Theses/Dissertations from 2023
Facilitators and Barriers to Seeking and Complying to Pelvic Floor Physical Therapy: An Integrative Review, Marisa Abbinanti and Amanda J. Pegram
Introduction: The prevalence of pelvic floor disorders (PFD) continues to rise in conjunction with life expectancy. Despite professional recommendations, pelvic floor physical therapy (PFPT) remains an underutilized resource for PFD. Resear...
Trauma-Informed Midwifery Care: An Integrative Review, Lisa M. Gregory and Tiffany J. Negley
Introduction: Trauma exposure is a common experience for people of all ages and demographics, especially women. During vulnerable times such as pregnancy and childbirth, midwives can address these concerns by providing trauma-informed care ...
Outpatient Cervical Ripening Balloon - Healthcare Costs and Patient Satisfaction: An Integrative Review, Krystal A. Hall and Danielle Pfister
Induction of labor (IOL) is common practice in the United States, with a rate of 25.7% in 2018. IOL can be a lengthy process, placing undue strain on the healthcare system, increasing healthcare costs, and decreasing patient satisfaction. T...
Vaginal Breech Birth - Simulation Training to Learn and Maintain Skills: An Integrative Review, Kayla Harajli and Moira Weitz
Introduction: Vaginal breech birth has been on the decline since the Term Breech Trial 2000 when adverse neonatal outcomes were found to be higher in vaginal breech births when compared to cesarean sections for breech presentation. However,...
Rural Maternal Care Crisis & Strained Workforce: An Integrative Review Revealing Factors in the Rural Maternal Care Crisis, Taylor F. High Elk
Introduction: The United States is comprised of 75% rural areas and settings (American College of Obstetricians and Gynecologists (2014). Nearly five million women in the US do not have access to maternity care in the county in which they r...
Peripartum Pelvic Floor Interventions and Postpartum Female Sexual Function: An Integrative Review, Shelby T. Johnson and Chelsey M. Mackenzie
Introduction: Many postpartum individuals experience sexual dysfunction. The purpose of this review was to identify which pelvic floor muscle training interventions might have the most impact on sexual function during the postpartum period....
Perinatal Palliative Care and Parents’ Grief Experience: An Integrative Review, Bonnie A. Ledford and Brianna Treaster
Perinatal loss due to fetal congenital anomalies places parents at high risk for complex grief. Perinatal palliative care is a holistic option that may decrease complex grief yet is under-utilized in midwifery practice in the United States....
The Promotion of Maternal Infant Bonding in Perinatal Incarcerated Women: Lived Experience, Policies, Programs, Nalah E'Linda Morrow
Introduction: Within the United States there are currently no federal guidelines or protocols to ensure appropriate medical care for incarcerated pregnant and postpartum women. The purpose of this integrative review examines incarcerated wo...
Management of Uterine Fibroids: An Integrative Approach, Raychell R. Smith and Kiana Venable
Introduction: Uterine fibroids (UF) affect at least 1 in 4 adult women and are the most frequent type of tumor affecting the female reproductive organs of women of reproductive age. This integrative review will examine alternative methods u...
Theses/Dissertations from 2022
Mindfulness and Its Impact on Perinatal and Postpartum Depression, Anxiety, and Perceived Stress: An Integrative Review, Julie Ann Andrzejczak and Kathryn Jean Berscheit
Introduction: Many patients have mental health concerns during the peripartum period. These include, but are not limited to, depression, stress, and anxiety. There is emerging research showing that using mindfulness exercises during this pe...
Expedient Resolution for Shoulder Dystocia: A Comparison of Maneuver Research, Alexis Ann Bischof
Introduction: The purpose of this review is to assess which order of interventions is the most effective and timely at resolving a shoulder dystocia according to the literature. This is important information for perinatal providers to utili...
The Use of Clary Sage in Women's Health: An Integrative Review, Kimberly S. Brenneman
Introduction: Women have used various herbal remedies for health issues for centuries. One of the most commonly used essential oils is clary sage (Salvia sclarea). It is important for women’s health providers to know and provide evidence-ba...
Facilitators and Barriers to Breastfeeding Success in Adolescent Mothers: An Integrative Review, Julie M. Edinger and Kara N. Fairbanks
Abstract Introduction: Breastfeeding is the optimal feeding method for infants and confers numerous health benefits to mothers and their children. Nevertheless, despite overwhelming data supporting breastfeeding, breastfeeding rates remain ...
Diet and Supplements to Prevent Hypertensive Disorders of Pregnancy, Allison J. Freese-Johnson and Ally A. Muehlenbein
Introduction: Hypertensive disorders of pregnancy (HDP) are complications that present many problems for both mothers and infants. The purpose of this systematic review is to identify what dietary patterns and supplements could decrease the...
Nonpharmacologic Interventions for the Treatment of Anxiety in Pregnancy, Mikayla K. Gratz and Katelyn Renee Sola
Introduction: Anxiety has become an increasing concern for women throughout the perinatal period. The mainstay treatment for anxiety in pregnancy is pharmacotherapy, particularly selective serotonin reuptake inhibitors (SSRIs). Less often a...
Impact of Secondary Birth Trauma on Perinatal Providers and Interventions to Promote Adaptive Coping Strategies, Angela Patrice Hale and Pa D. Vue
Introduction: Vicarious birth trauma can cause serious negative repercussions for perinatal providers worldwide. This methodological review aims to examine the aftermath of experiencing secondary birth trauma among perinatal providers and e...
Consolidating Prenatal Care: An Integrative Review, Rachel Irving
Introduction: The purpose of this integrative review was to examine how consolidating prenatal care visits can affect attendance, exploring aspects at five different levels of influence. Methods: Whittemore and Knafl’s five-stage review pro...
The Impact of Group Prenatal Care on Decreasing Racial Health Disparities, Nikki L. Jacobson
Introduction: Adverse birth outcomes are a significant public health issue for women and infants in the United States, with preterm birth identified as a major cause of neonatal complications leading to lifelong morbidity and mortality. BIP...
Including LGBTQ Content in Health Care Education: Improving Provider Preparedness, Marta M. Little
Introduction: The LGBTQ community experiences significant disparities within health care. Lack of provider competence contributes to this, stemming from insufficient medical training. The purpose of this integrative review was to examine or...
Prenatal Mindfulness Education and Childbirth Outcomes, Taylor Mae Rasmusson
Introduction: Mindfulness-based childbirth education focuses on supporting normal physiologic labor and birth. This article presents the findings of an integrative review examining the relationship between prenatal mindfulness education and...
Universal Depression Screening in Pregnancy, Kayla M. Schmidt
Introduction: Identifying the optimal timing and frequency of universal depression screening during pregnancy can optimize the current national recommendations. Identifying whether a protocol for universal depression screening is beneficial...
The Impact of Amniotomy on Induction of Labor: An Integrative Review, Sarah Jessica Seuntjens
Background/Purpose: There is clear evidence available that refutes the practice of routine amniotomy in the spontaneously laboring patient. Amniotomy is an intervention that disrupts a normal physiologic birth and therefore should be utiliz...
Antenatal Pelvic Floor Education: A Review of the Midwifery Role in Promoting Pelvic Floor Health, Hannah L. Shir
Introduction: Nurse-midwives care for women from puberty until the end of life. As primary care providers, they are “with women” to help them reach optimal well-being, including pelvic floor outcomes. Pelvic floor health is important not on...
Theses/Dissertations from 2021
Hydration and Nutrition During Labor, Muna Abdi and Katie Cooper
Background/Purpose: Historically women have birthed in their own homes. As birth moved to the hospital, concerns surrounding gastric aspiration following general anesthesia led to restrictive intake policies for laboring women. Current prof...
Postplacental Intrauterine Device Insertion: Efficacy and Barriers, Tommi Amanda Ladd Carrell
As many as half of all women do not attend postpartum care and receive desired family planning care. Left with little to no resources for obtaining contraception, many go on to have subsequent unplanned pregnancies. The American College of ...
Perineal Massage or Warm Compress to Decrease Perineal Trauma in Second Stage of Labor, Amanda Condon and Colleen Williams
Background/Purpose: The purpose of this review of research is to determine if the use of perineal massage or warm compress in the second stage of labor decreases perineal trauma, including spontaneous lacerations or the need for an episioto...
Benefits and Risk Associated With Physical Exercise During the Antenatal Period, Corrie Crump and Brittany Freeman
Background/Purpose: There are many misconceptions, uncertainties, and false narratives pertaining to how much physical activity and what types of activities are safe in pregnancy. This purpose of this critical literature review was to provi...
The Resilient Midwife, Sarah M. Dorsey
Midwives have been shown to significantly improve birth outcomes; the World Health Organization proposes that 83% of maternal deaths, newborn deaths, and stillbirths could be prevented through midwifery care. However, burnout level in this ...
Maintaining Postpartum Bleeding: Effects of Tranexamic Acid, Shenider Dufort
Background/Purpose: The purpose of this literature appraisal is to determine the effectiveness of tranexamic acid (TXA) and its ability to stabilize postpartum bleeding. TXA is an antifibrinolytic pharmacologic drug found to reduce blood lo...
Vaginal Microbiomes and Preterm Labor/Birth, Stephanie Dayl Feltman
Current standards of care for decreasing the incidence of preterm labor and preterm birth are not decreasing the public health burden of spontaneous preterm birth. Preterm labor and birth contribute to the high infant mortality rate in the ...
Telehealth Use During the Prenatal Period: Strengths and Limitations, Adrian M. Goblisch and Tessa L. Hand
Background/Purpose: The purpose of this paper is to examine the risks and benefits of telehealth use during the prenatal period. With the increasing use of technology to provide healthcare, especially during the COVID-19 pandemic, it is cri...
The Effectiveness of Comprehensive Sexual Education for Teens: an Exploration of the Advantages and Disadvantages, Crystal L. Iddings and Danielle J. Wadsworth
Background/Purpose: The teen pregnancy rate in the United States was18.8 per 1000 in 2017. Although this is an all-time low for teen pregnancy in the United States, it is still the highest rate among developed countries. This literature rev...
Dance: The Movement Supporting Safe, Sovereign and Satisfying Birth Experiences, Lisa Marie Morgan
Labor dance utilizes upright positioning, hands and knees position, use of the rebozo and other alternative labor and birth positions as a traditional means of taking advantage of gravity and increasing the pelvic diameter in labor and birt...
Evaluating the Impact of Volunteer and Facility Provided Doula Support in the Intrapartum Period on Maternal, Neonatal, and Psychosocial Outcomes in the Hospital Setting, Kayla Puent and Keirsta Marie Ragels
Background/Purpose: The unacceptably high maternal mortality rate in the United States has demanded a call to action for evaluation and implementation of efforts to improve both maternal and neonatal outcomes. Low-resource and low-socioecon...
Breastfeeding Education and Support for Marginalized Women to Increase Exclusive Breastfeeding Rates, Kelsea J. Rush and Leah Vogel
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 heal...
Theses/Dissertations from 2020
Adolescents & Long Acting Reversible Contraception, Nicole Elizabeth Amstutz and Jessica Kesterson
Background/Purpose: The purpose of this literature appraisal is to assess adolescent access to long-acting reversible contraception (LARCs). Theoretical Framework: The Health Belief Model (HBM) helps describe the psychological and behaviora...
Neonatal Outcomes in Planned Community Birth Settings, Catherine E. Binger and Kaitlin Kinkoph
Background/Purpose: The safety of community births is a common point of discussion, especially in regard to neonates. Planned community births are supported for low risk, informed patients by the ACNM. The purpose of this literature review ...
Supporting Physiologic Labor: Effects of Hydrotherapy on Labor Outcomes, Ashley Y. Blaine
Background/Purpose: The purpose of this literature analysis was to identify the effects of hydrotherapy use in the first stage of labor. Although hydrotherapy has been well-studied and its benefits well documented, it is use in labor still ...
Optimal Nutrition in Pregnancy, Monica G. Daugherty
This review provides valuable evidence for nurse-midwives about the major role that nutrition plays in the well being of the mother-infant dyad. Nutrition affects the pregnancy, maternal outcomes, and neonatal outcomes. Education about nutr...
Reducing Preterm Birth For Women of Color Through Group Prenatal Care, Laura C. Early and Aubrey Monson
The purpose of this paper is to critically review the literature to examine if group prenatal care can reduce preterm birth rates in women of color compared to individual prenatal care....
Lifestyle Changes for Women with Gestational Diabetes, Brooklyn Feustel Elkan and Kristen McCammon
Background/Purpose: The purpose of this paper was to evaluate the current literature to see if there was a common thread in treatment/prevention of the progression of gestational diabetes in pregnant women. Theoretical Framework: Dorthea Or...
Marijuana Use in Pregnancy and the Effects on the Fetus/infant, Amy Rebecca Hurst and Malia Smylie
The purpose of this paper is to critically examine the literature and evidence that is available surrounding pre-pregnancy and prenatal use of marijuana and the effects it has on the developing fetus/infant. It was found that across most fi...
The Effects of Sexual Abuse on Birth: Obstetric Outcomes, Maternal Experience, and Professional Intervention, Katelyn Alexandra Neufeld and Patricia Nguyen
Background/Purpose: The purpose of this literature review is to determine how a past history of sexual abuse impacts labor and birth and what strategies can be used to help mitigate retraumatization. The desire is that this review will enco...
Variations to Labor, Maternal, and Neonatal Outcomes Related to Oral Intake During Labor, Amanda J. Stepper
Background/Purpose: The purpose of this critical review of literature was to examine the risks and benefits of oral intake during labor and determine if oral intake is beneficial in promoting and supporting positive labor outcomes and mater...
Theses/Dissertations from 2019
Epidural analgesia Effect in Labor and Delivery, Deka A. Abdulle
Epidural analgesia has an impact on duration of labor, type of delivery and the neonate. Good research data supports epidural analgesia shorts first stage of labor, lengthens second stage, increases instrumental delivery but no increased ri...
The Effect of Amniotomy on Labor Progression, Lauren Marie Casey and Eric Johann Judd II
Background/Purpose: Amniotomy has been a tool used for over 50 years to progress labor. This literature review researches the effects that amniotomy has on active labor progression. Theoretical Framework: The theoretical framework selected ...
The Effect of Integrative Medicine Practices on the Use of Obstetric Intervention in Labor and Delivery, Rachel Cochran
Background/Purpose: The purpose of this paper is to review scholarly writings to discern if the use of integrative medicine practices affects the use of obstetric intervention in labor and delivery. Theoretical Framework: The Theory of Huma...
How Nurse-Midwives Can Best Support Families Who Have Experienced Perinatal Loss, Tina Marie Egner and Jennifer J. Kluck
Background/Purpose: Although perinatal loss remains a common occurrence and nurse-midwives are instrumental in this care, the American College of Nurse-Midwives has yet to issue a position statement or professional care guidelines for provi...
The Impact of Midwifery Care on Racial Disparities in African American Women and Infants, Madeline Grace Englund and Antionette Renee Estis
Background/Purpose: The purpose of this paper is to critically examine scholarly writings to understand the history and current manifestations of racism in maternal and perinatal outcomes and reproductive health care and to provide insight ...
Labor Induction Methods and Their Impact on Duration of Labor and Rate of Cesarean Section, Ashley M. Golinghorst
Background/Purpose: The purpose of this paper is to critically review current literature regarding current methods for labor induction and their impact on the duration of labor and rate of cesarean section. Theoretical Framework: Imogene Ki...
The Fertile Window, Ashley Joy Jensen
Purpose: The purpose of this paper is to examine various biological indicators and tracking methods to determine which are the most accurate in identifying the fertility window for reproductive-aged women. Results: Whether the woman has reg...
Risks and Benefits of Trial of Labor After Cesarean When Compared to Elective Repeat Cesarean Section in Rural Facilities, Cassie Marie Kurtz and Anna Ruth Picker
Background/Purpose: Trial of Labor After Cesarean (TOLAC) is a safe delivery option formany women. Due to demographics, availability in rural communities, and lack of education and opportunity, many women are not attempting them. Women shou...
Effects of Labor Support from Doulas on Birth Outcomes, Mattea Jo Otten
Background/Purpose: Women using a doula for support during labor and childbirth is increasing, with 6% of women in 2012 utilizing doulas (Dekker, 2017). The American College of Obstetricians and Gynecologists [ACOG] recommends one-to-one la...
The Effectiveness of Non-pharmacological Touch Therapies in Labor, Heather Rice
Background/Purpose: The purpose of this paper is to critically analyze literature in order to determine the effectiveness of non-pharmacological touch therapies during labor. The touch therapies included in this literature review are acupun...
Theses/Dissertations from 2018
Menstrual Cycle as a Vital Sign, Lauren Elizabeth Bennett and Lisa M. Brown
Purpose: The purpose of this paper is to examine and explore which factors affect the menstrual cycle and how the menstrual cycle has a significant health impact on women’s lives. Theoretical framework: Dorothea Orem, with the Orem Model of...
Identifying Barriers to Long-acting Reversible Contraceptive Usage Among Adolescents, Emily Kathleen Davis and Viktoryia Petrusevich
Although LARC methods including IUDs and implants are highly effective in preventing pregnancies and both the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) recommend it for adolescen...
Cognitive Behavioral Therapy a Treatment for Postpartum Depression, Lindsay Anne Nelson
Background/Purpose:The purpose of this paper is to critically analyze the literature in order to determine whether or not cognitive behavioral therapy is an effective intervention in the prevention and/or treatment of postpartum depression....
The Maternal and Neonatal Outcomes of Utilizing Nitrous Oxide for Labor Analgesia, Joy L. Sayler
Background: Inhaled nitrous oxide has been used in many developing countries for labor analgesia but fell out of practice in the United States over the past 40 years. Recently it has been reintroduced into practice in the U.S. Purpose: The ...
Theses/Dissertations from 2017
Non-Pharmacologic Measures to Prevent and Treat Gestational Diabetes, Dikshya Aryal
Background: Gestational Diabetes (GDM) can have adverse effects on the health of both mother and baby during pregnancy and for a lifetime thereafter. While insulin is the mainstay of treatment, metformin and glyburide may be considered as a...
Midwife Provider Education and Screening Can Prevent and Decrease the Prevalence of Perinatal and Postpartum Depression: A Critical Review of the Literature, Suzanne M. Chatters
Background: Perinatal and postpartum depression (PPD) has a diagnosed prevalence of 10-20%. Experts theorize that up to 60% of women experiencing PPD do not seek help. Mental depression carries a negative stigma in western culture and medic...
Routine Screening for Thyroid Peroxidase Antibodies During Pregnancy: Universal Versus targeted, Megan M. Gross
Background: There are currently no guidelines for screening for thyroid peroxidase antibodies (TPOAb) during pregnancy. Currently, there is some debate as to whether pregnant women should be screened for TPOAb, universally, or using a risk-...
Better Together: Group Prenatal Care Improves Outcomes, Rachel Hanus
Background: Neonatal outcomes have not improved over the past 30 years in spite of increases in funding and utilization. New models of prenatal care, such as Centering Pregnancy, need to be evaluated for effectiveness. This critical review ...
Culturally Sensitive and Holistic Care for Women Who Have Undergone Female Genital Circumcision, Maria Fernanda Honebrink
Background: Around the world, immigration is part of many people’s lives. In that context, obstetric healthcare providers must be ready to deliver culturally sensitive care to women of different backgrounds. Some of these women have undergo...
Variations to Birth Outcomes with Labor and Delivery Doula Support, Nicole I. Hunter-Severson
Background/Purpose: The purpose of this critical appraisal of the literature is to discern if there are variations to birth outcomes as a result of having a doula present as a continuous support during labor and delivery. Theoretical/Concep...
Reducing Perineum Injuries and Trauma During Vaginal Delivery, Joyce Elaine Pepple
Background: Perineal trauma and injury is extremely common during vaginal birth. Nurse-midwives and other obstetric providers should explore the most current literature for possible ways that perineal trauma and injury during vaginal birth ...
Implications for delayed versus immediate umbilical cord clamping, Laura Ann Shaver
Purpose: The purpose of the critical review of literature was to identify and analyze benefits of delayed umbilical cord clamping in full term and preterm infants with a focus on iron stores, hemoglobin, hematocrit, and hyperbilirubinemia. ...
Nitrous Oxide: Revival of an antiquated pain modality helps to empower women, April Shuneson
Background: Options for pharmacological pain management in labor are limited. The use of nitrous oxide during labor and gynecological procedures is supported by the American College of Nurse-Midwives (2016); they group suggested that differ...
Theses/Dissertations from 2016
Breastfeeding Effects with Early Intervention for Ankyloglossia (Tongue-tie), Hope L. Adams
Background: Anklyoglossia or tongue-tie in infants often goes undiagnosed primarily due to the lack of knowledge for assessing tongue-tie thus disrupting a successful breastfeeding experience. Education, diagnosis, and treatment of ankylogl...
The Use of Nitrous Oxide in the Management of Labor Pain: Safet and Effiacy, Jennifer Ruth Christensen
Background: All women will experience pain while going through childbirth. The pain is caused by pressure and stretching on the uterus and visceral organs, lack of oxygen during uterine contractions, and musculoskeletal and perineal stretch...
Birth Centers and Underserved Populations, Michelle M. Dabrowski
Background: Disadvantaged women in the United States experience disparities in prenatal and birth related health outcomes. Purpose: The purpose of this literature review is to answer the question, “Can freestanding birth centers (FBC) impro...
Centering Pregnancy: The Maternal and Neonatal Benefits of Group Prenatal Care, Trisha Lynn Nelson
Background/Purpose: Centering Pregnancy is a type of group prenatal care that allows women to meet and receive their prenatal care together. The groups meet ten times during the pregnancy and focuses on different aspects of prenatal care. T...
Non-Pharmacologic Antenatal Interventions to Reduce or Prevent Postpartum Depression, Jenny Rebecca Olson
Background/Purpose: The purpose of this paper is to critically examine the literature in order to identify whether there are non-pharmacologic antenatal interventions that are effective in reducing or preventing postpartum depression. Theor...
Delayed Cord Clamping Impact on Transitional Outcomes of the Newborn, Ann E. Rice
Background: Currently in the United States, after a baby is born, the umbilical cord is immediately clamped; this is a routine obstetric procedure despite lack of evidence supporting this practice (Elchenbaum-Pikser, 2009). The practice of ...
Safety for Women Opting for TOLAC Versus an Elective Repeat Cesarean Section, Nicole Marguerite Rothgarn
Background/Purpose: TOLAC is the trial of labor after cesarean. VBAC is the successful birth after cesarean. The aim of this paper is to establish safety for women opting for the trial of labor after a primary cesarean. The purpose is to be...
The Use of Supplemental Progesterone in Preventing Preterm Birth in High-Risk Women: A Critical Review of the Literature, Leah Marie Schroeder
Background: Twelve percent of births in the United States occur before 37 weeks of gestation and therefore are considered preterm births (Norwitz, 2015). While the ability to identify women at risk for preterm birth has improved dramaticall...
The Potential Benefits and Risks of Antidepressant, Antipsychotic and/or Mood Stabilizing Medications Use in Pregnancy: A Critical Review of the Literature, Brittany Kaye Schultz
Background: Medication use in pregnancy walks a fine line between safety of the mother and adverse effects in the developing fetus. Medications are prescribed to either help the mother maintain mental stability or they are discontinued out ...
Non-Antibiotic Alternatives for Reducing Antepartum Group B Streptococcus Colonization, Rebecca M. Smith
Background: Streptococcus agalactiae (known as Group B strep, or GBS) is a bacterium that resides in the gastrointestinal tract and/or vaginal canal and is typically benign, but during pregnancy and birth it can potentially colonize the neo...
The Benefits of Hydrotherapy During Labor, Karen M. Sonnenburg
Background: There are many holistic options available to help women cope with the discomforts of labor including pain and anxiety. The use of hydrotherapy during labor is supported by The American College of Nurse-Midwives (2014) due to its...