Structural Violence and Stress Experiences of Young Pregnant Black People.

INTRODUCTION: Approximately 10-20% of individuals suffer from mental health concerns during the prenatal period due to their vulnerability and emotional responses to stressful events. Mental health disorders are more likely to be disabling and persistent for people of color, and they are less likely to seek treatment due to stigma. Young pregnant Black people report experiencing stress due to isolation, feelings of conflict, lack of material and emotional resources, and support from significant others. Although many studies have reported the types of stressors experienced, personal resources, emotional stress responses on pregnancy, and mental health outcomes, there is limited data on young Black women's perceptions of these factors. METHODS: This study utilizes the Health Disparities Research Framework to conceptualize drivers of stress related to maternal health outcomes for young Black women. We conducted a thematic analysis to identify stressors for young Black women. RESULTS: Findings revealed the following overarching themes: Societal stress of being young, Black, and pregnant; Community level systems that perpetuate stress and structural violence; Interpersonal level stressors; Individual level effects of stress on mom and baby; and Coping with stress. DISCUSSION: Acknowledging and naming structural violence and addressing structures that create and fuel stress for young pregnant Black people are important first steps to interrogating systems that allow for nuanced power dynamics and for recognizing the full humanity of young pregnant Black people.

Obstetric experiences of young black mothers: An intersectional perspective.

BACKGROUND: In Chicago, maternal morbidity and mortality is six times more likely among Black birthing people than white, despite policy initiatives to promote maternal health equity. Disparities in maternal morbidity and mortality reflect experiences of structural inequities - including limited quality obstetric care, implicit bias, and racism resulting patient mistrust in the health care system, inadequate social support, and financial insecurity. Although there is published literature on Black women's experiences with obstetric care, including experiences with individual and structural racism, little is known about the intersection of age and race and experiences with health care. The purpose of this study was to explore the maternal health and pregnancy experiences of young Black women utilizing an intersectional theoretical lens. METHODS: In this study, we conducted two focus groups in a sample of 11 young Black pregnant people. We conducted a thematic analysis to identify codes, themes, and subthemes of the data. RESULTS: We developed two overarching themes: obstetric racism and obstetric resistance. To elucidate how obstetric racism framed our participants' healthcare experiences, we identified sub-themes: intersectional identities as young Black women, medical mistrust, and pregnancy trauma. The second major theme describes ways in which participants protected themselves against obstetric racism to engender positive health experiences. These methods of resistance included identifying advocates and relying on trusted providers. CONCLUSIONS: The current standard of obstetric care in the US is suboptimal due to individual and structural racism. This study provides unique data on the experiences with health care for young, Black pregnant individuals and delivers valuable insight into how individual and structural racism impacts obstetric care for young Black women.

Examining Whiteness in Obstetric and Pediatric Simulations: A Content Analysis.

BACKGROUND: Whiteness is a systemic construct that functions to make itself invisible and prevent its racialization. Whiteness informs the nursing profession on all levels and impacts how nurses learn, relate to, and perpetuate whiteness through structural, curricular, interpersonal, and ideological means. The aim of this study was to use an antiracist framework to analyze manifestations of whiteness in select prelicensure obstetric and pediatric clinical simulation scenarios at a large midwestern college of nursing. METHODS: Nine prelicensure nursing simulations were analyzed for themes using qualitative content analysis. RESULTS: Two themes related to whiteness emerged from the data-normalizing whiteness in assessment and othering. CONCLUSION: Applying an antiracist framework in clinical nursing education can assist educators and students to see the embedded whiteness and racism in the curriculum and begin to address it. Additional analysis is needed to explore nurse educators and student perceptions of whiteness in simulations. [J Nurs Educ. 2021;60(12):690-696.].

Reducing Barriers That Hinder Obstetric Providers From Addressing Perinatal Depression: A Provider Education Module.

BACKGROUND: Perinatal depression affects approximately one in seven women and is one of the most common complications that occurs during pregnancy and the postpartum period. Untreated depression can have devastating consequences for the mother and her children. Despite the high prevalence and negative effects, pregnant and postpartum women face barriers to establishing adequate care and thus many go untreated. Many obstetric providers lack the understanding and confidence needed to manage and treat women who screen positive. OBJECTIVE: The purpose of this quality improvement project was to create and deliver an education program to obstetric providers on depression screening, assessment, and treatment. The objective was to increase knowledge and confidence levels needed to affect recognition and management of perinatal depression. METHODS: A PowerPoint presentation was utilized to educate providers on assessment and management of perinatal depression. A pre- and post-test design was used to evaluate the impact on knowledge and confidence levels. RESULTS: Mean scores on knowledge and confidence levels were increased following the PowerPoint presentation. CONCLUSION: This intervention appeared to have a positive impact on depression knowledge and confidence levels in obstetric providers. IMPLICATIONS FOR NURSING: This project is anticipated to promote early identification and intervention for perinatal depression.

From Student to Practicing Oncology Nurse: A Novel Collaboration to Create a Transition to Practice Program in Ambulatory Cancer Care.

BACKGROUND: Healthcare reform and the shift of care to the ambulatory setting has created challenges for preparing nurses to practice in these complex clinical settings. Oncology is an area where dramatic transitions to ambulatory care have occurred, and the ambulatory oncology setting holds great potential for teaching evidence-based care to nursing students. OBJECTIVES: The article summarizes the collaboration between a baccalaureate nursing program and a cancer clinic to establish a dedicated education unit (DEU). METHODS: A pilot project was undertaken to create the DEU and residency program. FINDINGS: The collaboration has provided a clinical setting for baccalaureate nursing students to learn and develop clinical competencies, advance their critical thinking skills, and enhance advanced pathophysiology knowledge. The scope of the program includes a transition-to-practice model which maximizes the use of the DEU as students graduate and are eligible to apply for the oncology residency program. The DEU has created a pipeline for new nurses.

Aging in adults with intellectual disabilities.

A cross-sequential design was used to examine changes related to aging in adults with and without Down syndrome (ns = 55 and 75, respectively). Adults received yearly neuropsychological and medical evaluations. Support for precocious aging in adults with Down syndrome was evident only on a test of verbal fluency, with weaker support obtained on a test of fine-motor skills. Cross-sectional age differences for all adults were obtained on tests of memory and community living skills. General intellectual level, gender, and psychiatric status were consistently related to performance, indicating the need to examine such mediating variables in studies on aging.