PURPOSE:Limited research exists examining the use of pasteurized donor human milk (PDHM) in healthy and non-critically ill infants. To inform care for families using PDHM, we present three case exemplars of the experiences of families who used PDHM supplementation in the birth hospital for their healthy infants. STUDY DESIGN:Participants were recruited through word of mouth and social media and interviewed via Zoom using a semi-structured interview guide. Three interviews were conducted in April of 2025. METHODS:Qualitative interviews were compared, and characteristics, similarities, and challenges were identified. RESULTS:Experiences, motivations, and challenges of supplementation with PDHM were outlined and explained. Breastfeeding outcomes and perceptions of how PDHM played a role in the breastfeeding relationship were presented. CLINICAL IMPLICATIONS:Results reveal deeper insight into how PDHM supplementation may support breastfeeding and highlight necessary considerations for caring for healthy infants requiring PDHM supplementation.
BACKGROUND:Pregnant and postpartum individuals affected by opioid use disorder (OUD) experience barriers to accessing medications for opioid use disorder (MOUD) and engagement in treatment. Nursing-led approaches that integrate community and pharmacy may help close care gaps, especially in rural areas. METHODS:This scoping review examined current U.S.-based evidence describing certified nurse midwives (CNMs), community-based pharmacists (CBPs), and community health support (CHS) in caring for perinatal OUD. Using PRISMA-ScR guidelines, four databases were searched for English-language studies published between 2015 and 2025, reflecting the U.S. policy and practice context for MOUD delivery. The 2015 start date reflects contemporary policy changes expanding access to MOUD. Data were charted and summarized. RESULTS:Fifteen studies met inclusion criteria. CNMs and nurses were trusted clinicians who advanced MOUD initiation and retention through stigma reduction and relational care. Limited pharmacy evidence showed potential to expand MOUD access but found insurance and stigma barriers. CHS served as trusted navigators, improving engagement, mental health, and continuity of care. CLINICAL IMPLICATIONS:Collaborative CNM-CBP-CHS models may enhance access and retention in perinatal OUD care. Nursing leadership, education, and community partnerships are needed to advance care for perinatal OUD. Supplemental Digital Content is available in the text.
Purpose: To determine factors that increase the risk of newborn falls or drops during the birth hospitalization.Study Design and Methods: Using evidence from a review of the literature and newborn falls and drops at our hospital, a data collection instrument was developed and a retrospective, cross-sectional, exploratory review of a convenience sample from hospitals that had experienced at least one newborn fall was conducted. Data were collected from September 2016-June 2025.Results: Information on 88 newborn falls or drops was collected from 15 hospitals. Eleven potential risk factors were identified: nighttime, cesarean birth, second and third night after birth, maternal anemia/excessive blood loss, use of prescribed opioids within 4 hours of fall, comorbidities, maternal attachments, high-risk fall behaviors, breastfeeding, in-hospital use of prescribed sedating medications, and history of illegal substance use within the last 2 years.Clinical Implications: All newborns are at risk of falling or being dropped by a parent or support person, and some are at higher risk than others. Knowing the risk factors can help nurses and other members of the maternity care team to identify those at greater risk of falling or being dropped and implement preventative measures.
Abstract Purpose: To examine whether complications during childbirth moderates the relationship between exposure to a TeamBirth huddle during labor and patient trust and autonomy. Study Design and Methods: Secondary analysis of patient experience surveys from 31 birthing hospitals in Oklahoma implementing TeamBirth between March 2022 and June 2024. Sample included 6,528 patients ≥15 years, of whom 774 reported childbirth complications. Patients were asked about demographic and clinical characteristics, experience with TeamBirth huddles, and responses to the Health Care Relationship Trust Scale (HCRTS-R) and My Autonomy in Decision-Making (MADM) scale. We used multivariable regression with interaction terms, adjusting for key demographic and clinical factors, to explore the role of complications in the relationship between TeamBirth exposure and patient trust and autonomy levels. Results: Reported childbirth complications significantly strengthened the positive association between TeamBirth exposure and patient trust and autonomy (HCRTS-R: b = 2.86, p < .001; MADM: b = 3.77, p < .001). Clinical Implications: Experiencing a TeamBirth huddle during labor is positively associated with improved patient-reported trust and autonomy across groups, with the strongest effects observed among patients with childbirth complications. Nurses play a key role in implementing the TeamBirth model to enhance patient-centered care and mitigate the potential negative effects of complications on childbirth experiences.
Abstract Background: Postpartum depression (PPD) affects 10% to 20% of mothers, with higher rates among marginalized communities. Mental health issues contribute to 22.7% of pregnancy-related deaths. Doulas provide continuous emotional, physical, and informational support throughout the perinatal continuum. Methods: This narrative review synthesized data from articles published from 2020-2025 that examined the impact doula support had on PPD. PubMed, CINAHL, and Google Scholar were searched in February 2025. Search terms included “Depression, Postpartum,” “Social Support,” “Maternal Health Services,” “Doula,” “Birth Support,” and “Perinatal Mental Health.” Results: Nine articles met inclusion criteria and were included in the review. Qualitative, quantitative, and review articles were represented in this narrative review. Women receiving doula support had lower odds of developing PPD or postpartum anxiety. Outcomes for women who had doula participation during and after pregnancy include enhanced social support, reduced stress, improved birth experiences, and increased maternal self-efficacy. Clinical Implications: Doulas show promise for PPD prevention. Barriers exist for marginalized and underresourced populations of patients in accessing doula care, yet these are the populations who report maternal mental health disorders disproportionately compared with nonmarginalized women. We recommend focusing on the protective value of doulas in preventing PPD, overcoming barriers for patient access to doulas, and standardized mental health education for doulas. Integrating doula support into maternity care requires alignment with the health care team to ensure continuity and effectiveness. Nurses are critical in this partnership through assessment and collaborative care coordination.
Background: Gender-based violence (GBV) encompasses physical, emotional, verbal, coercive, and discriminatory forms of violence. Previous experiences of GBV have been shown to influence the childbirth experience negatively.Purpose: Examine subjective childbirth experiences of women with a history of GBV.Inclusion criteria: (1) Studies including qualitative content that discusses GBV; (2) participants identified as women; (3) aged 18 years or older; (4) focused on women's subjective childbirth experiences; (5) written in English; and (6) available as full-text sources.Study Design and Methods: The qualitative scoping review followed the Joanna Briggs Institute (JBI) methodology. Databases searched included CINAHL (EBSCO), MEDLINE (Ovid), ProQuest Nursing and Allied Health, Scopus, OVID Emcare, ProQuest Dissertations and Theses, PsycINFO, and grey literature. No publication date restrictions were applied. Two reviewers independently screened titles and abstracts, with full texts retrieved for eligible sources. Discrepancies were resolved through consensus discussion or adjudicated by a third reviewer. Data were extracted using a standardized data extraction tool.Results: Thirty-one articles were extracted. Six major themes were identified: (1) maintaining control; (2) triggers, flashbacks, and dissociations; (3) impact of support; (4) physical vulnerability; (5) desire to disclose; and (6) childbirth as healing.Clinical Implications: This review revealed novel findings regarding childbirth as a healing experience after GBV and emphasized women's desire to disclose GBV histories during the birthing process. Further research is needed to explore the childbirth experiences of individuals with diverse forms of GBV.
Abstract Purpose: To explore nurse perceptions of perinatal cannabis use, current nurse and patient education on perinatal cannabis use, and educational needs for nurses and patients on perinatal cannabis use. Study Design and Methods: We conducted a multiple-case qualitative case study. Using convenience and snowball sampling, we recruited perinatal nurses who worked in U.S. hospitals to complete an online interview. We identified themes and subthemes using Braun and Clarke's method of thematic analysis. Results: Between July 2023 and February 2024, we interviewed 22 perinatal nurses divided almost equally among states where recreational cannabis was illegal ( n = 12, 54.5%) and legal ( n = 10, 45.5%). We identified five themes under the category of nurse perceptions of cannabis use: adverse maternal outcomes during pregnancy, maternal risks during labor, adverse neonatal health outcomes, acceptance of perinatal cannabis use, and management of physical and mental symptoms. Nurses reported on existing nurse education and patient education, with only nurses in states with recreational cannabis legalization citing specific patient educational needs. Clinical Implications: Our findings indicate an urgent need for development and implementation of nurse and patient education about perinatal cannabis use, particularly in states with recreational cannabis legalization.
Purpose: To identify the prevalence and patterns of perinatal missed nursing care, potential factors contributing to perinatal missed care, and understand the impact of perinatal missed nursing care on patient outcomes.Study Design & Methods: Integrative review following the methodology of Whittemore and Knafl. Data were sourced from PubMed, CINAHL, EMBASE, Web of Science, and Scopus and appraised using the Mixed Methods Appraisal Tool. Data were extracted and iteratively compared to identify patterns, themes, and relationships.Results: Seventeen studies from eight countries met inclusion criteria. Use of different adapted instruments covering diverse aspects of perinatal care made comparison across studies challenging. The prevalence of perinatal missed nursing care was 21.9% to 78.9% depending on the aspect of care assessed and measure used. Inadequate staffing, competing demands, and lack of material resources were commonly reported antecedents to perinatal missed nursing care. Limited maternal and neonatal outcomes have been explored; however, missed nursing care during labor and birth was significantly associated with lower hospital-level rates of initiation and exclusivity of breast milk feeding.Clinical Implications: Missed nursing care is a recognized indicator of quality of care across hospital settings. The prevalence of missed perinatal nursing care was driven by inadequate staffing and other structural factors which may also contribute to nurse burnout and job dissatisfaction. National standards for registered nurse staffing in perinatal units should be budgeted for and followed to ensure safe, high-quality perinatal care. A universal measure for the perinatal context could advance understanding of perinatal missed care.
Abstract Fetal and neonatal hyperthyroidism are rare, but severe, conditions caused by transplacental passage of thyrotropin receptor antibodies from a pregnant patient with current or past Graves disease. We present the case of a late preterm infant who developed thyrotoxicosis secondary to maternal Graves disease treated with radioactive iodine, followed by a review of the literature, clinical implications, and best practices on the diagnosis and treatment of neonatal hyperthyroidism. We highlight the importance of finding the underlying cause for hypothyroidism during pregnancy, ensuring those with past Graves disease receive antibody monitoring, and neonatal thyroid function is assessed within the first few days of life, so timely treatment can be initiated if necessary.
PURPOSE:Working from home (WFH) increased during the COVID-19 pandemic. The purpose of this study is to explore mothers' breastfeeding experiences of mutual responsiveness and perceived adequate milk supply in the breastfeeding relationship for the first 6 months after birth. STUDY DESIGN METHODS:Descriptive longitudinal qualitative design was used as part of a large study. Data were analyzed from a purposive sample of 25 breastfeeding mothers who returned to WFH within the first 6 months and directly breastfed their infant at least once a day for the first 6 months between June 2022 and August 2023. Inductive content analysis was used to analyze mothers' written responses to 4 open ended questions using an online survey, including breastfeeding experience at home, mothers' thoughts and feelings during direct breastfeeding, strategies used to resolve their breastfeeding problems, and breastfeeding support at work. Trustworthiness was attained by coding to consensus, peer debriefing, and maintaining audit trail. RESULTS:Changes in Breastfeeding Relationships When Mothers Return to Work from Home was the core construct and organized into three domains: (1) changes in breastfeeding when returning to work from home , (2) social support for breastfeeding continuation , and (3) maternal distress following return to work from home . CLINICAL IMPLICATIONS:For mothers juggling paid work while integrating direct breastfeeding with breast milk expression at home, it is recommended that nurses promote unrestricted direct breastfeeding when possible, including nighttime feeding, to sustain the breastfeeding relationship. This strategy will remain relevant in a postpandemic context.
