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Spurlock EJ, Kue J, Gillespie S, Ford J, Ruiz RJ, Pickler RH. Integrative Review of Disparities in Mode of Birth and Related Complications among Mexican American Women. J Midwifery Womens Health 2021; 67:95-106. [PMID: 34958159 DOI: 10.1111/jmwh.13288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 08/04/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Cesarean rates are particularly high among Hispanic women in some regions of the United States, placing a disproportionate health burden on women and their newborns. This integrative review synthesized the literature on mode of birth (vaginal vs cesarean) and related childbirth complications (hemorrhage, surgical site infection, perineal trauma) among Mexican American women living in the United States. METHODS Four electronic databases, PubMed, Embase, CINAHL, and SCOPUS, were searched to identify studies meeting the inclusion criteria, research studies that included Mexican American women who were pregnant or postpartum. Results were limited to English language and publications that were peer-reviewed and published before May 2020. Covidence was used in article identification, screening, and assessment. Critical appraisal of the research was performed using the Quality Assessment Tool for Studies with Diverse Designs. RESULTS Ten articles met inclusion criteria. In some studies, Mexican American women born in the United States were more likely to have cesareans than women born in Mexico; in other studies, these findings were reversed. Mexican American women often had lower unadjusted cesarean rates compared with non-Hispanic white women, but adjusting for birth facility (some facilities perform more cesareans than others), sociodemographic, and risk factors often revealed Mexican American women have a higher adjusted risk for cesarean birth. Women with higher socioeconomic status had higher cesarean rates compared with women with lower socioeconomic status. In studies of birth outcome by level of acculturation, women who were US-oriented had higher rates of cesarean and more frequent perinatal complications. By ethnic subgroup, rates of cesarean and complications varied among Hispanic women. DISCUSSION Birth facility was associated with perinatal outcomes for Mexican American women; those who gave birth at higher-performing facilities had better outcomes when compared with women who gave birth at lower-performing facilities. After adjusting for pregnancy complications, Mexican American women had a greater risk for cesarean birth compared with non-Hispanic white women, a finding that may have clinical practice implications. Level of acculturation affected birth outcomes, but more research using precise instruments is needed.
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Affiliation(s)
| | - Jennifer Kue
- College of Nursing, University of South Florida, Tampa, Florida
| | | | - Jodi Ford
- College of Nursing, The Ohio State University, Columbus, Ohio
| | | | - Rita H Pickler
- College of Nursing, The Ohio State University, Columbus, Ohio
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Champlin S, Walker LO, Mackert M. Beliefs, Attitudes, and Practices of Latinas Related to Gestational Weight Gain: A Qualitative Meta-Synthesis. Matern Child Health J 2020; 25:107-117. [PMID: 33231823 DOI: 10.1007/s10995-020-03092-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Excessive and inadequate gestational weight gain (GWG) are associated with a number of negative health outcomes for mother and infant. Approximately two-thirds or more of Latinas gain outside of GWG guidelines. Acculturation plays a role in GWG-related factors, however the views of Latinas are often aggregated in overall study samples, thus trivializing the specific needs of this demographic group. The purpose of the present meta-ethnography was to better understand GWG beliefs, attitudes, and practice among Latinas by synthesizing extant qualitative findings on this topic. METHODS Qualitative studies offer an important window into Latinas' views and practices related to GWG. A qualitative meta-ethnography (a form of meta-synthesis) was implemented to synthesize qualitative studies about Latinas' views of GWG-related factors. An initial sample of articles was distilled based on meta-ethnography guidelines from Noblit and Hare (1988) to a final sample of six qualitative articles that included perspectives from Latinas. RESULTS Six concepts emerged across the studies, they included: shifts in feeling control, inconsistent/lacking information, self vs. other, applied wisdom, isolation vs. support, and everyday practicality. Studies met most quality assessment criteria (Atkins et al., BMC Medical Research Methodology 8:21, 2008). DISCUSSION The views of Latinas about GWG-related factors are often buried in with perspectives of other women, which hides important details that are valuable for health program interventions designed to support these women. Future research should further explore the cultural differences in experience among Latinas to produce information and resources that are culturally relevant and relatable.
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Affiliation(s)
- Sara Champlin
- Frank W. and Sue Mayborn School of Journalism, The University of North Texas, 1155 Union Circle #311460, Denton, TX, 76203-5017, USA.
| | - Lorraine O Walker
- School of Nursing, The University of Texas At Austin, 1710 Red River Street, Austin, TX, 78712, USA
| | - Michael Mackert
- Department of Population Health, Stan Richards School for Advertising and Public Relations, Center for Health Communication, The University of Texas At Austin, 300 W. Dean Keeton (A1200), BMC 4.338, Austin, TX, 78712-1069, USA
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Monteblanco AD, Vanos JK. Community-based maternal health workers' perspectives on heat risk and safety: a pilot qualitative study. Health Care Women Int 2020; 42:657-677. [PMID: 32956026 DOI: 10.1080/07399332.2020.1803873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In this study the authors examined how maternal health workers (MHWs) perceive the health risks of extreme heat exposure to pregnant women and fetuses. The authors conducted interviews with 12 MHWs (including midwives and doulas) in El Paso, Texas. Using qualitative analysis, the researchers identified numerous themes. Although heat was not communicated as a major health risk, participants expressed some concern with growing heat exposure and communicated standard protective measures. While all participants were familiar with some heat illness symptoms, they were generally unaware of their clients' vulnerability. MHWs' minimal heat-risk knowledge leaves pregnant women and developing fetuses at risk of preventable harm.
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Affiliation(s)
- Adelle Dora Monteblanco
- Department of Sociology and Anthropology, Middle Tennessee State University, Murfreesboro, Tennessee, USA.,Department of Sociology and Anthropology, University of Texas at El Paso, El Paso, Texas, USA
| | - Jennifer K Vanos
- School of Sustainability, Arizona State University, Tempe, Arizona, USA
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McDonald JA, Amatya A, Gard CC. Multi-level Drivers of Disparities in Hispanic Cesarean Delivery Rates in US-Mexico Border States. J Racial Ethn Health Disparities 2019; 7:238-250. [PMID: 31686370 DOI: 10.1007/s40615-019-00652-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 10/03/2019] [Accepted: 10/10/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hispanic women living along the US-Mexico border have higher cesarean delivery rates than non-Hispanic white women, African American women, and other Hispanic women in the USA. Their rates also exceed those of other Hispanic women in states that border Mexico and non-Hispanic white women along the border. Our objective was to determine the causes of the disparities in border Hispanic cesarean rates. METHODS Using the 2015 birth certificate file and other sources, we performed a twofold Oaxaca-Blinder decomposition analysis of the disparities in low-risk primary and repeat cesarean rates between Hispanic and non-Hispanic white women in the US-Mexico border counties and Hispanic women residing in nonborder counties of border states. RESULTS Rates of low-risk primary cesarean among border Hispanic, nonborder Hispanic, and border non-Hispanic white women were 21.1%, 15.0%, and 16.5%, respectively. Higher Hispanic concentration in county of residence, a larger proportion of for-profit hospital beds, and greater poverty accounted for 24.7%, 22.1%, and 11.1% of the border-nonborder Hispanic difference, respectively. No other variable explained more than 5% of the difference. Higher Hispanic concentration, more for-profit beds, less attendance by an MD, higher BMI, and greater poverty explained 60.6%, 42.4%, 42.4%, 27.4%, and 21.3%, respectively, of the Hispanic-non-Hispanic white difference. Hispanic concentration and for-profit beds were also important explanatory variables for low-risk repeat cesareans. CONCLUSION Efforts to address potentially unnecessary cesareans among Hispanic women on the border should recognize that community demographic and health delivery system characteristics are more influential than maternal medical risk factors.
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Affiliation(s)
- Jill A McDonald
- Department of Public Health Sciences, College of Health and Social Services, New Mexico State University, PO Box 30001, Las Cruces, NM, 88003-8001, USA.
- Southwest Institute for Health Disparities Research, College of Health and Social Services, New Mexico State University, PO Box 30001, Las Cruces, NM, 88003-8001, USA.
| | - Anup Amatya
- Department of Public Health Sciences, College of Health and Social Services, New Mexico State University, PO Box 30001, Las Cruces, NM, 88003-8001, USA
- Southwest Institute for Health Disparities Research, College of Health and Social Services, New Mexico State University, PO Box 30001, Las Cruces, NM, 88003-8001, USA
| | - Charlotte C Gard
- Southwest Institute for Health Disparities Research, College of Health and Social Services, New Mexico State University, PO Box 30001, Las Cruces, NM, 88003-8001, USA
- Department of Economics, College ofBusiness, Applied Statistics, and International Business, New Mexico State University, Las Cruces, NM, USA
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Champion JD, Collins JL, Papermaster A. Summative Content Analysis for Understanding of Romantic Relationships Among Rural Mexican American Adolescent Women. Issues Ment Health Nurs 2019; 40:405-412. [PMID: 30917067 PMCID: PMC6788791 DOI: 10.1080/01612840.2018.1543741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
An understanding of romantic relationships among adolescent Mexican-American females is lacking yet needed to provide culturally appropriate sexual health interventions. Although explored among other populations, romantic relationships among adolescents in rural settings is under-studied. This study explores romantic relationships for rural Mexican American female adolescents as a component of sexual health promotion. Rural Mexican-American adolescent females (n = 82) aged 14-18 years were recruited via convenience sampling at a rural health clinic. They completed open-ended individual interviews describing romantic relationships. Responses to open-ended questions were analyzed using summative content analysis. The majority reported sexual activity (62.2%) of which 23.5% had been pregnant. Summative content analyses identified personal characteristics and relationship characteristics as main categories with eight additional subcategories from responses. Sex was reported as what men wanted from women while physical attractiveness was perceived as important for both genders in development of romantic relationships. They prioritized other relational and personal characteristic such as integrity, and partner treatment of self and others. More obesity was present among those reportedly in romantic relationships. Description of parental roles as a component of romantic relationships was not present. Addressing adolescent romantic relationship with an emphasis on what male and female adolescents want or perceive as expected from relationships, long-term outcomes of relationships and on parental roles may enhance sexual health among rural Mexican-American adolescent populations. This study addresses a gap in literature by exploring romantic relationships for rural Mexican American female adolescents. This understanding of romantic relationships augments existing sexual health programing for these adolescents.
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Affiliation(s)
- Jane Dimmitt Champion
- The University of Texas at Austin, School of Nursing, 1710 Red River St, Austin, Texas 78701
| | - Jennifer L. Collins
- Texas Tech University Health Science Center, School of Nursing, 3601 4 St, Lubbock, Texas 78430
| | - Amy Papermaster
- The University of Texas at Austin, School of Nursing, 1710 Red River St, Austin, Texas 78701
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McDonald JA, Amatya A, Gard CC, Sigala J. In States That Border Mexico, Cesarean Rates Were Highest For Hispanic Women Living In Border Counties In 2015. Health Aff (Millwood) 2019; 38:276-286. [DOI: 10.1377/hlthaff.2018.05369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Jill A. McDonald
- Jill A. McDonald is the Stan Fulton Endowed Chair in Health Disparities Research; director of the Southwest Institute for Health Disparities Research; and a professor in the Department of Public Health Sciences, College of Health and Social Services, New Mexico State University, in Las Cruces
| | - Anup Amatya
- Anup Amatya is an associate professor in the Department of Public Health Sciences; is a member of the Biostatistics and Epidemiology Research Design Core of the Mountain West Idea Clinical and Translational Research–Infrastructure Network (CTR-IN); and is affiliated with the Southwest Institute for Health Disparities Research, College of Health and Social Services, New Mexico State University
| | - Charlotte C. Gard
- Charlotte C. Gard is an associate professor in the Department of Economics, Applied Statistics, and International Business and is affiliated with the Southwest Institute for Health Disparities Research, College of Business, New Mexico State University
| | - Jesus Sigala
- Jesus Sigala is a graduate student in the Department of Economics, Applied Statistics, and International Business and is affiliated with the Southwest Institute for Health Disparities Research, College of Business, New Mexico State University
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McDonald JA, Amatya A, Gard CC, Sigala J. Trends in Hispanic and non-Hispanic white cesarean delivery rates on the US-Mexico border, 2000-2015. PLoS One 2018; 13:e0203550. [PMID: 30183758 PMCID: PMC6124779 DOI: 10.1371/journal.pone.0203550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/22/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cesarean delivery occurs in one in three US births and poses risks for mothers and infants. Hispanic cesarean rates were higher than non-Hispanic white rates in the US in 2016. In 2009, cesarean rates among Hispanics on the US-Mexico border exceeded rates among US Hispanics. Since 2009, rates have declined nationwide, but border Hispanic rates have not been studied. OBJECTIVE To compare cesarean delivery rates and trends in Hispanics and non-Hispanic whites in border and nonborder counties of the four US border states before and after 2009. STUDY DESIGN We used data from birth certificates to calculate percentages of cesarean deliveries among all births and births to low-risk nulliparous women during 2000-2015, and among births to low-risk women with and without a previous cesarean during 2009-2015. We calculated 95% confidence intervals around rates and used regular and piecewise linear regression to estimate trends for four ethnic-geographic subpopulations defined by combinations of Hispanic ethnicity and border-nonborder status. RESULTS Of the four subpopulations, border Hispanic rates were highest every year for all cesarean outcomes. In 2015 they were 38.3% overall, 31.4% among low-risk nulliparous women, and 21.1% and 94.6% among low-risk women without and with a previous cesarean, respectively. Nonborder Hispanic rates in 2015 were lowest for all outcomes but repeat cesarean. Rates for all four subpopulations rose steadily during 2000-2009. Unlike rates for non-Hispanic whites, border and nonborder Hispanic rates did not decline post-2009. Most of the border Hispanic excess can be attributed to higher cesarean rates in Texas. DISCUSSION Border Hispanic cesarean rates remain higher than those among other Hispanics and non-Hispanic whites in border states and show no signs of declining. This continuing disparity warrants further analysis using individual as well as hospital, environmental and other contextual factors to help target prevention measures.
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Affiliation(s)
- Jill A. McDonald
- Department of Public Health Sciences, New Mexico State University, Las Cruces, New Mexico, United States of America
- Southwest Institute for Health Disparities Research, New Mexico State University, Las Cruces, New Mexico, United States of America
| | - Anup Amatya
- Department of Public Health Sciences, New Mexico State University, Las Cruces, New Mexico, United States of America
- Southwest Institute for Health Disparities Research, New Mexico State University, Las Cruces, New Mexico, United States of America
| | - Charlotte C. Gard
- Southwest Institute for Health Disparities Research, New Mexico State University, Las Cruces, New Mexico, United States of America
- Economics, Applied Statistics and International Business Department, New Mexico State University, Las Cruces, New Mexico, United States of America
| | - Jesus Sigala
- Southwest Institute for Health Disparities Research, New Mexico State University, Las Cruces, New Mexico, United States of America
- Economics, Applied Statistics and International Business Department, New Mexico State University, Las Cruces, New Mexico, United States of America
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Denize KM, Acharya N, Prince SA, da Silva DF, Harvey AL, Ferraro ZM, Adamo KB. Addressing cultural, racial and ethnic discrepancies in guideline discordant gestational weight gain: a systematic review and meta-analysis. PeerJ 2018; 6:e5407. [PMID: 30186674 PMCID: PMC6118200 DOI: 10.7717/peerj.5407] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 07/18/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To systematically review the literature and describe the discrepancies in achieving the 2009 Institute of Medicine (IOM) gestational weight gain (GWG) guidelines across cultures. METHODS Ten databases were searched from inception to April 2018. Observational cohort studies were included that examined adult women; reported on a measure of culture; compared cultural groups, and reported on GWG. Articles were broken down into papers that used the current 2009 IOM GWG guidelines and those that used others. A meta-analysis was conducted for studies using the 2009 guidelines examining the prevalence of discordant GWG across cultural groups. RESULTS The review included 86 studies. Overall, 69% of women experienced discordant GWG irrespective of culture. White women experienced excessive GWG most often, and significantly more than Asian and Hispanic women; Black women had a higher prevalence of excessive GWG than Hispanic and Asian women; however, this difference was not significant. CONCLUSIONS The majority of women experience excessive GWG, with White women experiencing this most often. Culturally diverse GWG guidelines are needed to individualize antenatal care and promote optimal maternal-fetal health outcomes across cultural groups.
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Affiliation(s)
- Kathryn M. Denize
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | - Nina Acharya
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | - Stephanie A. Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Danilo Fernandes da Silva
- Department of Physical Education, State University of Midwest/Parana (UNICENTRO), Guarapuava, Paraná, Brazil
| | - Alysha L.J. Harvey
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | | | - Kristi B. Adamo
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
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Paradox lost on the U.S.-Mexico border: U.S. Latinas and cesarean rates. BMC Pregnancy Childbirth 2018; 18:82. [PMID: 29614971 PMCID: PMC5883278 DOI: 10.1186/s12884-018-1701-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 03/15/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We apply Intersectional Theory to examine how compounded disadvantage affects the odds of women having a cesarean in U.S.-Mexico border hospitals and in non-border hospitals. We define U.S. Latinas with compounded disadvantage as those who have neither a college education nor private health insurance. RESULTS Analyzing quantitative and qualitative data from Childbirth Connection's Listening to Mothers III Survey, we find that, consistent with the notion of the Latinx Health Paradox, compounded disadvantage serves as a protective buffer and decreases the odds of cesarean among women in non-border hospitals. However, the Latinx Health Paradox is absent on the border. CONCLUSION Our data show that women with compounded disadvantage who give birth on the border have significantly higher odds of a cesarean compared to women without such disadvantage. Further, women with compounded disadvantage who give birth in border hospitals report receiving insufficient prenatal, pregnancy, and postpartum information, providing a direction for future research to explain the border disparity in cesareans.
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Malagon-Maldonado G, Connelly CD, Bush RA. Predictors of Readiness for Hospital Discharge After Birth: Building Evidence for Practice. Worldviews Evid Based Nurs 2017; 14:118-127. [PMID: 28226190 DOI: 10.1111/wvn.12208] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND Preparation for hospital discharge after birth became a global concern when hospitals in many developing countries began implementing shorter lengths of stay for uncomplicated deliveries. A mother's perceived readiness for hospital discharge may be influenced by many factors that can ultimately shape postdischarge outcomes. AIMS The purpose of this study was to explore the antepartum, intrapartum, and postpartum predictors of discharge readiness, including nursing educational practices that are predictive of postpartum mothers' perceptions of readiness for hospital discharge. METHODS The Adaptation to Transitions conceptual framework guided the descriptive correlational study design and measures. A purposive sample of 185 English- and Spanish-speaking postpartum mothers who experienced an uneventful vaginal or cesarean birth of a healthy infant completed demographic, quality of discharge teaching, and readiness for hospital discharge questionnaires prior to discharge. RESULTS Mothers with three or more children, delivery mode, bottle-feeding, the delivery of education, and the difference between educational content received and needed, were significant predictors that accounted for 42% of the variance in readiness for hospital discharge (R2 = 0.42, F[10,174] = 14.52, p < .001). Nurses' skill in teaching and educational content received were significant predictors even with parity, feeding, and delivery mode in the model. LINKING EVIDENCE TO ACTION The relationship between quality of discharge teaching and discharge readiness provides evidence of the critical role nurses have in the discharge preparation process. Nurse education programs and evidence-based guidelines should be designed to enhance patient education focused on the adequacy and delivery of teaching content.
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Affiliation(s)
- Gabriella Malagon-Maldonado
- Director of Education, Research, and Professional Practice, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA
| | - Cynthia D Connelly
- Director of Nursing Research and Professor, University of San Diego, Hahn School of Nursing and Health Science, San Diego, CA, USA
| | - Ruth A Bush
- Clinical Associate Professor, University of San Diego, Hahn School of Nursing and Health Science, San Diego, CA, USA
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