Journal of midwifery & women's health最新文献

Maternal health disparities persist as a significant issue in the United States, with Black, Indigenous, and marginalized women facing disproportionately high rates of maternal morbidity and mortality. Despite the United States having the highest maternal mortality rate among developed countries, addressing these disparities remains a challenge, particularly in rural areas and within underserved communities. One key strategy in mitigating these disparities involves training health care providers to recognize and combat systemic biases, particularly those rooted in race. This article discusses the development, implementation, and evaluation of a dedicated antiracism and health disparity prevention course developed for midwifery students at the University of Minnesota. In addition to content embedded in the existing midwifery curriculum, a course was designed and integrated that addresses racism, health disparities, and cultural competence designed for second-semester Doctor of Nursing Practice students. Faculty use a structured framework to increase awareness of implicit biases, historical oppression, and the importance of culturally sensitive care. The course encourages self-reflection and equips students with actionable strategies to address systemic inequities in maternal care. Students reported increased self-awareness and a stronger commitment to addressing racism in health care. Despite challenges such as balancing credit loads and emotional labor, midwifery students report that it positively contributes to their education. Additionally, the course has garnered interest from students and faculty in other health care disciplines. The authors advocate for the integration of such courses across health care programs to foster more equitable, antiracist practices within maternal health care.

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.

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.