Background: Intimate partner violence (IPV) during the perinatal period is a significant public health concern with adverse consequences for maternal, fetal, and infant health. Women with disabilities experience disproportionately high rates of perinatal IPV, often compounded by disability-related abuse that exploits dependence on caregiving, mobility, communication, or access to medical care. Despite frequent contact with health care providers during the perinatal period, IPV among women with disabilities remains underrecognized and inadequately addressed. Objective: To summarize current knowledge on perinatal IPV among women with disabilities and highlight considerations for identification and response within perinatal health care settings. Content: This narrative review synthesizes existing literature on the prevalence and risk factors for perinatal IPV among women with disabilities, including disability-related abuse. We describe associated physical and mental health consequences and examine multilevel barriers to identification and disclosure, including structural, provider-level, and interpersonal factors that contribute to inequities in care. Practical approaches for disability-informed IPV screening, safety planning, and referral are discussed within trauma-informed care frameworks relevant to perinatal and women’s health settings. Conclusions: Improving recognition and response to perinatal IPV among women with disabilities is critical for advancing equity in maternal health care and improving maternal and infant outcomes.

Background: Primary fallopian tube carcinoma (PFTC) is a rare and poorly studied disease. Given its low incidence and evolving diagnostic classification, population-based data are essential to improve understanding of its prognostic determinants. This study aims to identify the clinical prognostic factors of patients with PFTC. Materials and Methods: Patients diagnosed with PFTC between 2010 and 2015 were selected from the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox regression analyses were conducted to identify independent prognostic factors. Based on these factors, prognostic nomograms were developed to estimate 3- and 5-year overall survival (OS) and cancer-specific survival at the population level. Results: A total of 1241 patients were randomly assigned to the training cohort ( n = 869) and the test group ( n = 372). In the multivariate Cox regression, age (22–56, 57–71 and 72–92), race (White, Black, and Other), the International Federation of Gynecology and Obstetrics (FIGO) staging (I, II, III, and IV), and laterality (lateral and bilateral) were identified as independent prognostic factors for patients with PFTC. Finally, nomograms consisting of age, race, FIGO stage, surgery type, and lymphadenectomy were constructed. The area under the time-dependent receiver operating characteristic curve values for the 3-year/5-year OS were 0.730/0.750 in the training cohort and 0.726/0.803 in the test cohort. Conclusions: Nomograms derived from a large population-based cohort provide prognostic insight and risk stratification for patients with PFTC within a defined historical context. The identified prognostic factors serve as a reference for studies and warrant validation in contemporary cohorts and clinical trials.

Introduction: Multiple publications provide guidance on the conceptualization, development, and maintenance of women’s heart centers. Despite religious implementation of those guidelines, the practical experience is fraught with roadblocks. Objective: Our focus in this communication is to share those practical lessons learned from our experience in establishing seven women’s heart centers in Michigan and three in Tennessee. Conclusion: To better understand - What does it take to make the centers sustainable, successful, reproducible, and viable? What is the blueprint for the future generations of leaders to develop women’s heart centers that are accessible and effective?

Background: Despite a plethora of previous research on experiences of discrimination and physical health outcomes, there has been less attention to sex/gender differences, although some research suggests a greater stress-related biological and behavioral impact on women. Methods: Five databases were reviewed up to May 2023 using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We included studies that examined self-reported experiences of discrimination and physical health outcomes among adults (aged 18+) in the United States if results were either stratified by sex/gender or tested a sex/gender-by-discrimination interaction term. Results: A total of 3,397 articles were extracted, and 50 met the inclusion criteria, including 3 articles found through an external search. Ten studies reported that the measure of association between discrimination and physical health outcomes was greater among women, 7 reported a greater association among men, 21 reported homogenous associations, and 12 studies reported that the associations varied by sex/gender across multiple outcome measures or in more complex modeling analyses ( e.g., additional moderators, mediation analysis). Conclusion: Discrimination and physical health outcomes vary by sex/gender, irrespective of race/ethnicity. There are some limitations and methodological issues that were found in the literature. These considerations should be reconciled in future research for more streamlined and consistent analyses and reporting. We further provide recommendations on analyzing and interpreting sex/gender differences in future research. Future studies should also examine sex/gender differences between experiences of discrimination and mental health outcomes.

Introduction: Placenta accreta spectrum (PAS) represents a significant contributor to maternal mortality, primarily as a result of severe postpartum hemorrhage. The most prominent risk factors associated with PAS are the placenta previa and a history of cesarean delivery. Nevertheless, a normal location of placenta does not exclude PAS, although this is underreported. Case Report: We report a G3P2L0 female who was booked with us since her first trimester and had two previous cesarean deliveries, but with no live issue. During her elective lower segment cesarean section at term with all routine preparations, the placenta did not separate with the routine prophylactic dose of oxytocin, even though placenta was placed fundally. Non-separation of the placenta with a well-contracted uterus led us to consider manual removal of the placenta; however, no plane of cleavage was felt or seen, raising a suspicion of the placenta accreta syndrome. As we were at a secondary care setup without any ICU and blood bank facility, given no postpartum hemorrhage, a decision to leave the placenta in situ was taken, and the patient was shifted to a tertiary care setup for observation. She underwent an emergency hysterectomy at the referral center. Conclusion: In non-previa PAS cases, guidelines for management, tools for early suspicion and management when encountered as a surprise, and research toward its pathogenesis have a long way to go. Conservative management, particularly in uterine body PAS and resource-limited settings, with leaving the placenta in situ, should be strongly considered.

Background: Access to family planning (FP) information is vital for reproductive autonomy and the Sustainable Development Goals. In Somaliland, modern contraceptive uptake remains critically low. While sociodemographic barriers are known, geospatial dimensions of information accessibility remain unexplored. This study investigates individual, community, and spatial determinants of women’s exposure to FP messages. Methods: We analyzed data from the 2020 Somaliland Health and Demographic Survey among women aged 15–49. We employed multilevel mixed-effects logistic regression to assess predictors of media exposure. Additionally, spatial analysis techniques including Global Moran’s I and Getis-Ord Gi* statistics were utilized to identify geographic clusters (“hotspots” and “cold spots”) of exposure. Results: Only 25.28% of women reported exposure to FP messages, primarily via TV and radio; mobile dissemination was underutilized (11%). Multilevel analysis indicated that higher education (adjusted odds ratios [AOR] = 6.48), wealth, and internet usage significantly increased exposure odds. Conversely, nomadic populations (AOR = 0.38) and rural residents faced severe exclusion. Spatial analysis revealed a sharp East–West divide: significant “hotspots” clustered in western regions (Awdal, Marodijeh), while significant “cold spots” were identified in the eastern region of Sool. Conclusions: A profound “digital and developmental divide” characterizes reproductive health communication in Somaliland. Current strategies benefit urban, educated women in the west, leaving nomadic populations in an information vacuum. Policy must shift to spatially targeted interventions, utilizing community outreach in identified “cold spots” and voice-based mobile technology to reach uneducated and nomadic women.

Introduction: Cervical cancer is expected to become the second leading cause of female cancer mortality in low- and middle-income countries, with the majority of critical cases projected to occur in these regions by 2050. This study aimed to identify the prevalence and determinants of knowledge and attitudes toward cervical cancer prevention, including Pap smear uptake and human papillomavirus (HPV) vaccination, while highlighting actionable gaps for intervention. Methods: A cross-sectional study was conducted using an online structured questionnaire, administered to Lebanese women aged 18–50 years. A knowledge score (KS) was calculated from true-or-false questions on risk factors, symptoms, and prevention. An attitude score (AS) assessed the proportion of women with a positive attitude toward cervical cancer prevention. Results: Participants had a mean age of 28.5 years. The prevalence of women who had ever had a Pap smear was 18.6%, and HPV vaccination coverage was 17.9%. Bivariate analysis showed that HPV vaccination was significantly associated with younger age, being single, having a graduate degree, being a health care student/professional, perceiving income as sufficient, and never smoking. Binary logistic regression analysis indicated that only a KS above the mean and an AS above the mean remained significant predictors after adjustment. Physicians were the most influential incentive for vaccination, while lack of knowledge was the primary barrier. Conclusion: To improve HPV vaccination rates and reduce cervical cancer incidence in developing countries, strategies should focus on enhancing health care access and physician–patient communication. Targeted awareness campaigns addressing misconceptions and negative attitudes toward HPV vaccination are warranted to improve preventive practices and reduce disease burden.

Introduction: As HPV self-collection for cervical cancer screening is introduced into clinical practice, it is critical to understand factors that may potentially impact adoption. This article aims to describe clinicians’ attitudes toward self-collection guided by the Cabana Guideline Based Practice Improvement Framework. Methods: This study is a secondary analysis of a survey of clinicians at federally qualified health centers ( n = 147). The survey, distributed to clinicians practicing in safety net settings in 2021–2022, explored the potential benefits and concerns of HPV self-collection, and how helpful self-collection would be in catching up patients overdue for screening. Clinicians’ anticipated practices were evaluated by asking to which patients and in what location they would recommend self-collection. Descriptive frequencies were obtained for quantitative items. Qualitative comments were coded using thematic analysis. Results: Most participants were female (84%), White (69%), and non-Hispanic/non-Latinx (86%). Responses indicated a lack of awareness that primary HPV testing is a recommended form of screening and the management of positive HPV test results. The main benefits identified were convenience and increased access to care. Participants’ concerns included patients incorrectly conducting the test or obtaining an inadequate sample, fewer appointments with clinicians, and patients not returning the test or attending follow-up appointments. Conclusion: This study provides important baseline information for clinicians’ perceptions of self-collection prior to FDA approval. Now that HPV self-collection has received regulatory approval for routine use, further research is needed to address concerns and guide its adoption into clinical practice.

Objective: To understand the dynamics of vaccination conversations between obstetrician/gynecologists and pregnant women and the factors influencing vaccine acceptance and differences by patient race and ethnicity. Methods: In this qualitative study we used linguistic analysis to analyze vaccination conversations between 40 unique patients and 10 unique providers from the 2020 to 2021 influenza season. The results were stratified for non-Hispanic White (“White”) patients compared to non-Hispanic Black and Hispanic patients (“patients of color/POC”) to assess differences in the strength of provider vaccine recommendations, initiation of vaccination conversation, the patient reaction to vaccination prompts, and association of these factors with vaccination intent as the primary outcome. Results: The linguistic analysis demonstrated that 22 (55%) out of 40 patients intended to get vaccinated. More POC delayed or refused influenza vaccination (3/6) than White patients (2/10), while more White patients (5/5) than POC demonstrated intent to get the Tdap vaccine (6/10). While providers consistently explained the value of vaccination, greater emphasis was placed on communicating the benefits of Tdap compared with influenza vaccination to POC. Providers used fewer techniques indicative of strong vaccine recommendations when recommending influenza vaccination to POC compared with White patients. Conclusion: This hypothesis-generating study suggests some aspects of provider communication about prenatal vaccination may differ by patients’ race and ethnicity. Provider-based interventions to improve communication with pregnant women about prenatal vaccines may improve vaccine uptake and reduce racial and ethnic disparities.

Objective: Endometriosis is associated with significant diagnostic delays, averaging 6.7 years, largely due to nonspecific symptoms and inadequate diagnostic approaches. Over 15,000 emergency department (ED) visits in the United States annually involve patients with endometriosis, highlighting the need for knowledge of endometriosis. This study surveys emergency medicine (EM) attendings, residents, nurse practitioners, physician assistants, and fellows to assess knowledge and practice in managing endometriosis-related ED complaints. Methods: A questionnaire from a prior endometriosis survey was modified for EM providers and administered anonymously via email (Qualtrics, Provo, UT) in monthly newsletters to providers at an academic and six associated community EDs. Descriptive statistics were applied for analysis. Results: Among 59 respondents, 60.3% were female, 37.9% male, and 1.7% nonbinary. Most were attending physicians (44.8%) or residents (31.0%). Regarding knowledge of endometriosis, 50.0% of respondents rated themselves as “somewhat knowledgeable,” while 37.9% were “moderately knowledgeable,” and 5.2% were “not knowledgeable at all.” 36.2% felt they lacked adequate knowledge on managing endometriosis in the ED. 13.8% did not consider endometriosis in their differential diagnoses, despite 89.7% reporting that they evaluated gynecological complaints frequently (36.2% monthly, 43.1% weekly, and 10.3% daily). 74.1% desired education on endometriosis. Symptom recognition exceeded respondents’ self-reported knowledge; >60% reported they were at least “likely” to associate endometriosis with dyspareunia, cyclical painful defecation, dysmenorrhea, fertility disorders, menstrual cycle abnormalities, and chronic pelvic pain. Conclusions: There may be a gap in endometriosis knowledge among EM providers, with many expressing interest in further education. Targeted training may improve diagnostic accuracy, reducing diagnostic delays.