What We're Reading
By Joy Burkhard, MBA
Founder and Executive Director, 2020 Mom
Starting this month, I am breaking my “What We’re Reading” blog posts into twice-monthly posts so news reaches you more timely. Here are some of the topics highlighted in the articles I read over the last two weeks:
Two new tools that help obstetric providers/facilities understand if they are providing person-centered and non-racist care, to improve patient satisfaction and outcomes.
A new evidence-based “Person-Centered” Maternity Care survey (PCMC-U.S.) gives patients the opportunity to be heard and maternity care providers insight into how to improve even with limited resources.
Another patient reporting tool developed specifically for maternity care hospital settings is also highlighted below, called the PREM-OB Scale which specifically focuses on identifying obstetric racism, to support quality improvement initiatives.
An opinion article, written by a doctor who shows us that the time needed to provide optimal patient care and what is actually reimbursement in the U.S. Healthcare system just doesn’t add up.
New research connecting the immune system to postpartum depression - specifically, researchers have found significant differences in B cells, which produce antibodies and are tied to both pro and anti-inflammatory factors.
Read more about these important developments and the other articles that I took note of:
Closer Look: Between Primary Care and Serious Mental Illness, a Glaring Gap
Laura Brown knows that she has high cholesterol and that, as someone who lives with bipolar one disorder, she faces an even higher risk of cardiovascular problems. But going to a doctor's office for routine care is almost entirely out of the question.
Prescribing Sleep for Postpartum Depression
This new research explains the importance of protected sleep for both treating and preventing postpartum depression during this window of risk.
Psilocybin 'Rewires' the Brain to Alleviate Depression
New research points to a general mechanism that may explain how psychedelics (Magic mushrooms) act on the brain to alleviate depression/treatment-resistant depression and potentially other psychiatric conditions marked by fixed patterns of thinking, including rumination and excessive self-focus.
Many Faced Surprise Medical Bills, Survey Says
The 2021 Trends in Healthcare Payments Annual Report found that 87% of those surveyed were surprised by a medical bill. The report also found that 74% of millennials would switch providers for a better health care payment experience, compared with 27% of baby boomers, and although nearly all consumers want to know what they will owe upfront, only 1 in 5 always knows that.
Emotional Experiences of Pregnant and Postpartum People with Confirmed or Suspected COVID-19 Infection During the Initial Surge of the Pandemic
The COVID-19 pandemic may have a unique emotional impact on those who are pregnant. A better understanding of emotional experiences may lead to changes in clinical practice and institutional policies that are more supportive of their needs and congruent with their values.
Poll Spotlights Americans' Concerns About Health Costs
A Kaiser Family Foundation poll found that affordability and drug pricing are among Americans' top healthcare concerns. Sixty-one percent of adults said Congress should place limits on prescription drug price hikes, 53% said capping out-of-pocket insulin costs should be a priority, and 52% said limits on out-of-pocket care costs for older adults should be a top concern.
Trends In Outpatient Mental Health Services Use Before And During The COVID-19 Pandemic
According to the World Health Organization (WHO), anxiety and depression increased 25% worldwide in the first year of the COVID-19 pandemic. Widening gaps in care and stress factors—including constraints on the ability to seek support and engage in community and work—significantly contributed to this increase.
Can We Get Some Help Here? — Let's Figure Out How to Make the Healthcare System Work For Us, Not Against Us
It would be great if we had access to all the resources we needed to be thoughtful about each patient interaction, to really spend the time to address everything that needs addressing, and then do all the appropriate follow-ups. But if our visits are 20 minutes, where does the accounting come in that accounts for the 20 minutes of pre-charting; the 20 minutes of order entry, note editing, and billing documentation; and the 20 minutes of reviewing labs, contacting patients, and speaking with collaborating doctors? You do the math.
Biden Announces Rule to Fix the Affordable Care Act's 'Family Glitch'
Also signs executive order urging federal agencies to continue efforts to expand health coverage.
Postpartum Depression Has Been Closely Linked With The Immune System, Study Finds
Postpartum depression is thought to affect around 15 percent of women after childbirth – and can have a negative effect on kids too – but we still don't entirely understand why it happens in the first place. A new study has now uncovered a potential link with the person's immune system.
Behavioral Health CEO Report: Priorities and Insights on the State of Behavioral Health
What did nearly 100 Community Mental Health Center executives say about priorities and insights on the state of behavioral health in 2022? Report: U.S. Ranks Last for Women's Healthcare Among Wealthy Nations — Highest rates of preventable deaths, maternal mortality, and mental health needs.
Trends In Outpatient Mental Health Services Use Before And During The COVID-19 Pandemic
In-person mental health encounters were reduced by half in the early months of the pandemic, with rapid recovery of service delivery attributable to telehealth uptake (accounting for 47.9 percent of average monthly encounters).
House Members Remain Divided on Universal Healthcare — Republicans, Democrats Differ on Potential Costs and Effects of Medicare for All
One thing that committee members and witnesses agreed on: the current system is not working very well. "The U.S. system is completely broken," said Jeffrey Sachs, PhD, director of the Columbia University Center for Sustainable Development. "We are spending a fortune -- unlike every other country -- and we're getting worse outcomes. This is what needs to be understood beyond the ideology, beyond the anecdotes."
Study Finds Changes in B-Cells of Women with Postpartum Depression
Researchers found significant differences in B cells in women with postpartum depression. B cells are important components of the immune system that help produce antibodies and secrete both pro and anti-inflammatory factors.
House Chair Presses FDA on ‘Delayed Response’ to Contaminated Baby Formula
“FDA is tasked with protecting all Americans from life-threatening foodborne illness outbreaks, but fell short in protecting vulnerable infants from contaminated formula,” Krishnamoorthi wrote. “FDA must do more to ensure no lives are lost, or babies sickened, due to delayed inspections and late consumer warnings.” The letter requests a range of documents and presses the FDA for answers on why it did not act sooner.
State, Federal Policies Increase Virtual Access to Behavioral Health Care
The January 2020 Federal Public Health Emergency (PHE) declaration for the COVID-19 pandemic led to the temporary expansion of behavioral health service delivery models offered through telehealth, also known as telebehavioral health.
Women, Patients of Color Warning About 'Medical Gaslighting'
Many women and people of color have been speaking out about the frustrating and dismissive experiences that they have been having with medical professionals.
Disparities in Sleep Duration Have Grown
Disparities Evident with Black Women
Sleeping too much or too little can be bad for health, raising the risk of depression, cardiovascular disease, diabetes, and death. The disparities in short sleep, defined as fewer than seven hours, were highest for Black women, Black people with middle or high income, and young and middle-aged Black adults compared to other groups. Long sleep — more than nine hours — was also more prevalent among Black individuals, particularly among Black women.
Magic Mushrooms Can Make Long-term Improvements in Depression
Magic mushroom's drug psilocybin can lead to long-term improvements in depression symptom severity, a small study has found. The study, conducted by the Imperial College of London, looked at brain scans of 60 participants and combined two trials where psilocybin was administered.
Adaptation of the Person-Centered Maternity Care Scale in the U.S. - Prioritizing the Experiences of Black Women and Birthing People
Mistreatment by health care providers disproportionately affects Black, Indigenous, and other people of color in the United States. The goal of this study was to adapt the global Person-Centered Maternity Care scale for use in the United States, with particular attention to the experiences of Black women and birthing people. The 35-item PCMC-U.S. scale and its subscales have high validity and reliability in a sample of predominantly Black women. This scale provides a tool to support efforts to reduce the inequities in birth outcomes experienced by Black, Indigenous, and other people of color.
Psychometric Validation of a Patient-Reported Experience Measure of Obstetric Racism
Perinatal quality improvement lacks valid tools to measure adverse hospital experiences disproportionately impacting Black mothers and birthing people. Measuring and mitigating harm requires using a framework that centers on the lived experiences of Black birthing people in evaluating inequitable care, namely, obstetric racism. Researchers sought to develop a valid patient-reported experience measure of Obstetric Racism© in hospital-based intrapartum care designed for, by, and with Black women as patient, community, and content experts. The PREM-OB Scale™ suite was found to be a valid tool to characterize and quantify obstetric racism for use in perinatal improvement initiatives.
Improving Communication and Teamwork During Labor: A Feasibility, Acceptability, and Safety Study
TeamBirth was designed to promote best practices in shared decision making among care teams for people giving birth. Implementing a care process that aims to improve communication and teamwork during labor with high fidelity was found to be feasible. The process is acceptable to patients and clinicians and shows no negative effects on patient safety.
Social and Structural Determinants of Health Inequities in Maternal Health
Since the World Health Organization launched its commission on the social determinants of health over a decade ago, a large body of research has proven that social determinants—defined as the conditions in which people are born, grow, live, work, and age—are significant drivers of disease risk and susceptibility within clinical care and public health systems. Researchers will expand our review of social determinants of maternal health to include the terms “structural determinants of health” and “root causes of inequities” as they assess the literature on this topic.
People are Processing the Pandemic Like a Trauma
For most people, living through the pandemic hasn't been violent or included explosions or assault — all elements of a traumatic experience. So why are so many people processing the past two years as a trauma? Experts talk about the symptoms people are experiencing and why the pandemic's effect on mental health is so hard to categorize.
United States Preterm Birth Rate and COVID-19
Many countries imposed national lockdowns in March of 2020 in response to the COVID-19 pandemic. In the Netherlands, the lockdown was associated with an immediate decline in preterm birth. Subsequent analyses from other countries and from hospitals and states within the United States reported mixed support for a decline in preterm birth associated with the lockdowns. In this analysis, researchers use the census of births in the United States from 2010 to 2020 to characterize monthly changes in preterm birth by the method of delivery adjusted for seasonality and trend.
A Nurse-Midwife's View of Separation for Families Seeking Asylum
Maria was 37 weeks pregnant when Customs and Border Protection officers separated her from her husband, Alejandro, after they arrived at the U.S.-Mexico border, fleeing violence in Honduras. “This country’s immigration policies compound their trauma by splitting up families. This undue stress augments the risk of harmful outcomes for mothers and babies.”
Prenatal Exposure to Maternal Social Disadvantage May Affect Infant Brain Volumes at Birth
A study published online in the journal JAMA Network Open found that MRI scans performed on healthy newborns while they slept indicated that babies of mothers facing social disadvantages such as poverty tended to be born with smaller brains than babies whose mothers had higher household incomes.
Why Deaths by Suicide Often Go Uncounted in States’ Maternal Mortality Studies
On paper, one of the first deaths reviewed by Mississippi’s maternal mortality board looked like an accidental overdose. When Collier dug deeper into the patient’s life and pregnancy, she unraveled a story that exposed a series of systemic failures. Records showed the patient had a history of depression and sexual assault as a teen. She delayed prenatal care.