Facilitating Access to Prenatal Care Through an Interprofessional Student‐Run Free Clinic

Danhausen, Kathleen; Joshi, Deepa; Quirk, Sarah; Miller, Robert J.; Fowler, Michael J.; Schorn, Mavis N.

doi:10.1111/jmwh.12304

Cited by 17 publications

(40 citation statements)

References 26 publications

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“…Professional training and education to identify at-risk pregnant women and the opportunity to stratify appropriate and timely interventions are required. It would be essential to consult psychiatric and substance abuse practitioners to initiate innovative strategies to address the psychosocial risk factors (Danhausen et al, 2015). Mental illness and substance use disorder severity could be assessed using Diagnostic and Statistical Manual of Mental Disorders (5th ed.…”

Section: Discussionmentioning

confidence: 99%

Syndemic of Lifetime Mental Illness, Substance Use Disorders, and Trauma and Their Association With Adverse Perinatal Outcomes

McDonald

Antoine

Liao

et al. 2017

J Interpers Violence

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Adverse perinatal outcomes are a significant contributor to neonatal and infant deaths. Mental illness, substance use disorders, and interpersonal trauma are often prevalent within obstetrical populations. Previous literature has documented the individual associations between these psychosocial factors and adverse perinatal outcomes. The co-occurrence of these three psychosocial factors might represent a syndemic among pregnant women, although they have not been described as such in the literature. Analysis of the interrelatedness and aggregate effect of these factors may allow for a more effective screening process that may reduce adverse perinatal outcomes. The objective of this article is to examine whether psychosocial factors (mental illness, substance use disorders, and interpersonal trauma) were independently and synergistically associated with adverse perinatal outcomes. This is a retrospective cohort study of 1,656 pregnant women at a single institution. Perinatal outcome and psychosocial data were abstracted from each participant's electronic medical record. Univariate and bivariate analyses, and multiple logistic regression were performed. Mean age was 27.5 ( SD = 6.2) years. The majority was Black (60.6%) and single (58%). Psychosocial factors were reported in 35% of women. The incidence of adverse perinatal outcomes increased with greater number of psychosocial factors: 21.2% if no psychosocial factor, 27.0% if one psychosocial factor, 27.4% if two, and 35.3% if all three (for trend, p = .01). Women who reported all three psychosocial factors had twice the odds of adverse perinatal outcomes (adjusted odds ratio = 2.04, 95% confidence interval = [1.09, 3.81], p = .03) compared with those who reported none. Our data suggest there is a synergistic relationship between the psychosocial factors that is associated with increased adverse perinatal outcomes. A validated screening tool is needed to stratify patient's risk of adverse perinatal outcomes based on psychosocial factors. Such screening could lead to tailored interventions that could decrease adverse perinatal outcomes.

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Section: Discussionmentioning

confidence: 99%

Syndemic of Lifetime Mental Illness, Substance Use Disorders, and Trauma and Their Association With Adverse Perinatal Outcomes

McDonald

Antoine

Liao

et al. 2017

J Interpers Violence

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“…This issue among pregnant migrant women without medical insurance (PMWMI) is a complex subject. Several interventions exist to address this including; (i) earlier care (ii) regular care; (iii) culturally appropriate; (iv) geographically accessible; (v) multidisciplinary; (vi) integrated with other community services / resources and at lower cost [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Interventions facilitating access to perinatal care for migrant women without medical insurance: A scoping review protocol

et al. 2022

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Introduction Inadequate pregnancy monitoring for pregnant migrant women without medical insurance (PMWMI) exposes them to severe complications during childbirth and consequences for the health of their child (e.g. preterm delivery, low birth weight, etc.). This scoping review aims to identify existing interventions globally to improve access to perinatal care for PMWMI. It will also highlight the strengths, weaknesses as well as the costs of these interventions. Materials and methods The methodological framework developed by Arksey & O’Malley (2005) will be used. An electronic search of studies from 2000 to 2021, published in French or English, will be conducted in 12 databases. Publication in Websites of non-governmental organizations working on migrant women without medical insurance issues will be also searched. All articles related to perinatal follow-up and care of PMWMIs, regardless of design, will be included. Editorial comments will be excluded. Outcomes of interest will focus on the impacts, strengths, weaknesses, and cost of interventions. Selection of articles and data extraction will be done by two independent researchers following the Tricco et al. (2018) reporting guide. Finally, a deliberative workshop with experts will allow to identify the most promising and appropriate interventions that can facilitate access to perinatal services by PMWMIs in the Quebec province of Canada.

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“…US midwifery education programs have employed several strategies to facilitate program accessibility for students with different amounts of financial, geographic, and scheduling flexibility, in addition to different educational and employment backgrounds. These include offering various points of entry (eg, nonnursing, postgraduate), formats, degrees, and clinical and mentorship opportunities . Specifically, 19 of 38 midwifery graduate programs admit bachelors‐prepared individuals who are not nurses .…”

Section: Introductionmentioning

confidence: 99%

The Effect of Prior Work Experiences on the Preparation and Employment of Early‐Career Midwives

Woeber¹,

Sibley²

2018

J Midwife Womens Health

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Introduction Strategic recruitment, preparation, distribution, and retention of US midwives requires a solid body of knowledge about midwives’ education and workforce experiences. Although half of US midwifery education programs currently require or prefer prior registered nurse (RN) employment, data are lacking about whether and how these criteria influence efforts to scale up the workforce to meet reproductive care workforce shortages and maldistributions. Methods This cross‐sectional research used an online survey, developed using the framework of Social Cognitive Career Theory. Early‐career midwives were contacted through the American College of Nurse‐Midwives electronic mailing list and social media during the fall of 2016. Statistical analysis allowed for linkage of data related to the following constructs: personal characteristics, prior RN employment, educational experiences, employment situations, career perceptions, and future plans. Results All participants (N = 244) were certified nurse‐midwives. Compared with those without prior RN employment, midwives with prior RN employment were more likely to enroll part‐time in distance programs and complete single majors or degrees. During enrollment, the 2 groups experienced the same degree of mentorship and cultural support and were similarly likely to attend 30 births and to pass the certification examination on first attempt. In the workforce, those with prior RN employment were 6 years older and more likely to work full‐time. The 2 groups demonstrated no significant differences in their career perspectives or future career plans. Discussion Despite anecdotal concerns about training midwives who lack RN work experience, an individual without prior RN employment offers the workforce an employee who completes midwifery education at a younger age, may be educated more quickly, and is more likely to have earned a dual major or degree. Those with prior RN employment are more likely to work full‐time. Both groups may offer benefits to education and the workforce.

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Facilitating Access to Prenatal Care Through an Interprofessional Student‐Run Free Clinic

Cited by 17 publications

References 26 publications

Syndemic of Lifetime Mental Illness, Substance Use Disorders, and Trauma and Their Association With Adverse Perinatal Outcomes

Syndemic of Lifetime Mental Illness, Substance Use Disorders, and Trauma and Their Association With Adverse Perinatal Outcomes

Interventions facilitating access to perinatal care for migrant women without medical insurance: A scoping review protocol

The Effect of Prior Work Experiences on the Preparation and Employment of Early‐Career Midwives

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