“Heightened exposure to racial/ethnic discrimination is associated with poorer sleep health
among non-pregnant adults. This relationship has received limited research attention among pregnant women, despite the importance of prenatal sleep quality for optimal maternal and child health outcomes.”
Obstetric violence is considered a violation of the rights to equality, non-discrimination, information, integrity, health, and reproductive autonomy of women. It occurs in both public and private medical practice during pregnancy, delivery, and postpartum care. There is a growing global commitment to address this challenge, that has been supported by policy statements from the World Health Organization (WHO). Medicalization and pathologizing abuse of natural birth processes have been identified as obstetric violence patterns. Indigenous women and women who live in rural areas are particularly vulnerable to this kind of abuse. A new instrument called EPREVO has been developed to measure obstetric violence in Ecuador and the objective of this work is to validate its reliability and structural dimensionality.
Fors, M., Falcon, K., Brandão, T., Vaca, A., Cañadas, S., & Viada González, C. E. (2021). Reliability and Dimensionality of EPREVO (“Experiencias de Parto Relacionadas a Violencia Obstétrica”): Development of a New Instrument, Ecuador. International journal of women’s health, 13, 569–577.
“All oral anti-hypertensives reduced blood pressure to the reference range in most women. As single drugs, nifedipine retard use resulted in a greater frequency of primary outcome attainment than labetalol or methyldopa use. All three oral drugs—methyldopa, nifedipine, and labetalol—are viable initial options for treating severe hypertension in low-resource settings.” 1
“Labetalol intravenously and methyldopa orally are then the two most frequently used drugs. Short-acting oral nifedipine is suggested to be used only if other drugs or iv access are not available.” 2
(1) Easterling T, Mundle S, Bracken H, Parvekar S, Mool S, Magee LA, von Dadelszen P, Shochet T, Winikoff B. Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial. Lancet. 2019 Sep 21;394(10203):1011-1021. doi: 10.1016/S0140-6736(19)31282-6. Epub 2019 Aug 1. PMID: 31378394; PMCID: PMC6857437.
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(2) Cífková R, Johnson MR, Kahan T, Brguljan J, Williams B, Coca A, Manolis A, Thomopoulos C, Borghi C, Tsioufis C, Parati G, Sudano I, McManus RJ, van den Born BH, Regitz-Zagrosek V, de Simone G. Peripartum management of hypertension: a position paper of the ESC Council on Hypertension and the European Society of Hypertension. Eur Heart J Cardiovasc Pharmacother. 2020 Nov 1;6(6):384-393. doi: 10.1093/ehjcvp/pvz082. PMID: 31841131.
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Further Reading
Deshmukh US, Lundsberg LS, Culhane JF, Partridge C, Reddy UM, Merriam AA, Son M. Factors associated with appropriate treatment of acute-onset severe obstetrical hypertension. Am J Obstet Gynecol. 2021 May 20:S0002-9378(21)00559-7. doi: 10.1016/j.ajog.2021.05.012. Epub ahead of print. PMID: 34023314.
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Wilkerson RG, Ogunbodede AC. Hypertensive Disorders of Pregnancy. Emerg Med Clin North Am. 2019 May;37(2):301-316. doi: 10.1016/j.emc.2019.01.008. PMID: 30940374.
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Cox AG, Marshall SA, Palmer KR, Wallace EM. Current and emerging pharmacotherapy for emergency management of preeclampsia. Expert Opin Pharmacother. 2019 Apr;20(6):701-712. doi: 10.1080/14656566.2019.1570134. Epub 2019 Feb 1. PMID: 30707633.
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Watson K, Broscious R, Devabhakthuni S, Noel ZR. Focused Update on Pharmacologic Management of Hypertensive Emergencies. Curr Hypertens Rep. 2018 Jun 8;20(7):56. doi: 10.1007/s11906-018-0854-2. PMID: 29884955.
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Anderson CM, Schmella MJ. CE: Preeclampsia: Current Approaches to Nursing Management. Am J Nurs. 2017 Nov;117(11):30-38. doi: 10.1097/01.NAJ.0000526722.26893.b5. PMID: 29035901.
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Despite recognized health benefits for both mothers and infants, significant disparities still exist in the rates of breastfeeding in the United States. This article reviews the evidence related to barriers (prenatal, medical, societal, hospital, and sociocultural) that many mothers face, and explore the known barriers and the impact they have on a woman’s ability to breastfeed her infant.Strategies will be discussed to address (and potentially overcome) some of the most common barriers women face along with a list of resources that can be useful in this effort.
From: Sriraman, Natasha, et al
Evidence Matters 