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Perceptions of Maternal Discrimination and Pregnancy/Postpartum Experiences Among Veterinary Mothers.

ABSTRACT: Objective: To describe perceptions of maternal discrimination and to begin to understand patterns around timing of starting families, infertility, and post-partum depression among veterinary mothers. Design: Cross-sectional questionnaire with closed and open-ended questions posted to a social media platform "Moms with a DVM." Sample: 1,082 veterinary mothers in the United States. Procedures: An online questionnaire was administered regarding perceived discrimination, inequities in the work-place due to pregnant or maternal status, desired accommodations, timing of pregnancy(ies), fertility issues, and postpartum experiences. Results: At least one form of perceived discrimination was reported by 819 (75.7%) respondents (M = 2.6, SD = 2.1, range 0-10). Specifically, 789 (72.9%) reported maternal discrimination. Over half of the sample (n = 632, 58.4%) reported at least one instance of perceived inequity in the workplace due to status as a mother (M = 1.23, SD = 1.4, range 0-5). A majority (906, 83.7%) reported that their career had "definitely" or "maybe" affected the timing of their children. One hundred eighty-nine respondents (17.5%) experienced at least one miscarriage, and 192 (17.6%) used fertility treatment due to difficulty conceiving. Postpartum depression was diagnosed in 181 respondents (16.7%), and 353 (32.6%) reported symptoms consistent with postpartum depression but did not seek medical care. Of 953 participants who needed accommodations for breastfeeding and/or pumping while at work, 130 (13.6%) reported excellent accommodations, 454 (47.6%) adequate, 258 (27.1%) inadequate, and 111 (11.6%) had no accommodations provided. Conclusions and Clinical Relevance: Participants reported experiences of perceived maternal discrimination, as well as inequities and lack of support services due to status as a mother. These results highlight the need for attention and changes to ensure veterinarians have supportive and sustainable career options.

SUBMITTER: Wayne AS

PROVIDER: S-EPMC7069349 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Perceptions of Maternal Discrimination and Pregnancy/Postpartum Experiences Among Veterinary Mothers.

Wayne Annie S AS Mueller Megan K MK Rosenbaum Marieke M

Frontiers in veterinary science 20200306

Objective: To describe perceptions of maternal discrimination and to begin to understand patterns around timing of starting families, infertility, and post-partum depression among veterinary mothers. Design: Cross-sectional questionnaire with closed and open-ended questions posted to a social media platform "Moms with a DVM." Sample: 1,082 veterinary mothers in the United States. Procedures: An online questionnaire was administered regarding perceived discrimination, ...[more]

PMID: 32211426

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Project description:IntroductionCommunity-based mentor mothers (cMMs) are women living with HIV who provide peer support to pregnant/postpartum women living with HIV (PWLWH) to enhance antiretroviral therapy (ART) adherence, retention in care and prevent perinatal transmission of HIV. The goal of this study was to explore the experiences, perceptions, mechanisms and health impact of cMMs on PWLWH in Kenya from the perspective of cMMs.MethodsWe conducted a prospective mixed-methods study in southwestern Kenya in 2015-2018. In the qualitative phase, we completed in-depth interviews with cMMs to explore their perceptions and experiences in supporting PWLWH. Transcripts were broad-coded according to identified themes, then fine-coded using an inductive approach. In the quantitative phase, we analysed medical record data from PWLWH who were randomized in the cMM intervention to examine the impact of cMM visits on optimal prevention of mother-to-child transmission (PMTCT). We used cluster-adjusted generalized estimating equation models to examine relationships with a composite outcome (facility delivery, infant HIV testing, ART adherence and undetectable viral load at 6 weeks postpartum). Finally, qualitative and quantitative results were integrated.ResultsConvergence of findings from cMM interviews (n = 24) and PWLWH medical data (n = 589) revealed: (1) The cMM intervention was utilized and perceived as acceptable. PWLWH received, on average, 6.2 of 8 intended home visits through 6 weeks postpartum. (2) The cMMs reported serving as role models and confidantes, supporting PWLWH's acceptance of their HIV status, providing assurances about PMTCT and assisting with male partner disclosure and communication. cMMs also described benefits for themselves, including empowerment and increased income. (3) The cMM visits supported PWLWH's completion of PMTCT steps. Having ≥4 cMM home visits up to 6 weeks postpartum, as compared to <4 visits, was associated with higher likelihood of an optimal PMTCT composite outcome (adjusted relative risk 1.42, p = 0.044).ConclusionsWe found that peer support from cMMs during pregnancy through 6 weeks postpartum was associated with improved uptake of critical PMTCT services and health behaviours and was perceived as beneficial for cMMs themselves. CMM support of PWLWH may be valuable for other low-resource settings to improve engagement with lifelong ART and HIV services among PWLWH.

Project description:BackgroundThe global issue of low breastfeeding rates has been widely reported. Quantitative studies have shown the positive effects of peer support on breastfeeding. However, the experiences of mothers who receive breastfeeding peer support have been found to vary. To date, no systematic qualitative summary has been conducted to document the impact of peer support, nor to provide advice for its implementation from the perspective of breastfeeding mothers. This review aims to systematically synthesize qualitative findings on mothers' experiences of breastfeeding peer support to provide evidence for optimizing peer support services and ultimately enhancing their role in promoting breastfeeding.MethodsPubMed, Embase, Cochrane Library, Ovid, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), WanFang Datebase, VIP Database and Chinese Biomedical Database (CBM) were searched from the inception of each database until January 2023, to collect qualitative studies and mixed methods studies that included qualitative findings on mothers' experiences with breastfeeding peer support. The Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) was used to extract data and evaluate the quality of the included articles. The meta-integration method was used to explain and integrate the research findings. The review process was carried out by two authors independently, and the disagreements were resolved through consensus.ResultsA total of 15 articles were included in the study, consisting of 13 qualitative studies and 2 mixed methods studies. The analysis identified four integrated themes: (1) obtaining psycho-emotional support; (2) acquiring knowledge and skills; (3) expectations for breastfeeding peer support; and (4) feeding perceptions and behavior change. It should be noted that the articles reviewed are in English and mostly originate from developed countries or regions. Therefore, the generalizability of the integrated findings to underdeveloped regions or non-English speaking countries may be limited.ConclusionMothers perceived that peer support had a positive impact on breastfeeding. To improve the effectiveness of peer support in promoting breastfeeding, it is important to consider the individual needs of each mother. It is recommended that peer support services should be standardized in the future, including the accreditation, training, supervision, and management of peer supporters.

Project description:IntroductionPostpartum depression is considered a major public health problem, which immigrant mothers are at particular risk of being affected by, but it can also have long-lasting traumatic effects on the child's health and development. The Edinburgh Postnatal Depression Scale is the world's most commonly employed screening instrument for postpartum depression, used in connection with a clinical interview to screen for symptoms of postpartum depression. The aim of this study was to synthesize health care professionals (HCPs) experiences of identifying signs of postpartum depression and performing screening on immigrant mothers, since previous research suggested that this task might be challenging.MethodsThe databases CINAHL, PubMed, PsycINFO, SocINDEX, Embase and Cochrane were searched for papers published January 2000-December 2020, reporting qualitative data on immigrants, postpartum depression and the Edinburgh Postnatal Depression Scale. Eight papers representing eight studies from four countries were included and the Critical Appraisal Skills Program was used to assess their quality. The synthesis of studies was guided by Noblit & Hare's seven-step method based on meta-ethnography.FindingsThe synthesis resulted in two final themes: "I do my best, but I doubt that it's enough" and "I can find no way forward". The themes convey the fear and frustration that health care professionals experienced; fear of missing mothers with signs of postpartum depression, related to feeling uncomfortable in the cross-cultural setting and frustration in handling difficulties associated with communication, translated versions of the Edinburgh Postnatal Depression Scale and cultural implications of postpartum depression.Conclusions and clinical implicationBy supporting HCPs' self-efficacy in handling cultural implications of postpartum depression and by developing evidence-based clinical guidelines for the use of interpreters and translated versions of the Edinburgh Postnatal Depression Scale the screening of immigrant mothers may be facilitated.

Project description:ObjectiveTo explore the experiences and perceptions of stillbirth among mothers from a tertiary medical centre in Kano, Northern Nigeria.DesignQualitative, interpretative.SettingTertiary healthcare facility, Murtala Muhammad Specialist Hospital (MMSH), Kano, Northern Nigeria.SampleMothers who had given birth to a liveborn baby at the MMSH in the prior 6 months (n = 31). In order to capture the experiences and perception of stillbirth within this cohort we approached mothers who had in a previous pregnancy experienced a stillbirth. Of the 31 who attended 16 had a previous stillbirth.MethodsSemi-structured Focus Group Discussions, consisting of open-ended questions about stillbirth, beliefs, experiences and influences were held in MMSH, conducted over 1 day.ResultsOur findings highlight that this is a resource-poor tertiary facility serving an ever-growing population, increasing strain on the hospital and healthcare workers. Many of the participants highlighted needing permission from certain family members before accessing healthcare or medical treatment. We identified that mothers generally have knowledge on self-care during pregnancy, yet certain societal factors prevented that from being their priority. Judgement and blame was a common theme, yet a complex area entwined with traditions, superstitions and the pressure to procreate with many mothers described being made to feel useless and worthless if they did not birth a live baby.ConclusionsAs access to healthcare becomes easier, there are certain traditions, family and social dynamics and beliefs which conflict with scientific knowledge and act as a major barrier to uptake of healthcare services. The findings highlight the need for investment in maternity care, appropriate health education and public enlightenment; they will help inform appropriate interventions aimed at reducing stigma around stillbirth and aide in educating mothers about the importance of appropriate health seeking behaviour. Stillbirths are occurring in this area of the world unnecessarily, globally there has been extensive research conducted on stillbirth prevention. This research has highlighted some of the areas which can be tackled by modifying existing successful interventions to work towards reducing preventable stillbirths.

Project description:BackgroundMaternal pre-pregnancy body mass index (BMI) has been linked to altered gut microbiota in women shortly after delivery and in their offspring in the first few years of life. But little is known about how long these differences persist.MethodsWe followed 180 mothers and children from pregnancy until 5-year postpartum in the Gen3G cohort (Canada, enrolled 2010-2013). At 5 years postpartum we collected stool samples from mothers and children and estimated the gut microbiota by 16 S rRNA sequencing (V4 region) using Illumina MiSeq, and assigning amplicon sequence variants (ASV). We examined whether overall microbiota composition (as measured by microbiota β diversity) was more similar between mother-child pairs compared to between mothers or between children. We also assessed whether mother-child pair sharing of overall microbiota composition differed by the weight status of mothers before pregnancy and of children at 5-year. Furthermore, in mothers, we examined whether pre-pregnancy BMI, BMI 5-year postpartum, and change in BMI between time points was associated with maternal gut microbiota 5-year postpartum. In children, we further examined associations of maternal pre-pregnancy BMI and child 5-year BMI z-score with child 5-year gut microbiota.ResultsMother-child pairs had greater similarity in overall microbiome composition compared to between mothers and between children. In mothers, higher pre-pregnancy BMI and 5-year postpartum BMI were associated with lower microbiota observed ASV richness and Chao 1 index; in children's gut microbiota, higher maternal pre-pregnancy BMI was weakly associated with lower microbiota Shannon index, whereas child's 5-year BMI z-score was associated with higher observed ASV richness. Pre-pregnancy BMI was also linked to differential abundances of several microbial ASVs in the Ruminococcaceae and Lachnospiraceae families, but no specific ASV had overlapping associations with BMI measures in both mothers and children.ConclusionsPre-pregnancy BMI was associated with gut microbiota diversity and composition of mothers and children 5 years after birth, however, the nature and direction of most associations differed for mothers and children. Future studies are encouraged to confirm our findings and look into potential mechanisms or factors that may drive these associations.

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Perceptions of Maternal Discrimination and Pregnancy/Postpartum Experiences Among Veterinary Mothers.

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Perceptions of Maternal Discrimination and Pregnancy/Postpartum Experiences Among Veterinary Mothers.

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