Women's Choices Research Articles

We choose: Adolescent girls and young women's choice for an HIV prevention product in a cross-over randomized clinical trial conducted in South Africa, Uganda, and Zimbabwe.

With new pre-exposure prophylaxis (PrEP) modalities for HIV prevention becoming available, understanding how adolescent girls and young women (AGYW) navigate through PrEP options is essential, including factors underlying their choice. Through 16 focus group discussions (FGDs) and 52 in-depth interviews (IDIs) from REACH, an open-label crossover study in which AGYW were allocated 1:1 (between 06 February 2019 and 18 March 2020) to receive oral PrEP for six months and the dapivirine ring for six months, in a randomized sequence, followed by a 6-month period where either product (or neither) could be chosen, we explored decision-making process and product choice, using a mixed inductive-deductive analytical approach. Key themes included the desire to remain HIV-negative and weighing product attributes through experiential learning. Product triability appeared important in informing product choice as individual circumstances changed or assuaging side effects with a given product. Approved biomedical prevention innovations may also benefit from hands-on experience to help with adoption and use during real-world implementation. Furthermore, support from trusted providers will remain critical as AGYW contemplate navigating through PrEP options and choice.

Pregnant women autonomy when choosing their method of childbirth: Scoping review.

This paper has as its theme the autonomy of pregnant women in relation to choosing the method of birth for their child. The objective was to carry out a scoping review to study the literature and evidence of how autonomy is being offered to parturient women. Study design and location: In October 2023, a search was carried out using the terms "pregnant women" AND "delivery" AND "autonomy" in the following databases: PubMed, Web of Science, Scopus, Scielo and LILACS. The search included articles from 2016 to 2023. Of the 179 articles found, 15 met the criteria and were selected for this review. Results: the pregnant woman's autonomy in choosing the method of childbirth is influenced by several factors, such as the obstetrician's recommendation, the medical team, and negative and positive experiences. Thus, when this autonomy is shared with the obstetrician, the obstetrician recommends cesarean section as the safest route, but does not explain the benefits and harms of both routes (vaginal and cesarean section), causing the woman to accept the cesarean section. Midwives recommend vaginal birth because they believe it to be natural and safe and explain the benefits and harms of both methods, respecting the pregnant woman's choice of the method she prefers. Conclusion: women have the fundamental right to choose their method of birth and must be properly guided throughout prenatal care, whether by an obstetrician or a midwife, about the options, risks and benefits of each method of childbirth, respecting the ethical principle of beneficence.

Factors associated with the health and reproductive autonomy of Quilombola women in Brazil.

To verify the association between reproductive autonomy and sociodemographic, sexual, and reproductive characteristics in Quilombola women (a term indicating the origin of politically organized concentrations of Afro-descendants who emancipated themselves from slavery). Cross-sectional and analytical study with 160 women from Quilombola communities in the southwest of Bahia, Brazil. Data were collected using the Reproductive Autonomy Scale and the questionnaire from the National Health Survey (adapted). Out of the 160 participating women, 91.9% declared themselves as black, one out of every three were aged ≤ 23 years, 53.8% were married or had a partner, 38.8% had studied for ≤ 4 years, over half (58.1%) were unemployed, only 32.4% had a monthly income > R$ 430 (80 US dollars), 52.5% had their first menstruation at the age of 12, 70.7% had not accessed family planning services in the last 12 months, and over half used some method to avoid pregnancy (59.0%). The women had a high level of reproductive autonomy, especially in the "Decision-making" and "Freedom from coercion" subscales with a score of 2.53 and 3.40, respectively. A significant association (p<0.05) was found between the "Total reproductive autonomy" score and marital status, indicating that single or unpartnered women had higher autonomy compared to married or partnered women. The association of social determinants of health such as marital status, education, and age impacts women's reproductive choices, implying risks for sexual and reproductive health. The intergenerational reproductive autonomy of Quilombola women is associated with sociodemographic and reproductive factors.

Ethiopian women's tokophobia of childbirth and its predictors: a systematic review and meta-analysis.

Fear of childbirth is recognized as a growing problem in developing countries, including Ethiopia. The impact of this fear on women's reproductive choices and decisions is significant. Therefore, the systematic review and meta-analysis will help to consolidate the existing research on childbirth-related fear in Ethiopia. Synthesizing the findings and providing a pooled prevalence estimate, can contribute to a better understanding of the scale of the problem in the country. This systematic review and meta-analysis assessed the pooled prevalence of childbirth-related fear and its associated factors among pregnant mothers in Ethiopia. PubMed, Google Scholar, and African Journals Online were searched for included articles. A weighted inverse-variance random-effects model was used to estimate the prevalence of childbirth-related fear. Variations in the pooled estimates of the prevalence were adjusted through subgroup analysis according to the specific region where the study was conducted. Funnel plot and Egger's regression test were used to check for publication bias. STATA version 14 statistical software was used for meta-analysis. A total of 2,015 pregnant mothers were included. The combined prevalence of fear of childbirth among pregnant mothers was found to be 21% (95% CI: 19-22; I 2 = 0.00%, p value < 0.001). Based on the subgroup analysis, the prevalence of fear of childbirth among pregnant mothers was 24% in SNNPRs, 25% in Oromia, and 11% in Addis Ababa. The findings of the meta-analysis indicating a high prevalence of fear of childbirth among pregnant mothers in Ethiopia and identifying associated risk factors highlight the importance of addressing this issue within the healthcare system. Integrating prevention-based services for mothers with childbirth fears into the antenatal care model could be a valuable approach to support women and mitigate the impact of fear on their reproductive experiences. https://www.crd.york.ac.uk/prospero/#myprospero, identifier [CRD42023411103].

Evolution of Informal Employment from a Gender Perspective based on LSTM

This study provides an in-depth examination of gender differences in informal employment and its time evolution in Brazil, uses an LSTM model to quantitatively predict gender differences in informal employment and its evolution in Brazil, and explores the deeper reasons that lead to gender differences in informal employment based on labor market segmentation theory and gender role theory. The predictive analysis shows that Brazilian male and female informal employment will show a slight downward trend from the fourth quarter of 2023 to the third quarter of 2026, and that male informal employment is generally higher than that of females throughout the time series. In addition, market segmentation theory reveals that the structural segmentation of the informal employment market as a peripheral component of lower wages and social security affects the sexes differently, while gender role theory further expands on socio-cultural expectations of men's and women's behaviors and occupational choices, highlighting the reinforcement of gender differences by these structural barriers. Ultimately, the study makes policy recommendations to promote gender equality and improve the conditions of informal employment in support of the sustainable development goals.

College Gap Time and Academic Outcomes for Women: Evidence from Missionaries

Abstract This study leverages a policy change in the missionary program of The Church of Jesus Christ of Latter-day Saints that exogenously influenced the likelihood that a woman took gap time during college to understand how gap time influences women's subsequent choice of major and academic outcomes. If structured gap time shapes educational outcomes, increasing the uptake of gap time by women may be a mechanism to ameliorate later wage gaps. Using administrative data from Brigham Young University (N = 17,402) and an instrumental variables estimation strategy, we find that women who take gap time for missionary service shift into majors with higher expected salaries and are more likely to be in limited-enrollment majors and majors with a higher concentration of men. However, gap time decreases the likelihood of graduating within eight years of entering college, creating tension between the costs and benefits. On average, net benefits of expected wages are close to zero. Gap time most clearly benefits women with relatively low ACT scores who are more likely to be accepted into limited enrollment programs following gap time. This research informs university administrators and students alike seeking to understand the academic implications of taking planned time off during postsecondary education.

Perceptions of Income Inequality and Women's Intrasexual Competition.

Income inequality has been empirically linked to interpersonal competition and risk-taking behaviors, but a separate line of findings consistently shows that individuals have inaccurate perceptions of the actual levels of income inequality in society. How can inequality be both consistently misperceived and yet a reliable predictor of behavior? The present study extends both these lines of research by evaluating if the scope of input used to assess income inequality (i.e., at the national, state, county, or postal code level) can account for perception discrepancies and if actual/perceived inequality is associated with female intrasexual competition. Female participants recruited online from the general US population (n = 691) provided demographic information, measures of perceived income inequality, and measures of intrasexual competition attitudes and behavior. Actual and perceived income inequality (at any level) did not predict negative attitudes toward other women or female weighting of physical appearance as a desirable trait. Perceived income inequality and actual county-level inequality was, however, predictive of female competition in the form of self-sexualization clothing choice. Further analyses found that age and importance placed on physical attractiveness also predicted women's clothing choices. Perceptions of income inequality were predicted not by actual Gini indices, but by beliefs about the levels of poverty and income gaps. These results highlight the importance of better understanding the proximate cues by which people perceive environmental features such as inequality, and how those cues are used to adjust interpersonal behaviors.

The Promotion of Women's Leisure Sports Behavior Based on Improved Decision Tree Algorithm

In women's daily leisure choices, sports is an important content that cannot be ignored. In this context, this paper studies the promotion of women's leisure sports behavior based on improved decision tree algorithm. Based on the simple analysis of the research progress of leisure sports and decision tree algorithm, a female leisure sports behavior model based on decision tree is constructed. Based on the decision tree algorithm, the calculation method of information gain rate is optimized to avoid logarithmic operation, and the continuous attributes are discretized. Simulation results show that in terms of classification accuracy, the improved decision tree algorithm is significantly higher than the classical decision tree algorithm, and can significantly shorten the running time, which has high application value in the realization of accurate classification analysis of female leisure sports behavior.

Fashioning Herstory: Unveiling Women's Influence in Retail Apparel Trends

The research investigates the intricacies of women's choices and actions concerning retail fashion clothing. Focused on understanding the complex relationship between women and the retail fashion industry, the study tries to uncover key insights that shape their shopping decisions. By examining the interplay of various factors, the study seeks to contribute to both the academic understanding of consumer behavior and the practical strategies of the retail sector. The implications of the findings extend to both academia and industry, from an academic perspective, the research contributes to the existing literature on consumer behavior, particularly within the domain of fashion retail. The findings offer an understanding of how gender-specific factors influence buying preferences and choices.

Not before Twenty-Five: Contesting Marriage and Looking for the Good Life in Contemporary Urban China

This article explores how women of different class backgrounds contest the imperative to enter heteronormative marriage in urban China. While the state and the market propose marriage as the only path to the good life, these women describe it as a risky enterprise and an unequal partnership. The social pressure they face highlights the continuing exclusionary role of marriage in present-day Chinese society, as their stand challenges the state-sponsored narrative of “leftover woman.” These women see their unmarried status not as a sacrifice or loss, but rather as a strategy for preserving their autonomy, well-being, and relationships with their own kin and friends. Accordingly, they come across as desiring subjects, though not as uncivil individualists or affectively precarious. The women's affective choices privilege bonds that exceed the patrilineal family and the conjugal couple. Although this preference may jeopardize their social respectability and limit their prospects for upward mobility, it allows them to explore different avenues to the good life.

Who Do We Call “Creepy?”: Sex Workers’ Relationships as Targets of Intimate Intervention

Like other forms of problem-solving justice, prostitution diversion programs (PDPs) are designed to (re)shape thinking and behaviors. The authority to surveil and punish stems from criminalization of sex work, itself an act of control over women and their bodies. The court cues normative behaviors through rewards and punishments based on information gleaned through ongoing surveillance in and out of court. Using a critical feminist lens, we draw on ethnographic and interview data from studies of two court-affiliated PDPs to examine the regulation of women's bodies and intimate relationships. We found that criminal justice professionals explicitly viewed constant discussion and surveillance of all facets of PDP participants’ lives as a tool to cause participants to internalize particular understandings of normative relationships. Such normative understandings involve assumptions about which men are “creepy” that do not always reflect women's lived experiences and decontextualize relationships in ways that are incompatible with women's own assessments of these relationships. This analysis contributes to feminist social work by revealing the social control functions of such programs, which employ “creepy” intrusion to police the boundaries between unacceptable and normative behavior while simultaneously disregarding the systemic forces that shape women's choices and constructions of normativity.

Nudging food choice in a prison setting: an investigation using food choice data.

The prison population presents complex health needs and is disproportionately affected by poor health, compared to the general population. Diet has a clear role in prisoner health, and the prison food environment within which food choices are made is relatively under-researched. The aim of this study was to examine whether food choices in a women's prison changed after the introduction of a new menu design by the catering team. The adjusted menu design incorporated an emoticon (a smiley face) placed next to designated 'Healthy Choice' foods on the menu sheets, which were used to preselect meals. Data comprised all women's (n = 865) food choices (more than 115,000 selections) for a period of 8 weeks (with the new menu) as well as 8 weeks prior (baseline period). The study design was a pre-post intervention study, and food selection was examined using chi-square tests and binary logistic regression models. The selection of promoted foods overall significantly increased under the new menu design (with the emoticon nudge strategy) compared to baseline; the effect size, however, was small according to the usual guidelines (21.4% compared to 20% at baseline; χ2 (1) = 32.6, p < 0.001, φ = 0.02). Individuals were 11% more likely (p < 0.001) to select the promoted 'Healthy Choice' foods under the adjusted food choice architecture. A significant effect was found for lunch and evening meal - but not for desserts. A minority of individual food items that were promoted had significant positive changes in selection, and were 1.3-4 times as likely to be selected when emoticons had been introduced, compared to baseline. Further research is needed to examine the potential added benefit of multiple complementary nudge strategies, and the relevance of the preselection of foods in advance of consumption.

High-intensity Focused Ultrasound is a Better Choice for Women with Fertility Desire: A Systematic Review and Meta-analysis of the Comparison between High-intensity Focused Ultrasound and Laparoscopic Treatment of Uterine Fibroids.

High-intensity focused ultrasound (HIFU) is commonly used to treat uterine fibroids and adenomyosis, but there is no evidence using metadata to compare fertility outcomes between conventional laparoscopic procedures and HIFU. The purpose of this study analysis is that evidence-based fertility outcomes may provide better treatment options for clinicians and patients considering fertility. The literature on fertility data for HIFU surgery versus laparoscopic myomectomy was searched in seven English language databases from January 1, 2010, to November 23, 2022. A total of 1375 articles were received in the literature, 14 of which were selected. We found that women who underwent HIFU surgery had higher rates of spontaneous pregnancy, higher rates of spontaneous delivery, and higher rates of full-term delivery but may have higher rates of miscarriage or postpartum complications than women who underwent laparoscopic myomectomy. Looking forward to future studies, it is hoped that the literature will examine endometrial differences in women who undergo HIFU and laparoscopic myomectomy to demonstrate the ability of endometrial repair. The location of fibroids in the sample should also be counted to allow for attribution statistics on the cause of miscarriage.

'Drowned in a Sea of Inhumanity': Natural Childbirth, Postnatal Depression and the National Childbirth Trust, 1956-80s.

During the 1970s, the National Childbirth Trust (NCT) began to provide information and support to women experiencing postnatal mental illness, building on its promotion of natural childbirth and emphasis on the emotional wellbeing of women around birth, which had occupied the organisation since its establishment in 1956. This article argues that, alongside emotional, social and medical factors, the NCT attributed postnatal depression to the shift to hospital deliveries, involving high levels of intervention and frustrating women's choice and agency. While sharing ambitions to improve care in childbirth and giving women a voice in describing their experiences, it is suggested that the NCT's relationship with the feminist health movement remained ambiguous. The article also explores the NCT's collaboration with a variety of experts and advisors, some of whom emphasised the risk of postnatal depression to the bonding process and infant's development, potentially exacerbating the mental distress of new mothers.

What motivates young Arab Muslim women to choose nursing as a profession: A cross-sectional study.

This study examines the impact of nurse uniforms, the coronavirus pandemic, and the image of nurses and the nursing profession on the career choice of young Muslim Arab women in nursing, with a focus on policy implications. The global nursing shortage poses significant challenges, including in Israel. Attracting young Muslim Arab women to nursing careers is vital. Understanding how nurse uniforms, the pandemic, and perceptions of nurses and the nursing profession shape their career decisions can inform policy interventions. A cross-sectional study utilized digital questionnaires administered to 200 Muslim Arab women aged 20-30 in Israel. The study adhered to the EQUATOR checklist for cross-sectional studies. Only 29.2% of participants expressed interest in studying nursing. Findings revealed a positive correlation between the pandemic's impact and intention to pursue nursing. A linear regression analysis shows the impact of the white uniform, the image of nurses, and the image of the profession on the choice of a career in nursing. The study emphasizes the significance of nurse uniforms, the image of nurses, and the image of the nursing profession in shaping young Muslim Arab women's career choices in nursing. Policy interventions should raise awareness about nursing roles, expand responsibilities, and highlight nurses' contributions to society. Strategies to attract young Muslim Arab women to nursing careers should address nurse uniforms, the image of nurses, and the image of the nursing profession. Policy interventions should prioritize diversity, promote positive images of nurses and the nursing profession, and raise awareness of nursing roles and contributions among young Muslim Arab women.

Factors Affecting Women's Attitudes Toward the Use of Epidural Anesthesia During Labor in Riyadh in 2023.

Background Epidural analgesia (EA) is a type of central nerve block achieved by injecting a local anesthetic near the pain-transmitting nerves. It is commonly used to relieve pain during labor. The intensity of pain experienced and the effectiveness of pain relief can affect a woman's labor and delivery experience. Labor pain is a long-lasting and debilitating pain that women experience; therefore, pain relief techniques have become widely available. However, not all women are willing to use EA for pain relief. The factors that influence women's choices regarding EA should be explored. This study aimed to comprehend women's perspectives on EA in Riyadh and clarify the variables influencing their decision-making. Methodology A total of 336 women in their reproductive years participated in this study. An online questionnaire with five sections was used to collect data. The socio-demographic information in the first section covered age, level of education, occupation, income, marital status, pregnancy, maternity, and prenatal care. The second section focused on how painful labor was for women who had already given birth. The third and fourth sections discussed labor pain relief techniques, including epidural anesthesia. The final section assessed the participant's interest in receiving EA during the next delivery. Socio-demographic data were considered to be a predictor, whereas awareness levels and a desire to receive EA were seen as results. The information was cleaned, coded, and entered into SPSS version 29 (IBM Corp., Armonk, NY, USA). The results are presented as frequencies and percentages. A Likert scale was used for data analysis. Statistical significance was established at p-values <0.05. Results In total, 336 Saudi women were included in this study, 86% of whom were between the ages of 30 and 35 years, and 69% of whom had a university education. One-third of the women (32%) had a monthly income of 10,000 to 20,000 SAR, and 55% of them had experienced three or more pregnancies. Fear of pain was the main reason for using epidural anesthesia in more than half of the participants given the choice. The most reinforcing factor was obtaining proper and sufficient information about EA, while the most restrictive factor was the fear of harming the infant. In particular, women aged 30-35 years (i.e., most of the included women) were commonly influenced by negative factors. Marital status and educational level played no significant role in women's use of EA. Conclusions Saudi women showed a good attitude toward EA. However, the awareness of EA was quite low. Fear of labor pain appeared to be the main reason for using EA. Health education programs on EA can increase the knowledge of and intent to use EA among women.

Conditional cash transfers and women's reproductive choices.

We study potential non-targeted effects of a large-scale national conditional cash transfer program-Peru's Juntos-on the fertility and reproductive decisions of adult beneficiaries. We use an event study design, exploiting time and geographic variation in the rollout of the program, to identify the causal effects of the program. We find that Juntos decreases the number of children that adult beneficiaries have and that these effects persist over time. We explore various mechanisms and find that Juntos does not affect fertility preferences but rather empowers women to avoid unwanted births. We provide evidence that this decrease is most likely due to better access to and more extensive use of modern birth control methods.

Scientists explain the underrepresentation of women in physics compared to biology in four national contexts

AbstractWomen are consistently underrepresented in physics when compared to biology. Yet how scientists themselves explain the causes of this underrepresentation is understudied outside the US context. In this research, we ask the following question: How do scientists in different national/regional contexts explain why there are fewer women in physics than biology? Using original survey data collected among academic biologists and physicists in the US (N = 1777), Italy (N = 1257), France (N = 648), and Taiwan (N = 780), we examine how scientists' social identities, social locations, and country context shape essentialist, individualist, and structural explanations of gender inequality. Findings indicate that scientists across national contexts attribute the unequal gender distribution in physics and biology to women's individual choices. Explanations for the gender distribution also vary by social identities and social locations (gender, discipline, and seniority) in country‐specific ways. Scientists and advocates ought to engage conversations that explicitly confront scientists' assumptions about individual choices in global science.

Associations between maternal health literacy, neonatal health and breastfeeding outcomes in the early postpartum period.

Maternal health literacy is a social skill that is relevant to successful postnatal newborn adaptation, neonatal feeding, and neonatal health outcomes, given the importance of maternal health literacy in newborn healthcare. The study aims to identify and assess the associations between maternal health literacy, neonatal health, and breastfeeding outcomes during the early postpartum period. Five hundred women who gave birth to full-term newborns at Vilnius University Hospital were invited to the study from 1 May to 30 September 2022. The 47 questions of the European Health Literacy Questionnaire (HLS-EU-Q47) were used to assess maternal health literacy on days 2 and 3 after birth. Each subject's health literacy indices were divided into four categories: inadequate, problematic, sufficient, and excellent. The neonatal health indicators were birth weight and height, along with the APGAR score and the outcomes of feeding either exclusively with breast milk or with adapted formula in addition to breastfeeding. Most women who participated in the survey had insufficient or problematic health literacy (69%). The study showed that women's higher health literacy is associated with a lower risk of obesity, a healthier diet, regular physical activity, and a higher birth weight and height of their newborns (p<0.05). Mothers with inadequate/problematic health literacy were more likely to feed their newborns with adapted formula in addition to breastfeeding. Women's health literacy is a factor that affects women's healthy lifestyle choices before and during pregnancy and is significant for newborns' health indicators.

‘Doomed to Fail’: Dutch and West German Consulates Warning Against Mixed Marriages, 1950s–70s

This article demonstrates how official discourses in Western Europe warning against mixed marriages were built on colonial continuities as part of shared European heritage, as well as the importance of race and gender ideologies in those discourses. It addresses the exchange across borders of approaches to regulating ‘mixed’ marriages among Dutch and German consular officials, strongly advising European White women not to emigrate and not to marry Muslim men. Based on research in the archives of the Ministries of Foreign Affairs as well as newspaper archives in the Netherlands and West Germany, this article demonstrates the central role that consulates of both countries played in developing these official discourses. This study contributes to literature on female (e)migration as well as literature on present-day restrictive migration control practices by demonstrating the historical and colonial roots that still serve to justify state practices of regulating mixed intimacies in surveilling women's partner choice.