Female Gynecologists Research Articles

Breaking barriers: Analysing the professional landscape for female gynaecological surgeons in Italy

To examine the status of female gynaecological surgeons in Italy in terms of discriminatory practices and the availability of opportunities for improvement within the operating theatre. This study is a subanalysis of a comprehensive 83-item questionnaire, administered to 3242 female surgeons across various specialties from 1 November to 31 December 2020. This study focuses specifically on 219 female gynaecological surgeons in order to explore their unique experiences and challenges in surgical practice. Data concerning subjective satisfaction of respondents were collected. Satisfaction was evaluated using a five-point Likert scale. Data are presented using mean, median or frequency. This subanalysis included 207 respondents. Among the respondents, 47% reported that they had children, while 31% had decided not to have children for professional reasons. Nearly half of the respondents (42%) were trainees. Despite a considerable workload (mean working week of 45h), 96% of the respondents reported spending less than half of their working time in the operating theatre. They performed a median of two operations per week, compared with five operations for their male counterparts. Despite challenges, 65% expressed a commitment to their career path. Efforts to address gender bias, promote work-life balance, and enhance female leadership representation are essential. These findings emphasize the need for systemic changes to create a supportive environment for female gynaecologists. Further research with broader sampling is warranted to fully understand and address these challenges.

Clinical analysis of 80 patients with oblique vaginal septum syndrome

Objective: To investigate the clinical features, diagnosis and treatment of oblique vaginal septum syndrome (OVSS). Methods: The clinical data of 80 patients with OVSS admitted to The Second Hospital of Hebei Medical University from July 2005 to July 2023 were retrospectively analyzed. According to the classification system of OVSS proposed by Female Genital Anomalies Study Group, Chinese Obstetricians and Gynecologists Association in 2021, the patients were divided into four groups. The clinical manifestations, accompanied urinary system abnormalities, diagnosis and treatment methods and treatment outcomes were observed. Results: According to the above classification system, among the 80 patients with OVSS, 35 patients (44%, 35/80) were categorized as type Ⅰ, 33 patients (41%, 33/80) were categorized as type Ⅱ, 2 patients (3%, 2/80) were categorized as type Ⅲ and 10 patients (13%, 10/80) were categorized as type Ⅳ. The main onset symptom of patients was periodic abdominal pain (70%, 56/80), vaginal bleeding (20%, 16/80), dysuria or fecal impaction (15%, 12/80), vaginal mucopurulent discharge (10%, 8/80). The morbidity of combined urinary system abnormalities was 88% (70/80), and the most common urinary system abnormality was ipsilateral renal agenesis (81%, 65/80). Bilateral kidneys were normal in 13% (10/80) patients, and 6% (5/80) were combined with other urinary system abnormalities. A total of 74 patients underwent vaginal oblique septectomy or septum excision. Five of the 10 patients with type Ⅳ underwent hysterectomy on the cervical atresia side, 4 patients received hysteroscopy combined with cervicoplasty+oblique septotomy or septum excision, and one patient selected delayed menstruation. Two patients underwent laparoscopic resection of the dysplasia kidney and ectopic ureter which opening to the vagina. Eleven patients with endometriosis cyst, hydrosalpinx or empyema underwent laparoscopic surgery. Conclusions: The main symptom of type Ⅰ and Ⅳ patients is abdominal pain, while the main symptom of type Ⅱ and Ⅲ patients is bleeding. Magnetic resonance imaging (MRI) has advantages in the evaluation of complex OVSS, and MRI is recommended before operation to exclude other axial reproductive tract dysplasia and complex urinary system dysplasia. If there is leakage of urine, vaginal discharge or complex deformity, it is necessary to multidisciplinary discussion and formulate a reasonable surgical plan. The first treatment is related to the prognosis of patients especially children, and should be highly valued.

The personal experience of female obstetricians and gynaecologists with contraceptive use influences the guidance and prescription of contraceptive methods: a web-survey

Objective To evaluate the influence of the personal experience of female obstetricians and gynaecologists (Obst/Gyns) who utilise contraceptive methods on the provision of these methods. Methods An anonymous online web-based survey was carried out with female Obst/Gyns. The instrument contained questions about their current and previous contraceptive methods use, factors that influenced the choice and satisfaction with the ongoing method, as well as the occurrence of adverse events. They were also asked whether the experience of any adverse events influenced their decision in prescribing any particular contraceptive method. Results 476/9000 (5.3%) female Obst/Gyns answered the survey. The most common contraceptive in use was the 52-mg levonorgestrel-intrauterine device (52-mg LNG-IUD) (34%), followed by non-Long-Acting Reversible Contraception hormonal methods (21.2%). More than half of the respondents (57.6%) reported having some adverse effects and 18.7% reported that the personal experience of an adverse effect with the use of a contraceptive method influenced the prescription of that method. Conclusion Half of female Obst/Gyns encountered adverse events linked to contraceptive usage. Additionally, almost one-fifth believe that their own encounter with adverse effects from a contraceptive method impacts their decision to prescribe the same method.

Assessment of Health-care Professional’s Knowledge Regarding the Comorbidities of Vitamin D Deficiency and its Relationship with Uterine Fibroids

Vitamin D deficiency is a widespread global health issue, notably prevalent in the Middle East and more severe in women. Vitamin D deficiency increases the incidence of uterine fibroids in black and white women, the most frequent benign gynecologic malignancies. This study examined health-care providers’ understanding of the relationship between vitamin D insufficiency and uterine fibroid at Sulaimani Hospitals in Kurdistan, Iraq. A quantitative design, cross-sectional-descriptive study (non-probability purposive sample) of 113 female nurses and gynecologists. Data were collected using a checklist through Google Forms. The results showed that the majority of the participants were nurses (88.5%), and the remaining (11.5%) were gynecologist. Two-thirds of them work in maternity teaching hospital while others work in smart hospitals and Faroq medical cities. The results revealed that the level of knowledge was significantly associated with the position of participants and level of education (P < 0.05). As well, the study demonstrated that the majority of the participants were not trained regarding uterine fibroid and vitamin D deficiency. The study concluded that nearly a quarter of the health-care professionals had a medium level of knowledge, while nearly a quarter (24.8%) of them had a high level of knowledge. The study recommended to the Ministry of Health giving opportunities to health-care professionals, especially nurses, to participate in training courses, workshops, and conferences regarding the relationship between vitamin D deficiency and uterine fibroid.

Knowledge, practices and barriers to access sexual health of women in the menopausal stages: a cross-sectional study with Brazilian gynecologists

BackgroundSexual health access and care for women in the menopausal stages face significant barriers, presenting deficits in relation to diagnosis and treatment. Although epidemiological data indicate high prevalence of problems related to sexual health in this population, traditionally, the theme is not discussed in health care settings. This study aimed to analyze knowledge, practices and barriers to access sexual health of women in the menopausal stages in the context of women’s health care in Brazil.MethodsWith a cross-sectional design, a questionnaire was distributed electronically, encompassing variables related to knowledge; practices; and barriers to access sexual health of women in the menopausal stages. The data obtained were subjected to analysis using both descriptive and inferential statistics. Specifically, we employed multivariate analysis, employing multiple linear regression models, to discern potential factors associated with outcomes concerning the level of knowledge and the frequency of addressing the topic in professional practice.ResultsThe sample included 70 physicians with specialization in obstetrician/gynecologists who work in health care with women in the menopausal transition or postmenopausal women. A high level of self-reported knowledge about sexual health was identified. Regarding the practices, most of them reported directly proposing the subject and not using instruments. Although they reported frequently addressing the topic in general, topics related to vaginal lubrication, dyspareunia, and sexual dysfunction have been more present in the clinic compared to sexual orientation and women’s relationship with themselves. The main barriers were time limitation and patient discomfort with the topic. The multivariate models indicated that female gynecologists and professionals with higher levels of knowledge on the subject had a higher frequency of addressing sexual health in clinical practice with women in menopausal stages.ConclusionsSexual health access and care for brazilian women in the menopausal stages presents discrepancies in the frequency of approach between the various topics, in addition to the predictive character of technical knowledge in the practices of professionals. To ensure universal access to sexual health services for this population, an active approach through specific instruments is important, as well as the reinforcement of strategies to improve the level of knowledge of professionals.

Frequency of contraceptive use among Female Specialists and Consultants of Multan, Pakistan

Objective: To describe frequency of contraceptive use among female specialists and consultant doctors of Multan City. Study Design: Cross-sectional study. Place and Duration: It is a multicenter study on female doctors of Multan City from 01 April 2022 to 31 Dec 2022, conducted by Department of Obstetrics & Gynaecology Nishtar Hospital Multan. Methodology: An anonymous, predesigned questionnaire survey was performed on specialists and consultant female doctors, gynecologists and non-gynaecologists, during their reproductive age, practicing in the city of Multan. Total 100 female doctors (N) were included. Results: Overall prevalence of contraception was 84%. Amongst them 48% are from gynecology. In the gynecologist group, 91.7% used contraception, 50 % of them are from age 31 -38 years and 75% had parity ≤ 3. 50% of use the barrier methods, 16.7 % copper intrauterine contraceptive device, 16% calendar method, 4.2 % each for mirena and tubal ligation. No one used oral contraceptive pill. From the non-gynecologist group, prevalence was 76.9%. 53.8% were of age > 38 years, 80.8% had parity ≤ 3. Among choice of contraception, 42.3% used Barrier method, 23.1 % oral contraceptive pills, 3.8% copper intrauterine contraceptive device. None used calendar method, mirena and tubal ligation. Conclusion: Even amongst the most qualified doctors of Multan city, half of them used Barrier methods. 16% of the gynecologists used Calendar method. These results enable us to change the thinking and contraceptive practices of the most literate persons of an urban city of an underdeveloped country. Keywords: Contraception, Gynaecologists, Specialists, Consultants, Multan. How to Cite This: Ali S, Yasmeen S, Parveen R, Akhter S. Frequency of contraceptive use among Female Specialists and Consultants of Multan, Pakistan. Isra Med J. 2023; 15(2): 65-69. DOI: https://doi.org/10.55282/imj.oa1365

Attitudes of Gynecologists toward Referral of Women to Breast Imaging Clinics for Breast Cancer Screening or Diagnosis.

To investigate whether gynecologists considered the age of women when requesting ultrasound (US) and/or mammography examinations. Furthermore, to determine in which situations gynecologists referred patients to breast imaging clinics for breast examinations, and aimed to establish the reasons behind cases of non-referral. Aquestionnaire-based survey was conducted from February to April 2023 among gynecologists practicing at government, university, or private hospitals/centers. The participants were contacted through an online Web link ( www.googledocs.com ). The questionnaire was completed by 80 gynecologists. In total, 96.2% of the participants referred women to breast imaging clinics. The proportion of female physicians (70%) was higher than that of male physicians, and 55% were younger than 40years. Menopause, hormone replacement therapy, and hereditary/genetic or familial breast cancer were the most commonly considered risk factors when referring women. Overall, 75% of participants requested mammography for women aged ≥ 40years. For women between the ages of 30 and 40, mammography was requested by 40% of physicians. For women younger than 30, US was requested by 70% of participants, while asmall number of participants (7.5%) requested mammography if deemed necessary. Gynecologists tend to refer women to breast imaging clinics for screening rather than for diagnostic purposes. Female gynecologists have ahigher tendency for referral, especially if there is arisk factor involved. Seminars or courses at gynecology conferences can be organized by experienced breast imaging specialists to give detailed information about breast cancer and examination methods according to patient age. This will ensure better breast assessment.

Use of Contraceptive Methods Among Women in the General Population and Female Gynecologists in Spain: the ELEGIAN Survey.

The contraceptive preferences of obstetricians and gynecologists (OB/GYNs) are thought to influence the contraceptive counseling they provide. The purpose of this study was to assess contraceptive preferences of OB/GYNs and women in the general population (WGP) in the current Spanish contraceptive scenario. Anonymous online survey of 100 OB/GYNs and 1,217 WGP aged 23-49 years. WGP were younger (35.3 ± 7.3 vs. 37.9 ± 6.2 years, respectively) and less likely to have stable partners (64.7% vs. 84.0%) and children (49.1% vs. 62.0%) (all p < 0.05 vs. OB/GYNs). Seventy-nine percent versus 82%, respectively, used contraceptive methods, with condoms used most frequently by WGP (37% vs. 22% by OB/GYNs; p < 0.05) and pills by OB/GYNs (26% vs. 21% by WGP; p > 0.05). Intrauterine devices (IUDs) were more frequently used by OB/GYNs (20% vs. 5%; p < 0.05), especially the levonorgestrel-releasing intrauterine devices (LNG-IUDs) (18% vs. 2.6%; p < 0.05). The highest-rated methods were condoms among WGP and LNG-IUDs among OB/GYNs. Effectiveness was the most valued attribute of contraceptive methods for both. Reasons related to convenience were the main reason for choosing IUDs. OB/GYNs prescribed the contraceptive method in 40% of cases. Our study reveals differences between female OB/GYNs and WGP in contraceptive methods use and rating. The use of LNG-IUDs was much higher among OB/GYNs.

Cervical cancer screening and prevention among female gynecologic oncologists in Indonesia

Background: Cervical cancer has become a significant health problem in developing countries. We researched cervical cancer screening and prevention among all female gynecologic oncologists (FGO) registered with the Indonesian Society of Gynecologic Oncologists (INASGO). Methods: Participant data and cervical cancer screening and prevention data were collected using an online questionnaire. A total sampling technique was conducted, and 18 of 20 FGOs responded to the survey. All data were analyzed descriptively. Results: Fourteen FGOs (77.8%) had their first cervical screening at the age of 31-40 years old, primarily using Pap smears (77.8%) and Pap-human papillomavirus (HPV) co-testing (22.2%). Half of the included FGOs (50%) had irregular cervical cancer screening due to lack of time (66.7%), followed by forgetting (33.3%). Most FGOs preferred liquid-based cytology (77.8%) over conventional Pap smears (22.2%). Half of the FGOs preferred the HPV genotyping and half the HPV non-genotyping test. Most of the FGOs had screenings performed by female gynecologists (77.8%), male gynecologists (11.1%), and female general practitioners (5.6%). Most FGOs underwent screenings at health facilities outside their workplace (88.9%) and were funded by themselves (94.4%). Most FGOs were vaccinated with the HPV vaccine (77.8%), and most were with the quadrivalent (85.7%) over the bivalent vaccine (14.3%). All respondents were completely (three doses) vaccinated. Conclusion: Most of the FGOs in Indonesia have been vaccinated against HPV and screened for cervical cancer, although half are still not regularly screened. The liquid-based cytology Pap smear and the quadrivalent HPV vaccine are the preferred cervical screening and prevention methods among FGOs in Indonesia

Forensic Medical Examination After Sexual Violence: Implications Based on Victims' Perceptions.

The objective of this study was to assess the perception of the forensic medical examination (FME) by victims of sexual violence. Based on patient-related outcomes gained in terms of personnel, chronological and spatial parameters, an additional aim was to derive improved examination procedures. A total of 49 sexually assaulted women were enrolled in this study. After standardized FME by a forensic doctor followed by a gynecologist, women were asked to complete a questionnaire addressing general perception, preferences regarding attending staff's sex, sequence and time frame of the examinations performed. The attending gynecologist also completed a questionnaire addressing demographic and medical parameters of the patient as well as assault-related information. The examination setting in general was evaluated positively. Nevertheless, 52% of examined victims perceived the FME as an additional psychological burden. Overall, 85% of the affected women preferred a female forensic physician and 76% a female gynecologist to perform the examination. When women said they experienced a violation of their privacy during the gynecological examination, a male was more often present (60% vs. 35%, p=0.0866). Regarding the sequence of the examination components, 65% of the victims preferred to start with their medical history followed by the forensic and then the gynecological examination. Forensic medical and gynecological examination after sexual assault is an essential procedure, yet it is a potentially further traumatizing experience for the victim. The identified patient preferences should be taken into account in order to diminish further trauma.

Oral Hygiene Practices and Awareness of Pregnant Women about the Effects of Periodontal Disease on Pregnancy Outcomes.

Objectives Adverse pregnancy outcomes, such as preterm low birth weight (PTLBW), is a severe public health issue that needs to be dealt with by educating the general female population, dental practitioners, and gynecologist. One of the major contributing factors is periodontal disease, which accounts for about 18.2% of all PTLBW cases worldwide, and prevention of the same could reduce the occurrence of PTLBW babies. This study aimed to assess the oral hygiene practices and awareness of pregnant women about the effect of periodontal disease on pregnancy outcomes. Methods A descriptive cross-sectional study was conducted where 400 pregnant women after consent were requested to complete an anonymous, self-administered, structured questionnaire with twenty-one close-ended questions. Results Only 5% of participants in this study reported that gum diseases during pregnancy lead to preterm labor or low birth weight babies. About 70.7% of pregnant women mentioned that they did not use any interdental cleaning aids, and 54.5% did not use mouthwashes. Conclusion Tooth brushing practices among pregnant women were good; however, there was an overall lack in the use of adjunctive aids. The study highlighted a deficiency in the awareness of pregnant women regarding the association between periodontal disease and adverse pregnancy outcomes.

Retrospective study of the differences in patient characteristics and revenue between male and female surgeons in Taiwan

Surgery is traditionally a male-dominated field, and gender differences exist despite the growing numbers of female surgeons. A handful of studies have evaluated the condition in Asian societies. We aimed to examine the difference between female and male surgeons in urology, general surgery, and gynecology by analyzing a nationwide, population-based database. We identified surgeons with a clinical experience of six to thirteen years between 1995 to 2013 from the National Health Insurance Research Database. We collected patient numbers and revenue per month in outpatient and inpatient care, as well as monthly numbers of surgeries conducted by female and male surgeons in urology, general surgery, and gynecology, for analysis. Original student’s t-test and wilcoxon rank sum test was used to compare the differences between female and male surgeons, and p values less than 0.05 were considered statistically significant. Female urologists and general surgeons had a significantly higher ratio of female patients in Taiwan. Female urologists had patient numbers, revenues, and numbers of surgeries comparable to male urologists. In contrast, female general surgeons had significantly less involvement in outpatient and inpatient care and had low monthly revenues. Female general surgeons contradictorily performed more oncological surgeries per month than males. However, the difference in numbers of oncological surgeries was not significant after excluding breast cancer surgeries. Female gynecologists had a similar amount of outpatients and outpatient revenue but significantly less inpatient care and numbers of surgeries per month. A gender-based gap exists among surgeons in Taiwan. The gap between females and males appeared narrower in urology than in general surgery and gynecology. Management of diseases related to female sex organs, including breast, were more common among female surgeons. Efforts should be made to decrease gender stereotypes, to ensure that patients receive the best care regardless of the sex of the surgeons.

Obstetrics-Gynecology Educational Achievements in Iran (1979-2017): Trends, Consequences and Future Implications.

Background:To study the current trends in Obstetrics–Gynecology (Ob-Gyn) education and workforce in Iran since 1979 and to discuss the consequences and implications.Methods:This descriptive-analytical study was conducted to describe the Ob-Gyn residency and fellowship growth and workforce profile in Iran (1979–2017).The first-hand data gathered from MOHME and Iran’s Medical Council. The Obstetrician-Gynecologist (Ob-Gyns) per 100000 populations’ ratio and the percentage changes calculated and the trends analyzed.Results:Between 1979 and 2017, the proportion of trained Ob-Gyns at national universities increased by 86.27%, the number of certified Ob-Gyns increased by 333% and, female Ob-Gyns increased by 1142%.The ratio of active gynecologists per 100,000 people was 5.0 in 1979 and 8.05 in 2017, represents an increase of 70%. Since 1979 the number of active gynecologists has increased by 278 and the number of active female gynecologists has increased by 996%. Since 1990 the maternal mortality per 100,000 live births decreased by 79.9% in Iran. However, since 1980 the Cesarean proportion increased by 203% in Iran.Conclusion:Ob-Gyn education has undergone remarkable growth. Ongoing research should focus on Ob-Gyn’s geographic distribution, and potential implications of female Ob-Gyns practice pattern and technologies on women’s health.

Understanding Patient–Doctor Relationship via a Sample of Iraqi Doctors

Abstract Background: Rapid changes in health-care delivery system and sociopolitical climate have resulted in considerable strain on doctor–patient relationship. Doctors’ role is to install positive energy within the patient, through which sick people find relief from suffering. Without it, there continues to be more confusion, fear, and doubt. Objective: This study aims to understand the social dimensions of Iraqi doctor misbehavior and malcommunication with patients. Subjects and Methods: A cross-sectional study, with a tool consisting of two sketch drawings representing an agonizing misbehavior scenario for a female gynecologist encountering a pregnant patient, and a male orthopeditian encountering a disabled male patient. Scenarios were presented to a convenient sample of 155 Iraqi doctors in Baghdad, striking their feelings, to generate rich comments. Results: About two-thirds of doctors were female, and the majority were nonspecialists. Only 7.1% of doctors (with significant gender difference) offered an excuse for the misbehavior. Around 80% of doctors expressed patient sympathy. Scenario understanding showed significant doctors’ gender difference. Two-thirds of doctors stated reasons and suggested solutions for the misbehavior. Main reasons stated were commercialization of medicine (23.8%), loss of today’s doctor humanity (18.1%), and profession power and ability to threat (15.2%). Conclusion: Although doctor–patient misbehavior is not unprevalent, most Iraqi doctors disagree with it. The majority express professional sympathy. Less than tenth of doctors stand by misbehavior, trying to give excuses. Commercialization of medicine, loss of doctor’s humanity, professional power, and malcommunication are emerging challenges for future Iraqi doctor–patient relation.

Compassion fatigue among obstetricians and gynecologists.

Obstetricians and gynecologists are likely to be at risk of occupational distress because their quality of life is affected as a result of their experiences of assisting with traumatic births and/or providing abortions, among others. Nevertheless, there have been few studies of this group of doctors’ compassion fatigue. This study aimed to examine obstetricians and gynecologists’ compassion fatigue. This survey-based quantitative study examined 107 obstetricians and gynecologists’ compassion fatigue. Data were collected using a demographic information form and the Compassion Fatigue Short Scale. This established that had low levels of compassion fatigue related to secondary trauma and job burnout, but moderate levels of it overall. Among female obstetricians and gynecologists, compassion fatigue was higher than among their male counterparts, and respondents who worked at private hospitals had higher compassion fatigue related to secondary trauma than those who worked in state-run hospitals. The data also revealed that obstetricians and gynecologists with 11–15 years’ seniority scored higher on the job-burnout subdimension of compassion fatigue, and overall, than their more senior counterparts. Interestingly, however, no statistically significant differences in the participants’ compassion fatigue were found to be associated with their ages, marital statuses, numbers of children, number of patients seen per day, or number of daily operations performed. Professional sharing groups that allow doctors to share their experiences and to gain awareness about their colleagues’ traumas should be organized. Teamwork should also be encouraged; and various prevention strategies should also be considered.

Awareness about Vulvovaginal Aesthetics Procedures among Medical Students and Health Professionals in Saudi Arabia.

The present study aimed to explore the opinion and ethical consideration of vulvovaginal aesthetics procedures (VVAPs) among health professionals and medical students in Saudi Arabia. This is a cross-sectional study performed between January 2020 and April 2020. Data was collected through electronic media, WhatsApp, and emails. The results were analyzed by applying the Students t-test, and correlations were considered significant if they presented a p-value < 0.05. There is significant demand to educate doctors, health professionals, medical students, and gynecologists for the VVAPs to have a solid foundation, justified indications, and knowledge about various aesthetic options. Although female doctors, medical students, young doctors, and gynecologists have more knowledge about VVAPs, all health professionals ought to be aware of recent trends in vulvovaginal aesthetics (VVA). The present analysis determined that VVA should be under the domain of gynecologists, rather than under that of plastic surgeons, general surgeons, and cosmetologists. The majority of the participants considered that vaginal rejuvenation, "G-spot" augmentation, clitoral surgery, and hymenoplasty are not justifiable on medical grounds. The decision to opt for different techniques for vaginal tightening and revitalization should be taken very carefully, utilizing the shared decision-making approach. Ethical aspects and moral considerations are important key factors before embarking in the VVAPs purely for cosmetic reasons. Further research is required to determine the sexual, psychological, and body image outcomes for women who underwent elective VVAPs. Moreover, medical educators must consider VVAPs as part of the undergraduate and postgraduate medical curriculum.

Exploring the physician's role in contraceptive counseling at the time of abortion in the US

We explored how physicians conceptualize their role in contraceptive counseling at the time of abortion, including identifying clinician attitudes that may lead to patients' perceptions of contraceptive coercion. We conducted individual semi-structured interviews using questions based on components of the Theory of Planned Behavior. We recruited physician abortion providers using purposeful sampling to attain diversity in practice setting and geographic practice region. We analyzed transcribed interviews using initial and values coding methods. We interviewed 39 participants across the United States, who primarily self-reported as White female obstetrician gynecologists (OB/GYNs) aged 25 to 44. Over half of participants practiced in an academic setting. Participants perceived providing patient education and taking a patient-centered approach as part of their role in contraceptive counseling. Participants also believed it was their responsibility to prevent unintended pregnancies and subsequent abortions among their patients. External motivations behind this belief included wanting patients to avoid the challenges of obtaining another abortion, particularly in states with multiple abortion restrictions. Internal motivations included valuing professional goal attainment, discomfort with abortion, and abortion stigma. When physicians counseled about contraception, many expressed preferences toward methods of long-acting reversible contraception (LARC) and an emphasis on contraception provision for adolescents and women with prior abortions. Physicians providing abortions strive to use a patient-centered approach to contraceptive counseling. However, many continue to be motivated by the goal of avoiding a subsequent abortion which patients may perceive as coercion towards contraceptive uptake. Considering contraceptive counseling as a means to prevent subsequent abortion may lead to coercive practices, especially with specific patient populations. Moral codes and abortion stigma influence physicians' counseling practices and physicians must examine their personal values and motivations behind recommending contraception after an abortion.

Presence of Chaperone during Pelvic Examination: Women’s Opinions and Preferences in a Tertiary Hospital in Abakaliki, Ebonyi State, Nigeria

Introduction: Pelvic examination in the evaluation of patients can be a source of dissatisfaction and litigation from patients. A chaperone is beneficial in militating against unforeseen circumstances surrounding this clinical examination. Aim: To access the opinions and preferences of patients in pelvic examinations and factors associated with the use of chaperones in Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria. Materials and Methods: The present study was a cross-sectional study. Women were recruited between October 2017 to April 2018 among patients attending the Gynaecological Clinic at the Federal Teaching Hospital, Abakaliki, Nigeria. A structured questionnaire was used to collect data such as the socio-demographic characteristics, feelings towards pelvic examinations, and preferences about the gender of the examining doctor as well as the presence of a chaperone. Data analysis was done using International Business Machines Statistical Package for the Social Sciences (IBM SPSS) Statistics version 20.0 (IBM Corp., Armonk, NY, USA). Results: Out of 423 questionnaires distributed, 395 respondents completed the survey giving a response rate of 93.4%. The mean age of the respondents were 29.2±6.2 years. Majority of the respondents would prefer to be seen by a female gynaecologist 342 (86.6%). About 50 (12.7%) respondents would decline pelvic examination. The commonest reason given for refusing gynaecologic examination was uncomfortable environment 25 (50%). More than two-third 264 (76.5%) would prefer to have a chaperone present at any pelvic examination. Avoidance of sexual molestation was the commonest reason given for wanting a chaperone to be present 207 (78.4%). Nulliparous women (OR=2.25 95% CI 1.13-4.50) and those with at least a secondary education (OR=7.91 95% CI 4.54-13.78) were also more likely to request a chaperone. Conclusion: Majority of the women in present study wanted the presence of a chaperone during a pelvic examination. It is therefore recommended that chaperones should routinely be offered during pelvic examination in Abakaliki, Ebonyi, Nigeria.

Outcomes of Cricothyroid Visor Maneuver (CVM) for Treatment of Vocal Polyp: A Case Report

The aim of the study is the clinical investigation of a patient with a vocal fold polyp, and the visual, acoustical, perceptual, and self-report changes before and after using the cricothyroid visor manoeuvre (CVM). A 48-year-old female university professor, gynecologist, and obstetrician with a history of laryngopharyngeal reflux and a left vocal polyp participated. Treatment was provided in 10 sessions. Pre- and post-treatment audio recordings of sustained vowels, selected sentences, and connected speech samples were submitted to auditory-perceptual and acoustical analysis to assess the effects of the two-treatment program. Also, laryngoscopic images, perceptions by the patient about her voice quality and quality of life before and after therapy were assessed. Improvements in acoustic parameters were obtained especially in perturbation and CCPS parameters. The overall voice quality scores on the CAPE-V were moderate before therapy and became mild after therapy. Laryngoscopy images demonstrated improvement in the glottis closure configuration in two phases (open and close) in pre- and post- CVM therapy and a decrease in polyp size. The patient had improvement in VAS, IVQLP, and VRQOL scores. The CVM therapy used in the study resulted in positive changes in acoustic and perceptual-auditory aspects of voice production, self-report, and QOL for the patient. The CVM approach appears to have been effective for this case in decreasing the polyp size or its regression or for vocal adaptation.

Characteristics Related to Choice of Obstetrician-Gynecologist among Women of Ethiopian Descent in Israel.

Background: Patient satisfaction with the quality of health care services is complex with many known factors impacting upon satisfaction, among them the choice of physician. Previous studies examined characteristics of a woman’s choice of gynecologist, but information regarding reasons for these choices among women of Ethiopian descent is lacking. The objective of this study was to identify characteristics related preference of an obstetrician-gynecologist based on gender among women of Ethiopian descent. Method: Analysis of anonymous self-reported questionnaire distributed to 500 women of Ethiopian descent who visited an obstetrician-gynecologist at least once in the past three years (Mean age 29.5; SD = 8.2). Trust in physician was examined using the TPS scale; service quality was checked using the SERVQUAL; and the 5Qs model was used to measure patient’s satisfaction of health care. Results: Very religious (84.1%) and religious (53.6%) women of Ethiopian descent were more likely to prefer a female obstetrician-gynecologist compared to traditional (39.3%) or secular (34.4%) women (p < 0.001). Participants had higher probability to prefer a male gynecologist if they had more employment hours (OR = 3.57, 95% CI = 1.72–7.42, p < 0.001), and the responsiveness of the physician was less important to them (OR = 0.77, 95% CI = 0.60–0.99, p < 0.05). Age of participants, country of birth, years in Israel, family status, being a mother, education or health status were not associated with choosing a female obstetrician-gynecologist. Religious women would prefer to wait longer for a female gynecologist due to modesty imperatives, even at the cost of compromising their health as a result of waiting longer. Conclusions: The findings of this research highlight the importance of accessibility to female obstetrician-gynecologists for women of Ethiopian descent and demonstrate that determinants in the host population rather than immigrant’s past culture, affect the women’s decision. This study demonstrates the importance of the health care system in Israel to enable more female obstetrician-gynecologists to treat women of Ethiopian descent.