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Hoehn-Velasco L, Ross L, Phillippi RD, Niemczyk NA, Cammarano D, Calvin S, Phillippi JC, Alliman J, Stapleton SR, Wright J, Fisch S, Jolles D. Neonatal morbidity and mortality in birth centers in the United States 2018-2021: An observational study of low-risk birthing individuals. Birth 2024. [PMID: 38778783 DOI: 10.1111/birt.12823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/26/2023] [Accepted: 04/12/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Many studies reporting neonatal outcomes in birth centers include births with risk factors not acceptable for birth center care using the evidence-based CABC criteria. Accurate comparisons of outcomes by birth setting for low-risk patients are needed. METHODS Data from the public Natality Detailed File from 2018 to 2021 were used. Logistic regression, including adjusted and unadjusted odds ratios, compared neonatal outcomes (chorioamnionitis, Apgar scores, resuscitation, intensive care, seizures, and death) between centers and hospitals. Covariates included maternal diabetes, body mass index, age, parity, and demographic characteristics. RESULTS The sample included 8,738,711 births (8,698,432 (99.53%) in hospitals and 40,279 (0.46%) in birth centers). There were no significant differences in neonatal deaths (aOR 1.037; 95% CI [0.515, 2.088]; p-value 0.918) or seizures (aOR 0.666; 95% CI [0.315, 1.411]; p-value 0.289). Measures of morbidity either not significantly different or less likely to occur in birth centers compared to hospitals included chorioamnionitis (aOR 0.032; 95% CI [0.020, 0.052]; p-value < 0.001), Apgar score < 4 (aOR 0.814, 95% CI [0.638, 1.039], p-value 0.099), Apgar score < 7 (aOR 1.075, 95% CI [0.979, 1.180], p-value 0.130), ventilation >6 h (aOR 0.349; [0.281,0.433], p-value < 0.001), and intensive care admission (aOR 0.356; 95% CI [0.328, 0.386], p-value < 0.001). Birth centers had higher odds of assisted neonatal ventilation for <6 h as compared to hospitals (aOR 1.373; 95% CI [1.293, 1.457], p-value < 0.001). CONCLUSION Neonatal deaths and seizures were not significantly different between freestanding birth centers and hospitals. Chorioamnionitis, Apgar scores < 4, and intensive care admission were less likely to occur in birth centers.
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Affiliation(s)
| | - Lisa Ross
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | - R David Phillippi
- Department of Mathematics, Belmont University, Nashville, Tennessee, USA
| | - Nancy A Niemczyk
- Nurse-Midwife DNP Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dominic Cammarano
- Division of Gynecology, Reading Hospital, Reading, Pennsylvania, USA
| | - Steven Calvin
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Jill Alliman
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
- Frontier Nursing University, Lexington, Kentucky, USA
| | | | - Jennifer Wright
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | - Stanley Fisch
- Frontier Nursing University, Lexington, Kentucky, USA
| | - Diana Jolles
- Frontier Nursing University, Lexington, Kentucky, USA
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Niemczyk NA, Sokunbi A, Reale B. Decolonizing the midwifery curriculum: Jettisoning the Caldwell-Moloy pelvic types. Birth 2024. [PMID: 38268381 DOI: 10.1111/birt.12813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/17/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
As faculty in two different midwifery education programs, we have stopped teaching the Caldwell-Moloy classifications of the female pelvis, as have faculty in several other US midwifery programs. In this commentary, we explain the rationale for this change. We review the roots of the Caldwell-Moloy pelvic classification and the lack of contemporary scientific support for either classifying pelvic types or using such a classification for clinical decision-making, and propose an alternative approach to teaching assessment of the bony pelvis.
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Affiliation(s)
- Nancy A Niemczyk
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Adeyinka Sokunbi
- Midwifery Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Barbara Reale
- Midwifery Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Niemczyk NA, Narbey L. Research and Professional Literature to Inform Practice, May/June 2023. J Midwifery Womens Health 2023; 68:391-394. [PMID: 37218427 DOI: 10.1111/jmwh.13506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/03/2023] [Indexed: 05/24/2023]
Affiliation(s)
- Nancy A Niemczyk
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- The Midwife Center for Birth and Women's Health, Pittsburgh, Pennsylvania, USA
| | - Lauren Narbey
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Allegheny Health Network, Pittsburgh, Pennsylvania, USA
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Niemczyk NA, Humphreys E. Research and Professional Literature to Inform Practice, January/February 2023. J Midwifery Womens Health 2023; 68:135-139. [PMID: 36606661 DOI: 10.1111/jmwh.13465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Nancy A Niemczyk
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.,The Midwife Center for Birth and Women's Health, Pittsburgh, Pennsylvania
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Niemczyk NA, Narbey L. Research and Professional Literature to Inform Practice, September/October 2022. J Midwifery Womens Health 2022; 67:658-662. [PMID: 36165732 DOI: 10.1111/jmwh.13404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Nancy A Niemczyk
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.,The Midwife Center for Birth and Women's Health, Pittsburgh, Pennsylvania
| | - Lauren Narbey
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.,Allegheny Health Network, Pittsburgh, Pennsylvania
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Niemczyk NA, Arrington LA, Avery MD. Navigating the Changing Abortion Landscape: Implications for Midwives and Midwifery Practice. J Midwifery Womens Health 2022; 67:541-543. [DOI: 10.1111/jmwh.13411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/05/2022]
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Niemczyk NA, Ren D, Jolles DR, Wright J, Christy E, Stapleton SR. Adoption of Consensus Guidelines for Safe Prevention of the Primary Cesarean Delivery by Freestanding Birth Centers. J Midwifery Womens Health 2022; 67:580-585. [PMID: 35776073 DOI: 10.1111/jmwh.13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/14/2022] [Accepted: 05/06/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Slow or arrested progress in labor is the most frequent (64%) indication for nonemergent transfer of laboring people from freestanding birth centers to the hospital. After the 2014 publication of the Consensus Statement on Safe Prevention of Primary Cesarean Delivery (Consensus Statement), many freestanding birth centers changed their clinical practice guidelines to allow more time for active labor in the birth center prior to hospital transfer. The result of these changes has not been evaluated in birth centers. Evaluation of adoption of guidelines based on the Consensus Statement in hospitals has shown inconsistent results. METHODS Birth centers were contacted to determine whether they changed clinical practice guidelines in response to the Consensus Statement. A before-after analysis compared outcomes for the 2 calendar years before and the 2 calendar years after adoption of new guidelines with a retrospective analysis of deidentified client-level data collected in the American Association of Birth Centers Perinatal Data Registry. RESULTS A third of responding birth centers (11 of 33) changed their clinical practice guidelines, mostly redefining the onset of active labor as beginning at 6 cm cervical dilatation and allowing 4 hours of arrest of dilatation in active labor before transfer to the hospital. These changes were associated with fewer diagnoses of prolonged first stage of labor (13.8% vs 8.0%, P < .01) but not with fewer intrapartum transfers (14.0% vs 14.7%, P = .55) or cesarean births (5.0 vs 4.1%, P = .26.) DISCUSSION: We found no evidence that making these practice changes was associated with better outcomes. Two hours of a lack of documented cervical change in active labor is likely long enough to diagnose arrested progress in labor. Research on proportion of morbidity and mortality associated with prolonged labor could inform practice guidelines for transfers.
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Affiliation(s)
- Nancy A Niemczyk
- Department of Health Promotion and Development, University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
| | - Dianxu Ren
- Center for Research and Evaluation, University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
| | | | - Jennifer Wright
- American Association of Birth Centers, Perkiomenville, Pennsylvania
| | - Ellen Christy
- Department of Health Promotion and Development, University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
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Niemczyk NA. Research and Professional Literature to Inform Practice, May/June 2022. J Midwifery Womens Health 2022; 67:410-414. [PMID: 35522121 DOI: 10.1111/jmwh.13369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Nancy A Niemczyk
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.,Midwife Center for Birth and Women's Health, Pittsburgh, Pennsylvania
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Niemczyk NA, Ren D, Stapleton SR. Associations between prolonged second stage of labor and maternal and neonatal outcomes in freestanding birth centers: a retrospective analysis. BMC Pregnancy Childbirth 2022; 22:99. [PMID: 35120470 PMCID: PMC8815242 DOI: 10.1186/s12884-022-04421-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 01/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Current guidelines for second stage management do not provide guidance for community birth providers about when best to transfer women to hospital care for prolonged second stage. Our goal was to increase the evidence base for these providers by: 1) describing the lengths of second stage labor in freestanding birth centers, and 2) determining whether proportions of postpartum women and newborns experiencing complications change as length of second stage labor increases. METHODS This study is a retrospective analysis of de-identified client-level data collected in the American Association of Birth Centers Perinatal Data Registry, including women giving birth in freestanding birth centers January 1, 2007 to December 31, 2016. We plotted proportions of postpartum women and newborns transferred to hospital care against length of the second stage of labor, and assessed significance of these with the Cochran-Armitage test for trend or chi-square test. Secondary maternal and newborn outcomes were compared for dyads with normal and prolonged second stages of labor using Fisher's exact test. RESULTS Second stage labor exceeded 3 hours for 2.3% of primiparous women and 2 hours for 6.6% of multiparous women. Newborn transfers increased as second stage increased from < 15 minutes to > 2 hours (0.6% to 6.33%, p for trend = 0.0008, for primiparous women, and 1.4% to 10.6%, p for trend < 0.0001, for multiparous women.) Postpartum transfers for multiparous women increased from 1.4% after second stage < 15 minutes to greater than 4% for women after second stage exceeding 2 hours (p for trend < 0.0001.) CONCLUSIONS: Complications requiring hospitalization of postpartum women and newborns become more common as the length of the second stage increases. Birth center guidelines should consider not just presence of progress but also absolute length of time as indications for transfer.
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Affiliation(s)
- Nancy A Niemczyk
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, 3500 Victoria Street, 440 Victoria Building, Pittsburgh, PA, 15261, USA.
| | - Dianxu Ren
- Center for Research and Evaluation, School of Nursing, University of Pittsburgh, 3500 Victoria Street, 440 Victoria Building, Pittsburgh, PA, 15261, USA
| | - Susan R Stapleton
- American Association of Birth Centers, 3123 Gottschall Road, Perkiomenville, PA, 18074, USA
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Niemczyk NA. Updates from the Literature, September/October 2021. J Midwifery Womens Health 2021; 66:671-675. [PMID: 34596950 DOI: 10.1111/jmwh.13292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/31/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Nancy A Niemczyk
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.,Midwife Center for Birth and Women's Health, Pittsburgh, Pennsylvania
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Niemczyk NA, Osborne C. Updates from the Literature, March/April 2021. J Midwifery Womens Health 2021; 66:270-273. [PMID: 33720496 DOI: 10.1111/jmwh.13220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 01/23/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Nancy A Niemczyk
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.,Midwife Center for Birth and Women's Health, Pittsburgh, Pennsylvania
| | - Caroline Osborne
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
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Sanders SA, Niemczyk NA, Burke JG, McCarthy AM, Terry MA. Exploring Why Birth Center Clients Choose Hospitalization for Labor and Birth. Nurs Womens Health 2021; 25:30-42. [PMID: 33453158 DOI: 10.1016/j.nwh.2020.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/03/2020] [Accepted: 11/01/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify demographic and clinical factors associated with birth center clients electing hospitalization for labor and birth and to explore the timing and rationale for elective hospitalization via health records. DESIGN A secondary analysis of multiyear data from a quality assurance project at a single birth center. We compared two subsamples-birth center preference group and hospital preference group-and described the apparent rationale for transfers among clients in the latter group. SETTING A single freestanding birth center where all midwives have admitting privileges at a local hospital and can accompany labor transfers. PARTICIPANTS All cases included in the analytic sample represent women with low-risk pregnancies who were eligible for birth center birth. The birth center preference group represents clients planning to give birth at the center, and the hospital preference group consists of clients who elected for hospitalization. MEASUREMENTS Relevant demographic and clinical information was provided for the entire analytic sample and was matched with available data collected systematically by birth center staff via chart review. The data set also included anonymous responses to an e-mailed questionnaire from clients identified by birth center staff. RESULTS Approximately 56.1% (N = 1,155) of the cases in the data set were eligible for comparative analysis. The birth center preference and hospital preference groups included 899 (77.8%) and 256 (22.2%) individuals, respectively. In the hospital preference group, Black clients (n = 23), those who were publicly insured (n = 49), and primiparas (n = 101) were significantly overrepresented. Chart review data and questionnaire responses highlighted insurance restrictions, family preferences, pain relief options, and postpartum care as influential factors among members of the hospital preference subsample. CONCLUSION The present analysis shows associations between certain individual characteristics and elective hospitalization during labor for birth center clients. Health record data and questionnaire responses indicated a variety of reasons for electing hospitalization, illustrating the complexity of clients' decision-making during pregnancy and birth.
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Niemczyk NA, Osborne C. Updates from the Literature, July/August 2020. J Midwifery Womens Health 2020; 65:574-577. [DOI: 10.1111/jmwh.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Nancy A. Niemczyk
- School of NursingUniversity of Pittsburgh Pittsburgh Pennsylvania
- Midwife Center for Birth and Women's Health Pittsburgh Pennsylvania
| | - Caroline Osborne
- Department of Health Promotion and Development, School of NursingUniversity of Pittsburgh Pittsburgh Pennsylvania
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Faulk KA, Niemczyk NA. Key indicators influencing management of prolonged second stage labour by midwives in freestanding birth centres: Results from an ethnographic interview study. Women Birth 2020; 34:e279-e285. [PMID: 32434683 DOI: 10.1016/j.wombi.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 03/19/2020] [Accepted: 04/07/2020] [Indexed: 11/26/2022]
Abstract
PROBLEMS Complications for newborns and postpartum clients in the hospital are more frequent after a prolonged second stage of labour. Midwives in community settings have little research to guide management in their settings. AIM We explored how US birth centre midwives identify onset of second stage of labour and determine when to transfer clients to the hospital for prolonged second stage. METHODS Ethnographic interviews of midwives with at least 2 years' experience in birth centres and participant observation of birth centre care. FINDINGS We interviewed 21 midwives (18 CNMs, 3 CPMs/equivalent) from 18 birth centres in 11 US states, 45% with hospital practice privileges. Midwives relied on and engaged in embodied practice in evaluating each labour and making decisions concerning management of labour. Midwives considered time a useful but limited measure as a guiding factor in management. Though ideas of time and progress do play an important role in the decision-making process of midwives, their usefulness is limited due to the continual, multifactorial, and multisensory nature of the assessment. Relationship with the transfer hospital structured midwives' decision-making about transfers. DISCUSSION & CONCLUSION These findings can inform future robust multivariate evaluation of factors, including but not limited to time, in guidelines for management of second stage of labour. Optimal management may require formal consideration of more than just time and parity. Our findings also suggest the need for evaluation of how structural issues involving hospital privileges for midwives and relationships between birth centre and hospital staff affect the well-being of childbearing families.
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Affiliation(s)
| | - Nancy A Niemczyk
- Department of Health Promotion and Development, University of Pittsburgh, School of Nursing, 440 Victoria Building, 3600 Victoria Street, Pittsburgh, PA 15261, USA.
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Niemczyk NA, Osborne C. Updates from the Literature, January/February 2020. J Midwifery Womens Health 2020; 65:160-164. [DOI: 10.1111/jmwh.13078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Nancy A. Niemczyk
- School of Nursing University of Pittsburgh Pittsburgh Pennsylvania
- Midwife Center for Birth and Women's Health Pittsburgh Pennsylvania
| | - Caroline Osborne
- School of Nursing, Department of Health Promotion and Development, University of Pittsburgh Pittsburgh Pennsylvania
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Niemczyk NA. Updates from the Literature, September/October 2019. J Midwifery Womens Health 2019; 64:664-667. [DOI: 10.1111/jmwh.13032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/16/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Nancy A. Niemczyk
- School of NursingUniversity of Pittsburgh Pittsburgh Pennsylvania
- Midwife Center for Birth and Women's Health Pittsburgh Pennsylvania
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Niemczyk NA. Updates from the Literature, January/February 2019. J Midwifery Womens Health 2019; 64:118-122. [DOI: 10.1111/jmwh.12939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 11/28/2022]
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Niemczyk NA. Updates from the Literature, July/August 2018. J Midwifery Womens Health 2018; 63:483-486. [DOI: 10.1111/jmwh.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 05/29/2018] [Indexed: 11/27/2022]
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Niemczyk NA, Cutts A, Perlman DB. Prior Work and Educational Experience Are Not Associated With Successful Completion of a Master's-Level, Distance Education Midwifery Program. J Midwifery Womens Health 2018. [PMID: 29533523 DOI: 10.1111/jmwh.12716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In order to increase and diversify the midwifery workforce, admissions criteria for midwifery education programs must not contain unnecessary barriers to entry. Once accepted, students need to successfully complete the program. Many admissions criteria commonly used in midwifery education programs in the United States are not evidence based and could be unnecessary barriers to education. The primary objective of this study was to identify factors known during the admission process that were related to successful completion or failure to complete a midwifery program educating both student nurse-midwives (SNMs) and student midwives (SMs); a secondary objective was to quantify reasons for program noncompletion. METHODS This master's-level, distance education program educates a diverse group of both SNMs and SMs. A pilot, retrospective cohort study examined all students matriculating at the program from fall 2012 on and scheduled to graduate by summer 2016 (N = 58). Demographic information, admissions information, academic records, and advising notes were reviewed. Reasons for noncompletion were identified, and characteristics were compared between students who did and did not complete the program. RESULTS Program completion was not significantly associated with students' status as nurses prior to admission, labor and delivery nursing experience, length of nursing experience, nursing degree held, presence of children at home, working while in school, or undergraduate grade point average. DISCUSSION Being a nurse, years of nursing experience, type of nursing degree, or labor and delivery nursing experience were not associated with completion of this midwifery program.
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Niemczyk NA. Updates From the Literature, March/April 2018. J Midwifery Womens Health 2018. [DOI: 10.1111/jmwh.12731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Niemczyk NA, Kupiec N. Updates From the Literature, July/August 2017. J Midwifery Womens Health 2017; 62:484-487. [DOI: 10.1111/jmwh.12639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 11/30/2022]
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Niemczyk NA. Updates From the Literature, March/April 2017. J Midwifery Womens Health 2017; 62:227-231. [DOI: 10.1111/jmwh.12614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 02/02/2017] [Indexed: 11/29/2022]
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Niemczyk NA. The Influence of Group Versus Individual Prenatal Care on Phase of Labor at Hospital Admission, and Gestational Weight Gain and Breastfeeding Outcomes in Group Prenatal Care. J Midwifery Womens Health 2017; 62:127. [PMID: 28132425 DOI: 10.1111/jmwh.12594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 11/17/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Nancy A Niemczyk
- Assistant Professor, Director of Nurse-Midwifery Program, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania
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Niemczyk NA. Planned Home Vaginal Birth After Cesarean. J Midwifery Womens Health 2016; 61:276-7. [PMID: 27494009 DOI: 10.1111/jmwh.12444_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Niemczyk NA. Diet Therapy May Be As Effective As Glyburide For Treatment Of Mild Gestational Diabetes. J Midwifery Womens Health 2016; 61:277-8. [PMID: 27494010 DOI: 10.1111/jmwh.12444_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Niemczyk NA. Provider Skill Influences Perinatal Outcomes. J Midwifery Womens Health 2016; 61:279. [PMID: 27494012 DOI: 10.1111/jmwh.12444_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Niemczyk NA, Allison KS, Brody DS, Carratu L, Guernsey K, Hanbridge J, Heller J, Walker L. PREDICTION OF WOMEN AT LOW RISK FOR PREECLAMPSIA WITH SFLT‐1:P1GF RATIO. J Midwifery Womens Health 2016. [DOI: 10.1111/jmwh.12496_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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28
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Niemczyk NA. EARLY AND EXCLUSIVE BREASTFEEDING MAY PROTECT AGAINST NEONATAL MORTALITY. J Midwifery Womens Health 2016; 61:278-9. [DOI: 10.1111/jmwh.12444_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Niemczyk NA. PARENTS DESIRE PARENTING EDUCATION DURING PRENATAL CARE. J Midwifery Womens Health 2016; 61:278. [DOI: 10.1111/jmwh.12444_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Niemczyk NA. Exercise Reduces Gestational Diabetes Risk. J Midwifery Womens Health 2015; 60:472. [PMID: 26504944 DOI: 10.1111/jmwh.12342_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Niemczyk NA. Omega-3 Fatty Acids do not Appear to Prevent Preterm Birth. J Midwifery Womens Health 2015; 60:472. [PMID: 26504945 DOI: 10.1111/jmwh.12342_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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32
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Niemczyk NA. Antibiotic use in Pregnancy may be Associated with Childhood Obesity. J Midwifery Womens Health 2015; 60:471-2. [PMID: 26504943 DOI: 10.1111/jmwh.12342_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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33
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Niemczyk NA. Midwife Laborists Provide High-Quality Care. J Midwifery Womens Health 2015; 60:470-1. [PMID: 26504941 DOI: 10.1111/jmwh.12342_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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34
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Niemczyk NA. CAUSES OF PREGNANCY‐RELATED MORTALITY CHANGE, BUT RACIAL DISPARITIES REMAIN. J Midwifery Womens Health 2015. [DOI: 10.1111/jmwh.12357_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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35
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Niemczyk NA. LOW-MOLECULAR-WEIGHT HEPARIN NOT EFFECTIVE AT PREVENTING PREGNANCY COMPLICATONS IN WOMEN WITH THROMBOPHILIAS. J Midwifery Womens Health 2015. [DOI: 10.1111/jmwh.12281_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Niemczyk NA. REGULAR EXERCISE IN PREGNANCY DECREASES RISK OF CESAREAN BIRTH. J Midwifery Womens Health 2015. [DOI: 10.1111/jmwh.12281_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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39
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Niemczyk NA. LOW-CARBOHYDRATE VERSUS LOW-FAT DIET: A RANDOMIZED CLINICAL TRIAL. J Midwifery Womens Health 2015. [DOI: 10.1111/jmwh.12281_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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40
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Niemczyk NA. Life stress may be related to racial disparities in stillbirth. J Midwifery Womens Health 2014; 59:467-8. [PMID: 25215356 DOI: 10.1111/jmwh.12215_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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41
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Niemczyk NA. Most women think their cesarean birth was necessary. J Midwifery Womens Health 2014; 59:363-4. [PMID: 24983080 DOI: 10.1111/jmwh.12196_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Niemczyk NA. OTHER LITERATURE OF INTEREST. J Midwifery Womens Health 2014. [DOI: 10.1111/jmwh.12215_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Niemczyk NA. Some women with elevated body mass index are at low risk for complications in labor. J Midwifery Womens Health 2014; 59:361-2. [PMID: 24850288 DOI: 10.1111/jmwh.12214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Niemczyk NA. SOME WOMEN WITH ELEVATED BODY MASS INDEX ARE AT LOW RISK FOR COMPLICATIONS IN LABOR. J Midwifery Womens Health 2014. [DOI: 10.1111/jmwh.12196_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Niemczyk NA. OTHER LITERATURE OF INTEREST. J Midwifery Womens Health 2014. [DOI: 10.1111/jmwh.12196_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Niemczyk NA. Nurse practitioners, certified nurse-midwives, and physician assistants can safely perform first-trimester aspiration abortions. J Midwifery Womens Health 2013; 58:346-7. [PMID: 23656396 DOI: 10.1111/jmwh.12056_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Niemczyk NA. Can synthetic oxytocin be turned off in active labor? J Midwifery Womens Health 2013; 58:348-9. [PMID: 23656480 DOI: 10.1111/jmwh.12056_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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50
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Niemczyk NA. Postpartum hemorrhages are more common in planned hospital births compared with planned home births. J Midwifery Womens Health 2013; 58:347-8. [PMID: 23656427 DOI: 10.1111/jmwh.12056_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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