Maternal Health Research Research Articles

How Workplaces Should Design Lactation Rooms: A Wishlist Informed by Clinical Practice, Maternal Health Research, and Personal Experience as a Breastfeeding Mom

How Workplaces Should Design Lactation Rooms: A Wishlist Informed by Clinical Practice, Maternal Health Research, and Personal Experience as a Breastfeeding Mom

Challenges and opportunities of sustained public involvement in maternal health research: a practice case study with reflections from researchers and public contributors

It is widely agreed that collaboration with people with lived experience of specific health conditions or health services is both a moral imperative and a utility to improve research quality, validity and impact. However, there is little agreement about how to practise public involvement. In this article, we describe the formation and work of the Nottingham Maternity Research Network, an ongoing research reference panel that supports public involvement in maternal health research. Drawing on nine years’ experience, researchers and public contributors reflect together on the key issues to consider when co-producing research with maternity service users: first, pragmatic considerations, and second, creating a safe space for drawing on intimate and sometimes traumatic experiences. We argue that a sustained model of public involvement and engagement – that is, a standing group rather than a series of project-based, time-limited opportunities for involvement – brings opportunities to build trust and to develop a community that is supportive and inclusive. However, the sustained model of public involvement also brings practical challenges.

Electrocardiographic Changes in Second and Third Trimester in Bangladesh: A Comparative Study

Background: During pregnancy, there are notable changes in cardiovascular function to meet the increasing needs of the developing baby. The objective of this study was to compare ECG in pregnant women during their second and third trimesters with a control group of non-pregnant women in Bangladesh. This study aims to offer valuable insights into the cardiovascular changes that happen during pregnancy. This study's findings are important for maternal health research and clinical practice in Bangladesh and beyond. Objective: The purpose of this study is to analyze and compare the ECG variations in women during the second and third trimesters of pregnancy. Methods: The study took place in the gynecology Department at CMH Saidpur, Bangladesh. This study was conducted from March 2023 to August 2023. During this period, 75 pregnant patients in their 2nd trimester and 75 patients in their 3rd trimester were chosen as cases from antenatal outdoor, while 75 non-pregnant women of the same age were selected as the control group. We use the purposive sampling method. Results: During pregnancy, there were notable changes in BMI, heart rate, and PR interval. BMI decreased in the second trimester and increased in the third trimester.22.67% were nulliparous and 77.33% were multiparous in 2nd trimester. In the third trimester, 26.67% were nulliparous and 73.33% multiparous. So, no significant difference in parity. Heart rate increased in both trimesters, while the PR interval shortened in both trimesters. No significant changes were observed in the durations of the QRS complex or QT interval. In our study, the QTc interval displayed a significant rise. ST depression, which may suggest decreased blood flow, was exclusively seen in pregnant women, particularly in the third trimester. Conclusion: We found no significant changes in age, but BMI, heart rate, and PR interval were significantly different from the control group throughout pregnancy. No significant QRS complex or QT interval duration changes were identified. The QTc interval rose. ST depression, more prominent in the third trimester, only affected pregnant women. As shown by ST depression, pregnancy may change cardiac function, electrical activity, and ischemia.

A Community-Informed Maternal and Infant Health Needs Assessment in Alabama.

Maternal mortality is a global clinical and public health crisis. Researchers and leading organizations have highlighted the need for local partnerships to implement evidence-based strategies to mitigate poor outcomes. Alabama has the third highest maternal mortality rate in the nation. Research on the complexity of maternity mortality is strengthening, but poor outcomes in Alabama persist and there is limited data highlighting the perspectives of those on the frontlines of providing and receiving care. We conducted a qualitative, statewide, community-informed, maternal and infant health research assessment with physicians, providers, professionals, and birthing persons to identify challenges and solutions to addressing the states' poor perinatal health outcomes. METHODS: Data were collected using a four-phase, research design that included semi-structured interviews, focus groups, one state-wide data sharing event, and five regional data sharing events. Data were collected between January 2020 and October 2021. The data were analyzed using consensus coding and thematic analysis. Fifty-nine (N = 59) individuals participated. Three themes emerged: 1) "They were making me feel so overlooked.": A disconnect between perinatal healthcare services and patient needs; 2) "That shouldn't be something you have to ask for.": Limitations to providing respectful perinatal healthcare; and 3) "If they work together, they can have all the tools they need.": Building a case for collaborative care. Participants advocated for a collaborative perinatal healthcare model that focuses on the provision of respectful, quality perinatal healthcare. Our approach can be applied across contexts and used to support the effective implementation of contextually relevant maternity care practices.

A pathway to improved maternity research in Northern Ireland? Novel linkage of Northern Ireland Longitudinal Study and Northern Ireland Maternity Services System

ObjectiveOur primary objective was to determine the social and demographic determinants of interpregnancy weight change. A secondary aim is to highlight the novel linkage of two data resources in Northern Ireland (NI) and the potential for transformative research in maternal health. ApproachWe piloted a process to link two datasets in a safe, legal and ethical manner. The NI Maternity Services System (NIMATS) provides access to biological variables collected during the gestational period. The NI Longitudinal Study (NILS) is a rich source of Census information providing a demographic, social and economic background we would not otherwise obtain from NIMATS alone. ResultsThe linkage of these two datasets has allowed us to link pregnancies to the same mother, enabling exploration of weight changes during the interpregnancy period(s). In NI, just over half of women giving birth (52%) were overweight. This is the highest in the UK. Descriptive statistics provided further insight into the current situation together with logistic regression which identified socio-economic and demographic correlates of interpregnancy weight changes. Conclusion & ImplicationsObservation of women during pregnancy, linked with longitudinal, administrative data has provided valuable insights into the important public health issue of maternal obesity and into which socio-economic groups are most vulnerable to weight gain between pregnancies. Further research in maternal health has the potential to be facilitated by the unique linkage of NILS and NIMATS. This is important given the rise in complicated pregnancies during recent years and changes in maternal socio-demographic profiles.

Development of a core outcome set for maternal and perinatal health research and surveillance in light of emerging and ongoing epidemic threats.

Maternal and perinatal health is often directly and indirectly affected during infectious disease epidemics. Yet, a lack of evidence on epidemics' impact on women and their offspring delays informed decision-making for healthcare providers, pregnant women, women in the post-pregnancy period and policy-makers. To rapidly generate evidence in these circumstances, we aim to develop a Core Outcome Set (COS) for maternal and perinatal health research and surveillance in light of emerging and ongoing epidemic threats. We will conduct a Systematic Review and a four-stage modified Delphi expert consensus. The systematic literature will aim to inform experts on outcomes reported in maternal and perinatal research and surveillance during previous epidemics. The expert consensus will involve two individual, anonymous online surveys to rate outcomes' importance and suggest new ones, one virtual meeting to discuss disagreements, and one in-person meeting to agree on the final COS, outcomes definitions and measurement methods. Four panels will be established to participate in the modified Delphi with expertise in (a) maternal and perinatal health, (b) neonatal health, (c) public health and emergency response, and (d) representation of civil society. We will recruit at least 20 international experts for each stakeholder group, with diverse backgrounds and gender, professional, and geographic balance. Only highly-rated outcomes (with at least 80% of ratings being 7-9 on a 9-point Likert scale) and no more than 10% of low ratings (1-3) will be included in the final COS. Implementing this COS in future maternal and perinatal research and surveillance, especially in the context of emerging and ongoing epidemic threats, will facilitate the rapid and systematic generation of evidence. It will also enhance the ability of policy-makers, healthcare providers, pregnant women and women in the post-pregnancy period and their families to make well-informed choices in challenging circumstances.

Non-specialist delivered psycho-social interventions for women with perinatal depression living in rural communities: A systematic review.

Evidence from low- and middle-income countries suggests that non-specialist-delivered interventions effectively improve access to perinatal mental health care. However, there have been no systematic attempts to synthesize the evidence on effectiveness, relevance, and application of this strategy to resource-limited settings such as rural areas. The aim of this review is to synthesize the evidence about the effectiveness of non-specialist delivered interventions in improving depression and related outcomes in women with perinatal depression living in rural communities. Seven electronic databases were searched using the following search concepts: perinatal depression (e.g., puerperal depression, antenatal depression), rural areas (e.g., remote, nonmetropolitan, underserved), and non-specialist workers (e.g., lay worker, volunteer aide, informal caretaker. The risk of bias was assessed using RoB-2 and ROBINS-I tools. A narrative synthesis was performed as the high degree of study heterogeneity precluded a meta-analysis. Nine unique studies were eligible for inclusion. Psychoeducation and problem-solving techniques were the most used intervention elements. Two interventions significantly reduced the prevalence of perinatal depression compared to usual care, and three interventions reported effectiveness in reducing depression symptom severity. There was little to no consistent evidence for other outcomes, including but not limited to maternal health care utilization, breastfeeding behaviors, and child health. This review provides limited evidence to suggest that non-specialist delivered interventions effectively improved outcomes among women with perinatal depression living in rural communities. The paucity of high-quality studies included in this review demonstrates that this rural demographic is frequently neglected in the context of maternal mental health research.

Building Breastfeeding Research Relations and Beyond: An Interview With Fiona Dykes.

Professor Fiona Dykes is Professor Emerita of Maternal and Infant Health at the University of Central Lancashire in the United Kingdom (UCLAN). Fiona has a particular interest in the global, sociocultural, and political influences upon infant and young child feeding practices; her methodological expertise is in ethnography and other qualitative research methods. She founded the Maternal and Infant Nutrition and Nurture Unit (MAINN) in 2000 which she led until she retired from her full-time professorship in 2020. Fiona established the associated MAINN Conference in 2007. The MAINN conference is a 3 day, international, peer reviewed event held bi-annually in the United Kingdom and, more recently, in alternate years overseas (Sydney, Australia; Falun, Dalarna, Sweden; and Florida, United States). The conference draws together key researchers in the field of infant and young child feeding from around the world. Fiona was a founding member of the journal Maternal and Child Nutrition. She is author of Breastfeeding in Hospital: Mothers, Midwives and the Production Line (Routledge) and co-author, with Dr Tanya Cassidy, of Banking on Milk: An Ethnography of Donor Human Milk Relations (Routledge). She is also joint editor of several books including Infant and Young Child Feeding: Challenges to Implementing a Global Strategy (Wiley-Blackwell) and Ethnographic Research in Maternal and Child Health (Routledge). This interview was conducted on April 20, 2023, by Dr. Tanya Cassidy, and is based on a verbatim transcription and edited for readability.TC = Tanya Cassidy; FD = Fiona Dykes.

Development of a core outcome set for maternal and perinatal health research and surveillance in light of emerging and ongoing epidemic threats

Background Maternal and perinatal health is often directly and indirectly affected during infectious disease epidemics. Yet, a lack of evidence on epidemics' impact on women and their offspring delays informed decision-making for healthcare providers, pregnant women, women in the post-pregnancy period and policy-makers. To rapidly generate evidence in these circumstances, we aim to develop a Core Outcome Set (COS) for maternal and perinatal health research and surveillance in light of emerging and ongoing epidemic threats. Methods We will conduct a Systematic Review and a four-stage modified Delphi expert consensus. The systematic literature will aim to inform experts on outcomes reported in maternal and perinatal research and surveillance during previous epidemics. The expert consensus will involve two individual, anonymous online surveys to rate outcomes' importance and suggest new ones, one virtual meeting to discuss disagreements, and one in-person meeting to agree on the final COS, outcomes definitions and measurement methods. Four panels will be established to participate in the modified Delphi with expertise in (a) maternal and perinatal health, (b) neonatal health, (c) public health and emergency response, and (d) representation of civil society. We will recruit at least 20 international experts for each stakeholder group, with diverse backgrounds and gender, professional, and geographic balance. Only highly-rated outcomes (with at least 80% of ratings being 7–9 on a 9-point Likert scale) and no more than 10% of low ratings (1–3) will be included in the final COS. Conclusions Implementing this COS in future maternal and perinatal research and surveillance, especially in the context of emerging and ongoing epidemic threats, will facilitate the rapid and systematic generation of evidence. It will also enhance the ability of policy-makers, healthcare providers, pregnant women and women in the post-pregnancy period and their families to make well-informed choices in challenging circumstances.

Maternal and perinatal health research during emerging and ongoing epidemic threats: a landscape analysis and expert consultation

IntroductionPregnant women and their offspring are often at increased direct and indirect risks of adverse outcomes during epidemics and pandemics. A coordinated research response is paramount to ensure that this...

Expand and extend postpartum Medicaid to support maternal and child health.

Most early maternal deaths are preventable, with many occurring within the first year postpartum (we use the terms "maternal" and "mother" broadly to include all individuals who experience pregnancy or postpartum and frame our recognition of need and policy recommendations in gender-neutral terms. To acknowledge limitations inherent in existing policy and the composition of samples in prior research, we use the term "women" when applicable). Black, Hispanic, and Native American individuals are at the most significant risk of pregnancy-related death. They are more commonly covered by Medicaid, highlighting likely contributions of structural racism and consequent social inequities. State-level length and eligibility requirements for postpartum Medicaid vary considerably. Federal policy requires 60 days of Medicaid continuation postpartum, risking healthcare coverage loss during a critical period of heightened morbidity and mortality risk. This policy position paper aims to outline urgent risks to maternal health, detail existing federal and state-level efforts, summarize proposed legislation addressing the issue, and offer policy recommendations for legislative consideration and future study. A team of maternal health researchers and clinicians reviewed and summarized recent research and current policy pertaining to postpartum Medicaid continuation coverage, proposing policy solutions to address this critical issue. Multiple legislative avenues currently exist to support and advance relevant policy to improve and sustain maternal health for those receiving Medicaid during pregnancy, including legislation aligned with the Biden-Harris Maternal Health Blueprint, state-focused options via the American Rescue Plan of 2021 (Public Law 117-2), and recently proposed acts (HR3407, S1542) which were last reintroduced in 2021. Recommendations include (i) reintroducing previously considered legislation requiring states to provide 12 months of continuous postpartum coverage, regardless of pregnancy outcome, and (ii) enacting a revised, permanent federal mandate equalizing Medicaid eligibility across states to ensure consistent access to postpartum healthcare offerings nationwide.

Mental health, coping, and protective factors in mothers of children with 22q11.2 deletion syndrome.

Compared to the large body of maternal mental health research for other pediatric disorders, we know far less about the experience of mothers of children with 22q11DS. This study investigates the coping methods, protective factors, and mental health of this population. These findings might lead to better support for 22q11DS maternal mental health. An international sample of 71 mothers (M = 40.5 years) of children with 22q11DS (M = 9.2 years) was recruited and completed an online survey assessing maternal mental health (symptoms of depression, anxiety, traumatic stress, general stress, and alcohol consumption), coping methods, and mental health protective factors (social support, dyadic adjustment, parenting competence). Maternal ratings of child mental health symptoms were also obtained. Mothers' self-report revealed a high percentage who screened positive for elevated levels of general stress (69%), hazardous alcohol consumption (30.9%), traumatic stress (33.8%), anxiety (26.8%), and depression (26.8%). After controlling for demographic variables and child mental health symptoms, maternal self-reported maladaptive coping methods were positively associated with maternal symptoms of depression, anxiety, stress, and traumatic stress. Reducing maladaptive coping methods may be a promising intervention for improving mental health in mothers of children with 22q11DS.

Intersectionality in Black Maternal Health Experiences: Implications for Intersectional Maternal Mental Health Research, Policy, and Practice.

Black women experience significant maternal mortality and morbidity disparities in the United States. Although emerging research has focused on reducing maternal mortality rates among Black birthing individuals, we must explore structural and social factors contributing to mental health outcomes during the perinatal period. Gaps exist where intersectional identities and experiences in maternal and child health are examined. This study explores the intersectional stress experiences of Black perinatal women in the South. We collected qualitative data through virtual semistructured interviews with 9 pregnant and 7 postpartum participants (N = 16).These interviews assessed feelings, attitudes, and perceptions about psychological stress due to their intersectional experiences of being Black, pregnant, and a woman in the United States. Findings were analyzed through the lens of critical race theory and intersectionality. We identified 5 overarching themes: (1) perinatal mental health experiences, (2) birthing and parenting while Black, (3) socioeconomic factors, (4) how we cope, and (5) community and social support. Overall, this study revealed how the layers of race, gender, pregnancy, and socioeconomic status influence mental health during the perinatal period. These findings show the need for antiracist and intersectional maternal mental health policies and practices.

Maternal Health Considerations: Highlighting and advancing opportunities for improved maternal health.

The special collection on Maternal Health Considerations offers a comprehensive exploration of critical issues surrounding maternal well-being across diverse contexts and disciplines. Recognising that maternal health extends beyond the physiological realm, this collection delves into the multifaceted dimensions of maternal well-being, including physical, mental, and socio-ecological factors. The collection comprises a series of interdisciplinary studies that investigate various facets of maternal health, from conception to postpartum stages. It addresses the complex interplay between biological, psychological, and socio-cultural determinants that influence maternal health outcomes. By adopting a holistic approach, the contributors shed light on the interconnectedness of maternal well-being. Key themes explored within this collection include the impact of prenatal care on maternal and neonatal health outcomes, as well as the role of mental health in shaping maternal experiences. In addition, the collection presents innovative recommendations to enhancing maternal well-being, such as community-based interventions, technological advancements, and future policy considerations. Furthermore, the special collection emphasises the significance of culturally sensitive care in promoting maternal health. It highlights the need for tailored interventions that respect the diversity of maternal experiences across different ethnic, racial, and socioeconomic groups. Contributors to this collection employ a range of methodologies, including qualitative and quantitative research case studies, which provide an intricate overview of the current state of maternal health research. The collection also offers valuable insights for policymakers, healthcare practitioners, researchers, and advocates working towards improving maternal health outcomes worldwide. It serves as a vital resource for contributing to our understanding of the complexities surrounding maternal well-being. It offers a platform for critical dialogue and collaborative efforts aimed at promoting holistic maternal health.

Maternal and fetal factors associated with stillbirth in singleton pregnancies in 13 hospitals across six states in India: A prospective cohort study.

This study aimed to investigate the incidence of and risk factors for stillbirth in an Indian population. We conducted a secondary data analysis of a hospital-based cohort from the Maternal and Perinatal Health Research collaboration, India (MaatHRI), including pregnant women who gave birth between October 2018-September 2023. Data from 9823 singleton pregnancies recruited from 13 hospitals across six Indian states were included. Univariable and multivariable Poisson regression analysis were performed to examine the relationship between stillbirth and potential risk factors. Model prediction was assessed using the area under the receiver-operating characteristic (AUROC) curve. There were 216 stillbirths (48 antepartum and 168 intrapartum) in the study population, representing an overall stillbirth rate of 22.0 per 1000 total births (95% confidence interval [CI]: 19.2-25.1). Modifiable risk factors for stillbirth were: receiving less than four antenatal check-ups (adjusted relative risk [aRR]: 1.75, 95% CI: 1.25-2.47), not taking any iron and folic acid supplementation during pregnancy (aRR: 7.23, 95% CI: 2.12-45.33) and having severe anemia in the third trimester (aRR: 3.37, 95% CI: 1.97-6.11). Having pregnancy/fetal complications such as hypertensive disorders of pregnancy (aRR: 1.59, 95% CI: 1.03-2.36), preterm birth (aRR: 4.41, 95% CI: 3.21-6.08) and birth weight below the 10th percentile for gestational age (aRR: 1.35, 95% CI: 1.02-1.79) were also associated with an increased risk of stillbirth. Identified risk factors explained 78.2% (95% CI: 75.0%-81.4%) of the risk of stillbirth in the population. Addressing potentially modifiable antenatal factors could reduce the risk of stillbirths in India.

Mapping maternal and infant health in Morocco: A global scoping review of themes, gaps, and the "unseen" in the published health research literature, 2000-2022.

Global efforts to reduce Maternal Mortality Rates (MMR) have been significant, but researchers are exploring new approaches to address stalled progress and enduring health inequities. This scoping review offers an analytic synthesis of maternal and infant health (MIH) research in the low-middle income North African Islamic country of Morocco over 22 years, a mapping of the themes, research gaps, geographies, and methodologies, 2000-2022. Morocco is an official MIH success story with excellent health indicators, yet indicators do not address local contexts, gender issues, or health disparities. To understand how medical research has reflected social reality over the past 22 years, we explored not just what is known, but how it is known, where it is known, what remained unseen, and why. Four databases were searched: OVID: MEDLINE, Embase, APA PsycINFO, and EBSCO: CINAHL. 4590 abstracts were identified, 3131 abstracts screened, and 402 full MIH articles and 128 sub-group articles identified and subject to data extraction. The 402 full MIH articles were subject to qualitative thematic analysis, classified by 34 primary research themes and explored especially for gender, health equity, and methodology. Findings included significant geographic research disparities; four regions were the location of 75% of research and many regions remained virtually "unseen" by research. The best-equipped urban public hospitals in higher-income regions produced the most research, creating an urban, hospital-based research perspective. Maternal health articles predominated, often >50% more than articles published about infant health. Infants studied were mostly neonates. Socially marginalized women were often invisible to research, as were private healthcare, NGO care (non-governmental civic organizations), and healthcare in community. In articles, researchers recommended new policies, new laws, health system reform, and government actions to advocate for patients. Three solutions emerged to broaden the research perspective: increase geographic breadth, address missing topics and populations, and embrace interdisciplinary methods.

Birth in Brazil II: a postpartum maternal, paternal and child health research protocol.

Pregnancy, parturition and birth bring major changes to the lives of mothers and fathers. This article presents a research protocol for estimating the prevalence of postpartum mental health outcomes in mothers and fathers, abuse and satisfaction in delivery/abortion care, and the correlations between them and socioeconomic, obstetric, and child health factors. As a 2-component research, it consists of a prospective cohort study with all postpartum women interviewed in the 465 maternity hospitals included at the Birth in Brazil II baseline survey conducted from 2021 to 2023, and a cross-sectional study with the newborns' fathers/partners. Interviews will be conducted via telephone or self-completion link sent by WhatsApp with the mother at 2 and 4 months after delivery/abortion. Partners will be approached three months after birth (excluding abortions, stillbirths and newborn death) using the telephone number informed by the mother at the maternity ward. Postpartum women will be inquired about symptoms of depression, anxiety and post-traumatic stress disorder, abuse during maternity care and quality of the mother-newborn bond. Maternal and neonatal morbidity, use of postnatal services, and satisfaction with maternity care are also investigated. Fathers will be asked to report on symptoms of depression and anxiety, and the quality of the relationship with the partner and the newborn. The information collected in this research stage may help to plan and improve care aimed at the postpartum health of the mother-father-child triad.

Understanding the trends of maternal mental health research in India through bibliometric analysis

Pregnancy-related mental health issues are more common in low and middle‐income countries (LMICs). Common mental health disorders are more prevalent among women than men. In LMIC countries, the prevalence of mental health disorders is higher, estimated at 15.6% among pregnant women and 19.8% among postpartum women. According to the studies, Antenatal depression prevalence in India ranged from 9.8% to 36.7%, while antenatal anxiety prevalence was 55.7%. This study performed bibliometric profiling to shed light on maternal mental health research conducted in India since 1979 and to present the research output in the field of maternal mental health in India. SCOPUS databases have been chosen for data retrieval due to their extensive coverage, high-impact journal inclusion and ease of access to quality publications. In total, 146 publications were found in the field. Maternal mental health research increased significantly in 2022. The peak number of publications occurred in 2022.There has been a lot of focus on maternal mental health. This is evidenced by the fact that there has been a significant increase in the number of scientific publications in India since 1979. The bibliometric indicators provided important information on the research contributions from different institutes and authors. The results of this study can serve as a reference for researchers and policymakers to plan future research.

A correlation analysis on the postpartum anxiety disorder and influencing factors in puerperae with gestational diabetes mellitus.

The aim of this study is to discuss the postpartum anxiety disorder and influencing factors in puerperae with gestational diabetes mellitus (GDM) to provide a clinical basis for better early identification and intervention of adverse mood. Convenient sampling method was adopted to investigate 205 pregnant women as the observation group and 201 normal healthy pregnant women in the same period as the control group. The self-rating anxiety scale (SAS) was used to investigate and observe the respondents, evaluate the postpartum anxiety status of patients with GDM, and analyze the related influencing factors. Statistical analysis of the data was performed using SAS 3.0 software. A proposed P < 0.05 was considered as statistically significant. Patients with GDM had a higher risk than normal maternal anxiety, related to years of education, triglycerides, 1-h postprandial blood glucose, and a history of induced abortion. GDM can lead to the occurrence of postpartum anxiety, and the poor psychological state is not conducive to the maternal and infant health. Early identification and early intervention can reduce the harm caused by anxiety and promote the progress of maternal and infant health and clinical research.

(Re)birthing systems in the Qikiqtaaluk Region of Nunavut: a place-based inquiry into Inuit birthing, systems of care, and maternal health research

Objectives: Within the Qikiqtaaluk Region (Eastern Nunavut), pregnant women are required to travel outside their home communities for birthing care. This model differs from the prior norm of place-based, midwife-attended birth and impacts Inuit wellness. This research characterised Inuit women’s birthing experiences and perspectives on enriching the medical obstetric system through the lens of place, culture, and health, and explored how maternal health research methodologies might be increasingly place-based and locally-driven. Methods: Informed by a community-based approach, a team of Inuit and non-Inuit researchers conducted a case study with Inuit women in Iqaluit, Nunavut, Canada. A systematic critical review was completed to examine prior maternal health research methodology in Nunavut and underscored opportunities for maternal health research to be increasingly Inuit-led through all research stages. Sewing was explored as a locally-specific, arts-based approach for data gathering and was found to enhance data quality and participants’ research experience by creating space for voicing, sharing, relating, and embodying Inuit knowledge. Qualitative data were gathered (2017-2020) using: (1) focus groups (structured as two-part sewing sessions) (n = 5) with pregnant women (n = 19); and (2) conversational interviews with pregnant women, Inuit Elders, and other community members (n = 22); and validated in meetings with Inuit knowledge-holders (n = 4). Thematic analyses were iterative and guided by a grounded theory approach. Results: Participants described the importance of place-connections to Inuit birth experiences and the value of Inuit relational supports and knowledge-sharing throughout the birthing process. Inuit women voiced a desire for place-based birthing and further Inuit involvement and integration of Inuit birthing practices into obstetrical care. Women shared knowledge on stewarding birthing resources from the land and using skilled Inuit midwifery techniques: this knowledge connects to three Inuit Qaujimajatuqangit principles important for health system governance in Nunavut (Avatittinnik Kamatsiarniq, Inuuqatigiitsiarniq, and Pilimmaksarniq) and illustrates the importance of aligning the regional obstetric system with Inuit birthing values. Conclusions: This collaborative research emphasises how maternal health research and maternity care may be enriched by including place-specific, locally-embedded methods and by providing space for Inuit women to shape the systems that affect them. INUKTITUT TRANSLATION ᐃᕐᓂᓱᒃᓰᓂᖅ ᐊᐅᒪᓂᖓ ᕿᑭᕐᑖᓗᖕᒥ ᓄᓇᕘᒥ: ᓄᓇᒋᔭᖏᓐᓃᓪᓗᑎᒃ ᖃᐅᔨᓇᓱᖕᓂᖅ ᐃᓄᐃᑦ ᐃᕐᓂᓱᒃᓰᕙᖕᓂᖏᑦ, ᐸᕿᓂᕐᒥᒃᓗ ᐊᒻᒪᓗ ᓇᔾᔨᔪᑦ ᖃᓄᐃᖏᓐᓂᖏᓐᓂᒃ ᖃᐅᔨᓴᕐᓂᖅ ᓚᐅᕆ ᔭᐃᓐ ᐳᕈᐸᐃᑯ ᕿᑭᕐᑖᓗᖕᒥ (ᑲᓇᖕᓇᖓᓂ ᓄᓇᕗᑦ), ᓇᔾᔨᔪᖅ ᐊᕐᓇᖅ ᐊᐅᓪᒪᕆᐊᖃᖃᑦᑕᕐᒪᑕ ᓄᓇᓕᖓᑕ ᓯᓚᑖᓄᑦ ᐃᕐᓂᔭᕐᑐᕐᓗᑎᒃ. ᑕᐃᒪᐃᑎᓪᓗᒍ ᐊᔾᔨᒌᖏᒻᒪᒍ ᐃᓕᖁᓯᐅᕙᓚᐅᕐᑐᓂᒃ ᐊᖏᕋᕐᓯᒪᓪᓗᑎᒃ ᓄᓇᒋᔭᖏᓐᓃᓪᖢᑎᒃ ᐃᕐᓂᓱᒃᓰᕙᓚᐅᕐᒪᑕ ᖃᓄᐃᖏᑦᑎᐊᕐᓂᖏᓐᓄᓪᓗ ᐃᒃᐱᖕᓇᐅᑎᖕᒪᑦ. ᑖᓐᓇ ᖃᐅᔨᓴᕐᓂᖅ ᑐᑭᓯᓇᓱᒃᖢᓂ ᐃᓄᐃᑦ ᐊᕐᓇᐃᑦ ᐃᕐᓂᓱᒃᑎᓪᓗᒋᑦ ᐊᑐᕐᓯᒪᔭᖏᓐᓂᒃ ᐊᒻᒪᓗ ᐃᓱᒪᒋᔭᖏᓐᓂᒃ ᐱᐅᓯᒋᐊᕐᑕᐅᔭᕆᐊᖃᕐᓂᖓᓂᒃ ᐃᕐᓂᓱᒃᓰᓂᖅ ᓄᓇᒋᔭᖓᓂᓪᓗᓂ, ᐃᓕᖁᓯᖓᒍᑦ, ᐊᒻᒪᓗ ᖃᓄᐃᖏᑦᑎᐊᕐᓂᖓᒍᑦ, ᐊᒻᒪᓗ ᖃᐅᔨᓇᓱᒃᓗᓂ ᖃᓄᖅ ᓇᔾᔨᔪᑦ ᖃᓄᐃᖏᑦᑎᐊᕐᓂᖏᓐᓂᒃ ᖃᐅᔨᓴᕐᓂᖅ ᐃᓕᖁᓯᐅᔪᑦ ᓄᓇᓕᒋᔭᖓᓂᑦ ᐊᒻᒪᓗ ᓄᓇᓕᐅᔪᓂᒃ ᐱᒋᐊᕐᑎᑕᐅᕙᓪᓕᐊᓕᕐᓂᖓᓂᒃ. ᑐᓴᐅᒪᑎᑕᐅᓪᓗᑕ ᓄᓇᓕᖕᓂᑦ ᐱᒋᐊᕐᑎᑕᐅᓯᒪᔪᓂᑦ, ᐃᓄᐃᑦ ᖃᓪᓗᓈᓪᓗ ᖃᐅᔨᓴᕐᑎᑦ ᖃᐅᔨᓇᓱᓚᐅᕐᒪᑕ ᐃᓄᐃᑦ ᐊᕐᓇᐃᑦ ᐃᖃᓗᖕᓂ, ᓄᓇᕗᑦ, ᑲᓇᑕ. ᕿᒥᕈᔭᐅᓚᐅᕐᑐᖅ ᐃᓕᖁᓯᐅᓯᒪᔪᑦ ᖃᓄᐃᓕᖓᖃᑦᑕᓚᐅᕐᒪᖔᑕ ᐃᓕᖁᓯᐅᔪᑦ ᐃᕐᓂᓱᕐᑐᓂᒃ ᓇᔾᔨᔪᓂᒃᓗ ᓄᓇᕗᒥ ᐊᒻᒪᓗ ᐊᑐᖏᑎᑕᐅᓗᐊᕐᓂᖏᓐᓂᒃ ᐱᕕᖃᕐᓂᐅᔪᑦ ᐃᓄᖕᓄᑦ ᐊᐅᓚᑕᐅᓗᑎᒃ ᖃᐅᔨᓴᕐᓂᖅ. ᒥᕐᓱᕐᑎᑦᑎᓂᒃᑯᑦ ᓄᓇᓕᖕᓂ ᐊᑐᕐᑕᐅᕙᒋᕐᑐᖅ, ᓴᓇᐅᒐᓕᕆᓂᕐᓗ ᑎᑎᕋᕐᑕᐅᕙᓪᓕᐊᓪᓗᑎᒃ ᐊᒻᒪᓗ ᑐᑭᓯᔾᔪᑕᐅᓚᐅᕐᑐᖅ ᐱᐅᓯᒋᐊᕈᑕᐅᓪᓗᓂᓗ ᐊᒻᒪᓗ ᐃᓚᐅᖃᑕᐅᔪᑦ ᖃᐅᔨᓴᕐᓂᕐᒥᒃ ᑐᑭᓯᓪᓗᑎᒃ ᓂᓪᓕᕈᓐᓇᕐᑎᑕᐅᓪᓗᑎᒃᓗ, ᐅᖃᐅᓯᖃᕈᓐᓇᕐᖢᑎᒃᓗ, ᐊᖏᖃᑎᖃᕈᓐᓇᕐᓗᑎᒃᓗ, ᐊᒻᒪᓗ ᐃᓄᐃᑦ ᖃᐅᔨᒪᔭᖏᓐᓂᒃ ᑐᑭᓯᕚᓪᓕᕐᖢᑎᒃ. ᐱᐅᑎᒋᓂᖓ ᑎᑎᕋᕐᓯᒪᔪᑦ ᑲᑎᑕᐅᓚᐅᕐᑐᑦ (2017-2020) ᐊᑐᕐᖢᑎᒃ: (1) ᑲᑎᒪᔨᕋᓛᖑᒧᓂᒃ (ᐋᕿᒃᓯᒪᓪᓗᑎᒃ ᒪᕉᓕᓪᓗᑎᒃ ᒥᕐᓱᑲᑕᕐᑐᑦ) (n = 5) ᓇᔾᔨᔪᓂᒃ ᐊᕐᓇᓂᒃ (n = 19); ᐊᒻᒪᓗ (2) ᐅᖃᓪᓚᖃᑎᒋᔭᐅᓪᓗᑎᒃ ᐊᐱᕐᓱᕐᑕᐅᕙᓪᓕᐊᓪᓗᑎᒃ ᓇᔾᔨᔪᑦ ᐊᕐᓇᐃᑦ. ᐃᓄᐃᑦ ᐃᓐᓇᐃᑦ, ᐊᓯᖏᓪᓗ ᐃᓄᐃᑦ (n = 22); ᓇᓗᓇᐃᕐᑕᐅᕙᓪᓕᐊᓗᑎᒃᓗ ᑲᑎᒪᑎᑦᑎᓪᓗᑎᒃ ᐃᓄᐃᑦ ᖃᐅᔨᒪᔭᑐᖃᖏᓐᓂᒃ ᑎᒍᒥᐊᕐᑎᐅᔪᓂᒃ (n = 4). ᖃᐅᔨᓴᕐᑕᐅᕙᒃᖢᑎᒃ ᑐᑭᓯᔭᐅᓇᓱᒃᖢᑎᒃ ᐊᒻᒪᓗ ᐊᑐᐊᒐᖃᕐᖢᑎᒃ ᐃᓱᒪᒋᔭᐅᓯᒪᔪᓂᒃ. ᐃᓚᐅᖃᑕᐅᔪᑦ ᐅᖃᐅᓯᖃᖃᑦᑕᓚᐅᕐᑐᑦ ᓄᓇᒥ ᐊᒃᑐᐊᓂᖓ ᐱᓪᓚᕆᐅᓂᖓᓂᒃ ᐃᓄᐃᑦ ᐃᕐᓂᓱᒃᓰᓂᖏᑦ ᖃᐅᔨᓯᒪᔭᖏᑦ ᐊᒻᒪ ᐊᑑᑎᖃᕐᓂᖓᓂᒃ ᐃᓄᐃᑦ ᐃᒪᒋᔭᖏᓐᓂᒃ ᐃᒪᐅᑎᑦᑎᓂᕐᒥᒃ ᐊᒻᒪᓗ ᖃᐅᔨᒪᔭᕐᒥᓂᒃ ᐅᖃᐅᓯᖃᖃᑦᑕᕐᓂᖅ ᐃᕐᓂᓱᒃᓰᓂᕐᒥᒃ. ᐃᓄᐃᑦ ᐊᕐᓇᐃᑦ ᐅᖃᖃᑦᑕᓚᐅᕐᑐᑦ ᓄᓇᒦᓪᓗᓂ ᐃᕐᓂᓲᖃᑦᑕᕈᒪᓪᓗᑎᒃ ᐊᒻᒪᓗ ᐃᓚᐅᑎᑕᐅᓂᕐᓴᐅᓗᓂ ᐃᓄᐃᑦ ᐊᒻᒪᓗ ᐱᖃᓯᐅᔾᔭᐅᖃᑦᑕᕐᓗᑎᒃ ᐃᓄᐃᑦ ᐃᕐᓂᓱᒃᓰᓂᖏᑦ ᐃᕐᓂᓱᒃᑐᓄᑦ.. ᐊᕐᓇᐃᑦ ᖃᐅᔨᒪᔭᕐᒥᓂᒃ ᐅᖃᐅᓯᖃᖃᑦᑕᓚᐅᕐᑐᑦ ᐃᕐᓂᓱᒃᑐᓄᑦ ᐃᓕᖁᓯᕆᔭᐅᓚᐅᕐᑐᓂᒃ ᐊᐅᓪᓚᕐᓯᒪᓪᓗᑎᒃ ᐊᑐᕐᑕᐅᓪᓗᑎᒃᓗ ᖃᐅᔨᒪᓂᖏᑦ ᐃᕐᓂᓱᒃᓰᕙᒃᑐᑦ ᐃᓄᐃᑦ. ᑖᓐᓇ ᖃᐅᔨᒪᓂᖏᑦ ᐊᒃᑐᐊᓂᕆᔭᐅᖕᒪᑦ ᐱᖓᓱᓄᑦ ᐃᓄᐃᑦ ᖃᐅᔨᒪᔭᑐᖃᖏᑦ ᐊᑐᐊᒐᐅᔪᓂᒃ ᐱᓪᓚᕆᐅᓪᓗᑎᒃᓗ ᐊᓐᓂᐊᖃᕐᑕᐃᓕᒪᓂᕐᒧᑦ ᐊᐅᓚᓂᖓᓄᑦ ᓄᓇᕘᒥ (ᐊᕙᑎᑦᑎᓐᓂᒃ, ᑲᒪᑦᓯᐊᕐᓂᖅ,ᐃᓅᖃᑎᒌᑦᓯᐊᕐᓂᖅ ᐊᒻᒪᓗ ᐱᓕᒻᒪᒃᓴᕐᓂᖅ) ᓇᓗᓇᐃᒃᑯᑕᐅᓪᓗᓂᓗ ᐱᓪᓚᕆᐅᓂᖓᓂᒃ ᐃᕐᓂᓱᒃᑐᑦ ᒪᓕᒃᑎᑕᐅᓗᑎᒃ ᐃᓄᐃᑦ ᐃᕐᓂᓱᒃᓰᓂᖏᑦ ᐅᒃᐱᕆᔭᖏᑦ. ᐃᑲᔪᕐᑎᒌᒃᓗᑎᒃ ᖃᐅᔨᓴᕐᓂᖅ ᓇᓗᓇᐃᕈᑕᐅᓚᐅᕐᑐᖅ ᐱᓪᒪᕆᐅᓂᖓᓂᒃ ᓇᔾᔨᔪᑦ ᖃᓄᐃᖏᑦᑎᐊᕐᓂᖏᓐᓂᒃ ᖃᐅᔨᓴᕐᓂᖅ ᐊᒻᒪᓗ ᓇᔾᔨᔪᑦ ᖃᓄᐃᓐᓂᖏᓐᓂᒃ ᑲᒪᒋᔭᐅᑦᑎᐊᕐᓂᖏᓐᓂᒃ ᐱᐅᓯᒋᐊᕐᑎᑕᐅᒧᓐᓇᕐᓂᖓᓂᒃ ᓄᓇᒥᒃ ᐃᓂᖃᕐᓗᑎᒃ, ᓄᓇᓕᖕᓂ ᐃᓚᐅᖃᑕᐅᓗᑎᒃ ᐊᑐᕐᑕᐅᔪᓄᑦ ᐊᒻᒪᓗᐱᕕᖃᕐᑎᑕᐅᓗᑎᒃ ᐊᕐᓇᐃᑦ ᐃᓄᐃᑦ ᐋᕿᒃᓱᐃᖃᑕᐅᓗᑎᒃ ᐃᓅᓯᖏᓐᓄᑦ ᐊᒃᑐᐊᔪᓂᒃ.