Reproductive Health最新文献

{"title":"Challenges and strategies in the multicultural sexual and reproductive healthcare encounter - a qualitative study on the perspectives of health professionals.","authors":"Mia Appelbäck, Aubry Seery Wredle, Ayanthi Wickramasinghe, Birgitta Essén, Aje Carlbom","doi":"10.1186/s12978-026-02471-1","DOIUrl":"10.1186/s12978-026-02471-1","url":null,"abstract":"<p><strong>Background: </strong>Sexual and reproductive health (SRH) in Sweden is shaped by strong equity and gender-equality ideals, yet migrant patients continue to experience disparities in SRH outcomes. Social, cultural, and structural factors can complicate clinical encounters, potentially posing obstacles to equitable access. This study explored how SRH professionals experience and manage challenges in multicultural clinical encounters.</p><p><strong>Methods: </strong>Thirty‑one SRH professionals (midwives, nurses, physicians, social workers, sexologists, and nursing assistants) from youth and women's health clinics in Skåne were interviewed using semi‑structured interviews. The material was analysed with inductive thematic analysis to identify recurring patterns of challenges and strategies in encounters with patients of foreign background.</p><p><strong>Results: </strong>Four interconnected themes were identified: (1) Navigating Structural Barriers in SRH Care; (2) Family Involvement, Power Dynamics and Autonomy; (3) Person-Centred Care Beyond Cultural Competence; and (4) Structural Opportunities and Constraints in Care. Providers described navigating individual preferences, family relationships, social and religious norms, and structural constraints. They reported using flexible, individualized strategies to support confidentiality, informed decision-making, patient autonomy, and access to care.</p><p><strong>Conclusions: </strong>SRH professionals described multicultural clinical encounters as shaped by intersecting individual, familial, social, and structural factors. Their accounts suggest that equitable SRH care should not rely on individual clinicians adapting to structural barriers. Institutional support for confidential communication, appropriate interpretation, patient-centred decision-making, protection from coercion, accessible health information, and privacy-sensitive digital systems is needed.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184087","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":"Parental-couple well-being and relationship stability four years following childbirth: a mixed-methods study.","authors":"Åsa Gamgam Leanderz, Margaretha Larsson, Maria Henricson, Stina Thorstensson, Caroline Bäckström","doi":"10.1186/s12978-026-02469-9","DOIUrl":"10.1186/s12978-026-02469-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore parents' well-being and relationship stability during pregnancy and four years following childbirth.</p><p><strong>Background: </strong>Becoming a parent is a life event that challenges the parental couple and influences their relationship and well-being.</p><p><strong>Methods: </strong>This mixed-methods exploratory cohort study included 381 parents, followed longitudinally from pregnancy Week 25 to four years postpartum. Data were analysed using the logistic regression of survey data, Kaplan‒Meier estimates and qualitative content analysis. Survey instruments measured sense of coherence (a construct reflecting comprehensibility, manageability and meaningfulness), perceived social support and dyadic relationship quality, referring to the primary relationship between two cohabiting, unrelated adults.</p><p><strong>Results: </strong>After four years, 94% of the parental couples remained in a stable relationship. Greater relationship stability was associated with higher levels of a sense of coherence, stronger perceived social support and higher dyadic relationship quality among both mothers and partners. By four years after childbirth (T6), almost six out of 10 parents (59%) reported that nothing negatively impacted their well-being, indicating a decrease in well-being among the remaining 41% of the parents. Parents experience multidimensional vulnerability in the parental-couple relationship, and their well-being was negatively affected by the unpredictability of everyday life.</p><p><strong>Conclusion: </strong>Parents' ability to maintain a sense of coherence, access and receive social support and maintain a high-quality couple relationship is associated with their relationship stability four years after childbirth.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168478","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":"\"Do not leave me behind and do not put me in your box\": family-planning access and care needs among women with migration histories in Berlin, Germany-a mixed-methods study.","authors":"Bahar Hassantabar, Gaotswake Patience Kovane, Nure Jannat Ara Riya, Namanou Ines Emma Woks, Modupe M Fasina, Jalid Sehouli, Julia Leinweber, Angel Phuti","doi":"10.1186/s12978-026-02450-6","DOIUrl":"10.1186/s12978-026-02450-6","url":null,"abstract":"<p><strong>Introduction: </strong>Family planning is a fundamental human right and contributes to several Sustainable Development Goals. Women who have migrated from low- and middle-income countries may encounter barriers to family planning and reproductive healthcare. This study examined access to family planning information and services and related care needs among first-generation women with migration histories in Berlin, Germany.</p><p><strong>Methods: </strong>We conducted a qualitatively driven, emergent sequential mixed-methods study with 29 first-generation women who had migrated from low- and middle-income countries to Berlin and accessed maternal or reproductive healthcare services within the preceding two years. Semi-structured interviews were conducted between 17 July and 12 November 2024, analyzed thematically, and mapped to the Education, Training, and Research (ETR) Health Equity Framework. Selected codes were organized in a participant-by-code matrix for descriptive cross-case comparison. Findings were integrated through cross-case comparison and conceptual-model development.</p><p><strong>Findings: </strong>Four care-need domains were identified: communication and information; continuity and affordability; respect and shared responsibility; and cultural and life-course responsiveness. Access was shaped through four pathways: Systems of Power, Psychological Pathways, Individual Pathways, and Relationships and Networks. Structural, linguistic, financial, psychological, and relational conditions constrained access, while individual agency, peer and community networks, and navigation support could facilitate it. Barriers and facilitators co-existed.</p><p><strong>Conclusion: </strong>Equitable family planning access requires more than formal service availability. Health systems should provide affordable, understandable, continuous, respectful, responsive care that supports informed choice and reproductive autonomy while reducing structural, linguistic, financial, and administrative barriers. Agency and community support should complement, not substitute for, health-system responsibility.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064248","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":"Sexual health after childbirth: a qualitative study of women's experiences.","authors":"Lisa Goldkuhl, Linda Åkeflo, Elin Wallner, Helen Elden","doi":"10.1186/s12978-026-02458-y","DOIUrl":"10.1186/s12978-026-02458-y","url":null,"abstract":"<p><strong>Background: </strong>Sexual health is a vital component of overall well-being but receives limited attention in postpartum care. This study aimed to explore how pregnancy and childbirth shape women's experiences of sexual health, and to identify how care and support can be tailored to promote sexual well-being after childbirth.</p><p><strong>Methods: </strong>We conducted an inductive qualitative study based on individual interviews with twenty women who had given birth in Sweden within the previous two years. Data were analysed using Braun and Clarke's reflexive thematic analysis. The resulting themes were subsequently interpreted through Sara Ahmed's queer phenomenology.</p><p><strong>Findings: </strong>One overarching theme, Reorienting to sexual health after childbirth, described how participants viewed their sexual health as a process of adapting to physical, emotional, and relational changes rather than returning to pre-pregnancy experiences. Four sub-themes were identified: (1) Reviving desire in a changed body (2), Living with the impact of the childbirth experience (3), Balancing parental and sexual identity, and (4) Navigating postpartum sexual health without support. Participants generally perceived healthcare support after childbirth as inadequate, as it reinforced this narrow framing through a focus on contraceptive counselling and readiness for intercourse rather than sexual health more broadly. Drawing on queer phenomenology, healthcare support appeared to be shaped by heteronormative assumptions, while women re-oriented their sexual health after childbirth both within and beyond heteronormative sexual norms.</p><p><strong>Conclusion: </strong>Postpartum sexual health should be addressed as a broader aspect of well-being rather than being reduced to contraceptive needs or the resumption of intercourse. Care should be individualised, acknowledge variations in desire and intimacy, and ensure that persistent symptoms and concerns receive appropriate assessment and support.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040428","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":"Gender and Contraception in Kenya: a Scoping Review.","authors":"Simran Suri, Sarah Milton","doi":"10.1186/s12978-026-02443-5","DOIUrl":"10.1186/s12978-026-02443-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Access to the full range of contraceptive methods is a core component of sexual and reproductive health. While Kenya had one of the highest rates of contraceptive use compared to other countries on the African continent, studies since 2015 have shown prevalence of use has fallen; contraceptive usage rates are estimated at 38.7%, significantly lower than Kenya's target of 62% and in a context of high rates of unsafe abortions and high maternal mortality. This scoping review investigates the role of gender norms in determining patterns of contraceptive usage among women of childbearing age in Kenya.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A PRISMA-ScR approach was employed, involving a keyword search of population, concept and context using ProQuest. The 307 search results were iteratively screened using specific eligibility criteria, and rigorous JBI checklist critical appraisal was conducted. Data relevant to the aim was extracted, synthesised and distilled, ensuring comprehensive, rigorous and reproducible scoping of a final 16 papers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Studies showed that heteronormative and gendered norms influenced contraceptive use, unmet need and discontinuation, at social, societal and structural levels. Heterosexual male partner preferences largely shaped women's contraceptive decisions, with disapproval or intimate/gender-based violence triggering covert usage facilitated by injectable methods. Networks, involving friends, kin and healthcare providers modulated perceived gender norms, and therefore contraceptive decisions. Stigmatisation against adolescents' and premarital sexuality was identified as an important barrier to contraceptive use, as well as perceived marital duties of coitus and childbearing. As expected, female education, employment and wealth were structural determinants shaping access and understanding of contraception. The evidence base was largely concentrated in Western Kenya.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This review presents a comprehensive account of the influence of gender norms on contraceptive usage patterns, though addressing sociocultural norms is complex. Public health interventions can improve contraceptive counselling by providers, involve males due to their decision-making dominance, and improve service accessibility by integrating HIV, contraceptive and domestic violence services. Wider structural factors surrounding education, employment and subsequent socioeconomic mobility for women will always shape the success of interventions. Further research could identify how this varies by region or demographic. Women's access to contraception is an important health issue. Kenya aims for 62% of reproductive-age women to use contraception and had high rates of contraceptive use compared to other African countries. However, since 2015, contraceptive use fell well below that target, while rates of unsafe abortions and maternal deaths remain high. This review summarises wom","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081977","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":"Healthcare systems' readiness to address gender-based violence during COVID-19 and beyond in Pakistan: a mixed methods study.","authors":"Rozina Karmaliani, Arusa Lakhani, Laila Ladak, Marina Baig, Yasmin Parpio, Salima Somani, Gabriela Garcia Camacho, Armando Seuc, Moazzam Ali","doi":"10.1186/s12978-026-02356-3","DOIUrl":"https://doi.org/10.1186/s12978-026-02356-3","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has exacerbated gender-based physical, financial, sexual, and psychological harm on a global scale, resulting in a surge of gender-based violence incidents. Consequently, there has been an increased demand for Sexual Reproductive Health Services (SRHS) in response to the pandemic. This study aims to comprehend the impact of COVID-19 on contraception, comprehensive abortion care, sexually transmitted infections (STIs) prevention and treatment, and Gender-based violence (GBV) support at both sub-national and facility levels.</p><p><strong>Methodology: </strong>An explanatory sequential mixed-methods study was conducted from October 2021 to September 2022 across 9 public and private healthcare facilities in Sindh, Pakistan. Quantitative data were collected from 250 participants (156 women and 94 partners), and facility readiness assessments were conducted using WHO-adapted Service Availability and Readiness Assessment tools. Qualitative in-depth interviews were subsequently conducted with purposively selected women, partners, and 33 healthcare providers until thematic saturation was achieved. Quantitative and qualitative findings were integrated during analysis and interpretation.</p><p><strong>Results: </strong>Only 33.3% (3/9) of facilities routinely screened for domestic violence, 11.1% (1/9) provided referral linkages to external GBV support services, and 11.1% (1/9) had healthcare providers trained in GBV response within the preceding six months. Health Management Information Systems documented GBV cases in only 11.1% (1/9) of facilities. Qualitative findings indicated increased violence during the pandemic, driven by economic stress, unemployment, and restricted mobility, while sociocultural stigma, lack of trained personnel, and weak referral systems limited service utilization.</p><p><strong>Conclusion: </strong>The study identified notable deficiencies in healthcare facilities' preparedness to address instances of violence against women. These deficiencies encompassed the absence of national guidelines, limited resources, inadequate identification methods, scarce referral services, and insufficient privacy measures. Moreover, a lack of training for healthcare practitioners jeopardizes their capacity to provide adequate care and support to GBV victims and survivors.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 Suppl 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797442","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":"Global prevalence of multimorbidity during pregnancy: a systematic review and meta-analysis.","authors":"Lena Elise Wessing, Shrouq Daraiseh, Yasmin Semmane, Adamantia Styliani Chassioti, Adhithi Sreenivasan, Veronika Tirado, Emily White Johansson, Renee Gardner, Sibylle Herzig van Wees, Claudia Hanson, Sunjuri Sun","doi":"10.1186/s12978-026-02424-8","DOIUrl":"10.1186/s12978-026-02424-8","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity, defined as having two or more coexisting physical or mental health conditions, increases the risk of complications and need of specialist care during pregnancy. In women of reproductive age, pregnancy represents a critical period during which multimorbidity may manifest or be exacerbated. Multimorbidity during pregnancy has been associated with a wide range of adverse maternal and neonatal outcomes. This systematic review aims to estimate the global and regional prevalences of multimorbidity during pregnancy, as well as to understand how multimorbidity is defined across studies.</p><p><strong>Methods: </strong>We systematically searched four databases (Medline, Embase, CINAHL and Web of Science) for observational studies published from January 1, 2015, to September 26, 2025, without language or geographic restrictions. The protocol was registered in the PROSPERO database (CRD420251153876). We included peer-reviewed cross-sectional and cohort studies including ≥ 200 pregnant women, reporting the prevalence of multimorbidity. Data screening, extraction and quality assessment were conducted independently by two reviewers following PRISMA 2020 and Joanna Briggs Institute guidelines. Pooled prevalence was estimated via random-effects meta-analysis, and explored through predefined subgroup analyses.</p><p><strong>Results: </strong>The literature search retrieved 6,243 studies, and after title/abstract and full-text screening, 18 observational studies across eight countries were included in the review. The pooled prevalence of multimorbidity during pregnancy was 7.18% (95% CI: 3.31-14.89, I2 = 100.0%), with regional differences: 1.74% (95% CI: 0.46-6.37, I2 = 99.98%) in Asia, 9.07% (95% CI: 3.01-24.30, I2 = 100.0%) in North America, 11.17% (95% CI: 1.22-56.18, I2 = 99.94%) in Oceania and 12.64% (95% CI: 3.41-37.24, I2 = 99.99%) in Europe. However, the wide confidence intervals for Europe and Oceania warrant cautious interpretation of regional comparisons.</p><p><strong>Conclusion: </strong>Multimorbidity during pregnancy is a significant and under-researched global health concern. The pooled prevalence of 7.18% reflects a synthesis of highly heterogeneous studies and should not be interpreted as a definitive estimate of the global burden. More standardized research, particularly in low- and middle-income countries, is needed to generate more representative prevalence estimates.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607206","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":"Association of serum uric acid during pre-pregnancy with adverse pregnancy outcomes among women conceived by in-vitro fertilization: a retrospective cohort study.","authors":"Kexin Lan, Shaohua Yin, Yang Wang, Rong Li, Yangyu Zhao, Yuan Wei, Shaomin Chen, Zhaoping Li","doi":"10.1186/s12978-026-02406-w","DOIUrl":"https://doi.org/10.1186/s12978-026-02406-w","url":null,"abstract":"<p><strong>Background: </strong>Maternal serum uric acid (UA) levels have been linked to adverse pregnancy outcomes, but no studies have yet examined this association in women undergoing assisted reproductive technology. This study aimed to investigate the relationship between pre-pregnancy UA levels and adverse pregnancy outcomes in women conceived via in vitro fertilization and embryo transfer (IVF-ET).</p><p><strong>Methods: </strong>This retrospective cohort study included 2 111 singleton pregnancies conceived via IVF-ET, delivered at Peking University Third Hospital between 1 January 2017 and 30 April 2022. Restricted cubic splines were used to test nonlinear relationships between serum UA during pre-pregnancy and adverse outcomes, and multivariable logistic regression to calculate odds ratio (OR) and 95% confidence interval (CI).</p><p><strong>Results: </strong>Of the 2 111 women, no significant associations were found between pre-pregnancy UA levels and preeclampsia, preterm birth, or macrosomia. However, a J-shaped relationship was observed for gestational diabetes mellitus (GDM) and low birth weight (LBW), and an inverse U-shaped relationship for gestational hypertension (GH). Reflecting these distinct non-linear topologies, statistically significant peak risks were observed and reported at different strata: women in the higher quintile (4th quintile) of UA had a 3.20-fold increased risk of GH (adjusted OR 3.20, 95% CI 1.23, 8.33) and a 1.38-fold increased risk of GDM (adjusted OR 1.38, 95% CI 1.01, 1.88) compared with the lowest quintile. Conversely, the risk of LBW accelerated sharply and peaked at the highest quintile (5th quintile) (adjusted OR 1.98, 95% CI 1.11, 3.54). In the subgroup analysis, the positive association between pre-pregnancy UA and LBW was more pronounced among patients with day 5 embryo transfer.</p><p><strong>Conclusions: </strong>These findings suggest that optimizing serum UA levels in women planning pregnancy, particularly those undergoing IVF-ET, may have important clinical implications for improving pregnancy outcomes.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228553","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":"Women's empowerment and remaining within ideal family size in the East African Community.","authors":"Ange Chanelle Akimana, Zoran Bukumiric, Didace Kana, Dejana Vukovic","doi":"10.1186/s12978-026-02412-y","DOIUrl":"10.1186/s12978-026-02412-y","url":null,"abstract":"<p><strong>Background: </strong>One in every 27 people worldwide belongs to the East African Community, a region with shared cultural traits and free movement. Despite recent declines, the fertility rates in this Community remain high. This study assesses the link between women's empowerment and remaining within the woman's ideal family size, considering the women's perceptions of their husbands' desired family size.</p><p><strong>Methods: </strong>This study used Demographic and Health Survey datasets of Burundi (2015-2016), The Democratic Republic of the Congo (2013-2014), Kenya (2022), Rwanda (2019), Tanzania (2022), and Uganda (2016). A total of 5855 married or cohabiting women aged 35-49 who perceive that their husband wants more children than they do were included in this study. IBM SPSS Statistics 24 (SPSS: Statistical Package for the Social Sciences) was employed for data analysis. The Survey-based Women's empowerment (SWPER) index, across its three domains (attitude toward violence, social independence, and decision-making) was adopted to evaluate empowerment levels. Binary logistic regression was implemented to examine the association between the domains and the outcome variable, which indicates whether a woman has remained within her ideal number of children. Additionally, the link between potential confounders and the outcome variable was assessed. Univariable and multivariable models including country fixed effects were estimated. Sensitivity analyses excluded women below their ideal number. Variables showing p-values < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Overall, 63.3% of women were within their stated ideal number. Most women had medium levels of empowerment across all the index domains. Empowerment in the domains of social independence and decision-making was significantly associated with remaining within the woman's goal (Adjusted Odds Ratios: 1.41 (95% CI 1.28-1.56) and 0.80 (95% CI 0.72-0.89), respectively). From control variables, woman's age, household size, and ability to read a sentence showed significant association with the outcome. Only social independence was positively linked to the outcome. Attitude toward violence showed no significant association with the dependent variable in the univariable model.</p><p><strong>Conclusions: </strong>In settings where gender power imbalances may persist, strengthening women's autonomy and their reproductive health agency with a focus on factors that promote social independence empowerment is needed in the East African Community.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224813","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":"Postpartum contraception receipt among Oregon Medicaid-funded births with stimulant and substance use disorder.","authors":"Stephan R Lindner, Menolly Kaufman, Ann Martinez Acevedo, Deborah J Cohen","doi":"10.1186/s12978-026-02420-y","DOIUrl":"https://doi.org/10.1186/s12978-026-02420-y","url":null,"abstract":"<p><strong>Objective: </strong>To compare postpartum contraceptive receipt among (i) Medicaid beneficiaries with stimulant-related substance use disorder (SUD) to those without SUD; and (ii) Medicaid beneficiaries with other SUD to those without SUD.</p><p><strong>Methods: </strong>This was a retrospective cohort study of birthing events using Oregon's linked Medicaid claims and vital statistics data 2012-2019 (N = 141,479). We described demographic characteristics, birth outcomes, and substances used, and compared rates of contraception receipt (i) immediately postpartum (IPP), (ii) within 60 days postpartum excluding IPP, and (iii) within 60 days postpartum including IPP.</p><p><strong>Results: </strong>Prevalence of stimulant-related and other SUD diagnosis was 3.8% and 9.4%, respectively. After adjusting for demographic and clinical factors, contraception receipt within 60 days postpartum including IPP and contraception receipt IPP were greater for birth events with a stimulant-related SUD compared to birth events without SUD (adjusted relative risk [aRR], 60-days postpartum including IPP: 1.12, 95% CI: 1.07-1.17; aRR, IPP: 1.32, 95% CI: 1.24-1.40). Adjusted rates of contraception receipt were also elevated for birth events with other SUD compared to birth events with no SUD (aRR, 60-days postpartum including IPP: 1.12, 95% CI: 1.09-1.15; aRR, IPP: 1.21, 95% CI: 1.16-1.26; aRR, 60-days postpartum excluding IPP: 1.09, 95% CI: 1.06-1.13).</p><p><strong>Conclusions: </strong>Birthing people enrolled in Medicaid who misused stimulants were more likely than those without SUD, controlling for relevant factors, to receive postpartum contraception within 60 days due to elevated contraception receipt during the IPP period. Further research may examine whether these findings can be replicated outside of Oregon.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228563","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}