Smoothies, bone broth, and fitspo: the historicity of TikTok postpartum bounce-back culture.

TikTok, a now iconoclastic social media platform, hosts millions of videos on health, wellness and physical fitness, including content on postpartum wellness and 'bouncing back'. At present, few studies analyse the content of postpartum videos urging viewers to bounce-back or the potential influence of these videos. Given the acknowledged relationship between social media use and adverse mental health outcomes (eg, lowered self-esteem, increased stress, disordered eating risk), an investigation of bounce-back-related postpartum content on TikTok explores important intersections between wellness and fitness cultures and the embodied experience of postpartum recovery. Using a qualitative thematic analysis of bounce-back videos (n=175), we explore three themes: (1) Smoothies: eat, but don't be fat; (2) Bone broth: bounce-back with today's wellness trends; (3) Fitspo: moving your body matters. Importantly, videos recycle historically constructed thinking about what makes a 'good' or 'bad' body, invoke vintage diet-culture tropes (ie, drinking water to fill up before eating), and maintain potentially dangerous expectations for caregivers rooted in historical gender, race and class constructs. This results in a postfeminist mishmash of modern maternity practices and traditional hierarchies. Unpacking the historicity of TikTok content assists health practitioners, scholars and users in understanding the potential impacts of video content on new parents, as well as how to flag and contextualise potentially harmful content. Future studies should examine other TikTok subcultures, including teen mothers and trans parents, and explore the messaging directed at and the impact on those communities.

Expand and extend postpartum Medicaid to support maternal and child health.

Most early maternal deaths are preventable, with many occurring within the first year postpartum (we use the terms "maternal" and "mother" broadly to include all individuals who experience pregnancy or postpartum and frame our recognition of need and policy recommendations in gender-neutral terms. To acknowledge limitations inherent in existing policy and the composition of samples in prior research, we use the term "women" when applicable). Black, Hispanic, and Native American individuals are at the most significant risk of pregnancy-related death. They are more commonly covered by Medicaid, highlighting likely contributions of structural racism and consequent social inequities. State-level length and eligibility requirements for postpartum Medicaid vary considerably. Federal policy requires 60 days of Medicaid continuation postpartum, risking healthcare coverage loss during a critical period of heightened morbidity and mortality risk. This policy position paper aims to outline urgent risks to maternal health, detail existing federal and state-level efforts, summarize proposed legislation addressing the issue, and offer policy recommendations for legislative consideration and future study. A team of maternal health researchers and clinicians reviewed and summarized recent research and current policy pertaining to postpartum Medicaid continuation coverage, proposing policy solutions to address this critical issue. Multiple legislative avenues currently exist to support and advance relevant policy to improve and sustain maternal health for those receiving Medicaid during pregnancy, including legislation aligned with the Biden-Harris Maternal Health Blueprint, state-focused options via the American Rescue Plan of 2021 (Public Law 117-2), and recently proposed acts (HR3407, S1542) which were last reintroduced in 2021. Recommendations include (i) reintroducing previously considered legislation requiring states to provide 12 months of continuous postpartum coverage, regardless of pregnancy outcome, and (ii) enacting a revised, permanent federal mandate equalizing Medicaid eligibility across states to ensure consistent access to postpartum healthcare offerings nationwide.

Many maternal deaths happen within the first year postpartum and can be prevented. Black, Hispanic, and Native American mothers are at more risk for many reasons, including unfair systems and insufficient healthcare coverage from government insurance (Medicaid). Rules for getting Medicaid can be very different across states and in postpartum compared to pregnancy. The US government only requires states to continue providing Medicaid for 60 days postpartum, after which it is up to each state. If mothers are required to re-qualify for Medicaid shortly after giving birth, they could lose healthcare when they are at more risk of dying or getting sick. In this policy position paper, a team of maternal health researchers and clinicians reviewed and summarized recent research and current laws related to postpartum Medicaid to propose future laws that could address these issues. Some proposed laws would expand Medicaid coverage during postpartum, but lawmakers have not recently discussed them. This position paper recommends that lawmakers (i) consider laws that require states to provide 12 months of postpartum healthcare coverage and (ii) have the US government make the same rules to qualify for postpartum Medicaid across all states.

Bearing Witness to Joy and Sorrow: Narrative Medicine and Reproductive Endocrinologist and Infertility (REI) Providers' Journeys in Infertility Treatment.

This study examines providers' perceptions of provider-patient communication in reproductive endocrinology and infertility (REI) practices. Grounded in narrative medicine, we interviewed six REI providers about their experiences providing fertility care. REI providers crafted a narrative of bearing witness by (1) situating personal and professional self in REI narratives, (2) sharing news as important medical moments, and (3) cultivating affiliation between provider and patient. These findings offer insight into the power of narrative medicine in fertility care, the role of emplotment in narrative sense-making, and the emotional labor associated with information delivery in REI treatments. We offer several recommendations for how patients and providers can improve communication experiences in REI.

A Review of Miscarriage and Healthcare Communication in the United States.

Miscarriage is a pervasive and socioemotionally complex pregnancy complication. Evidence suggests that poor clinical management can worsen these experiences. Yet, assessments of healthcare communication during a miscarriage are limited and a systematic review of the literature is needed. This review identified and synthesized original research on miscarriage and healthcare communication in the United States from the past 20 years to identify existing knowledge gaps for future miscarriage research. The following databases were searched: PubMed, PsychINFO, and ERIC Database. Data were charted according to Arksey and O'Malley's Scoping Review Framework. Eleven articles were included in the review and three primary themes emerged: (a) patients overwhelmingly prefer patient-centered care; (b) miscarriage is often overmedicalized, which leads to poor communication; and (c) informed decision-making related to one's miscarriage can improve patient experiences. Several gaps were also identified, including studies seeking physician perspectives on miscarriage communication, evaluation of standard care guidelines, and studies evaluating diverse patients' perspectives. This review highlights the need for patient-centered care that utilizes compassionate and accessible language and promotes informed decision-making. Future research should use quantitative methodologies and longitudinal designs to build upon these findings and improve patient experiences of miscarriage.

Memorable Messages About Fat Bodies Before, During, and After Pregnancy.

Weight bias is prevalent for people in large bodies who are trying to conceive, pregnant, or postpartum. Using the theory of memorable messages as a framework, we explored the sources, valence, and content of messages that fat individuals (N = 237) recalled about their bodies before pregnancy through the postpartum stage. The most common source of memorable messages was healthcare providers, and most (77.2%) messages were negatively valenced. Thematic analysis revealed four overarching themes (fat mothers are bad mothers, denial of competent treatment, weight-normative commentary on fat bodies, and weight-inclusive counter-narratives). Our findings illuminate the significance of patient-practitioner communication across the pregnancy trajectory and highlight how counter-narratives can disrupt negative messages about fat pregnancy.

"Always on parade": Pregnancy experience of active-duty air force members.

Findings are reported from a qualitative study that sought to understand the maternity experience of active-duty women in the context of improved and expanded pregnancy accommodations. Semistructured interviews were conducted with 30 active-duty women serving in the United States Air Force (15 enlisted and 15 commissioned members). Women described experiencing negative pregnancy-related stereotypes and stigma in the workplace. Connotations unique to military culture were unavoidable changes to uniform and physical body shape, cultural expectations of fitness, and uniformity of dress/appearance. Use of necessary pregnancy accommodations led to increased exposure to stereotypes and stigma, such as being perceived as less disciplined, lazy, weak, or receiving unfair advantages/fewer duties at work. Women relied on "covering behaviors" to separate themselves from negative stereotypes. Extreme covering behaviors put pregnant women's health and well-being at risk. Finally, women navigated a shift in priorities from an indoctrinated "service before self" perspective to a prioritization of personal health and well-being during pregnancy. Leadership skills were strengthened through this change in perspective, which were perceived as positively influencing unit morale, cohesion, productivity, and retention. Study findings suggest the military will experience limited success in fully integrating and retaining active-duty women due to an organizational climate that lags behind the recent, progressive improvements in pregnancy policies and accommodations. Organizational culture related to pregnancy within the military must be targeted for change to reduce negative stigma and pregnancy-related bias. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Birth Doula Care in California During COVID-19: The Impacts of Social Distancing on a High-Touch Helping Profession.

Birth doulas were deemed "non-essential" personnel during the COVID-19 pandemic and were generally excluded from attending hospital births in person. This study documents the impacts of pandemic-related contextual factors on birth doula care in the San Francisco Bay Area, examines how doulas adapted their services, and explores implications for policy and practice. We employed a contextually bound qualitative case study methodology driven by social action theory and conducted interviews with 15 birth doulas. The pandemic disrupted physical settings, the social environment, communication modalities, contractual arrangements, and organizational level factors. The historical context also amplified awareness of institutionalized racism in birth settings and highlighted birth doulas' advocacy role. Striking deficits exist in birth doulas' integration into US healthcare systems; this made their services uniquely vulnerable to the pandemic circumstances. Birth doulas' value ought to be more formally recognized within health policy, health insurance, and hospital systems as complementary care to that provided by medical providers to improve access to high-quality perinatal care.

Universal Design for Measurement: Centering the Experiences of Individuals With Disabilities Within Health Measurement Research.

People with disabilities comprise roughly 25% of the U.S. adult population yet remain underrepresented in mainstream public health and evaluation research. The lack of measures of common constructs that are validated in but not specific to this population may impede their inclusion. This article describes the use of Universal Design for Measurement (UDM), a novel method for developing self-report measurement instruments validated among broad populations to minimize the need for scale adaptation. We applied UDM to the development and content validation of a new body image scale. We assessed content validity by surveying subject matter experts (SMEs) and conducted a Delphi panel study to assess consensus about scale items among community women with (n = 18) and without (n = 15) disabilities. Most scale items were found acceptable by SMEs and community women. The Delphi panel study was useful toward evaluating consensus about scale items among women with and without disabilities. Findings support the use of UDM in developing inclusive and psychometrically sound measurement scales to ultimately facilitate the full inclusion of people with disabilities within health research.

#Motherhoodishard: Narrating Our Research and Mothering in the Postpartum Stage through Texting and Social Media.

We narrate our personal journey through the political minefield that is postpartum crisis by examining our communicative strategies across friendship, research partnership and as mothers on social media platforms. In a country with the highest postpartum maternal death rate in the industrialized world, we argue sharing narratives is a radical feminist act and one that must continue to draw attention to marginalized bodies. We hope to elevate the study of communication challenges mothers may experience for personal and political reasons.

DooR to DooR's Acoustics of Care: Interrupting and Transforming the Biomedical Landscapes of Western Hospitals.

The present study was conducted at the University of North Carolina Hospitals. Data were collected from DooR to DooR (D2D), a healing arts program that brings professional artists into the hospital. Drawing from ethnographic data, we forefront music in health communication literature by exploring its performance by D2D artists in hospital settings that range from in-patient oncology wards, waiting rooms, and even burn units. From a narrative theoretical approach, we situate art programming in the historical development of the contemporary hospital system in the U.S. and our analysis amidst growing bodies of literature on the narrative and aesthetic potentials of healthcare. We offer an in-depth analysis of how D2D's music disrupts the soundscape of UNC hospitals, distracts patients from troubling exigencies, and fosters self-expression and storytelling among participants.

"It's very valuable to me that I appear capable": A qualitative study exploring relationships between body functionality and appearance among women with visible physical disabilities.

A current hypothesis is that women who learn to focus on their body's functionality versus appearance may experience improved body image outcomes. This research is underdeveloped in considering the perspectives of women with visible physical disabilities (WPD), who have differences in body functionality and appearance that influence their body image. Our study aimed to understand how WPD conceptualize body image and body functionality and to clarify relationships between these constructs. We conducted semi-structured interviews with 15 women representing a range of ages (21-53 years) and disabilities. We used a constructivist grounded theory approach, applying the constant comparative method and engaging in reflexivity throughout the research process. We interpreted themes and subthemes based on their emergence across and explanatory value within cases to develop a conceptual model of the findings. Four major themes emerged: meanings and definitions, body image stability, factors that influence body image, and the interaction of appearance and body functionality. A new concept, "functional-aesthetic body image," emerged describing women's perceptions about the appearance of their body when engaged in functions or activities. Results may stimulate advancements in body image theory and measurement, and guide further exploration of the complex appearance-functionality relationship and its links with holistic health outcomes.

Telenursing and Nurse-Patient Communication Within Fertility, Inc.

The purpose of this study is to examine patient perceptions of practitioner-patient communication in reproductive endocrinology and infertility (REI) practices. During this study, we uncovered the importance of telenursing for nurse-patient communication during REI treatment. Telenursing, which is defined as the use of wireless technology for out-of-office communication, is the basis for out-of-office communication. We examined participants' conceptualization of supportive and unsupportive communication, through the lens of biomedicalization theory. After conducting 23 interviews, we conclude that telenursing is integral to providing holistic nursing care during treatment at REI practices. We discuss efficient and effective uses of telenursing and patients' positive perceptions telenursing and assess telenursing as both an embrace of and form of resistance to biomedicalization within Fertility, Inc. Theoretical and practical implications are offered, including suggestions for increasing patient access to telenursing while protecting REI nurses from burnout.

High-Society Framing: The Brooklyn Eagle and the Popularity of Twilight Sleep in Brooklyn.

Twilight Sleep (TS) is an obstetric intervention during which a laboring woman enters a semiconscious state via injection. TS received enthusiastic support in Brooklyn, NY, in The Brooklyn Eagle (TBE) newspaper between 1914 and 1918. The purpose of this article is to analyze the framing of TS in TBE as the most popular obstetric intervention among wealthy, White socialites in Brooklyn during the period. The coverage in TBE prompted a nearly universally positive perception of TS among the newspaper's wider readership. After extensive historiographical research and rhetorical analysis of newspaper coverage of TS in TBE, we discovered a form of framing we call "high-society framing," rooted in both wealth and notoriety. We discuss four possible effects of high-society framing: The first is the ability of high-society framing to attract or repel the public regarding a health care issue, and the second is the impact of high-society framing on public perception of medical interventions, procedures, or pharmaceuticals. A third possible effect of high-society framing is that it can alter notions of necessity, and a fourth is that high-society framing can elicit a tacit acceptance of medical interventions, procedures, and pharmaceuticals, thus obfuscating risk. Finally, we argue that high-society framing has implications for the discussion of health care in present-day mediated discourses.

Informing or Exploiting? Public Reponses to Giuliana Rancic's Health Narrative.

Popular entertainment journalist Giuliana Rancic has shared her struggles with pregnancy loss, infertility, and breast cancer in an array of public forums. In this study, we analyzed online comments responding to public discourses surrounding Rancic's revelations, including her miscarriage and fertility treatments, her breast cancer diagnosis, and her decision to undergo a double mastectomy. Our goal was to explore how the public framed Rancic's health challenges. Using a narrative lens, we argue that online comments reveal the tensions that celebrities like Rancic must manage as they contend with public scrutiny of their stories. Online commenters in this study framed Rancic's narrative as a privileged vantage point in which she exploited her health struggles for personal and financial gain. Our analysis of these comments also demonstrates how Rancic's narrative exists in concert with other discourses that challenge and disrupt her own account of events. The examination of these mediated discourses has implications for understanding the role of celebrity experiences in personal and public conversations about health.

Constructing the dead: Retrospective sensemaking in eulogies.

Eulogies serve a sensemaking function of identity construction--both for the deceased and for the survivors. This work examines the communicative construction of identity in eulogies and shows how eulogia discourse affirms and reconstructs our relational identity through communication. The article extends scholarship on eulogies by using relational communication theories to investigate how eulogic discourse functions as identity construction, considering eulogies of ordinary people, and exploring the gendered nature of eulogies. We discuss how eulogies are specific ritualized forms of communication in which the bereaved focus on self-identity as they articulate their experience of grief.

"The Keepers of Stories": Personal Growth and Wisdom Among Oncology Nurses.

This study examined whether oncology nurses experience personal growth and wisdom as a result of caring for patients. Using a grounded theory approach, 30 nurses were interviewed regarding their experiences caring for cancer patients. Every nurse in this sample cited at least one example of growth and wisdom. Subthemes of personal growth were largely consistent with the documented domains of posttraumatic growth and included appreciation of life, new perspective on life, relating to others, spiritual/religious growth, and personal strength. Subthemes of wisdom were more varied, reflecting the diversity of this construct in the context of nursing. Benevolence arose as a unifying theme between personal growth and wisdom, with subthemes centering on altruistic attitudes and behavior toward patients and the greater community. Findings suggest that nurses develop personal growth, wisdom, and benevolence as a result of the emotional connections formed with patients and the subsequent struggle to cope with their loss. This process accords well with findings in other populations experiencing trauma and adversity directly.

Technical Versus Public Spheres: A Feminist Analysis of Women's Rhetoric in the Twilight Sleep Debates of 1914-1916.

Twilight Sleep (TS) describes the delivery, via an injection, of an amnestic drug cocktail to a parturient woman throughout labor. In order to understand the development of modern-day rhetoric surrounding childbirth methods and procedures, this article explores the debate over TS between the public and technical sphere in New York City between 1914 and 1916 and examines the ways in which this debate altered obstetric health care for middle- and upper-class White women. The public response to this campaign posed a direct challenge to male obstetricians in New York City, many of whom were ill-equipped, both literally and figuratively, to use this procedure. Using a feminist rhetorical criticism, we examined the pro-TS rhetoric of women writers in New York City, the methods they borrowed from the women's movement, and the ensuing dialogue between the public and technical spheres. For this study, we analyzed journal and newspaper articles, a pamphlet, a collection of pro-TS organizational documents, letters to the editor, and books published about TS and the history of birth. Lastly, we analyzed theoretical notions of childbirth in women's health and communication studies. After examining the TS debate, we found that birth practices for middle- and upper-class women in New York City shifted and the obstetric community gained ascendancy over female midwifery. We also found that in certain instances, the rhetoric of pro-TS activists was more technically accurate than the rhetoric of some physicians. Hence the TS debate emerged from an argument over the right to use technical language in the technical and/or the public sphere. Conclusions and implications offered by this historical, feminist analysis question our current understanding of women's health and birthing practices, doctor-patient communication, and patient empowerment and access to technical knowledge.

Determinants of adoption of smartphone health apps among college students.

OBJECTIVE: To examine the effects of cognitive and contingent factors on the adoption of smartphone health apps, focusing on the technology acceptance model (TAM). METHODS: American college students (N = 422), who currently owned smartphones but were not using health apps, completed an online survey. RESULTS: Results from a path analysis mostly supported the proposed hypotheses, showing that subjective norm, health consciousness, health information orientation, and Internet health information use efficacy significantly affected the main components of TAM. CONCLUSION: Study findings provide scholars and practitioners with an empirical model of explaining the cognitive and micro-mechanisms of determining the adoption of health apps, especially among younger populations.

Parkinson patients as partners in care.

Increasing physical activity, as part of an active lifestyle, is an important health goal for individuals with Parkinson's disease (PD). Exercise can positively impact health related quality of life. Given this, how can we promote physically active lifestyles among PD patients (most of whom are sedentary)? Here we suggest that health care professionals could significantly expand their impact by collaborating with PD patients and their spouses (or caregivers) as partners-in-care. We outline reasons why partners-in-care approaches are important in PD, including the need to increase social capital, which deals with issues of trust and the value of social networks in linking members of a community. We then present results of a qualitative study involving partners-in-care exercise beliefs among 19 PD patients and spouses, and conclude with our perspective on future benefits of this approach.