Background: Mental health disorders are the number one cause of maternal mortality and a significant maternal morbidity. This scoping review sought to understand the associations between social context and experiences during pregnancy and birth, biological indicators of stress and weathering, and perinatal mood and anxiety disorders (PMADs). Methods: A scoping review was performed using PRISMA-ScR guidance and JBI scoping review methodology. The search was conducted in OVID Medline and Embase. Results: This review identified 74 eligible English-language peer-reviewed original research articles. A majority of studies reported significant associations between social context, negative and stressful experiences in the prenatal period, and a higher incidence of diagnosis and symptoms of PMADs. Included studies reported significant associations between postpartum depression and prenatal stressors (n = 17), socioeconomic disadvantage (n = 14), negative birth experiences (n = 9), obstetric violence (n = 3), and mistreatment by maternity care providers (n = 3). Birth-related post-traumatic stress disorder (PTSD) was positively associated with negative birth experiences (n = 11), obstetric violence (n = 1), mistreatment by the maternity care team (n = 1), socioeconomic disadvantage (n = 2), and prenatal stress (n = 1); and inverse association with supportiveness of the maternity care team (n = 5) and presence of a birth companion or doula (n = 4). Postpartum anxiety was significantly associated with negative birth experiences (n = 2) and prenatal stress (n = 3). Findings related to associations between biomarkers of stress and weathering, perinatal exposures, and PMADs (n = 14) had mixed significance. Conclusions: Postpartum mental health outcomes are linked with the prenatal social context and interactions with the maternity care team during pregnancy and birth. Respectful maternity care has the potential to reduce adverse postpartum mental health outcomes, especially for persons affected by systemic oppression.

Member checking enhances the trustworthiness and transformative potential of qualitative research. There are a variety of aims and approaches to reengaging with participants in sharing data or preliminary analysis and soliciting feedback through member checking. Published studies often lack descriptions of member-checking methods or outcomes, and there is a lack of research on the use of technologies for this purpose. Asynchronous video and internet-based technologies can be valuable tools to improve the accessibility, equity, effectiveness, and acceptability of member checking and foster increased engagement. This publication presents a detailed description of member checking in an exemplar study that used readily available technologies to create a video synopsis of preliminary findings and embed that video in a multimedia, mixed methods web-based survey which was emailed to participants. This member-checking method was purposefully selected to advance the specific research aims of the study, reflect the epistemological stance of the researchers and unique considerations of the study population, and address relevant situational factors to optimize participant engagement. This strategy facilitated wide, cost-effective, and timely distribution and resulted in a good response rate with rich feedback. Asynchronous technologies were a useful alternative to in-person or synchronous meetings to facilitate voluntary participation, foster reflection that deepened analysis, and capture multiple voices and perspectives. Findings from this research support the use of video and electronic survey technologies to enhance study credibility, address ethical and methodological challenges related to member checking, and increase equity and engagement. Future studies are needed to expand and refine integration of technologies into member checking to address diverse research aims, contexts, and study populations.

Objective: Investigate maternal and neonatal outcomes associated with breech presentation in planned community births in the United States, including outcomes associated with types of breech presentation (i.e., frank, complete, footling/kneeling) Design: Secondary analysis of prospective cohort data from a national perinatal data registry (MANA Stats) Setting: Planned community birth (homes and birth centers), United States Sample: Individuals with a term, singleton gestation (N = 71,943) planning community birth at labor onset Methods: Descriptive statistics to calculate associations between types of breech presentation and maternal and neonatal outcomes Main outcome measures: Maternal: intrapartum/postpartum transfer, hospitalization, cesarean, hemorrhage, severe perineal laceration, duration of labor stages and membrane rupture Neonatal: transfer, hospitalization, NICU admission, congenital anomalies, umbilical cord prolapse, birth injury, intrapartum/neonatal death Results: One percent (n = 695) of individuals experienced breech birth (n = 401, 57.6% vaginally). Most fetuses presented frank breech (57%), with 19% complete, 18% footling/kneeling, and 5% unknown type of breech presentation. Among all breech labors, there were high rates of intrapartum transfer and cesarean birth compared to cephalic presentation (OR 9.0, 95% CI 7.7–10.4 and OR 18.6, 95% CI 15.9–21.7, respectively), with no substantive difference based on parity, planned site of birth, or level of care integration into the health system. For all types of breech presentations, there was increased risk for nearly all assessed neonatal outcomes including hospital transfer, NICU admission, birth injury, and umbilical cord prolapse. Breech presentation was also associated with increased risk of intrapartum/neonatal death (OR 8.5, 95% CI 4.4–16.3), even after congenital anomalies were excluded. Conclusions: All types of breech presentations in community birth settings are associated with increased risk of adverse neonatal outcomes. These research findings contribute to informed decision-making and reinforce the need for breech training and research and an increase in accessible, high-quality care for planned vaginal breech birth in US hospitals.

Introduction: Although current recommendations support vaginal breech birth as a reasonable option, access to breech birth in US hospitals is limited. This study explored the experiences of decision‐making and perceptions of access to care in people who transferred out of the hospital system to pursue home breech birth.Methods: We conducted a mixed methods study of people with a singleton, term breech fetus who transferred out of the US hospital system to pursue home breech birth. Twenty‐five people completed an online demographic and psychosocial survey, and 23 (92%) participated in semi‐structured interviews. We used an interpretive description approach informed by situational analysis to analyze qualitative data about participants' experiences and perceived access to care.Results: Of 25 individuals who left the hospital system to pursue a home breech birth, most felt denied informed choice (64%) and threatened or coerced into cesarean (68%). The majority reported low or very low autonomy in decision‐making (n = 20, 80%) and high decisional satisfaction using validated measures. Many participants felt safer in a hospital setting but were not able to access care for planned vaginal breech hospital birth, despite extensive efforts. Participants felt “backed into a corner” and “forced into homebirth,” perceiving a lack of access to safe and respectful care in the hospital system.Conclusion: Some service users believe that home birth is their only option when they cannot access hospital‐based care for vaginal breech birth. Current barriers to care for breech birth limit birthing people's autonomy and may be placing them and their infants at increased risk.