Womens Health Issues最新文献

{"title":"A Qualitative Analysis of the Lived Experiences of Active-Duty Servicewomen Receiving Perinatal Care Within the Military Health System","authors":"Caitlin Russell PhD, MBE, MSHP, WHNP-BC ,&nbsp;Emily Balog PhD, OTR/L, FNAP ,&nbsp;Anne Teitelman PhD, FNP-BC, FAANP, FAAN ,&nbsp;Rosemary Polomano PhD, RN, FAAN","doi":"10.1016/j.whi.2025.07.001","DOIUrl":"10.1016/j.whi.2025.07.001","url":null,"abstract":"<div><h3>Objectives</h3><div>We explored the lived experiences of active-duty servicewomen (ADSW) accessing and receiving care during the perinatal period (from discovery of pregnancy to 1 year postpartum) within the Military Health System.</div></div><div><h3>Study Design</h3><div>Using qualitative methods, we conducted semi-structured interviews between September 2022 and February 2023 with 23 ADSW participants who were pregnant or within their first year postpartum. Data were analyzed using inductive coding and thematic analysis techniques.</div></div><div><h3>Results</h3><div>Participants reported bureaucratic hurdles and long wait times for accessing care, too little choice in providers, and inadequate coordination between civilian and military care providers. Those who experienced perinatal complications perceived that the military health system did not adequately address their concerns. Some participants described disjointed and depersonalized perinatal care, whereas others reported positive experiences with their providers.</div></div><div><h3>Conclusions</h3><div>Opportunities exist for the Military Health System to improve the perinatal care experience by increasing access to perinatal care, providing more autonomy to ADSW in choosing providers and birth settings, and developing policies and procedures to improve inter-specialty communication.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Pages 368-375"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859780","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":"Addressing Racism and Discrimination in the Design of Physical Activity Interventions for Black Women: Insights and Recommendations From an Academic and Community Partnership","authors":"Rodney P. Joseph PhD ,&nbsp;LaTanya Mathis MSN ,&nbsp;Iyana Harris BA ,&nbsp;Shawntele M. Howie-Carlson ,&nbsp;Kanika Jones BSW ,&nbsp;Darlene Little EdD ,&nbsp;Dawn Augusta DNP, MBA","doi":"10.1016/j.whi.2025.06.001","DOIUrl":"10.1016/j.whi.2025.06.001","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Pages 301-305"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683408","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":"Safety Net Clinic Utilization for Sexual and Reproductive Health Services Among U.S.- and Foreign-Born Mexican-Origin Women","authors":"Blair G. Darney PhD, MPH ,&nbsp;Biani Saavedra-Avendaño PhD, MSc ,&nbsp;Emily R. Boniface MPH ,&nbsp;Laura E. Jacobson PhD, MPH ,&nbsp;Kate Coleman-Minahan PhD, FNP-BC ,&nbsp;Evelyn Fuentes-Rivera MSc ,&nbsp;Fernando Riosmena PhD","doi":"10.1016/j.whi.2025.05.004","DOIUrl":"10.1016/j.whi.2025.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>We describe utilization of sexual and reproductive health (SRH) services at safety net clinics (Title X and other publicly funded health care organizations) and private health care settings among U.S.- and foreign-born Mexican-origin women living in the United States. We also test whether nativity is associated with source of SRH care, adjusting for other factors.</div></div><div><h3>Data Sources and Study Setting</h3><div>We pooled four waves of the National Survey of Family Growth (NSFG)—2011–2013, 2013–2015, 2015–2017, and 2017–2019—and included in our sample women who received SRH services in the previous 12 months.</div></div><div><h3>Study Design</h3><div>We compared SRH service utilization and source (safety net clinics [Title X and non-Title X public] vs. private) between U.S.-born and foreign-born Mexican-origin women. We used multivariable regression to test whether nativity was associated with source of care.</div></div><div><h3>Principal Findings</h3><div>Our sample included <em>n</em> = 1,923 (N = 4,446,577) Mexican-origin women aged 15–44, 42.9% of whom were foreign born. Foreign-born women of Mexican origin were more likely to be uninsured (43.8% vs. 13.4% among the U.S. born) and had a significantly higher adjusted probability of using safety net clinics to access preventive SRH services compared with Mexican-American women (42.2%; 95% CI [35.5, 48.9%] vs. 27.6%; 95% CI [22.9, 32.2%]).</div></div><div><h3>Conclusions</h3><div>Safety net clinics such as Title X and other publicly funded health care organizations play an important role in access to preventive SRH care among Mexican-origin women living in the United States, especially for foreign-born women.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Pages 383-389"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565405","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":"Impacts of Medicaid Expansion on Contraceptive Use Among Women in Neighborhoods of Racialized Socioeconomic Deprivation in the United States","authors":"Alice F. Cartwright PhD, MPH ,&nbsp;Gustavo Angeles PhD ,&nbsp;Jessica Su PhD ,&nbsp;Maeve Wallace PhD, MPH ,&nbsp;Siân Curtis PhD ,&nbsp;Ilene S. Speizer PhD","doi":"10.1016/j.whi.2025.07.002","DOIUrl":"10.1016/j.whi.2025.07.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Medicaid expansion has the potential to increase access to contraception and improve women's health, although existing research examining state-level variation provides mixed evidence. The neighborhood context plays a crucial role in understanding the effects of Medicaid expansion on contraceptive use, as structural inequalities within neighborhoods may shape access to health care and reproductive services.</div></div><div><h3>Materials and Methods</h3><div>We used a unique restricted dataset of 13,224 female respondents ages 15–44 years interviewed in the 2011–2019 waves of the National Survey of Family Growth (NSFG). We merged these data with indicators of state Medicaid expansion status and respondents’ neighborhood context, operationalized as Index of Concentration at the Extremes (ICE) scores. We used quasi-experimental difference-in-differences models to assess if Medicaid expansion impacted provider-dependent contraceptive use and method type differentially by neighborhood-level context. We used multivariable linear probability and multinomial logistic regression models adjusting for individual and community covariates and state/region fixed effects.</div></div><div><h3>Results</h3><div>Living in a Medicaid expansion state was associated with significant increases in provider-dependent contraceptive method use among respondents in the most deprived neighborhoods (17.9 percentage points, 95% CI [9.0, 26.9], by 2017–2019). Specifically, long-acting reversible contraception (LARC) use increased 7.6 percentage points (95% CI [0.6–14.7]) and use of no method or barrier/coital methods declined 17.5 percentage points (95% CI [−26.3, −8.7]) among those in the most deprived neighborhoods by 2017–2019.</div></div><div><h3>Conclusions</h3><div>Changes in state-level policies can have major impacts on health systems, but the example of Medicaid expansion underscores the differential impacts on people with less access to health resources, such as those living in structurally disadvantaged neighborhoods. Ultimately, further expansion of Medicaid could facilitate access to the full range of contraceptive methods and advance population health equity in additional U.S. states.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Pages 314-323"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859781","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":"Examining Veterans', Doulas', and VA Maternity Care Coordinators’ Perceptions and Experiences With a Community-based Doula Pilot Program","authors":"Kristin M. Mattocks PhD, MPH ,&nbsp;Valerie Marteeny MS ,&nbsp;Lorrie Walker MA ,&nbsp;Karen M. Goldstein MD, MSPH ,&nbsp;Stephanie Condon-Perry PA-C ,&nbsp;Kathryn Berrien RN, BSN, MS ,&nbsp;Danielle Weber RN ,&nbsp;Lisa L. Shenette MS ,&nbsp;Kate Wallace MPH ,&nbsp;Michaela A. Ayisi MPH ,&nbsp;Akila Sanjay BS ,&nbsp;Aimee Kroll-Desrosiers PhD","doi":"10.1016/j.whi.2025.08.001","DOIUrl":"10.1016/j.whi.2025.08.001","url":null,"abstract":"<div><h3>Objective</h3><div>Racial disparities in maternal morbidity and mortality are well-documented and remain a pressing public health problem in the United States. Racial disparities in maternal health have also been noted among veterans receiving community-based maternity care benefits from the Department of Veterans Affairs (VA). Previous studies of doula care among minoritized racial groups have indicated lower rates of preterm and cesarean births, more positive feelings about childbirth experiences, and lower admissions to the neonatal intensive care unit. To assess whether doula care might be beneficial for veterans enrolled in VA care, we launched a small pilot study at two VA medical centers working in conjunction with community-based doula agencies. Therefore, the overarching objective of this study was to assess veterans', doulas', and VA maternity care coordinators’ (MCC) perceptions and experiences with a community-based doula program aimed at improving maternal outcomes.</div></div><div><h3>Methods</h3><div>Telephone or video interviews were conducted with veterans, doulas, and VA MCCs who had participated in the doula care program. Interviews were recorded, transcribed, and analyzed using content analysis techniques. Major themes and representative quotes were derived from the analyses.</div></div><div><h3>Results</h3><div>Twenty-eight veterans, seven doulas, and two VA MCCs enrolled in the doula study and participated in interviews. Four major themes were identified: 1) veterans’ previous negative birth experiences promoted desire for doula care, 2) veterans had positive pregnancy experiences with doula care, 3) doulas empowered veterans to advocate for themselves during pregnancy, and 4) VA MCCs welcomed doula partnerships.</div></div><div><h3>Conclusion</h3><div>Veterans expressed high levels of satisfaction with the doula care program. VA MCCs noted that a doula care program was an important addition to the existing VA MCC program and allowed MCCs to feel that they had an additional partner in caring for pregnant veterans.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Pages 390-397"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058780","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":"Reproductive Health Services in Abortion-Providing Clinics: A Scoping Review of Provision and Policy Contexts.","authors":"Katherine M Mahoney, Licia Bravo, Arden McAllister, Kacie Bogar, Sean Hennessey, Courtney A Schreiber, Alice Abernathy","doi":"10.1016/j.whi.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.whi.2025.07.007","url":null,"abstract":"<p><strong>Objectives: </strong>Abortion-providing clinics often offer preventive reproductive health services. We conducted a scoping review to characterize provision of contraceptive care, sexually transmitted infection (STI) testing and/or treatment, and cervical cancer prevention and/or screening at U.S. abortion-providing clinics and to highlight policy drivers of variation in access to and provision of these services at the time of abortion by abortion-providing clinics.</p><p><strong>Data sources: </strong>Researchers screened articles and extracted data from PubMed, Embase, Scopus, and CINAHL from inception through March 2023.</p><p><strong>Methods of study selection: </strong>Articles were eligible for review if they related contraceptive care, STI testing and/or treatment, or cervical cancer prevention and/or screening to abortion access, demand, or provision. Within these articles, we closely examined any discussion of health policy, conceptualized broadly based on existing literature describing policy associations with reproductive health care to identify policy drivers of reproductive health care provision in abortion care settings.</p><p><strong>Tabulation, integration, and results: </strong>A total of 5,359 articles were screened; 74 were included in the review. Sixty-five were about contraceptive care, seven on STI testing and/or treatment and two on cervical cancer prevention and/or screening. Drivers of variation in provision of preventive reproductive health services included insurance and billing policies and regulatory requirements on abortion-providing facilities and clinicians. Existing data on the association between policies that restrict or protect abortion access and provision of preventive health services by abortion-providing clinics on a national scale are limited.</p><p><strong>Conclusion: </strong>Abortion-providing clinics are an access point for reproductive health services. Legislative trends to constrain abortion access may have spillover effects on provision of preventive reproductive health care such as contraceptive care, STI testing and/or treatment, and cervical cancer prevention and/or screening.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974309","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":"Corrigendum to: An Exploratory Analysis of Factors Associated With Spontaneous Preterm Birth Among Pregnant Veterans With Post-Traumatic Stress Disorder [Women's Health Issues 33 (2023) 191-198]","authors":"Danielle M. Panelli MD ,&nbsp;Caitlin S. Chan SM ,&nbsp;Jonathan G. Shaw MD, MS ,&nbsp;Megha Shankar MD ,&nbsp;Rachel Kimerling PhD ,&nbsp;Susan M. Frayne MD, MPH ,&nbsp;Tiffany C. Herrero MD ,&nbsp;Deirdre J. Lyell MD ,&nbsp;Ciaran S. Phibbs PhD","doi":"10.1016/j.whi.2025.09.003","DOIUrl":"10.1016/j.whi.2025.09.003","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Page 414"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092496","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":"Patterns of Antepartum Care in Ontario Before and During a Time of COVID-19 and Virtual Care: A Population-Based Study","authors":"Stephanie C. Lapinsky MD, MSc ,&nbsp;Nancy N. Baxter MD, PhD ,&nbsp;Rinku Sutradhar PhD ,&nbsp;Karl Everett PhD ,&nbsp;Joan Porter MSc ,&nbsp;Mark H. Yudin MD, MSc ,&nbsp;Eliane M. Shore MD, MSc ,&nbsp;Howard Berger MD ,&nbsp;Douglas M. Campbell MD, MSc ,&nbsp;John W. Snelgrove MD, MSc ,&nbsp;Andrea N. Simpson MD, MSc","doi":"10.1016/j.whi.2025.05.002","DOIUrl":"10.1016/j.whi.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic resulted in changes to the way health care was delivered, including expansion of virtual care. We aimed to understand differences in antepartum care delivery prior to and during the pandemic.</div></div><div><h3>Methods</h3><div>We conducted a population-based retrospective cohort study of people 15–50 years with an in-hospital birth at 20+ weeks’ gestation in Ontario, Canada, across two time periods: December 1, 2020–November 30, 2022 (pandemic), and December 1, 2017–November 30, 2019 (pre-pandemic). Outcomes were total number and timing of antepartum visits, ultrasounds, and acute care encounters. Outcomes were compared between cohorts, and between those who did and did not receive virtual care during the pandemic. Regression modeling was used to examine associations between pregnancy during the pandemic and rates of outcomes.</div></div><div><h3>Results</h3><div>A total of 228,551 pandemic and 218,126 pre-pandemic births were included. Median number of antepartum visits was 10 (6–13) in the pandemic period and 9 (4–12) pre-pandemic (standardized difference (StD): 0.32), corresponding to a relative rate of 1.21 (95% CI [1.20, 1.21]). Significantly more individuals in the pandemic had &gt;11 visits, with no differences in acute care encounters and only a small increase in health care costs (&lt;10%). Those in the pandemic cohort were more likely to have their initial visit during the first trimester (79.3% vs. 66.5%, StD: 0.29). Those receiving virtual care were more likely to live in an urban area and be more materially advantaged.</div></div><div><h3>Interpretation</h3><div>Pregnancy during the pandemic was associated with in an increased rate of ambulatory antepartum visits and increased care in the first trimester.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Pages 330-341"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601906","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":"Promoting Improved Access to Tailored Hormonal Contraceptive Regimens for Menstrual Suppression","authors":"Beth Sundstrom PhD, MPH ,&nbsp;Angela Dempsey MD, MPH","doi":"10.1016/j.whi.2025.02.009","DOIUrl":"10.1016/j.whi.2025.02.009","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 219-224"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811977","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":"Evolving the Health Care Service Model for Menopause With Digital Health","authors":"Constance Guille MD, MSCR ,&nbsp;Hannah Jahnke PhD,&nbsp;Neel Shah MD, MPP,&nbsp;Natalie Henrich PhD, MPH","doi":"10.1016/j.whi.2025.03.005","DOIUrl":"10.1016/j.whi.2025.03.005","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 230-232"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041729","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}