Journal of midwifery & women's health
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J Midwifery Womens Health · Jan 2019
Feasibility and Acceptability of a Checklist and Learning Collaborative to Promote Quality and Safety in the Perinatal Care of Women with Opioid Use Disorders.
Perinatal opioid use disorder (OUD) represents a maternal-child health crisis in the United States. Untreated, OUD is associated with maternal and neonatal morbidity due to infectious disease, polysubstance use, co-occurring mental health conditions, prematurity, neonatal opioid withdrawal, and maternal mortality from overdose. Although national guidelines exist to optimize perinatal care for women with OUD, wide variation persists in health care providers' experience caring for this population and in the quality of care delivered. ⋯ Implementation of a checklist to facilitate best practice in the care of pregnant women with OUD is feasible, acceptable to maternity care providers, and represents a promising approach to improving quality of care for this vulnerable population. Additional research is needed to determine whether improvement in quality can transform perinatal outcomes.
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J Midwifery Womens Health · Jul 2018
Yoga and Quality of Life in Women with Primary Dysmenorrhea: A Systematic Review.
Primary dysmenorrhea is a prevalent condition causing quality of life (QOL) reduction for many women, resulting from pain as well as parallel social and psychological distress. Yoga reduces pain and sympathetic reactivity, thus promoting QOL. This article reports a systematic review of the evidence for the effectiveness of yoga as a QOL improvement method for women with primary dysmenorrhea. ⋯ Practitioners may consider yoga for management of primary dysmenorrhea. However, future research using larger RCTs of high methodological quality is needed to ascertain the magnitude of yoga's clinical significance.
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J Midwifery Womens Health · May 2018
Reduction of Peripartum Racial and Ethnic Disparities: A Conceptual Framework and Maternal Safety Consensus Bundle.
Racial and ethnic disparities exist in both perinatal outcomes and health care quality. For example, black women are 3 to 4 times more likely to die from pregnancy-related causes and have more than a 2-fold greater risk of severe maternal morbidity than white women. In an effort to achieve health equity in maternal morbidity and mortality, a multidisciplinary workgroup of the National Partnership for Maternal Safety, within the Council on Patient Safety in Women's Health Care, developed a concept article for the bundle on reduction of peripartum disparities. We aimed to provide health care providers and health systems with insight into racial and ethnic disparities in maternal outcomes, the etiologies that are modifiable within a health care system, and resources that can be used to address these etiologies and achieve the desired end of safe and equitable health care for all childbearing women.
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J Midwifery Womens Health · Jan 2018
ReviewDifferentiating Research, Quality Improvement, and Case Studies to Ethically Incorporate Pregnant Women.
Pregnant women have been called therapeutic orphans because data supporting common interventions, medications, health teaching, and models of care are meager. The generation of quality evidence benefits from proactive approaches that ensure ethical standards are met to protect participants. The purpose of this article is to differentiate among health care, quality improvement, and research and to discuss ethical involvement of women who are pregnant and potentially childbearing in these initiatives. ⋯ Traditional research activities, including clinical trials, remain crucial. However, to fill gaps in knowledge, we must expedite our ability to report informative cases, examine clinical data, share lessons learned during quality improvement campaigns, and publish and disseminate these findings. Accelerating improvements in care demands expansion of the evidence base.
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J Midwifery Womens Health · Jan 2018
Prevalence of Prolonged Latent Phase and Labor Outcomes: Review of Birth Records in a Swedish Population.
The prevalence of a prolonged latent phase of labor has been described as ranging from 5% to 6.5% in previous research. The aim of this study was to describe the prevalence of the prolonged latent phase of 18 hours or more, based on women's report, in women intending vaginal birth and who had spontaneous onset of labor. An additional aim was to compare the incidence of obstetric interventions, and the labor and neonatal outcomes in women with and without a prolonged latent phase. ⋯ Based on women's self-report, the prevalence of a prolonged latent phase in women at term who planned a vaginal birth and had spontaneous onset of labor was higher than previously reported. Women with a prolonged latent phase were more likely to receive obstetric interventions. Assisted vaginal birth was more common for nulliparous women with prolonged latent phase and emergency cesarean occurred more frequently for both nulliparous women and multiparous women with a prolonged latent phase.