Pub Date : 2025-01-16DOI: 10.1016/j.jogn.2024.11.009
Kelley N Robinson, Ashley Gresh, Crystal Trent-Paultre, Ndidiamaka Amutah-Onukagha
Objective: To explore and describe perceptions of provider inquiry regarding housing status among pregnant women experiencing housing instability.
Design: Secondary qualitative analysis using analytic expansion.
Setting: In-person and online interviews in the Mid-Atlantic and Washington, DC, region.
Participants: English-speaking women who were pregnant or gave birth within the past year, 18 years or older, and experiencing housing instability (N = 14).
Methods: We undertook a secondary analysis of primary data collected via semistructured interviews in the mid-Atlantic and Washington, DC, region between February 2020 and December 2021. In this secondary analysis, we used reflexive thematic analyses to interpret data and discover themes.
Results: Fourteen participants answered the question regarding provider inquiry. Nine participants (64%) expressed no inquiry about their housing status and reported that visits were too short or focused more on fetal health. Disclosing housing status depended on the patient-provider relationship and belief in the provider's ability to help and support. Three overarching themes emerged: Provider Inquiry About Housing, The Value of Relationships, and Improving Access to Housing Support and Services.
Conclusion: The current service delivery model for pregnant women does not adequately address social determinants of health. Future researchers should focus on the intersection of pregnancy and housing instability to determine whether restructuring of policy and practice is needed. Nurse-midwives and other maternity care providers can be key points of contact in facilitating housing support for pregnant women with unstable housing status.
{"title":"Perceptions of Provider Inquiry Regarding Housing Status Among Pregnant Women Experiencing Housing Instability.","authors":"Kelley N Robinson, Ashley Gresh, Crystal Trent-Paultre, Ndidiamaka Amutah-Onukagha","doi":"10.1016/j.jogn.2024.11.009","DOIUrl":"10.1016/j.jogn.2024.11.009","url":null,"abstract":"<p><strong>Objective: </strong>To explore and describe perceptions of provider inquiry regarding housing status among pregnant women experiencing housing instability.</p><p><strong>Design: </strong>Secondary qualitative analysis using analytic expansion.</p><p><strong>Setting: </strong>In-person and online interviews in the Mid-Atlantic and Washington, DC, region.</p><p><strong>Participants: </strong>English-speaking women who were pregnant or gave birth within the past year, 18 years or older, and experiencing housing instability (N = 14).</p><p><strong>Methods: </strong>We undertook a secondary analysis of primary data collected via semistructured interviews in the mid-Atlantic and Washington, DC, region between February 2020 and December 2021. In this secondary analysis, we used reflexive thematic analyses to interpret data and discover themes.</p><p><strong>Results: </strong>Fourteen participants answered the question regarding provider inquiry. Nine participants (64%) expressed no inquiry about their housing status and reported that visits were too short or focused more on fetal health. Disclosing housing status depended on the patient-provider relationship and belief in the provider's ability to help and support. Three overarching themes emerged: Provider Inquiry About Housing, The Value of Relationships, and Improving Access to Housing Support and Services.</p><p><strong>Conclusion: </strong>The current service delivery model for pregnant women does not adequately address social determinants of health. Future researchers should focus on the intersection of pregnancy and housing instability to determine whether restructuring of policy and practice is needed. Nurse-midwives and other maternity care providers can be key points of contact in facilitating housing support for pregnant women with unstable housing status.</p>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900527","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jogn.2024.12.002
Karen M. Tabb PhD, MSW
{"title":"Racial Categorization in Women’s Mental Health Research Fails to Meet the Needs of Multiracial, Biracial, and Mixed-Race Women in the United States","authors":"Karen M. Tabb PhD, MSW","doi":"10.1016/j.jogn.2024.12.002","DOIUrl":"10.1016/j.jogn.2024.12.002","url":null,"abstract":"","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"54 1","pages":"Pages 5-8"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873479","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jogn.2024.12.001
Shannon D. Simonovich PhD, RN, Janna Stephens PhD, RN, Hsiang Huang MD, MPH, Karen M. Tabb PhD, MSW
{"title":"Strategies to Improve Women’s Mental Health Across the Life Course","authors":"Shannon D. Simonovich PhD, RN, Janna Stephens PhD, RN, Hsiang Huang MD, MPH, Karen M. Tabb PhD, MSW","doi":"10.1016/j.jogn.2024.12.001","DOIUrl":"10.1016/j.jogn.2024.12.001","url":null,"abstract":"","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"54 1","pages":"Pages 9-12"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873497","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jogn.2024.07.005
Alescia M. Farr, Jocelyn Smith Carter, Kashica J. Webber-Ritchey
Objective
To examine associations among endorsement of elements of the superwoman schema (the obligation to manifest strength and the obligation to help others) and health outcomes and to test if stress mediates the association between the obligation to manifest strength and depression in adult Black women.
Design
Cross-sectional design.
Setting
Community space in the Chicago metropolitan area.
Participants
Ninety-one adult Black women.
Methods
Participants completed questionnaires to assess endorsement of superwoman schema roles, physical activity, healthy eating, weight satisfaction, depression, and stress. Height and weight were collected by research assistants. We used descriptive statistics, bivariate correlations, multiple regression models, and linear mediation analysis to analyze data.
Results
Higher levels of obligation to suppress emotions were associated with lower physical activity, r(88) = –0.25, p < .05. Obligation to manifest strength was associated with higher levels of stress, r(79) = 0.53, p < .01, and symptoms of depression, r(71) = 0.36, p < .01. Stress mediated the relationship between the obligation to manifest strength and depression with a significant indirect effect, β = 0.37, SE = 0.10, 95% confidence interval [0.20, 0.60].
Conclusion
Our findings offer insight into the psychological and social processes that affect Black women and may aid in the development of culturally responsive prevention and intervention programs at individual and community levels to reduce chronic diseases.
{"title":"Relationships Among Endorsement of the Superwoman Schema and Health Outcomes","authors":"Alescia M. Farr, Jocelyn Smith Carter, Kashica J. Webber-Ritchey","doi":"10.1016/j.jogn.2024.07.005","DOIUrl":"10.1016/j.jogn.2024.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>To examine associations among endorsement of elements of the superwoman schema (the obligation to manifest strength and the obligation to help others) and health outcomes and to test if stress mediates the association between the obligation to manifest strength and depression in adult Black women.</div></div><div><h3>Design</h3><div>Cross-sectional design.</div></div><div><h3>Setting</h3><div>Community space in the Chicago metropolitan area.</div></div><div><h3>Participants</h3><div>Ninety-one adult Black women.</div></div><div><h3>Methods</h3><div>Participants completed questionnaires to assess endorsement of superwoman schema roles, physical activity, healthy eating, weight satisfaction, depression, and stress. Height and weight were collected by research assistants. We used descriptive statistics, bivariate correlations, multiple regression models, and linear mediation analysis to analyze data.</div></div><div><h3>Results</h3><div>Higher levels of obligation to suppress emotions were associated with lower physical activity, <em>r</em>(88) = –0.25, <em>p</em> < .05. Obligation to manifest strength was associated with higher levels of stress, <em>r</em>(79) = 0.53, <em>p</em> < .01, and symptoms of depression, <em>r</em>(71) = 0.36, <em>p</em> < .01. Stress mediated the relationship between the obligation to manifest strength and depression with a significant indirect effect, β = 0.37, <em>SE</em> = 0.10, 95% confidence interval [0.20, 0.60].</div></div><div><h3>Conclusion</h3><div>Our findings offer insight into the psychological and social processes that affect Black women and may aid in the development of culturally responsive prevention and intervention programs at individual and community levels to reduce chronic diseases.</div></div>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"54 1","pages":"Pages 88-101"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057340","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jogn.2024.10.003
Veronica Barcelona, Jihye K. Scroggins, Danielle Scharp, Sarah E. Harkins, Dena Goffman, Janice Aubey, Maxim Topaz
Objective
To more clearly understand the use of stigmatizing and nonstigmatizing language in electronic health records in hospital birth settings and to broaden the understanding of discrimination and implicit bias in clinical care.
Design
A secondary qualitative analysis of free-text clinical notes from electronic health records.
Setting
Two urban hospitals in the northeastern United States that serve patients with diverse sociodemographic characteristics during the perinatal period.
Participants
A total of 1,771 clinical notes from inpatient birth admissions in 2017.
Methods
We used Krippendorff’s content analysis of categorial distinction to identify stigmatizing and nonstigmatizing language. We based our categories for the content analysis on our pilot study and preexisting categories described by other researchers. We also explored new language categories that emerged during analysis.
Results
We reviewed 1,771 notes and identified 10 categories that demonstrated stigmatizing language toward patients, nonstigmatizing language toward patients, and stigmatizing language among clinicians. We identified a new stigmatizing language category, Unjustified Descriptions of Social and Behavioral Risks. Positive or Preferred Language and Patient Exercising Autonomy for Birth are two new categories that represent language that empowers patients. Clinician Blame and Structural Care Barriers are new language categories that imply complex interprofessional dynamics and structural challenges in health care settings that can adversely affect the provision of care.
Conclusions
The results of this study provide a foundation for future efforts to reduce the use of stigmatizing language in clinical documentation and can be used to inform multilevel interventions to reduce bias in the clinical care in birth settings.
{"title":"Secondary Qualitative Analysis of Stigmatizing and Nonstigmatizing Language Used in Hospital Birth Settings","authors":"Veronica Barcelona, Jihye K. Scroggins, Danielle Scharp, Sarah E. Harkins, Dena Goffman, Janice Aubey, Maxim Topaz","doi":"10.1016/j.jogn.2024.10.003","DOIUrl":"10.1016/j.jogn.2024.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>To more clearly understand the use of stigmatizing and nonstigmatizing language in electronic health records in hospital birth settings and to broaden the understanding of discrimination and implicit bias in clinical care.</div></div><div><h3>Design</h3><div>A secondary qualitative analysis of free-text clinical notes from electronic health records.</div></div><div><h3>Setting</h3><div>Two urban hospitals in the northeastern United States that serve patients with diverse sociodemographic characteristics during the perinatal period.</div></div><div><h3>Participants</h3><div>A total of 1,771 clinical notes from inpatient birth admissions in 2017.</div></div><div><h3>Methods</h3><div>We used Krippendorff’s content analysis of categorial distinction to identify stigmatizing and nonstigmatizing language. We based our categories for the content analysis on our pilot study and preexisting categories described by other researchers. We also explored new language categories that emerged during analysis.</div></div><div><h3>Results</h3><div>We reviewed 1,771 notes and identified 10 categories that demonstrated stigmatizing language toward patients, nonstigmatizing language toward patients, and stigmatizing language among clinicians. We identified a new stigmatizing language category, <em>Unjustified Descriptions of Social and Behavioral Risks</em>. <em>Positive or Preferred Language</em> and <em>Patient Exercising Autonomy for Birth</em> are two new categories that represent language that empowers patients. <em>Clinician Blame</em> and <em>Structural Care Barriers</em> are new language categories that imply complex interprofessional dynamics and structural challenges in health care settings that can adversely affect the provision of care.</div></div><div><h3>Conclusions</h3><div>The results of this study provide a foundation for future efforts to reduce the use of stigmatizing language in clinical documentation and can be used to inform multilevel interventions to reduce bias in the clinical care in birth settings.</div></div>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"54 1","pages":"Pages 112-122.e4"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693813","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jogn.2024.06.006
Jessica L. Zemlak, Aleigha Barry, Nicole Mattson
Objective
To explore perceptions of policies and laws on sexual and reproductive health among women in recovery from opioid use disorder (OUD).
Design
Qualitative descriptive.
Setting
Telephone interviews conducted in a midsized urban area in the midwestern region of the United States.
Participants
Twenty-two women ages 18 to 49 years who self-identified as being in recovery from OUD.
Methods
We conducted individual, semistructured telephone interviews and analyzed the data using reflexive thematic analysis.
Results
We identified three themes: Barriers to OUD Treatment and Recovery, Pregnancy as a Gateway to Treatment and Recovery, and The Dobbs Effect. Participants described OUD treatment barriers such as inadequate recovery resources for women and the criminalization of drug use. Many participants described pregnancy as a gateway to recovery because of improved access to treatment services and enhanced motivation for engaging in recovery. Participants described unintended pregnancy as a threat to recovery that made them seek woman-controlled contraceptive methods they could use without negotiating with a partner (e.g., intrauterine devices) after the Supreme Court overturned constitutionally protected access to abortion.
Conclusion
Opioid use disorder is a public and mental health crisis in the United States that affects reproductive-age women. Participants in our study closely connected recovery from OUD with sexual and reproductive health policy and laws. There is a need for regulation to support the unique needs of women in OUD treatment. The recent Supreme Court decision that overturned constitutionally protected abortion creates challenges for women in recovery from OUD. Nurses are ideally positioned to advocate for recovery and sexual and reproductive health policies and laws that improve the physical and mental health of women in recovery.
{"title":"Perceptions of Women in Opioid Recovery Regarding Policies and Laws on Sexual and Reproductive Health","authors":"Jessica L. Zemlak, Aleigha Barry, Nicole Mattson","doi":"10.1016/j.jogn.2024.06.006","DOIUrl":"10.1016/j.jogn.2024.06.006","url":null,"abstract":"<div><h3>Objective</h3><div>To explore perceptions of policies and laws on sexual and reproductive health among women in recovery from opioid use disorder (OUD).</div></div><div><h3>Design</h3><div>Qualitative descriptive.</div></div><div><h3>Setting</h3><div>Telephone interviews conducted in a midsized urban area in the midwestern region of the United States.</div></div><div><h3>Participants</h3><div>Twenty-two women ages 18 to 49 years who self-identified as being in recovery from OUD.</div></div><div><h3>Methods</h3><div>We conducted individual, semistructured telephone interviews and analyzed the data using reflexive thematic analysis.</div></div><div><h3>Results</h3><div>We identified three themes: <em>Barriers to OUD Treatment and Recovery</em>, <em>Pregnancy as a Gateway to Treatment and Recovery</em>, and <em>The Dobbs Effect</em>. Participants described OUD treatment barriers such as inadequate recovery resources for women and the criminalization of drug use. Many participants described pregnancy as a gateway to recovery because of improved access to treatment services and enhanced motivation for engaging in recovery. Participants described unintended pregnancy as a threat to recovery that made them seek woman-controlled contraceptive methods they could use without negotiating with a partner (e.g., intrauterine devices) after the Supreme Court overturned constitutionally protected access to abortion.</div></div><div><h3>Conclusion</h3><div>Opioid use disorder is a public and mental health crisis in the United States that affects reproductive-age women. Participants in our study closely connected recovery from OUD with sexual and reproductive health policy and laws. There is a need for regulation to support the unique needs of women in OUD treatment. The recent Supreme Court decision that overturned constitutionally protected abortion creates challenges for women in recovery from OUD. Nurses are ideally positioned to advocate for recovery and sexual and reproductive health policies and laws that improve the physical and mental health of women in recovery.</div></div>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"54 1","pages":"Pages 50-59"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749796","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}
Pub Date : 2025-01-01DOI: 10.1016/S0884-2175(24)00354-X
{"title":"At Your Service","authors":"","doi":"10.1016/S0884-2175(24)00354-X","DOIUrl":"10.1016/S0884-2175(24)00354-X","url":null,"abstract":"","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"54 1","pages":"Page A4"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149584","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jogn.2024.11.003
Denise McGuinness, Timothy Frawley
Dysphoric milk ejection reflex (D-MER) is a dysregulation of emotions (dysphoria) that can occur during the milk ejection reflex and during breastfeeding or expressing breast milk. Symptoms of D-MER present suddenly and can include hopelessness, sadness, nervousness, irritability, nausea, dread, palpitations, and a hollow feeling in the stomach. Although D-MER was first reported in 2007, it remains understudied to date and should not be confused with postnatal depression or anxiety disorders. Knowing that they are experiencing symptoms of a named condition is very supportive for women who experience D-MER. It is important that health care professionals who interact with the breastfeeding dyad be aware of D-MER so they can provide supportive care, manage symptoms, and protect the breastfeeding relationship. In this article, we describe the case of a woman who experienced D-MER while she breastfed her newborn.
{"title":"Case Report of Dysphoric Milk Ejection Reflex","authors":"Denise McGuinness, Timothy Frawley","doi":"10.1016/j.jogn.2024.11.003","DOIUrl":"10.1016/j.jogn.2024.11.003","url":null,"abstract":"<div><div>Dysphoric milk ejection reflex (D-MER) is a dysregulation of emotions (dysphoria) that can occur during the milk ejection reflex and during breastfeeding or expressing breast milk. Symptoms of D-MER present suddenly and can include hopelessness, sadness, nervousness, irritability, nausea, dread, palpitations, and a hollow feeling in the stomach. Although D-MER was first reported in 2007, it remains understudied to date and should not be confused with postnatal depression or anxiety disorders. Knowing that they are experiencing symptoms of a named condition is very supportive for women who experience D-MER. It is important that health care professionals who interact with the breastfeeding dyad be aware of D-MER so they can provide supportive care, manage symptoms, and protect the breastfeeding relationship. In this article, we describe the case of a woman who experienced D-MER while she breastfed her newborn.</div></div>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"54 1","pages":"Pages 123-129.e2"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717836","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}
Pub Date : 2025-01-01DOI: 10.1016/j.jogn.2024.10.004
Cristina Chandra Mills, Eileen M. Condon, Cheryl Tatano Beck
Objective
To develop a deeper understanding of the health care experiences of women of color affected by severe maternal morbidity (SMM) or birth complications in the United States and opportunities to improve the delivery of maternal health care.
Data Sources
PubMed, CINAHL, Embase, and Scopus.
Study Selection
We included qualitative studies on the experiences of pregnancy or childbirth among women of color in the United States published within the past 10 years (to reflect recent societal events and obstetric practices) in which researchers examined women’s experiences of SMM or birth complications.
Data Extraction
Five reports of qualitative research studies met inclusion criteria. We assessed the methodological quality of each study using the JBI (Joanna Briggs Institute) critical appraisal checklist for qualitative research. We extracted the following data from the included studies: participants’ demographic characteristics (i.e., race/ethnicity, age, experiences), methodological characteristics of the studies (i.e., sample size, research design, data collection, data analysis), and individual study metaphors (i.e., concepts, phrases, participant quotes) related to the overarching themes.
Data Synthesis
We used the meta-ethnographic approach of Noblit and Hare (1988) to critically examine studies, translate the studies into one another, and synthesize reciprocal translations. Four overarching themes emerged from the meta-synthesis: Lack of Knowledge; Stigma, Discrimination, and/or Bias; Provider Communication Issues; and Barriers to Care and Services. Each overarching theme had complicating factors, which represented factors that exacerbated problems, and mitigating factors, which represented factors that alleviated some negative experiences. Complex layers of varying demographic characteristics and social determinants of health shaped women’s individual experiences.
Conclusion
The experiences of women of color with SMM or complications during pregnancy and/or childbirth reveal shortcomings in the delivery of maternal health care. Findings suggest opportunities for improvement across various levels of the health care system. Further qualitative studies using high-quality methodology are needed on this topic given that the research is limited.
{"title":"Meta-ethnography of the Experiences of Women of Color Who Survived Severe Maternal Morbidity or Birth Complications","authors":"Cristina Chandra Mills, Eileen M. Condon, Cheryl Tatano Beck","doi":"10.1016/j.jogn.2024.10.004","DOIUrl":"10.1016/j.jogn.2024.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>To develop a deeper understanding of the health care experiences of women of color affected by severe maternal morbidity (SMM) or birth complications in the United States and opportunities to improve the delivery of maternal health care.</div></div><div><h3>Data Sources</h3><div>PubMed, CINAHL, Embase, and Scopus.</div></div><div><h3>Study Selection</h3><div>We included qualitative studies on the experiences of pregnancy or childbirth among women of color in the United States published within the past 10 years (to reflect recent societal events and obstetric practices) in which researchers examined women’s experiences of SMM or birth complications.</div></div><div><h3>Data Extraction</h3><div>Five reports of qualitative research studies met inclusion criteria. We assessed the methodological quality of each study using the JBI (Joanna Briggs Institute) critical appraisal checklist for qualitative research. We extracted the following data from the included studies: participants’ demographic characteristics (i.e., race/ethnicity, age, experiences), methodological characteristics of the studies (i.e., sample size, research design, data collection, data analysis), and individual study metaphors (i.e., concepts, phrases, participant quotes) related to the overarching themes.</div></div><div><h3>Data Synthesis</h3><div>We used the meta-ethnographic approach of <span><span>Noblit and Hare (1988)</span></span> to critically examine studies, translate the studies into one another, and synthesize reciprocal translations. Four overarching themes emerged from the meta-synthesis: <em>Lack of Knowledge; Stigma, Discrimination, and/or Bias; Provider Communication Issues;</em> and <em>Barriers to Care and Services.</em> Each overarching theme had complicating factors, which represented factors that exacerbated problems, and mitigating factors, which represented factors that alleviated some negative experiences. Complex layers of varying demographic characteristics and social determinants of health shaped women’s individual experiences.</div></div><div><h3>Conclusion</h3><div>The experiences of women of color with SMM or complications during pregnancy and/or childbirth reveal shortcomings in the delivery of maternal health care. Findings suggest opportunities for improvement across various levels of the health care system. Further qualitative studies using high-quality methodology are needed on this topic given that the research is limited.</div></div>","PeriodicalId":54903,"journal":{"name":"Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing","volume":"54 1","pages":"Pages 38-49"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693796","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}