Partnering to Support Education for Midwives and Nurses in Liberia.

The midwifery and occupational health faculty of a U.S. university were approached by parish and health care leaders from Caldwell, Liberia, for assistance in addressing critical maternal health care needs in their community. Liberia has suffered setbacks in its efforts to improve health care for its people due to recent civil wars and the Ebola epidemic of 2014 to 2016. Initial discussions among international groups centered around realistic ways to help in the face of multiple compelling needs. Grant support for U.S. faculty to conduct exploratory meetings and educational workshops in Liberia was secured. Ethical principles and best practices in partnering across borders guided this partnership and include reciprocity, equity, and empowerment of health care workers, including nurses, midwives, community workers, and health center staff. Here, we describe the preparation for and implementation of these workshops, as well as plans for continuing collaborations that emerged from these workshops.

Management of Bartholin Duct Cysts and Gland Abscesses.

Bartholin duct cysts and gland abscesses can affect a woman's day-to-day functioning and be challenging to manage. Many Bartholin duct cysts that are not infected remain asymptomatic and resolve spontaneously without intervention. However, an infected Bartholin duct cyst or glandular abscess should be drained when larger than 2 cm because such cysts or abscesses do not tend to resolve spontaneously and can recur. Management options fall under 3 broad categories: expectant, medical, or surgical. With special training, midwives and women's health nurse practitioners can manage many women who present with Bartholin duct cysts or gland abscesses. Rarely, a woman with a severe or recurrent infection will need referral to a surgeon. Knowing which management option to choose may be challenging at first; this article is aimed at providing evidence-based knowledge about Bartholin duct cysts and gland abscesses for clinicians so that they can make the diagnosis and management plan with confidence. A clinical case is used to illustrate the identification, diagnosis, and management of Bartholin duct cysts and gland abscesses. The range of interventions, from expectant management with comfort measures to surgical intervention, is be explored to assist the clinician in choosing the correct management approach.

What Nurses Need to Know About Immediate Postpartum Initiation of Long-Acting Reversible Contraception.

Initiation of long-acting reversible contraception (LARC) in the immediate postpartum period is becoming more common, resulting in increased requests for early removal, primarily because of unpredictable bleeding patterns. Competing interests of healthful spacing of pregnancies, impact on breastfeeding, risks associated with pregnancy versus contraceptive method, potential adverse effects of LARC, and timing of informed consent make immediate postpartum initiation of LARC an important issue. Nearly 40% of women do not attend a postpartum visit at all, resulting in decreased initiation of contraception and increased risk of unplanned pregnancy. Nurses caring for women during the peripartum period can help women make informed decisions and can provide anticipatory guidance regarding this method of contraception. Evidence-based postpartum education and support can result in women's increased continuation of and satisfaction with LARC.

Cultural Meanings of Mothering Through the Eyes of African American Adolescent Mothers.

The life-course perspective considers the effects of chronic, high levels of stress as contributing to the disparity in infant mortality between African Americans and all other groups. Many young mothers are mothering their children in isolation without benefit of the cultural safety net that once existed, further contributing to a state of chronic stress. This study explored the cultural meanings of mothering for African American adolescent mothers using Photovoice, a participatory research methodology. Results suggested a network consisting of extended kin and "other mothers" is integral in providing support and identifying cultural strengths used in coping and reducing effects of chronic stress.

Cultural Preparation for Womanhood in Urban African American Girls: Growing Strong Women.

PURPOSE: Poor sexual health is a significant contributor to morbidity in young African American women. Knowing how sexual knowledge is transmitted to Black girls is needed to develop effective preventive interventions. The purpose of this study was to explore the ways in which Black mothers transmit sexual values and knowledge to their daughters. DESIGN: Interviews were conducted with 14 mothers, aged 25 to 34 years, with daughters aged 8 to 16 years. Data were analyzed using constant comparative analysis. FINDINGS: The themes derived were (a) truth telling, (b) building strength through self-esteem, and (c) spirituality as helper. The overarching cultural theme was "Growing Strong Black Women." DISCUSSION/CONCLUSIONS: Mothers' discussions with their daughters were infused with cultural meaning derived from their experiences. Black girls' behavioral responses to their mothers' strategies need to be studied. IMPLICATIONS: The findings will help nurses develop effective interventions that take into account the cultural realities of Black mothers.

Nurse-midwifery: art and science.

The gap in the health of the nations' people seems to be widening and reflects existing social inequalities affecting the ongoing health of individuals. From a historical and practical perspective, certified nurse-midwives (CNMs) are one group of advanced practice registered nurses uniquely situated to address existing disparities related to maternal-child health. This article provides an overview of the historical development, current status, and use of CNMs in the United States health care system; the impact of CNMs on maternal-child health outcomes; and future trends in the education of CNMs.