Journal of midwifery & women's health最新文献

Introduction: Mental health conditions are the leading cause of pregnancy-related death in the United States. The purpose of this study was to explore the use of interprofessional simulation for postpartum depression management.

Methods: Midwifery, women's health gender-related nurse practitioner, and psychiatric mental health nurse practitioner students participated in an interprofessional postpartum depression simulation. Full-time students enrolled at the university in 2024 and 2025 were eligible to participate in a study using a pre-posttest design. Attitudes toward and confidence in management of postpartum depression were assessed before and after the simulation using a modified version of the Revised Depression Attitude Questionnaire (R-DAQ).

Results: There was a significant increase in modified R-DAQ scores following the intervention. Students' comments showed that they found the experience positive and that it helped improve their interprofessional communication and confidence in the management of postpartum depression.

Discussion: This is the first known study assessing the efficacy of an interprofessional postpartum depression simulation. Limitations include a lack of longitudinal data, a single site, and the use of a modified rating scale. Interprofessional simulation can be an effective educational intervention to prepare advanced practice nursing students to manage postpartum depression.

Introduction: The Guatemalan Ministry of Health has offered traditional midwives (TMs) training programs in Spanish since 1955. Many Guatemalan TMs speak indigenous dialects, with limited reading and writing skills, and may not fully comprehend this information. Additionally, TMs have previously requested instruction on how to measure blood pressure in order to improve outcomes for women developing preeclampsia. Prompt diagnosis of preeclampsia would enable TMs to make more timely decisions for transport to a hospital. The purpose of this quality improvement project therefore was to develop culturally sensitive oral educational activities in the native language of participants to improve their knowledge of preeclampsia and improve their skills in assessing blood pressure.

Process: The project used an action research methodology based on Leininger's cultural care theory. Trainers employed a variety of teaching methods such as repetition, triangulation, role-plays, storytelling, hands-on practice, return demonstrations, and pictorial Preeclampsia Reminder Cards. During a 2-week period in August 2024, 179 TMs attended educational activities about preeclampsia in 11 groups located in the remote Petén. A 26-item written pretest and posttest was used to evaluate changes in knowledge about preeclampsia. An 11-item checklist was used to assess ability to correctly measure blood pressure.

Outcomes: Among 179 TM participants, 49% were found to have limited reading and writing skills. Following the education methods, however, the group demonstrated a significant improvement in knowledge when comparing the 26-item pretest (N = 179, mean [SD], 16.02 [4.04]) with the posttest (mean [SD], 21.5 [4.69]); t₁₇₈ = 12.262; P < .001. Some participants with limited reading and writing skills were provided 1:1 assistance writing down answers they provided to the tests. Additionally, 94% correctly demonstrated all 11 items on a blood pressure assessment checklist. The majority of participants reported the educational activity was useable, feasible, and satisfying.

Discussion: The success of these methods in educating TMs in remote Guatemala has wide-reaching implications for improving maternal and infant health outcomes in low- and middle-income countries.

The historically unidirectional movement of global health ideas, practices, and protocols from the Global North (United States, Canada, European countries, Japan, South Korea, Taiwan, Australia, New Zealand, and Israel) to the Global South (Latin American countries, African countries, the Middle East excluding Israel and Asia countries, and Oceania excluding those previously mentioned) has displaced local practice and produced little sustainable change. Actively addressing these unintended consequences, practitioners at Yale School of Nursing in the United States formed a sustainable, mutually beneficial partnership with Makerere University College of Health Sciences and Mother Health International community birth center in Atiak, Uganda, to reduce perinatal mortality in areas with the highest burden. Goals included establishing a collaborative midwifery education and research partnership; developing an interprofessional clinical rotation; and developing a blueprint for teaching the midwifery model of care in the Global South. The partnership has successfully produced outputs including midwifery education support, research, clinical training, interprofessional capacity building, and community integration within local health care systems. Lessons learned from program design, implementation, and evaluation can inform global learning collaborations that are multidirectional and lead to more equitable midwifery collaborations.

Burnout as a public health crisis has gained attention in recent years. Integrating a wellness curriculum into training programs can reduce burnout and cultivate the awareness and skills needed to support a sustainable career in health care. The faculty midwives within the residency program in obstetrics and gynecology at The Warren Alpert Medical School of Brown University have implemented a successful, evidence-based wellness curriculum for residents that focuses on the emotional, physical, and psychological needs of learners. Participants report that this program increases work satisfaction and reduces burnout. The initiative could be modified across many disciplines of clinical training, and with midwife learners, to decrease stress during an academically rigorous and emotionally overwhelming time and provide trainees with tools that will sustain their sense of well-being throughout their careers.

Substance use disorder (SUD) is the most common cause of pregnancy-associated deaths for women in Illinois. In this article, we describe how to provide multimodality education and teaching opportunities in SUD and medication for opioid use disorder, incorporate community outreach to offer new experiential clinical learning opportunities, and enhance preceptor relationships to bolster educational partnerships as an innovative approach to incorporating SUD education into midwifery programs. Our teaching efforts identify the most vulnerable communities and create an innovative, midwifery-led solution to provide much-needed culturally aligned care addressing health disparities of those in rural and underserved communities. We highlight our utilization of an online education and training platform that students enroll in to obtain foundational knowledge in medication management for opioid use disorder, describe how we expanded clinical partnerships with providers actively providing medication management for opioid use disorders, and discuss how we evaluated those experiences and provided teaching/learning opportunities for students to present material across multiple cohorts of students. This innovative approach to integrating education for medication management of SUD through the above teaching modalities highlights our ability to meet the needs of our patients and prepare the future midwifery workforce with the clinical skills necessary for the work needed in clinical settings across the United States.

The CHOICES Black Midwifery Fellowship Program is an exemplar of a transformative postgraduate model in midwifery education that extends beyond traditional training frameworks. The program is designed around 5 core pillars: full-scope reproductive health services education and training, Black feminist thought, leadership and mentorship, neonatal and postnatal care, and community and patient-centered care. By embedding these frameworks into the curriculum, the fellowship challenges the prevailing medicalized approach to birth that often neglects the unique needs of marginalized communities. This perspective equips fellows with a critical understanding of the social, political, and economic factors that influence health outcomes, enabling them to advocate effectively for their patients and communities. In addition to improving clinical outcomes, the fellowship has also played a crucial role in restoring trust between Black birthing people and the health care system. Historical injustices and ongoing systemic racism have led to deep-seated mistrust of mainstream health care institutions among many Black communities. By training Black midwives who understand and share the cultural and lived experiences of their patients, the CHOICES fellowship helps to bridge this trust gap. Fellows are taught to adopt a patient-centered approach that prioritizes informed consent, shared-decision-making, and respect for cultural practices. In this article we outline the structure, curriculum, and training activities of the CHOICES Black Midwifery Fellowship. Additionally, we review the challenges encountered and lessons learned during the implementation process.

Introduction: Maternal morbidity and mortality rates in the United States and Georgia remain alarmingly high, exceeding those of many low-resource regions despite extensive interventions. Research highlights the role of competent midwifery care in addressing key contributing factors, such as limited health care access, insufficient prenatal care, and adverse social determinants of health. To expand the pool of qualified certified midwives and certified nurse-midwives, there is a pressing need for robust midwifery education programs, reliable and valid evaluation tools for student assessment, and documentation of skill development and confidence improvement among trainees.

Process: To evaluate preparedness and competency, a quality improvement project was initiated to assess the effectiveness and efficiency of the intrapartum simulation laboratory. A modified version of the National League for Nursing Student Satisfaction and Self-Confidence in Learning tool was used. Third-semester midwifery students at Emory University School of Nursing in Atlanta, Georgia, completed pre- and postlaboratory surveys, which included a Likert scale to measure confidence in the simulation laboratory's ability to meet their educational needs. Qualitative questions were incorporated to identify suggestions for laboratory improvements.

Outcomes: Statistically significant improvements were observed in midwifery students' pre- and postlaboratory assessments, particularly in their confidence regarding the skills reviewed, the alignment of simulation and laboratory time with their learning styles, and their trust in faculty members' ability to effectively teach essential midwifery practices.

Discussion: The findings validate the effectiveness of intentional teaching strategies and innovative simulation technologies in enhancing midwifery education. Increasing the number of competent midwives in practice represents a critical step in addressing the persistently high maternal morbidity and mortality rates in the United States. These teaching approaches and technologies can also be applied to other midwifery simulation laboratories and adapted for use in other advanced practice registered nursing specialties.