Perspectives of Maternal Mortality Among Women Who Live in Indiana.

OBJECTIVE: To explore the perspectives of women in the lay public in Indiana on the topic of maternal mortality. DESIGN: Qualitative descriptive design. SETTING: The state of Indiana. PARTICIPANTS: Women in the lay public (N = 20) who were recruited from Facebook groups aimed at women with children. METHODS: We used semistructured phone interviews during which participants described their understanding of maternal mortality and their related experiences. We analyzed the transcribed interviews using content analysis to yield overall themes. RESULTS: We identified three main themes that described participants' perspectives of maternal mortality: Women Are Not Worried About Mortality Until They Experience Pregnancy Complications, Women Have Limited Information on Maternal Mortality, and Women Often Feel Dismissed During Maternity Care. CONCLUSION: Our findings suggest that nurses and other health care providers should increase their efforts to effectively communicate about maternal mortality and the associated risk factors and to follow evidence-based guidelines for respectful maternity care.

Descriptions of Maternal Mortality From Nurses Who Practice in Perinatal Settings.

OBJECTIVE: To explore nurses' descriptions of maternal mortality when caring for women in the perinatal period in Indiana. DESIGN: A qualitative descriptive approach was used to produce nurses' descriptions of maternal mortality. SETTING/PARTICIPANTS: Convenience sample of 16 nurses recruited from the Indiana Section of the Association of Women's Health, Obstetric and Neonatal Nurses. MEASUREMENTS: Semistructured phone interviews were conducted, and participants were asked to explain their experiences related to maternal mortality. This information, which was summarized using content analysis, provided data related to nurses' descriptions of maternal mortality when caring for women in the perinatal period. RESULTS: Analysis revealed three main themes that explain nurses' descriptions of maternal mortality: When It Comes to Maternal Mortality: Out of Sight Is Out of Mind, Nurses Express Detachment From Their Role in Preventing Maternal Mortality, and Experience With Maternal Mortality or a Near-Miss Event Is a Turning Point for Nurses. CONCLUSION: Nurses who have limited experience with maternal mortality and who approach the issue in a detached manner may miss opportunities to provide health education to women in the perinatal period. Nurses need education on substance use disorders in the perinatal period, guidance on how to support women in the postpartum period, and support for coping with death and dying in the perinatal period.

Provider Characteristics Associated with Trust When Caring for Women Experiencing Substance Use Disorders in the Perinatal Period.

INTRODUCTION: Women experiencing substance use disorders (SUD) have often reported challenges in their relationships with health care providers during the perinatal period that served as a barrier to care. Establishing trust is an important aspect in forming positive relationships. The purpose of this study was to identify provider characteristics associated with the development of trust when caring for women experiencing SUD during the perinatal period. METHODS: A systematic search was conducted using the databases of CINAHL, APA PsychINFO, and PubMed along with a manual search of Google Scholar between the years of 2000-2021. Studies were included if they were (1) original qualitative research; (2) published in English; (3) peer reviewed; (4) from the perspective of women experiencing SUD; (5) included descriptions of positive health care interactions between women experiencing SUD in the perinatal period and their health care providers; and (6) conducted in the United States or Canada. The studies were assessed for quality and validity using 10 criteria from the Joanne Briggs Institute critical appraisal checklist for qualitative research. RESULTS: Findings from 21 qualitative studies were synthesized using a thematic synthesis approach and revealed 3 overarching themes that included 7 descriptive subthemes which identified provider characteristics associated with trust. The 7 descriptive subthemes included: developing rapport with women, demonstrating caring behaviors, including women in care, understanding women's SUD treatment efforts, reassuring women, delivering competent care, and educating women. DISCUSSION: Participants' accounts of trusting interactions with health care providers occurred when providers viewed women approvingly, affirmed their treatment efforts and maternal abilities, and delivered competent care that was knowledgeable of issues associated with SUD. The findings suggest the importance of confronting implicit biases, integrated care, and fostering a stigma-free and trauma-informed working environment.