Theses and Dissertations at Montana State University (MSU)
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Item Implementing birth trauma screening at the post-partum appointment: a quality improvement project(Montana State University - Bozeman, College of Nursing, 2023) Milam, Kelsey Rene; Chairperson, Graduate Committee: Margaret HammerslaBirthing individuals perceive their birth experience as a traumatic experience in 30-45% of births. This can lead to negative consequences such as increased maternal stress, fears of subsequent pregnancies, and impaired infant bonding. Post-Partum Post Traumatic Stress Disorder (PP-PTSD) after childbirth is a significant clinical problem, as 4-9% of birthing individuals develop it. In order to prevent and reduce the negative impacts of traumatic births, perinatal providers can implement birth trauma screening into their assessments of perinatal mood disorders, increasing the identification and implementation of treatment. An Ob/Gyn clinic in Southwestern Montana sought to improve the identification of birth trauma in their population, as they relied on the patient to self-report concerns and post-traumatic symptoms. The Iowa Model of Evidence-Based Practice informed the implementation of birth trauma screening at the 2-week post-partum appointments over a 3-week period. At the 2-week post-partum appointment, birth trauma screening was implemented by the RN using the first two questions of the City Birth Trauma Scale (CBTS). If the patient screened positive, they were given a counseling referral and supportive education from the RN. The electronic health record (EHR) was modified for documentation. 37 patients attended a 2-week post-partum appointment. 37.84% received birth trauma screening. Of the patients screened, 100% received correct documentation of screening in the EHR. 14.29% screened positive for birth trauma. 100% of positive screens received an offer for a counseling referral and 50% attended that appointment. This project was effective at increasing the screening rate of birth trauma in birthing individuals and provided increased access to counseling and education on this topic to every patient screened, regardless of the result. By including involvement of Ob/Gyn providers, nursing staff and mental health clinicians in the development of this project, allowed for an increased knowledge base of this clinical issue, leading to increased commitment for the early identification of birth trauma for this organization.Item Images of pregnancy and birth in western painting(Montana State University - Bozeman, College of Art & Architecture, 1999) Johnson, LibbyRather than a survey of the entire history of the subject, I will focus on images of pregnancy and birth from the Renaissance to modem times. My goal is to study the symbolism of images of pregnancy in western painting. Some questions I hope to answer are: Is the symbolism of such paintings always the same or do they portray different meanings? What role do the images play in society? How have such images changed (or not) over time? I believe that art reflects the views and values of the society that produces it and that art therefore can be used as a sociological or anthropological tool. What do artist's depictions tell us of how pregnancy and birth were viewed in Renaissance society and how they are viewed in contemporary society?Item Traditional beliefs and behaviors affecting childbearing practices of Crow Indian women(Montana State University - Bozeman, College of Nursing, 1981) Harding, Rita Marie; Chairperson, Graduate Committee: Jacqueline TaylorThe purpose of this study was to explore and to describe the traditional beliefs and behaviors that currently affect childbearing practices of Crow Indian women. The design of the study was an exploratory and a descriptive ethnographic study and consisted of two stages. The first stage of the study collected data through unstructured interviews of key informants who were culturally knowledgeable Crow Indian women. This first stage of the study explored and described traditional beliefs and behaviors that affected childbearing practices of Crow Indian women in the past and at the present time. The second stage of the study collected data through structured interviews of participants who were pregnant Crow Indian women. The questions in the structured interview were part of a data collection method employed in a study currently being conducted on the Navajo Indian Reservation and were modified to reflect the Crow Indian culture. Modifications in the original questions were based on the literature review and the data collected in the first stage of the study. This second stage of the study explored and described traditional beliefs and behaviors that affected childbearing practices of Crow Indian women at the present time. The findings of this study identified and described contemporary childbearing practices of Crow Indian women and their families. Beliefs and behaviors in traditional and modified form appeared to influence contemporary childbearing practices and Crow Indian life in general. The majority of the Crow Indian people were transitional in life style between traditional Crow Indian culture and the modern Anglo society and were influenced by a wide variety of both traditional and modern beliefs and behaviors. Respect for and/or participation in combinations of traditional practices were suggestive of the type of life style practiced by individual Crow Indian people. The findings of this study supported the general concept that culture is a major variable in the determination of health and in the utilization of health care services. Through scientific knowledge and further research, modern health care services that are compatible with traditional beliefs and behaviors of the Crow Indian culture and that meet the unique needs of the Crow Indian people can be provided.Item The impact of family leave laws on cesarean delivery(Montana State University - Bozeman, College of Agriculture, 2008) Hogenson, Elise Catherine; Chairperson, Graduate Committee: Wendy A. Stock.Cesarean rates have increased dramatically since 1965, with nearly a third of all births being delivered by cesarean section in 2006. Although numerous factors have contributed to this increase, this paper estimates the impact of family leave laws on cesarean rates. Leave laws led to increased health insurance coverage, thus altering the financial incentives facing both parents and physicians in the choice of delivery method. The laws also changed leave taking by parents, which may have impacted cesarean rates. The impact of leave laws on cesarean rates is estimated using a difference-in-differences approach coupled with the variation in state leave laws that existed prior to the passage of the federal Family and Medical Leave Act (FMLA) in 1993. The empirical results suggest that state leave laws are associated with an 8 to 13 percentage point reduction in the probability of cesarean delivery, but that the FMLA had little impact on cesarean rates.