pandemic
    (Taylor & Francis, 2024) Brann, Maria; Bute, Jennifer J.; Foxworthy Scott, Susanna; Johnson, Nicole L.; Communication Studies, School of Liberal Arts
    Women who gave birth in the spring and summer of 2020 contended with a host of challenging factors. In addition to facing pregnancy, labor, and delivery during an emerging global pandemic, women grappled with health care restrictions that altered their birth experience. To explore how women made sense of their birth during COVID-19, we analyzed written narratives from 71 women who gave birth in the United States from March to July 2020. Based on tenets of communicated narrative sense-making, the themes that emerged from our data suggest that women framed the role of the pandemic as either completely overshadowing their birth experience or as an inconvenience. Women also wrote about threats to their agency as patients, mothers, and caregivers, as well as the evolving emotional toll of the pandemic that often prompted feelings of fear and sadness, along with self-identified anxiety and depression. We discuss these findings in light of the literature on birth stories as essential sites of narrative sense-making for women and their families.
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    “Our Birth Experiences are What Binds Us”: Women’s Motivations for Storytelling about Birth to Build Motherwisdom
    (Taylor & Francis, 2020) Johnson, Nicole L.; Scott, Susanna F.; Brann, Maria; Communication Studies, School of Liberal Arts
    Childbirth is widely considered to be a bonding experience among women. Women often feel compelled to share their story, and this research highlights communicative and reflexive aspects of storytelling as a means for meaning-making and relationship-building. This inductive thematic analysis explored 22 women’s motivations for engaging in storytelling about birth across five focus groups and two one-on-one interviews. Findings demonstrate one primary theme, building motherwisdom, a term coined here to reflect the uniqueness of the birth storytelling context. We also identified three secondary themes for motivation to engage in birth storytelling: (1) fulfilling a sense of responsibility to share one’s story to normalize a variety of birth experiences and to listen to learn about birth, (2) empowering women, and (3) seeking validation. Women receive positive therapeutic benefit from storytelling, and this may be particularly important in maintaining and improving mental health during the postpartum period. Our work informs the environments we can create to motivate mothers to share and listen to birth stories to foster this benefit.
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    Promoting positive maternal, newborn, and child health behaviors through a group-based health education and microfinance program: a prospective matched cohort study in western Kenya
    (BMC, 2020) Maldonado, Lauren Y.; Songok, Julia J.; Snelgrove, John W.; Ochieng, Christian B.; Chelagat, Sheilah; Ikemeri, Justus E.; Okwanyi, Monica A.; Cole, Donald C.; Ruhl, Laura J.; Christoffersen-Deb, Astrid; Medicine, School of Medicine
    Background Chamas for Change (Chamas) is a group-based health education and microfinance program for pregnant and postpartum women that aims to address inequities contributing to high rates of maternal and infant mortality in rural western Kenya. In this prospective matched cohort study, we evaluated the association between Chamas participation and facility-based delivery. We additionally explored the effect of participation on promoting other positive maternal, newborn and child health (MNCH) behaviors. Methods We prospectively compared outcomes between a cohort of Chamas participants and controls matched for age, parity, and prenatal care location. Between October–December 2012, government-sponsored community health volunteers (CHV) recruited pregnant women attending their first antenatal care (ANC) visits at rural health facilities in Busia County to participate in Chamas. Women enrolled in Chamas agreed to attend group-based health education and microfinance sessions for one year; controls received the standard of care. We used descriptive analyses, multivariable logistic regression models, and random effect models to compare outcomes across cohorts 12 months following enrollment, with α set to 0.05. Results Compared to controls (n = 115), a significantly higher proportion of Chamas participants (n = 211) delivered in a health facility (84.4% vs. 50.4%, p < 0.001), attended at least four ANC visits (64.0% vs. 37.4%, p < 0·001), exclusively breastfed to six months (82.0% vs. 47.0%, p < 0·001), and received a CHV home visit within 48 h postpartum (75.8% vs. 38.3%, p < 0·001). In multivariable models, Chamas participants were over five times as likely as controls to deliver in a health facility (OR 5.49, 95% CI 3.12–9.64, p < 0.001). Though not significant, Chamas participants experienced a lower proportion of stillbirths (0.9% vs. 5.2%), miscarriages (5.2% vs. 7.8%), infant deaths (2.8% vs. 3.4%), and maternal deaths (0.9% vs. 1.7%) compared to controls. Conclusions Chamas participation was associated with increased odds of facility-based delivery compared to the standard of care in rural western Kenya. Larger proportions of program participants also practiced other positive MNCH behaviors. Our findings demonstrate Chamas’ potential to achieve population-level MNCH benefits; however, a larger study is needed to validate this observed effect.
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    RACIAL DIFFERENCES IN LIFESTYLE: EFFECTS ON INFANT MORTALITY
    (Office of the Vice Chancellor for Research, 2012-04-13) Whitson, Tyra L.; Henry Anthony, Ronda
    Compared to Japan, Spain, Canada, and other post-industrialized coun-tries, the United States has the highest infant mortality rate (IMR) reaching almost 7 infant deaths per 1,000 live births. The rate for African-Americans is 13.63 while the rate for Caucasians is 5.76 and the gap continues to widen. The gap is even wider in Indiana, reaching 18.1 for African-Americans and 6.4 for Caucasians. A few determinants of infant mortality include maternal health, disorders related to short gestation, socioeconomic status, respirato-ry distress in newborns and inadequate prenatal care. High levels of stress also may pose some special risks for pregnant women. For example, stress may contribute to preterm labor by triggering the release of a hormone called corticotropin-releasing hormone (CRH). CRH, which is produced by the brain and the placenta, is closely tied to labor. This may cause premature birth and low birthweight, possibly resulting in death. Further research will be done to investigate if stress management differs among African-American women and Caucasian women and what affect the taboo of therapy among the African-American community has on managing stress related to preg-nant women. Research will also be conducted on the “Superwoman Syn-drome”. The purpose of this research is to provide information on how to de-crease the infant mortality rate of African-Americans in particular, and the United States IMR in general.