Doula support among brazilian women who attended the senses of birth health education intervention - a cross sectional analysis.

BACKGROUND: While maternal health is a priority in international goals, maternal health outcomes remain poor in many regions of the world. In Brazil, maternal mortality has decreased over the past decades, but the country's maternal mortality ratio is higher than over half of all countries at 59 deaths per 100,000 live births. The Brazilian maternal health care model facilitates high rates of medical interventions during labor and childbirth; 56% of births are by cesarean birth. Doula support is considered a potential strategy to reduce medically unnecessary interventions during childbirth that contribute to maternal mortality. METHODS: The cross-sectional study analyses associations with use of doula support and normal birth among Brazilian women who participated in a health education intervention named the Senses of Birth (SoB). The SoB intervention, implemented in five cities from 2015 to 2017, was developed to educate about normal birth and to evidence-based practices (EBP) reduce medically in childbirth. Chi-Square tests were performed to identify the relationship between doula support during childbirth and sociodemographic characteristics, childbirth information, perceived knowledge, and use of EBPs during labor. Logistic regression was performed to identify associations in adjusted analysis. RESULTS: Controlling for covariates, doula support was associated with vaginal delivery (OR 2.47, 95% CI: 1.37-4.45.) Findings also suggest that women who had doula support were more likely to use non-pharmacological pain relief methods during labor (OR 9.68, 95% CI: 2.67-34.61), deliver in a public hospital (OR 2.02, 95% CI: 1.09-3.72), and be low and mid-level income compared to women with high income. CONCLUSION: This study's findings suggest that doula support is significantly associated with vaginal birth. The results may be useful for advocating for changes to the childbirth care model in Brazil. Incorporating EBPs, such as doula support, for all women who desire may improve maternal and child outcomes.

Factors associated with experiencing lifetime intimate partner violence among pregnant displaced women living in refugee camps in Erbil, Iraq.

According to the World Health Organization, intimate partner violence (IPV) affects 35% of women worldwide and 40% of pregnant women, often resulting in maternal and infant death and harm. Displaced persons are at higher risk of abuse compared to the general population. While few studies have explored IPV in Iraq, research from Erbil, Iraq showed nearly 60% of women reported experiencing IPV in their lifetime. No publications examining IPV among displaced women in Iraq exist. Considering the severe impacts of IPV in pregnancy and the associated risks for IPV among women in refugee camps, this paper presents the first analysis of prevalence and factors associated with lifetime IPV among displaced pregnant women in two Iraqi refugee camps. Thirteen percent of women reported experiencing any abuse and experiencing IPV was associated with receiving fewer years of schooling (p = 0.04), not having a private doctor (p = 0.002), attending the first prenatal visit during the third trimester (p = 0.03), feeling pressure to have a child (p = 0.003), knowing someone who was physically injured by their husband (p = 0.05), experiencing suicidal ideation (p = 0.02), and being worried about harming one's baby (p = 0.02). Policy and programme recommendations for screening and prevention of IPV in resource-limited settings are provided.

A Call to Transform Maternal and Child Health Mentorship to Build Inclusivity, Honor Diversity of Experiences, and Tackle the Root of Health Disparities.

INTRODUCTION: Mentorship should be a transformative experience that propels mentees from one point in their career to another and drives personal growth. Within the field of maternal and child health (MCH), it is considered a critical professional duty. However, MCH has yet to explicitly embrace mentorship practice as a means to address workforce challenges including turnover, knowledge loss, and undue burden on the part of historically oppressed individuals and communities to overturn oppressive systems. CALL TO ACTION: We advocate for public calls for diversity and equity to be met with strategic enhancement of the practice of MCH mentorship. Transformative MCH mentorship should be used to promote positive identity formation, understanding of self in context, efficacy, and sustained commitment to working with MCH populations in ways that are inclusive and prevent the perpetration of the problematic power dynamics that lead to inequitable outcomes. RECOMMENDATIONS: We present recommendations to strengthen MCH mentorship practice. At the individual level, there should be a refreshment of norms and expectations, where mentorship is seen as a uniquely flexible opportunity for mutual learning. At the organizational level, embedding mentorship in all aspects of practice helps establish and sustain a culture of belonging. This transformative organizational culture can attract and retain future generations of professionals that are not only more representative of the populations that MCH programs support but are prepared to authentically elevate the needs and strengths of those populations. These suggestions incorporate best practices from other fields and include ideas for the MCH field in particular.