Unplanned cesarean deliveries linked to higher risk of acute psychological stress after childbirth

Study led by Mass General Brigham investigators found that more than 1 in 4 patients who had an unscheduled cesarean delivery reported psychological stress

Mass General Brigham

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A new study from researchers at Mass General Brigham finds that patients who undergo unscheduled or unplanned cesarean deliveries are at substantially increased risk for experiencing acute psychological stress during childbirth, with effects that can persist for months and impact maternal mental health and early bonding with infants. Results are published in Pregnancy.

The study, which followed more than 1,100 women who gave birth at Massachusetts General Hospital, a founding member of the Mass General Brigham healthcare system, found that over 1 in 4 patients who had an unscheduled cesarean delivery experienced clinically significant acute stress shortly after birth, compared with about 1 in 16 patients who delivered vaginally. Even after accounting for medical complications, prior trauma, and mental health history, individuals who had unscheduled cesareans remained more than twice as likely to experience severe stress.

“Unscheduled cesarean delivery can be lifesaving, but for some patients it is also a deeply distressing experience,” said lead investigator Sharon Dekel, PhD, MS, MPhil, of the Postpartum Traumatic Stress Disorders Research Program in the Mass General Brigham Department of Psychiatry. “Our findings show that the emotional impact of these births is common, measurable, and clinically meaningful. While most patients are resilient and won’t have a stress response, we want to make sure that people who are struggling get the resources they need.”

Stress levels were highest when cesarean delivery occurred during labor or in the presence of greater obstetric complications. Importantly, these early stress reactions were not fleeting. Women who reported high levels of acute stress shortly after childbirth were significantly more likely to develop posttraumatic stress symptoms, depression, and difficulties bonding with their infants two months later.

Dekel and her colleagues are actively working on next steps to implement a questionnaire that could help screen postpartum patients at Mass General Brigham and beyond. The findings also support growing calls for trauma-informed obstetric and postpartum care, particularly for patients who have undergone unexpected interventions during childbirth. Dekel notes that some patients may have an acute stress response but their symptoms may improve with time, which may mean it’s important to screen both immediately after birth and later.

“This study highlights the potential value of brief, low-burden screening for acute stress during postpartum hospitalization, especially after unplanned or medically complicated deliveries,” said Dekel. “Sometimes, childbirth can become an event that is emotionally loaded or a traumatic experience. But we have great ways of helping people cope, which is why we want to identify patients early and help them get connected.”

 

Authorship: In addition to Dekel, Mass General Brigham authors include Hadas Allouche-Kam, Isha Hemant Arora, Christina T Pham, Eunice Chon, Mary Lee, Onyekachi Agwu, Jiajia Zhang, Evelyn Milavsky, Andrea G. Edlow, Francine Hughes, and Scott P. Orr. Additional authors include Anjali J Kaimal.

Disclosures: Edlow reports consulting fees from Mirvie, Inc and Merck, Sharpe and Dohme, and research funding from Merck, Sharp and Dohme, all outside of this work. All other authors declare no conflicts of interest.

Funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Grant/Award Numbers: R01HD108619, R21HD100817, R21HD109546; American Physicians Fellowship for Medicine in Israel.

Paper cited: Allouche-Kam, H et al. “The psychological impact of childbirth: Unscheduled cesarean delivery associates with increased risk for acute stress response” Pregnancy DOI: 10.1002/pmf2.70220

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Journal

Pregnancy

DOI

10.1002/pmf2.70220 

Method of Research

Observational study

Subject of Research

People

Article Title

The psychological impact of childbirth: Unscheduled cesarean delivery associates with increased risk for acute stress response

Article Publication Date

15-Jan-2026

 

A new, cleaner way to make this common fertilizer

University of Illinois Chicago

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The last time you scrubbed a streaky window or polished a porcelain appliance, you probably used a chemical called ammonia. 

Also known as ammonium hydroxide when mixed with water, ammonia is more than a common household cleaner. More than 170 million metric tons of it are produced globally every year, with most of it ending up as fertilizer for corn, cotton and soybeans. 

UIC researchers are scaling up a system for farmers to produce ammonia in their own backyards. The method, which uses renewable electricity and Earth’s natural resources, appears in the journal PNAS. 

“So many people around the world need food. Farmers need fertilizer to grow food faster,” said project lead Meenesh Singh, a chemical engineering professor at the UIC College of Engineering. “I hope our project can help provide on-demand fertilizers to farmers, people and communities facing food scarcity.”  

Ammonia’s main ingredients are nitrogen — the atmosphere’s most frequent flyer — and hydrogen. It’s usually produced by smashing the elements together under high temperatures and high pressure in what’s called the Haber-Bosch process.  

While muscular enough to meet the world’s growing ammonia demand, the Haber-Bosch process is energy-intensive and responsible for 1-3% of global carbon dioxide emissions. 

Singh wanted to reduce ammonia’s environmental impact, which means turning down the heat on hydrogen and nitrogen’s high-pressure union. Previously, he’d tried using lithium, but obtaining enough of the metal wasn’t feasible. 

This time, Singh tried cooling the reaction with a more abundant mineral: calcium, which binds with nitrogen to form calcium nitride. He combined the calcium nitride with hydrogen atoms to create ammonia without emitting any carbon dioxide.  

Unlike the Haber-Bosch process, this reaction can take place at room temperature. If nitrogen and hydrogen gas are in good supply, ethanol can maintain the production of ammonia. Singh said his “holy grail” is finding a way to start with water, not hydrogen gas, making do-it-yourself ammonia production even easier. 

Physically, this looks like a 1-square centimeter, lab-scale reactor that produces about 1 gram of ammonia per day — about the weight of a jellybean. It’s a proof-of-concept and not supposed to be a commercial-size operation yet, Singh said. 

“This method could enable distributed ammonia production in smaller-scale devices, reducing reliance on large, centralized plants.” 

Modest though it is, this model represents the most scaled-up version in the field so far, Singh said. And, like the crops it’s destined to service, it will grow. First to 100 square centimeters, and up and up to, eventually, a square meter. Currently, Singh’s team is scaling up the reactor in collaboration with General Ammonia, Co. to produce 11 pounds of ammonia per day. 

“Every step forward is a step toward wider industrial use,” Singh said. “We’re taking things one step at a time.” 

Additional UIC coauthors include Ishita Goyal, Hasiya Najmin Isa, Vamsi Vikram Gande and Rohit Chauhan.  

The scientists are partnering with the General Ammonia Co. to pilot and scale up their calcium-mediated ammonia synthesis process in the Chicago area. UIC’s Office of Technology Management has filed a patent for the process.

Written by Jenna Kurtzweil

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Journal

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2513960122 

Article Title

Stabilizing calcium nitride for efficient, long-term electrochemical ammonia synthesis

 

Many drug-use treatment providers in N.C. demand unpaid labor, limit access to evidence-based treatment

North Carolina State University

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A new study finds many organizations that provide residential drug- and alcohol-use services in North Carolina have mandated labor requirements. Organizations with labor requirements are less likely to provide recommended evidence-based treatment for opioid-use disorders and are more likely to operate without a state license for adult substance-use services.

“More than a third of residential substance-use service providers in the state require patients seeking treatment to engage in some form of labor,” says Jennifer Carroll, lead author of the study and an associate professor of anthropology at North Carolina State University. “Unpaid labor is not a legitimate form of treatment or recovery support in any setting. And we observed almost a third of the service providers mandated labor in a commercial enterprise that is owned and/or operated by the service provider.

“That’s problematic, in part, because there is no evidence that mandated labor is part of an effective treatment for substance-use disorders,” Carroll says. “What’s more, the safest, most effective, evidence-based treatment for opioid-use disorder is opioid agonist treatment – and the vast majority of the providers that require participants to perform labor also do not allow patients to access opioid agonist treatment.”

These research findings stem from a statewide study that assesses the services provided by residential substance-use disorder treatment providers in North Carolina.

For the study, researchers conducted a statewide inventory of residential substance-use service providers in North Carolina. The researchers then had “secret shoppers” pose as people seeking help for heroin addiction and call every organization that claimed to provide residential services for opioid-use disorder, with the goal of learning more about how the different programs operate. The researchers identified 94 providers. Twenty-eight providers could not be reached or declined to answer questions when contacted. The remaining 66 answered some or all of the questions from the researchers.

Of the 66 providers surveyed, 28 (42.4%) mandated unpaid labor, usually associated with low-wage employment (mowing lawns, working in retail stores, etc.). And 20 of those 28 organizations mandated labor in an agency-owned or -operated commercial enterprise. Providers imposing labor requirements were more likely to offer residential services at low or no cost, which improves access to services.

“However, these providers were also less likely to provide patients with access to the gold standard in evidence-based treatment for opioid use,” Carroll says. “And providers that required patients to work in agency-owned and -operated commercial enterprises were more likely to restrict eligibility to people who were physically able to perform manual labor, which limits access to services. Work without pay is exploitation regardless of the circumstances.”

State regulations do allow service providers that are licensed as “therapeutic communities” to mandate labor in agency-owned or agency-operated enterprises. However, the study found that the majority of providers who imposed labor mandates were faith-based and operating under an exemption in state law that allows faith-based residential service providers to operate without a state license for adult substance-use services.

“There is no evidence that work is a form of treatment,” Carroll says. “And our findings suggest many residential substance-use treatment providers in N.C. are not providing patients with evidence-based treatment and are instead having patients engage in unpaid labor. That’s not healthcare, and there is no evidence that it helps patients on the road to recovery. The fact that many of these providers don’t give patients access to opioid agonist treatment also increases their risk of overdose.

“These providers are often presented as places where people can go for help with substance-use disorders,” Carroll says. “And it is troubling that there is no evidence the services they are providing can actually help people.”

The paper, “‘If you’re willing to work…we can work with you’: Obligatory labor at residential substance use services providers in North Carolina,” is published open access in the journal Substance Use & Misuse. The paper was co-authored by Brandon Morrissey, a Ph.D. student at NC State; Sarah Dixon, a recent master’s graduate from NC State; Alejandra Salemi of Duke University; Bayla Ostrach of Boston University; Taleed El-Sabawi of Wayne State University; and Roxanne Saucier of Open Society Foundations.

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Journal

Substance Use & Misuse

DOI

10.1080/10826084.2025.2611422 

Method of Research

Survey

Subject of Research

People

Article Title

“If You’re Willing to Work…We Can Work With You”: Obligatory Labor at Residential Substance Use Services Providers in North Carolina

Article Publication Date

7-Jan-2026

 

Fire-safe all-solid-state batteries move closer to commercialization

KRISS develops a cost-cutting materials technology that reduces oxide-based solid electrolyte production costs by over 90%, enabling low-cost, large-scale manufacturing

National Research Council of Science & Technology

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image: 

▲ Research team behind the development of key materials technology for oxide-based solid electrolyte membranes

(From left) Dr. Baek Seung Wook, Principal Research Scientist, Emerging Material Metrology Group, KRISS; Choi Minseo, Student Researcher; Dr. Kim Hwa-Jung, Postdoctoral Researcher, KRISS; Professor Park Hyeokjun, Department of Materials Science and Engineering, Korea University

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Credit: Korea Research Institute of Standards and Science (KRISS)

The Korea Research Institute of Standards and Science (KRISS, President Lee Ho Seong) has developed a key materials technology that accelerates the commercialization of all-solid-state batteries (ASSBs)—next-generation batteries designed to intrinsically eliminate the risks of fire and explosion.

The Emerging Material Metrology Group at KRISS demonstrated ultra-dense, large-area solid electrolyte membranes by applying a method that coats solid electrolyte powders with multifunctional compounds, reducing production costs to one-tenth of conventional levels.

Lithium-ion secondary batteries, which are widely used in electric vehicles (EVs) and energy storage systems (ESS), rely on flammable liquid electrolytes, making them vulnerable to fires and explosions. Once ignited, such fires are particularly difficult to extinguish. In recent years, a series of incidents—including a fire at a government data center operated by the National Information Resources Service (NIRS) and explosions involving EV batteries—has further underscored the urgent need for safer lithium battery technologies.

All-solid-state batteries (ASSBs) replace liquid electrolytes with non-flammable solid electrolytes, fundamentally improving battery safety. Among them, oxide-based all-solid-state batteries have attracted significant attention as a promising next-generation solution due to their high energy density and the absence of risks associated with toxic gas release, which can occur in sulfide-based systems.

Oxide-based all-solid-state batteries primarily employ garnet-type solid electrolytes as their core materials. Garnet-type solid electrolytes exhibit high ionic conductivity and excellent chemical stability; however, due to their intrinsic material properties, the fabrication of high-performance electrolyte membranes requires a high-temperature sintering process, in which the powder is compacted at temperatures exceeding 1,000 °C.

A major challenge during this sintering process is the evaporation of lithium, a key constituent of the solid electrolyte membrane. Lithium loss compromises the structural stability of the electrolyte, making large-area fabrication difficult, and leads to significant degradation in material quality, including reduced ionic conductivity and increased interfacial resistance, due to changes in chemical composition.

To mitigate lithium evaporation, conventional approaches have relied on covering the electrolyte membrane with a large quantity of mother powder—a lithium-containing electrolyte material—during sintering. However, this method results in more than ten times the amount of mother powder being discarded compared to the actual electrolyte membrane produced, significantly increasing production costs and posing a major barrier to commercialization.

The research team fully addressed this challenge by developing a fabrication technique that thinly coats solid electrolyte powders with Li–Al–O–based (lithium–aluminum–oxide) multifunctional compounds.

The resulting surface coating layer supplies lithium during the sintering process while preventing lithium evaporation, and simultaneously enhances interparticle bonding through a soldering-like effect, thereby maximizing the densification of the electrolyte membrane.

Using this approach, the team achieved a record-high density exceeding 98.2% without employing any expensive mother powder, producing high-strength solid electrolyte membranes free from chemical and mechanical defects, with ionic conductivity improved by more than twofold compared to conventional materials.

In addition, the electronic conductivity of the solid electrolyte membrane was reduced by more than 20 times, significantly lowering the risk of internal current leakage and thereby enhancing both the efficiency and safety of all-solid-state batteries.

Notably, the research team successfully fabricated large-area solid electrolyte membranes with an area of 16 cm²—more than ten times larger than conventional laboratory-scale pellets—while achieving an exceptional yield of 99.9%.

Dr. Baek Seung-Wook, Principal Research Scientist of the Emerging Material Metrology Group at KRISS, stated,

“This achievement fully resolves long-standing materials and manufacturing challenges that have remained unsolved for more than two decades in garnet-type solid electrolyte research. By dramatically reducing production costs, our technology is expected to significantly accelerate the commercialization of oxide-based all-solid-state batteries and drive technological innovation in the energy storage systems (ESS) and electric vehicle markets.”

Dr. Kim Hwa-Jung, a Postdoctoral Researcher in the Emerging Material Metrology Group at KRISS, noted,

“At present, Korea relies entirely on imports for garnet-type solid electrolyte pellets, which cost more than USD 550 per unit for a diameter of just 1 cm. This technological breakthrough is expected to open the door to domestic production of high-value next-generation battery materials.”

This research was conducted in collaboration with Professor Park Hyeokjun’s team from the Department of Materials Science and Engineering at Korea University. The work was supported by the Ministry of Science and ICT and the National Research Foundation of Korea (NRF) under the Nano and Materials Technology Development Program, and was published in the January issue of Materials Today (Impact Factor: 22.0; JCR top 3.5%).

Schematic illustration of the high-performance, large-area solid electrolyte fabrication process developed by KRISS

Credit

Korea Research Institute of Standards and Science (KRISS)

Key performance evaluation results of solid electrolytes to which the KRISS-developed process technology was applied

Credit

Korea Research Institute of Standards and Science (KRISS)

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Journal

Materials Today

DOI

10.1016/j.mattod.2025.11.033 

Article Title

Revitalizing multifunctionality of Li-Al-O system enabling mother-powder-free sintering of garnet-type solid electrolytes