Mapping the intersection of social determinants of health, postpartum visit attendance, and pregnancy-related deaths: A scoping review.

BACKGROUND: Maternal health outcomes in the United States raises concern due to elevated rates of pregnancy-related deaths compared to other developed and underdeveloped countries. This scoping review explores relationships between social determinants of health (SDOH), postpartum visit attendance, and pregnancy-related deaths. METHODS: Utilizing the Arksey and O'Malley framework and PRISMA-Scr guidelines, a systematic review was conducted to identify pertinent literature. RESULTS: Eight studies were analyzed, providing insights into SDOH, postpartum visits, and pregnancy-related deaths. The findings highlight healthcare access/quality, economic stability, education, and social/community context as influential in postpartum care utilization. Health insurance emerges a key factor for postpartum attendance.  In addition, disparities in geographic access to maternity care services were linked to pregnancy-related deaths. Social contextual factors, such as marital status and social support, exhibited varying associations with postpartum visit attendance. CONCLUSION: While the analyzed studies provided valuable insight, there remains a gap in the literature examining all three key elements: SDOH, postpartum visit attendance, and pregnancy-related deaths. In conclusion, this scoping review highlights the vital role of addressing social determinants in improving maternal health outcomes.  Further research is necessary to better inform interventions to reduce pregnancy-related deaths.

Replacing community clinical hours with an antepartum simulation-based experience.

BACKGROUND: Community and population health is an essential part of pre-licensure nursing education. Securing community clinical sites for large cohorts of nursing students is challenging. Individual community sites in nursing specialty areas, such as women's health, limit the number of students, making it difficult to provide a consistent clinical experience for all students. The literature shows simulation is an effective alternative to traditional clinical hours. PURPOSE: This article describes a pilot simulation-based antepartum experience in the community setting. This simulation-based experience replaced the clinical hours for a previous traditional clinical experience in the community setting, for which students were only able to observe and not interact. The objectives were to allow students to be engaged in communication, patient education, and anticipatory guidance with a live patient. METHOD: Faculty at a large southeastern university created an antepartum simulation-based clinical experience focused on important elements of obstetrics and maternal health assessment utilizing standardized patients. RESULTS: Student responses from the post-simulation survey showed 96 % strongly agreed they were more confident in communicating with clients. CONCLUSION: Faculty concluded this simulation-based experience is an effective alternative to traditional community clinical experiences in the antepartum setting.