Sexual & Reproductive Healthcare最新文献

{"title":"Hysterectomy and medical financial hardship among U.S. women","authors":"Biplab Kumar Datta ,&nbsp;Ashwini Tiwari ,&nbsp;Yara H. Abdelgawad ,&nbsp;Ruhun Wasata","doi":"10.1016/j.srhc.2024.101019","DOIUrl":"10.1016/j.srhc.2024.101019","url":null,"abstract":"<div><h3>Objective</h3><p>Hysterectomy is one of the common surgical procedures for women in the United States. Studies show that hysterectomy is associated with elevated risk of developing chronic conditions, which<!--> <!-->may cause financial toxicity in patients. This study aimed to assess whether women who underwent hysterectomy had a higher risk of experiencing medical financial hardship compared to women who didn’t.</p></div><div><h3>Methods</h3><p>Using data on 32,823 adult women from the 2019 and 2021 waves of the National Health Interview Survey, we estimated binomial and multinomial logistic regressions to assess the relationship between hysterectomy and financial hardship, defined as problems paying or unable to pay any medical bills. Further, we performed a Karlson-Holm-Breen (KHB) decomposition to examine whether the association could be explained by chronic comorbidity.</p></div><div><h3>Results</h3><p>While the prevalence of financial hardship was 13.6 % among all women, it was 16.2 % among women who underwent a hysterectomy. The adjusted odds of experiencing medical financial hardship among women with a hysterectomy were 1.36 (95 % CI: 1.22–1.52) times that of their counterparts who did not have a hysterectomy. The KHB decomposition suggested that 34.5 % of the size of the effect was attributable to chronic conditions. Women who had a hysterectomy were also 1.45 (95 % CI: 1.26–1.67) times more likely to have unpaid medical debts.</p></div><div><h3>Conclusions</h3><p>Our results suggested that women, who underwent a hysterectomy in the US, were vulnerable to medical financial hardship. Policy makers and health professionals should be made aware of this issue to help women coping against this adversity.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142088934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The vital role of birth centers in modern maternity care","authors":"Emma M Swift,&nbsp;Berglind Halfdansdottir","doi":"10.1016/j.srhc.2024.101020","DOIUrl":"10.1016/j.srhc.2024.101020","url":null,"abstract":"","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000752/pdfft?md5=f436a472363df7a2e2d0dd07c791eed4&pid=1-s2.0-S1877575624000752-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on the study by Aanstad et al. “Intrapartum fetal monitoring practices in Norway: A population-based study”","authors":"Katariina Laine ,&nbsp;Sari Räisänen ,&nbsp;Branka M. Yli ,&nbsp;Tiril Tingleff","doi":"10.1016/j.srhc.2024.101018","DOIUrl":"10.1016/j.srhc.2024.101018","url":null,"abstract":"","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142076381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A low cesarean section rate is not a reason for overusing CTG","authors":"Kristin Jerve Aanstad ,&nbsp;Are Hugo Pripp ,&nbsp;Rebecka Dalbye ,&nbsp;Aase Devold Pay ,&nbsp;Anne Cathrine Staff ,&nbsp;Anne Kaasen ,&nbsp;Ellen Blix","doi":"10.1016/j.srhc.2024.101017","DOIUrl":"10.1016/j.srhc.2024.101017","url":null,"abstract":"","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142076382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study of the experience of doula support to women in socially disadvantaged positions in Sweden: The voices of women and doulas","authors":"Pia Gudmundsson ,&nbsp;Helen Elden ,&nbsp;Anna Larsson ,&nbsp;Johanna Sundén ,&nbsp;Anja Björkman ,&nbsp;Helena Tegnér ,&nbsp;Karolina Linden","doi":"10.1016/j.srhc.2024.101016","DOIUrl":"10.1016/j.srhc.2024.101016","url":null,"abstract":"<div><h3>Background</h3><p>Women in socially disadvantaged positions face increased risk of fear of birth, birth complications, and postpartum depression, highlighting the need for targeted interventions for this group. Doula support is associated with positive emotional and medical outcomes for mother and child. Experience of doula support for women in socially disadvantaged positions in Sweden remains unexplored.</p></div><div><h3>Aim</h3><p>To describe experiences of doula support within a project for women in socially disadvantaged positions in Sweden.</p></div><div><h3>Methods</h3><p>In-depth interviews with seven women and focus group discussions with twelve doulas in a Doula support project were conducted. Data was analysed with inductive content analysis.</p></div><div><h3>Results</h3><p>Women and doulas described experiences of doula support as a significant relationship with challenges, due to unclear boundaries for the support, and the time and trust needed to establish the relationship. The support was perceived as comprehensive, far exceeding traditional doula support, with extensive assistance provided postpartum. The project was regarded as meaningful, and that it led to positive birth experiences.</p></div><div><h3>Conclusions</h3><p>Women in socially disadvantaged positions may benefit from doula support during the perinatal period. The support fosters feelings of calmness, security and empowerment, and alleviates feelings of isolation, which is crucial for a positive birth experience. Support for these women is complex due to increased social needs, leading to unclear expectations of the doula’s role. Support from colleagues is deemed crucial. Future projects should establish clear frameworks and a supportive structure for doulas.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000715/pdfft?md5=81182be8bffc98986fbcc7c3782c1741&pid=1-s2.0-S1877575624000715-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142002371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“But I’m not a professional” − How women with high-risk pregnancies voice the experiences of home-based telemonitoring; a qualitative interview study","authors":"Jane M. Bendix ,&nbsp;Mikala Heinsen ,&nbsp;Mette G. Backhausen","doi":"10.1016/j.srhc.2024.101015","DOIUrl":"10.1016/j.srhc.2024.101015","url":null,"abstract":"<div><h3>Objectives</h3><p>Telemonitoring of high-risk pregnancy complications is a new approach that offers remote obstetric caregiving using mobile and wireless technologies. New evidence shows that home-based obstetric telemonitoring is not only feasible but also a safe alternative to inpatient or frequent outpatient care. As little is known how performing obstetric telemonitoring is perceived, this study examined how women with pregnancy complications experienced performing home-based telemonitoring.</p></div><div><h3>Methods</h3><p>A qualitative, semi-structured interview study was conducted with women with ongoing experience in performing home-based telemonitoring procedures for high-risk pregnancy complications. Purposeful sampling strategy and data saturation were applied followed by verbatim transcription. The data were analyzed using systematic text condensation.</p></div><div><h3>Results</h3><p>Fifteen informants participated in the study and four major themes emerged. The study revealed that performing telemonitoring was overall positively experienced as an ‘Empowering yet challenging responsibility’ as well as an ‘Extended patient-clinician partnership.’ There were pros and cons as to the influence of telemonitoring in everyday life; ‘Tele-comfort yet ambivalence’ and that it could be accompanied by annoying practical issues; ‘Accompanying remote issues.’</p></div><div><h3>Conclusions</h3><p>Performing obstetric telemonitoring was experienced as an empowering yet challenging responsibility as well as an extended partnership between the clinician and the pregnant woman. Pros and cons were voiced as to the influence and ambivalence of telemonitoring in everyday life, and that it could be accompanied by annoying practical issues. Patient aspects and experiences of telemonitoring are important clinical knowledge that must be considered when a telemonitoring plan is tailored preferably in a shared decision-making process.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000703/pdfft?md5=d1833e7cdc6659071f25be21941639e3&pid=1-s2.0-S1877575624000703-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the role of midwives in humanitarian and developmental settings","authors":"Tewodros Seyoum,&nbsp;Jama Ali Egal","doi":"10.1016/j.srhc.2024.101014","DOIUrl":"10.1016/j.srhc.2024.101014","url":null,"abstract":"","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142076380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrimination against Roma women during childbirth? Unraveling the underlying effects of ethnic and socio-economic factors","authors":"Laura Szabó,&nbsp;Zsuzsanna Veroszta","doi":"10.1016/j.srhc.2024.101013","DOIUrl":"10.1016/j.srhc.2024.101013","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to identify discrimination in maternity care experienced by Roma women in Hungary, due to ethnic and socio-economic factors.</p></div><div><h3>Methods</h3><p>We used data from the Cohort’18 Hungarian Birth Cohort Study, covering births in 2018–2019 (n = 7805). Face-to-face interviews were conducted by health visitors during pregnancy and six months postpartum. Differences in obstetric care were tested using Welch’s ANOVA. Logistic regression models estimated the influence of Roma ethnicity on birth position, adjusting for socio-economic variables. Odds ratios with 95 % confidence intervals and adjusted predictions were calculated.</p></div><div><h3>Results</h3><p>Roma mothers had a lower rate of caesarean section due to fewer planned interventions (13.3% vs. 19.1% for non-Roma mothers). Roma women were less likely than non-Roma women to have a birth attended by a private obstetrician (15% vs. 52.6%) and less likely to have a family member present at the birth (40% vs. 65.5%). For vaginal births, 61.3% of Roma women had their birth position dictated by hospital staff, compared with 40.6% of non-Roma women. Ethnic background significantly influenced the choice of birth position, but these associations were attenuated after adjustment for socio-economic and territorial factors. Variables such as the presence of a private obstetrician, family support, and residence in Central Hungary reduced the likelihood of giving birth in a fixed position.</p></div><div><h3>Conclusion</h3><p>Roma women face significant disadvantages in maternity care in Hungary. Ethnic background has a negative impact on the quality of care, but it is also significantly influenced by adverse socio-economic and regional factors.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women’s experiences of maternal near miss: Qualitative findings from Malawi","authors":"Monica Patricia Malata ,&nbsp;Alisa Jenny ,&nbsp;Dilys Walker ,&nbsp;Luis Aaron Gadama","doi":"10.1016/j.srhc.2024.101012","DOIUrl":"10.1016/j.srhc.2024.101012","url":null,"abstract":"<div><h3>Objective</h3><p>This study explored the experiences of women with maternal near miss and their perceptions of the quality of care they received in three facilities in Malawi.</p></div><div><h3>Methods</h3><p>This study employed a qualitative phenomenological approach. Data were collected using in depth interviews and analysed using thematic content analysis. The data were collected in three hospitals between September and November 2020. The purposively selected participants were 18 women meeting criteria for maternal near miss related to obstetric haemorrhage (6), hypertensive disorders (7), sepsis (2) and ruptured ectopic pregnancy (3).</p></div><div><h3>Results</h3><p>Women’s experiences of maternal near miss fell under four broad themes; (a) realisation of the near miss; (b) religious beliefs and interpretation of near miss; (c) social and economic aspects of maternal near miss; and d) perceptions of quality of care. Women’s initial emotional responses were fear and anxiety but were soon overshadowed by the fear for their babies’ wellbeing. Most women perceived the care they received as timely, adequate, and respectful, yet many women also expressed that their service providers did not provide an opportunity to openly discuss their condition.</p></div><div><h3>Conclusions</h3><p>The experience of near miss goes beyond the immediate physical discomforts and has psychological, economic, and social consequences for women and their families. Despite women’s perception of care as respectful, there are still communication gaps with their service providers. Campaigns to improve the communication between providers and patients and their families in situation of severe morbidity warrant consideration.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social disparities in delivery choice among patients with history of cesarean","authors":"Sara R. Wetzler ,&nbsp;Nicola F Tavella ,&nbsp;Lily McCarthy ,&nbsp;Gabriele Baptiste ,&nbsp;Toni Stern ,&nbsp;Chelsea DeBolt ,&nbsp;Angela Bianco","doi":"10.1016/j.srhc.2024.101011","DOIUrl":"10.1016/j.srhc.2024.101011","url":null,"abstract":"<div><h3>Objective</h3><p>Given the call to reduce rates of non-medically indicated cesarean deliveries (CDs) by encouraging trials of labor after cesarean (TOLAC), this study looks at social characteristics of patients choosing a TOLAC versus a scheduled repeat cesarean delivery (SRCD) to determine disparities regarding delivery method choice.</p></div><div><h3>Methods</h3><p>This was a retrospective cohort study of patients with a history of one CD between April 29, 2015–April 29, 2020. Patients were divided based on type of delivery chosen at admission. Chi-squared tests examined proportional differences between groups and logistic regression models examined odd ratios of choosing TOLAC versus SRCD according to socially dependent categories including race/ethnicity, health insurance, pre-pregnancy body mass index, and Social Vulnerability Index (SVI).</p></div><div><h3>Results</h3><p>1,983 patients were included. Multivariable logistic regression models revealed that patients with a high SVI (reference: low/medium SVI) (AOR 2.0, CI: 1.5, 2.5), self-identified as Black/ African American (AOR: 2.4, CI: 1.6, 3.6) or Hispanic/Latina (AOR: 2.0, CI: 1.4, 2.8) (reference: White), had public insurance (reference: private insurance) (AOR: 3.7, CI: 2.8, 5.0), and who had an obese BMI (reference: non-obese BMI) were more likely to opt for a TOLAC rather than SRCD.</p></div><div><h3>Conclusion</h3><p>These findings demonstrate differences in delivery method preferences. Specifically, more disadvantaged patients are more likely to choose TOLAC, suggesting that social and economic factors may play a role in delivery preferences. These findings have implications for improving individualized counselling and engaging in shared decision-making around mode of delivery.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141895029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}