Women's health (London, England)最新文献

{"title":"Breaking the silence: Addressing sexual health challenges among migrant and refugee women.","authors":"Zohra S Lassi, Negin Mirzaei Damabi, Mumtaz Begum, Jodie C Avery, Salima Meherali","doi":"10.1177/17455057251331263","DOIUrl":"10.1177/17455057251331263","url":null,"abstract":"<p><p>This editorial addresses the critical yet often overlooked issue of sexual health among migrant and refugee women. With nearly half of the world's 281 million international migrants being women, their unique health challenges demand urgent attention. As a conceptual discussion, this editorial does not present empirical data but rather synthesizes existing literature and expert insights to explore the multifaceted barriers these women face, including financial constraints, language obstacles, cultural taboos, and social exclusion. We examine the complex interplay between acculturation and sexual function, emphasizing how cultural transitions influence sexual well-being. The discussion explores how cultural background shapes sexual attitudes, highlighting the need for culturally sensitive approaches in healthcare delivery. We propose multifaceted solutions, including developing culturally competent healthcare services, implementing targeted education programs, and improving research methodologies. This editorial aims to break the silence surrounding these issues and calls for concerted efforts to address the sexual health needs of migrant and refugee women, ultimately fostering healthier, more equitable societies.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251331263"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053571","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":"Applying an intersectional climate justice lens to understand climate crisis impacts on sexual and reproductive health and rights and identify local solutions: Qualitative findings from Khulna, Bangladesh.","authors":"Sally Dijkerman, Jakaria Hossain, Maria Persson, Rabeya Akter Konika, Dipika Paul","doi":"10.1177/17455057251339283","DOIUrl":"10.1177/17455057251339283","url":null,"abstract":"<p><strong>Background: </strong>Climate change has been described as the greatest health threat of the 21st century. Increased evidence of the linkages between climate change and sexual and reproductive health and rights (SRHR) is essential to achieving full realization of SRHR.</p><p><strong>Objective: </strong>To understand if and how women and girls' perceived climate vulnerability impacts their SRHR decision-making, behaviors, and outcomes in cyclone-affected communities in coastal Khulna, Bangladesh, we conducted qualitative research using an intersectional climate justice lens.</p><p><strong>Design: </strong>Climate justice states that the climate crisis is not just an environmental or health problem, it is equally a political and social problem, whereby different communities feel the consequences differently, unevenly, and disproportionately depending on a multitude of factors shaped by intersecting systems of power and oppression. We adopted an intersectional climate justice lens to explore how women and girls' intersecting identities impact their experiences with climate change - particularly extreme weather events - and impact their perceived vulnerability. We employed a two-phased participatory qualitative research design.</p><p><strong>Methods: </strong>We conducted key informant interviews with local SRHR and climate change experts (<i>n</i> = 10) plus in-depth interviews (<i>n</i> = 15) and community dialog meetings (<i>n</i> = 8) with women and girls of reproductive age (<i>n</i> = 49). Transcripts, activity outputs, and field notes were transcribed verbatim in Bangla, translated to English, and subsequently coded and analyzed thematically using Dedoose.</p><p><strong>Results: </strong>Participants perceived numerous SRHR outcomes to be worsened by the climate crisis, including unintended pregnancy, sexual and gender-based violence, and pregnancy complications. Impacts were experienced differently across social categories, with overlapping identities including age, marital status, and religion magnifying vulnerability and risks to SRHR. Participants identified comprehensive SRHR and advances toward gender equity as essential for building climate resilience.</p><p><strong>Conclusion: </strong>Our findings provide actionable recommendations to support the full realization of climate justice and SRHR.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251339283"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152968","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 influence of rurality on women's decision making and pregnancy choices following an unintended pregnancy: A systematic review.","authors":"Genevieve Edwards, Leesa Hooker, Kristina Edvardsson","doi":"10.1177/17455057251348986","DOIUrl":"10.1177/17455057251348986","url":null,"abstract":"<p><p>Almost half of all pregnancies worldwide and 34% of pregnancies in high-income countries are considered unintended. Several studies from high-income countries report that women from rural areas are more likely to continue their unintended pregnancy and give birth, while urban women are more likely to have an induced abortion. To explore how rurality influences women's decision making and pregnancy choices following unintended pregnancy by examining the global trends for women who reside in rural areas of high-income countries. This study is a systematic review of qualitative, cross-sectional and mixed-methods studies. A systematic review of peer-reviewed literature, published from January 2000 through to March 2024, retrieved from five databases: CINAHL, Embase, MEDLINE, PsycINFO and PubMed. Restrictions were applied to obtain original research that has been undertaken in high-income countries. The review included studies featuring participants that were either rural women who experience an unintended pregnancy or health care professionals providing direct care to rural women. Nineteen studies met the inclusion criteria and were included in this review. Several factors that influenced rural women's decision making following an unintended pregnancy were identified: access to abortion services; role of health care professionals; temporal factors; social norms and stigma; social factors and determinants; culture, ethnicity and religion; reproductive coercion and abortion legislation. The Social-Ecological Model highlighted the levels of interaction, the role health care professionals, family members and the wider community in supporting or obstructing rural women's decision making. Rural women's pregnancy decision making and reproductive autonomy can be compromised by intimate partners, family members, health professionals and rural culture. Health professionals have a pivotal role in supporting and respecting rural women's decision making when seeking an abortion and ensuring that rural women have timely access to abortion care. Registration number: PROSPERO CRD 42023409917.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251348986"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487413","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":"A scoping review on clinicopathological characteristics, diagnosis, and management of intermammary pilonidal sinus disease.","authors":"Sepalika Wijekoon, Hasthaka Dissanayake, Umayanga Dehigama, Jeewantha Senevirathna, Hasangi Gamage, N P M Surage, G K P M Godakanda, Kanchana Wijesinghe","doi":"10.1177/17455057251351739","DOIUrl":"10.1177/17455057251351739","url":null,"abstract":"<p><strong>Background: </strong>Intermammary pilonidal sinus disease (IMPSD) is a rare condition that primarily affects the young population. Due to the absence of standardized guidelines, IMPSD poses significant challenges during management.</p><p><strong>Objectives: </strong>This scoping review aims to map and characterize the existing literature on IMPSD to provide an overview of clinicopathological characteristics, risk factors, diagnosis, and management.</p><p><strong>Eligibility criteria: </strong>Studies were included if they were original articles, case reports, or case series that met the inclusion criteria published in English during 2004 to 2024.</p><p><strong>Sources of evidence: </strong>A search was conducted using MeSH keywords \"Intermammary\" AND \"Pilonidal sinus\" in PubMed, Google Scholar, and by citation searching up to date.</p><p><strong>Charting methods: </strong>The PRISMA ScR guidelines were used as a charting method. Data extraction included demographic characteristics, clinical pathological characteristics, diagnostic methods, treatment approaches, and follow-up outcomes.</p><p><strong>Results: </strong>Ten articles met the inclusion criteria, including 33 patients with a mean age of 18.7 years. The majority of cases were reported from Turkey, Iraq, and India. Mean body mass index was 28.74 kg/m². Significant other comorbidities included polycystic ovary syndrome in 24% of cases. Large pendulous breasts and wearing tight brassieres were noted as other risk factors. Clinical presentation commonly involved discharging sinuses and painful swellings, with a mean duration of 8 months. Complementary investigations were seldom performed as the diagnosis was mainly clinical. The main modes of treatment included resection with primary closure or resection with secondary healing.</p><p><strong>Conclusion: </strong>Low prevalence and management challenges highlight the need for further research to establish standardized guidelines and the importance of formulating an individualized plan for the management of IMPSD based on a comprehensive evaluation of clinicopathological characteristics and patient wishes.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251351739"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562252","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 strong Black woman stereotype and identity shifting among Black women in academic and other professional spaces.","authors":"Naomi M Hall, Danielle D Dickens, Kelly A Minor, Zharia Thomas, Cheyane Mitchell, Nailah Johnson","doi":"10.1177/17455057251335358","DOIUrl":"10.1177/17455057251335358","url":null,"abstract":"<p><strong>Background: </strong>Black women, relative to their Black male and White counterparts, may be more prone to experiencing racism and sexism in academic and other professional settings due to the \"double jeopardy\" or stigma of being both Black and a woman. Few studies have quantitatively studied how Black women in academic and professional spaces may mitigate the oppressive circumstances experienced by engaging in a coping strategy called identity shifting.</p><p><strong>Objectives: </strong>This study used an intersectional framework to investigate the relationships between the strong Black woman (SBW) stereotype, gendered racial identity centrality (GRIC), identity shifting, and mental health outcomes among 289 Black women (<i>M</i>_age = 29.46 years, SD = 10.74). It was hypothesized that there was a significant positive relationship between endorsement of the SBW schema, GRIC, and identity shifting. Additionally, we hypothesized the relationship between SBW and identity shifting is moderated by mental health such that more (a) depressive (b) and anxiety symptoms will result in a stronger relationship between stereotype endorsement and identity shifting strategies.</p><p><strong>Design: </strong>This study employed a quantitative, cross-sectional design using data collected in 2019 and 2020 from a larger validation study.</p><p><strong>Methods: </strong>Participants were recruited through emails, campus flyers, text messages, and social media postings. After providing informed consent, participants completed a 30- to 40-min online survey via Qualtrics.</p><p><strong>Results: </strong>There was partial support for the first hypothesis. While greater endorsement of the SBW stereotype by Black women did result in engagement with more identity shifting strategies, the relationship between these strategies and GRIC was not significant. The second hypothesis was not supported as mental health variables did not moderate the relationship between SBW and identity shifting.</p><p><strong>Conclusion: </strong>The importance of examining the gendered racial experiences of Black women is discussed, along with the importance of addressing SBW and identity shifting in academia and in professional workspaces.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251335358"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251264","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":"Pregnancy and physical disability: A scoping review.","authors":"Claire Z Kalpakjian, Lukonde Mulenga, Shannen M McIntosh, Jodi M Kreschmer, Rebecca Parten, Heidi Haapala, Elizabeth S Langen, Sara A S Rosenblum, Svati Pazhyanur, Susan Carlson, Maryam Berri, Susan D Ernst","doi":"10.1177/17455057251338424","DOIUrl":"10.1177/17455057251338424","url":null,"abstract":"<p><strong>Background: </strong>Women with disabilities have a similar desire for pregnancy as their non-disabled peers but experience more ambivalence and doubt about their intention to have a child. While many have healthy pregnancies, they face higher risks and trade-offs in health, function, and independence.</p><p><strong>Objectives: </strong>To review the literature on pregnancy in women with physical disabilities to guide interventions and clinical care guidelines.</p><p><strong>Eligibility criteria: </strong>Abstracts were reviewed if they were original research on pregnancy involving adult women with physical disabilities. Both qualitative and quantitative studies were included, with no restrictions on language or publication year.</p><p><strong>Sources of evidence: </strong>PubMed, Scopus, and CINAHL Complete and reference lists of eligible articles.</p><p><strong>Charting methods: </strong>Abstracts were eligible for full-text review if they were (1) original research, (2) in humans, (3) about pregnancy, and (4) involved adult women with physical disabilities. Data were extracted by independent reviewers using Covidence software and assessed with a customized critical appraisal guide.</p><p><strong>Results: </strong>Five major topics characterized 171 reviewed articles: (1) rates of pregnancy, fertility, and termination or loss; (2) pregnancy complications and infant outcomes; (3) effects of pregnancy on physical function disease activity; (4) maternal care; and (5) social and interpersonal dimensions of pregnancy. Most studies were conducted in the Americas and Europe, and high-income countries used a quantitative design and were assessed to have a moderate risk of bias.</p><p><strong>Conclusions: </strong>This review highlights the need for future research to (1) build a stronger evidence base for tailored maternal care, (2) examine disability discrimination's impact on pregnancy outcomes, (3) develop interventions to reduce disability-related inequities, and (4) improve disability competence among maternal care providers.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251338424"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152952","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 relation of heavy or prolonged bleeding during the menopause transition to risk of hysterectomy.","authors":"Siobán D Harlow, Michelle M Hood, Alain Mukwege, John F Randolph, Ellen B Gold, Michael R Elliott, Alaina C White, Gail A Greendale","doi":"10.1177/17455057251351418","DOIUrl":"https://doi.org/10.1177/17455057251351418","url":null,"abstract":"<p><strong>Background: </strong>During the menopause transition, one in three women experiences abnormal uterine bleeding. Few studies have evaluated the probability of hysterectomy associated with abnormal uterine bleeding during the menopause transition.</p><p><strong>Objectives: </strong>To estimate the risk of hysterectomy associated with abnormal uterine bleeding, specifically prolonged or heavy menstrual bleeding, during the menopause transition.</p><p><strong>Design: </strong>Prospective cohort studyMethods:We used data collected in the Study of Women's Health Across the Nation, a community-based, longitudinal cohort that followed women from pre- to post-menopause. It includes 1200 White (45.4%), Black (15.4%), Japanese (20.8%), and Chinese (18.4%) women, from three study sites that participated in a sub-study and provided at least 1 year of prospectively recorded menstrual calendars. Calendars ascertained bleeding days, menstrual interference with life in four domains (work, daily life, sexual life, and relationships), menopausal hormone therapy, and smoking. At baseline and 12 annual follow-up visits, information on surgeries, body mass index, pelvic pain, and socio-demographic characteristics was obtained. Multivariable Cox proportional hazard models were used to assess the relationships of hysterectomy with prolonged menstrual bleeding, heavy menstrual bleeding, and covariates.</p><p><strong>Results: </strong>Women who reported prolonged menstrual bleeding had an elevated hazard of hysterectomy (hazard ratio = 2.35, 95% confidence interval = 1.20-4.61), adjusting for pelvic pain, hormone use, and race/ethnicity; hazard ratios were attenuated after adjusting for life interference. The association of heavy menstrual bleeding with hysterectomy was not statistically significant (hazard ratio = 1.34, 95% confidence interval = 0.42-4.30). The adjusted hazard ratio for hysterectomy increased 1.5-fold for each domain in which bleeding interfered with a woman's life. Pelvic pain, hormone therapy, and Black race were also significant predictors of hysterectomy risk.</p><p><strong>Conclusion: </strong>Prolonged menstrual bleeding during the menopause transition, particularly when accompanied by interference in one or more domains of a woman's life, increased the risk of hysterectomy. Counseling women about non-surgical therapeutic options, and estimating the proximity of menopause, may mitigate against this increased risk.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251351418"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to increase self-reported physical activity during pregnancy: A systematic review.","authors":"Kallie Nowell, Deirdre Dlugonski, Emily DeFranco, Linda May, Johanna M Hoch","doi":"10.1177/17455057251351729","DOIUrl":"https://doi.org/10.1177/17455057251351729","url":null,"abstract":"<p><strong>Background: </strong>Only 52% of pregnant women achieve the recommended amount of physical activity throughout pregnancy. Many studies have aimed to improve health-related outcomes by introducing physical activity interventions during pregnancy. A systematic search summarizing studies using self-reported physical activity measures is necessary, as this is a clinical outcome measure that can be utilized routinely in clinical practice.</p><p><strong>Objectives: </strong>The purpose of this systematic review was to synthesize, critically appraise, and determine the effectiveness of interventions designed to improve self-reported measures of physical activity in pregnant women.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Data sources and methods: </strong>EBSCO and PubMed were searched from January 1, 2014, through January 1, 2024. A hand search of references was also performed. Included studies must have utilized a randomized controlled trial or clinical trial design where a physical activity intervention was implemented, included healthy pregnant women, and utilized a self-reported physical activity measure pre- and post-intervention. Two reviewers independently appraised each article with the Physiotherapy Evidence Database scale. The Strength of Recommendation Taxonomy was used to make an overall strength of recommendation.</p><p><strong>Results: </strong>Twelve studies met the inclusion criteria for this systematic review. Seven studies were ranked as \"fair\" quality, and five studies were ranked as \"good\" quality. The primary groupings of the interventions included the following: phone or app-based, face-to-face counseling, or group fitness classes/access to local resources. Eight studies provided sufficient data to calculate effect sizes and associated 95% confidence intervals. The largest effect sizes were calculated for the phone or app-based interventions.</p><p><strong>Conclusions: </strong>A level B strength of recommendation was given to evidence supporting phone or app-based interventions, counseling interventions, and group fitness or access to local resources interventions. Future research should focus on further investigating the use of phone or app-based interventions or counseling interventions to promote physical activity among pregnant women.</p><p><strong>Registration: </strong>Prospero CRD42024526761.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251351729"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging artificial intelligence for inclusive maternity care: Enhancing access for mothers with disabilities in Africa.","authors":"Obasanjo Bolarinwa, Aliu Mohammed, Victor Igharo, Sinegugu Shongwe","doi":"10.1177/17455057251326675","DOIUrl":"10.1177/17455057251326675","url":null,"abstract":"<p><p>Women with disabilities face significant barriers in accessing maternal healthcare, which increases their risk of adverse pregnancy outcomes, particularly in Africa, where resources are limited. Artificial intelligence (AI) presents a unique opportunity to improve inclusivity and accessibility to antenatal care, skilled birth attendance and postnatal care for these women. This paper explores the potential of AI to address the socio-economic, physical, and institutional barriers that limit the utilisation of maternal healthcare services by women with disabilities. AI-driven technologies, such as virtual assistants, predictive analytics, and wearable devices, can enhance maternal health outcomes by improving monitoring during pregnancy, providing real-time health data, and facilitating access to skilled care. However, the successful implementation of AI in maternal healthcare in Africa faces challenges, including technological infrastructure, data quality, and ethical concerns. Collaborative efforts between governments, healthcare providers, and AI developers are necessary to overcome these challenges and ensure AI tools are inclusive, culturally sensitive, and accessible. Integrating AI into maternal healthcare services could lead to improved maternal outcomes, reduce mortality rates, and promote equity for women with disabilities in Africa.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251326675"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634918","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":"Multi-level barriers to equitable postpartum permanent contraception.","authors":"Suzanna Larkin, Brooke W Bullington, Kristen A Berg, Kari White, Margaret Boozer, Tania Serna, Emily S Miller, Jennifer L Bailit, Kavita Shah Arora","doi":"10.1177/17455057251325977","DOIUrl":"10.1177/17455057251325977","url":null,"abstract":"<p><strong>Background: </strong>There are several barriers to fulfillment of desired postpartum permanent contraception (PC). Prior research has primarily focused on the federal Medicaid sterilization policy as a barrier to PC; however, other barriers need to be examined.</p><p><strong>Objectives: </strong>To explore the levels and intersections of barriers to postpartum PC that exist external to the Medicaid policy.</p><p><strong>Design: </strong>We interviewed postpartum people with a documented desire for PC and their delivering obstetrician-gynecologist (OB-GYN) at four hospitals in the United States in 2022-2023.</p><p><strong>Methods: </strong>We used rapid qualitative analysis to create initial key themes and sub-themes, which we further refined using thematic analysis to explore barriers to postpartum PC.</p><p><strong>Results: </strong>We interviewed 81 postpartum people and 67 OB-GYNs. Barriers were identified across four levels: clinical, physician, hospital, and sociocultural. At the clinical level, participants commented on how they believed individual patient characteristics and medical history can prevent PC fulfillment prior to discharge. At the physician level, participants discussed young age, low parity, and marital status as reasons clinicians decline to provide desired PC. At the hospital level, OB-GYNs described difficulties with scheduling and staffing, and patients described a lack of PC prioritization. At the sociocultural level, participants mentioned numerous barriers to fulfillment of interval PC including finding childcare, getting appointments scheduled quickly, and transportation.</p><p><strong>Conclusion: </strong>Improving access to postpartum PC should be focused within and across all levels of health disparity determinants. In the cases where immediate PC is not accessible, interventions should be formulated across levels to allow timely access to interval PC. As policy reform alone will not eliminate all barriers to postpartum PC, a multi-level approach to alleviating barriers is required.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251325977"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607549","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}