Nurse-Midwifery M.S.

Year Approved


First Advisor

Medhus, Lillian


Background/Purpose: Marginalized women have significantly lower rates of breastfeeding initiation and duration and also experience significant health disparities when compared to non-marginalized populations. Breastfeeding has positive health benefits to both mother and child and could help to reduce these disparities. The purpose of this critical appraisal of the literature was to determine the effects of additional breastfeeding education and support on breastfeeding among marginalized groups of women. Theoretical Framework: Ramona Mercer’s Maternal Role Attainment Theory was used as a framework for the literature review by following the four stages of attainment; anticipatory, formal, informal, and personal. Methods: Twenty relevant, scholarly articles were chosen and critically analyzed using the Johns Hopkins Research Evidence Appraisal Tool. Following the critical analysis, a literature synthesis was completed. Results/Findings: Four themes emerged emphasizing breastfeeding education methods and impact of that education for marginalized women. Seven studies showed that breastfeeding education and support increased initiation rates but had insignificant effects on breastfeeding duration and exclusivity, six studies compared breastfeeding initiation and duration rates for women receiving group prenatal education and support, seven studies showed breastfeeding education increased efficacy and intention to breastfeed, and lastly five studies showed limited prenatal breastfeeding education had no statistical significance for breastfeeding initiation or duration. Implications for Research and Practice: Studies show that prenatal breastfeeding education and support increases breastfeeding initiation. Midwives who work with marginalized women should utilize this research to provide culturally sensitive support interventions to encourage women to exclusively breastfeed for an extended duration of time. These providers should also work to develop policies; guide research; and identify opportunities, gaps, and solutions to increase breastfeeding outcomes and impact health for marginalized women and their infants. They should also improve their understanding of the social determinants of health to provide quality breastfeeding care to women, including those from underserved populations, which is one of the Hallmarks of Midwifery (ACNM, 2020). Midwives’ close relationship with patients and breadth of knowledge can be influential in all aspects of women’s maternity care.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis