The Impact of Racism on Breastfeeding and Lactation Inequities: A Scoping Review (Tisha Felder)
Q&A
11:30 – 11:50 Break
11:50 am - Session 3: Uniting Science and Care in Neonatal & Pediatric Health
Parental Identity in the NICU: How Guilt and Shame Shape Parental Confidence (Mary Murray* and Kayla Everhart)
In the Beginning: Bridging the gap between NICU stressors and Autonomic Dysregulation (Bryson Martin* and Kayla Everhart)
Q&A
12:40 pm - Session 4: Uniting Science and Care in Family Health
Miles apart: The psychological toll of neonatal transport on mothers (Karen Warren)
Early Brains, Early Language: Translating Neuroscience into Family-Centered Care (Ashley Darcy Mahoney)
Caring for the Caregivers: Stress and Health of Black Mothers Raising Young Children with Complex Health Needs (Jewel Scott)
Q&A
*Student Presenters
Wrap Up & Evaluation
Uniting Science and Care in Family Health & Models of Care
Keynote Speaker:
Amy L. Salisbury, Ph.D., LNP, PMH-CNS, BC, FAAN
Professor, Steigleder Endowed Chair for Research Associate Dean for Research, Scholarship, and Innovation, School of Nursing Director of Research for the Institute for Women's Health Virginia Commonwealth University, Richmond, VA
Dr. Salisbury received a Ph.D. in Developmental Psychobiology from the University of Connecticut, an M.S. in Nursing from the University of Rhode Island, and is an AACN board-certified advanced practice nurse in child and adolescent psychiatry. She has expertise in the measurement and assessment of fetal and infant neurobehavior and sleep development. Her work includes longitudinal research examining the impact of prenatal substance use, maternal psychiatric conditions, and their treatments on women’s health and fetal-infant neurodevelopmental outcomes. This work contributes to the evidence base for informed risk-benefit decisions for pregnant patients and their care providers, as well as to the development of novel interventions to improve outcomes for pregnant persons and their children.
Uniting Science and Care in Family Health & Models of Care
Reimagining practice authority:
Aligning midwifery policy with maternal health equity goals in the United States
Dr. Jennifer Baumstark is the Nurse-Midwifery Program Director at the University of South Carolina, president of the American College of NurseMidwives South Carolina affiliate, and secretary for the Directors of Midwifery Education. She is actively engaged in statewide efforts to grow the certified nurse-midwife workforce to improve maternal and neonatal outcomes. Before moving to South Carolina, Dr. Baumstark practiced full-scope midwifery and provided gynecologic and obstetric care in Illinois, Missouri, California, and on the rural island of Molokai, Hawai‘i, where she attended births in an eleven-bed hospital. A dedicated advocate for women, she is continually inspired by the strength and resilience of the women and families she serves.
Dr. Curisa Tucker is an assistant professor and nurse scientist with over a decade of clinical experience as a labor and delivery nurse. Her research focuses on maternal health equity, with an emphasis on the social and structural determinants that contribute to racial and ethnic disparities in maternal health outcomes. Using large administrative and electronic health record datasets, Dr. Tucker examines outcomes such as postpartum readmissions, severe maternal morbidity, and peripartum cardiomyopathy, with particular attention to neighborhood deprivation and health system factors. She also conducts qualitative research exploring the roles of doulas, nurses, and health systems in postpartum care. Her long-term goal is to generate evidence that informs equitable, community-engaged interventions to improve maternal health outcomes.
Uniting Science and Care in Family Health & Models of Care
Reimagining practice authority:
Aligning midwifery policy with maternal health equity goals in the United States
Abstract
Introduction
Access to certified nurse-midwives (CNMs) is a critical structural determinant of maternal health and is strongly influenced by institutional and policy-level factors, including state scope-of-practice laws. These laws govern the degree of professional autonomy granted to CNMs and may shape the availability and distribution of midwifery services across states. Restrictive practice environments can limit CNM workforce growth and geographic dispersion, potentially exacerbating inequities in access to high-quality maternity care, particularly in underserved and rural communities. Despite growing evidence that midwifery care is associated with improved maternal outcomes, less is known about how state-level CNM practice authority relates to broader indicators of maternity care access and vulnerability. This study examined the association between state-level CNM practice authority, CNM density, and population-level maternal health indicators.
Materials and Methods
We conducted an ecological cross-sectional analysis of all 50 U.S. states and the District of Columbia. State-level CNM counts were obtained from the American Midwifery Certification Board and used to calculate CNM density per 100,000 women of reproductive age. Maternity care access and quality were assessed using March of Dimes (MOD) maternity care grades, while structural and social vulnerability were measured using the Maternity Vulnerability Index (MVI). States were categorized as having Full, Reduced, or Restricted CNM practice authority based on classifications from the American Association of Nurse Practitioners. One-way analysis of variance (ANOVA) was used to assess differences in CNM density, MOD grades, and MVI scores across practice authority categories, followed by post hoc analyses.
Results
States with full CNM practice authority had significantly higher CNM densities (p<0.001), more favorable MOD maternity care grades (p<0.001), and lower MVI scores (p<0.001) compared with states with reduced or restricted authority. Post hoc analyses indicated that restricted practice states consistently demonstrated the lowest CNM densities and poorest maternity care grades.
Discussion and Conclusions
These findings align with prior research suggesting that less restrictive practice environments support greater access to midwifery care. By integrating workforce distribution with structural measures of maternity care vulnerability, this study highlights the role of practice authority as a policy lever for advancing maternal health equity. States with full CNM practice authority, combined with targeted workforce planning strategies, may be better positioned to reduce inequities in maternity care access and outcomes.
Why does this topic matter?
This topic matters because state policies governing certified nurse-midwives directly shape access to high-quality maternity care. Restrictive practice laws can limit the midwifery workforce, particularly in underserved communities, contributing to inequities in maternal health outcomes. Understanding how practice authority relates to workforce distribution and maternity care vulnerability can inform policy and workforce strategies to improve access, quality, and equity in maternal health care.
Uniting Science and Care in Family Health & Models of Care
Parents as Partners in NICU Caregiving
Marliese Nist, PhD, RNC-NIC is an Assistant Professor in the Martha S. Pitzer Center for Women, Children and Youth at The Ohio State University College of Nursing. She is a former neonatal intensive care nurse and a graduate of The Ohio State University College of Nursing’s PhD program. Dr. Nist studies the effects of NICU stress on neurodevelopmental outcomes of preterm infants with an emphasis on nursing interventions to decrease stress or buffer its effects. Dr. Nist’s predoctoral and postdoctoral studies were funded by the National Institute of Nursing Research of the National Institutes of Health and other nursing organizations and foundations. She is currently funded under a Multiple Principal Investigator R01-award from the National Institute of Child Health and Human Development to examine the barriers and facilitators of parent presence in the NICU and the buffering effects of parent presence on infant stress.
Rita H. Pickler, PhD, RN, FAAN
Dr. Rita Pickler is The FloAnn Sours Easton Professor of Child and Adolescent Health at The Ohio State University College of Nursing. Her educational and research background is in high-risk perinatology, neonatology, and pediatrics. For over 30 years, her work has focused on the care of preterm infants and their families and on efforts to reduce prematurity and improve maternal, child, and family outcomes. Her current NIH award with Dr. Marliese Nist focuses on understanding barriers and facilitators to parent presence and participation in care in the NICU. Dr. Pickler has over 200 publications. She has served on numerous research review committees at the NIH and on the National Advisory Council for Nursing Research. She has been honored for her research in many ways, including induction into the Sigma Theta Tau International Researcher Hall of Fame and receipt of the National Association of Neonatal Nurses 2022 Lifetime Achievement Award.
Introduction
Uniting Science and Care in Family Health & Models of Care
Parents as Partners in NICU Caregiving
Abstract
Parents are critical healthcare partners in the neonatal intensive care unit (NICU). Although parents have historically reported numerous and varied barriers that limit their ability to be present to participate in caregiving, these barriers and potential facilitators to presence have not been fully studied.
Purpose
The purposes of this presentation are to describe the importance of parent presence and participation in NICU caregiving and to report preliminary data of barriers and facilitators to presence.
Material and Methods
In a cross-sectional survey, parents of very preterm infants completed a demographic questionnaire and quantified the barriers and facilitators influencing their NICU presence within their infant’s first 10 days of life. Parents rated the influence of specific barriers and facilitators on a 5-point Likert scale (0=not influential, 4=always influential). Barrier and facilitator scores were calculated separately as mean scores for all included items and compared among groups of parents to identify disparities. Reported barriers and facilitators were compared between White participants and those identifying as another race, by parental income and parental education, and between mothers and fathers.
Results
Among enrolled parents (N=133), the most highly reported barrier to NICU presence was the need to spend time with other children (Mn=2.0, SD=1.3). The most influential facilitator among parents was knowing that their presence helped their baby (Mn=3.8, SD=0.6). While there were no differences in barrier and facilitator scores between White participants and those identifying as another race, those reporting annual incomes of less than $75,000 reported more barriers than those with annual incomes of at least $100,000. Similarly, participants with only a high school education reported more barriers than those with a Master’s or Doctoral degree. There were no differences in facilitator scores among racial, income, or educational groups. There were also no differ ences in barrier scores between mothers and fathers, but mothers reported more facilitators than fathers.
Conclusions: Parents reported a wide range of barriers and facilitators to their presence during the first weeks of their infants’ hospitalizations. Data collection remains ongoing; later analyses will include examination of potential mechanisms associated with barriers and facilitators over the course of NICU stay, as well as examining the relationship between parent presence and participation and infant health and development.
Why does this topic matter? - Parent presence and participation in NICU caregiving are important for improving clinical outcomes and development for preterm infants.
Uniting Science and Care in Pregnancy and the Fourth Trimester
From Evidence to the Bedside: Nurses’ Perspectives on Breastfeeding Education and Support
Joynelle R. Jackson, EdD, MSN, RNC-MNN, CNE, CBS, is an Associate Professor at the University of South Carolina College of Nursing. A maternal health nurse since 2003 and nurse educator since 2007, Dr. Jackson is dedicated to advancing breastfeeding education, equity, and community engagement. She is the co-founder of Mocha Mamas Milk, an organization focused on empowering families of color through breastfeeding support. As a 2023 PCORI grant recipient, Dr. Jackson leads initiatives to build community capacity for breastfeeding promotion and support. Her work integrates research, education, and advocacy to strengthen maternal health outcomes and nursing practice.
Uniting Science and Care in Pregnancy and the Fourth Trimester
From Evidence to the Bedside: Nurses’ Perspectives on Breastfeeding Education and Support
Abstract
Introduction
Nurses play an essential role in promoting successful breastfeeding initiation and continuation for new mothers. Despite this central role, there remains considerable variability in the breastfeeding education and training nurses receive. Institutional limitations, such as limits with access to lactation consultants and varying policies, can further hinder nurses’ ability to provide evidence-based support. These challenges are often amplified during night and weekend shifts, when nurses frequently serve as the primary source of breastfeeding education and encouragement for new mothers.
Methods
Understanding the lived experiences of bedside nurses is vital to strengthening breastfeeding education, clinical practice, and institutional support. This qualitative descriptive study explored the experiences of inpatient obstetric nurses to identify barriers and facilitators to providing evidence-based breastfeeding care. Semi-structured interviews were conducted with nurses across multiple hospital settings. Data was analyzed using thematic analysis.
Results
Three overarching themes emerged: (1) staffing and workload barriers that limit time for patient education and individualized breastfeeding support; (2) inconsistent institutional policies and limited access to lactation resources, which create gaps in continuity of care; and (3) training and knowledge disparities among nurses, reflecting the need for standardized, ongoing breastfeeding education across all stages of nursing practice.
Conclusion
Findings underscore the critical need for consistent, evidence-based breastfeeding education integrated throughout nursing curricula and continuing professional development. Institutional investment in staff training and access to lactation specialists can enhance nurses’ confidence and competence in supporting breastfeeding mothers. Strengthening nursing education and institutional infrastructure can ultimately improve breastfeeding initiation and duration rates key indicators of positive maternal and infant health outcomes. This study highlights the voices of bedside nurses as central to identifying practical solutions that promote equitable, effective, and sustainable breastfeeding support within maternal health care settings.
Why does this topic matter?
Understanding nurses’ experiences is essential to improving breastfeeding outcomes, as gaps in education and institutional support can limit the consistent application of evidence-based practice and equitable maternal care.
Uniting Science and Care in Pregnancy and the Fourth Trimester
Revealing the overlooked connection: Sickle cell conditions and pregnancy outcomes
Nansi Boghossian's research focuses on maternal morbidity and outcomes of extremely preterm infants, integrating social determinants of health, pregnancy complications, and health policy, with emphasis on the postpartum period, an often overlooked but critical phase of care. Nansi leads two NIH R01s on hospital quality, Medicaid expansion and extension, and racial/ethnic disparities in maternal outcomes, alongside additional grants focused on postpartum health. Nansi also leverages Vermont Oxford Network data to examine disparities in care practices and outcomes for extremely preterm infants. Using population-based and translational approaches, Nansi's work aims to reduce preventable maternal complications while improving long-term outcomes for mothers and infants.
Uniting Science and Care in Pregnancy and the Fourth Trimester
Revealing the overlooked connection: Sickle cell conditions and pregnancy outcomes
Abstract
Introduction
Sickle cell disease and sickle cell trait affect millions of individuals in the United States and disproportionately impact Black communities. While sickle cell disease is widely recognized as a highrisk condition across the life course, sickle cell trait has historically been viewed as a benign carrier state, and important gaps remain in understanding how both conditions contribute to adverse health outcomes and persistent racial inequities. This presentation will provide an overview of sickle cell disease and sickle cell trait, with a particular focus on severe maternal morbidity.
Why does this topic matter?
This topic matters because sickle cell disease and sickle cell trait, though often underrecognized, substantially contribute to severe maternal morbidity and persistent racial inequities in health outcomes.
Uniting Science and Care in Pregnancy and the Fourth Trimester
The Impact of Racism on Breastfeeding and Lactation Inequities: A Scoping Review
Dr. Tisha Felder (Dr. T) is a South Carolina native, behavioral scientist, and associate professor at the University of South Carolina. She is dedicated to reducing racial and socioeconomic disparities in breastfeeding and breast cancer among Black women. Inspired by her own breastfeeding journey, she cofounded Mocha Mamas Milk® to support Black families in SC and has a history of research funding from organizations such as the National Cancer Institute (NCI/NIH) and the Patient-Centered Outcomes Research Institute. In addition to research, Dr. Felder is passionate about mentoring students and enhancing diversity in the maternal health and scientific workforce. She is a proud wife and mother of three.
Uniting Science and Care in Pregnancy and the Fourth Trimester
The Impact of Racism on Breastfeeding and Lactation Inequities: A Scoping Review
Abstract
Introduction
Black families in the United States experience persistent inequities in breastfeeding outcomes. Although breastfeeding behaviors are shaped by social and structural determinants of health, racism is rarely examined explicitly as a driver of these disparities. This scoping review synthesizes recent U.S.-based literature on how racism influences breastfeeding and lactation outcomes among Black families.
Methods
Guided by Arksey and O’Malley’s framework and PRISMA-ScR guidelines, we searched six databases for empirical U.S. studies published between January 1, 2015, and January 29, 2026. Eligible studies included Black/African American participants or compared breastfeeding outcomes across racial/ethnic groups. Racism was conceptualized across internalized, interpersonal, institutional, and structural levels. Two reviewers independently screened studies, with conflicts resolved by a third reviewer. Four team members independently extracted data on study design, racism-related constructs, and breastfeeding outcomes.
Preliminary Results
Twenty-six studies met the inclusion criteria; data extraction was complete for 19 (12 quantitative, 7 qualitative), and preliminary findings are presented for quantitative studies. Studies examined initiation, duration, exclusivity, and breastfeeding experiences. Most quantitative studies assessed racism-related context implicitly through proxies such as workplace conditions, hospital characteristics, or neighborhood factors; few directly measured discrimination. Only two studies used explicit conceptual frameworks. Identified pathways included workplace inequities (e.g., low job control mediating breastfeeding duration), differential implementation of breastfeeding-supportive hospital policies, provider-level discrimination, restricted access to lactation resources, and psychosocial stress. Formal testing of mediation and multilevel mechanisms was limited.
Implications
Synthesizing mechanisms shifts accountability from individuals to systems and identifies actionable targets within workplace policy, health care delivery, and research. Advancing breastfeeding equity requires improved measurement of racism and equity-focused systems reform.
Why does this topic matter?
Breastfeeding inequities contribute to preventable differences in maternal and infant health outcomes. Understanding how racism operates through structural, institutional, and interpersonal pathways is essential to designing interventions that move beyond individual behavior change and toward systemic solutions.
Uniting Science and Care in Neonatal & Pediatric Health
In the Beginning: Bridging the gap between NICU stressors and Autonomic Dysregulation
Bryson Martin is a registered nurse and first year PhD student at the University of South Carolina. Bryson has extensive clinical experience working in the neonatal intensive care unit (NICU) caring for critically ill and complex neonates and their families. His research focuses on improving neurodevelopmental outcomes for preterm infants and specifically centers around understanding the autonomic nervous system. Bryson collaborates with various researchers across the state of South Carolina and beyond on diverse projects. These include studies on early identification of Autism Spectrum Disorder, neuromodulation to improve feeding outcomes for preterm infants, increasing understanding of stress in the NICU, and many more endeavors related to infant and family health. His passion is improving brain health and wellness for infants and their families across the life-course.
Dr. Kayla Everhart, PhD, RN is an Assistant Professor at the College of Nursing with 13 years neonatal clinical experience. Her research focuses on decreasing morbidity and mortality of preterm infants through clinical research. Currently she is funded by The Gerber Foundation to explore blood warming to decrease central hypothermia in very preterm infants. Dr. Everhart also mentors future maternal child researchers and collaborates with others to address the impact of severe maternal morbidity and its impact on preterm infants health outcomes.
Introduction
Uniting Science and Care in Neonatal & Pediatric Health
In the Beginning: Bridging the gap between NICU stressors and Autonomic Dysregulation
Abstract
The autonomic nervous system (ANS) is the body’s primary stress response system and plays a critical role in maintaining physiologic stability. It functions through the coordinated action of the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). These branches are integrated with the central and peripheral nervous system and act upon nearly every organ system. A properly regulated ANS responds to stressors while maintaining homeostasis. The ANS is underdeveloped in very preterm (VPT) infants, often leading to dysregulation, and has been implicated in brain injury and neurodevelopmental impairment. While the impact of stress exposure in VPTs has been explored, little work has examined how routine stressors influence the developing ANS. Standard-of-care procedures, such as endotracheal tube (ETT) suctioning, are often performed in mechanically ventilated VPT infants with little regard for their effects on the developing ANS. This work aims to understand how ETT suctioning affects the developing ANS for infants requiring mechanical ventilation.
Methods
A literature search was performed using PubMed, CINAHL, Web of Science, and PsycINFO. Key terms related to VPT infants, ETT suctioning, and ANS dysregulation were used. Studies were excluded if they were animal studies, included infants >32 weeks' gestational age, or were an intervention study.
Results
Five studies met the inclusion criteria for the final synthesis. The studies included a prospective observational study, a randomized controlled trial, a case report, and two secondary data analyses. Across studies, various methods were used to define the ANS's functioning. No studies specifically assessed how ETT suctioning affected the ANS. All studies found primary SNS activity with minimal regulation from the PNS.
Discussion
All included studies showed that VPT infants have a clear sympathovagal imbalance, indicating ANS dysregulation. The typically collaborative system of the SNS and PNS is not functioning optimally in the VPT infant. This has significant implications for how external stressors, such as ETT suctioning, affect the health and development of the VPT infant.
Conclusion
Standard of care stressors, acting on this dysregulated system, have clear consequences for infant health and development, especially the vulnerable brain. All but one of the studies were published over ten years ago, representing a significant gap in knowledge development. None of the studies explored how ETT suctioning affected the dysregulated ANS. Continued work is needed to understand how standard-of-care procedures and the resulting stress affect developmentally vulnerable systems, such as the ANS, in VPT infants.
Uniting Science and Care in Neonatal & Pediatric Health
Parental Identity in the NICU:
How Guilt and Shame Shape Parental Confidence
Mary Murray is a recent graduate of the University of South Carolina College of Nursing. Mary is deeply interested in critical care and family-centered nursing. Mary’s senior thesis, Parental Identity in the NICU: How Guilt and Shame Shape Parental Confidence, grew out of my desire to better understand the emotional realities families face during critical illness. Through this work, Mary developed a strong appreciation for the nurse’s role in building trust, reducing guilt and shame, and empowering parents to feel confident in their caregiving. My clinical experiences in high-acuity settings strengthened my passion for fast-paced, team-oriented environments and reinforced my commitment to providing compassionate, evidence-based care to both patients and their families as I began my nursing career.
Dr. Kayla Everhart, PhD, RN, is an Assistant Professor at the College of Nursing with 13 years of neonatal clinical experience. Her research focuses on decreasing morbidity and mortality of preterm infants through clinical research. Currently, she is funded by The Gerber Foundation to explore blood warming to decrease central hypothermia in very preterm infants. Dr. Everhart also mentors future maternalchild researchers and collaborates with others to address the impact of severe maternal morbidity on preterm infants' health outcomes.
Introduction
Uniting Science and Care in Neonatal & Pediatric Health
Parental Identity in the NICU:
How Guilt and Shame Shape Parental Confidence
Abstract
Parents of premature infants in the Neonatal Intensive Care Unit (NICU) often struggle with psychological distress, especially feelings of guilt and shame. These feelings emerge as parents believe they have failed to meet their infant’s needs, which has lasting effects on parental confidence. Previous research has focused primarily on the role guilt and shame play in shaping maternal confidence; however, more work is needed to understand how these feelings influence paternal confidence.
Methods
To explore the role that individual susceptibility to guilt and shame plays in shaping the parental confidence of both mothers and fathers with preterm infants in the NICU, and to identify the sources of these emotions. This project employed a mixed methods design and recruited five Mother-Father dyads from a Level III South Carolina NICU. Participants completed a survey measuring shame and guilt, created from a compilation of items from the Test of Self-Conscious Affect-3 and the Guilt Inventory (Jones, Schratter, & Kugler, 2000; Tangney & Dearing, 2002). In addition, parental confidence was measured using the Neonatal Intensive Care Unit Parental Beliefs Scale (NICU PBS: Özdemir, F. K. & Alemdar, D. K., 2019). Interviews were then conducted to expand upon the survey answers.
Results
It was found that maternal confidence is influenced by feelings of anatomical inadequacy, as mothers feel that their bodies failed their children. However, paternal confidence is influenced by feelings of conflict and helplessness as they are challenged with balancing the role of family provider with emotionally supporting their wife and child.
Conclusion
This research has valuable insights into how feelings of guilt and shame can be minimized and ways in which parental confidence can be promoted in parents during their infant’s NICU stay.
Why does this topic matter?
This thesis matters because it reveals how guilt and shame uniquely shape maternal and paternal confidence in the NICU, highlighting opportunities for more inclusive, emotionally supportive care that empowers both parents during a highly vulnerable time.
Uniting Science and Care in Family Health
Miles apart: The psychological toll of neonatal transport on mothers
Karen F. Warren, PhD, RN, is a Research Assistant Professor in the College of Nursing at the University of South Carolina and a Fellow in the University’s Bridge to Faculty Program. A firstgeneration college graduate, she began her nursing career nearly two decades ago after earning an associate degree in nursing in Virginia. She spent eight years working in the Neonatal Intensive Care Unit, followed by nine years as a flight nurse on a Neonatal/Pediatric Critical Care Transport team, supporting critically ill infants and their families during high-acuity transfers.
Dr. Warren earned her PhD from the University of South Carolina, where her dissertation examined outcomes for transported infants and the psychosocial health of their mothers. Her research focuses on the social, structural, and psychosocial factors that shape maternal mental and infant health, with the goal of reducing disparities and improving family well-being. She also has a secondary interest in the early identification of autism. Her work is rooted in South Carolina, where maternal and infant health inequities remain an ongoing challenge.
Introduction
Uniting Science and Care in Family Health
Miles apart: The psychological toll of neonatal transport on mothers
Abstract
The United States (US) is one of the ten countries with the most significant number of preterm births (PTB). Prematurity and low birth weight are the second leading causes of infant deaths in the US and the leading cause of short and long-term morbidities and infant mortality. Neonatal transport is a unique aspect of PTB, with tens of thousands of infants requiring transport to tertiary centers with NICUs to prevent and manage complications every year.
While transport is often lifesaving, it introduces an added challenge to parents, particularly when care is delivered far from the family’s home community. NICU hospitalization is a well-documented source of parental stress. These challenges are disproportionately borne by families from lower socioeconomic backgrounds, who may face additional barriers such as financial strain, transportation limitations, employment instability, childcare challenges for siblings, and reduced access to their hospitalized infant. Such barriers can limit parental presence and engagement in care, further compounding stress and emotional burden.
The psychological impact of neonatal transport cannot be fully understood without consideration of the broader structural and social determinants of health that shape families’ experiences. Factors such as income, housing stability, geographic location, and access to support play a critical role in influencing maternal mental health and family well-being during and after neonatal hospitalization.
This work seeks to examine the psychosocial experiences of mothers following neonatal transport, with particular attention to the ways in which structural and social determinants of health influence psychological outcomes. By identifying key stressors, barriers to access, and sources of support, this research aims to inform the development of targeted, equity-focused interventions. Ultimately, improving understanding of the maternal psychological burden associated with neonatal transport has the potential to enhance family-centered care, reduce health disparities, and promote long-term health and well-being for infants and their families.
Why does this topic matter?
Neonatal transport matters because while it is often lifesaving for infants, it can impose significant psychological and structural burdens on families, particularly those already facing social and economic disadvantages.
Uniting Science and Care in Family Health
Early Brains, Early Language:
Translating Neuroscience into Family-Centered Care
Dr. Ashley Darcy Mahoney, PhD, NNP-BC, FAAN, is a neonatal nurse practitioner and professor of nursing at The George Washington University School of Nursing. A renowned expert in early childhood development, Dr. Darcy Mahoney’s research focuses on improving long term outcomes for high-risk infants and addressing pediatric health disparities. She has secured significant funding from HRSA, NIH, and private foundations, supporting her innovative work. With over 60 peer-reviewed publications and a co-edited book, The Future of Nursing 20202030: Global Applications to Advance Health Equity, she has made substantial contributions to advancing nursing science. Dr. Darcy Mahoney also engages in national leadership roles, including as the previous NAM nurse scholar-in-residence fellow in the American Academy of Nursing and has been recognized for her significant impact on nursing and health policy.
Introduction
Uniting Science and Care in Family Health
Early Brains, Early Language:
Translating Neuroscience into Family-Centered Care
Abstract
Despite advances in neonatal and early childhood science, persistent disparities in developmental outcomes reflect a continued opportunity gap. Systemic differences in access to enriching environments and early supports shape children’s developmental trajectories long before school entry. Neurodevelopmental research demonstrates that early social and linguistic experiences influence brain structure and function in regions critical for language and executive function.
Methods
Our work with preterm-born children illustrates these mechanisms. Using functional near-infrared spectroscopy (fNIRS) during executive function tasks, we found that bilingual preterm-born children demonstrated faster cognitive processing and distinct patterns of prefrontal activation during cognitive flexibility challenges, particularly in regions associated with executive control and response inhibition. These findings suggest that enriched early language environments may support more efficient neural recruitment even among children at heightened neurodevelopmental risk.
Results
This neuroscience-informed work directly shaped the development of Háblame Bebé, a bilingual, parentcentered digital intervention designed to support caregiver–infant interaction, early language development, and sociolinguistic pride beginning in the neonatal period. Developed in partnership with families, Háblame Bebé translates evidence from developmental neuroscience into practical, culturally responsive strategies that can be embedded within clinical care and extended into the home and community.
Why does this topic matter?
Drawing on experiences from neonatal intensive care, home visiting, and community partnerships, this presentation demonstrates how uniting science and care through authentic family partnership translates evidence into practice, offering scalable strategies to support early developmental outcomes.
Uniting Science and Care in Family Health
Caring for the Caregivers: Stress and Health of Black Mothers Raising Young Children with Complex Health Needs
Dr. Jewel Scott is a family nurse practitioner and nurse scientist whose research centers on the cardiovascular health of young adult women. She is an assistant professor at the University of South Carolina College of Nursing and currently serves as interim co-director of the Perinatal, Pediatric, and Family Research Center, where she leads community-engaged research aimed at identifying, evaluating, and addressing conditions of daily living that drive disparities in both cardiovascular disease and maternal health outcomes.
Dr. Scott’s work highlights young adulthood as a critical period for cardiovascular risk and resilience. Her research seeks to identify opportunities for intervention to reduce the impact of stress and adversity on cardiovascular health and related behaviors, particularly among young adult women. She examines pathways to health and well-being with an emphasis on the experiences of women of color, the role of social connectedness, and the influence of systems, community, and interpersonal-level factors on health. Her work bridges clinical insight and population health to inform equitable, lifecourse–oriented interventions
Uniting Science and Care in Family Health
Caring for the Caregivers: Stress and Health of Black Mothers Raising Young Children with Complex Health Needs
Background:
Black women experience disproportionately high rates of hypertension and cardiovascular disease, often at younger ages than other groups. Major life transitions, including motherhood, are associated with changes in health behaviors and increased stress. For mothers raising children with complex health needs, including autism spectrum disorder (ASD), caregiving demands may intensify psychosocial strain. Guided by Pearlin’s Stress Process Model and an intersectional framework, this study explored stress and health among Black mothers of young children.
Methods:
In this exploratory, cross-sectional pilot study (N = 26), Black mothers of young children were recruited through autism-focused research networks and community referrals. Measures included racism-related stress, stress overload, caregiving strain, loneliness, social support, and physical activity. Given the pilot nature of the study, analyses focused on descriptive comparisons and effect sizes (Cohen’s d) rather than hypothesis testing.
Results:
Mothers of children with ASD reported substantially higher caregiving strain (d ≈ 1.6) and elevated stress overload (d ≈ 0.5) compared to mothers of typically developing children. Loneliness was markedly higher among mothers experiencing greater caregiving strain (d ≈ 1.6 overall; d > 2.0 among mothers of children with ASD). In contrast, physical activity levels did not differ meaningfully between groups, despite large differences in psychosocial stress. Qualitative responses highlighted feelings of dismissal and invisibility in healthcare interactions for both groups of mothers.
Conclusions:
Findings suggest that caregiving-related stress and loneliness cluster among Black mothers raising children with complex health needs, potentially shaping long-term cardiovascular risk. Interventions may benefit from prioritizing stress reduction and social connection alongside traditional health behavior strategies. Larger, longitudinal studies are needed to clarify stress pathways and protective factors in this population.
Why does this topic matter?
Black women face disproportionately high rates of cardiovascular disease, and the added caregiving demands of raising a child with complex health needs may intensify psychosocial stress in ways that threaten long-term cardiovascular health.
Informed Consent in Childbirth: A Global Scoping Review of Episiotomy Practices and the Gaps in U.S. Maternity Care
Rachel Gulczinski is an undergraduate Honors College student at the University of South Carolina, conducting research with Dr. Curisa Tucker. Through her work in the Maternal Outcomes Lab, she studies maternal health, patient-centered medicine, and the relationships that shape communication and decision-making within the delivery room. Rachel’s honors thesis examines informed consent practices in childbirth, with particular emphasis on the global disparities in obstetric care and the impact of non-consensual interventions on maternal autonomy. Her academic interests extend to public health, reproductive justice, and clinical ethics, and she plans to integrate these subjects into her future work. After graduating this May, she plans to pursue medical school, with the long-term goal of becoming a physician that advocates equitable, compassionate, and ethically grounded care.
Dr. Curisa Tucker is an assistant professor and nurse scientist with over a decade of clinical experience as a labor and delivery nurse. Her research focuses on maternal health equity, with an emphasis on the social and structural determinants that contribute to racial and ethnic disparities in maternal health outcomes. Using large administrative and electronic health record datasets, Dr. Tucker examines outcomes such as postpartum readmissions, severe maternal morbidity, and peripartum cardiomyopathy, with particular attention to neighborhood deprivation and health system factors. She also conducts qualitative research exploring the roles of doulas, nurses, and health systems in postpartum care. Her long-term goal is to generate evidence that informs equitable, community-engaged interventions to improve maternal health outcomes.
Additional Learning Opportunity
Informed Consent in Childbirth: A Global Scoping Review of Episiotomy Practices and the Gaps in U.S. Maternity Care
Purpose
The objective of this study was to examine the current state of the literature on the presence of informed consent for episiotomies during childbirth.
Background
Informed consent is a fundamental ethical and legal component of maternity care and provides a backbone of trust between patients and practitioners within healthcare. Despite this, current evidence suggests that many childbirth interventions, including episiotomies, are often performed without explicit patient consent. Our goal was to conduct a global scoping review to assess if informed consent is obtained during childbirth episiotomy procedures and to identify disparities between international and U.S. practices.
Methods
Following the PRISMA Scoping Review framework, peer-reviewed studies published in English from 2015-2025 were collected from databases including PubMed, Embase, and Web of Science. Eligible studies examined informed consent practices during childbirth and the presence of disrespect or unnecessary interventions during the labor and birth process.
Results
Findings indicate widespread global deficiencies in obtaining informed consent during childbirth interventions, particularly among women of low socioeconomic status, unmarried women, and women with no education. These deficiencies were prominent in episiotomies and led to birth dissatisfaction, lack of perceived control, and poorer birth outcomes.
Implications
By analyzing global maternal healthcare systems, these findings will identify gaps in care and provide the framework to improve informed consent procedures within childbirth episiotomy procedures.
Why does this topic matter?
Ensuring informed consent during childbirth for all birthing people is essential to protect maternal autonomy and create safer and more equitable maternal care worldwide.
