BackgroundObstetric violence is a widespread form of institutional abuse that violates women's sexual and reproductive rights during childbirth. Although informed consent is a fundamental ethical, legal, and human right requiring adequate information and active participation, it is frequently absent or incomplete, even in non-emergency obstetric care.AimTo identify which clinical practices, according to their context (emergency or routine) and the presence or absence of informed consent, are associated with higher perceptions of obstetric violence. Additionally, it is to assess the influence of professional treatment on these perceptions.Research designCross-sectional observational study.Participantsand research context: 2,367 women who gave birth in Spanish public hospitals. Perceptions of obstetric violence and quality of care were measured using the Childbirth Abuse and Respect Evaluation-Maternal Questionnaire (CARE-MQ) and the Quality from the Patient's Perspective-Intrapartal Questionnaire (QPP-I).Ethical ConsiderationsThe study was approved by the Clinical Research Ethics Committee of Reina Sofía University Hospital of Córdoba and by the ethics committees of Ciudad Real University Hospital and Mancha-Centro Hospital.FindingsClinical practices performed without informed consent or adequate information were significantly associated with higher CARE-MQ scores (p < .001). Procedures such as episiotomy and oxytocin administration, when carried out outside emergency situations, had a particularly strong impact on perceptions of abuse. Negative evaluations of professional treatment were also significantly associated with higher CARE-MQ scores (p < .001). Midwives received the highest ratings among healthcare professionals.ConclusionThe absence of informed consent is a key determinant of women's perceptions of obstetric violence, regardless of clinical context. Identifying procedures with low consent rates and highlighting the protective role of respectful professional behavior, particularly midwife-led care, provides actionable targets to improve maternity services. Strengthening communication, ethical training, and midwife-led models is essential to promote respectful maternity care and safeguard women's rights during childbirth.

Plan Do Study Act Quality Improvement Model in Maternity Care.

To identify determinants of selected pregnancy testing behaviors among pregnancy planners and to elucidate the relationship between pregnancy testing and detection. In PRESTO (Pregnancy Study Online), a North American prepregnancy cohort study of pregnancy planners (2018-2024), participants reported day-specific information about pregnancy testing spanning 4 days before day of expected menstruation through 4 days after. We used generalized linear models to estimate the association between maternal attributes and pregnancy testing behavior, characterized as the timing of the first test and testing frequency. We used quantile regression to estimate the timing of pregnancy detection among participants who conceived by maternal characteristics and pregnancy testing behavior. We estimated the adjusted risk of having a negative test result and the probability of detecting a very early pregnancy loss by the timing of the pregnancy test. We analyzed data from 20,458 pregnancy tests across 6,569 unique participants. Of the participants, 40.7% of reported they engaged in very early testing , defined as testing more than 4 days before their expected period. We observed a range of pregnancy testing intensity, with some participants testing only once and others testing every day. Among participants who detected pregnancy, very early testers were more than 5 times more likely to have a negative test result before a positive test result than those who waited until the day of expected period to test (adjusted risk ratio [aRR[ 5.89; 95% CI, 4.73-7.33). Very early testers were more than 3 times more likely to have an initial positive test result followed by a negative test result, likely reflecting increased detection of very early pregnancy losses (aRR 3.80; 95% CI, 2.12-6.80). Patterns in home pregnancy testing varied widely among pregnancy planners. Early initiation of pregnancy testing was associated with slightly earlier pregnancy detection, but also a marked increase in risk of negative test results and detection of very early pregnancy losses.

Access and engagement with maternity, social care and mental health services for perinatal migrant women with no recourse to public funds and irregular status: A cross-sectional study using the eLIXIR born in South London, UK, maternity-child data linkage.

Weaning is a stressful stage in the lives of young mammals. Early weaning, in particular, can lead to long-lasting physiological and psychological changes. We investigated the effects of precocial weaning on anxiety, social behavior, cognition, and maternal behavior in adult African four-striped mice (Rhabdomys dilectus chakae). Mice weaned at 12 days exhibited higher anxiety levels and reduced exploratory behavior in a novel environment compared with those weaned at 16 and 20 days. Early-weaned mice also showed decreased allogrooming and body contact, and increased aggression during social interactions. Females weaned early, groomed, and huddled their pups less, although they spent more time in proximity without touching their pups. Spatial learning and memory were not affected by the age at weaning. Early weaning induces stress-related changes in anxiety, exploration, and social behaviors, all of which are of ecological relevance. Although precocious weaning did not affect cognition, R. d. chakae are likely to be anxious and poor mothers, which could also impact the fitness of their offspring. These effects manifested in behaviors of ecological significance, suggesting that early weaning may influence the fitness of the four-striped mouse.

Implementing shared decision-making (SDM) in maternity care remains challenging in low-income and middle-income countries (LMICs). Decision aids can support SDM, but evidence on their effectiveness in such settings is limited. We assessed the impact of a decision analysis tool (DAT) for pregnant women on mode of birth (MOB) within the QUALIty DECision-making project, a multisite, multicountry pragmatic trial to reduce unnecessary caesarean sections. We conducted a cross-sectional survey among postpartum women considered at low risk for caesarean section in early pregnancy and who delivered in 32 hospitals across Argentina, Burkina Faso, Thailand and Viet Nam. Associations between DAT exposure and selected outcomes were analysed using multilevel, multivariate regression models adjusting for confounders and cluster effects. Of 2368 women included, 249 (11%) had used it outside antenatal care visits, 212 (9%) had heard of but not used it, and 1907 (80%) had never heard of the DAT. Compared with women who had never heard of the DAT, users were more likely to identify at least three risks/benefits of each MOB (adjusted OR (aOR) 1.9; 95% CI 1.3 to 2.8; p=0.001) and to communicate their preferred MOB to providers (aOR 2.3; 95% CI 1.5 to 3.6; p<0.001). DAT users were less likely to prefer caesarean section in late pregnancy (aOR 0.4; 95% CI 0.2 to 0.8; p=0.006) and reported higher birth experience and satisfaction scores (adjusted β=1.9; 95% CI 0.5 to 3.3; p=0.006). The use of the DAT was associated with improved knowledge, communication of birth preferences, lower caesarean preference and greater satisfaction, without adverse outcomes. Findings suggest that decision aids can strengthen SDM and promote respectful, women-centred maternity care in LMICs. ISRCTN67214403.

Towards a care continuum: A socio-material analysis of intra-acting public-private maternity care in South Africa.

Women's experiences of massage during childbearing: A Swedish qualitative interview study.

Barriers and facilitators to engage with the maternity continuum of care in northwest Ethiopia: a qualitative descriptive study.

Perinatal Quality Collaboratives and Patient Safety Bundles: Key Contributors to Improving Maternal Health Care Quality across the United States.

Heat and its effects on maternal and neonatal health care: Evidence from Burkina Faso.

Remodeling maternal health care: evaluating the impact of implementing the midwifery model of care on maternal and neonatal health outcomes in Ethiopia: The MiMoC project.

The California Perinatal Quality Care Collaborative: Together We Are Stronger.

Cross-linking geotagged social media data with public health registries for spatial health research.

Birth interventions and outcomes among first time mothers: A population-based register study in four Nordic countries.

Gestational environmental enrichment modulates neurophysiological and behavioral outcomes in adolescent rats after early-life stress: Sex differences in emotional and social behavior.

Perineal trauma remains a common outcome of spontaneous vaginal birth, often leading to immediate and long-term complications. Although numerous studies have examined clinical factors, the influence of individual clinician characteristics-such as professional role, experience, training, and attitudes-has received less attention. This scoping review synthesized existing evidence on the association between clinician characteristics and variations in perineal outcomes including obstetric anal sphincter injury, episiotomy, spontaneous tears and intact perineum. The review also examined methods of risk assessment and strategies to mitigate trauma related to clinician factors. The review was conducted following Joanna Briggs Institute methodology to map the breadth of evidence in this field. A systematic search was undertaken across multiple electronic databases using predefined keywords and inclusion criteria. Sixty-two studies, published between 1969 and 2024 from 25 countries, were included. Study designs encompassed cohort, cross-sectional, randomized controlled trials, qualitative and mixed methods. Episiotomy was the primary outcome in 57 studies, while 27 studies focused on obstetric anal sphincter injury and 10 on intact perineum. Clinician factors, particularly professional role, attitudes, experience and education, were consistently associated with variations in perineal outcomes. Midwifery-led care frequently corresponded with lower episiotomy rates, although it was sometimes linked with similar or slightly higher spontaneous tear rates. Reducing perineal trauma requires addressing both fixed and modifiable clinician factors. Standardized episiotomy training, adherence to evidence-based guidelines and collaborative, woman-centered care are recommended strategies to enhance the quality of maternity care for improved patient outcomes.

Measuring maternal healthcare accessibility in Florida by a data-driven extension of V2SFCA.

Maternal mortality continues to rise in the United States. In 2023, the National Center for Health Statistics reported 18.6 maternal deaths per 100,000 live births; for Black women the rate was 50.3 — over three times that of white women (14.5) and higher than Hispanic (12.4) and Asian (10.7) women. The data presented depict system failure. Maternal outcomes are the benchmark of enterprise performance, revealing how well health systems can manage chronic disease, advance equity, and deliver coordinated, preventive care. This viewpoint calls for elevating maternal health from a siloed clinical program to a core strategic priority that advances quality, equity, workforce sustainability, and community trust. This article sets forth a leadership agenda that: embeds maternal metrics in executive dashboards with stratification by race, ethnicity, language, and geography; redesigns care pathways; strengthens workforce well-being and retention in frontline maternal care staff; and aligns incentives with value-based contracts to reward prevention and equity. Physician leaders should set the agenda now by breaking silos and making maternal health a systemwide imperative.

Costs of maternal care revealed through body conditionin Northern Resident killer whales(Orcinus orca).