The Association of Maternal Satisfaction with Childbirth by Length of Second Stage.

OBJECTIVE: The aim of this study was to quantify patient satisfaction by hour of second stage of labor and subsequent delivery mode. STUDY DESIGN: Pilot cross-sectional study of nulliparous women delivered at George Washington University Hospital between April 2018 and March 2019. Patients completed three survey questionnaires in the immediate postpartum period: Patient Perception Score (PPS), Consumer Satisfaction Questionnaire (CSQ), and Six Simple Questions (SSQ). Length of second stage was divided into 2 groups (≤3 hours and >3 hours). Data on maternal characteristics, maternal outcomes, and neonatal outcomes were collected in REDCap and statistical analysis was performed using SAS version 9.4. RESULTS: Survey response rate was 100% (n = 100). Seventy-one patients had a normal second stage and 29 patients had a prolonged second stage. Prolonged second stage was significantly associated with a lower proportion of NSVD (65.5 vs. 90.1%; p <0.01) and a higher proportion of epidural (82.8 vs. 60.6%; p = 0.03) in comparison to a normal second stage. Length of second stage had a statistically significant negative correlation with overall PPS scores (ρ = - 0.25, p ≤0.01). Length of second stage was not correlated with the SSQ (ρ = 0.05, p = 0.25) or CSQ (ρ = - 0.18, p = 0.11) surveys. CSQ scores were statistically significantly lower in women who underwent second stage cesarean delivery. CONCLUSION: Maternal satisfaction with childbirth and health care experience was high regardless of length of second stage. Only the PSS survey showed that shorter length of second stage was correlated with higher satisfaction. Cesarean delivery in the second stage was significantly associated with decreased maternal satisfaction. Future studies with larger cohorts are needed to confirm our findings. KEY POINTS: · There is limited data on maternal satisfaction with childbirth.. · Mode of delivery may affect maternal satisfaction.. · Shared decision-making about delivery mode and timing is crucial..

Adult Reconstruction Hip and Knee Fellowship Program Content and Accessibility.

BACKGROUND: The objective of the study was to assess the accessibility and content of accredited adult reconstruction hip and knee fellowship program websites. METHODS: Using the online database of the American Association of Hip and Knee Surgeons (AAHKS), we compiled a list of accredited adult hip and knee/tumor reconstruction fellowship programs. A full list of adult reconstruction hip and knee fellowship programs was gathered from the AAHKS website. The program website links they provided were evaluated. A Google search was conducted to identify program websites and analyzed for accessibility and content in 3 domains: program overview, applying/recruitment, and education. RESULTS: At the time the study was conducted, there were 78 accredited adult reconstruction hip and knee fellowship programs identified through the AAHKS program directory. Three of the 78 programs identified had a functional link on the AAHKS fellowship program directory; however, Google search identified 60 websites. Eighteen programs did not have a website and were not evaluated for content. Data analysis of content in the domains of program details, application process/recruitment, and education revealed that most websites included a program description and director name with contact information. However, they were not as comprehensive in the application process/recruitment and education domains. CONCLUSIONS: AAHKS provides a reasonable method of identifying programs. Yet, most programs can readily be identified using a Google search (76.9%). Although most fellowship program websites contained program details, there is still paucity of information for fellowship candidates.

Young Women's Health Initiative.

OBJECTIVE: A reflective conversation amongst the Jamaica Hospital Medical Center obstetrics and gynecology team regarding the misinformation we believed as young women resulted in a program focused on young women. The program was designed to provide young women with accurate information on their health and well-being. Equipped with this information, we believe that young women would be poised to make better decisions for their future. PROJECT SUMMARY: We discussed community engagement and outreach to target schools in the surrounding Jamaica Hospital Medical Center community. In the midst of the pandemic, when educational systems moved toward virtual and electronic platforms, the Jamaica Hospital Medical Center obstetrics and gynecology team established a virtual program to promote the health and wellness of young women in middle and high schools. To accomplish these objectives, the Jamaica Hospital Medical Center obstetrics and gynecology team created seven modules that cover the following topics: Module 1-an informational session that addresses female hygiene and other health-related topics for young women and girls. This session allowed the team to assess the knowledge of our cohort. Module 2-a tutorial on the anatomy of the female body to empower young women and girls to understand how their bodies work. Modules 3 and 4-two sessions focused on puberty and the associated changes young women and girls should expect. Module 5-a session focused on sexually transmitted infections and their long-term effects, both physically and emotionally. Module 6-a session focused on physical and mental health wellness (including topics that resonate with our cohort such as body image and eating disorders). Module 7-a session focused on breast health, specifically gauged to the needs of our cohort.Each module required a commitment of at least 60 minutes, and, in some instances, a module had to be split into two sessions to ensure that the subject matter of that module was sufficiently covered. These modules were collaboratively developed from feedback provided by obstetricians in the community and educators at our target schools. The modules included interactive elements such as Poll Everywhere, videos, and diagrams that facilitated thoughtful and academic discussions. OUTCOME: We successfully implemented this pilot program in two classes (one middle school class and one high school class), with the curriculum adjusted to cater to its audience. We received overwhelmingly positive feedback from both the students and their educator liaisons. RELEVANCE TO WOMENS HEALTH OR PHYSICIANS IN PRACTICE: We recognize that this program is an important engagement tool to be shared with other communities to inform a wider audience of young women and girls.

Why is applying to fellowship so difficult?

Students at all stages of their medical careers rely on the internet to research programs during the application process to help them learn and make educated decisions. In fact, studies with prospective emergency medicine residents have shown that the quality of information online can even impact an applicant decision to apply. Fellowship program information on institutional websites in the fields of pediatrics, orthopedics surgery, and sports medicine have been studied each highlighting poor content and accessibility of information within the domains of program information, application process and educational curriculum. In this call to action, we aim to shed light on the content and accessibility of information on Maternal Fetal Medicine (MFM) fellowship program websites and discuss the benefits of further centralizing and standardizing program information.