Women's Health Commons^™

The Aca’S Contraceptive Mandate: Religious Freedom, Women’S Health, And Corporate Personhood, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

On June 30 2014 the Supreme Court decided Burwell v Hobby Lobby Stores, Inc, in a deeply divided judgment that engaged religious freedom, women’s health, and corporate personhood. Three closely held for-profit organizations challenged the Affordable Care Act’s contraceptive mandate, objecting to four contraceptive methods that they believe acted as abortifacients, in violation of their Christian beliefs.

The Court held that the contraceptive mandate violated the Religious Freedom Restoration Act of 1993, ruling that the Act’s protections extended to closely held corporations, with the mandate substantially burdening their religious freedoms. The Court acknowledged the federal government’s compelling interest in …

Implications Of The 2014 Quality Family Planning Services Guidelines Issued By The Cdc And The Office Of Population Affairs, Sara J. Rosenbaum, Susan Wood, Merle Cunningham, Tishra Beeson, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Unmet Need For Contraception And Unintended Pregnancies Among Women Of Reproductive Age Group: A Situation Analysis, Sumera Aziz Ali, Savera Aziz Ali

School of Nursing & Midwifery

Each year approximately 210 million pregnancies occur worldwide and more than one-third (75 to 80 million) of these are unintended, more than half of these (46 million) unintended pregnancies undergo unsafe abortions. In Pakistan 16% of the births are reported to be unwanted and if the unwanted fertility is eliminated, total fertility in Pakistan would be 3.1 births per woman. Total demand for family planning in Pakistan is 55%, while the contraceptive prevalence rate is 35% and unmet need for family planning is 20%. Reasons for unmet need and unintended pregnancy include lack of permission, fear of side effects, poor …

The Interplay Of Trait Anger, Childhood Physical Abuse, And Alcohol Consumption In Predicting Intimate Partner Aggression, Rosalita C. Maldonado, Laura E. Watkins, David Dilillo

Department of Psychology: Faculty Publications

The current study examined three well-established risk factors for intimate partner aggression (IPA) within Finkel and Eckhardt’s I³ model, including two impellance factors—trait anger and childhood physical abuse history—and the disinhibiting factor of alcohol consumption. Participants were 236 male and female college students in a committed heterosexual dating relationship who completed a battery of self-report measures assessing childhood physical abuse, trait anger, alcohol consumption, and IPA perpetration. Results revealed a significant three-way interaction showing that as the disinhibition factor alcohol consumption increased, the interaction of the two impelling factors, trait anger and childhood physical abuse, became increasingly more positive. …

Pregnancy Anxiety And Prenatal Cortisol Trajectories, Heidi S. Kane, Christine Dunkel Schetter, Laura M. Glynn, Calvin J. Hobel, Curt A. Sandman

Psychology Faculty Articles and Research

Pregnancy anxiety is a potent predictor of adverse birth and infant outcomes. The goal of the current study was to examine one potential mechanism whereby these effects may occur by testing associations between pregnancy anxiety and maternal salivary cortisol on 4 occasions during pregnancy in a sample of 448 women. Higher mean levels of pregnancy anxiety over the course of pregnancy predicted steeper increases in cortisol trajectories compared to lower pregnancy anxiety. Significant differences between cortisol trajectories emerged between 30 to 31 weeks of gestation. Results remained significant when adjusted for state anxiety and perceived stress. Neither changes in pregnancy …

Trauma-Informed Research And Planning: Understanding Government And Urban Native Community Partnerships To Addressing Substance-Exposed Pregnancies In Portland, Or, Amanda Mercier

Dissertations and Theses

In 2011, representatives from the Multnomah County Health Departments and several Native-serving organizations came together to address substance-exposed pregnancies among urban Native Americans in Portland, Oregon. From these partnerships, the Future Generations Collaborative was formed representing a significant shift toward community-led maternal child health research and planning. Additionally, the Future Generations Collaborative adopted a historical trauma-informed community based participatory research and planning process. This is particularly significant considering government agencies' role in colonization within Native communities. The purpose of this case study is to explore partnerships between government agencies and the Portland Native community within the Future Generations Collaborative. Given …

Association Between Symptomatic Vulvovaginal Candidiasis And Hiv Rna Levels In Plasma And Genital Secretions Among Women On Haart, Teke Apalata, William H. Carr, Benjamin Longo-Mbenza, Willem A. Sturm, P. Moodley

Publications and Research

Background. Genital tract (GT) inflammation plays a major role in HIV transmission. We aimed to determine the association between symptomatic vulvovaginal candidiasis (VVC) and HIV RNA levels in plasma and GTs of HIV-infected women on highly active antiretroviral therapy (HAART).

Method. Women with VVC on HAART were recruited from a primary healthcare clinic in KwaZulu-Natal Province, South Africa, between June 2011 and December 2011. VVC was diagnosed clinically, supported by Gram staining and culture of genital secretions. HIV RNA load was determined by reverse transcription polymerase chain reaction. CD4+ counts were obtained from patients’ medical records.

Results. Plasma HIV RNA …

A Study Protocol: Using Demand-Side Financing To Meet The Birth Spacing Needs Of The Underserved In Punjab Province In Pakistan, Syed Khurram Azmat, Moazzam Ali, Waqas Hameed, Ghulam Mustafa, Ghazanfer Abbas, Muhammad Ishaque, Mohsina Bilgrami, Marleen Temmerman

Community Health Sciences

Background: High fertility rates, unwanted pregnancies, low modern contraceptive prevalence and a huge unmet need for contraception adversely affect women's health in Pakistan and this problem is compounded by limited access to reliable information and quality services regarding birth spacing especially in rural and underserved areas. This paper presents a study protocol that describes an evaluation of a demand-side financing (DSF) voucher approach which aims to increase the uptake of modern contraception among women of the lowest two wealth quintiles in Punjab Province, Pakistan.
Methods/design: This study will use quasi-experimental design with control arm and be implemented in: six government …

Mi Cuerpo, Nuestra Responsabilidad: Using Photovoice To Describe The Assets And Barriers To Sexual And Reproductive Health Among Latinos In North Carolina, Barbara Baquero, Shira Goldman, Florence Siman, Sadiya Muqueeth, Laura Villa-Torres, Eugenia Eng, Scott D. Rhodes

Journal of Health Disparities Research and Practice

Latinos in North Carolina experience disparities in sexual and reproductive health. To identify and explore assets for and barriers to sexual and reproductive health in the Latino community, an academic-community partnership engaged community health workers (CHW) in Photovoice, a participatory qualitative research methodology. Five sessions were completed in which CHW agreed on photo assignments and discussed the photos. Themes included the role of men, cultural taboos, and the effect of undocumented immigrant status on access to resources. Findings were presented at a community forum. Building on the strengths of CHW to reduce barriers to sexual and reproductive health is a …

Rationale, Design, And Cohort Enrolment Of A Prospective Observational Study Of The Clinical Performance Of The New Contraceptive Implant (Femplant) In Pakistan, Syed Khurram Azmat, Waqas Hameed, Anja Lendvay, Babar Tasneem Shaikh, Ghulam Mustafa, Muhammad Ahmed Siddiqui, Sajid Brohi, Asif Karim, Muhammad Ishaque, Wajahat Hussain

Community Health Sciences

Introduction: The use of hormonal implants has gained positive traction in family planning programs in recent times. Compared to other popular methods, such as long-term reversible intrauterine devices, the use of hormonal implants as a family planning method has distinct advantages in terms of long-term efficiency and better user compliance and availability. This paper presents a study protocol to document and evaluate the efficacy, safety, and acceptability of Femplant (contraceptive implant) in Pakistan during the first year of its use among married women of reproductive age (18-44 years) at clinics in two provinces of Pakistan (Sindh and Punjab).
Materials and …

Application Of The Breastfeeding Personal Efficacy Beliefs Inventory And Acknowledgment Of Barriers For Improving Breastfeeding Initiation Rates In An Urban Population, Diwata Bose, Callie Cox Bauer, Kiley A. Bernhard, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Introduction: Breastfeeding (BF) is recognized as the preferred method of infant nutrition by American Academy of Pediatricians, American College of Obstetricians and Gynecologists, and the World Health Organization. Despite the benefits of BF, in 1998 only 69% of new mothers in the United States initiated BF and 29% continued to breastfeed at 6 months.

Objective: To assess perceived breastfeeding confidence (BFC) and determine barriers in regards to BF in an urban population.

Methods: The Breastfeeding Personal Efficacy Beliefs Inventory (BPEBI) was used to determine perceived BFC. The survey was distributed to 271 women during prenatal appointments at an urban Milwaukee …

"Transforming Care Through Disruptive Design": Incorporating A Midwifery Model Of Care Into Obstetric Practices, Lauren Marsh

Senior Theses

Maternal and child health outcomes in the United States are far poorer than in other industrialized nations. To improve women’s experiences with the maternity care system, nurse-midwife Sharon Schindler-Rising developed the CenteringPregnancy (CP) group model of prenatal care (PNC). Research comparing CP with ‘traditional’ one-on-one PNC has found that implementing CP results in decreased rates of preterm birth and low birth weight, increased rates of breastfeeding, and improved outcomes for women who typically experience health disparities, including African Americans. Documented success of the model in the Greenville Health System convinced the South Carolina Department of Health and Human Services of …

Exploring Obstacles To Perinatal Care-Seeking Behavior In Women Of Rural Odisha, India Using A Community Based Participatory Research Approach, Sarah Law, Runjhun Bhatia

Senior Theses

This project resulted from collaboration between USC student organization GlobeMed and the Alternative for Rural Movement (ARM), a non-governmental organization in Odisha, India. Rajendra Rana, the head of ARM, expressed the need to delineate the factors underlying the tendency of rural Odishan women to deliver with unskilled birth attendants as opposed to institutionally. A literature review was conducted to explore possible economic, cultural, and social factors. During five weeks in Odisha, discussions with women's groups, community health workers, and ARM staff members built on the literature review. A preliminary survey and plan for its dissemination were developed. The community based …

The Globalization Of Maternal Healthcare In Western Africa, Maura T. Magistrali

Celebration

Maternal healthcare is one of the most important global issues in today’s world, reflected in its inclusion in the Millennium Development Goals. Globalization, through increased acceleration and movement, has improved maternal healthcare in Western Africa, as observed through the spread of Westernized medicines and treatments and improved technology in prenatal and obstetric care. Another remarkable effect of globalization is the hybridity manifested in both women’s healthcare choices and in the pluralistic training of midwives. However, the same forces of movement and exchange can also bring negative consequences, visible through health-access inequalities, brain drain, and the exploitation West African countries.

Screening Asymptomatic Women For Cardiovascular Risk, Kathryn Nelson-Murphy

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) has long been recognized as a significant health problem in the U.S., and is the leading cause of preventable death in women, collectively causing about one death per minute (Caboral, 2013). A myriad of modifiable risk factors including dyslipidemia, hypertension, smoking, obesity, and type II diabetes are associated with 80-90% of CVD morbidity and mortality. Despite sobering statistics, valid risk prediction screening tools, and national preventive guidelines, adequate screening in clinical practice settings is sadly deficient. An evidence-based practice project was designed and implemented at a large OB/GYN practice in southern Ohio to address this identified gap …

A Manual To Improve The Health-Related Quality Of Life And Self-Efficacy For Older Adult Females Engaged In Physical Activity, Kimberly Berry

Graduate Theses

Health related quality of life and self-efficacy are two areas that decrease in older adulthood. Females experience numerous physical and mental changes through later adulthood and exercise can help ease this transition. This manual focuses on the positive effects of exercise on women's health related quality of life and self-efficacy. Older adult women can experience benefits from a regular exercise routine that incorporates cardio, strength training, flexibility and balance training.

The Baby Friendly Hospital Initiative, Kathryn E. Brackett

Senior Honors Theses

Abstract

The Baby-Friendly Hospital Initiative (BFHI) is a worldwide movement started by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) that is aimed at providing hospitals with a certification that guarantees the best possible patient-centered care for mothers and infants. It focuses on breastfeeding as optimal infant nutrition, and implements strategies to encourage and support mothers to breastfeed their infants exclusively for six months after birth. The Ten Steps to Successful Breastfeeding are a set of 10 simple, easy to understand guidelines developed by WHO and UNICEF for implementing this initiative in the hospital setting and …

Perinatal Distress In Women In Low- And Middle-Income Countries: Allostatic Load As A Framework To Examine The Effect Of Perinatal Distress On Preterm Birth And Infant Health, Shahirose Sadrudin Premji

School of Nursing & Midwifery

In low- and middle-income countries (LMIC), determinants of women's and children's health are complex and differential vulnerability may exist to risk factors of perinatal distress and preterm birth. We examined the contribution of maternal perinatal distress on preterm birth and infant health in terms of infant survival and mother-infant interaction. A critical narrative and interpretive literature review was conducted. Peer-reviewed electronic databases (MEDLINE, Embase, Global Health, CINHAL), grey literature, and reference lists were searched, followed by a consultation exercise. The literature was predominantly from high-income countries. We identify determinants of perinatal distress and explicate changes in the hypothalamic-pituitary-adrenal axis, sympathetic, …

Barriers Latin American Immigrant Women Face In Accessing Reproductive Health Services In The United States, Isabel Odean

Annual Undergraduate Conference on Health and Society

Immigration and reproductive health care are two high profile topics in the politics of the United States. Both are constantly on the news, with ongoing debates about policies and reform. However, the link between the two topics gets very little media coverage. In this paper, I will address some of the overlap, looking at the question: what are the barriers for Latina immigrant women in accessing reproductive health care? Immigrant women in the United States face pronounced barriers in accessing reproductive health care, legally, socially, and culturally. These barriers stem from a history of political control of immigrant women’s reproduction, …

Domestic Violence In The Spotlight: From The Private Sphere To Popular Culture, Taylor Rinefierd

Annual Undergraduate Conference on Health and Society

No abstract provided.

Prepregnancy Low-Carbohydrate Dietary Pattern And Risk Of Gestational Diabetes Mellitus: A Prospective Cohort Study, Wei Bao, Katherine Bowers, Deirdre K. Tobias, Sjurdur F. Olsen, Jorge Chavarro, Allan Vaag, Michele Kiely, Cuilin Zhang

Publications and Research

Background: Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown.

Objective: We aimed to prospectively examine the association of 3 prepregnancy low-carbohydrate dietary patterns with risk of GDM.

Design: We included 21,411 singleton pregnancies in the Nurses’ Health Study II. Prepregnancy LCD scores were calculated from validated food-frequency questionnaires, including an overall LCD score on the basis of intakes of carbohydrate, total protein, and total fat; an animal LCD score on the basis of intakes of carbohydrate, animal protein, and animal …

Changes In Sleep Time And Sleep Quality Across The Ovulatory Cycle As A Function Of Fertility And Partner Attractiveness, Brooke N. Jenkins, Elizabeth G. Pillsworth, Aaron T. Goetz

Psychology Faculty Articles and Research

Research suggests that near ovulation women tend to consume fewer calories and engage in more physical activity; they are judged to be more attractive, express greater preferences for masculine and symmetrical men, and experience increases in sexual desire for men other than their primary partners. Some of these cycle phase shifts are moderated by partner attractiveness and interpreted as strategic responses to women’s current reproductive context. The present study investigated changes in sleep across the ovulatory cycle, based on the hypothesis that changes in sleep may reflect ancestral strategic shifts of time and energy toward reproductive activities. Participants completed a …

Implementing A Community-Based Intervention For African American Mothers And Daughters, Teri Aronowitz, Nandini Sengupta

Office of Community Partnerships Posters

Adolescents represent one of the fastest growing risk groups for HIV. Inner-city, minority youth are at highest risk because of concentration of HIV in inner-city areas, higher rates of STDs, and early sexual initiation. Mothers are the primary sex educator of daughters, and girls state their relationship with their mother was an important influence on their delaying sexual activity. With 70% of adolescent HIV seroconversions occurring among African American (AA) females, studies are urgently needed to enhance mother-daughter sexual communication. The purpose of this poster is to offer insights on the logistics of carrying out a manualized program.

Two Community Collaborations With Sexual Minority Women’S Ngos In Shanghai & Hong Kong, Connie Chan, Hsin-Ching Wu

Office of Community Partnerships Posters

Based on research with sexual minority communities in the United States, Connie Chan, professor of public policy and public affairs, conducted comparative research with community groups in Hong Kong and Shanghai, China. She provided capacity building training and resources directly to the organization which provides outreach and service to sexual minority women and girls in Shanghai, China. Professor Chan also supported Queer Sisters – an NGO that provides advocacy and community outreach to sexual minority girls and women in Hong Kong – by co-creating a needs assessment survey and helping them to interview their membership in Hong Kong.

Connie Chan …

Grappling With Gatekeepers: Addressing Gender Hindrances To Mhealth, Jack O’Rourke

Independent Study Project (ISP) Collection

This study was conducted in order to understand the social and economic problems associated with Ugandan women’s usage of mobile phones and the ways in which different mHealth groups are approaching these problems. Seeing how these different groups approach this issue added new information and analysis to a relatively unexplored topic

The qualitative methodology undertaken was two pronged. First, single sex focus groups in rural Mukono District were assembled. Men, women without phones and women and with phones were all talked to in Luganda with the use of a translator. In addition to these focus groups in rural Mukono District, …

Barriers To Successful Cervical Cancer Screening In Rural Kwazulu-Natal, Cato Manor, And Cape Town, Amanda Comai

Independent Study Project (ISP) Collection

In 2000, the South African Department of Health produced a nationwide policy intended to combat the growing crisis of cervical cancer. Nearly fifteen years later, however, the disease remains a significant cause of death among certain female populations, especially those who are rural, poor, and HIV-positive. It is undeniable that challenges of access, awareness, resource demand, and stigmatization stand in the way of complete policy enactment.

In this study, I explore in detail the barriers that prevent successful implementation of the policy. My research combines interviews with a variety of individuals and participant observation at the Cancer Association of South …

Schoolgirls’ Experience Of Menstruation Ss Expressed Through Body Mapping In A Quasi-Rural South African Village, Angela Zablotny

Independent Study Project (ISP) Collection

The aim of this independent study project was to gain an understanding of menstruation as experienced by school aged girls in a quasi-rural village in the KwaZulu-Natal Province of South Africa. Though a fact of life for roughly half of the world’s population, menstruation continues to be a taboo topic and has implications related to both traditional Zulu beliefs as well as expectations for females in a largely patriarchal society.

The qualitative research method of body mapping was used with teenage girls in an effort to facilitate both reflection and discussion on their lived experiences with their periods. Supplemental interviews …

El Significado Cultural Del Parto: Perspectivas De Mujeres Mapuche, Erin Drake

Independent Study Project (ISP) Collection

The aim of this study is to understand the cultural meaning of childbirth within Mapuche culture, in order to promote culturally respectful childbirth practices related to intercultural programs of the public health system in Chile. This study focuses on the problem of the institutionalization and medicalization of childbirth in Chile, and how these processes have affected the childbirth experiences of Mapuche women. While there have been many studies on the cultural meaning of childbirth in distinct places of the world, very few studies focus on this theme within Mapuche culture. The few studies that have described Mapuche cultural practices regarding …

Smoking Behaviors Among Pregnant Women: A Romanian Case Study, Katherine Lemasters

Independent Study Project (ISP) Collection

Smoking behavior during pregnancy is one of few preventable factors associated with poor health outcomes for both women and children. The post-communist countries in Central and Eastern Europe face many challenges in this realm, as tobacco control efforts have not adequately addressed this behavioral health issue that has arisen since 1989. To better inform these efforts in Romania, this study categorizes the determinants of pregnant women’s prior smoking, current smoking, and current smoke exposure by using both quantitative and qualitative analysis. We find that those living with other smokers, exposed to smoke on a daily basis, and experiencing stress during …

Eating Disorders: Prevalence, Perceptions, And Treatments In Jordan, Brenda Gable

Independent Study Project (ISP) Collection

This study examines the perceptions that young women in Jordan have regarding their bodies and eating disorders, in addition to their opinion regarding media and familial pressures to fit societal norms. The study further examines eating disorders as a mental disorder and the obstacles that individuals face when seeking treatment. This study was implemented by 95 surveys distributed to women in a first aid course at Jordan University and by interviewing professionals in the nutritional, mental health, and educational field. It was found that 86% of surveyed students believed that young women in Jordan struggled with body image and 72% …