Reproductive Health最新文献

{"title":"Services availability and readiness assessment of adolescent sexual and reproductive health in primary healthcare facilities: evidence from selected districts in Ghana.","authors":"Michel Adurayi Amenah, Jacob Novignon, Ama Pokuaa Fenny, Irene A Agyepong, Tim Ensor","doi":"10.1186/s12978-025-01955-w","DOIUrl":"10.1186/s12978-025-01955-w","url":null,"abstract":"<p><strong>Background: </strong>Globally, adolescent health remains a public health priority given that adolescents often face unique vulnerabilities to health issues like mental disorders, substance abuse, and sexual health risks. In developing countries like Ghana, primary healthcare facilities (PHCs) are often the first point of contact for addressing these issues. However, there is a lack of literature examining the capacity of PHCs to address adolescent sexual and reproductive health (ASRH) issues. This study aims to fill this gap in the literature by assessing the availability and readiness of ASRH services within Ghana's PHCs.</p><p><strong>Methods: </strong>The study utilized a multi-stage sampling approach to select 67 PHCs across four districts in the Greater Accra region, reflecting Ghana's broad demographic diversity. We employed the WHO's Services Availability and Readiness Assessment (SARA) tool to measure the availability and readiness of ASRH services. This framework focused on key domains including service availability and readiness, assessing aspects such as HIV testing, family planning, and availability of contraceptives and necessary staff training. Data analysis was conducted using Stata version 17.0, analysing frequencies and percentages to capture the extent of service provision across the selected facilities.</p><p><strong>Results: </strong>The study highlighted significant disparities in the availability and readiness of essential ASRH services (HIV services, family planning, contraceptive pills, IUCD provisions, and male condoms) across selected districts and facility types. In Shai Osudoku, 65% of facilities offered a full range of selected ASRH services, the highest among the districts, whereas Ningo Prampram had the lowest at just 16%. In terms of facility types, 57% of CHPS facilities, 59% of health centres, and 44% of clinics provided all the selected ASRH services. Urban areas reported a 51% provision rate of these services, slightly less than the 54% observed in rural areas. Additionally, readiness disparities were evident: only 21% of urban facilities had adequate service guidelines compared to 29% in rural areas, and a higher percentage of rural facilities (46%) had trained staff, compared to 23% in urban areas.</p><p><strong>Conclusion: </strong>This study examined the availability and readiness of ASRH services in PHCs across the Greater Accra region, revealing significant disparities by location and facility type. Particularly, rural and public facilities demonstrated a higher availability of ASRH services compared to urban and private facilities. These findings suggest an uneven distribution of resources and highlight a potential urban underutilization of public health services. Moreover, the study identified a critical lack of service guidelines and trained staff across many facilities, emphasizing the need for enhanced training and resource allocation to improve service readiness. Targeted interventions ar","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"14"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075311","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":"Knowledge of Ghana's liberal abortion law and use of modern contraceptives among women of reproductive age.","authors":"Maxwell Tii Kumbeni, Jeff Luck, S Marie Harvey","doi":"10.1186/s12978-025-01957-8","DOIUrl":"10.1186/s12978-025-01957-8","url":null,"abstract":"<p><strong>Background: </strong>Modern contraceptives have been widely promoted as an effective tool for birth control. They are highly effective for preventing unintended pregnancies thereby reducing the risk of abortions, maternal morbidities, and mortalities. Abortion or planned abstinence from sexual intercourse may be perceived as alternatives to the use of modern contraceptives. The aim of this study was to assess whether knowledge of the legal status of abortion, and knowledge of the monthly fertile period, were associated with the use of modern contraceptives among women of reproductive age in Ghana.</p><p><strong>Methods: </strong>We used nationally representative secondary data from the 2017 Ghana Maternal Health Survey. A weighted sample of 23,466 non-pregnant women aged 15-49 years were included in the study. Pearson chi-square and multivariable logistic regression analysis were conducted to assess the association between the independent and the outcomes variables. Sampling weight, cluster, and strata were applied at all levels of the analysis.</p><p><strong>Results: </strong>More than half (55.4%) lived in urban area, 80.1% were 20 years or older, 52.2% were multiparous women, 61.9% had secondary or higher education, and 34.5% were in the lower two wealth quintiles. We found no statistically significant association between knowledge of the legal status of abortion and use of modern contraceptives, or between knowledge of the monthly fertile period and use of modern contraceptives. Women with history of an induced abortion were 1.57 times as likely to use modern contraceptives compared to those with no history [adjusted odds ratio (aOR) 1.57, 95% CI 1.41-1.75]. Each additional increase in knowledge of a different modern contraceptive method was associated with 1.25 times increase in modern contraceptive use (aOR 1.25, 95% CI 1.22-1.29).</p><p><strong>Conclusions: </strong>Intensifying education on modern contraceptive methods and use, especially at abortion facilities, may help improve the uptake of modern contraceptives among women in Ghana.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"15"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075307","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":"Folic acid supplementation in European women of reproductive age and during pregnancy with excessive weight: a systematic review.","authors":"Federica Loperfido, Francesca Sottotetti, Irene Bianco, Dana El Masri, Beatrice Maccarini, Chiara Ferrara, Antonio Limitone, Hellas Cena, Rachele De Giuseppe","doi":"10.1186/s12978-025-01953-y","DOIUrl":"10.1186/s12978-025-01953-y","url":null,"abstract":"<p><strong>Objective: </strong>Neural tube defects (NTDs), well-known consequences of folate deficiency, are the second most common cause of serious birth defects, affecting approximately one in a thousand pregnancies in Europe. Maternal folate deficiency before conception and during early pregnancy has been suggested as the most important preventable risk factor for NTDs; thus women should be supplemented before conception with 0.4 mg of folic acid (FA) until the first trimester of gestation. Findings have described a positive association between elevated Body Mass Index (BMI) and birth defect risk; data on plasma folate levels in pregnant women with obesity have shown values lower than recommended because of a state of chronic low-grade inflammation, resulting in increased metabolic demands. Nowadays, disparities exist regarding the recommended dose of FA in women at risk, including women of childbearing age with excessive weight. Therefore, this systematic review aimed to investigate if European childbearing age/pregnant women with overweight/obesity are supplemented according to the current country-specific FA recommendations and whether the dosage of 5 mg recommended for pregnant women with obesity is effective in preventing NTDs.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. An electronic database search of manuscripts was carried out in Web of Sciences, PubMed and Medline. The quality of the included studies was assessed by using the Quality Assessment for Diverse Studies statement.</p><p><strong>Results: </strong>Out of 1718 records identified, 8 manuscripts met all the inclusion criteria. Overall, the results showed that pregnant women with obesity adherent to FA recommendations ranged between 4% and 9.5%. Furthermore, the majority (61%) started the supplementation after conception, highlighting that European pregnant women are not particularly adherent to recommendations during the period of greatest need.</p><p><strong>Conclusions: </strong>The scarce adherence to the current guidelines shows an urgent need to standardize the recommendations across European countries. Particularly, women of childbearing age with excess weight should be monitored assessing serum folate, RBC folate, and homocysteine levels developing tailored supplementation protocols, to counteract the occurrence of NTDs.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"13"},"PeriodicalIF":3.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075255","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":"Reproductive health literacy scale: a tool to measure the effectiveness of health literacy training.","authors":"Maha Rauf, Zahra Goliaei, Lana Machta, Jenny Chang, Heike Thiel de Bocanegra","doi":"10.1186/s12978-025-01959-6","DOIUrl":"10.1186/s12978-025-01959-6","url":null,"abstract":"<p><strong>Background: </strong>Refugee women's reproductive health (RH) outcomes have been impacted by several factors, including experiencing war, lack of access to healthcare, and possible gender-based violence. After resettlement, low health literacy, financial difficulties, cultural and linguistic barriers, and unfamiliarity with the healthcare system also add to the preexisting barriers. Although several efforts have focused on health education and improving health literacy among refugee women, there has not been a validated tool to measure the effectiveness of these trainings and their possible impact. This study aims to adapt a culturally and linguistically appropriate survey that helps address this gap.</p><p><strong>Methods: </strong>We conducted a literature review to identify the existing tools and identified possible domains and items supporting RH literacy measures. The identified items were collected and adapted as a single scale with three domains: (a) general health literacy, measured with HLS-EU-Q6, (b) digital health literacy, measured with eHEALS, and (c) reproductive health literacy, measured through a composite of the Cervical Cancer Literacy Assessment Tool (C-CLAT) and the Refugee Reproductive Health Network (ReproNet) postpartum literacy scale. After content validity and face validity of the adapted scale, it was translated into Dari, Arabic, and Pashto and was administered to participants of RH literacy training sessions.</p><p><strong>Results: </strong>A total of 67 Dari, 53 Arabic, and 64 Pashto-speaking refugee women completed the survey. The mean scores obtained between the three language groups were similar in the domains of digital health literacy and reproductive health literacy (p > 0.05), whereas the scores for general health literacy were not (p > 0.05). The inter-item reliability score for the domains of general health literacy, digital health literacy and RH literacy across all three language groups was above α = 0.7.</p><p><strong>Conclusion: </strong>This scale addresses the need for validated tools to measure reproductive health literacy. It has the promise to provide a tool for assessing the effectiveness of health interventions on health literacy. Future applications can utilize this scale to investigate the differences in health literacy in refugee populations speaking Dari, Pashto, and Arabic.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"12"},"PeriodicalIF":3.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067467","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":"Examining the associations between social support and postpartum depression symptoms among adolescent mothers in Nairobi, Kenya.","authors":"Luwam T Gebrekristos, Anthony Idowu Ajayi, Allison K Groves, Caroline W Kabiru","doi":"10.1186/s12978-025-01943-0","DOIUrl":"10.1186/s12978-025-01943-0","url":null,"abstract":"<p><strong>Background: </strong>Globally, adolescent mothers are at increased risk for postpartum depression (PPD). In Kenya, 15% of adolescent girls become mothers before the age of 18. While social support can buffer a mother's risk of PPD, there are gaps in knowledge as to whether-and which types-of social support are protective for adolescent mothers in Kenya. Understanding the associations between support and postpartum depression symptoms among adolescent mothers can inform mental health interventions.</p><p><strong>Methods: </strong>Cross-sectional data of adolescent mothers ≤ 1 year postpartum (aged 14-19 years old) in an informal settlement in Nairobi, Kenya (N = 193) were used in analyses. Participants with scores ≥ 10 on the Patient Health Questionnaire-9 were classified as having postpartum depressive symptoms. To fully examine the different ways that social support might matter for adolescent mothers, we examined several domains of social support: child's father support during pregnancy, parental support during pregnancy, parental support of girl's education, membership in a social club, having a good female friend and having a supportive female adult one can turn to for help. We used bivariate and adjusted modified Poisson regression with robust standard errors to examine the associations between support measures and depressive symptoms, controlling for relevant covariates.</p><p><strong>Results: </strong>One-quarter of participants experienced postpartum depressive symptoms (24.9%). Adolescent mothers who reported their mothers or their fathers as being very supportive of girls' education had a lower risk of depressive symptoms (ARR 0.35, 95% CI 0.20-0.61; ARR:0.34, 95% CI 0.13-0.90, respectively) than those whose mothers or fathers were less supportive. Adolescent mothers who had a good female friend to confide in had decreased risk of depressive symptoms (ARR 0.61; 95% CI 0.37-0.99).</p><p><strong>Conclusions: </strong>Having a mother or father being very supportive of girls' education and having a good female friend reduced risk of depressive symptoms. With the unique challenges of early childbearing and high adolescent birth rates in Kenya, interventions which increase parental and peer support during pregnancy and the postpartum period could improve adolescent mothers' mental health.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"11"},"PeriodicalIF":3.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067475","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":"Correlations among hope, fertility quality of life and negative emotions for couples undergoing their first in vitro fertilization-embryo transfer: a cross-sectional analysis.","authors":"Hui Ye, Jing Zhao, Yujie Zou, Xiaorun Song, Mi Xu, Yu Zhang, Lili Zhang, Gaohua Wang","doi":"10.1186/s12978-025-01954-x","DOIUrl":"10.1186/s12978-025-01954-x","url":null,"abstract":"<p><strong>Background: </strong>The global incidence of infertility is increasing, and infertility has become an important medical and social issue. With the widespread application of in vitro fertilization-embryo transfer (IVF-ET) technology, the mental health problems of patients undergoing this treatment have gradually attracted widespread attention. The purpose of this study was to explore the relationships among the level of hope, the fertility quality of life and negative emotions of patients who underwent IVF-ET treatment for the first time to provide a scientific basis for subsequent psychological support interventions.</p><p><strong>Methods: </strong>This study was a cross-sectional survey conducted at the Reproductive Medicine Center of Renmin Hospital of Wuhan University. From February 2023 to October 2023, 1425 patients who received IVF-ET treatment for the first time participated in the questionnaire survey. The survey content included the General Information Questionnaire, the Fertility Quality of Life (FertiQoL) Questionnaire, and the Herth Hope Index (HHI). Pearson correlation analysis was used to examine the relationships among the level of hope, fertility quality of life, and negative emotions.</p><p><strong>Results: </strong>The survey included 805 women and 620 men representing 603 couples. The level of hope in patients undergoing IVF-ET treatment for the first time was positively correlated with fertility quality of life (r = 0.247, P < 0.01), and the level of hope was negatively correlated with negative emotions (stress: r = - 0.135, P < 0.01; anxiety: r = - 0.105, P < 0.01; depression: r = - 0.189, P < 0.01). Fertility quality of life was negatively correlated with negative emotions (stress: r = - 0.609, P < 0.01; anxiety: r = - 0.533, P < 0.01; depression: r = - 0.591, P < 0.01). Among couples undergoing IVF-ET treatment for the first time, the husband's level of hope (r = 0.131, P < 0.01), fertility quality of life (r = 0.372, P < 0.01), and negative emotions (stress: r = 0.181, P < 0.01; anxiety: r = 0.163, P < 0.01; depression: r = 0.210, P < 0.01) were positively correlated with those of his wife.</p><p><strong>Conclusions: </strong>In patients undergoing their first IVF-ET treatment, there is a significant correlation among hope, fertility quality of life, and negative emotions. Moreover, within couples, the levels of hope, fertility quality of life, and negative emotions of husbands and wives mutually influence each other. Enhancing the level of hope in this population is conducive to alleviating negative emotions and improving their fertility quality of life. The mutual influence of spouses should not be overlooked in clinical practice, and psychological support for both partners should be emphasized.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"10"},"PeriodicalIF":3.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060595","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":"Trends and contributors of complete continuum of maternal healthcare service utilization in Ethiopia: a multivariate decomposition analyses.","authors":"Ayal Debie, Molla M Wassie, Claire T Roberts, Murthy N Mittinty, Annabelle Wilson, Jacqueline H Stephens","doi":"10.1186/s12978-025-01945-y","DOIUrl":"10.1186/s12978-025-01945-y","url":null,"abstract":"<p><strong>Background: </strong>Most maternal deaths are preventable by accessing essential maternity healthcare services. However, maternal mortality rates remain high in Ethiopia partly due to only a few women using a complete Continuum of Maternal Healthcare Services (CMHS). This study aims to assess trends and contributors for complete CMHS utilization in Ethiopia.</p><p><strong>Methods: </strong>Ethiopian Demography and Health Survey (EDHS) 2011-2019 data were used to assess the trends of complete CMHS utilization. A total weighted sample of 10,768 women (3333 in 2011, 4590 in 2016, and 2845 in 2019) were included in the analysis. A logit-based multivariate decomposition analysis was undertaken to assess the change in the proportion of complete CMHS utilization and its contributors between 2011 and 2019.</p><p><strong>Results: </strong>In Ethiopia, trends of complete CMHS utilization among women increased from 9.6% (95% CI 8.4, 10.9) in 2011 to 29.9% (95% CI 27.3, 32.6) in 2019. In the decomposition analysis, 60.6% of the difference in the proportion of complete CMHS utilization was explained by the differences in the composition of women's characteristics, and 39.4% was attributed to coefficients of characteristics. As such, equalizing the number of women who attended school at secondary level or higher, had television, initiated antenatal care (ANC) visits in the first trimester, were aware of pregnancy-related complications, delivered by caesarean section for their most recent childbirth, were from poorer households, gave urine and blood samples during pregnancy in 2019-2011 levels, would reduce the differences between 2011 to 2019 in complete CMHS utilization. In contrast, equalizing the number of women from richer (higher) household wealth categories in 2019-2011 levels would increase the 2011-2019 gaps in complete CMHS utilization.</p><p><strong>Conclusion: </strong>While progress has been made, complete CMHS utilization was low in Ethiopia. Differences in the composition of characteristics and effect of coefficients had a substantial contribution to the change in complete CMHS utilization between 2011 and 2019. Adopting a multi-faceted approach that considers the unique challenges within the country, including women's education, wealth status, and quality of care, will improve CMHS utilization. Empowering women through education can enhance their decision-making ability regarding their own health.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"9"},"PeriodicalIF":3.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053374","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":"Designing and validating an adaptation tool for endometriosis: an exploratory mixed method study protocol.","authors":"Sanaz Mollazadeh, Nahid Marvi, Talat Khadivzadeh","doi":"10.1186/s12978-025-01948-9","DOIUrl":"10.1186/s12978-025-01948-9","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a benign and chronic gynecological estrogen-dependent condition. Research findings have highlighted its impact on different aspects of women's lives. Enhancing quality of life and supporting the well-being of those affected is advised. Yet, none of the conducted studies have taken action toward these objectives. Therefore, the present study will be conducted with the aim of \"Designing adaptation tool for endometriosis\".</p><p><strong>Methods/design: </strong>The method used in this study is an exploratory mixed-method study. The study will consist of two phases, starting with a qualitative phase followed by a quantitative phase. Upon approval Ethics Code from the endometriosis clinic at Imam Reza Hospital in Mashhad, Iran. The research will involve women of reproductive age diagnosed with endometriosis. In-depth and semi-structured interviews with open-ended questions will be conducted. The research aims to explore the experiences of women with endometriosis in adapting to the condition, utilizing qualitative content analysis with an approach based on the \"ROY adaptation model.\" Sampling will be purposive until data saturation is achieved. Data analysis will follow the suggested steps using Elo Kingas' method and MAXQDA20 software. Tool design will involve an inductive approach (informed by qualitative findings) and a comparative method (based on literature review) to develop and refine tool items.</p><p><strong>Discussion: </strong>This study is the first to employ a mixed-method approach in developing an adaptation tool for endometriosis. It uncovers underlying issues in the attitudes of patients, medical staff, and healthcare providers, offering insight into factors that can enhance the health and quality of life of affected women. The research findings can inform the creation of a relevant strategy for policymakers, planners, and healthcare professionals to better address the needs of women impacted by endometriosis. Ethical code: IR.MUMS.NURSE.REC.1403.069.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"8"},"PeriodicalIF":3.6,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046528","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":"Infertility stigma and openness with others are related to depressive symptoms and meaning in life in men and women diagnosed with infertility.","authors":"Brennan Peterson, Orit Taubman-Ben-Ari, Bonnie Chiu, Douglas Brown, David A Frederick","doi":"10.1186/s12978-025-01951-0","DOIUrl":"10.1186/s12978-025-01951-0","url":null,"abstract":"<p><strong>Background: </strong>Stigma is the experience of feeling different from socially accepted norms which can lead to personal devaluation or fear of disapproval from others. For men and women experiencing infertility, stigma has been associated with psychological distress, feelings of otherness in relation to people with children, and selective disclosure with others about their infertility challenges. However, there are few studies which examine how infertility stigma and being open with others are related to depressive symptoms and meaning in life for men and women diagnosed with infertility.</p><p><strong>Methods: </strong>Participants experiencing infertility were recruited for this cross-sectional study during November 2023-January 2024 via announcements on infertility discussion listservs and social media accounts. Four-hundred fifty-eight women and 89 men completed an online survey. Participants were primarily from the United States (81%), followed by Europe, Canada, and Australia/New Zealand. Participants completed validated and reliable measures of infertility stigma, openness with others, depressive symptoms and meaning in life.</p><p><strong>Results: </strong>Hierarchical regression models explained substantial variance (adjusted R-squared) for depressive symptoms (41% men; 27% women), search for meaning in life (12% men; 14% women), and presence of meaning in life (19% men; 25% women). For both men and women, higher personal infertility stigma was significantly related with higher depressive symptoms and search for meaning. For both men and women, higher openness with others about infertility was significantly associated with lower levels of depressive symptoms and greater presence of meaning.</p><p><strong>Conclusions: </strong>The current findings support prior research indicating a significant association between infertility stigma and depressive symptoms and adds to the infertility literature by offering new insights into the relationships between stigma, openness with others, and meaning in life. Health care providers can use these findings to assist individuals and couples in reducing infertility stigma through collaborative conversations that reduce feelings of personal failure. Providers can also help those with infertility challenges to reduce psychological distress and increase meaning in life through accessing existing social networks and expanding social connections with others in ways that facilitate support.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"7"},"PeriodicalIF":3.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041524","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":"Fear of childbirth and psychiatric disorders decrease the likelihood of subsequent births: a retrospective register-based cohort study.","authors":"Elina Silvan, Terhi Saisto, Tia Mäkelä, Katariina Salmela-Aro, Mika Gissler, Laura Lampio","doi":"10.1186/s12978-025-01949-8","DOIUrl":"10.1186/s12978-025-01949-8","url":null,"abstract":"<p><strong>Background: </strong>Mirroring other developed countries globally, the birth rate has decreased in Finland in recent years. The effects of a fear of childbirth (FOC) and psychiatric disorders on the likelihood of having more than one child remain relatively unstudied. This study aims to assess the influence of FOC, psychiatric disorders, and the mode of first delivery on the likelihood of the second birth among primiparous women.</p><p><strong>Methods: </strong>Data were collected from the Medical Birth Register, the Hospital Discharge Register, and Statistics Finland census data. We used the t-test to compare continuous variables and the chi-square test or test for relative proportions to compare categorical variables. We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) using the Cox regression analysis.</p><p><strong>Results: </strong>Altogether, 317 219 women delivering their first child in 2006-2016 met the inclusion criteria, 216 521 of whom (68.3%) had their second birth during that time. A total of 11 108 (3.5%) of women were diagnosed with FOC during their first pregnancy, 34 381 (10.8%) women were diagnosed with a psychiatric disorder before or during their first pregnancy and 10 331 (3.3%) women received a new diagnosis of a psychiatric condition following the first birth. Between 2006-2021, the second child was born to 47.5% of women with FOC (n = 5276), 56.8% of women with a psychiatric disorder before or during their first pregnancy (n = 19 540), 53.4% of women receiving a psychiatric diagnosis after their first delivery (n = 5514) and 70.2% of women without either of these diagnoses (n = 191 572). Women with FOC had a 22% lower likelihood of the second birth [aHR 0.78 (95% CI 0.76-0.80)] compared to women without FOC. A psychiatric disorder before or during the first pregnancy decreased the likelihood of the second birth by 28% [aHR 0.72 (95% CI 0.71-0.73)] and by 51% (aHR 0.49 (95% CI 0.48-0.50)] with a psychiatric disorder following a first birth compared with women without a diagnosed psychiatric disorder. Among all women, a caesarean section as the mode of a first delivery reduced the likelihood of the second birth.</p><p><strong>Conclusion: </strong>FOC and psychiatric disorders are associated with a low birthrate following the first delivery. Caesarean section as the mode of delivery decreases the likelihood of the second birth among women with FOC and psychiatric disorders.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"6"},"PeriodicalIF":3.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024672","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}