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Interdisciplinary Perspectives in Maternal Health: Integrating Theoretical Frameworks and Practical Applications

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Perinatal and Neonatal Medicine".

Deadline for manuscript submissions: closed (30 April 2025) | Viewed by 10481

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Special Issue Editors

Dr. Elena Dragioti

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Guest Editor

1. Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, SE-581 83 Linköping, Sweden
2. Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece
Interests: epidemiological studies; health interventions; chronic diseases; care practice

Dr. Antigoni Sarantaki

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Guest Editor Assistant

Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, 12243 Athens, Greece
Interests: women’s mental health; pregnancy; maternal infant health; infertility; assisted reproduction; family dynamics

Special Issue Information

Dear Colleagues,

We are excited to announce a call for submissions for the upcoming Special Issue entitled “Interdisciplinary Perspectives in Maternal Health: Integrating Theoretical Frameworks and Practical Applications” to be published in Healthcare. This Special Issue aims to bridge the gap between theoretical knowledge and practical applications in maternal health, fostering a multidisciplinary dialogue that contributes to improved maternal health outcomes worldwide.

This Special Issue endeavors to serve as a confluence of cutting-edge research, innovative practices, and theoretical advancements addressing the complex challenges in maternal health care.

We invite submissions from a broad spectrum of professionals, including, but not limited to, doctors, midwives, psychologists, nurses, public health experts, and researchers in related fields. We welcome original research articles, review papers, case studies, and commentaries that explore innovative approaches, methodologies, policies, and interventions in maternal health. This Special Issue seeks to gather insights from a wide range of disciplines, including, but not limited to, midwifery, public health, medicine, sociology, psychology, anthropology, health economics, and computer science, encouraging a holistic understanding of maternal health issues.

Our objective is to compile a comprehensive collection of articles that reflect the multidisciplinary nature of maternal health, highlighting novel interventions, evidence-based practices, and insightful analyses that can inform policy, education, and clinical care. Contributions may encompass a variety of topics, such as technological innovations in maternal care, psychological aspects of maternal health, socio-economic determinants, and global health perspectives.

This Special Issue seeks to foster a dialogue among professionals from diverse backgrounds, encouraging the exchange of ideas, collaboration, and the integration of different disciplines to enhance maternal health outcomes. We believe that your contribution can significantly impact this field, pushing the boundaries of what is currently known and practiced.

We look forward to receiving your manuscripts and having the opportunity to share your valuable insights with a global audience.

Dr. Elena Dragioti
Guest Editor

Dr. Antigoni Sarantaki
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

maternal health
public health
interdisciplinary approach
health policy
pregnancy and childbirth
women’s health
socioeconomic factors
health interventions
mental health in pregnancy
cultural competency in healthcare
AI in perinatal healthcare

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Published Papers (8 papers)

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Research

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13 pages, 227 KiB

Open AccessArticle

Validation of the Wijma Delivery Expectancy/Experience Questionnaire (Version B) Among Greek Postpartum Women

by Pinelopi Varela, Ioannis Zervas, Christina Nanou, Victoria Vivilaki, Aikaterini Lykeridou and Anna Deltsidou

Healthcare 2025, 13(8), 896; https://doi.org/10.3390/healthcare13080896 - 14 Apr 2025

Viewed by 216

Abstract

Background/Objectives: Postnatal fear of childbirth (FOC) has a significant impact on women’s mental health following childbirth. A widely employed tool for evaluating postnatal FOC is the Wijma Delivery Expectancy/Experience Questionnaire version B (W-DEQ-B). This study aimed to validate the Greek version of the W-DEQ-B (GrW-DEQ-B) and confirm its reliability among Greek postpartum women having a low-risk pregnancy. Methods: At four weeks postpartum, 200 mothers after a low-risk pregnancy completed questionnaires, which included the GrW-DEQ-B and the Edinburgh Postnatal Depression Scale (EPDS). Results: The majority of participants had a vaginal delivery (80%), 52.0% of the sample were primigravida, and the mean gestational age at delivery was 38.8 weeks (SD = 0.8). The exploratory factor analysis yielded six factors (“Lack of self-efficacy”, “Lack of positive anticipation”, “Lack of feeling lonely”, “Concerns about delivery and losing control”, “Calmness”, and “Concern for the child”) of 33 items from the W-DEQ-B. The instrument’s multidimensionality was verified by the confirmatory factor analysis (RMSEA = 0.07; CFI = 0.90; TLI = 0.88). All Cronbach’s alphas were over 0.7, indicating acceptable reliability of the factors. Almost all factors of the GrW-DEQ-B were significantly correlated with each other (p < 0.001), demonstrating the convergent validity of the tool. Significant correlations were found between almost all dimensions of the GrW-DEQ-B and the EPDS (p < 0.001), indicating the divergent validity of the tool. Conclusions: This study provides evidence that the Greek version of the W-DEQ-B proved to be a reliable and valid measure of FOC among Greek postpartum women. Full article

(This article belongs to the Special Issue Interdisciplinary Perspectives in Maternal Health: Integrating Theoretical Frameworks and Practical Applications)

21 pages, 1770 KiB

Open AccessArticle

Maternal Health Risk Detection: Advancing Midwifery with Artificial Intelligence

by Katerina D. Tzimourta, Markos G. Tsipouras, Pantelis Angelidis, Dimitrios G. Tsalikakis and Eirini Orovou

Healthcare 2025, 13(7), 833; https://doi.org/10.3390/healthcare13070833 - 6 Apr 2025

Viewed by 595

Abstract

Background/Objectives: Maternal health risks remain one of the critical challenges in the world, contributing much to maternal and infant morbidity and mortality, especially in the most vulnerable populations. In the modern era, with the recent progress in the area of artificial intelligence and machine learning, much promise has emerged with regard to achieving the goal of early risk detection and its management. This research is set out to relate high-risk, low-risk, and mid-risk maternal health using machine learning algorithms based on physiological data. Materials and Methods: The applied dataset contains 1014 instances (i.e., cases) with seven attributes (i.e., variables), namely, Age, SystolicBP, DiastolicBP, BS, BodyTemp, HeartRate, and RiskLevel. The preprocessed dataset used was then trained and tested with six classifiers using 10-fold cross-validation. Finally, the performance metrics of the models erre compared using metrics like Accuracy, Precision, and the True Positive Rate. Results: The best performance was found for the Random Forest, also reaching the highest values for Accuracy (88.03%), TP Rate (88%), and Precision (88.10%), showing its robustness in handling maternal health risk classification. The mid-risk category was the most challenging across all the models, characterized by lowered Recall and Precision scores, hence underlining class imbalance as one of the bottlenecks in performance. Conclusions: Machine learning algorithms hold strong potential for improving maternal health risk prediction. The findings underline the place of machine learning in advancing maternal healthcare by driving more data-driven and personalized approaches. Full article

(This article belongs to the Special Issue Interdisciplinary Perspectives in Maternal Health: Integrating Theoretical Frameworks and Practical Applications)

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16 pages, 800 KiB

Open AccessArticle

Post-Traumatic Stress Symptoms Following Childbirth: A Contribution to the Psychometric Evaluation of the Greek Version of the Traumatic Event Scale (TES) (Version B)

by Pinelopi Varela, Ioannis Zervas, Athina Diamanti, Christina Nanou, Aikaterini Lykeridou and Anna Deltsidou

Healthcare 2025, 13(7), 768; https://doi.org/10.3390/healthcare13070768 - 30 Mar 2025

Viewed by 270

Abstract

Background/Objectives: Research has shown that postnatal post-traumatic stress (PTS) symptoms may adversely affect women’s lives, their infants’ development, and their relationships with their partners. The study aimed to evaluate the psychometric features of the Traumatic Event Scale (TES) (version B) in a sample of Greek postpartum women. Methods: Two hundred women completed the Greek version of the TES-B (GrTES-B) and the Edinburgh Postnatal Depression Scale (EPDS) at four weeks postpartum. Results: The GrTES-B data from the sample were applied to the previously established five-factor structure of version A of the TES (“Anticipation of trauma”, “Intrusion”, Avoidance”, “Resignation”, and “Hyperstimulation”) employing confirmatory factor analysis. Considering that every Cronbach’s alpha was greater than 0.7, the factors’ reliability proved satisfactory. Significant correlations were observed regarding the convergent and divergent validity, indicating the instrument’s sufficient validity. Conclusions: The Greek version of the TES-B demonstrated satisfactory psychometric characteristics for the assessment of PTS symptoms among Greek postpartum women. Full article

(This article belongs to the Special Issue Interdisciplinary Perspectives in Maternal Health: Integrating Theoretical Frameworks and Practical Applications)

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13 pages, 247 KiB

Open AccessArticle

Effect of Women’s Education, Information and Communication Technologies, and Income on Maternal Mortality: Evidence from BRIICS Countries

by Adrian Teodor Moga Rogoz, Gamze Sart, Yilmaz Bayar, Marina Danilina and Marius Dan Gavriletea

Healthcare 2025, 13(6), 602; https://doi.org/10.3390/healthcare13060602 - 10 Mar 2025

Viewed by 581

Abstract

Maternal mortality has been among one of the most significant global health problems despite noteworthy decreases in maternal mortality during recent decades, and reducing maternal mortality is one of the targets of Sustainable Development Goal 3 (Good Health and Well-being). Objectives: This study investigates the effect of women’s education, ICTs (information and communication technologies), and income level on maternal mortality in the BRIICS countries for the 2000–2020 period. Methods: Panel causality and regression approaches are employed to analyze the interaction amongst women’s education, ICTs, income level, and maternal mortality. Results: The results of the causality test reveal that women’s education, ICTs, and income have a significant influence on the maternal mortality ratio. Specifically, the regression results indicate that women’s education, ICTs, and income have a negative effect on maternal mortality, but women’s education has been identified as one of the most significant factors in reducing maternal mortality ratios. Conclusions: Institutional and legal measures to increase women’s education would be useful to globally decrease maternal mortality. Full article

(This article belongs to the Special Issue Interdisciplinary Perspectives in Maternal Health: Integrating Theoretical Frameworks and Practical Applications)

20 pages, 1461 KiB

Open AccessArticle

Cultural Competence of Obstetricians/Gynecologists and Midwives Providing Midwifery Care to Roma Women in Western Greece

by Chrysoula Chinoporou, Athina Diamanti, Eleni Asimaki, Christina Nanou, Pinelopi Varela, Victoria Vivilaki and Anna Deltsidou

Healthcare 2025, 13(2), 190; https://doi.org/10.3390/healthcare13020190 - 19 Jan 2025

Viewed by 781

Abstract

Background: Providing midwifery care to Roma women is a significant public health issue due to their status as a vulnerable population, often facing unique challenges and discrimination in accessing healthcare. Cultural competence refers to the ability of maternity providers to understand and incorporate cultural factors within the broader healthcare system. Objective: This study aimed to investigate the cultural competence of obstetricians/gynecologists and midwives working in Western Greece who provide midwifery care to Roma women. Methods: A cross-sectional quantitative study was conducted using a questionnaire from the Roma Women’s Empowerment and Fight against discrimination in Access to Health (REACH) project, which focuses on empowering Roma women and combating healthcare access discrimination. The questionnaire covered three areas: the cultural competence of maternity professionals, their knowledge of Roma women’s lifestyle, and participants’ demographics. The sample included 100 maternity professionals from hospitals and health centers in Western Greece. Results: Cultural competence was found to be moderate to high, with a mean score of 6.9 (SD = 2.2) for the ability to provide adequate care. In the past six months, 33% had provided care to 1–5 Roma women with communication issues, and 53% frequently faced challenges in service delivery. Common problems included Roma women not understanding the information provided (72.9%), and not having necessary documents (41.7%). Obstetricians/gynecologists had higher knowledge scores compared to midwives, and higher educational attainment correlated with better knowledge. Older age was associated with higher cultural competence (p = 0.048). Conclusions: Cultural competence was positively correlated with knowledge levels, with obstetricians/gynecologists exhibiting higher competence than midwives. Enhancing cultural competence among perinatal care providers is crucial to addressing health disparities faced by Roma women. The study’s cross-sectional design and reliance on self-reported data may limit the generalizability and introduce bias. Enhancing cultural competence through targeted training programs can help address healthcare disparities faced by Roma women. Full article

(This article belongs to the Special Issue Interdisciplinary Perspectives in Maternal Health: Integrating Theoretical Frameworks and Practical Applications)

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21 pages, 1531 KiB

Open AccessArticle

Perinatal and Demographic Risk Factors Associated with Autism Spectrum Disorder: A National Survey of Potential Predictors and Severity

by Aikaterini Sousamli, Elena Dragioti, Dimitra Metallinou, Aikaterini Lykeridou, Panagiota Dourou, Chrysoula Rozalia Athanasiadou, Dimitrios Anagnostopoulos and Antigoni Sarantaki

Healthcare 2024, 12(20), 2057; https://doi.org/10.3390/healthcare12202057 - 16 Oct 2024

Cited by 1 | Viewed by 5538

Abstract

INTRODUCTION: This study investigates autism spectrum disorders (ASD) in Greece, focusing on estimating prevalence and identifying regional disparities in children aged 4 to 7 years. MATERIALS AND METHODS: Utilizing a quantitative, descriptive, and exploratory methodology, the research employed a structured questionnaire to gather extensive maternal and child health data. RESULTS: The sample consisted of 517 mothers of children diagnosed with ASD from all over Greece, contributing to a nuanced understanding of ASD predictors. This study aims to elucidate the role of prenatal factors in the likelihood of an ASD diagnosis and their impact on the subsequent functionality of children with ASD. The study identified significant predictors of lower functionality in children with ASD, including higher maternal age, delayed ASD diagnosis, lower family income, and higher birth order. Prenatal health issues, such as vaginal bleeding and infections, also influenced functional outcomes. Notably, a family history of neurological or psychiatric conditions appeared protective. DISCUSSION: The regression model demonstrated robust predictive power, underscoring the complexity of genetic, environmental, and socioeconomic factors in ASD development. The findings advocate for early diagnosis and intervention, systematic screening, and addressing socioeconomic disparities to improve functional outcomes. The results support evidence-based service development and policy adjustments to enhance early identification, intervention, and rehabilitation for children with ASD. CONCLUSIONS: Establishing standardized case-recording procedures and an ASD register at national and regional levels is recommended for systematic monitoring and resource evaluation. Full article

(This article belongs to the Special Issue Interdisciplinary Perspectives in Maternal Health: Integrating Theoretical Frameworks and Practical Applications)

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15 pages, 1701 KiB

Open AccessArticle

Government Health Expenditure and Maternal Mortality: The Moderating Role of External Debt

by Gildas Dohba Dinga, Gisele Mah and Teboho Mosikari

Healthcare 2024, 12(20), 2030; https://doi.org/10.3390/healthcare12202030 - 12 Oct 2024

Cited by 1 | Viewed by 1346

Abstract

Background/Objectives: The impact of government health spending and external debt on maternal mortality has been the subject of ongoing theoretical and empirical discussions. However, this relationship has remained controversial with no perspective on the moderating role of external debt on the government’s health expenditure and maternal mortality link. This study examines the moderating effect of external debt on the government’s health expenditure and maternal mortality relation using data from 13 Southern African economies spanning from 2000 to 2022. Methods: We employed the augmented mean group, the dynamic common correlation effect mean group, and the Driscoll–Kraay and Granger causality techniques to attain the study’s objective. Results: The outcome revealed that government health expenditure and external debt reduce maternal mortality in the Southern African Development Community (SADC) region. Equally, the magnitude of government health spending is moderated by external debt. The results revealed a bidirectional relation amidst maternal mortality and government health expenditure, and maternal mortality and external debt. Conclusions: The study recommends that policymakers within the SADC zone should avoid austerity measures and encourage expansionary measures in terms of spending, and the contraction of debt for capital investment in the health sector. This will enhance the delivery of health services within the zone and equally reduce the rate of maternal mortality that is still a major health concern within the sub-region. Full article

(This article belongs to the Special Issue Interdisciplinary Perspectives in Maternal Health: Integrating Theoretical Frameworks and Practical Applications)

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Review

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17 pages, 1024 KiB

Open AccessReview

Mixed Methods Studies on Breastfeeding: A Scoping Review

by Greyce Minarini, Eliane Lima, Karla Figueiredo, Nayara Pereira, Ana Paula Carmona, Mariana Bueno and Cândida Primo

Healthcare 2025, 13(7), 746; https://doi.org/10.3390/healthcare13070746 - 27 Mar 2025

Viewed by 429

Abstract

Prenatal and postnatal health guidance, along with women’s individual experiences, greatly influences mothers’ breastfeeding decisions and duration. To understand this better, a methodology combining quantitative and qualitative data is essential. Objective: To map the scientific production on the promotion, protection, and support of breastfeeding developed from mixed methods research. Method: A scoping review that followed the JBI and PRISMA-ScR methodology. The search was carried out in the following databases: Medline/PubMed, EMBASE, Cochrane, BVS, CINAHL, Web of Science, and BDTD. The guiding question was: Which studies on the promotion, protection, and support of breastfeeding were developed using mixed methods? The research took place from December 2023 to June 2024. Results: Of the 3569 studies found, 36 studies using mixed methods were included, with a prevalence of explanatory sequential approaches. Breastfeeding rates in the selected studies remain lower than global recommendations. The barriers to breastfeeding reported by mothers include biological; emotional; cultural; unfavorable social and hospital environment; difficulties in clinical management; lack of support from family, friends, health professionals, and employers; and skepticism about the benefits of breastfeeding. On the other hand, the main facilitators of breastfeeding reported were education and counseling during prenatal, childbirth, and postpartum periods; women’s intention to breastfeed; support from family, employer, spouse, and health professionals. Conclusions: The studies highlighted various issues related to breastfeeding rates, barriers, and facilitators across different contexts and cultures worldwide. The findings demonstrate that employing mixed methods enables a comprehensive and nuanced assessment of breastfeeding practices and the evaluation of relevant interventions. Full article

(This article belongs to the Special Issue Interdisciplinary Perspectives in Maternal Health: Integrating Theoretical Frameworks and Practical Applications)

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