Journal of midwifery & women's health最新文献

Mental health is how you think, feel, act, and handle emotions. It includes your psychological, emotional, and social well-being. Your mental health affects your physical health, relationships, and ability to do daily activities. It influences how you cope with life and stress, learn and work, and make decisions. Taking care of your mental health is important for staying healthy, having good relationships, handling stress well, and adapting to change and difficult times.

If you are experiencing times of stress or loss, consider working with a mental health professional especially if you are having trouble performing your daily activities. Talk to your health care provider if you are experiencing any of the above symptoms. They may recommend talk therapy and/or medication. Insurance often pays for access to therapy. If you have thoughts of hurting yourself or someone else, get help right away. Go to the closest emergency room or call 911. You can also call the National Suicide Prevention Lifeline 24 hours a day at 1-800-273-TALK (8255), or the Suicide and Crisis Lifeline 988 available in English or Spanish.

Flesch Kincaid reading level 6.8

Approved December 2024.

This handout may be reproduced for noncommercial use by health care professionals to share with patients, but modifications to the handout are not permitted. The information and recommendations in this handout are not a substitute for health care. Consult your health care provider for information specific to you and your health.

As access to doula services expands through state Medicaid coverage and specific initiatives aimed at improving maternal health equity, there is a need to build and improve upon relationships between the doula community, hospital leaders, and clinical staff. Previous research and reports suggest rapport-building, provider education, and forming partnerships between community-based organizations and hospitals can improve such relationships. However, few interventions or programs incorporating such approaches are described in the literature. This article describes the development and 5 core components of the Champion Dyad Initiative (CDI), a novel program that uses bidirectional feedback between SisterWeb, a community-based doula organization, and 5 clinical sites (4 hospitals and one birthing center) to ensure pregnant and birthing people receive fair and equitable treatment. We also describe implementation challenges related to documentation, funding, and institutional support. The CDI is a promising model for community-based doula organizations and health care institutions to develop collaborative partnerships, build respectful doula-provider relationships, and work toward improving the pregnancy-related care that Black, Indigenous, and people of color receive in hospital and birth center settings. It is our hope that this innovative initiative can serve as a model that can be adapted for other locales, organizations, and hospitals.

As we welcome 2025 and begin celebrating 70 years of the American College of Nurse-Midwives (ACNM) and the Journal of Midwifery & Women's Health (JMWH), a recent World Health Organization (WHO) report¹ should be in the hands of every practicing midwife. In the United States in particular, this position paper can help promote midwifery care models at the federal, state, local, and health system practice levels. WHO recommends a transition to midwifery care models worldwide, linked to a strategy of primary health care as part of attaining universal health coverage.

WHO urges moving from fragmented and risk-focused care approaches to midwifery models of care so that women and newborns receive “equitable, person-centred, respectful, integrated and high-quality care, provided and coordinated by midwives working within collaborative interdisciplinary teams”^1(p8) prior to pregnancy through the postpartum period. The report notes that while the terms women and mothers are used, the recommendations are inclusive of all individuals identifying as women and all persons who give birth. Although improvements have been made in maternal and neonatal outcomes globally, many challenges remain. Improvements are needed in both access to health care and the provision of high-quality care. In addition, inappropriate use of medical interventions is highlighted as a barrier to improving perinatal outcomes.

Midwifery models of care are defined as those consistent with midwifery philosophy and where the care is provided by autonomous midwives who are educated, licensed, and regulated. Midwives provide high-quality care that is person-centered, based on a relationship between the midwife and the woman, promotes physiologic processes, with interventions used only when needed. Care is coordinated within resourced and functional health systems where interprofessional teams function with respect and trust. These care models are modifiable to be used in all care settings and related contexts.¹

Principles of midwifery models of care include (1) access to equitable and human rights–based care for all women and newborns, (2) person-centered and respectful care in a partnership between women and midwives, (3) high-quality care consistent with midwifery philosophy, (4) care provided by autonomous, educated, regulated midwives throughout health systems, and (5) midwives are integrated into interprofessional care teams.¹ By using models incorporating these principles, WHO believes a transition to midwifery models can save lives, improve women's and newborns' health outcomes, improve satisfaction with care, reduce health inequities, promote women's rights, and maximize the use of health care resources.¹

In making the case for midwifery care models, the WHO report synthesizes recent research and other repo

Las parteras en los Estados Unidos (EE. UU.) proporcionan servicios de atención médica a individuos en todas las etapas de la vida. Colaboran con sus pacientes/clientes en la toma de decisiones importantes sobre su salud. Trabajan en conjunto con otros miembros del equipo de atención médica cuando es necesario. También pueden ser proveedoras de atención primaria.

Es importante aclarar que el término “partera” en Latinoamérica no corresponde a la profesión de partería que se practica en EE. UU. El tipo de educación, el proceso de acreditación para ejercer esta profesión, la percepción cultural, el respaldo legal, y la relación con otros profesionales de la salud y con los centros de salud que tienen las parteras en EE.UU son diferentes que en muchas otras partes del mundo. Las parteras en EE. UU. tienen un alcance profesional que es parecido al de los gineco-obstetras, aunque con diferencias importantes.

Las enfermeras parteras certificadas (CNM, por sus siglas en inglés) y parteras certificadas (CM, por sus siglas en inglés) se han educado en programas acreditados y han aprobado un examen de certificación nacional. Deben tener una licencia para practicar en el estado donde trabajan. Tanto las CNM como las CM atienden a sus pacientes en todos los tipos de centros de salud, incluyendo los hospitales, los centros de maternidad, clínicas o consultorios, y también en el hogar. Proporcionan atención general durante el embarazo (seguimiento prenatal) y durante el parto, atención de salud reproductiva y también cuidado primario. Pueden recetar la mayoría de los medicamentos. Tanto las CNM como las CM pueden cuidar a los recién nacidos durante los primeros 30 días de vida.

Las parteras certificadas profesionales (CPM, por sus siglas en inglés) pueden haber tenido capacitación como aprendices o pueden haberse graduado de un programa de educación acreditado. Han tomado un examen de certificación nacional diferente al que toman las CNM o las CM. Las CPM proveen cuidado durante el embarazo, el nacimiento y después del parto en entornos comunitarios, usualmente en centros de maternidad o en los hogares. También proveen cuidado de los recién nacidos. No pueden recetar la mayoría de los medicamentos. Tampoco trabajan en hospitales.

La mayoría de las parteras en EE. UU. son CNM y tienen licencia en los 50 estados. No todos los estados conceden licencia a las CM ó a las CPM.

Las parteras proveen atención durante el embarazo, el trabajo de parto, el nacimiento y el posparto. También atienden a bebés recién nacidos. Las CNM y las CM cuidan a aproximadamente 1 de cada 10 mujeres que dan a luz cada año en EE. UU. Además de ser expertas en salud reproductiva, las CNM y las CM proveen atención primaria de salud. Los cuidados que brindan incluyen exámenes físicos anuales, planificación familiar, cuidado durante la menopausia, detección y tratamiento de infecciones de transmisión sexual y otros problemas de salud. Las