Carrie E. Neerland CNM, PhD, APRN, Melissa A. Saftner CNM, PhD, MBA, APRN, Stephanie Delkoski DNP, APRN, WHNP-BC, Erin Galegher CNM, DNP, MPH, APRN, Maria Ruud DNP, APRN, WHNP-BC, Anne Woll MS, Joseph M. Miller BS, CHSE, David Melchionne-Martinez MA, OTA, Lou Clark PhD, MFA
The US Supreme Court's 2022 decision in Dobb's v Jackson Women's Health Organization, which overturned Roe v Wade, has led to varying state-level restrictions and expansions in abortion access. In Minnesota, certified nurse-midwives and advanced practice registered nurses, including women's health nurse practitioners, were granted the ability to provide medication abortion. This expanded role necessitates comprehensive education to ensure students are equipped with the skills and confidence to provide high-quality abortion care. Simulation-based training, particularly using simulated patient (SP) methodology, offers an effective approach to preparing students for medication abortion care. An interprofessional team at the University of Minnesota School of Nursing developed an SP-based simulation curriculum to supplement midwifery and women's health student's training in medication abortion. The curriculum, designed using the Association of SP Educators’ Standards of Best Practice, provided students with the opportunity to practice patient counseling, consent, and medication dispensing in a safe and supportive environment. The simulation was implemented with 20 midwifery and women's health students. Students highlighted the simulation's effectiveness in improving confidence, with some suggesting more detailed presimulation preparation. The SP-based simulation effectively enhanced students' perceived clinical skills and confidence in providing medication abortion care. The positive feedback emphasizes the value of SP-based simulation in preparing students for emerging clinical needs. Future improvements could include earlier didactic content and broader simulation scenarios. This innovation demonstrates the need for accessible and high-quality medication abortion care training to address disparities in health care access.
{"title":"Development of a Medication Abortion Simulation for Midwifery and Women's Health Nurse Practitioner Students: Not Just Another Sim","authors":"Carrie E. Neerland CNM, PhD, APRN, Melissa A. Saftner CNM, PhD, MBA, APRN, Stephanie Delkoski DNP, APRN, WHNP-BC, Erin Galegher CNM, DNP, MPH, APRN, Maria Ruud DNP, APRN, WHNP-BC, Anne Woll MS, Joseph M. Miller BS, CHSE, David Melchionne-Martinez MA, OTA, Lou Clark PhD, MFA","doi":"10.1111/jmwh.13786","DOIUrl":"10.1111/jmwh.13786","url":null,"abstract":"<p>The US Supreme Court's 2022 decision in <i>Dobb's v Jackson Women's Health Organization</i>, which overturned <i>Roe v Wade</i>, has led to varying state-level restrictions and expansions in abortion access. In Minnesota, certified nurse-midwives and advanced practice registered nurses, including women's health nurse practitioners, were granted the ability to provide medication abortion. This expanded role necessitates comprehensive education to ensure students are equipped with the skills and confidence to provide high-quality abortion care. Simulation-based training, particularly using simulated patient (SP) methodology, offers an effective approach to preparing students for medication abortion care. An interprofessional team at the University of Minnesota School of Nursing developed an SP-based simulation curriculum to supplement midwifery and women's health student's training in medication abortion. The curriculum, designed using the Association of SP Educators’ Standards of Best Practice, provided students with the opportunity to practice patient counseling, consent, and medication dispensing in a safe and supportive environment. The simulation was implemented with 20 midwifery and women's health students. Students highlighted the simulation's effectiveness in improving confidence, with some suggesting more detailed presimulation preparation. The SP-based simulation effectively enhanced students' perceived clinical skills and confidence in providing medication abortion care. The positive feedback emphasizes the value of SP-based simulation in preparing students for emerging clinical needs. Future improvements could include earlier didactic content and broader simulation scenarios. This innovation demonstrates the need for accessible and high-quality medication abortion care training to address disparities in health care access.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 6","pages":"917-926"},"PeriodicalIF":2.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13786","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692860","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}
Heather M. Bradford CNM, PhD, Melicia Escobar CNM, WHNP-BC, DNP, Kathryn Atkin WHNP-BC, ANP-BC, DNP, Ella T. Heitzler WHNP-BC, FNP-BC, RNC-OB, PhD
<p>Pass rates on national certification examinations (NCEs) vary by health care profession and specialty.<span><sup>1-3</sup></span> Pass rates serve as critical indicators for both the student and the graduate education program. Improving pass rates is a challenge because ensuring examination success requires not only quality education, but critical thinking and test-taking skills. There is extensive research indicating that well-designed practice tests can serve as valuable tools in preparing for health care professional NCEs.<span><sup>4, 5</sup></span></p><p>Students of Accreditation Commission for Midwifery Education (ACME)-accredited midwifery and accredited women's health nurse practitioner (WHNP) education programs must successfully pass a comprehensive exam during their last term and meet program requirements to take the American Midwifery Certification Board (AMCB) and National Certification Corporation (NCC) WHNP NCEs, respectively, to become certified nurse-midwives/certified midwives (CNMs/CMs) or board certified WHNPs. AMCB overall certification pass rates have decreased from 91.8% in 2015 to 73.0% in 2024, and NCC WHNP overall certification pass rates have decreased from 94% in 2020 to 79.0% in 2024.<span><sup>1, 6, 7</sup></span> Consistent with national trends, AMCB and NCC pass rates among graduates of one large, distance-based education program also decreased.</p><p>In response to the pass rate trend and a goal to bolster students’ confidence, readiness, and knowledge, program leadership identified a critical need for an additional study resource. Consequently, over the course of 2 years, nurse-midwifery and WHNP faculty developed an online question bank of 600 multiple choice (MC) questions titled the <i>Review Portal</i>. Practice review of MC questions has been found to be an effective study technique, assisting with recall and requiring active, engaged learning rather than passively absorbing information from textbooks.<span><sup>8, 9</sup></span> The <i>Review Portal</i> was constructed in Canvas, a learning management system, and launched in 2018. It is a free resource to program students to assist with preparation for their comprehensive examinations and NCEs.</p><p>The design and development of the <i>Review Portal</i> was unique in many ways (see Table 1). First, to promote optimal review of midwifery content, the percentage of items was mapped to the AMCB examination proportionally by content area (see Table 2). It was not originally mapped to the NCC WHNP certification examination since pass rates among program graduates were higher on the NCC WHNP examination compared with the AMCB examination. However, except for intrapartum and newborn care, the content for both examinations is similar, so the resource was offered to students preparing for both examinations. Second, specific topics within each content area were determined using the AMCB and NCC WHNP Candidate Handbook blueprints.<span><sup>6, 10</sup></span> Altho
{"title":"Development of an Online Question Bank for Midwifery and Women's Health Nurse Practitioner Comprehensive and Certification Examination Preparation","authors":"Heather M. Bradford CNM, PhD, Melicia Escobar CNM, WHNP-BC, DNP, Kathryn Atkin WHNP-BC, ANP-BC, DNP, Ella T. Heitzler WHNP-BC, FNP-BC, RNC-OB, PhD","doi":"10.1111/jmwh.13784","DOIUrl":"10.1111/jmwh.13784","url":null,"abstract":"<p>Pass rates on national certification examinations (NCEs) vary by health care profession and specialty.<span><sup>1-3</sup></span> Pass rates serve as critical indicators for both the student and the graduate education program. Improving pass rates is a challenge because ensuring examination success requires not only quality education, but critical thinking and test-taking skills. There is extensive research indicating that well-designed practice tests can serve as valuable tools in preparing for health care professional NCEs.<span><sup>4, 5</sup></span></p><p>Students of Accreditation Commission for Midwifery Education (ACME)-accredited midwifery and accredited women's health nurse practitioner (WHNP) education programs must successfully pass a comprehensive exam during their last term and meet program requirements to take the American Midwifery Certification Board (AMCB) and National Certification Corporation (NCC) WHNP NCEs, respectively, to become certified nurse-midwives/certified midwives (CNMs/CMs) or board certified WHNPs. AMCB overall certification pass rates have decreased from 91.8% in 2015 to 73.0% in 2024, and NCC WHNP overall certification pass rates have decreased from 94% in 2020 to 79.0% in 2024.<span><sup>1, 6, 7</sup></span> Consistent with national trends, AMCB and NCC pass rates among graduates of one large, distance-based education program also decreased.</p><p>In response to the pass rate trend and a goal to bolster students’ confidence, readiness, and knowledge, program leadership identified a critical need for an additional study resource. Consequently, over the course of 2 years, nurse-midwifery and WHNP faculty developed an online question bank of 600 multiple choice (MC) questions titled the <i>Review Portal</i>. Practice review of MC questions has been found to be an effective study technique, assisting with recall and requiring active, engaged learning rather than passively absorbing information from textbooks.<span><sup>8, 9</sup></span> The <i>Review Portal</i> was constructed in Canvas, a learning management system, and launched in 2018. It is a free resource to program students to assist with preparation for their comprehensive examinations and NCEs.</p><p>The design and development of the <i>Review Portal</i> was unique in many ways (see Table 1). First, to promote optimal review of midwifery content, the percentage of items was mapped to the AMCB examination proportionally by content area (see Table 2). It was not originally mapped to the NCC WHNP certification examination since pass rates among program graduates were higher on the NCC WHNP examination compared with the AMCB examination. However, except for intrapartum and newborn care, the content for both examinations is similar, so the resource was offered to students preparing for both examinations. Second, specific topics within each content area were determined using the AMCB and NCC WHNP Candidate Handbook blueprints.<span><sup>6, 10</sup></span> Altho","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"812-814"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13784","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621618","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}
Briana E. Kramer CNM, MS, MPH, Amy Ushry RN, MPH, Andreea A. Creanga MD, PhD, Nicole Warren CNM, PhD, MSN, Cheri Wilson MA, MHS, Kelly M. Bower RN, PhD, MSN
Introduction
In response to alarming and persistent perinatal health inequities, policymakers, professional organizations, researchers, and advocates have called for the widescale dissemination of implicit bias training (IBT) for health care professionals. However, evaluations of such trainings are lacking. This study examines maternal health care professionals’ self-reports of knowledge, awareness, and skills changes after completing an IBT developed specifically for this audience.
Methods
We conducted a secondary analysis of qualitative responses to a posttest-only evaluation of a one-hour online IBT delivered to 2760 maternal health care professionals, 2257 (81.8%) of whom completed the evaluation survey. We applied reflexive thematic analysis to responses to 2 open-ended questions that directly addressed learning outcomes: (1) What did you learn that will help you in your practice? and (2) Please explain how this activity improved your competence. We then assessed the themes for alignment with Sukhera and Watling's conceptual framework for the integration of implicit bias recognition and management into training for health professionals.
Results
Five themes identified were foundational knowledge, general awareness, self-awareness, skills and strategies, and practice change. These themes mapped onto 5 of the 6 domains of the conceptual framework.
Discussion
A one-hour online IBT can lead to intended learner outcomes that align with a theorized framework reflecting an individual-level progression from increasing knowledge about implicit bias to building sensitivity to the experiential effects of one's bias on others. Learner responses indicate that building awareness of structural drivers and fostering a sense of acceptance and personal responsibility to address implicit bias may be additional key training components.
{"title":"Qualitative Evaluation of a Statewide Implicit Bias Training for Maternal Health Professionals","authors":"Briana E. Kramer CNM, MS, MPH, Amy Ushry RN, MPH, Andreea A. Creanga MD, PhD, Nicole Warren CNM, PhD, MSN, Cheri Wilson MA, MHS, Kelly M. Bower RN, PhD, MSN","doi":"10.1111/jmwh.13783","DOIUrl":"10.1111/jmwh.13783","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In response to alarming and persistent perinatal health inequities, policymakers, professional organizations, researchers, and advocates have called for the widescale dissemination of implicit bias training (IBT) for health care professionals. However, evaluations of such trainings are lacking. This study examines maternal health care professionals’ self-reports of knowledge, awareness, and skills changes after completing an IBT developed specifically for this audience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a secondary analysis of qualitative responses to a posttest-only evaluation of a one-hour online IBT delivered to 2760 maternal health care professionals, 2257 (81.8%) of whom completed the evaluation survey. We applied reflexive thematic analysis to responses to 2 open-ended questions that directly addressed learning outcomes: (1) What did you learn that will help you in your practice? and (2) Please explain how this activity improved your competence. We then assessed the themes for alignment with Sukhera and Watling's conceptual framework for the integration of implicit bias recognition and management into training for health professionals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five themes identified were foundational knowledge, general awareness, self-awareness, skills and strategies, and practice change. These themes mapped onto 5 of the 6 domains of the conceptual framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>A one-hour online IBT can lead to intended learner outcomes that align with a theorized framework reflecting an individual-level progression from increasing knowledge about implicit bias to building sensitivity to the experiential effects of one's bias on others. Learner responses indicate that building awareness of structural drivers and fostering a sense of acceptance and personal responsibility to address implicit bias may be additional key training components.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"749-756"},"PeriodicalIF":2.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577455","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}
Kelly M. Bower PhD, MSN, MPH, RN, Lauren A. Arrington CNM, DNP, Briana E. Kramer CNM, MPH, MS, RN, Noelene K. Jeffers CNM, PhD, IBCLC, S. Michelle Ogunwole PhD, MD, Tanay Lynn Harris
Inequities in maternal health outcomes are persistent, widespread, and unacceptable. Despite growing awareness that health care organizations play a critical role in addressing the maternal health crisis and eliminating racial inequities in outcomes, hospitals report barriers and limitations in implementing policy changes. We developed a Maternal Health Equity Toolkit and provided hospital maternal care units and departments with a comprehensive systems-level approach to advance health equity. The toolkit offers hospitals access to curated guidance from leading professional, quality and safety, and advocacy organizations. Detailed action steps for operationalizing change ideas are included. This article describes the development process and the final toolkit structure and content.
{"title":"Development of a Community- and Patient-Engaged Maternal Health Equity Toolkit for Hospitals","authors":"Kelly M. Bower PhD, MSN, MPH, RN, Lauren A. Arrington CNM, DNP, Briana E. Kramer CNM, MPH, MS, RN, Noelene K. Jeffers CNM, PhD, IBCLC, S. Michelle Ogunwole PhD, MD, Tanay Lynn Harris","doi":"10.1111/jmwh.13771","DOIUrl":"10.1111/jmwh.13771","url":null,"abstract":"<p>Inequities in maternal health outcomes are persistent, widespread, and unacceptable. Despite growing awareness that health care organizations play a critical role in addressing the maternal health crisis and eliminating racial inequities in outcomes, hospitals report barriers and limitations in implementing policy changes. We developed a Maternal Health Equity Toolkit and provided hospital maternal care units and departments with a comprehensive systems-level approach to advance health equity. The toolkit offers hospitals access to curated guidance from leading professional, quality and safety, and advocacy organizations. Detailed action steps for operationalizing change ideas are included. This article describes the development process and the final toolkit structure and content.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"800-806"},"PeriodicalIF":2.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13771","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556289","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":"Research and Professional Literature to Inform Practice, July/August 2025","authors":"Amy Alspaugh CNM, PhD, MSN","doi":"10.1111/jmwh.13785","DOIUrl":"https://doi.org/10.1111/jmwh.13785","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 4","pages":"658-663"},"PeriodicalIF":2.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870071","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}
Tazim Merchant MD, MA, Julia D. DiTosto MS, Maria Gomez-Roas MD, Brittney R. Williams MPH, Charlotte M. Niznik APN, CDCES, Joe Feinglass PhD, MPH, William A. Grobman MD, MBA, Lynn M. Yee MD, MPH
Introduction
Given the rising incidence and importance of treatment adherence for gestational diabetes (GDM), this study aimed to examine patient perspectives on social support's role in gestational diabetes (GDM) management during pregnancy and early postpartum.
Methods
This is an analysis of qualitative data collected during a feasibility randomized controlled trial of postpartum patient navigation for individuals with GDM. Participants completed semistructured interviews at 4 to 12 weeks postpartum on their experiences with GDM as well as facilitators and barriers to its management, including social support. Data were analyzed using the constant comparative method.
Results
Of 38 participants, 55% reported a family member or friend with a history of GDM, type 1, or type 2 diabetes mellitus. The analysis identified 4 themes: (1) communal support, (2) indirect GDM support (ie, removing logistical barriers to care), (3) direct GDM support, and (4) barriers of social support (eg, stigma), which impeded disease understanding. Participants identified communal support as a catalyst for lifestyle change and a source for advice and emotional support. Indirect support included transportation, childcare, and work accommodations. Direct support included providing healthy food, giving insulin shots, or providing accountability.
Discussion
Harnessing social support may be a key strategy to activate and sustain lifestyle and self-management skills in GDM and should be considered in intervention development.
{"title":"The Role of Social Support on Self-Management of Gestational Diabetes Mellitus: A Qualitative Analysis","authors":"Tazim Merchant MD, MA, Julia D. DiTosto MS, Maria Gomez-Roas MD, Brittney R. Williams MPH, Charlotte M. Niznik APN, CDCES, Joe Feinglass PhD, MPH, William A. Grobman MD, MBA, Lynn M. Yee MD, MPH","doi":"10.1111/jmwh.13782","DOIUrl":"10.1111/jmwh.13782","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Given the rising incidence and importance of treatment adherence for gestational diabetes (GDM), this study aimed to examine patient perspectives on social support's role in gestational diabetes (GDM) management during pregnancy and early postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is an analysis of qualitative data collected during a feasibility randomized controlled trial of postpartum patient navigation for individuals with GDM. Participants completed semistructured interviews at 4 to 12 weeks postpartum on their experiences with GDM as well as facilitators and barriers to its management, including social support. Data were analyzed using the constant comparative method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 38 participants, 55% reported a family member or friend with a history of GDM, type 1, or type 2 diabetes mellitus. The analysis identified 4 themes: (1) communal support, (2) indirect GDM support (ie, removing logistical barriers to care), (3) direct GDM support, and (4) barriers of social support (eg, stigma), which impeded disease understanding. Participants identified communal support as a catalyst for lifestyle change and a source for advice and emotional support. Indirect support included transportation, childcare, and work accommodations. Direct support included providing healthy food, giving insulin shots, or providing accountability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Harnessing social support may be a key strategy to activate and sustain lifestyle and self-management skills in GDM and should be considered in intervention development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"791-799"},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510148","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}
Stefanie L. Boyles RN, BSN, Sarah R. Weinstein CNM, MN, IBCLC, Aleeca F. Bell CNM, PhD, Elise N. Erickson CNM, PhD
Introduction
The purpose of this article is to describe the relationship between postpartum hemorrhage (PPH) and exclusive breastfeeding (EBF) duration among participants who planned to breastfeed their infants. We also describe factors that were protective or prohibitive of breastfeeding.
Methods
We performed a secondary analysis of data from a case-control study examining genetic variations associated with PPH linked to uterine atony in individuals with singleton vaginal births (n = 60case, n = 40 control participants). Bivariate analyses examined the relationships between breastfeeding exclusivity and various factors, including maternal demographics, birth characteristics, and case-control status. Breastfeeding exclusivity, cessation, challenges, and formula introduction were determined from self-reported infant feeding surveys administered to participants at 6 to 10 weeks, 4 months, and 6 months postpartum. Regression models were used to describe the relationship between breastfeeding exclusivity, breastfeeding duration, and PPH, adjusting for relevant confounding variables.
Results
EBF rates for participants with normal postpartum bleeding versus PPH were 82.5% versus 64.1% (P = .05), 77.5% versus 55% (P = .02), and 70.3% versus 49.1% (P = .04) at 6 to 10 weeks, 4 months, and 6 months, respectively. Early EBF (6-10 weeks) was more strongly associated with psychosocial factors, including higher education, lower depression scores, and higher resilience scores. Median ferritin levels at 6 to 10 weeks postpartum were higher in those who continued to exclusively breastfeed at 4 and 6 months (24.1 ng/mL; interquartile range [IQR], 14.7-46.5) compared with those who did not (17.7 ng/mL; IQR, 10.3-32.0) (P = .03 for both). Higher early breastfeeding self-efficacy emerged as the strongest predictor of EBF across all time points.
Discussion
PPH significantly impacts breastfeeding initiation and duration, requiring tailored interventions to support affected individuals. Enhancing maternal self-efficacy may improve EBF outcomes. Future research is needed to elucidate the complex relationship between postpartum ferritin levels and EBF outcomes in those who experience PPH.
{"title":"Postpartum Hemorrhage and the Likelihood of Exclusive Breastfeeding Through 6 Months Postpartum: A Case-Control Study","authors":"Stefanie L. Boyles RN, BSN, Sarah R. Weinstein CNM, MN, IBCLC, Aleeca F. Bell CNM, PhD, Elise N. Erickson CNM, PhD","doi":"10.1111/jmwh.13781","DOIUrl":"10.1111/jmwh.13781","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The purpose of this article is to describe the relationship between postpartum hemorrhage (PPH) and exclusive breastfeeding (EBF) duration among participants who planned to breastfeed their infants. We also describe factors that were protective or prohibitive of breastfeeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a secondary analysis of data from a case-control study examining genetic variations associated with PPH linked to uterine atony in individuals with singleton vaginal births (n = 60case, n = 40 control participants). Bivariate analyses examined the relationships between breastfeeding exclusivity and various factors, including maternal demographics, birth characteristics, and case-control status. Breastfeeding exclusivity, cessation, challenges, and formula introduction were determined from self-reported infant feeding surveys administered to participants at 6 to 10 weeks, 4 months, and 6 months postpartum. Regression models were used to describe the relationship between breastfeeding exclusivity, breastfeeding duration, and PPH, adjusting for relevant confounding variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>EBF rates for participants with normal postpartum bleeding versus PPH were 82.5% versus 64.1% (<i>P</i> = .05), 77.5% versus 55% (<i>P</i> = .02), and 70.3% versus 49.1% (<i>P</i> = .04) at 6 to 10 weeks, 4 months, and 6 months, respectively. Early EBF (6-10 weeks) was more strongly associated with psychosocial factors, including higher education, lower depression scores, and higher resilience scores. Median ferritin levels at 6 to 10 weeks postpartum were higher in those who continued to exclusively breastfeed at 4 and 6 months (24.1 ng/mL; interquartile range [IQR], 14.7-46.5) compared with those who did not (17.7 ng/mL; IQR, 10.3-32.0) (<i>P</i> = .03 for both). Higher early breastfeeding self-efficacy emerged as the strongest predictor of EBF across all time points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>PPH significantly impacts breastfeeding initiation and duration, requiring tailored interventions to support affected individuals. Enhancing maternal self-efficacy may improve EBF outcomes. Future research is needed to elucidate the complex relationship between postpartum ferritin levels and EBF outcomes in those who experience PPH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 5","pages":"780-790"},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532039","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":"Thank You to 2024 Peer Reviewers","authors":"","doi":"10.1111/jmwh.13778","DOIUrl":"https://doi.org/10.1111/jmwh.13778","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13778","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300182","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":"Complementary and Integrative Therapies in Midwifery Practice (2025-001JMWH)","authors":"","doi":"10.1111/jmwh.13775","DOIUrl":"https://doi.org/10.1111/jmwh.13775","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 3","pages":"526-527"},"PeriodicalIF":2.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13775","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300503","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}
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