Pregnancy Website Research Articles

Willingness-to-use and preferences for model-informed antenatal doses: a cross-sectional study among European healthcare practitioners and pregnant women.

Background: Physiological changes in pregnancy may affect drug safety and efficacy, sometimes requiring dose adjustments. Pregnancy-adjusted doses, however, are missing for most medications. Increasingly, pharmacokinetic models can be used for antenatal dose finding. Given the novelty of this technique and questions regarding dose credibility, the acceptability of model-informed antenatal doses should be explored. Objective: We aimed to assess the willingness-to-use and preferred features for model-informed antenatal doses among healthcare practitioners (HCPs) and pregnant women in European countries. Methods: A cross-sectional, web-based study drawing on two open surveys was performed between 8 September and 30 November 2022. Each survey comprised statements drawn from prior focus groups, associated with Likert-scales. Themes included respondents' information needs, search behaviours along with their willingness-to-use and preferred features for model-informed antenatal doses. The surveys were disseminated through professional societies, pregnancy websites and social media. A descriptive analysis was performed. Results: In total, 608 HCPs from different specialties and 794 pregnant women across 15 countries participated, with 81% of respondents across both groups in the Netherlands or Belgium. Among pregnant women, 31% were medical professionals and 85% used medication during pregnancy. Eighty-three percent of HCPs found current antenatal pharmacotherapy suboptimal and 97% believed that model-informed antenatal doses would enhance the quality of antenatal care. Most HCPs (93%) and pregnant women (75%) would be willing to follow model-informed antenatal doses. Most HCPs desired access to the evidence (88%), including from pharmacokinetic modelling (62%). Most pregnant women (96%) wanted to understand antenatal dosing rationales and to be involved in dosing decisions (97%). Conclusion: The willingness-to-use model-informed antenatal doses is high among HCPs and pregnant women provided that certain information needs are met.

Australian women’s perceptions and practice of sleep position in late pregnancy: An online survey

BackgroundGoing-to-sleep in the supine position in later pregnancy (≥28 weeks) has been identified as a risk factor for stillbirth. Internationally, public awareness campaigns have been undertaken encouraging women to sleep on their side during late pregnancy. AimThis study aimed to identify sleep practices, attitudes and knowledge in pregnant women, to inform an Australian safe sleeping campaign. MethodsA web-based survey of pregnant women ≥28 weeks’ gestation conducted from November 2017 to January 2018. The survey was adapted from international sleep surveys and disseminated via pregnancy websites and social media platforms. FindingsThree hundred and fifty-two women participated. Five (1.6%) reported going to sleep in the supine position. Most (87.8%) had received information on the importance of side-sleeping in pregnancy. Information was received from a variety of sources including maternity care providers (186; 66.2%) and the internet (177; 63.0%). Women were more likely to report going to sleep on their side if they had received advice to do so (OR 2.3; 95% CI 1.0–5.1). Thirteen (10.8%) reported receiving unsafe advice, including changing their going-to-sleep position to the supine position. DiscussionThis indicates high level awareness and practice of safe late-pregnancy going-to-sleep position in participants. Opportunities remain for improvement in the information provided, and understanding needs of specific groups including Aboriginal and Torres Strait Islander women. ConclusionFindings suggest Australian women understand the importance of sleeping position in late pregnancy. Inconsistencies in information provided remain and may be addressed through public awareness campaigns targeting women and their care providers.

Nesting behaviours during pregnancy: Biological instinct, or another way of gendering housework?

Nesting is a hormonally-determined set of behaviours, observed in some animals, relating to the preparation of the space in which the offspring will be born and raised. Texts on childbirth and pregnancy advise women that they will experience nesting behaviours during pregnancy, causing them to tidy, clean, and prepare their living space. In this paper, I analyse the discussion of nesting behaviours on popular pregnancy websites. I then investigate the evidence base for nesting in humans through conducting a systematic review of the academic literature, and conclude that it is inadequate to ground the claims made in the popular discourse. The article concludes by presenting social explanations for nesting behaviours which are more plausible than the proposed biological narrative. These explanations make reference to the influence of gender stereotypes and the specific pressures experienced by women during pregnancy.

Measurement of Maternal Mindful Awareness of Fetal Movement.

Decreased fetal movement is a common concern late in pregnancy that may be associated with increased fetal morbidity and mortality. Limited research suggests a relationship between maternal psychological factors and perception of fetal movement. The goal of this study was to test the reliability and external validity of a novel self-report instrument for maternal mindful awareness of fetal movement. Pregnant women who were at 20 weeks' gestation or later and feeling regular fetal movement (N = 497) were recruited online through a commercial pregnancy website to complete an internet survey from April to May 2016. The online survey included demographic and pregnancy characteristics, psychological and mindfulness measures, and investigator-developed items on mindful awareness of fetal movement. Reliability and validity of the instrument were tested with exploratory factor analysis, correlations with psychological variables, and hierarchical linear regression. Exploratory factor analysis of mindful awareness of fetal movement items using principal components analysis showed a 2-factor structure, noticing and distracted, with internal consistency of α equal to .69 and .57, respectively. Hierarchical multiple regression analysis showed that noticing was associated with increased gestational age, mindfulness (observing facet), and maternal-fetal attachment. Distracted was associated with increased education level and prenatal anxiety and with decreased mindfulness (nonjudging facet). There was moderate internal consistency in the items measuring mindful awareness of fetal movement. Findings suggest relationships between mindful awareness of fetal movement and state mindfulness, maternal-fetal attachment, and prenatal anxiety. More research is needed to further develop items for a mindful awareness of fetal movement scale suitable for research and clinical practice.

Zika Pregnancy Surveillance: Transforming Data into Educational and Clinical Tools

ObjectiveTo describe how Zika virus (Zika) surveillance data informs and improves testing guidance, clinical evaluation and management of pregnant women and infants with possible Zika infectionIntroductionLittle was known about the maternal and fetal/infant effects of Zika infection before the 2015 outbreak in the Americas, which made it challenging for public health practitioners and clinicians to care for pregnant women and infants exposed to Zika. In 2016, CDC implemented a rapid surveillance system, the US Zika Pregnancy and Infant Registry, to collect information about the impact of Zika infection during pregnancy and inform the CDC response and clinical guidance. In partnership with state, tribal, local, and territorial health departments, CDC disseminated information from this surveillance system, which served as the foundation for educational materials and clinical tools for healthcare providers.MethodsThroughout the Zika response, CDC worked closely with health officers, epidemiologists, and clinical partners to seek expert input on the interpretation of emerging data and the evaluation and management of these vulnerable populations. In response to requests from clinical and public health partners, CDC created targeted educational materials and tools to facilitate the implementation of clinical guidance. These materials equipped healthcare providers with the information needed to care for pregnant women and infants with Zika infection. Examples of products developed included: 1) screening tools to identify pregnant women for whom testing is indicated; 2) an interactive web tool to assist with implementation and interpretation of Zika testing guidance (Pregnancy and Zika Testing Widget); 3) patient counseling scripts; and 4) videos to explain critical clinical concepts (e.g., measurement of infant head circumference). These tools were informally pre-tested with the target audiences prior to dissemination, specifically to assess usefulness in clinical settings. CDC disseminated these tools through the CDC website and through comprehensive outreach (e.g., webinars, calls, email alerts) to various audiences. Additionally, several professional organizations incorporated these tools into regular communication with their membership.ResultsThe US Zika Pregnancy and Infant Registry is currently monitoring infants from approximately 7,300 pregnancies in the US states and territories with laboratory evidence of Zika. Surveillance data provided valuable information, including clues toward the pattern of defects and other neurologic disabilities associated with congenital Zika infection, estimates of the risks associated with congenital infection, and timeframes of greatest risk during pregnancy, to help clinicians counsel pregnant patients with potential Zika exposure. CDC used these data to inform their clinical tools, particularly in pretest counseling materials and educational factsheets for healthcare providers to use with pregnant women with potential Zika exposure.After informal testing among healthcare providers, the tools received positive feedback regarding usefulness and applicability in clinical settings. Collectively, CDC’s Zika clinical tools were downloaded more than 300,000 times from CDC’s website. The Pregnancy and Zika Testing Widget was accessed and followed to an endpoint (e.g., Zika testing recommended) more than 17,000 times, with more than 75% of users self-identifying as clinicians.ConclusionsRapid implementation of Zika surveillance captured evolving data about the impact of Zika on pregnant women and their infants. These data informed the development of clinical tools for healthcare providers caring for and counseling patients with Zika exposure. These tools ensured pregnant women and infants were adequately monitored during the Zika outbreak. Health education materials and clinical tools based on surveillance data should be considered in future emergency responses, particularly when knowledge is rapidly evolving.ReferencesCDC Zika Pregnancy Website: https://www.cdc.gov/pregnancy/zika/materials/index.html

Views on and experiences of electronic cigarettes: a qualitative study of women who are pregnant or have recently given birth

BackgroundElectronic cigarettes (ECs) are increasingly used for reducing or stopping smoking, with some studies showing positive outcomes. However, little is known about views on ECs during pregnancy or postpartum and previous studies have nearly all been conducted in the US and have methodological limitations, such as not distinguishing between smokers and ex/non-smokers. A greater understanding of this topic will help to inform both clinicians and EC interventions. We elicited views and experiences of ECs among UK pregnant or recently pregnant women.MethodsWe conducted semi-structured telephone interviews, using topic guides, with pregnant or recently pregnant women, who were current or recent ex-smokers. To ensure broad views of ECs were obtained, recruitment was from several geographical locations and via various avenues of recruitment. This included stop smoking services, antenatal and health visitor clinics, a pregnancy website and an informal network. Participants were 15 pregnant and 15 postpartum women, including nine current EC users, 11 ex-users, and 10 never-users. Five women who were interviewed in pregnancy were later interviewed in postpartum to explore if their views had changed. Audio data was transcribed verbatim and framework analysis was applied.ResultsFive main themes emerged: motivations for use (e.g., for stopping or reducing smoking), social stigma (e.g., avoiding use in public, preferring ‘discrete’ NRT), using the EC (e.g., mostly used at home); consumer aspects (e.g., limited advice available), and harm perceptions (e.g., viewed as less harmful than smoking; concerns about safety and addiction).ConclusionsECs were viewed positively by some pregnant and postpartum women and seen as less harmful than smoking and useful as aids for reducing and stopping smoking. However, due to perceived social stigma, some women feel uncomfortable using ECs in public, especially during pregnancy, and had concerns about safety and nicotine dependence. Health professionals and designers of EC interventions need to provide women with up-to-date and consistent information and advice about safety and dependence, as well as considering the influence of social stigma.

Evaluation of websites that contain information relating to malaria in pregnancy

ObjectivesThe study identified available websites on malaria in pregnancy on the World Wide Web and sought to evaluate their readability and information quality. Study designA purposeful sample of websites were selected which provided information on Malaria in pregnancy. MethodsA total of 31 websites were identified from searches using Google, Yahoo and Bing search engines. Two generic tools (Discern and HON), one specific tool designed to assess information quality of malaria in pregnancy and readability tests (Flesch Reading Ease and Flesh-Kincaid Grade level) were used to evaluate the websites. ResultsMost of the websites scored below 50% with the HON Code tool, with most lacking information on the symptoms. One website scored over 70 with the reading ease with two (2) achieving a score of 7 for the reading level test. The readability of the websites was too advanced for an ordinary consumer. ConclusionThe results of this study indicated that the information quality of malaria in pregnancy websites varied from fair to medium. It was also found that the readability of the websites was too advanced for an ordinary consumer. These findings suggest that most websites are not comprehensive in addressing all the relevant aspects of malaria in pregnancy.

Human Pregnancy Resources

ABSTRACTThe Interactive Web column reviews freely available Internet resources that are interactive in some form and/or provide helpful videos and animations. The websites are used for assignments, lectures, and self-study purposes and are available for viewing within The Interactive Web blog at https://thewebisinteractive.wordpress.com/. For information on how to search the blog, please see the About, How to Search, Writing Opportunity, and Disclaimer webpage within the blog. Each of the favorite websites of users is labeled with a star. This issue will highlight pregnancy websites.

From birth plan to birth partnership: enhancing communication in childbirth

Birth plans were developed with the intention of enhancing a woman's prepared decision-making in the labor and delivery process and to offer obstetric care providers with important details about those decisions. Through the use of birth plans, women can reflect on their values and choices regarding what care practices and interventions they do and do not want in birth; they can communicate these values in advance to their care providers. However, birth plans are often ineffective at accomplishing their goals for a number of reasons. They may reflect outdated concerns about routine practices or overly emphasize minor matters. Many popular pregnancy websites offer birth plans that use checklist formats, and women who use these are not counseled about which options may require or preclude other options. Some women may have inappropriately rosy expectations of how their labor and delivery processes will progress or have received poor advice. The use of a birth plan may invoke hostility from hospital staff members who may disregard the plans and look down on the women who make them. An alternative approach to the use of birth plans to enhance a woman's participation and informed consent in the birth process is the birth partnership, in which women and their obstetric care providers take time to discuss thoroughly the choices to be made in birth in advance to have those choices best reflect the values of the woman giving birth. Meeting to discuss values and choices before labor offers the opportunity for mutual education between provider and patient about the choices to be made and the values that inform those choices. Effective communication and working to build mutual trust can serve as preventive measures to avoid many conflicts that arise in the birth process.

Women’s beliefs about medication use during their pregnancy: a UK perspective

Background Previous research has examined the number and extent of medicines taking in pregnant women but not their beliefs and risk perception surrounding their use. Objective To describe beliefs and risk perception associated with medicines use for the treatment of common acute conditions among UK women and explore whether this is related to actual medicines use. Settings Cross-sectional, web-based study in the UK. Methods Pregnant women and mothers within 1 year of giving birth were invited to participate in an online cross-sectional questionnaire-based study via a pregnancy website in the UK. Anonymous data were collected from women regarding their use of medicines (both over-the-counter and prescribed) and their beliefs regarding medicines use during pregnancy. Main outcome measures Pregnant women’s beliefs about medicines and their relation to pharmacological treatment of acute conditions in pregnancy. Results Pharmacological treatment of conditions in pregnancy ranged from 65.4 % for urinary tract infections (UTIs) to 1.1 % for sleeping problems. Almost three out of ten women avoided using some medications during pregnancy. For heartburn and UTIs, women who did not treat the condition viewed medicines in general as being overused, more harmful and less beneficial, than those who treated the condition. In general, UK pregnant women perceived medicines to be beneficial and slightly overused. Conclusions Women’s beliefs about medications impact on treatment of specific conditions in pregnancy such as heartburn and UTIs. Healthcare professionals should explore patient’s beliefs regarding medication at the first maternity care visit to promote appropriate medication use in pregnancy.Electronic supplementary materialThe online version of this article (doi:10.1007/s11096-016-0322-5) contains supplementary material, which is available to authorized users.

Internet use in pregnancy

Background: More and more women are turning to the internet in pregnancy. Yet the value of this ever increasing quest for information is an area that appears to be under researched. Objective: This qualitative study aimed to explore the perceived value of internet use in pregnancy, conducted from the viewpoint of three distinct groups: midwives, pregnant women and postnatal women. Methods: Thirteen midwives, seven antenatal women and six postnatal women were recruited to three focus groups and seven in-depth interviews. Results: Appropriate internet usage during pregnancy was positively valued by all groups. However, midwives were more negative in their perceptions of inappropriate use. The data indicated that this could be influenced by their lack of awareness of current pregnancy website use. Conclusion: Greater collaboration between midwives and pregnant women is required to enable access to consistent, verified internet information which can be used appropriately and with confidence.

Does Social Support Predict Pregnant Mothers’ Information Seeking Behaviors on an Educational Website?

We examine how social support (perceived support and support from a spouse, or committed partner) may influence pregnant women's information seeking behaviors on a pregnancy website. We assess information seeking behavior among participants in a trial testing the effectiveness of a web-based intervention for appropriate gestational weight gain. Participants were pregnant women (N = 1,329) recruited from clinics and private practices in one county in the Northeast United States. We used logistic regression models to estimate the likelihood of viewing articles, blogs, frequently asked questions (FAQs), and resources on the website as a function of perceived social support, and support from a spouse or relationship partner. All models included socio-demographic controls (income, education, number of adults and children living at home, home Internet use, and race/ethnicity). Compared to single women, women who were married or in a committed relationship were more likely to information seek online by viewing articles (OR 1.95, 95 % CI [1.26-3.03]), FAQs (OR 1.64 [1.00-2.67]), and blogs (OR 1.88 [1.24-2.85]). Women who felt loved and valued (affective support) were more likely to seek information by viewing articles on the website (OR 1.19 [1.00-1.42]). While the Internet provides a space for people who have less social support to access health information, findings from this study suggest that for pregnant women, women who already had social support were most likely to seek information online. This finding has important implications for designing online systems and content to encourage pregnant women with fewer support resources to engage with content.

Pregnancy, birth and babies in the online digital world

The online world has many websites targeting the pregnant and birthing population, few of which present an unbiased trusted source of information, not focussed on selling them something. This presentationwill demonstrate an innovative newwebsite that provides the pregnant and birthing community the opportunity to be fully informed and take the central role in their care provision The Pregnancy, Birth and Baby website has been developed to provide women and their families with a trusted source of information, without taking a stance on the choices they make. A review of the ‘pregnancy website’ world was undertaken and there was nothing of this calibre found that did not promote their site’s host perspective on birth, or inundate the site visitor with advertisements. An average of 3500 calls per month are received by the Pregnancy Birth and Baby Helpline seeking information on topics ranging from birthing options to ‘is what’s in my baby’s nappy normal?’ These calls are mostly from women and then their families, and show a need within the community for trusted digital health information sites. This website is supported by a 24h free counselling support service, available for women and their families. A robust clinical governance framework has been applied to the content development and information architecture of the site. This includes customer useability and satisfaction feedback processes to ensure this site remains the first place to look rather than asking ‘Dr Google’. The pregnant and birthing community now have an online service that is comprehensive and responsive to their needs, that they can use to source information on a topic or health issue and then take that with them when they visit their health care provider to assist in the discussion regarding theircare. Relevance: It is generally acknowledged that the internet is the first place people will go when searching for information on an illness or health and pregnancy related topic is the. Nowmidwives have a site that they, and women, can trust.

Pregnancy Web Sites for Women and Families

Women who are pregnant or thinking of becoming pregnant are often filled with questions they may consider too trivial to ask their health care provider, or they think of them after leaving the doctor's office. Often they attempt to get answers by searching the Internet. Most of those who go online use a search engine, but unfortunately most never check the source of the information they access. The types of questions pregnant women have can be as simple as, “Can I have caffeine,” or “How do I know whether I am really in labor,” and the results they find most quickly online can be highly inaccurate and potentially harmful. Helping pregnant patrons by suggesting reliable Web sites is one of the most valuable services a librarian can offer.

The Home Pregnancy Test: A Feminist Technology?

In the United States, one of the primary ways that the feminist movement has worked to overcome gender bias has been through changes in the law and public policy. Technologies are forms of legislation (Winner 1977) that have not yet received the level of feminist attention they deserve.1 As Win ner observed, Just as surely as . . . the laws and regulations of government, technological design is a place where some basic decisions are made about the identities and relationships, power and status, life and limits upon these chances (2002,1). Hence, it is important to work toward the achieve ment of feminist technologies (Layne, forthcoming). In this essay, I examine the home pregnancy test as a candidate for femi nist technology. Home pregnancy tests have been promoted and greeted as libratory for women.They are relatively low cost and easy for women in the United States to obtain and use. In addition, they are noninvasive, pose no apparent health risks, and boast high levels of accuracy. In other words, they appear to be the very type of technology advocated by the women's health movement and by science and technology studies scholars who seek more democratic design and use of technoscience. Yet examination of ninety-two first-person accounts of use posted between 2003 and 2005 as part of a U.S. National Institutes of Health (NIH) project on the history of the test, ac counts published on a pregnancy website, and the newsletters of two U.S. pregnancy loss support organizations spanning the period of 1981-2004 sug gest that the presumed benefits of this technology are not so clear.2 In fact, there are a number of hidden costs that come into relief when we examine

Digitizing race: visual cultures of the Internet

In the nineties, neoliberalism simultaneously provided the context for the Internets rapid uptake in the United States and discouraged public conversations about racial politics. At the same time many scholars lauded the widespread use of text-driven interfaces as a solution to the problem of racial intolerance. Todays online world is witnessing text-driven interfaces such as e-mail and instant messaging giving way to far more visually intensive and commercially driven media forms that not only reveal but showcase peoples racial, ethnic, and gender identity. Lisa Nakamura, a leading scholar in the examination of race in digital media, uses case studies of popular yet rarely examined uses of the Internet such as pregnancy Web sites, instant messaging, and online petitions and quizzes to look at the emergence of race-, ethnic-, and gender-identified visual cultures. While popular media such as Hollywood cinema continue to depict nonwhite nonmales as passive audiences or consumers of digital media rather than as producers, Nakamura argues the contrarywith examples ranging from Jennifer Lopez music videos; films including the Matrix trilogy, Gattaca, and Minority Report; and online joke sitesthat users of color and women use the Internet to vigorously articulate their own types of virtual community, avatar bodies, and racial politics. Lisa Nakamura is associate professor of speech communication and Asian American studies at the University of Illinois, Urbana-Champaign. She is the author of Cybertypes: Race, Ethnicity, and Identity on the Internet and coeditor, with Beth Kolko and Gilbert Rodman, of Race in Cyberspace.

LAURISTON S. TAYLOR LECTURE: FIFTY YEARS OF SCIENTIFIC RESEARCH: THE IMPORTANCE OF SCHOLARSHIP AND THE INFLUENCE OF POLITICS AND CONTROVERSY

Over the past 50 years our laboratory has performed and published many studies in the fields of teratology, radiation biology and radiation embryology. The early work took place when I was a research employee at the University of Rochester Manhattan Project in 1944 and where I had my introduction to embryology and genetics. Over the years our lab has provided consultations dealing with the risks of various environmental toxicant exposures during pregnancy. With the advent of the Internet, consulting has become more rapid and efficient. In the past year our pregnancy Web site of the Health Physics Society received approximately 154,000 hits, of which over a thousand contacts were still quite anxious after reading the Web site answers and requested a personal consultation. From this extensive experience we have learned that many physicians and other counselors are not prepared to counsel patients concerning radiation risks. Approximately 8% of the patient contacts who have consulted a professional have been provided with inaccurate information that would have resulted in an unnecessary interruption of a wanted pregnancy. There are five areas of radiation embryology that are considered to be controversial. 1) Can the fetus be harmed by ionizing radiation if the fetus is not directly exposed? 2) Is the production of mental retardation from radiation during pregnancy a threshold phenomenon? 3) Does fractionation and protraction of radiation decrease the magnitude of the reproductive and developmental risks? 4) Is there a period during pregnancy when radiation will result in an increased mortality but not an increase in malformations? 5) How sensitive is the fetus to the oncogenic effects of radiation? We utilize the scientific information obtained from studies in these five areas to counsel patients concerning pregnancy radiation risks. The willingness and persistence of scientists to debate the controversial aspects of this research and apply the best available scientific information to assist patients in turmoil about the risks of radiation to themselves and their offspring has saved thousand of lives and changed family histories.

HIV and Pregnancy Web Sites.

This column reviews seven Web sites that address HIV and pregnancy.