Sacred space: a qualitative interpretive meta-synthesis of women's experiences of supportive birthing environments.

BACKGROUND: In the United States there are roughly three million births a year, ranging from cesarean to natural births. A major aspect of the birthing process is related to the healing environment, and how that helps or harms healing for the mother and child. Using the theoretical framework, Theory of Supportive Care Settings (TSCS), this study aimed to explore what is necessary to have a safe and sacred healing environment for mothers. METHOD: This study utilized an updated Qualitative Interpretive Meta-synthesis (QIMS) design called QIMS-DTT [deductive theory testing] to answer the research question, What are mother's experiences of environmental factors contributing to a supportive birthing environment within healthcare settings? RESULTS: Key terms were run through multiple databases, which resulted in 5,688 articles. After title and abstract screening, 43 were left for full-text, 12 were excluded, leaving 31 to be included in the final QIMS. Five main themes emerged from analysis: 1) Service in the environment, 2) Recognizing oneself within the birthing space, 3) Creating connections with support systems, 4) Being welcomed into the birthing space, and 5) Feeling safe within the birthing environment. CONCLUSIONS: Providing a warm and welcoming birth space is crucial for people who give birth to have positive experiences. Providing spaces where the person can feel safe and supported allows them to find empowerment in the situation where they have limited control.

"Gutting It Out" Does Not Work: Why Mental Health Days are Needed.

College student mental health issues negatively impact academic performance. Over half of college students in the U.S. report a mental health issue, with 60% reporting one at the two-year mark. Even when aware of such mental health issues, students are still hesitant to seek treatment. As such, investigating perceptions of mental health time off may illuminate perceived usefulness of such policies as well as potential processes for defining and implementing such policies. This study sought to answer the question, "What are the perspectives of time-off for mental health?" Using Reddit's responses, this study extracted (N = 392) quotes and used thematic analysis to identify four main themes. Implications include the need for school-level mental health time-off policies or integration of instructors' policies into their syllabi for transparency to students, which may alleviate student stress and further stigmatization.

The dynamics of providing street medicine to a geographically diverse homeless population in Hawaii.

PURPOSE: Since Hawaii has the highest rate of per capita of persons experiencing homelessness (PEH) in the United States, the purpose of this qualitative evaluation study was to evaluate the experiences of both the providers and clients of a Street Medicine (SM) program serving one side of the island of O'ahu. METHOD: This evaluation used Story Inquiry to qualitatively assess one SM program serving one side of the island of O'ahu in Hawa'i. Since the culture in Hawaii is largely based upon stories, a qualitative approach was taken to better understand the lived experiences of PEH who utilized the SM services, as well as provider perspectives. RESULTS: The findings of this evaluation include strengths of increased primary care engagement and improved quality of life for PEH; barriers to success included transportation scarcity and limitations of services available. CONCLUSIONS: The findings lend implications for new SM programs, including gathering community support, having culturally aware outreach and that mobility and flexibility can overcome health-care barriers for PEH.

Women are the thread: Keetoowah elders' experiences of becoming a mother.

Becoming a mother can simultaneously be a shared experience while having cultural distinctions. Indigenous motherhood, for example, has been heavily influenced by colonisation, medicalisation and Western imperialism. Historical and generational trauma has contributed to shifts in Indigenous practices surrounding becoming a mother and a disconnection from traditional birthing practices that has impacted maternal mental health. Nevertheless, recovering traditions can be beneficial for contemporary Indigenous mothers. This study utilised a culturally appropriate method, Story Inquiry. Using this approach, the paper coalesces community stories about a health challenge across time to better understand elders' experiences of becoming a mother in one Indigenous tribe, the United Keetoowah Band of Cherokee. The results of this inquiry illustrate the acute effects of colonialism and the historical trauma that resulted from it on Keetoowah experiences of Becoming a Mother and the cultural transmission of practices and beliefs surrounding maternal role transition. At the same time, it demonstrates the strategies that have shaped women's experiences of motherhood and made possible community persistence: especially the relationships between female kin within the Keetoowah tribe that have been integral to tribal resilience. Findings stress the value of healthcare approaches that include cultural traditions surrounding becoming a mother and more culturally informed perinatal care.

American Indian Motherhood and Historical Trauma: Keetoowah Experiences of Becoming Mothers.

BACKGROUND: American Indian/Alaskan Native (AI/AN) women disproportionally experience postpartum depression in the United States as compared to the rest of the population. Despite being disproportionately represented, the current body of knowledge lacks research on depression in this particular population. Specifically, the current literature lacks research pertaining to the experiences of postpartum AI/AN women, their culture, birthing and mothering expectations, and trauma. This qualitative study used the theories of becoming a mother, historical-trauma framework, and reproductive justice as they relate to Indigenous women's personal and historical trauma to assess their lived experiences of becoming a mother. METHODS: Keetoowah mothers (N = 8) were interviewed by using a story inquiry method to understand the perinatal experiences of members of one Indigenous tribe in the US. FINDINGS: The story inquiry coding resulted in two main themes, namely maternal mental health challenges and inadequacies of perinatal care. CONCLUSION: The subthemes illuminate the intersection of historical trauma and the perinatal experience, continued colonization of mothering, and the resilience of tribal culture during the postpartum period. Implications include advocacy for increasing culturally derived perinatal interventions, increased healthcare coverage of culturally appropriate birthing practices, and future research evaluating the correlation between historical trauma and maternal mental health challenges.

Qualitative, Interpretive Metasynthesis of Women's Experiences of Intimate Partner Violence During Pregnancy.

OBJECTIVE: To describe the perspectives of women who experienced intimate partner violence (IPV) during pregnancy through a qualitative, interpretive metasynthesis. DATA SOURCES: We searched 12 electronic databases to identify articles on qualitative studies pertaining to women's experiences of IPV during pregnancy. We searched Academic Search Complete, AgeLine, CINAHL Complete, Family Studies Abstracts, MEDLINE, PsycARTICLES, Psychology and Behavioral Sciences, PsycINFO, Social Work Abstracts, Health Source-Consumer Edition, Health Source-Nursing/Academic Edition, and Humanities Full Text for articles published from 2008 through 2018. DATA EXTRACTION: We used inclusion and exclusion criteria to identify eight reports of qualitative studies that contained direct quotations in which women described their experiences of IPV. DATA SYNTHESIS: We used a methodologic reduction to provide a theoretical context that helped us synthesize the data to five key themes: Pregnancy Escalates Abuse, Concern for Unborn Fetus, Importance ofSupport, My Child Saved Me, and Pregnancy Is a Catalyst for Reflection. CONCLUSION: The results of our synthesis illustrate the unique perspectives of women who experienced IPV during pregnancy. Understanding these experiences can help health care providers assist pregnant women through enhanced screenings and education. Health care providers can also help women identify resources for emotional and financial support as they determine the best courses of action for themselves and their children.

"I keep it to myself": A qualitative meta-interpretive synthesis of experiences of postpartum depression among marginalised women.

Postpartum depression (PPD) is a significant public health concern due to the physical, emotional, economic, and life course outcomes. Rates of PPD are significantly higher for marginalised populations and can impact low-income, minority, and/or immigrant women differently when compared to white middle-class women. Commonly studied negative effects of PPD include poor health outcomes, mother-child bonding challenges, and negative child educational outcomes. However, research surveying the postpartum experience and negative outcomes among marginalised women is sparse. This study implemented a qualitative meta-interpretive synthesis (QIMS) methodology to synthesise themes across 12 qualitative research articles surveying postpartum experiences of marginalised women in North American countries. Articles included in the QIMS were extracted from online databases from a 10-year window spanning January 2008-2018. The guiding research question was "What are the PPD experiences of women belonging to marginalized populations?" Constant comparative analysis was used with coding in atlas.ti and themes were synthesised with input of all three authors. Five main themes emerged. The themes are (a) intersections of PPD and poverty, (b) culture and PPD, (c) pressures of mothering, (d) strengths and coping, and (e) abuse affects my PPD experience. Subthemes such as "I keep it to myself" relating to cultural response to PPD and idealised mothering were also discovered. Implications for social workers, nurses, and future research are discussed.