COVID-19 and reproductive injustice
J. Michael Ryan in COVID-19, 2020
While pregnancy is not a medical condition, access to quality prenatal care is critical. Quality prenatal care that is culturally appropriate and that involves positive relationships with providers can offer maternal support, reassurance, and practical advice and reduce the risk of maternal and infant mortality (Oparah et al. 2018). Particularly for those individuals with higher-risk pregnancies, prenatal care can save the lives of mothers and babies. Pre-eclampsia, eclampsia, and gestational diabetes are all potentially life-threatening health conditions that are identified and treated through prenatal care (Oparah et al. 2018). Despite these known benefits, many practitioners are reducing, modifying, and cancelling prenatal services due to risk of disease transmission. In-person maternity tours, birthing and maternal education classes, support groups, and in-person prenatal visits are being cancelled, particularly in COVID-19 hotspots. While COVID-19 presents a need for providers to offer alternative delivery approaches, it is important to think through the implications of such alternatives for different groups of pregnant individuals.
Gender, choice and time
Kate Reed in Gender and Genetics, 2012
Discussions on the issue of reproductive choice have also tended to focus on the routinised nature of screening. Numerous authors have considered how the tests have become increasingly constructed and communicated as routine in order for them to be conveyed effectively (see Press and Browner 1994). McCourt (2006) in particular has raised this in two rhetorical patterns of communication: in ‘routine as choice’ and ‘choice as routine’. Through either type of communication, professionals emphasise that women have choice over which tests to opt for. However, the choice to have tests is often presented as routine, and as a normal aspect of prenatal care (Press and Browner 1997). This has led authors such as Kerr (2004) to argue therefore, that many of today’s ‘choices’ can be said to be encouraged by the state, not made freely but within social and professional contexts.
Would You Like to Become Pregnant in the Next Year? The One Key Question® Initiative in the United States
Mary Nolan, Shona Gore in Contemporary Issues in Perinatal Education, 2023
In the United States, two consistent realities are obvious. The first is that reproductive education, counseling, and care are seen as the ‘business’ of specialists, rather than of primary care providers. The second is that while prenatal care is ‘part of the wallpaper’ in America (for those with adequate health coverage), little pre-pregnancy information, preparatory counseling, or care are received or routinely accessible by everyone for whom pregnancy is a possibility. People are largely left on their own to understand the need for, seek out, and afford quality advice and assistance in preparing for a healthy pregnancy before conception. It is as if pregnancy does not begin until the first prenatal visit, late in the first trimester (Sher, 2021; Skogsdal et al, 2019; Stephenson et al., 2018).
Poor prenatal care does not predict well child care for children born to mothers with opioid use disorder
Published in Journal of Substance Use, 2020
Esther K. Chung, Vanessa L. Short, Dennis J. Hand, Ruth S. Gubernick, Diane J. Abatemarco
Sociodemographic and health characteristics for the overall sample of 138 mother-child dyads are shown in Table 1. The study population consisted of largely young, White, non-Hispanic, multiparous mothers who reported father involvement and were Medicaid recipients or uninsured. The majority of women reported a history of depression and at least half, a history of anxiety. Bipolar disorder was reported in one-quarter and post-traumatic stress disorder in 11%. Separate from their MMT, approximately two-thirds of mothers had evidence of other substance use with 1/3 having additional opioid use during pregnancy. Gestational age at the onset of prenatal care ranged from six to 39 weeks (median = 18 weeks). Approximately two-thirds (59%) of women lacked adequate prenatal care. For 14 mothers, there were incomplete, “unknown” or no prenatal care records; and four lacked prenatal care records attributed to incarceration. Twenty-nine (21%) enrolled in the MBP program noted above, with 69% (20) completing the 12-week program.
Association of maternal neutrophil count in early pregnancy with the development of gestational diabetes mellitus: a prospective cohort study in China
Published in Gynecological Endocrinology, 2022
Man Kong, Hongmei Zhang, Xianchang Liu, Yanyan Ge, Zhen Zhang, Rui Zhao, Yan Li, Shanshan Huang, Guoping Xiong, Xuefeng Yang, Liping Hao, Zhongxin Lu
The study participants formed part of the Tongji Birth Cohort (TJBC), an ongoing prospective cohort of pregnant women and their offspring in Wuhan, China. A major objective of this cohort is to assess the effect of diet and lifestyle factors on both mothers and children. Women who began prenatal care before 16 weeks’ gestation at the authors’ hospital and who were eligible for entry into our cohort from Mar 2018 to the present were included. The analysis process followed the procedure described in Figure 1. Among the 1467 pregnant women who performed prenatal care before 14 weeks of gestation in the cohort, women without information on GDM diagnosis (n = 353) or missing blood cell test (n = 373) were excluded. Those who reported infectious disease (e.g. HIV, virus, hepatitis, syphilis) (n = 5), abnormal liver or renal function (n = 2), preexisting diabetes (n = 4). Finally, a total of 731 participants with blood test results in the first trimester were selected to determine the association between the levels of blood cell parameters and GDM risk. The TJBC study was approved by the Ethics Review Committee of Tongji Medical College, Huazhong University of Science and Technology, in accordance with the principles of the Helsinki Declaration II. Each participant in the study was informed of the study protocol and signed informed consent before participating in this study.
Polish maternity services in times of crisis: in search of quality care for pregnant women and their babies
Published in Health Care for Women International, 2020
Maria Węgrzynowska, Antonina Doroszewska, Magdalena Witkiewicz, Barbara Baranowska
The model of maternity care in Poland is strongly OB/GYN driven. Midwives are almost entirely excluded from providing prenatal care. Their role is often limited to parental education classes and postnatal home visits. While there are some community-based midwifery units, they remain at the margins of maternity services and usually cater for a handful of women who either consider homebirth or seek to escape the mainstream model of maternity care (Łata et al., 2019). Prenatal care is delivered almost exclusively by doctors in outpatient clinics that may be located on or off the hospital grounds (in a community). Births are centralized in hospitals with almost no community-based alternative. Homebirths are not available through any public, national maternity programme and are provided privately by a relatively small group of independent midwives (Baranowska et al., 2019).
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