Matching Items (7)

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Comparative Policy Analysis of Maternal Mental Health in Bangladesh and Nepal

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Maternal health and mental health have recently become globally recognized as critical areas of focus. The continued research into the relationship between maternal health and mental health—in particular, how they

Maternal health and mental health have recently become globally recognized as critical areas of focus. The continued research into the relationship between maternal health and mental health—in particular, how they are affected by public policy and infrastructure—is vital to the improvement of general health outcomes. An investigation of literature, current health landscape and indicators, gray literature, and the current policy landscape in an exemplar country (Australia), Bangladesh and Nepal was done. Bangladesh and Nepal were chosen due to the recent amounts of change seen in each country’s maternal health status. Both Bangladesh and Nepal are severely lacking in official mental health services, facilities, and personnel. The analysis revealed flaws and disparities in each country’s current policy landscape. Despite these disparities it should be recognized that policies and programs are being implemented – just in a very piecemeal manner, and not entirely by each country’s respective government. Integration of maternal health services and mental health services is recommended to improve functionality of already existing services. The addition of minimal but necessary components to health systems is recommended.

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  • 2015-05

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Pregnancy Outcomes in ICE Detention Facilities

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Policy trends show that pregnant women have been detained in ICE facilities since as early as 2015. As the laws and policies have continued to shift, pregnant women have become

Policy trends show that pregnant women have been detained in ICE facilities since as early as 2015. As the laws and policies have continued to shift, pregnant women have become more exposed to being detained. Executive Order 13768 made by former President Donald Trump effectively removed all protections against being detained for pregnant women. While the previous policy exempted pregnant women from being detained aside from in extraordinary cases, this executive order puts women at increased risk of being detained while pregnant. The Trump Administration's goal of protecting the American people and promoting national security puts women in a position in which their health status is no longer seen as a detention exemption. There is almost no published work on this topic. It is extremely under-researched and there is an urgent need for more academic, legal, and medical research on the impacts of detaining pregnant women. This paper functions to fill a very pressing research gap in order to highlight the experiences of pregnant women in detention centers and the health outcomes they face as a result of their status as detainees. I argue that detaining pregnant women is a form of gendered violence as it puts them at increased risk of maternal health complications, such as preterm birth, low birth weight, and more. While more women migrate to the United States, the laws and policies regarding detaining pregnant women are often contradictory and it is difficult to ascertain the true number of pregnant women in detention centers. In this paper, I examine the preceding factors to female migration, the climate of detention in the United States, the policies regarding pregnancy, and the outcomes that women experience.

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  • 2021-05

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Racial Disparities in Maternal Mortality: A Review of the Literature

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The rising national maternal mortality rate has brought international attention to the United State's maternal healthcare crisis. This literature review consolidates and compares academic research on the best practices for lowering maternal mortality rates and reducing racial disparities in healthcare.

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  • 2021-05

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Midwifery around the World: A Study in the Role of Midwives in Local Communities and Healthcare Systems

Description

2015 marks the deadline for the UN Millennium Development Goal 5 to reduce global maternal mortality rate (MMR) by 75% since 1990. As of 2015, MMR has only been reduced

2015 marks the deadline for the UN Millennium Development Goal 5 to reduce global maternal mortality rate (MMR) by 75% since 1990. As of 2015, MMR has only been reduced by 45%. Many international organizations claim that more medically trained midwives can meet global maternal health care needs. This study investigates two major questions. What is the role of midwives in diverse international maternal healthcare contexts? How do midwives in these different contexts define their roles and the barriers to providing the best care for women? From May to August 2015, I conducted over 70 interviews with midwives in Netherlands, Sweden, Rwanda, Bangladesh, Australia and Guatemala, interviewing between 6 and 13 midwives from each country. The majority of midwives defined their roles as supporting women's individual capacities and power through normal birth, and knowing when to refer when high-risk complications arise. Although thematic barriers vary by country, midwives in all countries believed that maternal healthcare can be improved by increased collaboration between midwives and other health care professionals, better access to culturally appropriate services, and greater public awareness of the role of midwives.

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Date Created
  • 2016-05

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Maternal health in Ethiopia: global and local complexities

Description

WHO estimates that 830 women die every day due to maternal health complications. The disparities in maternal health are unevenly distributed between wealthy and poor nations. Ethiopia has one of

WHO estimates that 830 women die every day due to maternal health complications. The disparities in maternal health are unevenly distributed between wealthy and poor nations. Ethiopia has one of the highest mortality rates in the world. Existing high maternal mortality rates worldwide and in Ethiopia indicate the shortcomings of maternal health interventions currently underway. Understanding the socio-cultural, economic and political factors that influence maternal health outcomes locally while simultaneously examining how global reproductive and development programs and policies shape and influence the reproductive needs and knowledge of women is important. Employing feminist and African indigenous methodologies, in this research I explore maternal health issues in Ethiopia in two of the largest regions of the nation, namely Oromia and Amhara, more specifically in Seden Sodo and Mecha districts. Using qualitative interviews and focus group discussions, I examined the various socio-cultural, political and economic factors that influence maternal health outcomes, assessing how gender, class, education, marriage and other social factors shape women's health outcomes of pregnancy and childbirth. I also explored how global and local development and reproductive health policies impact women's maternal health needs and how these needs are addressed in current implementation strategies of the Ethiopian health system. Recognizing women's social and collective existence in indigenous African communities and the new reproductive health paradigm post-ICPD, I addressed the role of men in maternal health experience. I argue that global and local development and reproductive policies and their implementation are complex. While comprehensive descriptions of national and maternal health policies on paper and gender-sensitive implementation strategies point toward the beginning of a favorable future in maternal health service provision, the global economic policies, population control ideas, modernization/development narratives that the nation employs that focus on biomedical solutions without due emphasis to socio-cultural aspects have a detrimental effect on maternal health services provision. I advocate for the need to understand and include social determinants in policies and implementation in addition to legal enforcement and biomedical solutions. I also argue for alternative perspectives on masculinities and the role of men in maternal health to improve maternal health service provision.

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Created

Date Created
  • 2017

The Power of Yoga: Investigating the Feasibility and Preliminary Efficacy of a Prenatal Yoga Intervention to Prevent Excessive Gestational Weight Gain

Description

Excessive gestational weight gain (EGWG) affects 50% of US pregnant women and may be an important contributor to obesity in both the mother and child. Novel strategies to prevent EGWG

Excessive gestational weight gain (EGWG) affects 50% of US pregnant women and may be an important contributor to obesity in both the mother and child. Novel strategies to prevent EGWG are needed to reduce the risk of adverse health outcomes for the mother and child. This dissertation presents three manuscripts that 1) propose a novel model to explain how prenatal yoga may prevent EGWG through behavioral, psychological/emotional, and physical factors, 2) test the feasibility and preliminary efficacy of a prenatal yoga intervention to prevent EGWG compared to a pregnancy education comparison group, and 3) qualitatively investigate pregnant women’s experiences participating in a prenatal yoga intervention to prevent EGWG. In manuscript two, 49 women were recruited and randomized to a 12-week prenatal yoga intervention (n=23) or a time-matched pregnancy education comparison group (n=26). A satisfaction survey was administered at post-intervention to assess feasibility outcomes (e.g., acceptability, demand). Mindfulness, emotion regulation, self-awareness, sleep quality, depression, anxiety, and perceived stress were assessed at baseline and post-intervention (12-weeks) and GWG was assessed weekly. Linear mixed models were used to analyze pre-post changes in primary (i.e., GWG during pregnancy) and secondary (i.e., mindfulness, emotion regulation, self-awareness, sleep quality, depression, anxiety, and stress) outcomes. In manuscript three, interviews were conducted with pregnant women who participated in the prenatal yoga intervention (n=13). Interview responses were summarized using an inductive approach to thematic analysis. Findings in manuscript two suggest that prenatal yoga was a feasible method to prevent EGWG with high enjoyment and satisfaction reported among participants. The average number of prenatal yoga sessions attended was 8.84 (SD = 3.85). There was no significant group differences on the rate of GWG or total GWG throughout the intervention and a significant group x time interaction effect for stress (p=.03). In manuscript three, twelve themes were identified among the data and were organized into the following categories (three themes each): 1) experiences of prenatal yoga, 2) prenatal yoga and weight, 3) barriers to prenatal yoga, and 4) facilitators of prenatal yoga. This initial evidence suggests that prenatal yoga has potential as a strategy to prevent EGWG in pregnant women.

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  • 2019

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Relationship between resting energy expenditure and sleep parameters on gestational weight gain and the mediation effect of macronutrient composition

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No studies have evaluated the impact of tracking resting energy expenditure (REE) and modifiable health behaviors on gestational weight gain (GWG). In this controlled trial, pregnant women aged >18 years

No studies have evaluated the impact of tracking resting energy expenditure (REE) and modifiable health behaviors on gestational weight gain (GWG). In this controlled trial, pregnant women aged >18 years (X=29.8±4.9 years) with a gestational age (GA) <17 weeks were randomized to Breezing™ (N=16) or control (N=12) for 13 weeks. The Breezing™ group used a real-time metabolism tracker to obtain REE. Anthropometrics, diet, and sleep data were collected every 2 weeks. Rate of GWG was calculated as weight gain divided by total duration. Early (GA weeks 14-21), late (GA weeks 21-28), and overall (GA week 14-28) changes in macronutrients, sleep, and GWG were calculated. Mediation models were constructed using SPSS PROCESS macro using a bootstrap estimation approach with 10,000 samples. The majority of women were non-Hispanic Caucasian (78.6%). A total of 35.7% (n=10), 35.7% (n=10), and 28.6% (n=8) were normal weight, overweight, and obese, respectively, with 83.3% (n=10) and 87.5% (n=14) of the Control and Breezing™ groups gaining above IOM GWG recommendations. At baseline, macronutrient consumption did not differ. Overall (Breezing™ vs. Control; M diff=-349.08±150.77, 95% CI: -660.26 to -37.90, p=0.029) and late (M diff=-379.90±143.89, 95% CI:-676.87 to -82.93, p=0.014) changes in energy consumption significantly differed between the groups. Overall (M diff=-22.45±11.03, 95% CI: -45.20 to 0.31, p=0.053), late (M diff=-23.16±11.23, 95% CI: -46.33 to 0.01, p=0.05), and early (M diff=20.3±10.19, 95% CI: -0.74 to 41.34, p=0.058) changes in protein differed by group. Nocturnal total sleep time differed by study group (Breezing vs. Control; M diff=-32.75, 95% CI: -68.34 to 2.84, p=0.069). There was a 11.5% increase in total REE throughout the study. Early changes in REE (72±211 kcals) were relatively small while late changes (128±294 kcals) nearly doubled. Interestingly, early changes in REE demonstrated a moderate, positive correlation with rates of GWG later in pregnancy (r=0.528, p=0.052), suggesting that REE assessment early in pregnancy may help predict changes in GWG. Changes in macronutrients did not mediate the relationship between the intervention and GWG, nor did sleep mediate relationships between dietary intake and GWG. Future research evaluating REE and dietary composition throughout pregnancy may provide insight for appropriate GWG recommendations.

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Created

Date Created
  • 2019