Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing最新文献

Objective: To identify lifetime discrimination typologies and examine their associations with psychological health outcomes among Black and Hispanic women after birth.

Design: Secondary analysis of the Community and Child Health Network study data.

Participants: A total of 1,350 Black and 607 Hispanic women.

Methods: We built two latent class models for Black and Hispanic women using eight indicator variables from different life domains of discrimination (childhood, family, work, police, education, housing, health care, and loans). We used bivariate and multiple regression analyses to examine the association among the identified typologies and postpartum depression and perceived stress at 6 months postpartum.

Results: We selected the three-class model with best fit indices and interpretability: no lifetime discrimination (n = 1,029; 76.22%), high childhood-family racial discrimination (n = 224, 16.59%), and moderate lifetime discrimination (n = 97, 7.19%) among Black women and no lifetime discrimination (n = 493, 81.22%), high childhood-family racial discrimination (n = 93, 15.32%), and high education discrimination (n = 21, 3.46%) among Hispanic women. The adjusted postpartum depression and perceived stress scores were significantly greater in Typologies 2 and 3 than Typology 1 in Black women. The adjusted perceived stress scores were significantly greater in Typologies 2 and 3 than Typology 1 in Hispanic women.

Conclusion: Lifetime discrimination experiences manifested in complex patterns. Women who experienced moderate to high discrimination across all or specific life domains had worse postpartum depression and perceived stress at 6 months after birth. It is crucial to address lifetime discrimination to improve maternal mental health.

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, b = 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.

In this commentary, we explore the significance of traditional Black midwifery practices across diaspora and global contexts, focusing on their potential for birth justice. By integrating cultural, health, and historical perspectives, we highlight the transformative power of traditional Black midwifery. Furthermore, we address the challenges that Black traditional and formally trained midwives face within contemporary health care systems. Barriers such as legal restrictions, limited recognition, and inadequate resources hinder the integration of Black midwifery into formal health care frameworks. Finally, strategies to promote collaboration, cultural, and respectful dialogue between traditional Black midwives and modern health care providers are proposed to overcome these challenges.

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.