Women In Denmark Research Articles

Cost-Effectiveness of Trastuzumab Deruxtecan in Patients with Unresectable or Metastatic HER2-Low Breast Cancer Who Have Received Prior Chemotherapy.

In 2021, breast cancer affected 75,619 women in Denmark. Approximately 50% of breast cancers are considered human epidermal growth factor receptor2 (HER2)-low. The DESTINY-Breast04 (DB-04) trial led to European Medicines Agency (EMA) approval of trastuzumab deruxtecan (T-DXd) as a treatment for patients with unresectable or metastatic HER2-low breast cancer who have received prior chemotherapy in the metastatic setting or developed disease recurrence during or within 6months of completing adjuvant chemotherapy. Moreover, the Danish Breast Cancer Group guidelines recently included T-DXd as a treatment for HER2-low metastatic breast cancer. This economic evaluation aims to estimate the cost-effectiveness of T-DXd for the approved EMA indication in Denmark. A three-state-progression-free, post-progression, and death-partitioned survival model was developed to estimate the cost-effectiveness of T-DXd versus treatment of physician's choice over a lifetime horizon following the Danish Medicines Council guidelines. Clinical data were gathered from the DB-04 trial, and cost and resource use data were sourced from the literature. Sensitivity and scenario analysis were conducted to explore uncertainty. T-DXd led to 0.78 incremental quality-adjusted life years (QALYs) gained and incurred DKK621,325 in incremental costs compared to the treatment of physician's choice. This resulted in an incremental cost-effectiveness ratio of DKK795,181 per QALY gained, which falls below the willingness-to-pay threshold. Sensitivity and scenario analyses showed the robustness of the deterministic result, with T-DXd remaining cost-effective. Our study demonstrates that T-DXd is a cost-effective treatment for patients with HER2-low unresectable or metastatic breast cancer who have received prior chemotherapy in Denmark.

Prevalence and associated factors of intimate partner violence against pregnant women who attend antenatal care in Denmark and Spain: A digital screening approach.

Intimate partner violence against women is a global health issue. Exposure to intimate partner violence during pregnancy leads to health-related problems for both the mother and the newborn. However, current knowledge on its occurrence varies widely and assessing the problem using standardized tools in different contexts is needed. This study aimed to estimate the prevalence and associated factors of IPV in pregnant women in Denmark and Spain through digital screening tools. A cross-sectional design was used to systematically screen for intimate partner violence among pregnant women attending antenatal care by using standardized digital screening tools, Woman Abuse Screening Tool and Abuse Assessment Screen. A total of 17 220 pregnant women in Denmark and 2222 pregnant women in Spain were invited to participate. The response rate was high in both countries (77.3% and 92.5%, respectively). Overall, 6.9% (n = 913) and 13.7% (n = 282) screened positive in Denmark and Spain, respectively. Logistic regressions estimated crude and adjusted odds ratio with 95% confidence intervals of the relationship between sociodemographic variables and intimate partner violence. In both countries, being unmarried and lacking social support were risk factors of intimate partner violence. Additionally, in Denmark, pregnant women older than 40 years, unemployed or foreign, were at higher risk, while having higher educational levels was a protective factor. In Spain, not having a partner at the time of questionnaire completion and having at least one child prior to the current pregnancy were risk factors of intimate partner violence. Prevalence results and found associated factors contribute to a more comprehensive understanding of the occurrence of intimate partner violence during pregnancy in Denmark and Spain, while highlighting the feasibility of digital systematic screening in antenatal settings.

Co-creating the intervention ‘MAMAACT’ for improved care for pregnant migrant women in Denmark

Abstract Background The MAMAACT intervention was developed as a response to documentation of ethnic and social inequities in stillbirth in Denmark, despite free and universal access to antenatal care. The MAMAACT intervention aimed to reduce stillbirth in migrant families by improving communication about pregnancy complication during antenatal care. Methods The intervention consisted of a training program for midwives and health education materials. It was implemented at a structural level (training of midwives) and, through strengthened needs-based communication during antenatal care, the aim was to improve the health literacy of the women. 19 of the 20 Danish maternity wards participated in the study in 2018-19 and a comprehensive evaluation was conducted. The intervention was co-created with midwifery managers, midwives, and migrant women. Results The management and selected clinical midwives participated in the design of the midwifery training and the health education material as well as the intervention’s implementation and recruitment strategies for the evaluation. As representatives of the target group, a partnership with the non-profit organization Bydelsmødre was initiated. Bydelsmødre trains migrant mothers living in socially deprived areas to help vulnerable migrant women. Evening sessions were conducted with a specific group of women in their community, where the intervention components, the recruitment to the evaluation, and the interpretation of evaluation findings were discussed. A significant contribution was a video explaining the migrant experiences of becoming a mother in Denmark used in the midwifery training. MAMAACT researchers were invited to present the evaluation at the annual assembly for Bydelsmødre organization in 2019. Conclusions The partnership with Bydelsmødre provided a strong voice for migrant women, enhancing engagement with the intervention, recruitment for the trial, and its real-world relevance.

Neighborhood Disadvantage and Birth Outcomes Among Refugees.

To examine the association between neighborhood socioeconomic disadvantage and birth outcomes among refugee women in Denmark, leveraging a natural experiment. This register-based study included 15 118 infants born to women who arrived in Denmark as refugees during 1986 to 1998, when a dispersal policy was in place that quasirandomly assigned newcomers to neighborhoods with varying degrees of socioeconomic disadvantage. Neighborhood disadvantage was measured using a composite index representing neighborhood-level income, education, unemployment, and welfare assistance. These data were linked to individual-level birth register data. Outcomes included low birth weight, preterm birth, and small-for-gestational-age infants. Associations between neighborhood disadvantage at resettlement and birth outcomes up to 20 years after resettlement were examined using multivariable regressions adjusting for characteristics of the women at resettlement. Each SD of increase in neighborhood disadvantage was associated with an 18% increase in low birth weight risk (0.61 percentage points [pp], 95% confidence interval [CI]: 0.19-1.02), 15% increase in preterm birth risk (0.64 pp, 95% CI: 0.22-1.07), and 7% increase in small-for-gestational-age risk (0.78 pp, 95% CI: 0.01-1.54) 5 years after resettlement. Results did not differ after adjusting for urbanicity and conational density, but associations were attenuated after adjusting for municipality-level fixed effects, suggesting that local government characteristics may partially explain the associations. Resettling in a disadvantaged neighborhood is associated with higher risk of adverse birth outcomes among refugee women. This highlights how policy decisions affecting settlement of refugees can have long-term consequences, including on the health of the next generation.

Biopsy-verified vulvar lichen sclerosus and the risk of non-vulvar cancer: A nationwide cohort study.

Vulvar lichen sclerosus (VLS) is a chronic inflammatory mucocutaneous disease known to be associated with human papillomavirus-independent vulvar squamous cell carcinoma. Evidence on the association with other types of cancer, however, is sparce. We conducted a large nationwide cohort study examining the incidence of non-vulvar cancers among women with biopsy-verified VLS compared with the general female population. By using the nationwide Pathology Registry, we identified all women in Denmark with a biopsy-verified VLS diagnosis during 1978-2019 (n = 16,921). The cohort was followed up in the Danish Cancer Registry until 2022 for a subsequent non-vulvar cancer diagnosis. Standardized incidence ratios (SIRs) were computed with 95% confidence intervals (CIs) as relative risk estimates of all specific non-vulvar cancer sites. Compared with general female population rates, women with biopsy-verified VLS had decreased rates of several non-vulvar cancers, including HPV-related cancers (combined estimate: SIR = 0.5; 95% CI: 0.3-0.7), and lung (SIR = 0.6; 95% CI: 0.5-0.7), liver (SIR = 0.5; 95% CI: 0.2-0.9), and thyroid cancer (SIR = 0.5; 95% CI: 0.3-0.9). The decreased SIRs tended to sustain throughout the follow-up period following the VLS diagnosis. This large nationwide cohort study shows that women with biopsy-verified VLS may have a long-term reduced risk of developing HPV-related (cervical, vaginal, oropharyngeal, and anal) and smoking-associated cancers (lung, liver, and cervical) as well as thyroid cancer. Future studies focusing on the mechanisms behind the decreased cancer risk are needed.

O-158 Social disparities in achieving a live birth after initiating ART treatment: a national register-based study among women in Denmark

Abstract Study question How are educational level, labor market attachment and income associated with achieving a live birth after initiating ART treatment among women in Denmark? Summary answer Higher educational level, labor market attachment and higher income were strongly associated with achieving a live birth after initiating ART treatment among women in Denmark. What is known already Infertility is increasing in populations worldwide with an estimated lifetime prevalence of 17.5%. Approaches to this issue differs between societies and healthcare systems. In the public Danish healthcare system, three fresh ART treatments are currently offered free of charge. Additional ART treatments are self-financed in the private healthcare sector. Socioeconomic disparities in health are widely recognized. Previous studies have indicated that higher socioeconomic position (SEP) is associated with a greater probability of achieving a live birth after initiating ART treatment. However, there is limited knowledge about SEP and its relation to outcomes of ART treatment. Study design, size, duration This is a national, register-based study based on the DANAC II Cohort. Women undergoing ART treatment during 1994–2017 registered in the Danish IVF register were individually linked with data from sociodemographic registries and the Medical Birth Registry using the Danish Personal Identification number. The study population consisted of 68,738 women treated with ART. The outcome was a live birth. The women were followed until outcome, death, migration, or end of study (31/12/2017). Participants/materials, setting, methods Women included in the analyses were aged 18–45 years. Overall associations between achieving a live birth after initiating ART treatment and educational level, labor market attachment and income were examined and further stratified by nulliparity at baseline and age group. Hazard ratios (HRs) with confidence intervals (CIs) were estimated by Cox proportional hazards regression, and with adjustment for potential confounders age and ethnicity. Death was incorporated as a competing risk in all analyses. Main results and the role of chance Adjusted results showed that educational level, labour market attachment and income significantly determined the probability of achieving a live birth after initiating ART treatment. HRs of achieving a first live birth after initiating ART treatment increased stepwise with higher education and income level, respectively. Compared with primary school education the highest HR was found among women with a research education (HR = 3.02 [95% CI 2.71; 3.35]). Unemployed women had the lowest HR of achieving a live birth after initiating ART treatment (HR = 0.67 [95% CI 0.64; 0.69]) compared to employed women. Women in the highest income group had two times higher HR of achieving a live birth after initiating ART compared to women in the lowest income group. Analyses of different age groups showed that higher SEP was associated with a live birth after ART treatment in all ages. The same consistency was found for both childless women and women who had a child or children prior to ART treatment. Subanalyses showed that women with higher SEP were more likely to continue ART treatment after unsuccessful attempts, which could explain the observed social inequality in achieving a live birth after ART treatment. Limitations, reasons for caution The Danish IVF register did not register non-ART treatments (intrauterine inseminations) before 2007, thus these treatments are not included. Whether severity of infertility/prognosis differs among SEP groups is unclear. Also, geographical distance to fertility clinics could have provided additional perspectives. Wider implications of the findings Free access to fertility treatment in public healthcare should ideally provide equal access. Patients encounter barriers during treatment and, as shown, treatment success differs based on socio-economic background. Difficulties encountered during treatment that challenge certain patients more than others based on their socio-economic background needs to be addressed. Trial registration number Not applicable

Textile Craft as Empowerment

Focusing on museums, this article illustrates how textile crafts can become a source for scholarly inquiry and can enhance more inclusive practices at museums. The empirical data comprises four museum-related projects conducted since 2017 focusing on textile craft and creativity with women in Denmark, particularly women of refugee, migrant, or second-generation migrant background. Through these cases, we unravel the potential of textile crafts as a medium and encounter for engagement in museums within a societal context, both as a professional outlook, an education, a cultural heritage, an object of research, and a pastime for pleasure and socializing. The common thread—our academic quest—is how, when, and why textile craft is entwined with female empowerment, and how textile craft, as a shared community action, can empower and represent an opportunity for museums to reach new audiences as well as use the museum space in new ways.

Violence among pregnant women in Denmark from 2019 to 2021 – A hospital-based cross-sectional study

We examined the prevalence of lifetime physical and any recent violence and related maternal characteristics and health in pregnant women. We used Patient Reported Outcomes data retrieved from the Copenhagen Pregnancy Cohort (n = 7,361). The prevalence of lifetime physical and any recent violence was 4.0 % and 1.6 %, respectively. For both lifetime and any recent violence, the highest prevalence rates were seen among women aged 18–24, non-cohabiting, smokers, low levels of educational attainment, and women with chronic medical and psychiatric disease and lower psychological well-being. The prevalence may potentially be underestimated in this study, highlighting the need for improving screening for violence.

Motivation towards first trimester screening for preeclampsia among pregnant women in Denmark: A cross-sectional questionnaire study.

The aim of this cross-sectional questionnaire study was to investigate motivation to participate in a possible new screening for preeclampsia in the first trimester of pregnancy among Danish pregnant women through a questionnaire based on Theory of Planned Behavior developed for this specific purpose. The new screening combines maternal characteristics with mean arterial pressure, uterine artery pulsatility index and biochemical markers to predict the risk of preeclampsia, whereas the current Danish screening uses maternal characteristics alone. Participation was offered to a proportion of women attending a first or a second trimester screening scan at two University Hospitals in Copenhagen. The questionnaire was set up in REDCap® and answers were entered directly into the database, which was accessed via a QR-code. We invited 772 pregnant women to participate in the questionnaire survey between November 2021 and April 2022 at Copenhagen University Hospital Rigshospitalet (study site one) (n = 238) and Copenhagen University Hospital Hvidovre (study site two) (n = 534). The response rate was 71.8% (171/238) at study site one and 33.9% (181/534) at study site two. A total of 352 women were included in the study (total participation rate 45.6%). Most women had a positive attitude towards preeclampsia screening in pregnancy, and 99.4% said they would participate in a risk assessment for preeclampsia if given the opportunity. A total of 97.4% answered "yes" to whether a first trimester preeclampsia screening should be offered to all pregnant women in Denmark. Positive motivation to participate in preeclampsia screening was correlated with having a network with a positive attitude towards preeclampsia screening. The results of this study indicate that Danish pregnant women have a positive attitude towards participation in a first trimester screening for preeclampsia. This observation might be useful in relation to possible future implementation in Denmark.

A qualitative investigation into the perceptions and experiences of the stigma attached to gestational diabetes mellitus among women in Denmark

AimThe aim of this study was to explore the perceptions of women with gestational diabetes mellitus (GDM) in Denmark, with a particular focus on GDM-specific stigma. MethodWe conducted semi-structured interviews with 20 women with GDM from January to May 2022. All interviews were transcribed and analysed abductively using Braun and Clarke’s framework for applied reflexive analysis. ResultsFive themes were identified, 1) victim-blaming narrative, 2) identity threat, 3) non-disclosure and anticipated stigma, 4) stigma in a clinical setting, and 5) stigma reduction in a clinical setting. Additionally, intersectionality was identified between GDM-specific stigma, notions of how to be a good mother, and stigma associated with having type 2 diabetes mellitus and overweight. Implications of GDM-specific stigma included suboptimal GDM care and management, i.e., not attending screening for GDM, and not wanting to disclose the diagnosis. ConclusionThe impact of GDM-specific stigma on the informants’ lives included some informants not accepting all services provided by the healthcare system, and some not wanting to identify with the diagnosis. These findings may help inform both healthcare personnel and future health promotion interventions to minimize the reproduction of a victim-blaming narrative and thereby promote well-being among women with GDM.

Maternal serum dioxin-like activity and gestational age at birth and indices of foetal growth: The Aarhus birth cohort

Human exposure to lipophilic persistent organic pollutants (lipPOP) is ubiquitous and life-long, beginning during foetal development. Exposure to lipPOP elicits a number of species and tissue specific responses including dioxin-like activity which involve the activation of aryl hydrocarbon receptor (AhR). This study aims i) to describe the combined dioxin-like activity in serum from Danish pregnant women collected during 2011–2013; ii) to assess the association between maternal serum dioxin-like activity, gestational age at birth and foetal growth indices.The serum lipPOP fraction was extracted using Solid Phase Extraction and cleaned-up on Supelco multi-layer silica and florisil columns. The combined dioxin-like activity of the extract was determined using the AhR reporter gene bioassay, expressed as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) toxic equivalent (TEQ) [AhR-TEQ (pg/g lipid)]. The associations of AhR-TEQ and foetal growth indices (birth weight, birth length and head circumference) and gestational age were assessed by linear regression models.We detected AhR-TEQ in 93.9 % of maternal first trimester serum samples, with a median level of 185 pg/g lipid. Each ln-unit increase in AhR-TEQ was associated with an increase in birth weight of 36 g (95 % CI: 5; 68), birth length of 0.2 cm (95 % CI: 0.01; 0.3) and pregnancy duration of 1 day (95 % CI: 0; 1.5). In women who never smoked, higher AhR-TEQ values were associated with higher birth weight and longer duration of gestation, while in smokers the association was the opposite. Mediation analyses suggested that gestational age may mediate the association of AhR-TEQ with foetal growth indices.We conclude that AhR activating substances are present in the bloodstream of almost all pregnant women in Denmark and the AhR-TEQ level was around four times higher than previously reported. The AhR-TEQ was associated with slightly longer gestational duration and thereby higher birth weight and birth length.

P-464 Childbirth after cancer treatment among young women in Denmark

Abstract Study question Do young women with cancer have children after cancer treatment comparable to the background population? Summary answer Results show differences between young women with cancer and those without cancer including that young woman with cancer more often have children prior to diagnosis. What is known already Each year approximately 900 young women are diagnosed with cancer in Denmark. Due to advanced cancer therapy many of them face long-term survival after cancer. A well-known consequence of cancer treatment is the risk of reduced fertility. Also, cancer types in the reproductive organs or diagnosis affecting the hormone-system are accountable for infertility in this population. The last decades have entailed great development in fertility preservation such as cryopreservation of oocytes, embryos or ovarian tissue and therefore increased the possibilities of having children in the future, however, international cohort studies still report less pregnancies and childbirth compared to control populations. Study design, size, duration This is a national, register-based study based on the DANAC II cohort. Women diagnosed with cancer as adolescents and young adults (aged 18-39) were registered in the Danish Cancer Register from 1978–2016. According to diagnosis onset, the young women with cancer were randomly age-matched with 60 undiagnosed women from the background population at the time of diagnosis. The primary outcome was childbirth. The women were followed until end of study, death and migration (31/12-2017). Participants/materials, setting, methods Both childbirth and IVF treatment before and after cancer treatment were compared with the aged-matched comparison group in all statistical analysis. Cancer diagnoses were divided into sub-groups. We adjusted for having children prior to cancer diagnosis in the statistical analysis. Death was also incorporated as a competing risk in all analyses. Main results and the role of chance The study population consisted of 21.596 young women diagnosed with cancer between 1978-2016 and 1.295.760 young women in the age-matched comparison group (CG). The study population consisted of a haematological subgroup (n = 1110), median age at diagnosis 29,7 (IQR 24,0-35,4) and an oncology subgroup (n = 20.486), median age at diagnosis 33,7 (IQR 29,1-37,2). The five-year mortality for haematological cancer was 26% and for oncological cancer 17%. Among all women diagnosed with cancer 57% had children prior to cancer diagnosis compared to 47% in the age-matched CG. After cancer diagnosis, 19% of women with cancer had children compared to 30% in the CG. Including children before and after diagnosis, 23% of women with cancer had no children vs 23% in the CG; 20 % had 1 child vs 16% in the CG; 39% had 2 children vs 39% in the CG and 17% had 3 or more children vs 22% in the CG. Among women with hematological cancer 38% had no children during the observation-period, with a corresponding percentage for oncological cancer of 22%. In the hematological and oncology sub-group seeking of ART-treatment before cancer diagnosis was 3%. After diagnosis, 5% in the hematological subgroup, 4% in the oncology subgroup sought ART-treatment. Limitations, reasons for caution Our study is based on registry data. Information about fertility preservation prior to cancer treatment, desire to- or deliberate opt-out of children after cancer treatment could have provided more insights. Also, we have in these preliminary results not yet adjusted for level of education. Wider implications of the findings A cancer diagnosis during the reproductive lifespan can affect childbearing substantially and result in fewer children. Although women diagnosed with cancer had similar levels of childlessness and seeking of ART treatment, vulnerable groups such as women with hematological cancer should be prioritized. Trial registration number NA

Unveiling Hatred

Although anti-Muslim hate crimes have been on the rise in most Western nations for decades, according to influential hate crime scholar, Barbara Perry, little attention has been given to the particular vulnerability of veiled Muslim females to such crimes (Perry 2013), thereby potentially disregarding a sustained source of human rights violations (Perry and Olsson 2009). This paper delves into Danish sociolegal reality to delineate the scope of such concern, attempting to ascertain any specific hate crime vulnerability among veiled Muslim women in Denmark. It identifies a number of preliminary empirical indications that resonate with Perry’s claim, reasoning that the hate crime vulnerability of veiled women be more thoroughly scrutinized in a Danish context. However, it also argues that such hate crime vulnerability is most productively addressed, at least prima facie, as a tangible and principal human rights issue (Brudholm 2016) rather than in the terms of human rights violations.

Prayer and meditation practices in the early COVID-19 pandemic: A nationwide survey among Danish pregnant women. The COVIDPregDK study

BackgroundThe emergence of the COVID-19 pandemic and the derived changes in maternity care have created stress and anxiety among pregnant women in different parts of the world. In times of stress and crisis, spirituality, including spiritual and religious practices, may increase. ObjectiveTo describe if the COVID-19 pandemic influenced pregnant women's considerations and practises of existential meaning-making and to investigate such considerations and practices during the early pandemic in a large nationwide sample. MethodsWe used survey data from a nationwide cross-sectional study sent to all registered pregnant women in Denmark during April and May 2020. We used questions from four core items on prayer and meditation practices. ResultsA total of 30,995 women were invited, of whom 16,380 participated (53%). Among respondents, we found that 44% considered themselves believers, 29% confirmed a specific form of prayer, and 18% confirmed a specific form of meditation. In addition, most respondents (88%) reported that the COVID-19 pandemic had not influenced their responses. ConclusionIn a nationwide Danish cohort of pregnant women, existential meaning-making considerations and practices were not changed due to the COVID-19 pandemic. Nearly one in two study participants described themselves as believers, and many practised prayer and/or meditation.

A cervical screening initiative for elderly women in Denmark

To assess outcome of a one-time human papillomavirus (HPV)-screening in 2017 of Danish women aged 70+. Women born 1947 or before were personally invited to have a cell-sample collected by their general practitioner. Screening- and follow-up samples were analyzed in hospital laboratories in the five Danish regions and registered centrally. Follow-up procedures varied slightly across regions. Cervical intraepithelial neoplasia 2 (CIN2) was recommended treatment threshold. Data were retrieved from the Danish Quality Database for Cervical Cancer Screening. We calculated CIN2+ and CIN3+ detection rates per 1000 screened women, and number of biopsies and conizations per detected CIN2+ case. We tabulated annual number of incident cervical cancer cases in Denmark for the years 2009-2020. In total, 359 763 women were invited of whom 108 585 (30% of invited) were screened; 4479 (4.1% of screened, and 4.3% of screened 70-74 years) tested HPV-positive; of whom 2419 (54% of HPV-positive) were recommended follow-up with colposcopy, biopsy and cervical sampling, and 2060 with cell-sample follow-up. In total, 2888 women had histology; of whom 1237 cone specimen and 1651 biopsy only. Out of 1000 screened women 11 (95% confidence interval [CI]: 11-12) had conization. In total, 579 women had CIN2+; 209 CIN2, 314 CIN3, and 56 cancer. Out of 1000 screened women five (95% CI: 5-6) had CIN2+. Detection rate of CIN2+ was highest in regions where conization was used as part of first-line follow-up. In 2009-2016, number of incident cervical cancers in women aged 70+ in Denmark fluctuated around 64; in 2017 it reached 83 cases; and by 2021 the number had decreased to 50. The prevalence of high-risk HPV of 4.3% in women aged 70-74 is in agreement with data from Australia, and the detection of five CIN+2 cases per 1000 screened women is in agreement with data for 65-69 year old women in Norway. Data are thus starting to accumulate on primary HPV-screening of elderly women. The screening resulted in a prevalence peak in incident cervical cancers, and it will therefore take some years before the cancer preventive effect of the screening can be evaluated.

Video Counseling and a Safety Planning App to Support Pregnant Women Exposed to Intimate Partner Violence in Denmark and Spain During COVID-19

Background Isolation was a consequence of the COVID-19 lockdowns, which led to increased incidence of intimate partner violence (IPV). During antenatal care, it is possible to screen pregnant women for IPV; this offers a unique opportunity for early intervention. During the pandemic, we designed and implemented a digital IPV intervention tailored to pregnant women in Denmark and Spain. Objective This study aimed to identify pregnant women exposed to IPV through digital screening and offer video counseling as well as a safety planning app to those who screened positive. Methods Pregnant women attending antenatal care were screened for IPV through a digital questionnaire. Women who screened positive were offered 6 video consultations with an IPV counselor and provided with access to a dedicated safety planning app. In-depth interviews inspired by the Model for Assessment of Telemedicine Applications were conducted with counselors and participants. The intervention was cocreated with women who have been exposed to IPV, nongovernmental organizations, and health care providers. Results Despite the COVID-19 shutdowns, more than 15,000 pregnant women have been screened for IPV since January 2021. Qualitative interviews with women who completed the intervention as well as IPV counselors show broad acceptance of the video counseling, particularly the ability to participate from a safe environment and talk to a stranger about sensitive and stigmatizing issues. Preliminary findings show that both women and counselors find the video counseling highly supportive, empowering, and aligned with the needs for safety. The majority indicate improved well-being after the intervention, and neither counselors nor participants see video counseling as a barrier toward talking about sensitive topics such as IPV. The safety app was not perceived as effective. Conclusions The preliminary results show that video counseling conducted during the COVID-19 pandemic supports pregnant women exposed to IPV and is highly feasible and accepted in both Denmark and Spain. Conflicts of Interest None declared.

Internalized Heterosexism and Exposed Psychological Intimate Partner Violence: Experiences of Lesbian and Bisexual Women in Turkey and Denmark.

The current study investigates how associations between internalized heterosexism (IH) and psychological intimate partner violence (IPV) victimization differ for lesbian vs. bisexual (LB) women in Denmark, where queer people are relatively well accepted, and Turkey, where discrimination is still very high. The first purpose of the current study is to explore differences in the prevalence of psychological IPV victimization as a function of sexual orientation (LB women) and country (Denmark and Turkey). As the second purpose, we look at the moderating role of sexual orientation and moderated moderating role of country on the association between IH and psychological IPV victimization. A sample of 257 LB women aged 18-71 years (M = 33.23, SD = 11.15) from Denmark and 152 LB women aged 18-52 years (M = 28.88, SD = 7.70) from Turkey participated. The results of chi-square analyses indicate that LB women from Turkey reported significantly higher psychological IPV victimization than LB women from Denmark. Lesbian than bisexual women from both countries reported more hostile withdrawal and dominance/intimidation-related psychological IPV victimization. The results of moderated moderation analyses reveal that lesbian women in Turkey and bisexual women in Denmark with higher IH were more likely to report experiencing denigration acts. Mental health professionals working with queer psychological IPV survivors may benefit from understanding that IH is associated with LB women's victimization of psychological IPV, which might be further associated with mental health challenges.

“Then someone takes my picture…” and other disrupted (drinking) stories: constructing narratives about alcohol and intoxication among young Muslim women in Denmark

PurposeThis paper aims to explore the existence of drinking stories among young Muslim women in Denmark. More specifically, the author investigates the significance of having a double audience (one Muslim, one Danish) for the construction of narratives about alcohol and intoxication.Design/methodology/approachThe paper draws on qualitative data from semi-structured in-depth interviews with 32 young Muslim women (average age 23 years) and uses the analytical concept of storytelling.FindingsFirstly, the narratives are qualitatively different from majority narratives, revealing distinct Muslim minority experiences. Secondly, the stories are disrupted in more serious ways than majority drinking stories. Lastly, for some young women, there is no wriggle room, and rather than being part of stories of intoxication, they subvert the drinking story into sober narratives to uphold respectable norms around alcohol while being both Muslim and Danish.Originality/valueThis research is unique in its focus on alcohol and parties among Muslim minority youth in a white-majority country. The narratives would usually be overlooked in a drinking story context because of the association between Muslims and abstinence and because the drinking story literature originates from a narrower focus on young white men’s experiences. Including more ethnic, religious and gender-diverse minorities in future research on drinking stories will challenge our knowledge in the field and add much-needed nuances.

Risk of stillbirth and preterm birth among undocumented pregnant migrant women in Denmark: A retrospective case-control study.

To examine the associations between undocumented pregnant migrant women and the risk of experiencing stillbirth or preterm birth. A retrospective case-control study based on nationwide registers from Statistics Denmark and hospital journals from the seven largest hospital wards in Denmark from 1 January 2011 to 31 December 2018. A total of 882 undocumented pregnant migrant women and 3528 matched controls (both documented migrant and non-migrant women) were included. Logistic regression models were used to estimate the risk of undocumented pregnant migrant women experiencing (a) stillbirth and (b) preterm birth compared with the control group. Of the undocumented pregnant migrant women, 33.3% were EU citizens, 16.2% were applicants for residence and 50.5% had an unknown basis for residence. The mean age of the undocumented pregnant migrant women was 28.4 years, whereas the mean age of women in the control group was 30.9 years. Higher adjusted odds of experiencing stillbirth (aOR 3.50; 95% CI 1.31-9.38) and preterm birth (aOR 1.41; 95% CI 1.04-1.93) were observed among the undocumented pregnant migrant women compared with the control group. The basis of residence was not associated with higher odds of experiencing stillbirth or preterm birth. We found a higher risk of stillbirth and preterm birth among the undocumented pregnant migrant women than in the control group. Our findings suggest a need to increase the focus on providing access to antenatal care among those women currently excluded from this care.

Concurrent participation in breast, cervical, and colorectal cancer screening programmes in Denmark: A nationwide registry-based study

Women in Denmark are invited to breast, cervical, and colorectal cancer screening in their fifties and sixties. We determined the patterns of concurrent participation in the three programmes. Participation in organised cancer screening was determined using the highly complete Danish population and health care registers for all women aged 53–65 years on 31 March 2018 who continuously resided in Denmark since 1 April 2012. Data were linked using unique personal identification numbers. We studied overall and cancer-specific proportions of women undergoing screening for all three, two, one, and none of the cancers. Among all 468,507 women, 406,306 (87%) participated in breast, 345,768 (74%) in cervical, and 316,496 (68%) in colorectal cancer screening. Despite high participation, only 255,698 (55%) women were screened for all three cancers, while 123,469 (26%) were screened for two, 54,538 (12%) for one, and 34,802 (7%) were not screened for any cancer. Cancer-specific patterns were highly heterogeneous across the population but changed little after accounting for women's medical history. A significant proportion of women who are screened for a specific cancer remain unscreened for other cancers. The consistency of these data at the international level requires a reconsideration of invitational practices for organised screening.