Introduction Young sexual minority women (YSMW)'s sexual health is often overlooked in research, with most studies focusing on men who have sex with men or transgender women. Methods This study compares the sexual and mental health of young lesbians and bisexual women with exclusively heterosexual women using data from a 2017 Swiss study on young adults’ sexual health and behaviors. The sample includes 2,316 sexually active cisgender women. Bivariate analyses were conducted, followed by a multinomial regression using exclusively heterosexual women as the reference group. Results Sexual orientation is associated with STI diagnosis, HIV testing, age at first gynecological visit, protection at last intercourse, intercourse involving multiple partners and sexual violence. At the multivariate level, lesbians are more likely to use no protection, to be older at their first gynecological visit, to have experienced three-way intercourse and to smoke. Bisexual women are more likely to use no protection, to report STI diagnosis, to be victims of sexual abuse, and to have experienced intercourse involving multiple partners. Conclusion Further research and inclusive sexual health education and prevention campaigns are urgently needed to provide inclusive, comprehensive information on topics such as same-gender relationships, bisexual behaviors to reduce disparities in sexual and mental health outcomes.

Introduction This study applies the Benner interpretation of the Dreyfus Model of Skill Acquisition to birth doulas. Methods Sixty-five doulas participated in open-ended interviews in five waves between 2002 and 2022. Constructivist grounded theory methods were used to collect and analyze the data. Participants attended over 25 births, spoke English fluently, and did not utilize any medical skills. The doulas ranged in age from 22 to 65 and practiced in a variety of areas and settings in the United States, Canada, and the Netherlands. Results The Benner model was relevant. Birth doulas grow similarly to nurses from novice to expert, including the development of intuition. However, the skill set is different. As they improved in skill acquisition, birth doulas showed advancement in information processing; confidence; decision-making; communication; self-awareness; client and staff relationships; professional detachment; definition of an ideal birth; management of witnessing medical maltreatment and feelings of overwhelm; the ability to read client cues; anticipation of labor events and staff responses; managing the challenges of a professional doula lifestyle; sense of identity, the maturation of expert intuition; and awareness of when they had power to influence a situation. Swiftness in development depended on the variety of birth experiences and locations; the doula's ability to reflect and find meaning; and life and career background. Conclusion Birth doula work is more complex and multifaceted than previously thought and requires growth in specific skill sets to be successful. Effective birth doula work requires sophisticated emotion management, analytical and communication skills, in addition to labor support skills. Public perception that anyone can be a doula is erroneous. It is a separate profession from obstetrical nursing, although some skills may overlap. Rather than continually training new people, programs could concentrate on removing the challenges to continuing birth doula work. Doula programs should address the challenges of each stage, thus encouraging greater expertise and retention and growth of an experienced workforce.

Background Sexual health is a vital component of overall well-being and life happiness. The ability of women to make independent decisions regarding consensual sexual relationships is essential for their empowerment and the achievement of reproductive rights. Globally, only 55% of women can make their own decisions about sexual and reproductive health (SRH). Socioeconomic factors such as age, income, education, and early marriage significantly influence sexual autonomy. Therefore, this study aims to assess socioeconomic inequalities in sexual autonomy among women of reproductive age in four sub-Saharan African countries, using recent Performance Monitoring for Action (PMA) data. Methods This study analyzed data from four sub-Saharan African countries—Burkina Faso, Ethiopia, Kenya, and Uganda—using the PMA project dataset. A weighted sample of 17,855 women of reproductive age was included. The dependent variable was sexual autonomy, defined as the presence of choice in sexual decision-making. Socioeconomic inequality was measured using the concentration curve and concentration index. Additionally, decomposition analysis was conducted to determine the contribution of explanatory variables to the overall inequality. Results The weighted Erreygers normalized concentration index for low sexual autonomy was calculated as −0.184, with a standard error of 0.021 ( P < 0.0001). Similarly, the corresponding concentration curve lies above the line of equality, showing that sexual autonomy is disproportionately distributed among the poor. Decomposition analysis revealed that rural residence (38.62%), followed by media access (16.52%), lower wealth quintile (13.71%), women's education (8.87%), and husband's education (7.24%) contribute to the overall inequality. Conclusion Socioeconomic inequality was evident in low sexual autonomy across the four countries. According to the decomposition analysis of this inequality, the primary contributor was rural residence, followed by media access, wealth quintile, women's education, and husband's education.

Background Physical activity offers numerous health benefits and helps prevent various diseases, making it an essential component of a healthy lifestyle. Objective This study aims to examine the barriers and enablers that affect female participation in physical activity. Methods This was a cross-sectional quantitative study. The study questionnaire was adopted from a previous study. The survey was conducted online and completed by 668 Saudi women from across the country. Results The study findings regarding low physical activity levels among Saudi women are concerning, as 72.2% of participants were classified as sedentary or physically inactive. The study revealed that age, employment status, and income were significant factors affecting engagement of women in physical activity. Moreover, barriers such as expensive gym memberships, a lack of women-only clubs, a lack of enjoyment in sports, and prolonged use of the same exercise devices prevented Saudi women from participating in physical activities. However, women reported exercising to boost their self-satisfaction and self-confidence, thereby promoting overall health. Conclusion Saudi women exhibit a low level of physical activity. Barriers such as expensive gym memberships, a lack of women-only clubs, a lack of enjoyment in sports, prolonged use of the same exercise devices, and motivations related to self-satisfaction and self-confidence prevent Saudi women from practicing physical activities. Health system policymakers need to take action to increase physical activity levels and address these barriers.

Indigenous women experience distinctive mental health risks that accumulate across the life course under the continuing impacts of colonization, gendered violence, and systemic racism. Drawing on recent mandates from the United Nations Permanent Forum on Indigenous Issues and the World Health Assembly's Resolution 76.16 (2023), as well as community-based exemplars such as Partners In Health's women-led peer models, this policy brief applies the analytical dimensions of the National Collaborating Centre for Healthy Public Policy to synthesize evidence, contextual factors, and feasible policy options. It identifies disproportionate burdens in suicide rates, perinatal depression, caregiver stress, and menopausal symptom severity, alongside a persistent lack of validated Indigenous-specific screening tools and gender-disaggregated data. The brief recommends an integrated, rights-based strategy that funds Indigenous governance of culturally safe mental health services across the life course, builds an Indigenous Women's Mental Health Data Strategy grounded in data sovereignty, embeds traditional knowledge and place-anchored healing in coverage policies, and extends targeted support for caregiving and menopausal transitions. Implementing these measures would operationalize reconciliation commitments, reduce documented inequities, and generate long-term social and economic benefits for communities and health systems alike.

This paper explores the use of Housing First services for women experiencing homelessness, focusing on those aged 35 and over, who have multiple and complex needs. The paper draws on an evidence review and the results of a five-year evaluation of a Housing First for Women pilot project (2015–20) and three-year longitudinal study of two further Housing First services for Women in the UK (2021–24), which centred on the lived experience of women using these services. Four main arguments are advanced. The first is that the original Housing First model from the US and the initial deployments of the Housing First approach in Europe and the UK used a model designed in a context in which the nature and extent of middle aged and older women's homelessness was poorly understood. High fidelity Housing First services were less likely to be fully effective because the original model did not properly account for the level of trauma associated with domestic abuse and violence against women in middle age and later life. The second argument is that there is, on current and emergent evidence, a clear case for developing Housing First that is designed, managed and run by women for women which includes safeguarding as one of its key operating principles. The third argument is that Housing First for Women, with its comprehensive co-productive support and intensive case management, may offer important advantages over Sanctuary Schemes 1 and other services that are designed to counteract middle aged and older women's homelessness that is associated with abuse, violence and multiple and complex needs. The paper concludes by arguing that in order to fully meet the needs of middle aged and older women experiencing long term and repeated homelessness with multiple and complex needs, an integrated and preventative strategy, including preventative approaches like Domestic Abuse Housing Alliance (DAHA) Accreditation and Housing First for Women must be developed. If Housing First for Women is to be effective, it must be situated within a wider integrated strategy to counteract women's homelessness to reach its full potential.

BackgroundNausea and vomiting of pregnancy (NVP) often go undertreated due to several reasons including medication costs, patient hesitancy, underestimation of NVP by healthcare professionals, and their reluctancy to treat pregnant patients.CaseA 24-year-old primigravida with severe NVP and stress-related concerns received behavioral health consultation integrated into prenatal care via the Primary Care Behavioral Health model.InterventionThe patient engaged in brief behavioral strategies including supportive contact, diaphragmatic breathing, prayer, music, and mindfulness techniques across four consultations.OutcomeSymptom improvement was observed during the course of behavioral support.ConclusionThis case supports Primary Care Behavioral Health integration into prenatal care as a feasible, cost-effective adjunct to routine medical interventions, particularly in underserved communities.LimitationsMeaningful clinical conclusions cannot be made due to the nature of this being a case report and to the confounding nature of NVP typically resolving by the second trimester. Further investigation is warranted.

BackgroundPelvic inflammatory disease (PID) is mainly induced by the sexually transmitted infection (STI). However, the global burden and trends of STI excluding human immunodeficiency virus (HIV)-associated PID (non-HIV PID) has not been specifically assessed.MethodsThe prevalence and years lived with disability (YLDs) were collected from the Global Burden of Disease (GBD) 2021 database. The disease burden was evaluated with the case numbers, age-standardized rates (ASR) and estimated annual percentage changes (EAPC). According to the SocioDemographic Index (SDI), frontier and health inequality analysis were conducted. Autoregressive Integrated Moving Average (ARIMA) model was applied to predict the future trends of Non-HIV PID.ResultsThe age-standardized prevalence rates (ASPR) and YLDs of non-HIV PID was 27.02/100,000 and 3.68/100,000 in 2021 globally. Except for the decline of gonococcal-associated PID, the EAPC of chlamydial and other non-HIV PID were stable. The countries with fastest-growing prevalence were Brazil (4.19 [2.92, 5.47]), Spain (3.98 [3.19, 4.77]), Greece (3.05 [2.55, 3.55]), Portugal (2.76 [2.22, 3.29]), which suggested the increased burden of non-HIV PID in these years. Moreover, the non-HIV PID was mainly concentrated in 30–34 years, which was most common in the low and low-middle SDI. Additionally, prevention of non-HIV PID should also be concerned in the high SDI regions, especially for United Kingdom, Canada, Japan, and Singapore, which would also increase in the next 30 years.ConclusionThe burden and prevention of non-HIV PID were still arduous and required a long-term effort, especially for the 30–34 years, which need more attentions even for the developed countries.

BackgroundPregnant women with disabilities experience significantly higher rates of adverse pregnancy outcomes compared to those without disabilities. Evidence-based interventions that address disability-related barriers during pregnancy are essential to reducing health disparities.ObjectiveWe aimed to update a 2014 systematic review to identify interventions designed for pregnant women with disabilities.MethodsWe conducted a systematic review of studies published between 2012 and 2025 to identify interventions addressing disability-related barriers during pregnancy and birth.ResultsWe found a striking absence of evidence with no eligible studies identified from 22,719 publications. While we found multiple studies that evaluated the safety and efficacy of medications to manage disability-associated conditions during pregnancy, none of these studies focused on the potential disabling impact of the health conditions for pregnant women with disabilities, our intended focus. However, in our discussion, we describe three recent pilots, including co-produced resources for pregnant patients with disabilities, educational interventions for midwives, and an innovative patient empowerment tool, that suggest the field may be at a turning point.ConclusionsOur systematic review did not find evidence of disability inclusive maternal health interventions to improve pregnancy and childbirth experiences. However, we point to limited but promising studies for their use of co-production and patient engagement principles underscoring the potential for accelerating progress when research is conducted with, rather than on, disabled communities. While the pilots serve as proof of concept that disability-inclusive reproductive health research is both necessary and achievable, investments in disability inclusive maternal healthcare could yield significant returns for those with disabilities.

BackgroundThis study was conducted to assess the effectiveness of visual inspection with acetic acid (VIA) followed by colposcopy for cervical cancer screening. Like many low- and middle-income countries (LMICs), Bangladesh struggles with inadequate cervical cancer screening and diagnostic facilities, as well as a shortage of cytopathologists and histopathologists in remote rural areas. Human papillomavirus (HPV) testing has not yet been implemented effectively in Bangladesh, and cytology (Pap smear) is a costly procedure. The current study performed VIA and colposcopy on apparently healthy adult women, primarily to screen for cervical lesions and, secondarily, to identify associated risk factors.MethodsThis cross-sectional study was conducted in a remote rural health center in Bangladesh using a straightforward and affordable approach: VIA followed by colposcopy. This facility-based, cross-sectional study included 384 married women aged between 18 and 65 years recruited after field-level awareness on cervical cancer prevention.ResultsOut of 384 women tested, 247 (64.3%) were adults, 85 (22.1%) were middle-aged, 33 (8.6%) were older, and only 19 (4.9%) were young adults. The study found that more than one-third of the participants (39.1%) engaged in sexual activities without using condoms. A total of 20 participants tested VIA-positive (5.2%), of whom 60% were confirmed by colposcopy. The chi-squared test identified multiple sexual exposures without condom use as a significant risk factor for cervical cancer. All double-positive cases (n = 12) received treatment; 7 (58.3%) underwent thermocoagulation (heat-based ablation), and 5 (41.7%) received a loop electrosurgical excision procedure (LEEP) at referral hospitals.ConclusionWe propose that, to achieve Sustainable Development Goals 3.7 and 3.8, VIA followed by colposcopy is suitable for screening cervical cancer in rural areas of Bangladesh and other LMICs, where screening techniques such as Pap smear and HPV tests are not yet widely available and accessible.