Women's Health Commons^™

Implementation Of Warning Tool To Improve Maternal Newborn Health Outcomes In A Developing Country, Sana Sheikh, Rahat Qureshi, Sidrah Nausheen, Rozina Sikandar Sultanali

Department of Obstetrics & Gynaecology

Objective: To improve health outcomes through the implementation of national early warning sign tool for babies delivered through emergency caesarean section in off-work hours.

Methods: This comparative clinical study was conducted at the Aga Khan Hospital for Women and Children, Karachi, from April to August 2014, and comprised women who had an emergency caesarean section. Maternal and perinatal outcomes were compared of patients in Group A and Group B which represented individuals before and after the implementation of the national early warning score respectively.

Results: Of the 200 participants, there were 100(50%) in each group. The overall mean age was …

Maternal And Fetal Outcome In Renal Transplant Recipients, Wajeeha Syed, Lumaan Sheikh

Department of Obstetrics & Gynaecology

Objective: To determine maternal and fetal outcome in renal transplant recipients.
Methodology: Retrospective analysis of the antenatal patients with renal transplant
was done between January 1st 2005 till December 31st 2015 and maternal
and fetal outcomes were determined. Data was entered and analyzed in SPSS
version 20.
Results: 08 pregnancies in 07 women who had undergone renal transplant
were included in this study. The mean age at the time of transplantation was
25.29 ±5.5 years (16-32 years). 25% cases had gestational diabetes mellitus,
75% had anemia and 50% had urinary tract infection. The mean birth weight
of babies was 2210 …

Unintended Pregnancies Among Married Women In Sindh Pakistan: Role Of Lady Health Workers, Sumera Aziz Ali, Unaib Rabbani

Community Health Sciences

Background: Unintended pregnancies, which pose substantial risks to both mothers and children, account for 24% of all pregnancies in Pakistan. Door to door visits and service provision by lady health workers (LHWs) may be related to the reduction of such pregnancies, particularly in rural areas. This study aimed to determine the association of knowledge about Lady Health Visitors (LHWs) and door to door visits by LHWs with unintended pregnancies among rural women.
Methods: We conducted a community-based, nested case-control study of 800 pregnant women, identified from the database of an active surveillance mechanism, which registers and follows all pregnant women …

Drink Me And Abort Your Baby: The Herbal Abortion Tea, Maya Lewis

Capstones

For most of history every abortion was a herbal abortion. Herbal abortion is exactly what it sounds like––a series of herbs that, if taken at the right time, in the right form and dosage, can induce a miscarriage. It's risky, under researched and rarely supported. But with women's clinic dwindling all over the country and a president elect who wants to repeal Roe v. Wade, herbal abortion might soon make a major come back–– for better or worse.

Link to capstone project: https://medium.com/@maya.lewis/drink-me-and-abort-your-baby-the-herbal-abortion-tea-46aadd15f659

Doula Support As A Means To Improve Birth Outcomes For Minority Women, Christina Bao Ngoc Thich

Master's Projects and Capstones

Ethnic minorities such as African Americans, American Indians, Hispanics, Laotions, Hmongs, and Alaskan Natives have higher rates of cesarean delivery, pre-term birth, fetal demise, perinatal laceration, and congenital abnormalities than their white counterparts. Continuous labor support by way of doula care has been recommended for all pregnant women as a means to prevent adverse birth outcomes. Despite this, the population most in need of such support in unable to access doula services due to low socioeconomic status, availability of services, and cultural inaccessibility. This paper focuses on my capstone experience with UCSF and Roots of Labor Birth Collective as we …

Antenatal Renal Pelvic Dilatation And Foetal Outcomes - Review Of Cases From A Tertiary Care Center In Karachi, Pakistan, Ruqiya Afroz, Shafia Shakoor, Muhammad Sohail Salat, Shama Munim

Woman and Child Health

Objective: To determine the incidence of antenatal renal pelvic dilatation to evaluate antenatal resolution/ progression and post-natal outcome.
Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of all women found with renal pelvic dilatation in antenatal scans between January 2011 and December 2013. A cut-off of 5mm was used to diagnose renal pelvic dilatation. Renal pelvic dilatation was categorised into three groups: mild (5-6mm in second trimester and 5-9mm in third trimester), moderate (7-10mm in second trimester and 10-15 in third) and severe (more than 10mm in second trimester and more than …

Syrian Refugee Women In Jordan: Family Planning Preferences And Barriers In A Host Community, Hilary Smith

Independent Study Project (ISP) Collection

The aims of this pilot study were to research and analyze the availability of birth control and family planning resources among Syrian refugee women at a reproductive age. This study took place in the host community of Karak, Jordan. Syrian women are a vulnerable population based solely on their gender. But being refugee women makes them more vulnerable and sometimes, their needs do not get met. This study is important because it will look into reproductive health aspects for this vulnerable population to ensure that there is satisfaction among women about their own health. This cross-sectional study sought to answer …

Breast Is Best: Determinants Of Breastfeeding In Bali, Leah Hardenbergh

Independent Study Project (ISP) Collection

Breastfeeding greatly benefits the health of newborns, providing them with needed antibodies and protection from numerous diseases, including some of the leading causes of infant mortality. This paper explores breastfeeding practices in Bali, and the wide array of factors that have led to these practices. After discussing how breastfeeding fits into the larger context of maternal and newborn health, I explain factors in Bali that affect a woman’s decision to breastfeed and experience while breastfeeding. Determinants include those related to health, financial position, and social status. I explore the history of formula companies and formula as an alternative to breastmilk, …

The Road Into The Future Of Health Care: The Importance Of Addressing Access To Health Facilities In Transportation Infrastructure Investment Decisions, Nicola (Nikki) Van Den Heever

Independent Study Project (ISP) Collection

Background: One school of thought argues that transportation infrastructure is not an ultimate end goal of development and therefore shouldn’t be addressed within development funding decisions while the other argues that transportation infrastructure is the crucial foundation from which all development efforts are based and therefore needs to be addressed within development funding decisions. Within this framework, there is a lack of academic and other research addressing how physical access to health care for pregnant women can better be addressed when making decisions regarding funding of transportation infrastructure projects.

Purpose: To demonstrate the importance of considering access to health care …

A Preliminary Study Of Intergenerational Differences In Masxha Regarding Practice And Attitudes Towards Zulu Traditions During Pregnancy And Birth, Momoko Oyama

Independent Study Project (ISP) Collection

In the Zulu culture, several traditions and rituals are practiced during a woman’s pregnancy and perinatal period. However, as urbanization spreads and western influences strengthen, these rituals risk being lost. This project aims to capture existing knowledge of these traditions and to assess the intergenerational changes in practice and attitudes towards practicing the rituals.

Information on Zulu traditions practiced during a woman’s pregnancy and perinatal period was collected through two interviews and a focus group consisting of three elderly women in Masxha, a Black township in KwaZulu-Natal. Following the interviews and focus group, 32 Masxha residents were recruited to complete …

Continuous Care In Complex Contexts: Access To Health Services For Noncommunicable Diseases Among Syrian Refugee Women In Jordanian Host Communities, Jennifer Ostrowski

Independent Study Project (ISP) Collection

This study examines how, when and where Syrian refugee women living in a host community in central Jordan access health services related to noncommunicable diseases. Noncommunicable diseases are the leading cause of death and disability worldwide, but can be effectively managed through timely treatment. Examining access to care for these diseases in the context of humanitarian emergencies, such as war and displacement, is particularly important because they require continuous care, which may be interrupted during emergencies, and because they can cause acute complications, which may be exacerbated by emergencies (WHO, 2016).

Previous studies indicate a high burden of NCDs among …

“Always A Double-Edged Sword”: How Women And Health Care Providers Navigate Issues Of Contraception In Differing Senegalese Communities, Angelina Strohbach

Independent Study Project (ISP) Collection

This paper examines how women and health care providers in two distinct Senegalese settings—Dakar and Mouit, a village located within the Gandiol region-- navigate contraception as both a social and medical good. Contraception is an invaluable tool in terms of advancing women’s right to reproductive health, but major discrepancies in its usage exist across a variety of social lines in Senegal, including level of education, marital status, occupation, age, and living in a rural versus urban setting. What socially constructed thought processes and lived experiences contribute to these discrepancies? In a cultural context heavily based upon tradition and Islamic faith, …

Comparing Effectiveness Of Active And Passive Client Follow-Up Approaches In Sustaining The Continued Use Of Long Acting Reversible Contraceptives (Larc) In Rural Punjab: A Multicentre, Non-Inferiority Trial, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque, Ghazunfer Abbas, Erik Munroe, Rebecca Harrison, Wajahat Hussain Shamsi, Ghulam Mustafa, Omar Farooq Khan

Community Health Sciences

Background: The use of long-acting reversible contraceptive (LARC) methods is very low in Pakistan with high discontinuation rates mainly attributed to method-related side effects. Mixed evidence is available on the effectiveness of different client follow-up approaches used to ensure method continuation. We compared the effectiveness of active and passive follow-up approaches in sustaining the use of LARC-and within 'active' follow-up, we further compared a telephone versus home-based approach in rural Punjab, Pakistan.
Methods: This was a 12-month multicentre non-inferiority trial conducted in twenty-two (16 rural- and 6 urban-based) franchised reproductive healthcare facilities in district Chakwal of Punjab province, between November …

Perceptions Of Fidelity And Adaptation In Evidence-Informed Interventions By Women Of Color Sexuality Health Educators, Sara C. Flowers

Dissertations, Theses, and Capstone Projects

Sexuality health educators (SHEs) adapt interventions to the participants’ needs in the dissemination and implementation of comprehensive sexuality education (CSE) programming. However, there is a lack of understanding of how, why and when SHEs make such adaptations. Success or failure of the transfer of prevention technology to practitioners occurs by determining community capacities and preparedness to adopt/adapt high-impact interventions to effectively manage implementation. Experts argue for evidence-informed interventions (EII), as opposed to evidence-based interventions (EBI), as the best way to incorporate research in applied settings. EBIs are solely guided by recommendations from current evidence, whereas EIIs recognize and incorporate the …

Using Process Mining To Assess The Fidelity Of A Home Visiting Program, Riyad Haq, Sofia Campos Vidal Pires, Julie M. Kapp, Sara Schlemper, Eduardo J. Simoes

Frontiers in Public Health Services and Systems Research

Background: The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program is a federal public health initiative which supports at-risk families through evidence-based programs and promising approaches for pregnant women, and childhood development for children aged 0 to 5. These public health program funding mechanisms commonly include process evaluation mandates.

Purpose: The use of process mining was explored as a methodology to assess the fidelity of the MIECHV programs’ actual workflow to that of their intended models.

Methods: Research Electronic Data Capture (REDCap) data files that were populated with program process data elements from the local implementing agencies were …

Maternal Healthcare In Eastern Uganda: The Three Delays, Mothers Making Empowered Choices, And Combatting Maternal Mortality, Emma Gier

Independent Study Project (ISP) Collection

Maternal and child health has been noted as an international concern and issue. While access to maternal healthcare has improved in Uganda since 2000, maternal mortality rates have remained high in the country as of 2015. However, maternal and child healthcare are inherently important in promoting sustainable and positive development. For that reason, I have explored maternal healthcare in Uganda’s Eastern region, specifically in Mbale Town and surrounding rural areas including Kween and Manafwa districts. Specifically I have looked at what factors influence women’s decision to give birth in a health centre or hospital, versus at home. I have also …

Sociodemographic And Geospatial Correlates Of Stillbirths And Neonatal Mortality In Indonesia (1993–2007), Alka Dev

Dissertations, Theses, and Capstone Projects

Little research has focused on the determinants of stillbirth and neonatal mortality in Indonesia despite the fact that the country has one of the highest rates of stillbirths in the world and one of the highest rates of neonatal mortality in Asia. Several areas have not been explored due to data limitations, such as shared risk factors and measurement challenges, which can inform health policy and interventions and guide future research. This dissertation addresses this gap by comparing measurement challenges for stillbirth and neonatal mortality and identifying risk factors for both using Indonesian reproductive health survey data. Differences in estimates …

Research Brief: "Spousal Military Deployment During Pregnancy And Adverse Birth Outcomes", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study assesses the association between a spouse’s military deployment and adverse birth outcomes, and concluded that the effect of a spouse’s deployment on adverse birth outcomes can vary by maternal age. Given that a deployment during pregnancy or delivery can negatively affect the mother and baby, policymakers might allocate funds for additional research on the needs of expectant mothers with a deployed spouse. Future work in this field should further evaluate maternal age and number of children as modifiers of the association between these variables.

Beyond The Three Delays: A Case Study Of Haiti's Maternal Health Sector, Stephanie Rapp

Capstone Collection

This research seeks to understand how the maternal health sector in Haiti can be understood and perhaps improved through the framework of the Three Delays, developed by Thaddeus and Maine (1994). These delays are (1) the delay in the decision to seek care, (2) the delay in reaching a health facility, and (3) the delay in receiving adequate care at a health facility. The findings of this capstone strongly demonstrated that global health practitioners in Haiti often opt for technical solutions, but in fact there are numerous shadow delays preventing these solutions from taking hold and ameliorating maternal mortality. Tensions …

Psychological And Sociocultural Influences Of Current And Historical Intimate Partner Violence In Pregnancy, Cindy D. Phillips

Electronic Theses and Dissertations

The Centers for Disease Control and Prevention (CDC) estimates that 1.5 million women are victims of intimate partner violence (IPV) each year, and 324,000 of these women are pregnant (2013). Research on the predictability of certain factors and their relationship to current and historical IPV is limited. In order to better understand IPV as it related to a sample of 1,016 Appalachian pregnant women selected for the Tennessee Interventions for Pregnant Smokers (TIPS), it was important to evaluate various influences that may predict the prevalence of IPV in this population when compared to the State of Tennessee and the U.S. …

The Presence Of Stem Cells In Human Breast Milk And Research Implications, Melody (Brooke) Peterson

Senior Honors Theses

Stem cell therapy research is an expanding area of study as stem cell therapy is believed to have the potential to provide treatment options for numerous disease processes. Currently, embryonic stem cell research is the method of choice to evaluate the potential for stem cell therapy. The use of human embryos for stem cell research raises moral and ethical controversies. Stem cells are found in a variety of mediums, but until the recent discovery of stem cells in human breast milk, the most versatile stem cells have been those found in the human embryo. Human breast milk stem cells could …

A Comparative Study Of Women’S Health Care: Non-Syrian Refugee Women Living In Amman And Syrian Refugee Women Living In Refugee Camps, Megan Kerstein

Independent Study Project (ISP) Collection

The purpose of this study is to compare access and quality of women’s health care in Amman for non-Syrian refugee women and women’s health care in Syrian refugee camps. I also sought to understand how women’s health care could be improved in both Amman and in Syrian refugee camps. I hypothesized that Syrian refugee women in camps will have less access and lower quality women’s health care since refugee camps’ funding is limited, making medical equipment and women’s health care providers short. Since women in Amman often have more stable family situations and jobs, I thought they would have more …

Hypertensive Disorders Of Pregnancy In Rural Maharashtra: A Preventative Approach To Risk Factor Reduction Through Lifestyle Interventions, Jess Wiken

Independent Study Project (ISP) Collection

The primary purpose of this study is to assess the contribution and correlation between lifestyle behaviors and modifiable risk factors (MRF) established in adolescence and during pregnancy with development of hypertensive disorders of pregnancy (HDP) exclusive to preeclampsia (PE), eclampsia, and pregnancy induced hypertension (PIH). MRF include but are not exclusive to diet and nutrition, physical activity, and Mishri use. Associations of HDP with increased premature cardiovascular risk in the affected woman and child indicate the importance of healthy lifestyle modifications that promote cardiovascular health and longevity and reduction of risk factors through prevention. While cardiac conditions are primarily associated …

The Changing Roles And Reputations Of Dais In Rural Uttarakhand: An Investigation Into The Maternal Health Services Of Villages In Okhalkanda Block In Nainital, Jenna Davis

Independent Study Project (ISP) Collection

The dai, once a prominent figure in Indian maternal health, now faces marginalization as the government of India adopts the goal of universal institutional delivery. Under pressure from international discourse that Skilled Birth Attendants (SBAs) were more effective at lowering Maternal Mortality Rate (MMR) than Traditional Birth Attendants (TBAs) like dais (World Health Organization), dai training was discontinued and left in the hands of NGOs, while concurrently women and ASHAs were monetarily incentivized for every institutional birth (Park, 419). Yet in rural, isolated, or hilly areas like Okhalakanda block in Uttarakhand, institutional delivery is a long way from universal—only …

Engaging With Community-Based Public And Private Mid-Level Providers For Promoting The Use Of Modern Contraceptive Methods In Rural Pakistan: Results From Two Innovative Birth Spacing Interventions, Syed Khurram Azmat, Waqas Hameed, Hasan Bin Hamza, Ghulam Mustafa, Muhammad Ishaque, Ghazunfer Abbas, Omar Farooq Khan, Jamshaid Asghar, Erik Munroe, Safdar Ali

Community Health Sciences

Background: Family planning (FP) interventions aimed at reducing population growth have negligible during the last two decades in Pakistan. Innovative FP interventions that help reduce the growing population burden are the need of the hour. Marie Stopes Society--Pakistan implemented an operational research project--'Evidence for Innovating to Save Lives', to explore effective and viable intervention models that can promote healthy timing and spacing of pregnancy in rural and under-served communities of Sindh, Punjab and Khyber Pakhtunkhwa provinces of Pakistan.
Methods: We conducted a quasi-experimental (pre- and post-intervention with control arm) study to assess the effectiveness of each of the two intervention …

(Video) Maternal Depression And Child Externalizing Behaviors, Julia Gruspier, Shannon Shisler, Rina C. Eiden

GW Research Days 2016 - 2020

About 10.97% of women with children aged 1 to 4 years old are identified with depression. Children of mothers with depression are more likely to exhibit externalizing behavior problems, and these problems have been reported to appear more frequently in male children. We examined the association between maternal depression and externalizing behavior in toddlers, and whether child sex moderated these effects, as previous studies have shown child behavior to be linked to both child sex and maternal depression. The sample included 186 mother/child dyads (95 male children) who were recruited in the first trimester of pregnancy from an urban hospital. …

Maternal Leisure-Time Physical Activity And Risk Of Preterm Birth: A Systematic Review Of The Literature, Mira Kahn, Loretta Dipietro, Kimberly Robien

GW Research Days 2016 - 2020

Background: Preterm birth is a leading cause of infant death and regular physical activity may reduce the risk for preterm birth because of its beneficial effects on pregnancy complications such as preeclampsia, excessive weight gain, and gestational diabetes. On average, however, pregnant women report lower levels of physical activity compared with those who are not pregnant. This systematic review examined low, moderate and vigorous leisure-time physical activity (LTPA) during pregnancy and the outcome of preterm birth.

Methods: Key words related to preterm birth and physical activity were used to search relevant databases (Medline, Cochrane, CINAHL, Sports Discuss and Scopus). Studies …

An Investigation Into The Dietary And Health Behaviours Of Pregnant Women In Ireland, Laura Mullaney

Doctoral

Maternal obesity increases the risk of metabolic complications in pregnancy such as gestational diabetes mellitus (GDM). Effective weight management following childbirth may reduce long-term metabolic risks among women of child bearing age. The aim of this study was to investigate the diet and health behaviours of pregnant and postpartum women in Ireland. Accurate dietary assessment in pregnancy is often difficult to achieve. We have shown that dietary under-reporting is more likely among pregnant women who are younger, materially deprived, obese and who have increased adiposity. These findings suggest that dietary underreporting represents a source of potential bias in obstetric obesity …

Bridging The Divide White Paper: Long-Acting Reversible Contraception (Larc) In The United States, Julia Strasser, Liz Borkowski, Megan Couillard, Amy Allina, Susan Wood

Jacobs Institute of Women's Health

Long-acting reversible contraceptive (LARC) methods – specifically, intrauterine devices (IUDs) and subcutaneous hormone-releasing implants – demonstrate great potential in reducing unintended pregnancy. Although LARC methods have had a rocky history in the US and use rates have remained low here in comparison to other countries where the methods are available, there has been a significant increase in uptake of newer LARC products in recent years. Researchers have identified this change as a likely contributor to the declines seen in unintended pregnancy, abortion, and teen pregnancy rates.

Decades of research have shown that current LARC methods are highly safe and effective, …

Healthcare Access In Women’S Prisons: An Intersectional Perspective, Megan R. Bray

UROP Posters

This project will be identifying the key factors that contribute to the significant lack of health care in prisons in the U.S., specifically in women’s correctional facilities. I will be lending my focus to disparities in mental health, HIV/AIDs care, reproductive health, trans health, and physical health issues among women who are either currently incarcerated or those who have completed their sentences and are at higher risk for re-entry after attempting re-integration. There is a lack of care, access, and proper treatment for women inmates in U.S. prisons and reform is needed. I foresee the best possible way to accomplish …