Reproductive Health最新文献

{"title":"Changes in the utilization of prenatal and delivery services in the United States prior to, during, and after the COVID-19 pandemic.","authors":"Hannah Silverstein, Larissa Jennings Mayo-Wilson, Anna Austin","doi":"10.1186/s12978-025-02084-0","DOIUrl":"https://doi.org/10.1186/s12978-025-02084-0","url":null,"abstract":"<p><strong>Background: </strong>Starting in March 2020, the COVID-19 pandemic strained the healthcare system in the United States, directly and indirectly changing the provision of many types of care, including maternity care. This paper describes longer-term changes in maternal health services utilization in the U.S. during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Using United States monthly aggregated birth record data from 2016 to 2023, we examined changes in the average number of prenatal visits (overall and by delivery pay type) and total births (overall, by pay type, and by birthplace) before, during, and after the pandemic. We estimated monthly time series models replicating pre-pandemic patterns from January 2016 to February 2020. We then extended those models to predict monthly levels of each outcome had COVID-19 not occurred from March 2020 through December 2023. We compared observed and predicted levels from March 2020 onward, assessing differences associated with COVID-19.</p><p><strong>Results: </strong>There were persistent and significantly lower-than-expected levels of average number of prenatal care visit across all COVID-19 months. There was also a temporary significant drop in total births during 2020 that recovered to expected levels in 2021, except for an increase in the total self-pay births in 2023. Patterns by pay type were similar to the overall patterns observed. Total non-hospital births were significantly higher than expected for the entirety of the pandemic, with large increases in intentional home births.</p><p><strong>Conclusion: </strong>Most initial changes to maternity care persisted throughout and continued after the pandemic, resulting in lower levels of prenatal care visits and higher numbers of home births. These findings show sustained changes to maternity care provision and access prompted by COVID-19, which highlight how vulnerable maternity services are to healthcare disruptions and suggest prolonged effects on equitable access to safe care.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"136"},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144744479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of paternal education on maternal and child health outcomes in Sub-Saharan Africa: evidence from demographic and health surveys.","authors":"Joshua Okyere, Demisu Zenbaba Hey, Sanni Yaya","doi":"10.1186/s12978-025-02086-y","DOIUrl":"https://doi.org/10.1186/s12978-025-02086-y","url":null,"abstract":"<p><strong>Background: </strong>Maternal and child health outcomes remain pressing challenges in Sub-Saharan Africa (SSA), characterized by persistently high under-five mortality and inadequate utilization of essential maternal healthcare services. While the impact of maternal education on these outcomes is well documented, the influence of paternal education remains underexplored. This study investigates the association between paternal education and maternal health service utilization, focusing on antenatal care (ANC) and skilled birth attendance (SBA), as well as child survival across 22 SSA countries.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using nationally representative data from Demographic and Health Surveys (DHS) administered between 2013 and 2024 in 22 SSA countries. The study sample included a weighted total of 109,818 children aged 0-59 months and their mothers. Key outcomes included maternal healthcare utilization (≥ 4 ANC visits and SBA) and child survival. Paternal education was classified into three categories: no education, primary education, and secondary or higher education. Logistic and ordered logistic regression models were employed, adjusting for maternal, child, household, and regional covariates.</p><p><strong>Results: </strong>Overall, 96.5% (95% CI: 96.4-96.6%) of children survived to age five, while 61.8% of mothers reported ≥ 4 ANC visits and 73.8% had skilled birth attendance. Higher paternal education was significantly associated with increased maternal healthcare utilization. Women whose partners had secondary or higher education were nearly twice as likely to attend ≥ 4 ANC visits (AOR: 1.99; 95% CI: 1.91-2.07) and more likely to access SBA (AOR: 1.60; 95% CI: 1.52-1.67) than those whose partners had no education. Marked regional and socioeconomic disparities persisted, with Southern SSA showing more favorable outcomes than Central and Eastern regions.</p><p><strong>Conclusion: </strong>Paternal education is strongly associated with improved maternal healthcare utilization, which is itself linked to enhanced child survival in SSA. Although no direct relationship was found between paternal education and child survival, these findings underscore the indirect but influential role fathers play in shaping health outcomes. Targeted strategies that promote male educational attainment and actively involve fathers in maternal and child health interventions-particularly in underserved regions-are essential for reducing health disparities and improving outcomes across the region.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"137"},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144744480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing equity in cervical cancer screening for sexual and gender minoritized people assigned female at birth (SGM AFAB) in the United States: recommendations from healthcare equity leaders.","authors":"Merrily E LeBlanc, Emmett C Line, Jennifer Potter, Roberta E Goldman, S Bryn Austin, Madina Agénor","doi":"10.1186/s12978-025-02082-2","DOIUrl":"https://doi.org/10.1186/s12978-025-02082-2","url":null,"abstract":"<p><strong>Background: </strong>Sexual and gender minoritized (SGM) people, including but not limited to lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people assigned female at birth (AFAB), experience a greater burden of cervical cancer relative to their heterosexual and cisgender counterparts. However, they face pronounced systemic barriers to regular cervical cancer screening. Although evidence-based clinical guidelines play an integral role in the implementation of preventive measures, existing United States (U.S.) cervical cancer screening guidelines do not consider the specific experiences, needs, and contexts of SGM AFAB people concerning cervical cancer outcomes nor cervical cancer screening. Thus, it is imperative to determine how cervical cancer screening guidelines can be revised to better address the unique and specific cervical cancer prevention needs of SGM AFAB people in the U.S.</p><p><strong>Methods: </strong>We conducted virtual key informant interviews to elicit recommendations for advancing SGM health equity in developing and implementing cervical cancer screening guidelines from healthcare equity leaders (N = 18), including half with expertise in SGM AFAB people's healthcare. Interviews were analyzed using a template-style thematic analysis approach to develop themes and sub-themes.</p><p><strong>Results: </strong>Healthcare equity leaders provided three key recommendations for advancing SGM health equity in the development and implementation of U.S. cervical cancer screening guidelines. Healthcare equity leaders recommended prioritizing community and person-centered strategies, including engaging SGM communities in the development of the guidelines and using SGM-affirming approaches in their implementation. Revising language that (re)produces harmful normative and exclusionary assumptions about gender and sexuality in the context of cervical cancer screening guidelines was also recommended. Lastly, leaders recommended a range of strategies to mitigate systemic barriers to cervical cancer screening among SGM AFAB people, including collecting and utilizing representative data on SGM AFAB people's needs, experiences, and contexts to develop the guidelines and ensure cultural responsiveness in the delivery of cervical cancer screening to SGM AFAB people across healthcare systems.</p><p><strong>Conclusion: </strong>This study's findings can contribute to improving and advancing health equity in cervical cancer screening for SGM AFAB populations through the community-centered development of inclusive, evidence-based guidelines and their person-centered implementation in clinical settings.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"135"},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144744478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial support during pregnancy: perceptions and expectations among pregnant teenagers in Ahvaz, Iran-a qualitative content analysis.","authors":"Setareh Yousefi, Simin Montazeri, Nahid Javadifar, Saeed Ghanbari","doi":"10.1186/s12978-025-02081-3","DOIUrl":"https://doi.org/10.1186/s12978-025-02081-3","url":null,"abstract":"<p><strong>Background: </strong>Teenage pregnancy remains a major global concern, with profound effects on young mothers and their families. Understanding the specific needs and expectations of pregnant adolescents regarding psychosocial support is crucial for developing effective interventions. This study explores how pregnant adolescents perceive and what they expect from psychosocial support during pregnancy.</p><p><strong>Methods: </strong>A qualitative study was conducted in Ahvaz, Iran, from 2023 to 2024. Participants were selected using purposive sampling to ensure maximum diversity and included pregnant adolescents, family members, and healthcare providers. Data were gathered through 30 semi-structured, in-depth interviews and analyzed using conventional qualitative content analysis with MAXQDA 2020 software. To enhance validity, member checking was employed, allowing participants to verify the accuracy of the interpretations. Reliability was ensured by applying a consistent coding framework across all interviews.</p><p><strong>Results: </strong>The analysis revealed three major themes: Challenges and Burdens- Participants reported societal stigma, emotional instability, limited family support, autonomy conflicts, and health issues, highlighting a disconnect between societal expectations and their lived realities. Positive Experiences and Adaptations- Despite challenges, many adolescents described resilience, the joy of motherhood, emotional bonding, personal growth, and improved spousal relationships. These experiences underscore the importance of strengths-based psychosocial support. Support and Intervention Needs- Participants emphasized the need for tailored education, active family involvement, and culturally sensitive healthcare to provide holistic care for pregnant adolescents.</p><p><strong>Conclusions: </strong>These findings highlight the urgent need for culturally tailored interventions that address the unique developmental and psychosocial needs of adolescent mothers. Effective strategies should include targeted education, accessible counseling, active family engagement, and specialized training for healthcare providers. Implementing a comprehensive, strengths-based support framework is essential to promote the well-being and resilience of this vulnerable population.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"134"},"PeriodicalIF":3.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Availability and readiness of health facilities in Burkina Faso to provide antenatal care: trend analysis from 2012 to 2020.","authors":"Marie-Jeanne Offosse, Kadari Cissé, Désiré Somda, Anna Gage, Annie Haakenstad, Aduragbemi Banke-Thomas","doi":"10.1186/s12978-025-02072-4","DOIUrl":"10.1186/s12978-025-02072-4","url":null,"abstract":"","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"133"},"PeriodicalIF":3.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does prolonged postpartum insusceptibility undercut the impact of postpartum family planning programming in Sub-Saharan Africa?","authors":"Sarah Eustis-Guthrie, Benjamin Williamson, Iqbal Shah","doi":"10.1186/s12978-025-02056-4","DOIUrl":"10.1186/s12978-025-02056-4","url":null,"abstract":"<p><p>Integrating family planning into postpartum care at health facilities is a well-regarded health intervention recommended by major organizations in the sexual and reproductive health space. However, several recent studies have found limited to no effects on rates of short-spaced pregnancies associated with these interventions. This paper will investigate the role of prolonged postpartum insusceptibility to pregnancy due to abstinence and breastfeeding alongside other factors in reducing the impact of increased postpartum contraceptive use, ultimately concluding that these factors may substantially reduce the efficacy of postpartum family planning programming at reducing unintended short-spaced pregnancies.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"132"},"PeriodicalIF":3.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with adolescent pregnancy in Nyarugenge and Burera districts, Rwanda.","authors":"Sandra Isano, Ziad El Khatib, Karl Blanchet","doi":"10.1186/s12978-025-02077-z","DOIUrl":"10.1186/s12978-025-02077-z","url":null,"abstract":"","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"131"},"PeriodicalIF":3.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"English- and Spanish-speaking U.S. adults' perceptions of the most common reasons for abortion: a study of open-ended data before and after Dobbs v. Jackson.","authors":"Lucrecia Mena-Meléndez, Xiana Bueno, Kyla M Cary, Nana Amma Asamoah, Brandon L Crawford, Ronna C Turner, Kristen N Jozkowski","doi":"10.1186/s12978-025-02039-5","DOIUrl":"10.1186/s12978-025-02039-5","url":null,"abstract":"<p><strong>Background: </strong>The 2022 Dobbs v. Jackson decision, which overturned Roe v. Wade, has given individual states more capacity to legislate abortion. State legislators have and continue to design and pass laws that restrict or ban abortion, often naming exceptions based on specific reasons (i.e., fetal health, woman's health, rape). Given that these reasons often do not align with those reported by abortion-seekers, it is crucial to assess whether the U.S. public accurately understands why people seek abortions. This study explored a sample of U.S. adults' perceptions of the three most common reasons why someone might get an abortion.</p><p><strong>Methods: </strong>We analyzed open-ended data from two waves of a 2022 longitudinal survey (n = 681 participants; n = 2,043 responses per wave; n = 4,086 total responses) collected before and after the Dobbs decision in English and Spanish via Ipsos's KnowledgePanel®. We explored three main research questions: (1) What does the U.S. public perceive to be the most common reasons for someone to seek abortion? (2) Are there differences in perceived reasons before and after the Dobbs v. Jackson decision? (3) Are there differences in perceived reasons across languages?</p><p><strong>Results: </strong>Findings indicated that people perceive the three most common reasons to seek abortion to be: unwanted/unplanned pregnancy reasons, violence-related reasons, and health reasons. After the Dobbs decision, there was an increase in respondents mentioning that people have abortions for health reasons and financial reasons, and a decrease in responses related to unwanted/unplanned pregnancy reasons, not ready/unprepared reasons, and partner-related reasons. Additionally, we found significant differences in perceptions between languages (i.e., English and Spanish). We also note discrepancies between perceived reasons among our sample and reasons reported by abortion patients in national studies.</p><p><strong>Conclusions: </strong>This study underscores the public's misconceptions of reasons for seeking abortion and the importance of correcting such misunderstandings to ensure alignment of public sentiment and legislative and judicial policy post-Dobbs.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"130"},"PeriodicalIF":3.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A global living systematic review and meta-analysis hub of emerging vaccines in pregnancy and childhood.","authors":"Agustín Ciapponi, Ariel Bardach, Mabel Berrueta, Jamile Ballivian, Martin Brizuela, Julieta Caravario, Noelia Castellana, Daniel Comande, Esteban Couto, Agustina Mazzoni, Vanesa Ortega, Edward P K Parker, Juan M Sambade, Salva Florencia, Juan Pablo Smutny, Katharina Stegelmann, Xu Xiong, Andy Stergachis, Flor M Munoz, Pierre Buekens","doi":"10.1186/s12978-025-02090-2","DOIUrl":"10.1186/s12978-025-02090-2","url":null,"abstract":"<p><p>The COVID-19 pandemic accelerated vaccine development and generated a rapidly evolving body of evidence before and after the vaccine rollout. We developed a robust online platform to efficiently synthesize this emerging information for current and future challenges. Expanding upon our interactive living systematic review-initially focused on COVID-19- we now include chikungunya and Lassa fever (with protocols presented in this issue), Mpox, and Disease X ( https://www.safeinpregnancy.org ). We aim to continuously monitor and periodically update and disseminate high-quality data on vaccine safety, efficacy, effectiveness, and immunogenicity in pregnancy and childhood. This platform computes real-time meta-analyses and features a visualization tool to present findings in a clear and accessible manner, supporting decision-making, vaccine development pipelines, and implementation strategies worldwide. It is also designed to integrate data on a hub of emerging vaccines in pregnancy and childhood and reflects a collaborative effort among multiple organizations.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"129"},"PeriodicalIF":3.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arabic speaking women's experience of postpartum contraceptive counselling in Sweden.","authors":"Sofia Berglundh, Khadija Abunnaja, Sibylle Herzig van Wees, Elin C Larsson, Helena Kilander","doi":"10.1186/s12978-025-02074-2","DOIUrl":"10.1186/s12978-025-02074-2","url":null,"abstract":"<p><strong>Background: </strong>Immigrant women living in Europe report lower use of contraceptives compared to native born women. The postpartum period is a key opportunity to provide high quality contraceptive counselling to support birth spacing, but little is known on how the counselling could be adapted to meet the needs and preferences of immigrant women. Approximately a third of all women giving birth in Sweden have an immigrant background, whereof Arabic speaking women constitutes one of the largest groups. Hence, the aim of this study was to explore Arabic speaking women's perspectives of contraceptive counselling postpartum.  METHOD: Five focus group discussions (FGDs) were conducted with 23 Arabic speaking women. The FGDs were conducted in Arabic and translated to English. Data was analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Four main themes were created: 1) Adapting to new circumstances influence reproductive intentions:raising children in a new setting was described as a double burden and birth spacing was seen as essential for the family's wellbeing. 2) Reproductive decision-making - the women's choice but partner's support is important: inviting the partner to the contraceptive counselling was thought to enhance both his knowledge of contraceptives and his understanding of the woman's entire life situation postpartum. 3) Conflicting information about contraceptives creates hesitancy: navigating opposing information on contraceptives from the woman's home country and midwives in Sweden was confusing and fears of negative side effects from contraceptives were deep-rooted. 4) Trust and mistrust in antenatal and postpartum contraceptive services: trust included experience of emotional support and an open-minded attitude from the midwife. Mistrust involved scarce support in handling side effects, limited decision support and a feeling of breached privacy.</p><p><strong>Conclusion: </strong>To provide person-centred and equitable contraceptive counselling postpartum, health care services need to shift attention from individual barriers to how the counselling can be improved. Key elements include integrating the concept of birth spacing in the postpartum contraceptive counselling, ensuring accessible follow-up services and to provide comprehensive information in the native language to support informed choices. An open-minded engagement with patients is also central to provide contraceptive counselling that is inclusive for all women.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"128"},"PeriodicalIF":3.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}