Frontiers in global women's health最新文献

{"title":"Effective coverage of antenatal care and associated factors among pregnant women in Tanzania: a multilevel analysis.","authors":"Amanuel Yosef Gebrekidan, Beshada Zerfu Woldegeorgis, Gizachew Ambaw Kassie, Kirubel Eshetu Haile, Ashenafi Teklay Abrha, Angwach Abrham Asnake, Yordanos Sisay Asgedom","doi":"10.3389/fgwh.2025.1477666","DOIUrl":"10.3389/fgwh.2025.1477666","url":null,"abstract":"<p><strong>Background: </strong>Antenatal care (ANC) is a crucial part of reproductive health care, providing opportunities for health promotion, screening, diagnosis, and illness prevention. However, evidence has shown that poor-quality ANC is prevalent. Therefore, this study aimed to investigate the effective coverage (quality-adjusted coverage) of ANC and its associated factors among pregnant women in Tanzania.</p><p><strong>Methods: </strong>This research was based on data from the 2022 Tanzania Demographic and Health Survey. The study utilized a weighted sample of 3,890 pregnant women. Given the influence of clustering and the binary nature of the outcome variable, we used a multilevel binary logistic regression model. Statistical significance was determined using the adjusted odds ratio (AOR) with a 95% confidence interval (CI), taking into account the model with the lowest deviation that best matched the data.</p><p><strong>Results: </strong>In this study, the effective coverage of ANC was 39.3% [95% confidence interval (CI): 37.8, 40.8]. After considering both individual- and community-level variables, women's age, educational status, husbands'/partners' employment status, wealth index, number of ANC visits, administrative zones, and urban residence were all found to have statistically significant associations with effective ANC coverage among pregnant women in Tanzania.</p><p><strong>Conclusion: </strong>Only four out of ten pregnant women received effective ANC (quality-adjusted ANC), underscoring that crude coverage and access to healthcare do not ensure quality ANC. Emphasis should be placed on integrating component-based indicators. Furthermore, all attempts to provide all components should be considered during women's first visit, in addition to the need to increase the number of visits by pregnant women. Additionally, more attention should be paid to disadvantaged groups in terms of wealth and residence, and the fee exemption strategy should be supported by boosting the availability of healthcare supplies, particularly in remote areas.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1477666"},"PeriodicalIF":2.4,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Setbacks in the road to self-injection: a descriptive study of provider and mystery client reports on the DMPA-SC care-seeking experience in Nigeria.","authors":"Madeline Griffith, Sneha Challa, Ayobambo Jegede, Ivan Idiodi, Chioma Okoli, Aminat Tijani, Shakede Dimowo, Awawu Grace Nmadu, Elizabeth Omoluabi, Jenny Liu","doi":"10.3389/fgwh.2025.1552379","DOIUrl":"10.3389/fgwh.2025.1552379","url":null,"abstract":"<p><p>This mixed-methods study describes perspectives from health providers and simulated clients on initiation and continuation of DMPA-SC for self-injection in Nigeria. Through mystery (simulated) client interactions, we found that providers were similarly willing to dispense units of DMPA-SC for self-injection to different client profiles, which varied in age, marital status, and parity. However, in-depth interviews with providers revealed nuance in their approaches to assessing clients' eligibility for unsupervised self-injection of DMPA-SC. Factors including client age, marital status, parity, and education influenced who they deemed able to self-inject, which may limit access to DMPA-SC for clients who wish to self-inject the method. Quantitative and qualitative data also indicated that clients faced setbacks in continuing unsupervised self-injection when seeking refills from an unfamiliar provider. Stockouts of DMPA-SC further complicated access; some providers resorted to purchasing DMPA-SC privately and passing the cost onto clients. These findings highlight the need for clearer refill protocols and more consistent supply to ensure equitable access to DMPA-SC for self-injection in Nigeria.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1552379"},"PeriodicalIF":2.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I feel like it gets worse as I get older\": perspectives of peri-postmenopausal women with PCOS.","authors":"Pamela J Wright, Cynthia F Corbett, Robin M Dawson, Charlotte Burts","doi":"10.3389/fgwh.2025.1588505","DOIUrl":"10.3389/fgwh.2025.1588505","url":null,"abstract":"<p><strong>Introduction: </strong>Polycystic ovary syndrome (PCOS) is a chronic endocrinopathy that transcends the reproductive years. Peri-postmenopausal women with PCOS remain at cardiometabolic risk or subsist with established comorbidity while continuing to contend with persistent PCOS signs and symptoms such as hirsutism. Evidence based information for peri-postmenopausal women with PCOS is scant. The purpose of this qualitative study was to explore the physical, psychosocial, and healthcare perspectives of peri-postmenopausal women with PCOS.</p><p><strong>Methods: </strong>Peri-postmenopausal women with PCOS aged ≥43 years (<i>n</i> = 29) were recruited using ResearchMatch to participate in a virtual interview. Interviews were conducted using a semi-structured guide. The interviews were transcribed, de-identified, and analyzed using the steps of reflexive thematic analysis.</p><p><strong>Results: </strong>Participants were aged 52.5 (±6.6) years, mostly White (69.0%), and highly educated with 62.0% having at least a college degree. In terms of health, most participants were perimenopausal (<i>n</i> = 20; 69.0%), categorized as \"obese\" (BMI ≥30) (<i>n</i> = 20, 69%), had ≥3.0 comorbidities (<i>n</i> = 26; 90%), and took ≥5 prescribed medications (<i>n</i> = 17; 58.0%). Five overall themes were identified: (1) Déjà vu?, (2) Sociocultural Stigma, (3) Trauma Experiences, (4) Self-Advocacy, and (5) Resilience vs. Resignation.</p><p><strong>Discussion: </strong>The identified themes highlight the need for a more proactive, trauma-informed, culturally tailored healthcare approach that provides education and support in managing PCOS over the lifespan. Women's needs include resources after adverse pregnancy outcomes and routine screening of emotional health, with subsequent treatment when indicated. The findings indicate a need for healthcare provider communication and sensitivity training. Women with PCOS could benefit from advocacy and resilience training. As a relatively unexplored area of women's health, more research is needed to address the needs of older women with PCOS and develop and test programs that train healthcare providers to deliver patient-centered care and equip women with the information and resources to properly manage PCOS and cop effectively over their life course.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1588505"},"PeriodicalIF":2.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness of gestational diabetes mellitus and its associated factors among pregnant women in public hospitals in the East Gojjam Zone, Northwest Ethiopia: a cross-sectional study.","authors":"Getachew Tilaye Mihiret, Kumlachew Solomon Wondmu, Fekadu Baye, Mulunesh Minale, Mastewal Yechale, Misganaw Fikrie Melese, Aysheshim Belaineh Haimanot, Temesgen Getaneh","doi":"10.3389/fgwh.2025.1535344","DOIUrl":"10.3389/fgwh.2025.1535344","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is the most common metabolic complication during pregnancy and is associated with an increased risk of maternal and neonatal adverse outcomes. Despite it being the most prevalent complication and leading to poor pregnancy outcomes, there have been very few studies assessing awareness of GDM among pregnant women in Ethiopia. Therefore, this study aimed to determine the awareness of GDM and its associated factors among pregnant women in public hospitals in the East Gojjam Zone, Northwest Ethiopia.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted from June to August 2024. A systematic random sampling technique was utilized to select 423 participants. The data were collected using an interviewer-administered questionnaire. The collected data were analyzed using SPSS version 25. Binary logistic regression was fitted to assess the association between the explanatory variables and the outcome variable. Variables with a <i>p</i>-value less than 0.05, along with corresponding 95% confidence intervals, were used to declare statistical significance.</p><p><strong>Results: </strong>This study found that 27.0% (95% CI: 0.23-0.31) of the pregnant women were aware of GDM. The most common source of information about GDM was friends at 53.2%, followed by family and healthcare professionals. Factors such as partner involvement [adjusted odds ratio (AOR) = 0.58; 95% CI = (0.35-0.95)], family history of chronic medical conditions [AOR = 5.20; 95% CI = (2.40-11.25)], mistimed but wanted pregnancies [AOR = 3.36; 95% CI = (1.40-8.10)], and being Muslim [AOR = 2.89; 95% CI = (1.34-6.24)] were significantly associated with awareness of GDM.</p><p><strong>Conclusion: </strong>Only a small proportion of pregnant women were aware of GDM. Mistimed but desired pregnancies, partner involvement, and family history of chronic medical conditions were significantly associated with GDM awareness. In order to mitigate the growing burden of GDM, healthcare professionals need to do more to educate women about GDM during their prenatal care follow-ups.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1535344"},"PeriodicalIF":2.4,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Ischemic stroke in a young transgender woman due to unsupervised estrogen therapy.","authors":"Lucas Blanco Insaurralde da Luz Silva, Andressa Camilo Oliveira, Anny Gabriela Marçal de Carvalho Araújo, Maria Luiza Ferri Cury, Isabela de Carvalho Florêncio, Amanda Boutrik, Franciely Hyun Su Barakat Kim, Egidi Mayara Firmino Silva, Luana Karen Dos Santos, Renata Gratão Rezende, Rodolfo Antônio Corona, Gabriel Pereira Braga","doi":"10.3389/fgwh.2025.1588553","DOIUrl":"10.3389/fgwh.2025.1588553","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke is often associated with the elderly population, but recent epidemiological data indicate an increasing incidence among young adults. Among the risk factors, estrogenic hormone therapy (HT) has been linked to cerebrovascular events. This report presents the case of a transgender woman who suffered an ischemic stroke during the inappropriate use of HT, highlighting the importance of medical follow-up and risk assessment in gender-affirming therapy.</p><p><strong>Case description: </strong>A 30-year-old transgender female patient had been using estrogenic HT purchased on the black market (cyproterone 2 mg + ethinyl estradiol 0.035 mg/day) since the age of 17, without medical supervision. She had a history of HIV infection under irregular treatment and previously treated syphilis. She developed sudden-onset right-sided hemiparesis and homonymous hemianopsia. The initial computed tomography scan revealed no abnormalities, but magnetic resonance imaging showed ischemia in the territory of the left posterior cerebral artery. Etiological investigation with echocardiography, carotid and vertebral Doppler ultrasound, electrocardiogram, Holter monitoring, and thrombophilia panel revealed no abnormalities. The final etiological diagnosis was classified according to the TOAST criteria as \"other causes,\" attributed to the inappropriate use of estrogenic therapy. She was discharged with antiplatelet therapy, a statin, and fluoxetine, along with the discontinuation of hormone therapy and referral to transgender and vascular neurology outpatient clinics.</p><p><strong>Discussion: </strong>HT is essential in gender affirmation; however, its use is associated with increased risks of thromboembolic and cerebrovascular events. The patient in this case did not present traditional risk factors for stroke, reinforcing the suspicion of estrogen's role in the event. Studies suggest that supervised hormone therapy carries a lower risk of complications compared to indiscriminate use. Nonetheless, there are still gaps in the literature regarding the correlation between HT and stroke in transgender individuals.</p><p><strong>Conclusion: </strong>This case highlights the risks of inappropriate use of gender-affirming hormone therapy and the need for rigorous medical supervision. Given the growing access to this treatment, continuous monitoring is essential to minimize complications. Further research is needed to establish safer guidelines for the use of hormone therapy in the transgender population.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1588553"},"PeriodicalIF":2.4,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The depth structure of a good birth: reconfiguring the environment in a high-risk labour ward birth and creating sanctuary behind a screen.","authors":"Jane Clossick","doi":"10.3389/fgwh.2025.1610077","DOIUrl":"10.3389/fgwh.2025.1610077","url":null,"abstract":"<p><p>This article explores how the spatial, relational, and sensory conditions within an obstetric-led hospital birth room were subtly reconfigured to support a safe, satisfying birth, even though the birth in question was considered high risk. Drawing on autoethnographic reflections and interviews with caregivers from the author's own birth at the National Health Service Royal London Hospital, the paper examines the transformation of a standard labour ward room through a low-tech intervention: the erection of a cloth screen brought from home. This simple act created a distinct spatial zone in which institutional norms were less prevalent, fostering privacy, autonomy, and integrative care practices that protected physiological labour and enhanced maternal agency. The article situates this personal narrative within broader theoretical frameworks of birth territory, sociospatial theory, environmental psychology, and institutional power, arguing that space and care interact in complex ways to shape birth experiences. It contributes to calls for more humanised, woman-centred approaches to birth architecture and practice, particularly in highly techno-rational and medicalised settings, and proposes that even small acts of spatial resistance have the potential to generate meaningful shifts in care culture.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1610077"},"PeriodicalIF":2.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in clinical risk factors for Alzheimer's dementia patients with early-onset and late-onset.","authors":"Nathan Gerhard Faulstich, Sammy Hilmi Omar, Connor John O-Brien, Dami Taiwo Ojo, Philip Cole Brewer, Emmanuel I Nathaniel, Richard Goodwin, Laurie Roley, Adebobola Imeh-Nathaniel, Thomas I Nathaniel","doi":"10.3389/fgwh.2025.1601375","DOIUrl":"10.3389/fgwh.2025.1601375","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study is to identify the risk factors that contribute to sex differences in patients with Alzheimer dementia (AD), specifically focusing on Early-Onset Alzheimer's Dementia (EAOD) and Late-Onset Alzheimer Dementia (LOAD). Additionally, the study aims to determine whether these risk factors differ between male and female EAOD and LOAD patients.</p><p><strong>Methods: </strong>Our retrospective cohort study included a total of 6,212 patients diagnosed with either EOAD or LOAD from February 2016 to August 2020. Among this population, 687 patients (11.06%) were diagnosed with EOAD, while 5,525 patients (88.94%) had LOAD. We conducted a univariate analysis to identify differences in risk factors between male and female AD patients. A multivariate analysis was also performed to predict specific risk factors associated with male and female EOAD and LOAD patients.</p><p><strong>Results: </strong>In the adjusted analysis, males with LOAD were found to have significantly higher odds of several comorbidities, including dyslipidemia [Odds Ratio (OR) = 1.720, 95% Confidence Interval (CI) = 1.489-1.987, <i>p</i> < 0.001], peripheral vascular disease (OR = 2.324, 95% CI = 1.828-2.955, <i>p</i> < 0.001), obstructive sleep apnea (OR = 2.330, 95% CI = 1.768-3.070, <i>p</i> < 0.001), and pneumonia (OR = 1.235, 95% CI = 1.004-1.520, <i>p</i> = 0.046). In contrast, females with LOAD were associated with lower odds of having hypertension (OR = 0.715, 95% CI = 0.623-0.820, <i>p</i> < 0.001), osteoporosis (OR = 0.310, 95% CI = 0.254-0.380, <i>p</i> < 0.001), urinary tract infections (OR = 0.638, 95% CI = 0.521-0.782, <i>p</i> < 0.001), congestive heart failure (OR = 0.626, 95% CI = 0.481-0.815, <i>p</i> < 0.001), and rheumatoid arthritis. In male patients with EAOD the analysis indicated a strong association with gait dysfunction (OR = 10.797, 95% CI = 3.257-35.792, <i>p</i> < 0.001), peripheral vascular disease (OR = 3.835, 95% CI = 1.767-8.321, <i>p</i> < 0.001), and Chronic Obstructive Pulmonary Disease (COPD) (OR = 5.984, 95% CI = 2.186-16.381, <i>p</i> < 0.001). Conversely, females with EOAD were associated with significantly lower odds of experiencing cerebrovascular accidents (OR = 0.347, 95% CI = 0.155-0.778, <i>p</i> < 0.001), osteoporosis (OR = 0.345, 95% CI = 0.155-0.778, <i>p</i> = 0.030), and anxiety (OR = 0.412, 95% CI = 0.203-0.833, <i>p</i> = 0.014).</p><p><strong>Conclusions: </strong>Our findings indicate sex differences in the risk factors for EAOD and LOAD patients. Understanding these risk factors can help us develop strategies to improve diagnostic accuracy, create targeted interventions, and enhance clinical outcomes for both male and female EAOD and LOAD patients.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1601375"},"PeriodicalIF":2.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting under the skin of the menopausal hot flush: a protocol to examine skin function and structure in symptomatic postmenopausal women.","authors":"Kirsty A Roberts, Abigail Doyle, Helen Jones, David A Low","doi":"10.3389/fgwh.2025.1514960","DOIUrl":"10.3389/fgwh.2025.1514960","url":null,"abstract":"<p><strong>Introduction: </strong>The major pathophysiological symptom of the menopause affecting daily life is hot flushes, which are also associated with elevated cardiovascular disease risk. A hot flush is a sudden and intense heat sensation causing skin flushing and profuse sweating. Menopause-induced oestrogen deficiency could increase the sensitivity of skin blood vessels and sweat glands in postmenopausal women, which could result in more frequent and larger increases in skin blood flow in postmenopausal women consistent with hot flushes. Furthermore, oestrogen withdrawal could also alter the structure of the skin blood vessels and/or sweat glands which may also contribute to hot flushes. This trial aims to examine the function and structure of skin blood vessels and sweat glands in premenopausal and postmenopausal women.</p><p><strong>Methods and analysis: </strong>This is a single-centre multi-cohort observational study. Participants will attend the laboratory at Liverpool John Moores University (LJMU) on two separate occasions, ∼7 days apart. Visit 1 will consist of anthropometry, a blood sample and assessment of post-ganglionic skin blood vessel and sweat gland responsiveness via cutaneous microdialysis. At visit 2, participants will return for a skin punch biopsy. A between groups statistical analysis of the pre- and postmenopausal cohorts will be conducted in a blinded manner.</p><p><strong>Ethics and dissemination: </strong>The trial was approved by the North West - Greater Manchester South Research Ethics Committee (22/NW/0300) in the UK. The study adheres to The Declaration of Helsinki and is being conducted in accordance with the UK Policy Framework for Health and Social Care Research.</p><p><strong>Discussion: </strong>Identifying functional and/or structural changes in skin blood vessels or sweat glands in women with hot flushes would increase our understanding of their cause(s) and side effects, and help to design effective treatments, including interventions that can manipulate the activity of the skin blood vessels and/or sweat glands via pharmacological or non-pharmacological methods.</p><p><strong>Trial registration numbers: </strong>NCT06222073.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1514960"},"PeriodicalIF":2.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnoracial and rural-urban differences in female sterilization in Bolivia, Colombia, Guatemala, and Peru.","authors":"Lucrecia Mena-Meléndez","doi":"10.3389/fgwh.2025.1582729","DOIUrl":"10.3389/fgwh.2025.1582729","url":null,"abstract":"<p><strong>Introduction: </strong>In Latin America, 26 percent of women use sterilization to avert unwanted pregnancies. Although sterilization provides first-tier effectiveness, long-acting continuation over time, and life-long cost-benefit, previous research has documented persistent inequalities in access and use worldwide.</p><p><strong>Methods: </strong>This study uses Demographic and Health Survey (DHS) data for Bolivia, Colombia, Guatemala, and Peru (1986-2015), to explore ethnoracial, geographic, socioeconomic, individual, and reproductive differences in female sterilization [N (level-1 women) = 112,135; N (level-2 clusters) = 4,946].</p><p><strong>Results: </strong>Results from descriptive analyses and logistic multilevel regression models indicate that ethnoracial minorities and rural women had lower odds of reporting female sterilization as their current contraceptive method. Compared to Bolivian women, Colombian and Guatemalan women had higher odds of reporting sterilization, while Peruvian women had lower odds. Older, wealthier, more educated, and those employed outside the home had higher odds of reporting sterilization. Additionally, those older at first birth, with higher parity, with a longer interval since preceding birth, and with previous experience with unintended pregnancies had higher odds of reporting sterilization.</p><p><strong>Discussion: </strong>Findings suggest that social, geographic, and structural factors may shape equitable access to sterilization for some groups. Future efforts should prioritize reducing access gaps between ethnoracial groups and rural-urban populations by strengthening health systems and ensuring culturally appropriate, equitable care.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1582729"},"PeriodicalIF":2.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological functioning in pregnant women who experienced complex trauma.","authors":"Geneviève Lapointe, Christine Drouin-Maziade, Julia Garon-Bissonnette, Florence Bordeleau, Roxanne Lemieux, Nicolas Berthelot","doi":"10.3389/fgwh.2025.1611034","DOIUrl":"10.3389/fgwh.2025.1611034","url":null,"abstract":"<p><strong>Introduction: </strong>The concept of complex trauma, which has been operationalized by the diagnosis of developmental trauma disorder (DTD) in children and adolescents, may contribute to our understanding of the large interindividual variability in maternal health and functioning among pregnant women who experienced childhood maltreatment. The study examines whether three groups of pregnant women (one including women who experienced childhood maltreatment and suffered from DTD, a second including women who experienced childhood maltreatment but did not suffer from DTD, and a third group including women who did not report experiencing childhood maltreatment) differ on mental health and functioning during the prenatal period. Several markers associated with the intergenerational trajectories of childhood maltreatment were examined: severity of PTSD symptoms, quality of prenatal attachment, perception of maternal competence, reflective functioning, disruptions in mentalization of trauma and adverse relationships, intimate partner violence, and mental health disorders.</p><p><strong>Methods: </strong>The study includes 373 pregnant women who participated in a comprehensive diagnostic assessment of current and lifetime psychiatric disorders conducted by two blinded and independent clinical psychologists. The women also completed self-report measures of symptoms and functioning.</p><p><strong>Results: </strong>Women with DTD (<i>n</i> = 26) had more severe symptoms of PTSD, lower quality of prenatal attachment to the fetus, lower perceptions of maternal competence, less curiosity about mental states, and more severe disruptions in mentalizing trauma and adverse relationships than women who experienced childhood maltreatment but never met the diagnostic criteria for a DTD (<i>n</i> = 99) and women not exposed to childhood maltreatment (<i>n</i> = 248). In contrast, women who experienced childhood maltreatment but did not develop a DTD did not differ from women not exposed to maltreatment on all domains except the level of disruptions in mentalizing trauma and adverse relationships. Women who had a DTD in childhood or adolescence also had an 18.5-fold and 25.4-fold increased risk of having a mental health disorder during pregnancy compared, respectively, to women who had experienced maltreatment without DTD and women who had not experienced maltreatment. Persistent complex trauma, defined as the presence of a diagnosis of Complex PTSD during pregnancy, was present in over a third (34.6%) of women with DTD.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1611034"},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}