Articles

Understanding the lived experience of pregnancy and birth for survivors of rape and sexual assault

This qualitative research took an intersectional feminist approach. The authors conducted in-depth individual interviews in England with fourteen women who self-identified as survivors of rape or sexual assault, and who had experienced pregnancy and birth after the assault. Findings suggest that survivors of sexual violence have specific maternity care needs. For our participants, these needs were often not met, leading to negative or traumatic experiences of pregnancy and birth. Systemic biases and poor birth experience jeopardise both psychological and physical safety. Funding for maternity and mental health services must be improved, so that they meet minimum staffing and care standards. Maternity services should urgently introduce trauma-informed models of care.

Racial disparities in adequacy of prenatal care during the COVID-19 pandemic in South Carolina, 2018-2021

Findings from this study suggests that compared to pre-pandemic, the odds of not receiving adequate prenatal care in South Carolina was increased by 10% for White women and 26% for Black women during the pandemic, highlighting the needs to develop individual tailored interventions to reverse this trend.

Neonatal and Maternal Outcomes at 22-28 Weeks of Gestation by Mode of Delivery

Findings from this study suggests that cesarean delivery in cephalic fetuses was associated with increased odds of adverse neonatal outcomes (24 weeks of gestation or greater) and SMM (all gestational age groups). Cesarean delivery was associated with decreased odds of neonatal death compared with vaginal delivery for noncephalic fetuses in all gestational age groups.

Racial Inequities in Drug Tests Ordered by Clinicians for Pregnant People Who Disclose Prenatal Substance Use

Findings from this study suggests that when pregnant people disclosed drug use, clinicians were more likely to order urine drug testing for Black pregnant people compared with their White counterparts, suggesting clinician racial bias. Current practice patterns and protocols such as urine drug testing in pregnancy care deserve review to identify and mitigate areas of potential clinician discrimination.

Preventing Eviction During Pregnancy: A Cost-Effectiveness Analysis of a Theoretical Safety-Net Program

The objective of the study was to evaluate the cost-effectiveness of a program covering the cost of rent to prevent eviction during pregnancy. The no eviction strategy is cost-effective and reduces cases of preterm birth, neonatal death, and neurodevelopmental delay. When rent is below the median of $1,016 per month, no eviction is the cost-saving strategy. These findings suggest that policies supporting social programmatic implementation for rent coverage for pregnant people at risk of eviction have the potential to be highly beneficial in reducing costs and disparities in perinatal outcomes.

Breastfeeding moderates childhood obesity risk associated with prenatal exposure to excessive gestational weight gain

This study examined the associations between gestational weight gain (GWG), breastfeeding during infancy and childhood obesity at 2–4 years, and determined whether breastfeeding moderated the association between GWG and childhood obesity. Findings suggested that longer fully breastfeeding duration may provide greater protection against obesity among children at higher risk due to intrauterine exposure to high gestational weight gain.

Physical violence during pregnancy in sub-Saharan Africa: why it matters and who are most susceptible?

The study assessed the prevalence of physical violence against pregnant women and its associated factors in sub-Saharan Africa (SSA). Based on the findings, community leaders are encouraged to liaise with law enforcement agencies to strictly enforce laws on gender-based violence by prosecuting perpetrators of IPV against pregnant women as a deterrent. Also, intensifying education on what constitutes IPV and the potential consequences on the health of pregnant women, their children, and their families will be laudable. Improving the socioeconomic status of women may also help to eliminate IPV perpetration against women at their pregnancy stage.

Is there a relation between stillbirth and low levels of vitamin D in the population? A bi-national follow-up study of vitamin D fortification

The authors aimed to assess the odds of stillbirth in relation to changes in national vitamin D fortification. Findings suggest that each increment of vitamin D fortification was associated with a 15% drop in stillbirths on a national level. If true, and if fortification reaches the entire population, it may represent a milestone in preventing stillbirths and reducing health inequalities.

Unplanned pregnancy and the association with maternal health and pregnancy outcomes: A Swedish cohort study

The aims were to study whether pregnancy planning was associated with antenatal care utilization and pregnancy outcomes in a Swedish setting. Findings suggest that unplanned pregnancy was associated with delayed initiation of antenatal care, higher odds for induction of labor and longer hospital stay, but not with any severe pregnancy outcomes. These findings suggest that women with an unplanned pregnancy cope well in a setting with free abortion and free health care.

Experiences of childbirth care among immigrant and non-immigrant women: a cross-sectional questionnaire study from a hospital in Norway

This study aimed to investigate immigrant and non-immigrant women's experiences of health care during childbirth, particularly assessing two dimensions: perceived general quality of care and attainment of health care needs during childbirth. Findings indicate that many women feel they receive high-quality health care during childbirth, but a considerable number still report not having their health care needs met. Also, multiparous immigrant women report significantly more unmet health care needs than non-immigrants. Further research is required to assess immigrant women's childbirth experiences and for health care providers to give optimal care, which may need to be tailored to a woman's cultural background and individual expectations.

Perinatal mortality rate and adverse perinatal outcomes presumably attributable to placental dysfunction in (near) term gestation: A nationwide 5-year cohort study

This study aimed to evaluate, among (near) term births, the burden of hypoxia-related adverse perinatal outcomes reflected in an association with birth weight centiles as a proxy for placental function. This study aimed to evaluate, among (near) term births, the burden of hypoxia-related adverse perinatal outcomes reflected in an association with birth weight centiles as a proxy for placental function.

The influence of acculturation on the risk of preterm birth and low birthweight in migrant women residing in Western Australia

The authors aimed to study the influence of acculturation on the risk of these outcomes in Australia. Findings suggest that acculturation is an important factor to consider when providing antenatal care to prevent PTB and LBW in migrants. Acculturation may reduce the risk of term-LBW but, conversely, may increase the risk of spontaneous PTB in migrant women residing in Western Australia. However, the effect may vary by ethnicity and warrants further investigation to fully understand the processes involved.

The impact of the Covid-19 pandemic on postnatal depression: analysis of three population-based national maternity surveys in England (2014–2020)

This analysis indicates that Covid-19 had an important negative impact on postnatal women's mental health and may have accelerated an existing trend of increasing prevalence of postnatal depression. Risk factors for postnatal depression were consistent before and during the pandemic. Timely identification, intervention and follow-up are key to supporting women at risk, and it is essential that mechanisms to support women are strengthened during times of heightened risk such as the pandemic.

Factors associated with receipt of adequate antenatal care among women in Rwanda: A secondary analysis of the 2019-20 Rwanda Demographic and Health Survey

The study aimed to determine the factors associated with the receipt of adequate ANC among pregnant women in Rwanda. Findings suggest that the prevalence of women who receive adequate ANC remains low in Rwanda. Effective interventions to increase access and utilization of adequate ANC are urgently needed to further improve the country's maternal and child health outcomes. 

Disparities in who is asked about their perinatal mental health: an analysis of cross-sectional data from consecutive national maternity surveys

The aim of this study was to assess the proportions of women who reported being asked about their mental health during the perinatal period across consecutive national maternity surveys (NMS) in England and to evaluate sociodemographic disparities in who was asked. Despite the UK National Institute for Health and Care Excellence (NICE) recommendations, many women are still not asked about their mental health during the perinatal period, particularly after giving birth. Women from ethnic minority backgrounds are less likely to be asked and these disparities have persisted over time.

Can allostatic load in pregnancy explain the association between race and subsequent cardiovascular disease risk: A cohort study

The objective of the study was to assess the relationship between allostatic load, a measure of cumulative chronic stress in early pregnancy and cardiovascular disease risk, 2-7 years postpartum, and pathways contributing to racial disparities in cardiovascular disease risk. Findings suggest that high allostatic load during pregnancy is associated with cardiovascular disease risk. The relationships between stress, subsequent cardiovascular risk and race warrant further study.

Breastfeeding after return to work: An Australian national workplace survey

This cross-sectional online survey is the first Australian study to explore women's experience of maintaining breastfeeding after return to work, in all work sectors. This study reveals that supportive workplace environments can lead to increased confidence in maintaining milk supply, extending durations of breastfeeding. Women who are confident in their rights to express breastmilk, or breastfeed at work, are more likely to meet their own breastfeeding goals. Education, and awareness raising, on the rights of breastfeeding women in the workplace, is a gender equity imperative that can improve experiences for breastfeeding women, and, increase manager and co-worker knowledge for creating enabling workplace environments for breastfeeding employees.

Stillbirths and neonatal mortality in LMICs: A community-based mother-infant cohort study

The authors aimed to provide reliable estimates of the incidence of stillbirth and neonatal death in three LMICs (Madagascar, Cambodia and Senegal) and to identify their main causes and associated risk factors. These findings underscore the immediate need to improve care for and monitoring of children at birth and during early life to decrease infant mortality. Surveillance of stillbirth and neonatal mortality and their causes should be improved to mitigate this burden in LMICs.

Disrespect and abuse in maternity care in a low-resource setting in Tanzania: Provider's perspectives of practice

This study used a descriptive qualitative design to obtain thick and rich data on disrespect and abuse in maternity care in a low-resource setting in Tanzania. The actions of disrespect and abuse are alarming in practice and are associated with ignorance of fundamental human rights by both providers and recipients of services. Conducting workshops seems a useful approach to revealing disrespect and abuse deep-rooted in practice and provides an opportunity to rectify the problem with providers. A more extensive interventional study will be crucial to address the widespread actions of disrespect and abuse.

Subsequent pregnancy after stillbirth: a qualitative narrative analysis of Canadian families' experiences

This study explores the lived experiences and the most important aspects of person-centred care for Canadian families experiencing a pregnancy after a stillbirth. Participants' responses identified that pregnancy after stillbirth is an extremely stressful time requiring patient-oriented care and support, both physically and psychologically. Families were able to articulate specific areas that would have improved the experience of their subsequent pregnancy. Parents asked for high-quality clinical and psychosocial prenatal care that was specific to them having experienced a prior stillbirth. They also requested connections to others experiencing this similar scenario. Further research is needed to delineate what supports and resources would be needed to ensure this care would be available to all families experiencing pregnancy after stillbirth across Canada and their caregivers.