Care Of Pregnant Women Research Articles

“Diabetes Champion” Nurses Initiate Improvements to Transform Care of Pregnant Women With Diabetes

“Diabetes Champion” Nurses Initiate Improvements to Transform Care of Pregnant Women With Diabetes

Implementation of Group Prenatal Care for Pregnant Women on Opioid-agonist Therapy at a Community-based Substance Use Treatment Clinic.

Implementation of Group Prenatal Care for Pregnant Women on Opioid-agonist Therapy at a Community-based Substance Use Treatment Clinic.

Language of the Heart? Health Services Perspectives on Care of Pregnant Women with Rheumatic Heart Disease

Language of the Heart? Health Services Perspectives on Care of Pregnant Women with Rheumatic Heart Disease

Weight management during pregnancy: a qualitative study of women\u2019s and care providers\u2019 experiences and perspectives

BackgroundObesity during pregnancy is a serious health problem for women and their children. Despite the high prevalence of high body mass index (BMI) among women of reproductive age in high-income countries, there is insufficient evidence to inform practice and policy about weight management for women with high BMI who are pregnant. The aim of this project was to describe women’s and midwives’ experiences and perspectives of care for weight management during pregnancy in Melbourne, Australia.MethodsA qualitative study. Semi-structured interviews were conducted with pregnant women and midwives. Transcripts were analysed thematically.ResultsA total of 17 women and 2 midwives were interviewed. Five themes were identified: 1. Reluctance to and difficulties discussing weight and its implications; 2. Barriers to providing appropriate pregnancy care for women with high BMI; 3. Inconsistent weighing practices; 4. Beliefs about the causes of obesity; and 5. Opportunities to assist women to manage their weight. Although most women were satisfied with the pregnancy care they had received, both women and midwives expressed concerns about effective weight management during pregnancy. These included constraints on discussing weight, difficulties accessing appropriate resources and additional support from other health care providers, and inconsistent weighing practices.ConclusionsThe findings suggest that women with high BMI would benefit from additional information and support about weight management prior to conception, during pregnancy, and postnatally.

Guideline about Antenatal Care for Pregnant Women at Damietta City

Guideline about Antenatal Care for Pregnant Women at Damietta City

Understanding High Utilization of Unscheduled Care in Pregnant Women of Low Socioeconomic Status

BackgroundPregnant high utilizers of unscheduled care may be at particular risk for poor perinatal outcomes, but the drivers of this association have not been explored from the patient perspective. PurposeWe sought to understand maternal preference for unscheduled hospital-based obstetric care to inform interventions and improve value of publicly funded care during pregnancy. MethodsWe conducted a comparative qualitative analysis of in-depth semistructured interviews. Low-income pregnant women presenting to an inner city hospital-based obstetric triage unit were purposively sampled, categorized as either high or low utilizers of unscheduled care, and interviewed about challenges faced in obtaining pregnancy care and reasons for choosing between unscheduled versus scheduled care delivery. ResultsDemographically, high utilizers were similar to low utilizers, but were more likely to report adverse childhood experiences (p = .01). All 40 participants reported resource constraints and perceived hospital-based unscheduled obstetric care to be more accessible than outpatient prenatal care. Beyond this, high (n = 20) and low (n = 20) utilizer narratives differed significantly. Two distinct high utilizer profiles emerged. Some high utilizers repetitively used unscheduled hospital-based services owing to psychosocial determinants. Other high utilizing participants were driven by severe experiences of illness insufficiently addressed by outpatient prenatal care. Low utilizer narratives demonstrated high self-efficacy and social support compared with high utilizers. ConclusionsLow-value, unscheduled, hospital-based care utilization by pregnant women of low socioeconomic status was driven by unmet clinical and psychosocial need. Implications for Policy and/or PracticeTailored community-focused innovations that use unscheduled visits as signals of risk may improve value of both outpatient and inpatient maternity care and better address adverse perinatal outcomes in vulnerable subgroups.

The Roles of Multidisciplinary Team Members in the Care of Pregnant Women.

The Roles of Multidisciplinary Team Members in the Care of Pregnant Women.

The Determinants of Husband Behavior in The Care of Pregnant Women

Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Banyumas District are still below The Minimum Service Standard (MSS), especially in Puskesmas (Public Health Center) I Ajibarang. The strategies for reducing maternal mortality are conducted by increasing mothers health status during pregnancy. This study aims at determining the factors of husbands role in womens prenatal care. Cross-sectional method was used. The populations were all of the pregnant women in Puskesmas I Ajibarang. Proportional random sampling was applied to select 90 pregnant women. Logistic regression was used to determine factors. Theory of planned behavior was used to explore the determinants of husbands role. The results show that the level of education, family income, the knowledge, the attitude, and subjective norm are not related to husbands role in mother prenatal care. However, husbands behavior control (p=0.045) and intention (p=0.000) have relation with husbands role in women prenatal care. Variable of intention is the most dominant variable related to husbands role in womens prenatal care.

The Role of Qualitative Research in Clinical Trial Development: The EASE Back Study

This article outlines the rationale for adopting a mixed methods approach within randomized controlled trials (RCTs) and explores challenges associated in doing so. Taking the example of the EASE Back feasibility and pilot study ( Evaluating Acupuncture and Standard care for pregnant wom En with BACK pain: ISRCTN49955124), we detail why and how we operationalized a concurrent-sequential mixed methods research design. We present key findings from the exploratory research (focus groups and interviews) and explain how these were integrated with descriptive findings (a national survey of physical therapists) in order to inform and refine the design of the explanatory phase (the pilot RCT). We conclude with a discussion of lessons learned and implications for future research design and conduct.

PHS40 - Opportunity Cost And Health Impact Of Prenatal Care In Pregnant Women With Public Health Insurance In Colombia

PHS40 - Opportunity Cost And Health Impact Of Prenatal Care In Pregnant Women With Public Health Insurance In Colombia

Update: Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016

Update: Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016

Pregnancy among US women: differences by presence, type, and complexity of disability

Approximately 12% of women of reproductive age have some type of disability. Very little is known about sexual and reproductive health issues among women with disabilities, including what proportion of women with disabilities experience pregnancy. Data on pregnancy are important to inform needs for preconception and pregnancy care for women with disabilities. The purpose of this study was to describe the occurrence of pregnancy among women with various types of disability and with differing levels of disability complexity, compared with women without disabilities, in a nationally representative sample. We conducted cross-sectional analyses of 2008-2012 Medical Expenditure Panel Survey annualized data to estimate the proportion of women aged 18-44 years with and without disabilities who reported a pregnancy during 1 year of participation on the survey panel. We used a multivariable logistic regression to test the association of pregnancy with presence, type, and complexity of disability, controlling for other factors associated with pregnancy. Similar proportions of women with and without disabilities reported a pregnancy (10.8% vs 12.3%, with 95% confidence intervals overlapping). Women with the most complex disabilities (those that impact activities such as self-care and work) were less likely to have been pregnant (adjusted odds ratio, 0.69, 95% confidence interval, 0.52-0.93), but women whose disabilities affected only basic actions (seeing, hearing, movement, cognition) did not differ significantly from women with no disabilities. Women with a variety of types of disabilities experience pregnancy. Greater attention is needed to the reproductive health care needs of this population to ensure appropriate contraceptive, preconception, and perinatal care.

Ethical Framework of Healthcare Delivery to Stigmatized Populations, Implications for Care in Pregnant Women with Substance Related-related Disorders

Background: Policy-making of healthcare delivery to stigmatized populations is one of the most challenging areas in public health ethics. Marginalized people carry societal stigmas as a result of various determinants including their health and social conditions. By creating a framework, which helps to guide decision making towards an ethical provision of optimal healthcare, more trust and solidarity will be built within and among healthcare organizations, and the social support system. Good healthcare planning requires reflection on values because, by far, the defined social determinants of health alone have not been sufficient to provide a continuum of care to vulnerable, stigmatized populations. Methods and findings: This paper presents an ethical framework for healthcare delivery to stigmatized populations. The framework was developed considering the needs of these populations and validated through a process involving community agencies and stakeholder engagement. Guidelines of ethical conduct for healthcare delivery by health professionals; community agencies providing care to stigmatized populations, and the public health and social support system is proposed. Application of this framework in the healthcare delivery to pregnant women with substance- related disorder is discussed. Conclusions: Application of this framework can optimize healthcare delivery to the stigmatized. It will require re-evaluation and refinement because the merits and limits will be revealed when applied to different subpopulations of stigmatized people.

Understanding High Utilization of Emergency Obstetric Care in Pregnant Women of Low Socioeconomic Status [170

INTRODUCTION: Drivers and impact of low-value care use in pregnant women with high levels of emergency care utilization are poorly understood. METHODS: Deidentified records of all obstetric triage visits from October 2013 to August 2014 at an urban academic medical center were analyzed for utilization trends and clinical outcome. We conducted semistructured interviews with 40 low-income women presenting to obstetric triage after 16 weeks of gestation, purposively sampling those presenting for a fourth or higher visit (high utilizers) or a first visit at term (low utilizers). Interviews were recorded and coded by theme. RESULTS: Six thousand seven hundred and ninety-four triage visits representing 3,539 patients occurred during the study period with 1.9 mean visits per patient. High utilizers made up 10.9% of the sample and were more likely than other triage users to report prior psychosocial trauma (17.8% compared with 7.7%, P<.001) and medical illness (64.0% compared with 47.5%, P<.001). High utilizers were less likely than other triage users to deliver at our center (16% compared with 42%, P<.001); those who did were more likely to deliver preterm (22.6% compared with 12.3%, P=.02). Interview participants perceived triage care to be of higher quality and more accessible than outpatient prenatal care. High utilizers reported social dysfunction and difficulty coping with pregnancy. Low utilizers reported social stability and self-efficacy. CONCLUSION: High emergency utilization can be a signal of unmet need. Interventions targeting perinatal disparities should incorporate low-income patient perspectives by leveraging emergency visits, addressing social determinants, and promoting access to quality prenatal care.

Care of Pregnant Women in the Criminal Justice System

Current practices in the treatment and transfer of pregnant inmates in this country may negatively affect maternal and fetal health or well-being. Some violate federal or state laws; others conflict with standards of obstetric care and are widely considered unethical or inhumane. This article discusses these practices; their legal status; and implications for nursing practice, policy, and research.

Commentary on “Medical Care of Pregnant Women in Eastern North Carolina with Human Immunodeficiency Virus”

Commentary on “Medical Care of Pregnant Women in Eastern North Carolina with Human Immunodeficiency Virus”

Integrating Exercise Is Medicine® into the Care of Pregnant Women

A majority of women do not meet the recommended levels of physical activity before and during pregnancy. Physically active women experience fewer complications of pregnancy such as gestational diabetes, hypertensive disorders of pregnancy, and low back pain, to name only a few. Exercise is Medicine encourages adults to achieve a minimum of 150 min·wk of moderate-intensity physical activity, and the same is true for women having uncomplicated pregnancies. Prenatal care is an opportune time to counsel women on how to achieve an active lifestyle to support their own health and the health of their developing fetus.

Potential Development in Dental Health Care for Pregnant Women : Chakkarat Hospital,Chakkarat district, Nakhonratchasima Province

Potential Development in Dental Health Care for Pregnant Women : Chakkarat Hospital,Chakkarat district, Nakhonratchasima Province

Reproductive Concerns and Pregnancy after Bariatric Surgery: Practice Implications

Approximately 113,000 bariatric procedures are conducted yearly. From 1998 to 2005, 83% of those having bariatric surgery in the 18 to 45-year-old age group were women. Reproductive implications are ideally addressed when surgery is planned, including the possibility of increased fertility after surgery, appropriate contraception, and the interval from surgery to pregnancy. Maternal and neonatal outcomes post bariatric surgery have generally been found to be positive and are often improved over those seen in obese women without a history of bariatric procedures. However, surgical complications have been reported, as well as nutritional deficits. Some studies have suggested an increase in small for gestational age (SGA) newborns and increased cesarean section rates, while others have not found these relationships. Neonatal complications have also been reported. Pregnancy care for women with a history of bariatric surgery includes screening for and managing nutritional deficits, careful assessment to rule o...

Impact of the Creation of a Specialized Clinic for Prenatal Blood Sampling and Follow-up Care in Pregnant Women

ObjectiveTo evaluate (1) the effect on gestational diabetes mellitus (GDM) screening rates of having a specialized clinic for pregnant women offering blood sampling and screening for GDM, and (2) the impact on perinatal outcomes of having early GDM screening and follow-up provided by the specialized clinic. MethodsWe performed a retrospective cohort study, based on electronic health records. We compared data from women who delivered during a period when the Blood Sampling in Pregnancy (BSP) clinic was operating (2008–2009; n=2780) to a time period before the clinic was established (2006–2007; n=2591). During the 2008–2009 period, we compared data from women who had GDM screening in the first trimester with women who had screening during the second trimester and with women who were not screened. ResultsFollowing the creation of the BSP clinic, overall GDM screening rates reached 72.4% in 2008–2009, compared with 48.9% in 2006-2007 (P<0.001) and GDM screening was more likely to be performed in the first trimester (36.7% vs. 0.4%; P<0.001). During the period when the BSP clinic was operating (2008-2009), women who had GDM screening in the first trimester had lower rates of Caesarean section (15.7% vs. 22.1 %; P<0.001) and neonatal complications (bradycardia: 3.6% vs. 6.8%; P=0.003; respiratory distress: 9 6% vs 13 2%; P=0 02; and admission to NICU: 15.4% vs. 26.8%; P<0.001) than women who did not perform GDM screening. ConclusionIn our population, creation of a clinic offering specialized care to pregnant women improved GDM screening rates. With the support of the BSP clinic, women who had early GDM screening were less likely to undergo Caesarean section and their offspring had fewer perinatal complications.