Aim: To measure the association between job satisfaction and perceived quality of care among nurses on labor and delivery (LD) units. Background: Nurses constitute the largest segment of the US healthcare workforce. Low job satisfaction is a critical factor in nurse turnover and quality of care. Methods: A web-based survey was distributed across LD units in the United States. We used logistic regression to assess the association between job satisfaction, as measured by the employee net promoter score (eNPS), and perceived indicators of quality of care. Results: Among 1021 LD nurses who responded, those characterized as passive or detractors had greater odds of rating that the quality of care on their LD unit was fair or good rather than excellent (adjusted odds ratio [aOR] 3.45, 95% CI: 2.44-4.88 and aOR 6.58, 95% CI: 4.08-10.75, respectively, with both p < 0.0001), agreeing that nurses were spending less time with laboring patients suspected or confirmed to have COVID-19 (aOR 1.42, 95% CI: 1.04-1.95, p = 0.0288; aOR 2.08, 95% CI: 1.33-3.28, p = 0.0014) and reporting that professional labor support was frequently or always missed during the pandemic (aOR 2.19, 95% CI: 1.49-3.20, p < 0.0001; aOR 1.82, 95% CI: 1.09-3.03, p = 0.0217) compared to respondents characterized as promoters. Conclusions: Higher nursing job satisfaction as measured by the eNPS is associated with higher perceived quality of care on the LD units. Implications for Nursing Management: eNPS is a one-question survey that is easy to deliver, simple to interpret, and is associated with perceived quality of care. Nursing management can use it to track progress over time and understand reasons for job dissatisfaction on their units.

The Editor in Chief examines the responsible use of citations and references, the influence of artificial intelligence and common errors, and strategies that authors and reviewers can use to maintain trust in the scholarly record.

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.

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.

The Editor in Chief examines the multifaceted nature of censorship in academic research, the implications for nursing and midwifery research, and strategies to resist censorship.

PURPOSE:To examine relationships between the subdomains of professional quality of life and intention to stay in the job and the profession among perinatal registered nurses in the United States during the COVID-19 pandemic. BACKGROUND:There is limited knowledge about professional quality of life, encompassing burnout, secondary traumatic stress, and compassion satisfaction, and its impact on turnover intention among U.S. perinatal registered nurses. METHODS:We conducted a repeated, cross-sectional survey. Surveys were distributed online in May 2021 and May 2022 to a convenience sample of perinatal registered nurses ( N = 113). We conducted descriptive statistics, Mann-Whitney U, Kruskal-Wallis, Spearman's rank correlation, and multiple linear regression. RESULTS:There was an increase in burnout ( P = .004) and secondary traumatic stress ( P < .001) and a decrease in compassion satisfaction ( P < .001), and intention to stay in the job ( P < .0001) and the profession ( P < .001). Higher compassion satisfaction was associated with higher intention to stay in the job ( P < .0001) and the profession ( P < .0001). Higher burnout was associated with lower intention to stay in the job ( P < .0001) and the profession ( P < .0001). Higher secondary traumatic stress was associated with lower intention to stay in the job ( P < .0001) and the profession ( P < .0001). CONCLUSION:We observed deteriorating professional quality of life and decreased intention to stay in the job and in the profession among U.S. perinatal registered nurses. IMPLICATIONS FOR PRACTICE AND RESEARCH:Strategies are needed to foster a health care environment in which compassion satisfaction is maximized among perinatal registered nurses.

Despite childbirth being a leading cause of hospitalization, the system of care has not been optimized for patients in the United States. Rates of maternal mortality are high, increasing, and disproportionate. In addition to disparities in health outcomes, the quality of perinatal care, as assessed by patient experiences of care, is variable. Although clinicians strive to actively support families through labor and childbirth, various forms of mistreatment are common in perinatal care. Such instances of patient mistreatment highlight an urgent need to further enact respectful maternity care principles so that services are more person-focused and supportive. Welcoming clinical environments with relationship-centered care, trauma-informed interactions, and anti-racist practices support maternal autonomy. As a part of these quality care approaches, effective communication by clinicians helps patients understand their healthcare options and the events that shape their childbirth experiences. Nonstigmatizing interactions, using linguistically and culturally appropriate language, and integrating tools for shared decision making are essential elements of quality intrapartum care. A reproductive justice lens focuses attention on the need to eliminate infringements on health and build assurances to enable positive health outcomes and thriving.

BACKGROUND:Understanding future demand for midwifery-led birth centers is critical to increasing utilization of this high-value model of care. This study examines factors associated with interest in birth center care for a future pregnancy. METHODS:We analyzed data from the Listening to Mothers in California survey. The study included 1447 people who had a singleton hospital birth in 2016 and did not have a history of cesarean birth. Multivariate logistic regression models were conducted with variables that were aligned with the Coxon model of birth setting decision-making. RESULTS:More than half of respondents (n = 789; 54.5%) expressed interest in receiving care at a birth center in the future. Respondents were more likely to express interest in birth center care if they had experienced pressure to have an obstetric intervention (AOR 1.86, 95% CI = 1.83-1.90) or believed that birth is a natural process that should not be interfered with unless medically necessary (AOR 1.74, 95% CI = 1.71-1.78), compared to respondents who did not. They were also more likely to have sought information about hospital cesarean rates (AOR 1.50, 95% CI = 1.47-1.52), had a doula in labor (AOR 1.42, 95% CI = 1.39-1.45), and experienced mistreatment (AOR 1.23, 95% CI = 1.21-1.26). CONCLUSIONS:Broadening access to midwifery-led birth centers to accommodate future demand is needed. Providing pregnant people with comparable quality measures of birth center and hospital care may facilitate informed decision-making. Improving the shared decision-making abilities of healthcare providers could help prevent instances of mistreatment or undue pressure on pregnant individuals to undergo obstetrical interventions.

JOGNN's Editor in Chief explores the global decline in fertility rates in the context of reproductive agency and considers implications of this trend for perinatal nurses and midwives.

Background:Patient-provider communication (PPC) increasingly occurs in online patient portals. Variations in portal usage might worsen communication inequities for pregnant people of color (POC), widening the digital divide. The objective of this study was to examine the relationships between respectful PPC, patient portal usage, and digital health literacy (DHL) in pregnant POC. Methods:A multimethod cross-sectional survey design was used. Ordered logistic regression was performed to determine the relationship between PPC and portal use, controlling for trimester prenatal care was initiated, insurance type, age, gestational age, and parity. The moderating effect of Digital Health Literacy Instrument (DHLI) was tested on the association between portal usage and PPC. Results:A total of 130 self-identified pregnant POC participated in the study. Participants who did not use the portal had 68% lower odds of rating higher quality PPC (odds ratio [OR] = 0.32, 95% confidence interval [CI] = 0.12-0.86, p = 0.02). Participants with public versus private insurance had 62% lower odds of rating high-quality PPC (OR = 0.38, 95% CI = 0.14-0.99, p = 0.04). For portal users, DHL moderated the association between PPC and portal use - eHealth Literacy Scale (adjusted OR [aOR] = 1.06, 95% CI = 1.01-1.12, p = 0.02) and DHLI (aOR = 2.36, 95% CI = 1.12-4.95, p = 0.02). The moderation effect of DHLI was also significant among limited portal users (aOR = 2.32, 95% CI = 1.04-5.19, p = 0.04). Conclusion:Addressing the digital divide for pregnant POC requires further investigation into portal non-users with consideration to insurance type, DHL, and social determinants of health.

PURPOSE:To explore how perinatal nurses perceive the effects of visitor restrictions on patient care within a hospital setting. STUDY DESIGN AND METHODS:We distributed a cross-sectional survey online to perinatal nurses in May of 2022. Characteristics of respondents were analyzed using descriptive statistics. Responses to an open-ended question were analyzed via conventional content analysis. RESULTS:Among our sample of 101 nurses, we identified seven codes representing positive effects and seven codes representing negative effects. The most frequently reported positive effects were ability to provide person-centered care ( n = 36, 35.6%) and less patient stress and more rest ( n = 29, 28.7%). The most frequently reported negative effects were limited patient support ( n = 22, 21.8%) and emotional distress to the patient ( n = 15, 14.9%). Fourteen percent ( n = 14) of respondents cited both positive and negative effects. CLINICAL IMPLICATIONS:Nurses perceived that visitor restrictions resulted in both positive and negative patient experiences. Balancing clinical needs and safety considerations with emotional needs of the childbearing individual requires careful consideration by maternity care clinicians and health care systems. Subsequent research is needed to determine optimal visitation policies during intrapartum and postpartum with consideration to hospital context and patient preferences for optimal care.

Switzerland's midwifery model of postpartum care is described and compared to postpartum care in the United States.

Abstract Purpose: To describe the expectations of early labor by nulliparous pregnant women in their third trimester and first-time mothers' experiences of early labor after they had given birth. Study Design and Methods: A descriptive qualitative approach involving semi-structured, video-call interviews conducted between September 2020 and April 2021. Data were analyzed using content analysis. Results: Twenty-two women took part in this study. Only 3 of the 10 nulliparous pregnant participants reported pain as an expected symptom of early labor. There were two themes identified from interviews with pregnant participants: Desire to stay at home in early labor and Lack of knowledge and two themes from interviews from postpartum participants: Expectations didn't match experiences and Feelings of anxiety and uncertainty during early labor. Clinical Implications: Nulliparous women lack knowledge of and skills to effectively cope with pain during early labor while at home. There is a need for an innovative labor support program for childbearing women to remain safely at home in early labor. Women who are giving birth for the first time need information about what to expect in early labor, how to manage pain, discomfort, fear, rupture of membranes, and when to come to the hospital. In this study, women at term shared their knowledge of early labor and women during postpartum described the experience of early labor compared to what they had expected. More research is needed on how to improve knowledge and support of women in early labor to promote safely staying at home until admission to the hospital is clinically appropriate.

Problem The high-value, midwifery-led birth centre (BC) model of care is underutilized in the United States, a country with high rates of obstetric intervention and maternal morbidity and mortality. Background Birth setting decision-making is a complex, preference-sensitive, and resource-dependent process. Understanding how people choose BCs for care may help increase the utilization of BCs and generate positive perinatal outcomes. Aim This study explores the decision-making experiences of people with Medicaid insurance who chose to give birth in a BC in Massachusetts by gathering interview data to interpret and provide meaning about their selection of birth setting. Methods We employed a hermeneutic phenomenology study to interview people about their decision to give birth in a BC. Interview data were coded using a hybrid deductive-inductive approach and analyzed using reflexive thematic analysis to interpret and provide meaning. Findings Twelve women participated in the study. Five themes emerged that described participants’ decision-making processes: 1) Stepping Away from “the System,” 2) Decision-Making with External Influences, 3) Accessing BC Care, 4) Finding a Home at the BC, and 5) Decision-Making as a Temporal Process. Discussion The decision to choose a BC was a dynamic process that occurred over time and was influenced by factors such as the quality of care, accessibility, external influences, and the physical environment. Conclusion Prioritizing an individual's capacity to choose their birth setting and fostering awareness about options in the context of informed decision-making are pivotal steps toward attaining equity in perinatal health. Securing public insurance coverage and equitable reimbursement for BCs represent essential policies aimed at facilitating universal access to the BC model for all people.

The Editor in Chief reflects on uncertainty in maternity care.

The Journal of Obstetric, Gynecologic, & Neonatal Nursing (JOGNN) is the scientific journal of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). JOGNN maintains its position as one of the top-rated nursing journals in the specialties of women’s health care; prenatal, intrapartum, and postpartum care; and neonatal care in North America through a steadfast commitment to publishing high-quality, peer-reviewed nursing and interdisciplinary scholarship. As I officially stepped into my new role as editor in chief of JOGNN in July 2022, one of my goals was to be engaged and transparent with JOGNN’s editorial advisory board members, reviewers, authors, and readers regarding the journal’s performance and how we might improve its quality, reach, and impact. The purpose of this report is to describe current metrics, highlight accomplishments from the past year, and outline plans to advance the mission and position of JOGNN as a leading choice for authors and readers. JOGNN’s editorial team consists of an editor in chief, senior managing editor, three associate editors, and one assistant editor who provides statistical consultation. Like other nursing journals, JOGNN has and continues to experience a marked growth in the number of review articles submitted (Carter-Templeton et al., 2022Carter-Templeton H. Wrigley J. Nicoll L.H. Owens J.K. Oermann M.H. Ledbetter L.S. A bibliometric analysis of review types published in the nursing scientific literature. Advances in Nursing Science. Advance online publication.https://doi.org/10.1097/ANS.0000000000000424Date: 2022Google Scholar). In response to this trend, in September 2022, Elizabeth Eisenhauer, PhD, RN, was appointed as associate editor, reviews. The focus of her role is the oversight of the review manuscripts submitted to JOGNN and related initiatives to enhance the rigor, methods, and reach of published review articles. JOGNN’s other associate editors, Cheryl Tatano Beck, DNSc, RN, CNM, FAAN, and Patricia Robin McCartney, PhD, RN, FAAN, focus on qualitative methods and application methods, respectively, and share the goals of improved quality and reach. The success of JOGNN is highly dependent on the work of our editorial advisory board members and reviewers. We currently have 13 editorial advisory board members who all work in North America. We welcomed four new members to the editorial advisory board in 2022: Stacey Iobst, PhD, RNC-OB, C-EFM, CNE, Towson University; Kelly McGlothen-Bell, PhD, RN, IBCLC, University of Texas Health San Antonio; Shannon D. Simonovich, PhD, RN, DePaul University; and Jennifer Woo, PhD, CNM/WHNP, FACNM, Texas Woman’s University. We currently have 226 active reviewers for JOGNN, and we appointed 55 new reviewers in 2022. The new reviewers are diverse in terms of age, race and ethnicity, geographic location, and area of expertise. One goal is to continue to develop our pool of qualified reviewers, including those from diverse backgrounds. If you are interested in becoming a reviewer for JOGNN, please e-mail your curriculum vitae to ahartley@awhonn.org. JOGNN currently accepts the following article types: original research, reviews, health care improvement and evaluation, principles and practice, critical commentary, methods, and case reports. All manuscripts except editorials and letters to the editor undergo peer review. JOGNN uses a double-blind peer review system; that is, authors do not know the names of the reviewers, and reviewers do not know the names of the authors. JOGNN also publishes official AWHONN documents, including clinical practice guidelines, practice briefs, and position statements. In 2021, JOGNN received 373 unsolicited manuscripts for consideration for publication; the number of submissions has steadily increased for the last 12 years. The overall acceptance rate in 2021 was 17.5%. A journal’s impact factor is one metric of the quality of the journal although by no means the only one. JOGNN’s impact factor is currently 2.042, and the 5-year impact factor is 2.452. CiteScore is an evaluation metric based on citations recorded in the Scopus database. JOGNN’s Cite Score is 3.2. We launched a social media strategy in 2022 to increase the visibility of the journal and the postpublication discoverability of our content and authors. We now regularly post journal content on JOGNN’s Facebook, Twitter, and LinkedIn accounts, including the lead author’s name. We encourage readers to follow JOGNN on social media, and we encourage readers and users of JOGNN’s website to sign up to be alerted when new issues are available or when articles are published in their areas of interest. JOGNN currently maintains five article collections: AWHONN Journals Awards; Women, Infants, and Opioids; COVID-19; Racism, Disparities, and Social Determinants of Health; and Health Care Improvement and Evaluation. The articles included in these special collections are available on the JOGNN website. JOGNN also publishes an evidence-based practice column. In 2022, we updated the column with a new author and format. “Current Evidence to Guide Practice, Policy, and Research” is written by Summer Sherburne Hawkins, PhD, MS, an associate professor in the School of Social Work, Boston College. The column provides a review of the current scientific and professional literature on contemporary topics that affect the health of women, childbearing families, and newborns, including implications for nursing practice, policy, and research. The first column in the new format appeared in the November 2022 issue and was focused on cannabis use in pregnancy (Hawkins, 2022Hawkins S.S. Current evidence to guide practice, policy, and research: Cannabis use during pregnancy.Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2022; 51: 643-650https://doi.org/10.1016/j.jogn.2022.09.005Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar). The topic of the column in this issue is extending Medicaid coverage in the postpartum period. Future topics may include maternity leave and breastfeeding, clinical screening for firearms in the home, prenatal and postpartum domestic violence screening, measurement of maternal morbidity and mortality, and sexually transmitted disease. The JOGNN editors and editorial advisory board are publicly committed to promoting justice, equity, diversity, and inclusion in health and health care through editorial policies and processes and the articles published in JOGNN (Lowe and Hartley, 2022Lowe N.K. Hartley A. JOGNN’s editorial statement on justice, equity, diversity, and inclusion, 2021.Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2022; 51: 1-3https://doi.org/10.1016/j.jogn.2021.11.002Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar). The following initiatives were implemented in 2022 that reflect our ongoing commitment. We added new classification terms to our online submission and review system, Editorial Manager. These terms are used to identify the areas of interest and expertise of our reviewers and the content of submitted manuscripts. The new terms include diversity, health equity, social determinants of health, social justice, and life course approach. The diversity classification is further specified with the terms access to care, disability, educational attainment, gender, geography, language, race and ethnicity, and sexuality. We finalized and activated new reviewer forms with the following review question: “Contributes to or expands the understanding of diversity, equity, and inclusion as they relate to the problem under study.” In making these changes within Editorial Manager, our hope is to raise awareness among reviewers and authors of the critical importance of addressing and reducing the racism and implicit and explicit bias that contribute to inequity in maternal outcomes for women of color and those from other marginalized backgrounds. Finally, we solicited and published an editorial on the importance of collecting and reporting accurate data on race and ethnicity in scholarly publications (Abuelezam, 2022Abuelezam N.N. Collecting and reporting accurate data on race and ethnicity are necessary to achieve health equity.Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2022; 51: 562-565https://doi.org/10.1016/j.jogn.2022.09.001Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar). Annually, we acknowledge excellence by issuing the Best of JOGNN Award and recognizing the JOGNN Reviewer of the Year. In 2022, the Best of JOGNN Award winner was Laura Foran Lewis for her qualitative study about the birth stories of women on the autism spectrum (Lewis et al., 2021Lewis L.F. Schirling H. Beaudoin E. Scheibner H. Cestrone A. Exploring the birth stories of women on the autism spectrum.Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2021; 50: 679-690https://doi.org/10.1016/j.jogn.2021.08.099Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar), and the JOGNN Reviewer of the Year was Beverly Rossman, PhD, RN. JOGNN was inducted into the International Academy of Nursing Editors (INANE) Nursing Journal Hall of Fame, an award to recognize scholarly nursing journals that have 50 or more years of continuous publication and sustained contributions to nursing knowledge. As an award winner, JOGNN was recognized during the INANE Annual Meeting on August 3, 2022. Looking ahead, we plan to continue to improve the journal’s quality, reach, and impact. We will be launching an editorial fellowship, expanding the editorial advisory board, encouraging the submission of editorials, developing plans for special issues, and continuing to increase the discoverability of authors. In 2023, JOGNN and Nursing for Women’s Health will launch an editorial fellowship to mentor early-career scholars and aspiring editors interested in learning about scholarly publishing. Through the program, editorial fellows will gain hands-on experience with peer review and publication with a primary focus on peer review. Other aspects of scholarly publishing will also be addressed, such as what editors look for in submitted manuscripts and how they approach their editorial visions for each journal; how editorial advisory boards function; impact metrics and content discoverability; diversity, equity, and inclusion in nursing scholarship; and what happens after manuscripts are accepted. The intent is to develop a pool of interested and qualified individuals to serve as reviewers and, potentially, editorial advisory board members and editors. We aim to grow and diversify the editorial advisory board to support an inclusive peer review process and increase the depth and breadth of the content that contributes to our specialty. We plan to maintain our existing members and recruit at least two new editorial board members in the year ahead. We publish at least one editorial in each issue and want to increase the number of invited editorials we publish. We actively encourage members of the editorial board to contribute editorials and invite reviewers and readers to contact us with ideas for editorials. We are also interested in the development of special issues or in issuing calls for articles on timely and relevant topics. Potential topics may include social determinants of health that affect women’s health outcomes throughout the life cycle, mental health disparities in the perinatal period, health and maternity outcomes for Black women, and reproductive justice. Our editorial board members and their colleagues are invited to serve as guest editors as well as thought leaders and scholars with perspectives, interests, and expertise that align with the journal. Please contact me to discuss your interests (joyce.edmonds@bc.edu). We will continue to increase the visibility and discoverability of JOGNN content and support authors in promoting their research by implementing two initiatives in 2023. The first is the use of the Gather Voices platform through which authors can record and share short videos about themselves and their research findings on a user-friendly platform. This video content can be used on the website and social media to promote the author’s research and drive engagement with journal content. In the second initiative, we will implement a process to develop visual abstracts that can be included on the JOGNN website, on social media platforms, and in author presentations. As a refereed journal publication, JOGNN serves as one of the main mechanisms through which research output is evaluated and disseminated. Providing stakeholders with information to assess how well the journal is working is fundamental to maintaining trust in what we do and how we do it. As we progress as a journal, we will continue to set goals for raising research and publication standards and meeting the needs of JOGNN authors, readers, and reviewers. If you have ideas about how we can improve, please feel free to reach out with your suggestions.

INTRODUCTION:Racism and discrimination negatively affect patient-provider communication. Yet, pregnant people of color consistently report being discriminated against, disrespected, and ignored. The purpose of this integrated review was to identify studies that examined communication between pregnant people of color and their prenatal care providers and evaluate the factors and outcomes arising from communication.METHODS:We searched the PubMed, Embase, CINAHL, and PsychINFO databases for studies published between 2001 and 2023. Articles were eligible for inclusion if they reported on primary research conducted in the United States, were written in English, and focused on patient-provider communication with a sample that included pregnant people of color, defined as those who self-identified as Black, African American, Hispanic, Latina/x/e, Indigenous, American Indian, Asian, Asian American, Native Hawaiian, and/or Pacific Islander American. Twenty-six articles were included in the review. Relevant data were extracted and compiled into an evidence table. We then applied the rating scale of the Johns Hopkins Evidence-Based Practice model to assess the level of evidence and quality of the studies. Themes were identified using a memoing technique and organized into 3 a priori categories: factors, outcomes, and recommendations.RESULTS:Two overarching themes emerged from our analysis: racism/discrimination and unmet information needs. Subthemes were then identified as factors, outcomes, or recommendations. Factors included provider behaviors, language barriers, structural barriers, provider type, continuity of care, and fear. Outcome themes were disrespect, trust, decision-making power, missed appointments, and satisfaction with care. Lastly, culturally congruent care, provider training, and workforce development were categorized as recommendations.DISCUSSION:Inadequate communication between prenatal care providers and pregnant people of color continues to exist. Improving access to midwifery education for people of color can contribute to delivering perinatal care that is culturally and linguistically aligned. Further research about digital prenatal health communication is necessary to ensure equitable prenatal care.