Objective To evaluate the effects of a mobile phone-based intervention on postnatal maternal health behavior and maternal and infant health in a middle-income country. Methods A prospective evaluation enrolled consecutive postpartum women at two public hospitals in Quito, Ecuador, between June and August 2012. Inclusion criteria were live birth, no neonatal intensive care admission, and Spanish speaking. Intervention and control groups were assigned via random number generation. The intervention included a telephone-delivered educational session and phone/text access to a nurse for 30 days after delivery. Maternal and infant health indicators were recorded at delivery and 3 months after delivery via chart review and written/telephone-administered survey. Results Overall, 102 women were assigned to the intervention group and 76 to the control group. At 3 months, intervention participants were more likely to attend the infant’s postnatal check-up (P = 0.022) and to breastfeed exclusively (P = 0.005), and less likely to feed formula (P = 0.016). They used more effective forms of contraception (more implants P = 0.023; fewer condoms P = 0.036) and reported fewer infant illnesses (P = 0.010). There were no differences in maternal acute illness or check-up attendance. Conclusion Mobile phone-based postnatal patient education is a promising strategy for improving breastfeeding, contraceptive use, and infant health in low-resource settings; different strategies are needed to influence post-partum maternal health behavior.

African American young women are overwhelmingly disproportionately burdened by HIV/AIDS in the United States today. The purpose of the current systematic review was to identify the characteristics of efficacious HIV risk-reduction prevention interventions targeting African American adolescent women in order to inform future intervention development and expansion. We searched PubMed, PsychInfo, and ProQuest databases for journal articles and dissertations published between 2000 and 2015 reporting the impacts of HIV risk-reduction prevention interventions in the U.S. targeting African American adolescent women under age 25. Twenty articles assessing the efficacy of 12 interventions were eligible for inclusion. Selected interventions represented a total of 5,556 African American adolescent women and primarily drew from self-efficacy and self-empowerment-based theoretical frameworks. One intervention targeted girls under age 13; eight included participants ages 13–17; ten targeted adolescents aged 18–24 years; and five interventions included women over age 24 among their participants. Most interventions consisted of in-person knowledge and skills-based group or individual sessions led by trained African American female health professionals. Three were delivered via personal electronic devices. All programs intervened directly at the individual-level; some additionally targeted mothers, friends, or sexual partners. Overall, efficacious interventions among this population promote gender and ethnic pride, HIV risk-reduction self-efficacy, and skills building. They target multiple socio-ecological levels and tailor content to the specific age range, developmental period, and baseline behavioral characteristics of participants. However, demonstrated sustainability of program impacts to date are limited and should be addressed for program enhancements and expansions.

Compared with their heterosexual peers, sexual minority women (SMW; e.g., queer, bisexual, lesbian, pansexual) have an elevated risk for unintended pregnancy. A team of social science and clinical researchers qualitatively documented the multilevel pathways leading to this disparity, particularly the contexts of contraceptive use. From August 2017 to April 2018, we conducted focus groups and interviews with young adult cisgender SMW in 3 cities: Chicago, Illinois; Madison, Wisconsin; and Salt Lake City, Utah. Most participants reported experience with both penile–vaginal intercourse and contraception. However, they faced several queer-specific barriers to preventing unwanted pregnancy, including a comparative lack of self-concept as contraceptive users, fear of stigma from both queer and health care communities, use of less-effective methods because of infrequent penile–vaginal intercourse and a sense that longer-acting methods were “overkill,” and previous experiences of discrimination such as homophobia and gender-based violence. However, participants also reported ways that contraception could align with queer identity, including both taking advantage of noncontraceptive benefits and framing contraception as sex- and queer-positive. These facilitators can inform future efforts to help SMW better meet their pregnancy prevention needs.

Background Education is an important social determinant of many health outcomes, but the relationship between educational attainment and the amount of weight gained over the course of a woman's pregnancy (gestational weight gain (GWG)) has not been clearly established. Methods We used data from 1979-2010 for women in the National Longitudinal Survey of Youth 1979 cohort (n= 6344 pregnancies from 2769 women). We used generalized estimating equations to estimate the association between educational attainment and GWG adequacy (as defined by 2009 Institute of Medicine guidelines), controlling for diverse social factors from across the life course (e.g., income, wealth, educational aspirations and expectations) and considering effect measure modification by race/ethnicity and pre-pregnancy overweight status. Results In most cases, women with more education had increased odds of gaining a recommended amount of gestational weight, independent of educational aspirations and educational expectations and relatively robust to sensitivity analyses. This trend manifested itself in a few different ways. Those with less education had higher odds of inadequate GWG than those with more education. Among those who were not overweight pre-pregnancy, those with less education had higher odds of excessive GWG than college graduates. Among women who were white, those with less than a high school degree had higher odds of excessive GWG than those with more education. Conclusion The relationship between educational attainment and GWG is nuanced and nonlinear.