Womens Health Issues最新文献

{"title":"Postpartum Hospital Readmissions Among Women With Gestational Diabetes and Pregestational Diabetes in the United States, 2016 to 2022.","authors":"Barbara H Bardenheier, Jean M Lawrence, Ibrahim Zaganjor, Oscar Rincón-Guevara, Osatohamwen I Idubor, Catherine E Barrett, Dayna S Alexander, Christopher Holliday, Holly Du, Kai McKeever Bullard","doi":"10.1016/j.whi.2026.05.005","DOIUrl":"https://doi.org/10.1016/j.whi.2026.05.005","url":null,"abstract":"<p><strong>Objective: </strong>We estimated postpartum hospital readmissions trends among women with gestational diabetes mellitus (GDM), pregestational diabetes mellitus (PDM; i.e., diabetes present before pregnancy), and neither.</p><p><strong>Methods: </strong>Using the National Readmissions Database, we identified women aged 15-44 years who had a live birth or stillbirth between January 1 and June 30 annually, from 2016 through 2022. Births by diabetes status (GDM, PDM, and no diabetes diagnosis) were grouped to obtain the 1) rates of postpartum rehospitalization for all causes, severe maternal morbidity (SMM), diabetes-related diagnoses, and mental health-related diagnoses, 2) repeated admissions, and 3) the leading causes of readmission. Joinpoint regression was used to assess trends in outcomes for 30, 60, and 180 days postpartum.</p><p><strong>Results: </strong>From 2016 to 2022, rates of all-cause postpartum readmissions increased significantly among women with GDM and women without diabetes by 30 days (annual percent change [APC], 2.78 for both), whereas rates of SMM postpartum readmissions decreased significantly among women with GDM by 30 days (APC, -7.44), 60 days (APC, -7.12), and 180 days (APC, -6.37), among women with PDM by 60 days (APC, -7.05), and among women with no diabetes by 30 days (APC, -5.83), 60 days (APC, -5.68), and 180 days (APC, -4.45). Postpartum diabetes-related readmission rates decreased for all periods among women with GDM and without diabetes (APC p values < .05) and by 180 days among women with PDM (APC, -7.03). Repeated diabetes-related admissions decreased at 60 and 180 days postpartum (APC p values < .05) among women with PDM. Hypertensive disorders were among the top three reasons for readmissions, regardless of diabetes status.</p><p><strong>Conclusion: </strong>Although all-cause readmissions increased by 30 days among women with GDM and without diabetes, postpartum SMM and diabetes-related readmissions decreased overall among women with GDM, PDM, and neither. Hypertensive disorders as a top reason for readmission suggests the need to monitor these disorders among women with GDM and PDM at birth.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892216","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":"\"Bearing in Mind That I Am a Black Mother\": Black Women's Anticipation of Poor Perinatal Care and Related Coping Strategies.","authors":"Amy Alspaugh, Julie Blumenfeld, Christiana Abara, Constance Akhimien, Fauziyya Allibay-Abdulkadir, Patricia Arias-Reynolds, Cherriece Battle, Maria Oluwayemi, Danae Palomino, Olanike Salimon, Laura D Lindberg, Leslie Kantor","doi":"10.1016/j.whi.2026.07.003","DOIUrl":"https://doi.org/10.1016/j.whi.2026.07.003","url":null,"abstract":"<p><strong>Background: </strong>Black women in the United States continue to experience disproportionate rates of severe maternal morbidity and mortality and frequently report disrespectful perinatal care. Although prior research has documented discriminatory encounters within perinatal care, less is known about how Black women anticipate and prepare for potential poor treatment before and during pregnancy. We aimed to better understand how Black women's anticipation of racism shapes their engagement with care during the perinatal period.</p><p><strong>Methods: </strong>This qualitative secondary analysis draws on in-depth interviews with 93 Black, English-speaking women across four urban areas of New Jersey who gave birth within the previous 24 months. Data analysis utilized a thematic analysis approach within a community-based participatory research framework.</p><p><strong>Results: </strong>Two major themes were identified: 1) fear of negative outcomes, including acute awareness of the Black maternal health crisis, and resulting vigilance and anxiety, and 2) fear of poor treatment by health care providers, characterized by expectations of being labeled, ignored, or dismissed, which led to anticipatory self-regulation.</p><p><strong>Conclusions: </strong>These findings bring attention to the phenomenon where some Black women in our study entered perinatal care expecting harm, a reality that creates a profound psychological burden and may undermine the patient-provider relationship before it even begins. This reality also places Black women in a double-bind, wherein they balance the vigilance needed to protect themselves with modifying their behavior to avoid stereotypes. Efforts to improve perinatal health must address clinical disparities in outcomes and the systemic conditions that make anticipatory fear a rational and necessary coping strategy.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820103","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":"The Value of Peer Support Groups Among Those Experiencing Miscarriage Grief.","authors":"Jennifer Schindler-Ruwisch, Christine Denhup, Kimberly Watson","doi":"10.1016/j.whi.2026.07.004","DOIUrl":"https://doi.org/10.1016/j.whi.2026.07.004","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to understand the experiences of miscarriage grief among childbearing people and their perception of helpful and nonhelpful elements of peer support groups.</p><p><strong>Methods: </strong>English-speaking participants, over the age of 18, who personally experienced a miscarriage in the last 10 years were eligible to complete a one-time Qualtrics survey. An international online sample was recruited through social media sites, support groups, and other networks serving childbearing people. A total of 1,709 individuals from the United States and 32 other countries consented to participate. Of those who indicated peer support involvement (n = 115), approximately 95% (n = 109) shared their personal experiences with peer support. Researchers used SPSS to analyze quantitative data and Dedoose to complete an iterative thematic analysis of qualitative responses.</p><p><strong>Results: </strong>Participants perceived peer support to have both helpful and nonhelpful components. Those who found it helpful had a range of reactions that were grouped into the following major themes: receiving authentic empathy, camaraderie, finding a safe space, learning coping tools and strategies, processing a shared experience, and seeking or providing advice. Those who found the groups unhelpful commented on thematic elements such as the fit and format of the group (i.e., virtual, facilitator type, and structure) and the group feeling overwhelming, uncomfortable, or not specific enough to their needs.</p><p><strong>Conclusions: </strong>This study's findings suggest that, although perceptions of peer support groups vary depending on format and other elements, such as fit and structure, there are many potentially helpful attributes of these groups to support processing miscarriage grief in a safe space. Health care providers and others caring for those experiencing a pregnancy loss should offer peer support options for individuals who wish to explore them.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820100","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":"Multimorbidity and Risk of Adverse Pregnancy Outcomes in a Safety-Net Hospital Cohort.","authors":"Michelle Huezo Garcia, Samantha E Parker, Collette N Ncube, Christina D Yarrington, Martha M Werler","doi":"10.1016/j.whi.2026.06.007","DOIUrl":"https://doi.org/10.1016/j.whi.2026.06.007","url":null,"abstract":"<p><strong>Background: </strong>It is well documented that single chronic conditions increase the risk of adverse pregnancy outcomes, but less is known about the impact of multiple chronic conditions in pregnancy. We assessed the association between multimorbidity and adverse pregnancy outcomes, including hypertensive disorders of pregnancy, gestational diabetes, intrapartum hemorrhage, placental abruption, prolonged length of hospital stay, stillbirth, preterm birth, and low birthweight.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 6,455 births using medical record data at a safety-net hospital (2015-2019). Multimorbidity was defined as having at least two diagnosis codes before or during pregnancy. Pregnancy outcomes were ascertained using clinical data and diagnosis codes. Log-binomial regression models using generalized estimating equations were fit to assess the association between multimorbidity and each outcome. We additionally stratified results by body mass index (BMI; <30 and ≥30 kg/m²) and describe the prevalence of adverse pregnancy outcomes by multimorbidity across racial and ethnic subgroups.</p><p><strong>Results: </strong>Multimorbidity affected more than one in three births (35.2%) and was associated with greater risks of hypertensive disorders of pregnancy (adjusted risk ratio [aRR], 1.26; 95% confidence interval [CI], 1.12, 1.41), preterm birth (aRR, 1.68; 95% CI, 1.47, 1.93), low birthweight (aRR, 1.61; 95% CI, 1.24, 2.09), stillbirth (RR, 1.84; 95% CI, 0.94, 3.60), placental abruption (aRR, 1.90; 95% CI, 1.00, 3.60), and prolonged hospital stay for cesarean (aRR, 1.40; 95% CI, 1.11, 1.77) and vaginal (aRR, 1.26; 95% CI, 1.07, 1.48) births, compared with individuals without multimorbidity. Further, greater risks of hypertensive disorders of pregnancy (aRR, 1.64; 95% CI, 1.37, 1.96) and gestational diabetes (aRR, 2.58; 95% CI, 1.86, 3.59) were found among those with multimorbidity and a co-occurring BMI of ≥30 kg/m² compared with those with multimorbidity with a BMI of <30 kg/m². Most adverse pregnancy outcomes were more frequent among patients with multimorbidity who identified as non-Hispanic Black and Hispanic/Latine and less frequent among white patients with multimorbidity.</p><p><strong>Conclusion: </strong>The high prevalence of multimorbidity and its association with adverse pregnancy outcomes highlight the importance of collaborative approaches for preconception and pregnancy care to optimize perinatal health.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763784","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":"Interest in and Experience With Intrauterine Device Self-Removal Among Current and Past Intrauterine Device Users in Utah.","authors":"Brooke W Bullington, Alexandra Gero, Sarah Elliott, Jami Baayd, Rebecca Simmons, Lori M Gawron, Jessica N Sanders, Susanna R Cohen","doi":"10.1016/j.whi.2026.06.010","DOIUrl":"https://doi.org/10.1016/j.whi.2026.06.010","url":null,"abstract":"<p><strong>Objectives: </strong>We sought to assess current and former intrauterine device (IUD) users' interest in and experiences with IUD self-removal and to examine associations between participant characteristics, past experiences with removal, and future interest in self-removal.</p><p><strong>Study design: </strong>We conducted a cross-sectional follow-up survey of HER Salt Lake participants who had ever used an IUD and consented to follow-up. Participants completed an electronic survey assessing interest in receiving self-removal information, past self-removal attempts and outcomes, and experiences with provider removal. We used descriptive statistics and χ² tests to explore self-removal interest and experiences, and differences in interest by characteristics and past removal experiences.</p><p><strong>Results: </strong>More than one-half of the 621 participants (57%) expressed an interest in IUD self-removal. Among current IUD users, 49% reported willingness to try self-removal. One in 10 participants had attempted self-removal; 68% were successful and most (61%) reported no problems. Among those who attempted self-removal, the most commonly reported problems were experiencing more pain than they felt comfortable with (21%) and being unable to feel their IUD strings (9%). Participants who faced prior barriers to provider removal, including cost, scheduling delays, discomfort with care, or distrust of the health care system, were more likely to express interest in self-removal (p < .05). Those interested were also more often nulliparous, current IUD users, those not married or cohabitating with their partners, and those who did not identify as heterosexual.</p><p><strong>Conclusion: </strong>In our sample, interest in self-removal was high, and most participants who had attempted self-removal did so successfully and without problems. Providing accessible information about self-removal in preferred formats may help to reduce barriers to IUD discontinuation and support reproductive autonomy.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764759","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":"Sex Differences in Fatal Poisoning Among Drug Users in France: An Exploratory Analysis of the DRAMES Register.","authors":"Agathe Langlamet, Marc Manceau, Hélène Eysseric-Guérin, Bénédicte Lelièvre, Jean-Michel Gaulier, Nathalie Fouilhé Sam-Laï, Théo Willeman, Bruno Revol","doi":"10.1016/j.whi.2026.07.002","DOIUrl":"https://doi.org/10.1016/j.whi.2026.07.002","url":null,"abstract":"<p><strong>Background: </strong>The DRAMES register (Décès en Relation avec l'Abus de Médicaments Et de Substances) is a French database of drug-related deaths reported by forensic toxicology experts. This study evaluated sex differences in the substances involved in deaths, with the aim of improving public policy on prevention and care for women with substance use disorders.</p><p><strong>Methods: </strong>We assessed 6,068 drug-related deaths that occurred from January 1, 2010, to December 31, 2023, in France (1,120 women [18.5%] with a mean age of 38 ± 11 years and 4,948 men [81.5%] with a mean age of 38 ± 10 years). Individual demographic characteristics and medical history, forensic autopsy findings, and toxicology reports were evaluated.</p><p><strong>Results: </strong>The proportion of deaths related to polydrug use was higher in women than in men (39.4% vs. 28.4%; p < .001). Female sex was significantly associated with mortality from taking antidepressants (p < .001), antipsychotics (p < .001), benzodiazepines and z-drugs (p < .001), codeine (p = .002), other anxiolytics and hypnotics (p = .029), pholcodine (p = .005), and tramadol (p < .001), all of which are legal prescription medicines in France. Male sex was significantly associated with mortality from taking amphetamine-type stimulants (p = .044), buprenorphine (p = .042), cannabis (p < .001), gamma-hydroxybutyrate (p = .002), heroin (p < .001), and new psychoactive substances (p < .001). Apart from buprenorphine, all of these drugs are illegal in France.</p><p><strong>Conclusion: </strong>The observed differences in causes of death between women and men, specifically more polydrug related-deaths (especially with pharmaceuticals), highlight the need to address female-specific concerns. Further studies and resources are needed to develop programs dedicated to women with substance use disorders.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759447","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":"State Abortion Policy Knowledge and Opinions Among Young Adults in North Carolina.","authors":"Cecelia Wasco, M Kate Bundorf, Colleen Judge-Golden","doi":"10.1016/j.whi.2026.07.001","DOIUrl":"https://doi.org/10.1016/j.whi.2026.07.001","url":null,"abstract":"<p><strong>Background: </strong>Knowledge of state-level abortion policies may impact an individual's ability to obtain abortion care. We assessed knowledge and opinions about state abortion policies among young adults in North Carolina following the implementation of new abortion restrictions.</p><p><strong>Methods: </strong>This was a cross-sectional online survey of individuals ages 18-24 living in North Carolina, recruited via social media from July to October 2024. The primary outcome was high knowledge of state abortion policy (6 or more correct answers on 11 policy knowledge questions). We generated descriptive statistics and evaluated the associations between respondent characteristics and high knowledge.</p><p><strong>Results: </strong>Of 217 participants, 80% were cis women and 49% were current students. Overall, 79% identified abortion as legal in North Carolina, but only 45% had high abortion policy knowledge. More than one-half identified exceptions allowing abortion after 12 weeks in cases of threat to maternal life (62% correct) or rape (52% correct); fewer had knowledge of waiting periods (45% correct), ultrasound examination requirements (43% correct), or exceptions for life-limiting fetal anomalies (47% correct). Individuals reporting household use of public nutrition benefits were more likely to have high knowledge compared with those not receiving nutrition benefits (adjusted odds ratio, 2.18; 95% confidence interval [1.10, 4.35]). High policy knowledge was not associated with personal views about abortion morality or opinions about state abortion law, but was associated with knowledge about abortion safety (p = .002). More than one-half of the participants (60%) believed abortion is extremely or somewhat difficult to obtain in North Carolina, and 62% disapproved of the new restrictions.</p><p><strong>Conclusion: </strong>Young adults in this study sample had limited knowledge about the specifics of state abortion policy, highlighting a need to educate the public about policies impacting reproductive health care.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708066","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":"Comorbidity Patterns Among Pregnant Individuals With a History of Seeking Health Care for Migraine: A Population-Based Latent Class Analysis in Ontario, Canada.","authors":"Carmela Melina Albanese, Susan J Bondy, Christine Lay, Manav V Vyas, Zhiyin Li, Jun Guan, Hilary K Brown","doi":"10.1016/j.whi.2026.06.008","DOIUrl":"https://doi.org/10.1016/j.whi.2026.06.008","url":null,"abstract":"<p><strong>Background: </strong>Comorbidity is common with migraine. To inform services to support maternal well-being, we identified comorbidity patterns among pregnant individuals with a history of seeking health care for migraine before pregnancy.</p><p><strong>Methods: </strong>In a population-based cohort of pregnancies in 2007-2022 in Ontario, Canada, to individuals with migraine-related health care encounters in the 5 years before conception, we used latent class analysis to identify subgroups using 33 comorbidities. Classes were chosen using statistical fit indices, parsimony, and clinical interpretability. We compared the sociodemographic and reproductive health-related characteristics of the classes using standardized differences.</p><p><strong>Results: </strong>Of 174,164 pregnant individuals with migraine, 67.2% had one or more comorbidities. The most prevalent comorbidities were mood/anxiety disorders (41.4%), low back pain (16.9%), obesity (12.1%), and asthma (10.6%). Three distinct subgroups characterized comorbidity patterns: class 1, the \"mood/anxiety disorder comorbidity,\" included 81.2% of the cohort; class 2, the \"mood/anxiety disorder and low back pain comorbidity\" cohort included 8.3%' and class 3, the \"multiple mental health comorbidity\" cohort included 10.6%. Compared with class 1, at conception individuals in the \"multiple mental health comorbidity\" group were more likely to be aged 13 to 24 years (37.9% vs. 18.9%; standardized difference, 0.43), reside in neighborhoods in the lowest income quintile (29.7% vs. 22.1%, 0.17), be Canadian born or a long-term resident (87.0% vs. 74.4%, 0.32), and be nulliparous (53.2% vs. 47.5%, 0.11). Those in the \"mood/anxiety disorder and low back pain comorbidity\" group were more likely to be 35 to 44 years of age (31.9% vs. 20.6%, 0.26) or 45 to 54 years of age (2.1% vs. 0.6%, 0.14), more likely to reside in neighborhoods in the lowest income quintile (26.6% vs. 22.1%, 0.11), and less likely to be nulliparous (38.6% vs. 47.5%, 0.18). Findings were similar in a sensitivity analysis including only comorbidities with a prevalence of 1% or greater. Using physical conditions as indicators only, we also identified three latent classes: \"low back pain comorbidity\" (4.3%), \"obesity comorbidity\" (2.8%), and \"no physical comorbidity\" (92.9%).</p><p><strong>Conclusion: </strong>Comorbidity affects two-thirds of pregnant individuals with a history of seeking health care for migraine. Identified patterns of comorbidity suggest subgroups who may benefit from tailored perinatal support related to mental health and chronic pain.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702219","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":"Randomized Controlled Trial of a Tubal Sterilization Decision Aid Among Medicaid Enrollees: Effects on Intended Contraceptive Method and Decision-Making Satisfaction.","authors":"Elizabeth A Mosley, Nikki Zite, Christine Dehlendorf, Kaleab Z Abebe, Nicole Luche, Catherine Wright, Michaella Wu, Sonya Borrero","doi":"10.1016/j.whi.2026.06.009","DOIUrl":"https://doi.org/10.1016/j.whi.2026.06.009","url":null,"abstract":"<p><strong>Introduction: </strong>Tubal sterilization is a permanent contraceptive method, yet misconceptions about its permanence are prevalent, and its history is marked by both coercion and barriers to access-particularly among Medicaid enrollees. Decision aids may help to support more informed, value-concordant decision-making.</p><p><strong>Methods: </strong>From March 2020 to November 2023, English- and Spanish-speaking pregnant Medicaid enrollees at less than 24 weeks' gestation were randomized to either receive or not receive a novel web-based tubal sterilization decision aid. Participants completed surveys after randomization (control group) and after the decision aid (intervention group) at time point 1 (T1), in the third trimester (T2), and at 3 months postpartum (T3). Positive impacts of the decision aid on the primary outcomes of tubal sterilization knowledge and decisional conflict were previously reported. Secondary outcomes analyzed were intended contraceptive method at T1 (sterilization vs. other/no method) and satisfaction with the contraceptive decision-making process at T3.</p><p><strong>Results: </strong>We included 350 pregnant Medicaid enrollees who completed surveys at T1, 301 who completed them at T2, and 286 who completed them at T3. There were no statistically significant differences between the decision aid and control groups in the intention to use tubal sterilization (55.6% vs. 61.24%; p = .238) or optimal contraceptive decision-making satisfaction (59.2% vs. 54.9%; p = .406).</p><p><strong>Conclusion: </strong>Although the decision aid was previously shown to improve sterilization decision quality, it did not appear to influence intended contraceptive method immediately after use of the tool during pregnancy or satisfaction with contraceptive decision-making.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608726","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":"Moving Toward a Positive Birth: The Protective Role of Psychological Capital in Shaping Childbirth Experiences.","authors":"Charlotte V Farewell, Julia M L Pangalangan, Emily Curl, Jenn A Leiferman","doi":"10.1016/j.whi.2026.06.005","DOIUrl":"10.1016/j.whi.2026.06.005","url":null,"abstract":"<p><strong>Purpose: </strong>Positive childbirth experiences (CBEs) impact maternal and child well-being, but many women, particularly those of low socioeconomic status, report negative or traumatic births. This mixed-methods longitudinal study investigated whether and how psychological capital-a psychological construct composed of hope, self-efficacy, resilience, and optimism-moderates the associations between birth complications, birth trauma, and perceived own capacity, a critical indicator of positive CBEs.</p><p><strong>Methods: </strong>Mixed-methods data were extracted from a prospective longitudinal perinatal cohort study of birthing individuals experiencing at least one indicator of socioeconomic disadvantage. The quantitative data are from 141 individuals during pregnancy (third trimester) and the postpartum period (6 weeks postpartum); 16 of these individuals participated in an interview at 6 weeks postpartum to share their perceptions of their birth experiences. Quantitative data were analyzed using hierarchical linear regression modeling; postpartum interviews were analyzed using thematic and sentiment analysis.</p><p><strong>Results: </strong>Hierarchical linear regression revealed that psychological capital during pregnancy was positively and significantly associated with perceived own capacity related to subjective CBEs, after adjusting for birth complications, birth trauma, and sociodemographic characteristics (p < .01). Interview participants who reported positive CBEs displayed self-efficacy, hope, and optimism. Mixed-methods integration further indicated that self-efficacy and optimism were associated with positive CBEs, even among those who experienced birth complications.</p><p><strong>Conclusions: </strong>Public health efforts should consider targeting strengths-based strategies to bolster psychological resources during pregnancy, such as evidence-based psychological capital interventions, to promote more positive CBEs. Future work is necessary to understand how to adapt and tailor interventions to better support perinatal individuals experiencing socioeconomic disadvantage through the childbirth process.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594022","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}