Women's Health Commons^™

Bridging The Divide White Paper On Medication Abortion: Overview Of Research & Policy In The United States, Liz Borkowski, Julia Strasser, Amy Allina, Susan Wood

Jacobs Institute of Women's Health

Medication abortion (also called medical abortion) is a safe method of abortion available for the past 15 years in the US. The Bridging the Divide white paper summarizes the scientific evidence related to the current medication abortion process and potential changes to the process that could make it even safer and more accessible for patients, as well as policy considerations and directions for future research.

In the fall of 2000, the US Food & Drug Administration (FDA) approved the drug Mifeprex© (generic: mifepristone) for use in medication abortions. That approval included requirements that affect both patients and providers and that …

Educated Birth: Beliefs Vs. Outcomes, Lauren Presley

Human Nutrition and Hospitality Management Undergraduate Honors Theses

“Our infant mortality rate is a national embarrassment.”¹ The words seem shocking and harsh across the headline of a 2014 Washington Post article. The thought of America not only not being the best at something, but falling upsettingly behind, is a foreign concept to many who view America as a nation inferior to none. However, the statistics on infant mortality rate tell the stark truth that of 26 “wealthy” countries, the U.S. ranks last, with a sobering 6.1 deaths per 1,000 live infant births.²

Part of the Healthy People 2020 Objectives is to reduce the rate of infant …

Continuation Rates And Reasons For Discontinuation Of Intra-Uterine Device In Three Provinces Of Pakistan: Results Of A 24-Month Prospective Client Follow-Up, Waqas Hameed, Syed Khurram Azmat, Muhammad Ishaque, Wajahat Hussain, Erik Munroe, Ghulam Mustafa, Omar Farooq Khan, Ghazunfer Abbas, Safdar Ali, Qaiser Jamshaid Asghar

Community Health Sciences

Background: Long-acting reversible contraceptives, such as the intrauterine device (IUD), remain underutilised in Pakistan with high discontinuation rates. Based on a 24-month prospective client follow-up (nested within a larger quasi-experimental study), this paper presents the comparison of two intervention models, one using private mid-level providers branded as "Suraj" and the other using community midwives (CMWs) of Maternal Newborn and Child Health Programme, for method continuation among IUD users. Moreover, determinants of IUD continuation and the reasons for discontinuation, and switching behaviour were studied within each arm.
Methods: A total of 1,163 IUD users, 824 from Suraj and 339 from the …

Teen Births In South Dakota, 2006-2014, Wei Bai, Bonny Specker, Lon Kightlinger

Ethel Austin Martin Program Publications

According to the Office of Adolescent Health at the U.S. Department of Health & Human Services, the teen birth rate in the U.S. has dropped continuously over the past 20 years and dropped 10% nationwide between 2012 and 2013. In 2013, about 273,000 babies were born nationally to adolescent teens aged 15-19 years for a rate of 26.5/1,000 adolescent females. According to the data from the World Bank, the U.S. teen birth rate in 2010-14 was higher than that of many developed countries, including Canada, Japan, Australia, and the majority of European countries. Teen pregnancies are associated with negative outcomes …

Determinants Of Method Switching Among Social Franchise Clients Who Discontinued The Use Of Intrauterine Contraceptive Device, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Wajahat Hussain, Ghulam Mustafa, Muhammad Ishaque, Safdar Ali, Aftab Ahmed, Marleen Temmerman

Community Health Sciences

Introduction: Women who do not switch to alternate methods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether.
Methods: The data used for this study comes from a larger cross-sectional survey conducted in nine (9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, …

The Role Of Quality Health Services And Discussion About Birth Spacing In Postpartum Contraceptive Use In Sindh, Pakistan: A Multilevel Analysis, Hannah Tappis, Anis Kazi, Waqas Hameed, Zaib Dahar, Anayat Ali, Sohail Agha

Community Health Sciences

Introduction: Rapid population growth, stagnant contraceptive prevalence, and high unmet need for family planning present significant challenges for meeting Pakistan's national and international development goals. Although health behaviors are shaped by multiple social and environmental factors, research on contraceptive uptake in Pakistan has focused on individual and household determinants, and little attention has been given to community characteristics that may affect access to services and reproductive behavior.
Methods: Individual and community determinants of contraceptive use were identified using multivariable multilevel logistic regression to analyze data from a 2014 cross-sectional survey of 6,200 mothers in 503 communities in Sindh, Pakistan.
Results: …

Reproductive Rights In Latin America: A Case Study Of Guatemala And Nicaragua, Katherine W. Bogen

Scholarly Undergraduate Research Journal at Clark (SURJ)

A lack of access to contraceptives and legal abortion for women throughout the nations of Nicaragua and Guatemala creates critical health care problems. Moreover, rural and underprivileged women in Guatemala and Nicaragua are facing greater limitations to birth control access, demonstrating a classist aspect in the global struggle for female reproductive rights. Although some efforts have been made over the past half-century to initiate a dialogue on the failure of medical care in these nations to adequately address issues of maternal mortality and reproductive rights, the women's reproductive health movements of Nicaragua and Guatemala have struggled to reach an effective …

Socioeconomic Differences In Antenatal Care Between The United States And Scandinavia, Joshua B. Kiehl

Student Publications

Despite their analogous status as economically developed nations, the United States and Scandinavian countries have marked differences in their healthcare systems. In particular both areas discernibly differ in the antenatal treatment provided for expecting women and their babies. Sweden and Denmark’s healthcare systems are universal, run primarily on taxpayer dollars, and provide equal antenatal care regardless of socioeconomic status. The United States’ healthcare system is run on a combination of private and government run insurance, in which socioeconomic status often determines insurance coverage. This variability in insurance coverage often results in differing levels of antenatal care. An overarching question remains …

El Parto Humanizado: Perspectivas De Profesionales En Las Maternidades Públicas De Buenos Aires, Lara Kaplan Westbrook

Independent Study Project (ISP) Collection

Con el reconocimiento de la tecnologización y medicalización del embarazo y parto en años recientes, el término violencia obstétrica y la ley del parto humanizado han surgido en Argentina. Aunque la ley define cómo los hospitales deben actuar para garantizar un parto donde la mujer sea la protagonista, su implementación depende de muchos factores, incluyendo la interpretación y opinión del profesional. Además, las mujeres que viven en situaciones de pobreza son quienes más frecuentemente usan los servicios de salud públicos y por ello suelen estar más expuestas a la naturalización de la violencia en la atención de la salud y …

Goddesses Versus Gynecologists: An Analysis Of The History Of Women’S Healthcare, Marion A. Mckenzie

Student Publications

Starting from the downfall of Goddess cultures in Europe, women's health care has been negatively impacted for generations. The rise of the white, male Indo-European "dominator model" along with the witch craze, caused the end of widespread wise women traditions and pharmacopeia methods. After women's traditional voice was silenced, medical colleges were established to pronounce new, "professional" knowledge. Only those who attended these universities were allowed to legally practice medicine; however, during this time, medical research and treatments for women primarily included mutilation and painful, nonsensical regimens. The horrifying state of women's healthcare has since improved, but was originally a …

La Santé Maternelle À Antsiranana Selon La Médicine Occidentale Et La Médicine Traditionnelle : Une Étude Des Traitements Opposés Pour Les Femmes Enceintes, Lauren Nguyen

Independent Study Project (ISP) Collection

Dans un pays comme le Madagascar, où des coutumes traditionnelles et le lien avec les ancêtres demeurent une grande partie de la culture, l’introduction des aspects « occidentales » présente un peu du désaccord. Cela est vu avec l’introduction de la médecine « occidentale », et le choix que font des Malagasy pour leurs soins médicaux. Spécifiquement dans le secteur de la médecine, la tension entre des pratiques occidentales et des pratiques traditionnelles est significative.

La présence des guérisseurs traditionnels et de la médecine traditionnelle sur l’île existait bien avant l’introduction de la médecine occidentale. Bien que de plus en …

Intra-Individual Consistency In Endocrine Profiles Across Successive Pregnancies, Molly Fox, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Context: It is yet unknown how similar women’s hormone levels are during successive pregnancies, and very little is known about the degree to which siblings experience similar prenatal environments. Given the importance of understanding how women’s reproductive life-histories exert cumulative effects on health via hormone exposure, and the importance of understanding how fetal programming via endocrine signaling affects sibling trait concordance, here we address this important lacuna in the literature.

Objective: To investigate how consistent are women’s hormone profiles across two successive pregnancies.

Design and Main Outcome Measures: This longitudinal, prospective study followed a cohort of 28 …

Ideas For A Healthy Baby--Reducing Disparities In Use Of Publicly Reported Quality Data: Study Protocol For A Randomized Controlled Trial, Sarah L. Goff, Penelope S. Pekow, Katharine O. White, Tara Lagu, Kathleen M. Mazor, Peter K. Lindenauer

Sarah L. Goff MD

BACKGROUND: Publicly reported performance on quality measures is intended to enable patients to make more informed choices. Despite the growing availability of these reports, patients' use remains limited and disparities exist. Low health literacy and numeracy are two barriers that may contribute to these disparities. Patient navigators have helped patients overcome barriers such as these in other areas, such as cancer care and may prove useful for overcoming barriers to using publicly reported quality data. METHODS/DESIGN: The goals of this study are: to determine the efficacy of a patient navigator intervention to assist low-income pregnant women in the use of …

Proyecto Mama: A Lifestyle Intervention In Overweight And Obese Hispanic Women: A Randomised Controlled Trial--Study Protocol, Lisa Chasan-Taber, Bess H. Marcus, Milagros C. Rosal, Katherine L. Tucker, Sheri J. Hartman, Penelope S. Pekow, Edward J. Stanek Iii, Barry Braun, Caren G. Solomon, Joanne Manson, Sarah L. Goff, Glenn Markenson

Sarah L. Goff MD

BACKGROUND: The proportion of women entering pregnancy overweight or obese has been rising and, in turn, is associated with adverse maternal and fetal outcomes. Gestational weight gain (GWG) exceeding Institute of Medicine (IOM) guidelines further increases health risks and has been independently associated with postpartum weight retention. Hispanic women are disproportionately affected by overweight and obesity, but have had limited access to interventions that promote healthy lifestyles due to cultural, socioeconomic, and language barriers. Therefore, the overall goal of this randomized controlled trial is to test the efficacy of a culturally and linguistically modified, individually-tailored lifestyle intervention to reduce excess …

Family Planning Knowledge, Attitudes, And Practices Among Married Men And Women In Rural Areas Of Pakistan: Findings From A Qualitative Need Assessment Study, Ghulam Mustafa, Syed Khurram Azmat, Waqas Hameed, Safdar Ali, Muhammad Ishaque, Wajahat Hussain, Aftab Ahmed, Erik Munroe

Community Health Sciences

This paper presents the findings of a qualitative assessment aimed at exploring knowledge, attitudes, and practices regarding family planning and factors that influence the need for and use of modern contraceptives. A descriptive exploratory study was conducted with married women and men aged between 15 and 40. Overall, 24 focus group discussions were conducted with male and female participants in three provinces of Pakistan. The findings reveal that the majority knew about some modern contraceptive methods, but the overall contraceptive use was very low. Knowledge and use of any contraceptive method were particularly low. Reasons for not using family planning …

Smoking Cessation During Pregnancy: An Evidence Based Practice Protocol, Katherine J. Ruhlman

Master of Science in Nursing Evidence-Based Practice Projects

Intrauterine exposure to nicotine is one of the largest modifiable risk factors for infant morbidity and mortality. Previous progress toward decreasing the number impacted by intrauterine nicotine exposure has recently plateaued. While guidelines for assisting pregnant women to stop smoking are available, few providers have a formalized protocol in place. This project will evaluate most current research evidence regarding smoking cessation during pregnancy in order to develop a formalized protocol for implementation in an obstetric clinic in Southwest Ohio. Reviewed literature was summarized and level of evidence was established. Recommendations were made and categorized as strong, moderate, and weak. The …

Understanding Multifactorial Influences On The Continuum Of Maternal Weight Trajectories In Pregnancy And Early Postpartum: Study Protocol, And Participant Baseline Characteristics, Tiffany A. Moore Simas, Silvia Corvera, Mary M. Lee, Ningning Zhang, Katherine Leung, Barbara C. Olendzki, Bruce A. Barton, Milagros C. Rosal

Mary M. Lee

BACKGROUND: Maternal and offspring immediate and long-term health are affected by pregnancy weight gain and maternal weight. This study was designed to determine feasibility of: 1) recruiting a socio-economically and racially/ethnically diverse sample of pregnant women into a longitudinal observational study, including consenting the women for serial biologic specimen evaluations; 2) implementing comprehensive assessments (including biologic, anthropometric, behavioral, cognitive/psychosocial and socio-demographic, and cultural measures) at multiple time points over the study period, including collecting biologic specimens at planned and unplanned pregnancy delivery times; and 3) retaining the sample for one year into the postpartum period. Additionally, the study will provide …

Does Satisfaction With Perinatal Health Care Influence Postpartum Weight Retention?, Andreea Bente

Electronic Thesis and Dissertation Repository

The primary aim of this thesis is to identify whether satisfaction with perinatal health care encounters is associated with lower postpartum weight retention (PPWR). PPWR is the difference between postpartum and pre-pregnancy weight. Principal components analysis confirmed the validity of a summed satisfaction score representing six dimensions: information, compassion, competency, privacy, respect and decision-making. Confounders were identified using a directed acyclic graph. Multivariable linear regression models were constructed using blocks, and backwards elimination. Results reflect a mean PPWR of 2.5 kg, and high satisfaction, with more than 90% of respondents being very satisfied or satisfied on each dimension. The multivariable …

Know Your Value: Negotiation Skill Development For Junior Investigators In The Academic Environment—A Report From The American Society Of Preventive Oncology's Junior Members Interest Group, Allison B. Burton-Chase, Maria C. Swartz, Stephanie A. Navarro Silvera, Karen Basen-Engquist, Faith E. Fletcher, Peter G. Shields

Department of Public Health Scholarship and Creative Works

The American Society of Preventive Oncology (ASPO) is a professional society for multidisciplinary investigators in cancer prevention and control. One of the aims of ASPO is to enable investigators at all levels to create new opportunities and maximize their success. One strategy adopted by ASPO was to develop the Junior Members Interest Group in 1999. The Interest Group membership includes predoctoral fellows, postdoctoral fellows, and junior faculty members who are provided career development and training opportunities (1). Responsibilities of the members of the Junior Members Interest Group include serving on the ASPO Executive Committee and the Program Planning …

Assessing Predictors Of Contraceptive Use And Demand For Family Planning Services In Underserved Areas Of Punjab Province In Pakistan: Results Of A Cross-Sectional Baseline Survey, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque, Ghulam Mustafa, Waqas Hameed, Omar Farooq Khan, Ghazunfer Abbas, Marleen Temmerman, Erik Munroe

Community Health Sciences

Background: Although Pakistan was one of the first countries in Asia to launch national family planning programs, current modern contraceptive use stands at only 26% with a method mix skewed toward short-acting and permanent methods. As part of a multiyear operational research study, a baseline survey was conducted to understand the predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan. This paper presents the baseline survey results; the outcomes of the intervention will be presented in a separate paper after the study has been completed.
Method: A cross-sectional baseline household survey …

Perinatal Health Education Intervention For Adolescent And Young Adult Pregnant Homeless Women Living In Transitional Housing, And Best Practice Teaching Intervention Program For Staff Responsible For Care Of The Mother-Baby Dyad, Colleen Carrington

Seton Hall University DNP Final Projects

Purpose: A population at great risk is pregnant homeless adolescents and young adult women. Research shows that about 20% of homeless young women become pregnant (Bender, & Thompson, 2007). These pregnant young women are at an increased risk for low birth weight infants and a high infant mortality due to inadequate health care, poor dietary habits, and a knowledge deficit related to maintaining good health during pregnancy and to care of the infant and growing child. A transitional shelter may offer many psychosocial services to assist the women in becoming independent; however, a significant gap exists regarding the medical …

The Relationships Among Perceived Stress, Birth Satisfaction, And Breastfeeding Self-Efficacy In Early Postpartum Women, Katherine Hinic

Seton Hall University Dissertations and Theses (ETDs)

This descriptive correlational study examined the relationships among perceived stress, birth satisfaction, and breastfeeding self-efficacy in women in the early postpartum period. The study, guided by self-efficacy and stress and coping theories, aimed to identify factors related to breastfeeding self-efficacy, an important psychological variable in sustained breastfeeding. The sample (N =107) was comprised of primarily well-educated, higher income, non-Hispanic White (69.8%) women recruited from a single New Jersey hospital in the first four days postpartum. The sample was comprised of nearly equal numbers of primiparous and multiparous women, all of whom expressed an intention to breastfeed, with an overall …

Maternal Obesity And Incidence Of Depression, Caroline A. Habjan

Honors Capstone Projects - All

Obesity is a national epidemic in the United States, which both directly and indirectly affects the social productivity of individuals, the American macro economy and individuals’ personal health and well being. Depression often interferes with an individual’s ability to work, sleep, study, eat, and enjoy life. A maternal state of both obesity and depression may cause serious adverse medical conditions in the mother’s child. Taking steps to treat depression and obesity are critical in the construct of modern medicine. This project yields results that have the potential to make treatment options better tailored, more efficient, effective and economically-sound for the …

"A Doula Can Only Do So Much": Birth Doulas And Stratification In United States Maternity Care, Kaylee S. Wolfe

Honors Projects

No abstract provided.

The Girl With The Peanut Necklace: Experiences Of Infertility And In Vitro Fertilization In China, Ruoxi Yu

Student Work

A 2014-2015 William Prize for best essay in East Asian Studies was awarded to Ruoxi Yu (Berkeley College '15) for her essay submitted to the Department of Anthropology, “The Girl with the Peanut Necklace: Experiences of Infertility and in vitro Fertilization in China.” (Marcia Inhorn, William K. Lanman Jr. Professor of Anthropology, advisor; Susan Brownell, Professor of Anthropology at USML, secondary reader.)

Ruoxi Yu’s essay, “The Girl with the Peanut Necklace: Experiences of Infertility and in vitro Fertilization in China,” situates original research within the history of the one-child birth control policy and the tension between the …

Babies First: Ensuring Proper Infant Nutrition During Emergencies, Abigail M. Alonso

Independent Study Project (ISP) Collection

Background: Breastfeeding is the best source of nutrition for an infant, living in all regions and cultures. Recommendations apply across the board, from developed nations to refugee camps, from women with HIV to those with time constraints regarding feeding. There also exists a complex relationship between corporations that provide BMS and the NGOs working to promote breastfeeding in emergency situations amongst vulnerable populations.

Objective: The objective of this paper is to expose breastfeeding promotion, using the Dadaab camps in Northeastern Kenya as a case study of IYCF programs and support of breastfeeding among low-literacy populations with an emphasis on women …

Ouch, That Hurts: Childbirth-Related Pain Management And The Inappropriate Replacement Of Traditional Obstetrical Knowledge In Kumaon, Uttarakhand, India, Sabrina Zionts

Independent Study Project (ISP) Collection

Throughout India, obstetrical knowledge and practice has been developed and passed down by generations of women. In many Indian societies, traditional birth attendants, or dais, remain the gatekeepers of childbirth-related knowledge. Yet with the push towards institutional delivery, traditional knowledge and practices are being increasingly replaced with modern and Western ones. While the trend of hospital deliveries has yielded positive health outcomes, its socio-cultural consequences remain unclear. Situated in Uttarakhand’s Kumaon Himalayas, this study employs a bio-social framework and begins to reveal these consequences. Using labor pain management as an entry point, this study argues that the push towards institutional …

El Rol Del Parto Mapuche En El Mundo De La Medicina Moderna / The Role Of Mapuche Birth In A World Of Modern Medicine, Nita Chai

Independent Study Project (ISP) Collection

Research Question: Is there existing demand for Mapuche birth practices and what are the barriers to incorporating them in the Chilean healthcare system? Objective: Analyze the current role of Mapuche birth practicesby determining what is the demand from the Mapuche for their use, describing the quality of communication between Mapuche women andmodern professionals, and identifying the perspectives of modern professionals on Mapuche birth practices. Background: Childbirth is an integral process for the human race. For many indigenous communities, the arrival of a new life holds cultural significance that is recognized through ceremonies during or after childbirth. Chile has implemented health …

The Impact Of Jordanian Health Care Policy On The Maternal And Reproductive Health Care Seeking Behavior Of Syrian Refugee Women, Momina Mazhar

Independent Study Project (ISP) Collection

On November 20, 2014, the Jordanian government rescinded the free health care it had provided to Syrian refugees living in the host community. Now, Syrians must pay the same amount as uninsured Jordanians when seeking health care in facilities run by the Jordanian Ministry of Health. Identified as a vulnerable and disadvantaged population, most of the Syrian community is not financially secure and has difficulty meeting the cost of living in Jordan. This study surveyed 36 Syrian women and interviewed 2 of them in order to determine the effects this policy has had on their maternal and reproductive health seeking …

The Benefits Of Breastfeeding, Helen L. Byers

Senior Honors Theses

It is important to educate women of childbearing age, their families, and society of the benefits that breastfeeding has over bottle-feeding and formula-feeding. The benefits of breastfeeding are in three main categories. First, the developmental, physical, emotional, and spiritual benefits of the baby will be discussed. Then the physical, emotional, and spiritual benefits for the mother will be talked about along with possible contraindications or difficulties. Finally, the financial benefits of breastfeeding over feeding an infant from the bottle will be discussed as it relates to the family and government. The goal is to persuade that breastfeeding is a superior …