Introduction The U.S. has the highest rate of preterm birth (PTB), of all developed countries, especially among African American women. Social determinants of health and inequalities in health outcomes are understudied areas. The intersectionality of race and socioeconomic status has been shown to contribute to chronic stress, stress has been shown to be associated with PTB, yet the mechanisms that affect pregnancy outcomes have not been explicit. Mindfulness-based Interventions that address stress reduction during pregnancy may improve quality of life during pregnancy, perhaps enhancing resilience, and be on the pathway to reducing the risk of negative pregnancy outcomes such as PTB. Methods We over-enrolled African American women and those covered by Medicaid to reach women at higher risk for PTB and included women in substance use treatment. Participants were enrolled in a 6-week mindfulness in pregnancy (MIP) intervention at the obstetric clinic. Sociodemographic characteristics and psychosocial assessments were obtained at three time points.
ResultsWe enrolled 35 women who self-identified as: non-white, Medicaid recipients, aged 25-35 years, with high school or less education. We found reductions in perceived stress, pregnancy specific stress, trait anxiety and depression and increases in mindfulness that sustained post-intervention at 2 and 7 months. Discussion Social determinants and stress in particular have been associated with negative birth outcomes. This paper describes a brief intervention and results of MIP tailored to women who have significantly more stress due to race, poverty, homelessness, substance use treatment and other comorbid health risks including PTB.
This article, the third in the series exploring midwifery in Scotland from 1916-1983, with the help of examples from oral history testimonies, examines some aspects of midwives' practice in the care of mothers in labour. It explores the extent to which midwives were able to fulfil their role as autonomous practitioners as specified in the 1915 Midwives (Scotland) Act. This includes discussion on: who delivered the babies; the shift during the time-period from an estimated 95% home births to 99.5% hospital births, along with increasing medicalisation of childbirth. This took the normality out of many births and had a negative impact on midwifery. The subsequent change in midwife/mother relationships and the requirement for midwives to follow hospital policy and protocol will also be discussed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.