Women's Health Commons^™

Devalued, Turned Away, And Refused Health Care: What Happens To Women Of Color When Religion Dictates Patient Care, Elizabeth Boylan

Center for Gender & Sexuality Law

Columbia Law School's Law, Rights, and Religion Project, and the National Women’s Law Center hosted a Capitol Hill Briefing at 10:15 am on Thursday, May 24th to discuss the impact of religious health care refusals on women of color. The event, entitled Devalued, Turned Away, and Refused Health Care: What Happens to Women of Color When Religion Dictates Patient Care, was presented in cooperation with Senator Kamala Harris and Representative Bonnie Watson Coleman.

Culture Care Needs Of Puerto Rican Women Receiving Hiv Care From Nurse Practitioners In New York City, Michele Crespo-Fierro

Dissertations, Theses, and Capstone Projects

The purpose of this mini-ethnonursing research study was to discover, describe, and interpret culture care values, beliefs, expressions, practices and needs of Puerto Rican women receiving HIV care from nurse practitioners (NPs) and other providers in New York City. The emic, or insider, perspective of Puerto Rican women living with HIV was the focus of this study and Leininger’s Culture Care Theory (CCT) provided the theoretical framework. Various enablers of the CCT, including Leininger’s Sunrise Enabler to Discover Culture Care, guided the design andimplementation of the study. Six key and twelve general informantswere interviewed and data from the interviews were …

Identifying What Matters To Hysterectomy Patients: Postsurgery Perceptions, Beliefs, And Experiences, Andrew S. Bossick, Roopina Sangha, Heather Olden, Gwen L. Alexander, Ganesa Wegienka

Journal of Patient-Centered Research and Reviews

Purpose: Hysterectomy is the most common nonobstetrical surgery for women in the United States. Few investigations comparing hysterectomy surgical approaches include patient-centered outcomes.

Methods: The study was performed at Henry Ford Health System (Detroit, MI) between February 2015 and May 2015. A total of 1,038 eligible women — those 18 to 65 years of age and who had an electronic medical record-documented Current Procedural Terminology (CPT^®) code or an International Statistical Classification of Diseases, Ninth Edition (ICD-9) code of hysterectomy between December 2012 and December 2014 — were selected and recruited. A question guide was developed to investigate …

The Needs Of Women Treated For Ovarian Cancer: Results From A #Gyncsm Twitter Chat, Teresa Hagan Thomas, Karin Nauth-Shelley, Michael A. Thompson, Deanna J. Attai, Matthew S. Katz, David Graham, Dee Sparacio, Christina Lizaso, Audun Utengen, Don S. Dizon

Journal of Patient-Centered Research and Reviews

Purpose: Ovarian cancer is the most fatal of all gynecologic cancers, with a high relapse rate regardless of stage. Women treated for ovarian cancer, therefore, likely have supportive care needs that extend well beyond the time frame of first-line therapy. Unfortunately, there is minimal data describing these needs. The purpose of this qualitative study is to understand the supportive care needs of women with ovarian care at the end of treatment.

Methods: To better understand the issues faced by women with ovarian cancer, we conducted a public Twitter chat in collaboration with gynecologic cancer social media (#gyncsm). Both quantitative and …

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.

Where Trying To Conceive Becomes A Community Effort: A Digital Ethnography Of Online Infertility Forums, Megan Burns

Sociology Honors Papers

Online forums for women using in vitro fertilization (IVF), or similar assisted reproductive technologies (ARTs), provide a useful setting to further evaluate and understand women’s expectations of motherhood, the relationship infertile women have with physicians and biomedicine, and their interactions on the forums. Some critics of ARTs consider them a tool of oppression in a pronatalist state. The pressure and desire to become a biological mother leads the women with access to these technologies to use them regardless. Through digital ethnographic research on four online ART forums, this research examines the intersection of altruism and self-interest in the ways forum-users …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

The Medical Evaluation Of The Newly Resettled Female Refugee: A Narrative Review, Anne Duckles, Aba Barden-Maja, Julie Caplow

Journal of Refugee & Global Health

The number of forcibly displaced individuals worldwide is increasing each year, reaching 65 million persons by the end of 2015, half of which were women and children. As the population of displaced persons grows, it is every physician’s responsibility to understand these patients and their health needs. Refugee patients and the providers who care for them face many barriers to effective patient care, including language barriers, cultural differences, and systematic inequalities. Female refugees commonly experience gender-based violence, repetitive trauma, stigmatized mental illness, and cultural barriers to women’s healthcare. This review is intended to be a comprehensive guide for the provider …

Perceptions, Careseeking, And Experiences Pertaining To Non-Cephalic Births In Rural Sarlahi District, Nepal: A Qualitative Study., Naoko Kozuki, Luke C Mullany, Subarna K Khatry, James M Tielsch, Steven C Leclerq, Caitlin E Kennedy, Joanne Katz

Global Health Faculty Publications

BACKGROUND: In low-resource settings, a significant proportion of fetal, neonatal, and maternal deaths can be attributed to intrapartum-related complications. Certain risk factors, such as non-cephalic presentation, have a particularly high risk of complications. This qualitative study describes experiences around non-cephalic births and highlights existing perceptions and care-seeking behavior specific to non-cephalic presentation in rural Sarlahi District, Nepal.

METHODS: We conducted in-depth interviews with 34 individuals, including women who recently gave birth to a non-cephalic infant and female decision-makers in their households. We also conducted two focus groups with mothers (have two or more children, with at least one child under …

Geospatial Inequalities And Determinants Of Nutritional Status Among Women And Children In Afghanistan: An Observational Study, Nadia Akseer, Zaid Ahmad Bhatti, Taufiq Mashal, Sajid Bashir Soofi, Rahim Moineddin, Robert E Black Md, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Undernutrition is a pervasive condition in Afghanistan, and prevalence is among the highest in the world. We aimed to comprehensively assess district-level geographical disparities and determinants of nutritional status (stunting, wasting, or underweight) among women and children in Afghanistan.
Methods: The study used individualised data from the recent Afghanistan National Nutrition Survey 2013. Outcome variables were based on growth and weight anthropometry data, which we analysed linearly as Z scores and as dichotomous categories. We analysed data from a total of almost 14 000 index mother–child pairs using Bayesian spatial and generalised least squares regression models accounting for the …

Seroprevalence Of Anti-Polio Antibodies In Children From Polio High Risk Area Of Afghanistan: A Cross Sectional Survey 2017, Imtiaz Hussain, Ondrej Mach, Nasir A. Hamid, Zaid Bhatti, Deborah D. Moore, Shahid Khan, Hasan Khan, William C. Weldon, Zulfiqar Ahmed Bhutta, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Afghanistan is one of the remaining wild-poliovirus (WPV) endemic countries. We conducted a seroprevalence survey of anti-poliovirus antibodies in Kandahar Province.
Methods: Children in two age groups (6–11 months and 36–48 months) visiting Mirwais hospital in Kandahar for minor ailments unrelated to polio were enrolled. After obtaining informed consent, we collected venous blood and conducted neutralization assay to detect poliovirus neutralizing antibodies.
Results: A total of 420 children were enrolled and 409/420 (97%) were analysed. Seroprevalence to poliovirus type 1 (PV1) was 97% and 100% in the younger and older age groups respectively; it was 71% and 91% for …

Involuntary Sterilization Among Hiv-Positive Garifuna Women From Honduras Seeking Asylum In The United States: Two Case Reports, Holly G. Atkinson, Deborah Ottenheimer

Publications and Research

Voluntary sterilization is one of the most widely used forms of contraception by women worldwide; however, involuntary sterilization is considered a violation of multiple human rights and grounds for asylum in the United States. Women have been disproportionately affected by this practice. We report two cases of involuntary sterilization in HIV-positive Garifuna women from Honduras who sought asylum in America and were medically evaluated at the request of their attorneys. Key lessons can be drawn from these cases with regard to the importance of medical evaluations in establishing persecution. These include the need for a detailed account of the events …

Violencia Obstétrica: Los Derechos De Autonomía Reproductiva, Tratamiento Justo Y Accesibilidad En El Ámbito De La Salud Maternal En San Carlos, Salta / Obstetric Violence: The Rights To Reproductive Autonomy, Fair Treatment, And Accessibility Of Maternal Health Services In San Carlos, Salta, Emily Gleason

Independent Study Project (ISP) Collection

In Argentina, there exists a national legislature (Ley N° 25.929 and 26.485) that is intended to ensure women’s rights to maternal and reproductive healthcare services free from obstetric violence; that is, the right to autonomy, fair treatment, and accessibility of maternal healthcare services. Women have the inherent right to receive fair and equitable maternal healthcare and receive humanized births, or partos humanizados. Despite the existence of these laws, however, there is still a rampant amount of obstetric violence that women in Argentina experience. Their rights to autonomous, accessible, and just maternal health services are often ignored or outright denied. …

Increasing Cervical Cancer Screening In Hiv Positive Women By Introduction Of A Provider Prompted Algorithm Tool: A Quality Improvement Project, Aubri B. Hickman

Doctoral Projects

Continuous quality improvement projects and appropriate documentation are an essential component to continue to receive Ryan White grant funding. Compliance with mandated aspects of quality improvement is an extremely important concept-specifically for a clinic setting that cares for the largest HIV positive population in the state of Mississippi. The Health Resources and Services Administration (HRSA) provides directives mandating that quality improvement projects should be applicable to areas of need and provide for outcomes that ensure quality care for HIV positive individuals (2016).

Initially, this clinic’s rate of compliance with the HRSA Cervical Cancer Screening Performance Measure was subpar to the …

An Exploration Of Global Women’S Health: Findings From A Pilot Online Course Elective For Health Sciences Studies At Gw, Marisa Cordon, Maranda Ward, Leslie Davidson

GW Research Days 2016 - 2020

In 1995, 189 countries endorsed the Platform for Action, designed to address issues of gender equality, including health. Despite this 23 year old initiative, women’s health issues continue to be a global crisis (WHO, 2015). The SMHS piloted an 8-week online 1-credit course in Fall 2017 to educate GW students on the top ten issues for women’s health delineated by the World Health Organization (WHO). Each of the eight weeks covered a core women’s health WHO issue while tying in a global human rights perspective. Issues included but were not limited to reproductive health, STIs, violence against women, to name …

Toolkits To Help Women Who Have Experienced Or Are At Risk Of Female Genital Cutting: A Review, Hina Shaikh, Karen Mcdonnell, Nadia Kalley, Christine Hedstrom, Ghada Khan

GW Research Days 2016 - 2020

In recent years, written guidance and other tools to assist professionals in multiple sectors has been issued to increase their awareness about female genital mutilation/cutting (FGM/C), knowledge of how to respond appropriately, and means of delivering optimal care to women who have undergone FGM/C. A long-standing human rights-framed issue, FGM/C is a global health concern and is most often carried out on young girls. Apart from practicing origin countries, increased international migration has given rise to FGM/C in countries in the Americas, Europe, and Oceania, and compelled domestic legislation to outlaw FGM/C. This prohibition makes FGM/C an area in which …

Sans-Papiers, Sans-Santé: A Study Of Undocumented Migrant Women’S Access To Reproductive And Obstetric Health Care In Switzerland, Sarah Kinch

Independent Study Project (ISP) Collection

In recent years, Switzerland has seen increasing numbers of foreign-born residents, making it one of the many countries affected by the European Migrant Crisis. Of these newly-settled migrants, many live in the country illegally, otherwise known as undocumented migrants or “Sans-Papiers.” While Switzerland grants its Sans-Papiers population a right to health, thus making medical insurance and care legal for the undocumented community, many still see increased adverse health outcomes among the population. As more than half of the Sans-Papiers living in Switzerland are female, women are therefore increasingly at risk for worse reproductive and obstetric health. This study sought to …

Stress Of Infertility: Can The Couple Cope?, Faiza Alam, Taseer Ahmed Khan, Rehana Rehman

Department of Biological & Biomedical Sciences

No abstract provided.

What To Expect When You’Re Expecting: The Impacts China’S Maternal And Child Health Care Law Has Had On Tibetan Birthing Practices In The Diqing Tibetan Autonomous Prefecture, Hannah Mishriky

Independent Study Project (ISP) Collection

While childbirth is universal, it is undeniable that class, culture, ethnicity, and the scientific and political state of medicine all influence how women experienced it. The Tibetan ethnic minority of the People’s Republic of China (PRC) is a culture that exemplifies the uniqueness of each birth. Due to both their distinctive childbirth beliefs and practices, as well as the swift changes China has undergone, Tibetan birthing experiences are asking to be explored.

This study will focus on two major factors influencing Tibetan women's birthing experiences. To begin, research will be done to understand the Buddhist influences surrounding pregnancy and childbirth, …

Attitudes Toward Contraception Among Fourth Wave College-Aged Women, Caroline L. Lewis

Student Publications

This research examines how college-aged women today view contraception in comparison to the ways it has been viewed by previous generations of women, as well as what they view the future of contraception in the United States to look like. This has been done through a lens of political action and advocacy, which has defined the fight for access to contraception and reproductive justice throughout history. In light of the recent threats on contraception and the corresponding responsive social movements, such as the Women’s March, women in the United States are shifting their views on the matter, but what actions …

Participatory Development And Menstrual Health Management In South Africa: A Case Study Of Project Dignity, Natalie Geismar

Independent Study Project (ISP) Collection

Menstrual health management (MHM) poses a significant public health concern in many South African communities. Though the national government is beginning to devote attention and resources to MHM, civil society organizations play a critical role in providing menstrual health products and education to female-bodied individuals who may otherwise lack access. This study examines the praxis and impact of Project Dignity, a nongovernmental organization which distributes washable, reusable sanitary pads and panties to students in public schools. The researcher collected qualitative data through participant observation as well as interviews and focus group discussions with Project Dignity’s staff and intended beneficiaries. Using …

Sling Complications, David L. Howard, Andrea Mcglynn, Joy A. Greer

Research Briefs

No abstract provided.

Utilization Of Prevention Of Mother-To-Child Transmission (Pmtct) Services Among Pregnant Women In Hiv Care In Uganda: A 24-Month Cohort Of Women From Pre-Conception To Post-Delivery., Rhoda K Wanyenze, Kathy Goggin, Sarah Finocchario-Kessler, Jolly Beyeza-Kashesya, Deborah Mindry, Josephine Birungi, Mahlet Woldetsadik, Glenn J Wagner

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: We assessed the uptake of prevention of mother-to-child transmission (PMTCT) services in a cohort of HIV infected women in care at The AIDS Support Organization Jinja and Kampala in Uganda, who were trying to conceive, over a period of 24 months, to inform the strengthening of PMTCT service access for women in care.

RESULTS: Of the 299 women 127 (42.5%) reported at least one pregnancy within 24 months; 61 women (48.0%) delivered a live child. Of the 55 who had a live birth at the first pregnancy, 54 (98.2%) used antenatal care (ANC) starting at 15.5 weeks of gestation …

Exploring The Need Of Hpv Education Programs In Korean American Communities, Emilia Mondragón, Young-Me Lee

Grace Peterson Nursing Research Colloquium

Aim: 1) To identify cultural influences and other barriers affecting HPV vaccination decisions, 2) To identify educational methods that can deliver HPV related information to Korean American (KA) parents effectively

Background: Given significant concerns about HPV infection, lower immunization rates, and higher cervical cancer risks facing Korean Americans, it is imperative to better understand the barriers to vaccination. Currently, there is no HPV-focused education program that considers the linguistic and cultural barriers of the KA community. Additionally, there is a lack of effective educational content and methods available to reach KA parents.

Methods: An exploratory, qualitative design was conducted. Content …

Women's Experiences Of Mistreatment During Childbirth: A Comparative View Of Home- And Facility-Based Births In Pakistan, Waqas Hameed, Bilal Iqbal Avan

Community Health Sciences

Introduction: Respectful and dignified healthcare is a fundamental right for every woman. However, many women seeking childbirth services, especially those in low-income countries such as Pakistan, are mistreated by their birth attendants. The aim of this epidemiological study was to estimate the prevalence of mistreatment and types of mistreatment among women giving birth in facility- and home-based settings in Pakistan in order to address the lack of empirical evidence on this topic. The study also examined the association between demographics (socio-demographic, reproductive history and empowerment status) and mistreatment, both in general and according to birth setting (whether home- or facility-based). …

Premenstrual Syndrome: Existence, Knowledge, And Attitude Among Female University Students In Karachi, Aleena Mohib, Amara Zafar, Areeba Najam, Hafsa Tanveer, Rehana Rehman

Department of Biological & Biomedical Sciences

Objective: The aim of this study was to investigate the existence, knowledge, and the attitude of female students towards premenstrual syndrome (PMS).
Methods: This cross-sectional study was conducted in three universities in Karachi, Pakistan. A total of 448 female students participated in the study. The clinical criterion of American College of Obstetricians and Gynecologists (ACOG) for PMS was used to assess the prevalence of PMS in the participants. The questionnaire was set in four parts, one each to assess the knowledge, the attitude, and practices regarding PMS and one to assess the gap between self-perceived PMS and actual PMS. Data …

A Rare Case: Rupture Of Internal Pudendal And Uterine Artery In A Vaginal Delivery, Novera G. Chughtai, Raheela Mohsin Rizvi

Department of Obstetrics & Gynaecology

The management of puerperal hematomas after normal delivery has always been challenging for obstetricians. Vulvar, vulvovaginal, or paravaginal hematomas are common. On the other hand, retroperitoneal hematomas are uncommon and can be life-threatening. The diagnosis of vascular injury is rarely made preoperatively as atonic or traumatic postpartum hemorrhage (PPH), uterine rupture and amniotic fluid embolism are more common differential diagnoses. Injury to internal pudendal and uterine vessels is extremely rare in cases of vaginal delivery and, therefore, the literature on this topic is very scarce. We present a rare case of both internal pudendal and uterine artery rupture in a …

Comment On U.S. Department Of Health And Human Services Rule, Public Rights/Private Conscience Project

Center for Gender & Sexuality Law

In medical facilities across the country, doctors whose conscience would require them to perform a sterilization on a patient who requests one, offer truthful information about accessing abortion services, or provide comprehensive LGBTQ+ health care are forbidden from doing so by their employer. The conscience of such medical providers is entirely ignored by the U.S. Department of Health and Human Service’s (HHS) recently proposed rule that purports to “ensure that persons or entities” providing health care “are not subjected to certain practices or policies that violate conscience, coerce, or discriminate.” As explained in a comment submitted today by the Columbia …

Uterine Arteriovenous Malformations After Suction Evacuation Of Missed Miscarriage, Arshia Javed, Reeta Chander, Zahra Hoodbhoy

Department of Obstetrics & Gynaecology

Uterine arteriovenous malformation (AVM) is an uncommon but life-threating source of bleeding. AVM is an abnormal connection between uterine arteries and veins. Patients typically present with vaginal bleeding following miscarriage (medical/surgical) or cesarean section. The treatment of choice depends on the symptoms, age, desire of fertility, localization and size of the lesion. Uterine artery embolization is the first choice in symptomatic patients of reproductive age group. We report a case of AVM presenting after dilation and evacuation with extensive lesion, which was successfully treated with bilateral uterine artery embolization.

Relationships Among Common Illness Symptoms And The Protective Effect Of Breastfeeding In Early Childhood In Mal-Ed: An Eight-Country Cohort Study, Stephanie A. Richard, Benjamin J. J. Mccormick, Jessica C. Seidman, Zeba Rasmussen, Margaret N. Kosek, Elizabeth T. Rogawski, William Petri, Anurahda Bose, Zulfiqar Ahmed Bhutta, Ali Turab

Department of Paediatrics and Child Health

Children in low-income countries experience multiple illness symptoms in early childhood. Breastfeeding is protective against diarrhea and respiratory infections, and these illnesses are thought to be risk factors of one another, but these relationships have not been explored simultaneously. In the eight-site MAL-ED study, 1,731 infants were enrolled near birth and followed for 2 years. We collected symptoms and diet information through twice-weekly household visits. Poisson regression was used to determine if recent illness history was associated with incidence of diarrhea or acute lower respiratory infections (ALRI), accounting for exclusive breastfeeding. Recent diarrhea was associated with higher risk of incident …