Catherine Daily CNM, DNP, Ashley Gresh CNM, PhD, Elizabeth R. Hamilton MPH, CPHQ, Christina X. Marea CNM, PhD, MA, MSN
The use of telehealth prenatal care increased exponentially during the coronavirus disease 2019 (COVID-19) pandemic, but there is no literature describing its use for group prenatal care during this time. The COVID-19 pandemic also exacerbated structural barriers to care that disproportionately affect Black and Latinx people. Telehealth enabled pregnant people to access health care and minimize infectious risks. Telehealth group prenatal care (T-GPNC) incorporated the essential elements of CenteringPregnancy with telehealth is an innovative care delivery method borne out of necessity during the COVID-19 pandemic that has potential to mitigate structural barriers to care.
Mary's Center is a federally qualified health center (FQHC) in Washington, DC, and Maryland that rapidly pivoted to individual telehealth prenatal care early in the pandemic. Mary's Center used our experience with group care and guidance from the Centering Healthcare Institute on virtual Centering to launch T-GPNC. This new model included home self-monitoring equipment and video classrooms, mixed with in-person individual care visits. We used a team-based approach with nurses, midwives, and community health workers to provide holistic care to pregnant people. Our robust care coordination team also connected them to home visiting, mental health services, and nutrition counseling.
The purpose of this article is to describe how Mary's Center modified the CenteringPregnancy model of group prenatal care for telehealth, following the hallmarks of CenteringPregnancy, and met the needs of Spanish-speaking clients, henceforth Latinx clients. A secondary purpose is to demonstrate how telehealth can expand access to health care and remove structural barriers that may prevent pregnant people from attending in-person appointments. We also discuss the structural inequities in digital access and literacy in the context of program implementation.
{"title":"Adapting Group Prenatal Care for Telehealth: A COVID-Era Innovation to Address Barriers to Care for Latinx Clients","authors":"Catherine Daily CNM, DNP, Ashley Gresh CNM, PhD, Elizabeth R. Hamilton MPH, CPHQ, Christina X. Marea CNM, PhD, MA, MSN","doi":"10.1111/jmwh.13701","DOIUrl":"10.1111/jmwh.13701","url":null,"abstract":"<p>The use of telehealth prenatal care increased exponentially during the coronavirus disease 2019 (COVID-19) pandemic, but there is no literature describing its use for group prenatal care during this time. The COVID-19 pandemic also exacerbated structural barriers to care that disproportionately affect Black and Latinx people. Telehealth enabled pregnant people to access health care and minimize infectious risks. Telehealth group prenatal care (T-GPNC) incorporated the essential elements of CenteringPregnancy with telehealth is an innovative care delivery method borne out of necessity during the COVID-19 pandemic that has potential to mitigate structural barriers to care.</p><p>Mary's Center is a federally qualified health center (FQHC) in Washington, DC, and Maryland that rapidly pivoted to individual telehealth prenatal care early in the pandemic. Mary's Center used our experience with group care and guidance from the Centering Healthcare Institute on virtual Centering to launch T-GPNC. This new model included home self-monitoring equipment and video classrooms, mixed with in-person individual care visits. We used a team-based approach with nurses, midwives, and community health workers to provide holistic care to pregnant people. Our robust care coordination team also connected them to home visiting, mental health services, and nutrition counseling.</p><p>The purpose of this article is to describe how Mary's Center modified the CenteringPregnancy model of group prenatal care for telehealth, following the hallmarks of CenteringPregnancy, and met the needs of Spanish-speaking clients, henceforth Latinx clients. A secondary purpose is to demonstrate how telehealth can expand access to health care and remove structural barriers that may prevent pregnant people from attending in-person appointments. We also discuss the structural inequities in digital access and literacy in the context of program implementation.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"945-951"},"PeriodicalIF":2.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sheila Kaufman CNM, WHNP-BC, MSN, Patricia D. Suplee RNC-OB, PhD, Damali M. Campbell-Oparaji MD, Julie Blumenfeld CNM, DNP
Screening for substance use disorder (SUD) is an essential part of antepartum care. Best practice for screening requires the use of a validated tool early in pregnancy to identify those at risk and to connect them with counseling and treatment. In many health systems and practices, urine toxicology testing is erroneously employed as a SUD screening tool despite consistent recommendations against its routine use. The results are often misinterpreted as diagnostic of SUD and can have harmful downstream effects for pregnant and birthing people. This Clinical Rounds reviews the tools available for evidence-based SUD screenings in pregnancy care, pitfalls of urine toxicology testing, and ways in which midwifery care is well-positioned to implement evidence-based screening practices in pregnancy care.
药物使用障碍（SUD）筛查是产前护理的重要组成部分。筛查的最佳实践要求在孕早期使用有效的工具来识别高危人群，并为他们提供咨询和治疗。在许多医疗系统和医疗实践中，尿液毒理学检测被错误地用作 SUD 筛查工具，尽管一直有反对常规使用该工具的建议。其结果往往被误解为对药物滥用的诊断，并可能对孕妇和分娩者造成有害的下游影响。本临床讨论回顾了在孕期保健中进行循证 SUD 筛查的可用工具、尿液毒理学检测的误区，以及助产护理在孕期保健中实施循证筛查实践的有利条件。
{"title":"Implementing Best Practice When Screening Birthing People for a Substance Use Disorder","authors":"Sheila Kaufman CNM, WHNP-BC, MSN, Patricia D. Suplee RNC-OB, PhD, Damali M. Campbell-Oparaji MD, Julie Blumenfeld CNM, DNP","doi":"10.1111/jmwh.13697","DOIUrl":"10.1111/jmwh.13697","url":null,"abstract":"<p>Screening for substance use disorder (SUD) is an essential part of antepartum care. Best practice for screening requires the use of a validated tool early in pregnancy to identify those at risk and to connect them with counseling and treatment. In many health systems and practices, urine toxicology testing is erroneously employed as a SUD screening tool despite consistent recommendations against its routine use. The results are often misinterpreted as diagnostic of SUD and can have harmful downstream effects for pregnant and birthing people. This Clinical Rounds reviews the tools available for evidence-based SUD screenings in pregnancy care, pitfalls of urine toxicology testing, and ways in which midwifery care is well-positioned to implement evidence-based screening practices in pregnancy care.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"952-957"},"PeriodicalIF":2.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Si ha quedado embarazada pero no planeaba estarlo, será necesario decidir si desea continuar con el embarazo. Recuerde que no está sola, esto es una situación común ya que en los Estados Unidos aproximadamente la mitad de las personas que quedan embarazadas no planeaban estarlo. Si piensa que está embarazada, es importante consultar a un proveedor de atención médica para verificar si esto es el caso.</p><p>Cuando uno descubre que está embarazada, es normal estar emocional e incluso tener sentimientos encontrados. Es posible que se sienta asustada, enojada, feliz o emocionada. Lo primero será decidir si quiere seguir embarazada, o si prefiere interrumpir el embarazo. Si decide continuar con el embarazo, deberá decidir si va a querer criar al niño o si prefiere un plan de adopción. Si decide interrumpir el embarazo, es posible que necesite elegir qué tipo de aborto se realizará. Estas decisiones son importantes y sólo usted puede hacerlas. Es probable que querrá saber todo lo posible acerca de sus opciones antes de llegar a una decisión.</p><p>La crianza de los hijos es una gran responsabilidad, y ser madre tiene sus momentos felices y también difíciles. Los niños necesitan mucha atención y cuidado. Si decide criar a este bebé, será responsable de la vida de su hijo en todos los sentidos y su vida tendrá que cambiar de muchas maneras.</p><p>La adopción es un acuerdo legal entre usted y otra(s) persona(s) las cuales se convertirán en los padres legales de su bebé. Las personas quienes eligen un plan de adopción para su hijo(a) a menudo lo hacen porque sienten que otro hogar podrá brindarle más a su bebé de lo que ellas mismas podrían. Si usted decide por un plan de adopción, podrá elegir cuánto contacto desea tener con su hijo después de la adopción (desde ningún contacto hasta contacto regular). Una agencia de adopción o un abogado (o ambos) le brindaran apoyo pare encontrar un hogar para su bebé. Es muy importante que un profesional en el ámbito de adopción asesore su situación y le brinde consejo antes de que usted tome una decisión permanente.</p><p>Hay 2 tipos de aborto. En la etapa temprana del embarazo, es posible tomar medicamentos de receta los cuales consiguen que el cuerpo elimine el embarazo. Este proceso es algo similar a un aborto espontáneo. Otra opción es que un proveedor médico evacue el tejido del embarazo (aborto quirúrgico). A este procedimiento también se le conoce como “aspiración”, “legrado”, o “dilatación y evacuación”. En los primeros meses de embarazo el aborto quirúrgico es simple y se puede realizar en una clínica o consultorio médico. Si el embarazo va más adelantado, el aborto quirúrgico debe realizarse en un hospital o clínica. Dependiendo en el estado en el cual uno viva, el acceso al aborto puede estar muy restringido o, incluso, prohibido. Quizás tendrá que viajar a otro estado para recibir un aborto. Si es menor de edad (18 años) y no puede decirle a sus padres que quiere un aborto, es posible que pueda conversa
{"title":"El embarazo no planificado: ¿Qué debo hacer?","authors":"","doi":"10.1111/jmwh.13678","DOIUrl":"https://doi.org/10.1111/jmwh.13678","url":null,"abstract":"<p>Si ha quedado embarazada pero no planeaba estarlo, será necesario decidir si desea continuar con el embarazo. Recuerde que no está sola, esto es una situación común ya que en los Estados Unidos aproximadamente la mitad de las personas que quedan embarazadas no planeaban estarlo. Si piensa que está embarazada, es importante consultar a un proveedor de atención médica para verificar si esto es el caso.</p><p>Cuando uno descubre que está embarazada, es normal estar emocional e incluso tener sentimientos encontrados. Es posible que se sienta asustada, enojada, feliz o emocionada. Lo primero será decidir si quiere seguir embarazada, o si prefiere interrumpir el embarazo. Si decide continuar con el embarazo, deberá decidir si va a querer criar al niño o si prefiere un plan de adopción. Si decide interrumpir el embarazo, es posible que necesite elegir qué tipo de aborto se realizará. Estas decisiones son importantes y sólo usted puede hacerlas. Es probable que querrá saber todo lo posible acerca de sus opciones antes de llegar a una decisión.</p><p>La crianza de los hijos es una gran responsabilidad, y ser madre tiene sus momentos felices y también difíciles. Los niños necesitan mucha atención y cuidado. Si decide criar a este bebé, será responsable de la vida de su hijo en todos los sentidos y su vida tendrá que cambiar de muchas maneras.</p><p>La adopción es un acuerdo legal entre usted y otra(s) persona(s) las cuales se convertirán en los padres legales de su bebé. Las personas quienes eligen un plan de adopción para su hijo(a) a menudo lo hacen porque sienten que otro hogar podrá brindarle más a su bebé de lo que ellas mismas podrían. Si usted decide por un plan de adopción, podrá elegir cuánto contacto desea tener con su hijo después de la adopción (desde ningún contacto hasta contacto regular). Una agencia de adopción o un abogado (o ambos) le brindaran apoyo pare encontrar un hogar para su bebé. Es muy importante que un profesional en el ámbito de adopción asesore su situación y le brinde consejo antes de que usted tome una decisión permanente.</p><p>Hay 2 tipos de aborto. En la etapa temprana del embarazo, es posible tomar medicamentos de receta los cuales consiguen que el cuerpo elimine el embarazo. Este proceso es algo similar a un aborto espontáneo. Otra opción es que un proveedor médico evacue el tejido del embarazo (aborto quirúrgico). A este procedimiento también se le conoce como “aspiración”, “legrado”, o “dilatación y evacuación”. En los primeros meses de embarazo el aborto quirúrgico es simple y se puede realizar en una clínica o consultorio médico. Si el embarazo va más adelantado, el aborto quirúrgico debe realizarse en un hospital o clínica. Dependiendo en el estado en el cual uno viva, el acceso al aborto puede estar muy restringido o, incluso, prohibido. Quizás tendrá que viajar a otro estado para recibir un aborto. Si es menor de edad (18 años) y no puede decirle a sus padres que quiere un aborto, es posible que pueda conversa","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 5","pages":"811-812"},"PeriodicalIF":2.1,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The American College of Nurse-Midwives Lifetime Visionary Award 2024: Marsha Elaine Caldwell Jackson, CNM, MSN, FACNM","authors":"","doi":"10.1111/jmwh.13694","DOIUrl":"10.1111/jmwh.13694","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 5","pages":"629"},"PeriodicalIF":2.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Research and Professional Literature to Inform Practice, September/October 2024","authors":"Amy Alspaugh CNM, PhD, MSN","doi":"10.1111/jmwh.13692","DOIUrl":"10.1111/jmwh.13692","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 5","pages":"790-795"},"PeriodicalIF":2.1,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Are you one of the many American College of Nurse-Midwives (ACNM) members who reads the <i>Journal of Midwifery & Women's Health</i> (<i>JMWH</i>) when your copy of arrives in the mail every 2 months? If so, you are in a small majority. A <i>JMWH</i> March 2024 ACNM member survey revealed that just over 50% of respondents read the Journal when it arrives in their mailbox. However, you may be missing out on <i>JMWH</i>’s online offerings, including earlier access to excellent research and scholarship.</p><p>Did you know that articles are published online in <i>Early View</i> as soon as the publication processes are complete? This occurs before an article appears in a print issue and lands in your mailbox. Newly published articles can be found on the Journal's homepage at jmwh.org. Along with finding the most recently published articles online, readers can check and see which articles have been cited or downloaded most often. ACNM members and other readers can sign up to receive alerts with article links as soon they are published online. Email alerts can be selected for monthly, weekly, or daily notification. ACNM members can also locate instructions on the <i>JMWH</i> homepage to access all <i>JMWH</i> articles back to our 1955 founding via the ACNM website.</p><p>ACNM members receive the electronic table of contents (eTOC) via email when each new compiled issue goes up online, a few weeks before the hard copy arrives in the mail. ACNM membership staff can help members who have had an email address change, or who may have opted out of an association email, and thus are not receiving the eTOC.</p><p>Under the <i>About</i> dropdown menu on the homepage, readers can find information about the <i>JMWH</i> Editors and Editorial Board. The <i>JMWH</i> Aims and Scope, our recent <i>Statement of Inclusivity</i>, and other helpful information are also available.</p><p>The <i>JMWH</i> column <i>Ask the Midwife</i>, available via handouts that can be downloaded or printed freely, is a great resource to share with your patients. <i>Ask the Midwife</i> is located on both the homepage, and at a separate link from the homepage <i>Ask the Midwife</i> dropdown menu. This is a frequently used <i>JMWH</i> resource.</p><p>The <i>JMWH</i> website has information about the Journal to help authors, welcome and support peer reviewers, and share collections of our recent work on current topics with readers. From the <i>JMWH</i> homepage <i>Contribute</i> dropdown menu, authors can link to <i>JMWH</i> Instructions for Authors and the <i>JMWH</i> Preparation and Style Guide, invaluable resources for preparing manuscripts for submission. Authors can find information about citations and full text views of their article by linking to the article on the website. Likewise, individuals interested in becoming a peer reviewer or who are current reviewers can find resources and helpful information about peer review and <i>JMWH</i>.</p><p><i>JMWH</i> leadership provides a num
{"title":"Midwifery Information at Your Fingertips: The Journal of Midwifery & Women's Health Online","authors":"Melissa D. Avery CNM, PhD","doi":"10.1111/jmwh.13689","DOIUrl":"10.1111/jmwh.13689","url":null,"abstract":"<p>Are you one of the many American College of Nurse-Midwives (ACNM) members who reads the <i>Journal of Midwifery & Women's Health</i> (<i>JMWH</i>) when your copy of arrives in the mail every 2 months? If so, you are in a small majority. A <i>JMWH</i> March 2024 ACNM member survey revealed that just over 50% of respondents read the Journal when it arrives in their mailbox. However, you may be missing out on <i>JMWH</i>’s online offerings, including earlier access to excellent research and scholarship.</p><p>Did you know that articles are published online in <i>Early View</i> as soon as the publication processes are complete? This occurs before an article appears in a print issue and lands in your mailbox. Newly published articles can be found on the Journal's homepage at jmwh.org. Along with finding the most recently published articles online, readers can check and see which articles have been cited or downloaded most often. ACNM members and other readers can sign up to receive alerts with article links as soon they are published online. Email alerts can be selected for monthly, weekly, or daily notification. ACNM members can also locate instructions on the <i>JMWH</i> homepage to access all <i>JMWH</i> articles back to our 1955 founding via the ACNM website.</p><p>ACNM members receive the electronic table of contents (eTOC) via email when each new compiled issue goes up online, a few weeks before the hard copy arrives in the mail. ACNM membership staff can help members who have had an email address change, or who may have opted out of an association email, and thus are not receiving the eTOC.</p><p>Under the <i>About</i> dropdown menu on the homepage, readers can find information about the <i>JMWH</i> Editors and Editorial Board. The <i>JMWH</i> Aims and Scope, our recent <i>Statement of Inclusivity</i>, and other helpful information are also available.</p><p>The <i>JMWH</i> column <i>Ask the Midwife</i>, available via handouts that can be downloaded or printed freely, is a great resource to share with your patients. <i>Ask the Midwife</i> is located on both the homepage, and at a separate link from the homepage <i>Ask the Midwife</i> dropdown menu. This is a frequently used <i>JMWH</i> resource.</p><p>The <i>JMWH</i> website has information about the Journal to help authors, welcome and support peer reviewers, and share collections of our recent work on current topics with readers. From the <i>JMWH</i> homepage <i>Contribute</i> dropdown menu, authors can link to <i>JMWH</i> Instructions for Authors and the <i>JMWH</i> Preparation and Style Guide, invaluable resources for preparing manuscripts for submission. Authors can find information about citations and full text views of their article by linking to the article on the website. Likewise, individuals interested in becoming a peer reviewer or who are current reviewers can find resources and helpful information about peer review and <i>JMWH</i>.</p><p><i>JMWH</i> leadership provides a num","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 5","pages":"633"},"PeriodicalIF":2.1,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13689","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
During pregnancy, you can eat most of the same things that you normally eat when you are not pregnant. Your immune system is less strong during pregnancy. Especially in the first few months of your pregnancy, your baby can be hurt by toxins (poisons) or bacteria (germs). For this reason, you need to be aware of these food dangers and learn how to choose and prepare your food safely. The back side of this page has more information on each of the foods described below.
This page may be reproduced for noncommercial use by health care professionals to share with clients. Any other reproduction is subject to JMWH approval. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JMWH suggests that you consult your health care provider.
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