Women's Responses Research Articles

Factors associated with secretory IgA levels in colostrum and breastmilk

Background Secretory IgA (sIgA) content of breastmilk in the first postpartum month is a reflection of the pregnant woman's immune response to environmental antigen exposure. The role of secretory IgA in breastmilk is to protect and support the development of the neonatal immune response in early life.
 Objective To examine possible factors associated with sIgA levels in breastmilk and colostrum, including environmental exposure, food consumed, maternal history of atopy, and the appearance of allergic symptoms in infants. As a secondary objective, we determined the association between infant factors (IgE, exposure to cigarette smoke) and maternal factors (sIgA, maternal allergies) with infant allergies.
 Methods This prospective cohort study of 80 postpartum mothers and their infants was conducted at Sultan Agung Islamic Hospital, Semarang. We collected maternal colostrum on the second or third postpartum day and mature milk between the 22nd to 25th postpartum day. Exposure factors to mothers and infants in the final trimester of pregnancy up to one month postpartum was recorded through a questionnaire and home visits. The infant’s IgE level was measured at 4 months of age.
 Results Mean colostrum sIgA was 108.9 (SD 16.5) mg/dL (95%CI 97.9 to 121.1 mg/dL) and mean mature milk sIgA was 94.1 (SD 23.9) mg/dL (95%CI 89.1 to 99.2 mg/dL). Mean colostrum sIgA levels were higher in mothers exposed to cigarette smoke [119.1 (SD 1.7) vs. 92.9 (SD 1.5) mg/dL; P=0.026] and frequent infections [128.2 (SD 1.7) vs. 95.9 (SD 1.6) mg/dL; P=0.007] compared to that in unexposed mothers. Mean colostrum sIgA was also higher in mothers with atopic allergy than in those without (136.8 mg/dL vs. 99.3 mg/dL; p=0.017) and in mothers of infants with IgE levels >29 IU/ml than in mothers of infants with IgE levels <29 IU/mL (136.8 vs. 101.2 mg/mg/dL; P=0.045). Elevated colostrum sIgA (>136.8 mg/dL) was not associated with allergies in the infants (P=0.269).
 Conclusions Maternal atopic allergy and frequent infections are associated with increased colostrum sIgA levels. Breastmilk sIgA levels are not associated with allergies in the infant. Maternal exposure to antigens may stimulate the production of specific breastmilk sIgA.

Checking the scales: A psychometric evaluation of the Weight Concerns Scale in a sample of college-aged cisgender men from the United States.

Historically, western societies have considered body image issues to predominantly affect young, White women. While in recent years men's body image issues have been increasingly highlighted by researchers and the media alike, many instruments currently used to identify clinically significant body image disturbances were developed and validated with samples solely of women and/or girls. One such measure, Killen et al.'s (1994) Weight Concerns Scale (WCS), was initially validated in a sample of adolescent girls. The WCS has yet to be validated in samples of men, despite being used in large national surveys of college men and women (e.g., the Healthy Minds Study; HMS) used to inform resources on college campuses. Accordingly, we used structural equation modeling to conduct invariance testing between college student cisgender men's (n = 2,248) and women's (n = 4,733) responses on the WCS via the HMS. Through the use of two different approaches of invariance testing, evidence for metric noninvariance of two of the five items was identified, and all five items evidenced a response pattern that favored women over men. Additionally, removing noninvariant items on the WCS impacted the moderating effect of gender with indicators of depression, anxiety, and eating disorder symptomology. These findings suggest that the use of the WCS may not be appropriate for use in a cis-male sample without modification. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Understanding the Positive Effects of the COVID‐19 Pandemic on Women's Fertility in Norway

AbstractThis study examines the effect of the COVID‐19 pandemic on fertility in Norway at the individual level. Studies using data at the macrolevel have found a positive short‐term effect of the pandemic on the fertility level in Norway, but women's fertility response to the pandemic may differ depending on their life situation. We use the first lockdown on March 12, 2020, as a marker of the pandemic and apply a regression discontinuity design to compare births of women that were conceived before the pandemic started with those conceived during the first eight months of the pandemic. The positive effect on women's fertility in Norway was mainly driven by women in life phases that have generally high fertility rates (women aged 28–35 years and women who already have children). These groups are likely to be in an economically and socially secure and stable situation in which the restrictions due to the pandemic had limited influence. Besides two exceptions, we do not find differences in the effect of the pandemic on childbearing by women's work situation. This is most likely related to the strong welfare state and the generous additional pandemic‐related measures taken by the Norwegian government.

Women's Experiences of Forcible Sterilization under the Nazi Regime, 1933–1945

Women's Experiences of Forcible Sterilization under the Nazi Regime, 1933–1945 Tiarra Cooper (bio) Situated at the intersection of German studies and women's, gender, and sexuality studies, my dissertation, "Women's Experiences of Forcible Sterilization under the Nazi Regime, 1933–1945," advances novel theorizations as to how sterilized women subsequently understood themselves and forged kin in the postwar world. Fashioning an archive that contains the voices of women sterilized under the law in medical facilities as well as those sterilized experimentally in concentration camps, my dissertation looks to women's shared affective responses in the wake of the Holocaust and World War II. Drawing on survivors' experiences in testimonies, interviews, and ego-documents, this refashioned archive of forced infertility understands bodily experience as valid knowledge, and victimized women as active agents in their own life stories. First, my dissertation includes the experiences of women who, under 1933 legislation, were deemed unfit to reproduce and forced to undergo sterilization. Summoned to hereditary health courts, candidates were often sentenced to infertility after a trial lasting fifteen minutes, on average.1 Those impacted were overwhelmingly "Aryan," though with a spectrum of abilities. Notably, this legislation included those of Sinti and Roma background—though only until more targeted legislation was created. Second are those who, transported to concentration camps Auschwitz-Birkenau and later Ravensbrück, were sterilized experimentally by Professor Carl Clauberg and Doctor Horst Schumann. Here, victimized groups of predominantly female subjects were sterilized in a larger effort to refine methods that could be used cheaply and quickly on Eastern European forced laborers en masse. Whereas Clauberg injected women with varying chemical concoctions into their uterus, Schumann used radiative and surgical means on female subjects. The women targeted for these experiments—sequestered initially in Block 30 of Birkenau and later in Block 10 of Auschwitz—were [End Page 141] all of Jewish or Sinti/Roma background. Meanwhile, other women were sterilized via established methods (i.e., non-experimentally) in the medical block of various Nazi camps as well. Looking toward the shared responses of women in the respective contexts, I ask, How has gender impacted women's experiences of forced infertility? Though we generally know the details of these procedures, we have yet to deeply investigate how survivors were impacted—let alone women. Thus far, scholars have only concluded that women were especially impacted by sterilization. Stefanie Westermann writes that "Insbesondere im Selbstverständnis von Frauen stellt die genommene Option einer Mutterschaft…die vorgesehene und anerzogene Rolle, die soziale Orientierung, die jeweilige Lebensplanung und bisweilen auch die eigene Identität in Frage."2 Given the gendered nature of reproduction, including gendered social and familial norms, the impact on women calls for further analysis and theorization. It is telling that one survivor of sterilization later recalled that the ability to bear children was "das heiligste [sic] was eine Frau besitzt."3 Centrally, my dissertation locates women's responses not only in gendered bodies, but within greater socio-historical and cultural contexts. I examine, for instance, the lived impact of the edict for Jewish women to replenish—if not avenge—an entire people. I also include the female survivors in a host of countries (i.e., Poland, Denmark, France, the Netherlands, and West Germany) who, in heightened claims for restitution, were repeatedly probed for damages in the form of infertility. These are but two of many situations in the wake of World War II and the Holocaust for which reproduction was the currency and from which sterilized women were precluded. Against the backdrop of postwar reproduction, my dissertation reveals that whereas some sterilized women found themselves illegible within resurgent pronatalism, others forged new ways of relating to other beings, such as bonding with animals and forging non-biological kin with other "forgotten victims." Under the mandate to reproduce, in which infertile women could not bring to bear the social currency of offspring, sterilized women experienced a range of porous responses, including a) gender dissociation, b) social exclusion, c) suicidal ideation, d) an increase in human-animal bonds and e) a disjointing of time. These findings are framed and complemented by scholars in queer theory, through which I illuminate the heterosexual underpinnings of (encouraged...

Women's political agency in difficult settings: Analysis of evidence from Egypt, Nigeria, Mozambique, and Pakistan

SummaryMotivationMale gatekeeping and biased social norms in difficult settings characterized by fragility, authoritarianism, and conflict create challenges for women's political participation. This article explores the nature of challenges experienced by women and how they exercise political agency in such settings—as voters, claimants, and brokers of services, and as activists.PurposeI investigate the range of expressions of women's political agency and responses they secure from public authorities in difficult settings. I ask the question: how and to what effect do women exercise political agency in difficult settings? Analysis of the range of expressions of political agency allows a broader view of women's engagement in politics.Methods and approachThe article develops a framework to identify the range of expressions of women's individual and collective agency from Action for Empowerment and Accountability (A4EA) studies conducted in Egypt, Mozambique, Nigeria, and Pakistan. This synthesis explores social norms and male gatekeeping; strategies women use to navigate these and limit backlash; and the changes that result from women taking action.FindingsEvidence shows that social norms and male gatekeeping limit women's engagement in politics and their relations with multiple public authorities that operate in difficult settings. Women use gender‐specific repertoires to organize protests and make claims on authorities and specific strategies to reduce the risk of backlash from their own communities and security agencies. The findings show that, while there is some success in claim‐making on specific issues and that at a personal level women feel more empowered, these do not necessarily lead to systemic change.Policy implicationsDonors and local authorities need to develop interventions that tackle male gatekeeping within political parties and communities to facilitate women's political engagement. Flexibility in funding will enable donors to work directly or indirectly with grassroots and national women's rights groups in difficult settings for developing contextualized, bottom‐up interventions. Strengthening pro‐gender‐equality alliances and spaces for deliberation will help to ensure that gender equality is not co‐opted by authoritarian leaders and populist groups and will sustain counter‐narratives.

Influence of maladaptive personality traits on women's posttraumatic cognitions of IPV.

Intimate partner violence (IPV) is a problem for women worldwide. One factor that affects the severity of women's distress in the aftermath of IPV is how they make meaning of the violence they experienced. Posttraumatic meaning-making takes the form of 3 distinct posttraumatic cognitions: self-blame, other negative thoughts about oneself, and negative thoughts about the world. Women's posttraumatic cognitions in the aftermath of IPV are in part a function of personality. Research on personality and posttraumatic cognitions has focused primarily on the influence of normative personality traits, although maladaptive personality traits are more common in clinical assessment. One of the most common models of maladaptive traits is DSM-5's Alternative Model of Personality Disorder (AMPD), which contains 5 maladaptive variants of normative personality traits (Antagonism, Detachment, Disinhibition, Negative Affect, and Psychoticism). Although there is increasing research on the AMPD traits in general, there is limited research on the influence of these traits on women's response to IPV specifically. In this study we examine the association between AMPD traits and posttraumatic cognitions of IPV in a sample of women exposed to IPV (N = 199) using a Bayesian approach to multiple regressions. Results suggest that IPV and Negative Affect were the primary influences on all 3 IPV-related posttraumatic cognitions and that other traits had differential effects depending on the type of posttraumatic cognition under analysis. These findings clarify our understanding of individual differences in posttraumatic response and have implications for the treatment of women exposed to IPV. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Patriarchy and patriarchal customs in the Meitei Society of Manipur

Based on an auto-ethnographic insight and complementary ethnographic interactions with 52 women, we document and analyze the patriarchal customs in the Meitei society of Manipur; thereby challenging conventional wisdom which would have us believe that is replete with empowered women. We briefly comment on certain aspects of these customs including their relationship with the Sanskritization of the Meiteis and how they are affected by socio-economic indicators. We also identify two central mechanisms that legitimize such customs: the idea of touheidaba, which is the selective mystical prohibition/commandment of certain acts that cannot be committed/should be committed; and the eulogization of an “ideal Meitei woman”. Lastly, we locate such legitimizing mechanisms and the Meitei woman's response in extant literature on power, resistance, agency and consciousness; thereby seeking to construct a grounded emancipatory theory for the Meitei women.

Communal expectations conflict with autonomy motives: The western drive for autonomy shapes women's negative responses to positive gender stereotypes.

Western culture idealizes an autonomous self-a self that strives for independence and freedom from the influence and control of others. We explored how the value placed on autonomy in Western culture intersects with the normative trait expectations experienced by men and women. While trait expectations placed on men (i.e., to be confident and assertive) affirm an autonomous sense of self, trait expectations placed on women (i.e., to be caring and understanding) conflict with an autonomous sense of self. We theorized that this conflict contributes to women's resentment toward positive gender stereotypes that emphasize women's interdependent qualities. Six preregistered studies (N = 2,094) demonstrated that U.S. women experienced more anger in response to positive-gendered trait expectations and less motivation to comply with them compared to U.S. men. We found that these effects were partially attributable to stereotypically feminine communal expectations affirming autonomy less than stereotypically masculine agentic expectations. Cross-cultural comparisons between the U.S. (a Western context) and India (a non-Western context) further indicated that the conflict between communal expectations placed on women and Western prioritization of autonomy contributes to U.S. women's anger toward positive gender stereotypes: Although traits expected of women in both the U.S. and India oriented women away from feeling autonomous more than traits expected of men, this diminished sense of being autonomous only elicited anger in a U.S. context. For Western societies, findings illuminate the uniquely frustrating nature of stereotyped expectations that demand interdependence and thus the unequal psychological burden placed on those who must contend with them. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Parental well-being: Russian women's view

The article presents the results of a qualitative sociological study using the author's technology in order to conceptualize the phenomenon of parental well-being. The methodology of the study is based on the generalization of the theoretical provisions of parenthood and family well-being. It is concluded that parental well-being as a factor of demographic processes has not been studied enough, the concept of parental well-being has vague contours, there is no detailed formulation of its content and basic elements. In May — July 2022, on the results of an online survey there were collected and processed empirical data based on the responses of women (N = 335) to the open question "What do you associate with the concept of "parental well-being"? Write one or two phrases/sentences." The respondents' responses were processed using semantic content analysis. The word "happiness" was used in 18.8% of the responses received. Thematic coding was applied, individual and collective trajectories of meanings were identified. There are 10 collective trajectories combined in the author's system of markers of parental well-being. The frequency of markers mentioning in women's responses was calculated, that made it possible to identify key, basic markers: relationships with children (32.5%); well-being and success of children (29.6%); health (28.4%); security: income, work, housing (19.1%); emotional state of parents (10.4%); time (8.4%). Childless women were 3 times less likely to mention the topic "Well-being and success of children", but they are much more likely to associate parental well-being with finances and the ability to provide everything necessary for children. It makes sense to take these results into account when forming programs to popularize parenthood among young people. The author has formulated a "working" definition of the concept of parental well-being, substantiated the need for further research to clarify it on the basis of surveys of men using a similar technology. The practical value of the system of basic markers of parental well-being lies in the possibilities of its application for further development of the sample survey program "Digitalization of employment, fertility and parental well-being".

The exercise-induced suppression of acylated ghrelin is blunted in the luteal phase of the menstrual cycle compared to the follicular phase following vigorous-intensity exercise

Limited work examining woman's appetite-regulatory response to exercise has been focused on the follicular phase (FP) of the menstrual cycle. This is an important limitation as estradiol (E2) and progesterone (P4) fluctuate across phases with greater concentrations in the luteal phase (LP). Objective: To examine the appetite-regulatory response to vigorous-intensity continuous exercise (VICT) in the FP and LP. Methods: Twelve women completed 30 min of VICT at 80% V˙O2max in the FP and LP. E2, P4, acylated ghrelin, active peptide tyrosine-tyrosine (PYY), active glucagon-like peptide-1 (GLP-1), and appetite perceptions were measured pre-exercise, 0-, 30-, and 90-min post-exercise. Energy intake was recorded for a 2-day period (day before and of each session). A series of two-way repeated measure ANOVA were used to compare all dependent variables. Results: Pre-exercise E2 (P = 0.005, d = 1.00) and P4 (P < 0.001, d = 1.41) concentrations were greater in the LP than the FP and exercise increased both at 0- and 30-min post-exercise (E2: P < 0.009; P4: P < 0.001, d = 0.63). Acylated ghrelin was lower in the FP versus LP at pre-exercise as well as 0-min (P = 0.006, d = 0.97) and 90-min (P = 0.029, d = 0.72) post-exercise. There were no differences of menstrual phase on PYY (P = 0.359, ηp2 = 0.092), GLP-1 (P = 0.226, ηp2 = 0.130), or overall appetite (P = 0.514, ηp2 = 0.066). Energy intake was greater on the day of in the LP versus the FP (P = 0.003, d = 1.2). Conclusion: Acylated ghrelin was lower in the FP compared to the LP and though there were no differences in anorexigenic hormones or subjective appetite, energy intake was greater on the day of the session in the LP suggesting important differences across the menstrual cycle where greater concentrations of ovarian hormones in the LP may blunt the exercise response.

Validation of laser Doppler flowmetry for the continuous measurement of women's genital response.

Laser Doppler imaging is a valid method of assessing genital response, detecting increases in genital blood flow to sexual, but not nonsexual stimuli. Although laser Doppler imaging provides a direct measure of genital blood flow, its discrete perfusion images provide a discontinuous assessment of genital response, limiting some study designs. The aims of this study were to investigate the measurement properties of laser Doppler flowmetry, a direct and continuous measure of blood flow, as well as examine the time course of genital response using flowmetry. A sample of 45 cisgender women attended two experimental sessions wherein they viewed sexual and nonsexual stimuli (e.g., neutral, anxiety, humor) while their genital responses were assessed using laser Doppler flowmetry. As expected, laser Doppler flowmetry was a valid measure of genital response-detecting increases in genital blood flow elicited by the sexual stimuli only-and was sensitive to varying degrees of genital response elicited by low, moderate, and high-intensity sexual stimuli. The measure also exhibited convergent validity with genital response assessed via laser Doppler imaging, test-retest reliability across testing sessions, and internal consistency as well as high sexual concordance with self-reported sexual arousal. Descriptive analyses showed that genital blood flow assessed using laser Doppler flowmetry was highly responsive, with initial, peak, and return to baseline responses occurring within timeframes appropriate for repeated measurement within a single session. Laser Doppler flowmetry is a valid, reliable, and sensitive measure of women's genital response that can be usefully applied in sexual psychophysiology research.

How valid are women’s reports of the antenatal health services they receive from Community Health Workers in Gombe State north-eastern Nigeria?

BackgroundCommunity health workers (CHWs) in low- and middle-income countries are key to increasing coverage of maternal and newborn interventions through home visits to counsel families about healthy behaviours. Household surveys enable tracking the progress of CHW programmes but recent evidence questions the accuracy of maternal reports. We measured the validity of women’s responses about the content of care they received during CHW home visits and examined whether the accuracy of women’s responses was affected by CHW counselling skills.MethodsWe conducted a criterion validity study in 2019, in Gombe State-Nigeria, and collected data from 362 pregnant women. During accompanied CHW home visits the content of CHW care and the presence or absence of 18 positive counselling skills were observed and documented by a researcher. In a follow-up interview three months later, the same women were asked about the care received during the CHW home visit. Women’s reports were compared with observation data and the sensitivity, specificity, and area under receiver curve (AUC) calculated. We performed a covariate validity analysis that adjusted for a counselling skill score to assess the variation in accuracy of women’s reports with CHW counselling skills.ResultsTen indicators were included in the validity analysis. Women consistently overestimated the content of care CHWs provided and no indicator met the condition for individual-level accuracy set at AUC ≥ 0.6. The CHW counselling skill score ranged from 9–18 points from a possible 18, with a mean of 14.3; checking on client history or concerns were the most frequently missed item. There was evidence that unmarried women and the relatively most poor women received less skilled counselling than other women (mean counselling scores of 13.2 and 13.7 respectively). There was no consistent evidence of an association between higher counselling skill scores and better accuracy of women's reports.ConclusionsThe validity of women's responses about CHW care content was poor and consistently overestimated coverage. We discuss several challenges in applying criterion validity study methods to examine measures of community-based care and make only cautious interpretation of the findings that may be relevant to other researchers interested in developing similar studies.

“Your Body Is Not Representative of Who You Are”: Exploring the Relations Between Feminist Attitudes, Feminist Identity, and Responses to Negative Body Talk Among Women

Negative body talk is a normative behavior among United States women and is an important area of intervention for women's health and well-being. Identifying as a feminist and/or endorsing feminist beliefs, which can promote a resistant stance toward cultural appearance standards, may protect against negative body talk. We conducted a mixed-methods study with an online sample of 447 predominantly White (81.1%) United States women between the ages of 18–73 years ( M = 41.25, SD = 12.54). We used Consensual Qualitative Research-Modified to systematically code open-ended survey data comprising responses to negative body talk and assessed whether liberal feminist attitudes or feminist identity relate to response categories. We categorized women's responses to negative body talk along with a feminist spectrum which ranged from explicit reinforcement of the thin ideal to a resistant stance toward beauty standards. Liberal feminism was negatively correlated with explicit reinforcement of the thin ideal, and both liberal feminism and feminist identity were positively correlated with a resistant stance. Therapists and practitioners who work with women on issues related to body image disturbance might consider supporting their clients in developing a feminist identity that can critically filter cultural messages that further objectify women.

The way of a patriarchal bargain: how the bargain under the structure and agency perspective

This paper aims to present a different perspective on presenting patriarchal bargains from the existing ones. The patriarchal system is generally understood as a system that places men as superior to women. In the western view, the patriarchal system has become a 'way of life which is considered ahistorical, eternal and the subordination of women is a universal act, so this hierarchy has always existed and will continue, and like other natural rules, this rule is also unchangeable and unnecessary. questioned again. Radical feminists embrace and apply classical patriarchal theory to explain almost all forms of male domination over the exploitation of women. However, women's responses to male domination vary widely, according to the objective opportunities available under each patriarchal variant, thus through patriarchal bargaining, Kandiyoti opens up opportunities for women to see patriarchy as an entity that is not eternal. Patriarchal bargain studies have also emerged with the dominance of a strong agency character. The agency character is indeed considered to have the power to target other forces outside the structure, but this becomes problematic because patriarchal bargain studies seem to ignore the existence of (partial) structure. While according to Giddens, agency plays in the realm of structure, just as the structure is an unavoidable epistemic aspect in social science, the structure is not conceptualized as only placing constraints on human agency, but is also seen as possible. Social change cannot be seen partially, both structure and agency are present simultaneously and interactively.

Cognition, Behavior, Sexuality, and Autonomic Responses of Women with Hypothalamic Amenorrhea.

(1) Background: Functional Hypothalamic Amenorrhea (FHA) can be caused by the hyper activation of neuro-endocrine responses to stress. Among other endocrine factors and hypothalamic dysfunctions, the psychophysiological stress response can very frequently lead to an inhibition of the gonadal-pituitary axis. The aim of this study was to investigate the level of neurovegetative activation in a group of young women affected by this condition. (2) Methods: Twenty-five women (mean age = 21.1 ± 4.34) with FHA were consecutively recruited. Information on psycho-physiological distress was collected through a Psychopathological assessment (with the administration of three psychometric tests) and the Psychophysiological Stress Profile (PSP). Their data were compared with a control group. (3) Results: In the PSP, the patients displayed significantly higher values compared to controls in terms of the parameters of muscle tension (sEMG), skin conductance (SCL/SCR), heart rate (HR), and peripheral temperature (PT). Furthermore, autonomic hyper-activation at rest, marked reactivity to stress, and reduced recovery were seen. Moreover, a condition characterized by psychological distress (anxiety and somatic complaints, depressed and irritable mood, obsessive-compulsive traits) emerged. (4) Conclusions: The results highlight autonomic hyper-activation in FHA, which is also associated with psychological distress. Considering that FHA is a condition that affects multiple systems between mind and body, a multimodal, multidimensional, and multidisciplinary assessment of stress is becoming an emerging need.

Do Islamist parties help or hinder women? Party institutionalization, piety and responsiveness to female citizens

AbstractDoes electing Islamist parties help or hurt women? Due to Ennahda winning a plurality in the 2011 elections and women from all parties winning 31% of seats, Tunisia offers an opportunity to test the impact of legislator gender and Islamist orientation on women's representation. Using original 2012 surveys of 40 Tunisian parliamentarians (MPs) and 1200 citizens, we find that electing female and Islamists MPs improves women's symbolic and service responsiveness by increasing the likelihood that female citizens are aware of and contact MPs. Electing Islamist female MPs has a positive impact on women's symbolic and service responsiveness, but decreases the likelihood that men will interact with legislators. We argue that Islamist deputies are more responsive to women due to an Islamic mandate effect—that is, Islamist parties' efforts to institutionalize their constituency relations, provide services to the marginalized through direct contact with citizens, and respect norms of piety by using female parliamentarians to reach women in sex‐segregated spaces. While Islamist parties positively impact some dimensions of women's representation, they also reinforce traditional gender relations. Our results extend the literature on Islam, gender, and governance by demonstrating that quotas and party institutionalization improve women's representation in clientelistic contexts.

Sensitivity-to-change and predictive validity of the Cervantes Short-Form (C-SF) questionnaire in postmenopausal women.

To explore, for the first time, the ability of the Cervantes Short-Form (C-SF) questionnaire to detect and to predict meaningful changes (sensitivity-to-change and predictive validity) in women with menopausal symptoms receiving any therapeutic management under routine medical care. Postmenopausal women included in a registry study were the source of data. Sensitivity-to-change was explored by assessing the responses of C-SF to different type of treatment management: no treatment, natural therapies or systemic hormonal therapy (SHT). Predictive validity assessed the ability of baseline score to predict the reduction in the impact of menopausal symptoms in C-SF scoring equal or higher than one time its minimally important difference (MID) of improvement (response rate). A total of 245 women were enrolled. C-SF score was significantly reduced (better QoL) with SHT by 10.62 points versus no change or 2.32 point by natural therapies or no treatment, respectively (p < 0.001 in both cases). Women declaring better improvement after treatment showed higher significant reduction in C-SF score versus those with no self-perceived improvement or impairment: -12.49 point versus +1.06 and +12.71, respectively (p < 0,01 in both cases). Responder rate showed a significant lineal growing trend with higher C-SF scoring at baseline in women who received SHT: higher scoring showed higher response rates (lineal Chi2 = 15.9, p < 0.001), but not in the case of receiving natural therapies or no treatment. C-SF was shown to be sensitive-to-change when postmenopausal QOL status changes due to mainly systemic hormonal treatment, therefore, supporting the utilization of this instrument to monitor response to treatment. Likewise, pre-treatment scoring in C-SF was able to predict woman's QOL meaningful response with hormonal treatment.

Women's responses to prenatal genetic diagnosis and attitudes to termination of pregnancy after non-invasive prenatal testing: An online survey of Western Australian women.

Non-invasive prenatal testing (NIPT) using cell-free DNA (cfDNA) has expanded from detecting chromosome aneuploidy to testing for a variety of genetic conditions, including some select single gene disorders. As next generation sequencing/whole exome sequencing technology develops, it may be possible to expand NIPT of cfDNA to identify hundreds of single gene and chromosomal disorders in a fetus, thereby increasing the complexity of pretest counselling and parental decision-making. The aim of this study was to assess the views of women on the phenotypes of genetic conditions potentially detectable with expanded NIPT that they would consider severe enough to warrant pregnancy termination. Using multiple clinical scenarios, we asked women via an online survey about the early detection of several well-described genetic phenotypes in pregnancy that in theory could be detected by expanded NIPT. Two hundred and nineteen women participated in this study. There was high support for early diagnosis and the option for termination of pregnancy in conditions perceived as severe (52-71%). Women expressed a preference for testing to be provided by general practitioners and assigned a high value to genetic counselling support (75-90%). In the case of a continuing pregnancy, women recognised the essential role of ongoing psychosocial counselling for family members and childhood early intervention programs. Women expressed clear preferences for termination of pregnancy for severe conditions and as early in gestation as feasible. Information and support from genetic counsellors are a highly valued resource in decision-making following a prenatal diagnosis of a fetal genetic abnormality.

'My biggest fear is that people will forget about him': Mothers' emotional transitions after terminating their pregnancy for medical reasons.

To explore women's emotional responses throughout the process of terminating a pregnancy for medical reasons. Making the choice to terminate a desired pregnancy for medical reasons has a negative impact on women's health, as it is a distressing process that involves making hard decisions and readjusting one's expectations of an idealised pregnancy. A qualitative phenomenological study was conducted following the COREQ checklist. Fifteen semi-structured interviews and two focus groups were conducted with women who had terminated their pregnancies for medical reasons, previous to and during the COVID-19 lockdown. Subsequently, we analysed the content. One main category, emotional journey during the process of terminating the pregnancy, and six subcategories were identified: (I) representation and desire to become a mother, (II) main concerns, (III) impact of the news, (IV) decision-making, (V) emotional responses before termination for medical reasons and (VI) emotional responses after termination for medical reasons. All contributed to understanding the specificities of the different phases that make up the emotional journey of terminating a pregnancy for medical reasons. The findings of this study suggest that there are a number of predominant emotions that professionals need to be aware of in order to help women work through them and lessen the impact of pregnancy termination on their mental health. COVID-19 had different connotations depending on the women's experiences. Our results highlight how important the role of healthcare staff is in caring for these women and their partners, which involves recognising their emotions throughout the process. Our results also underline how useful it is to conduct qualitative studies in this context, since they constitute a set of activities and interventions that result in the administration of nursing care in itself. The ultimate goal of the action research study is to design a positive mental health intervention. Participants will contribute to the design and final approval of the intervention.

COVID-19 affects psychological symptoms of pregnant women indirectly by increasing their maternal concerns

BackgroundPregnant women themselves are at higher risk for psychological symptoms. The impact of ongoing COVID-19 may increase the risk. However, it is uncertain whether COVID-19 affects pregnant women's psychological symptoms directly or indirectly being mediated. MethodsThis survey was conducted in four obstetrics and gynecology hospitals in Beijing from February 28, 2020, to April 26, 2020. Pregnant women who visited the antenatal-care clinic were mobilized to finish the online questionnaires, including the Generalized Anxiety Disorder 7-Item Scale, Patient Health Questionnaire-9, Connor-Davidson resilience scale, and Insomnia Severity Index. ResultsA total of 828 pregnant women were included in the analysis. The estimated self-reported rates of anxiety, depression, insomnia, and any of the three were 12.2 %, 24.3 %, 13.3 %, and 33.1 %, respectively. Mediating effect analysis showed that pregnant women's response to COVID-19 was not directly associated with psychological symptoms but indirectly through the mediating effect of maternal concerns, which accounted for 32.35 % of the total effect. Stratified analysis by psychological resilience showed that women's attitude toward COVID-19 (OR, 2.68, 95 % CI: 1.16–6.18) was associated with a higher risk of psychological symptoms in those with poor psychological resilience. LimitationsThe study was a non-probability sampling survey, and the causal relationship between maternal concerns and psychological symptoms could not be determined due to the study's design. ConclusionsUnder public health emergencies such as COVID-19, routine antenatal care should still be prioritized, and concerns related to childbirth-related caused by such emergencies should also be addressed, especially for those with weak psychological resilience.