Need For Women Research Articles

Supporting pregnant women in need

British Journal of MidwiferyVol. 22, No. 1 CommentSupporting pregnant women in needSandra HorleySandra HorleySearch for more papers by this authorSandra HorleyPublished Online:3 Apr 2014https://doi.org/10.12968/bjom.2014.22.1.55AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Department of Health (2003) Women's Mental health: Into the Mainstream. Department of Health, London Google ScholarDepartment of Health (2004) National Service Framework for Children, Young People and Maternity Services. Department of Health, London Google ScholarMezey GC (1997) Domestic violence in pregnancy. BMJ 314(7090): 1295 Crossref, Google ScholarOffice for National Statistics (2013) Focus On: Violent Crime and Sexual Offences 2011/12. ONS Statistical Bulletin tinyurl.com/axfgvzh Google Scholar FiguresReferencesRelatedDetails 1 January 2014Volume 22Issue 1ISSN (print): 0969-4900ISSN (online): 2052-4307 Metrics History Published online 3 April 2014 Published in print 1 January 2014 Information© MA Healthcare LimitedPDF download

Reproductive Health Needs of Women Living with HIV/AIDS in Yaounde, Cameroon

The population plagued with the HIV/AIDS pandemic in Cameroon is young, a generation that may desire or control fertility. For those who may become pregnant, the desire to have children may not be there. We carried out this study to look at the picture of the reproductive health needs of women living with HIV/AIDS in our setting. In this cross-sectional non-analytic design that lasted for three years, we employed both qualitative and quantitative methods to collect data from them after receiving ethical clearance (N221/CM/2009) from the National Ethics Committee. Consenting HIV infected women who were attending the “HIV Day Care” clinics and those who delivered and were in the post partum wards in four of our major hospitals in Yaounde were enrolled. Interviews were individualized. We used both CSPro version 4.1 and Statistical Package for Social Sciences (SPSS) version 19.0 softwares for data analysis. Four hundred and fifteen (415) women were enrolled; the mean age was 29 ± 7.8 years; the most represented age group was 24 -29 years. They were single (36.14%), well educated (5 out of 10 had attained university level of education), 61.20% revealed that their partners knew their HIV status, 82.4% believed that screening for cancer of the cervix was necessary for their status and 47.70% would want to be screened for some or all STIs. About 36.86% had the desire to have children, 57.1% of those who delivered did not plan to have the pregnancies out of which 82% would have wanted a modern method of contraception but did not have (82% unmet needs). Modern contraceptive use was associated with age and individual characteristics such as level of education. It was 64.34% among women who had secondary level of education and below as against 35.66% among those who had high school level of education and above. Contraceptive use was also high among women who were unmarried as against those who were married (89.64% vs 10.36%). The desire to have children decreased as age increased (43.85% vs 18.79%) and was lower among married women compared to those who were single (13.01% versus 49.64%). These women were found to have high unmet needs for modern contraception and showed interest in STIs and cervical cancer screening.

First births with a simplified culture system for clinical IVF and embryo transfer

This study reports the outcome results from a pilot clinical trial using a simplified laboratory method for human IVF. This system reproducibly generates de novo the atmospheric and culture conditions that support normal fertilization and preimplantation embryogenesis to the hatched blastocyst stage without the need for specialized medical-grade gases or equipment. Development from insemination to the hatched blastocyst stage occurs undisturbed in a completely closed system that enables timed performance assessments for embryo selection in situ that, in this study, involved single-embryo transfers on day 3. With the simplified culture system, 8/23 embryos implanted, one miscarried at 8weeks of gestation and seven healthy babies have been born. The methodology and results are discussed with regard to how this simplified system can be adopted worldwide to meet the growing need for accessible and affordable IVF.A common notion concerning the demographics of infertility is that it is largely a phenomenon associated with developed countries, where infertility treatments are commonplace. In fact, most infertile couples reside in developing/low-resource countries where infertility diagnosis and treatment is nonexistent, inaccessible or unaffordable by the vast majority of young men and women in need. The irony of this situation is that bilateral tubal occlusions, for which IVF was originally indicated and is the most effective treatment, is by far the most common cause of their infertility. We have addressed one aspect of this issue, the IVF laboratory, as part of a wider effort by the Walking Egg Project to design and establish small, dedicated centres in developing countries to provide assisted reproduction technologies that are affordable and accessible to a wider proportion of the population in need. The methods for conventional IVF designed to addresses tubal obstructions are relatively simple and free of complex instrumentation and the highly developed infrastructure common to high-resource centres. This simplified IVF system self-generates culture conditions in a closed system. After prolonged preclinical testing, a pilot clinical study was initiated in 2012 in Genk, Belgium. The findings suggest that a significant first step has been achieved in the effort to bring advanced assisted reproduction to developed countries using a low-resource but highly effective IVF system capable of bringing modern reproductive medicine to infertile couples in low-resource societies.

Unintended pregnancy: magnitude and correlates in six urban sites in Senegal

BackgroundIn Senegal, unintended pregnancy has become a growing concern in public health circles. It has often been described through the press as a sensational subject with emphasis on the multiple infanticide cases as a main consequence, especially among young unmarried girls. Less scientific evidence is known on this topic, as fertility issues are rarely discussed within couples. In a context where urbanization is strong, economic insecurity is persistent and the population is globalizing, it is important to assess the magnitude of unintended pregnancy among urban women and to identify its main determinants.MethodsData were collected in 2011 from a representative sample of 9614 women aged 15–49 years in six urban sites in Senegal. For this analysis, we include 5769 women who have ever been pregnant or were pregnant at the time of the survey. These women were asked if their last pregnancy in the last two years was ‘wanted ’then’, ‘wanted later’ or ‘not wanted’. Pregnancy was considered as unintended if the woman responded ‘wanted later’ or ‘not wanted’. Descriptive analyses were performed to measure the magnitude of unintended pregnancies, while multinomial logistic regression models were used to identify factors associated with the occurrence of unintended pregnancy. The analyses were performed using Stata version 12. All results were weighted.ResultsThe results show that 14.3% of ever pregnant women reported having a recent unintended pregnancy. The study demonstrates important distinctions between women whose last pregnancy was intended and those whose last pregnancy was unintended. Indeed, this last group is more likely to be poor, from a young age (< 25 years) and multiparous. In addition, it appears that low participation of married women in decision-making within the couple (management of financial resources) and the lack of discussion on family planning issues are associated with greater experience of unintended pregnancy.ConclusionThis study suggests a need to implement more targeted programs that guarantee access to family planning for all women in need. In urban areas that are characterized by economic insecurity, as in Senegal, it is important to consider strategies for promoting communication within couples on fertility issues.

Understanding and Meeting the Needs of Women in the Postpartum Period: The Perinatal Maternal Health Promotion Model

A new model for the care of women in the postpartum focuses on the development of life skills that promote complete well-being. The year following childbirth is a time of significant transition for women. In addition to the physiologic changes associated with the postpartum period, a woman undergoes marked psychosocial changes as she transitions into a motherhood role, reestablishes relationships, and works to meet the physical and emotional needs of her infant and other family members. It is a time when women are vulnerable to health problems directly related to childbirth and to compromised self-care, which can manifest in the development or reestablishment of unhealthy behaviors such as smoking and a sedentary lifestyle. In addition to long-term implications for women, compromised maternal health in the postpartum period is associated with suboptimal health and developmental outcomes for infants. Maternal health experts have called for a change in how care is provided for women in the postpartum period. This article presents the rationale for a health promotion approach to meeting the needs of women in the postpartum period and introduces the Perinatal Maternal Health Promotion Model. This conceptual framework is built around a definition of maternal well-being that asserts that health goes beyond merely the absence of medical complications. In the model, the core elements of a healthy postpartum are identified and include not only physical recovery but also the ability to meet individual needs and successfully transition into motherhood. These goals can best be achieved by helping women develop or strengthen 4 key individual health-promoting skills: the ability to mobilize social support, self-efficacy, positive coping strategies, and realistic expectations. While the model focuses on the woman, the health promotion approach takes into account that maternal health in this critical period affects and is affected by her family, social network, and community. Clinical implications of the model are addressed, including specific health promotion strategies that clinicians can readily incorporate into antepartum and postpartum care.

The Mismatch Between Postpartum Services and Women's Needs: Supermom Versus Lying‐In

The Mismatch Between Postpartum Services and Women's Needs: Supermom Versus Lying‐In

Efficient Identification of Low-Income Asian American Women at High Risk for Hepatitis B

Hepatitis B disproportionately affects Asian Americans. Because outreach to promote testing and vaccination can be intensive and costly, we assessed the feasibility of an efficient strategy to identify Asian Americans at risk. Prior research with California's statewide toll-free phone service where low-income women call for free cancer screening found 50% of English-and Spanish-speaking callers were willing to participate in a study on health topics other than cancer screening. The current study ascertained whether Asian Americans could be recruited. Among 200 eligible callers, 50% agreed to take part (95% confidence interval 43%-57%), a rate comparable to our previous study. Subsequent qualitative interviews revealed that receptivity to recruitment was due to trust in the phone service and women's need for health services and information. This was a relatively low-intensity intervention in that, on average, only five minutes additional call time was required to identify women at risk and provide a brief educational message. Underserved women from diverse backgrounds may be reached in large numbers through existing communication channels.

Changing models of public antenatal care in Australia: Is current practice meeting the needs of vulnerable populations?

Objectiveto investigate women's views and experiences of public antenatal care. Designpopulation-based survey in two states. SettingSouth Australia and Victoria, Australia. Participants4366 women surveyed at 5–6 months post partum. Findingsof 8468 eligible women mailed the survey, 52% returned completed questionnaires. Fifty-seven per cent of women (2496/4339) received public antenatal care. Of these, half attended a GP for some/all antenatal visits, 38% attended a public hospital clinic or midwives clinic, and 12% had primary midwife care, mostly in a midwifery group practice. Women with complex needs – young women, those experiencing multiple social health problems, women of non-English speaking background, and women at higher risk of complications in pregnancy – were the least likely to say that care met their needs. Women attending a GP or midwife as a primary caregiver were the most positive about their antenatal care: 69% and 74% respectively describing their antenatal care as ‘very good’. Women attending a standard public hospital clinic were the least positive about their antenatal care with only 48% rating their care as ‘very good’. Women enroling in GP shared care or attending a midwives clinic at a public hospital gave intermediate ratings. Conclusion and implications for practiceModels of public antenatal care involving a designated lead primary caregiver (GP or midwife) came closest to meeting women's need for information, individualised care and support.

The Affordable Care Act: Addressing the Unique Health Needs of Women

The Affordable Care Act: Addressing the Unique Health Needs of Women

Exploring Women's Values, Choices, Expectations, and Outcomes for Birth After Cesarean

Purpose/AimTo explore women's values and expectations about birth after cesarean during decision making to better inform the design of strategies to support women to achieve consistency between their values, birth expectations, and birth experiences.Research QuestionsWhat reasons underpin the choices women make about method of birth after cesarean? What do women value and expect from their birth choices after cesarean? What factors influence consistency between choice and outcome?Significance/BackgroundShared decision making around birth after cesarean necessitates shared understanding of individual values and expectations of women. Reduction in dissonance between providers and women is needed to achieve high‐quality health decisions and outcomes.MethodsOne hundred and eighty‐seven women participating in a decision‐aid trial for birth after cesarean wrote about their choices for birth at 36 to 38 weeks’ gestation. At 6 to 8 weeks after the birth, 168 also wrote about their experiences of birth, satisfaction with the decision process, and health after the birth. Narrative analysis identified values and expectations underpinning birth decisions and the extent to which these were realized.FindingsDecision making was difficult for many women, and emotions such as fear and anxiety were expressed as women explained their different birth choices. Avoidance of the previous cesarean experience, an expectation of a “better” or “faster” recovery, and issues around “safety” for the baby, were common reasons given for trial of labor as well as for elective repeat cesarean. Provider preferences were influential, and women's need for information about their options underpinned levels of confidence and certainty during decision making. Satisfaction with the birth experience and adherence to choice largely depended on practice patterns of the birth setting, commitment by providers to support choice, and women's strength of preference or commitment to their birth choice.DiscussionWomen do not always choose the mode of birth that providers expect them to. Greater understanding and support of individual values and expectations of women is needed to effectively support shared decision making for birth after cesarean.

Unsupportive Social Interactions in the Weeks Immediately Following Breast Cancer Diagnosis

Unsupportive social interactions (USIs) experienced by people with cancer negatively affect psychological well-being. Forty-five interviews with 26 women were analyzed using directed content analysis to explore USIs experienced during the stressful pretreatment and early postsurgical periods after early-stage breast cancer diagnosis. Cognitive, emotional, and behavioral responses to USIs were also explored. Seventy incidents of USIs were identified within the interviews and grouped into four previously defined and five additional categories. Anxiety, avoiding future interactions, and nondisclosure of thoughts and feelings were typical responses to USIs. These responses hold implications for women's psychological well-being and need for future interventions and research.

Organicism, womanhood and domesticity in Anne LaBastille's Woodswoman saga

Anne LaBastille's Woodswoman saga presents an ecological approach to organicism that aims to recuperate the notion of nature and the wilderness as live organisms in perpetual, cyclical transition. LaBastille's conception of nature as an animate entity to which the self is intimately connected unleashes her discursive advocacy for a necessary reversion to a communion with natural rhythms. Her hermitage represents a voluntary conversion into the laws of nature, a conversion which results in the identification of the self as a self-in-place, and in the redefinition of the categories of domesticity, privacy and territoriality from an ecofeminist perspective. Such redefinitions lead to an implosion of the notion of femininity itself: as LaBastille negotiates between the categories of womanhood, the wilderness, and private and public domains in accordance to organicist principles, she opens a new discursive space that acknowledges women's need for a territory of their own where they too can become independent selves-in-relation.

Are Transition Houses Equipped to Meet the Needs of Women in Midlife and Older?

This study addresses the extent to which transition houses, defined as residential facilities for abused women and children, meet the needs of women in midlife and older. Seventeen transition house directors completed an on-line survey and eight participated in an interview. Women in midlife and older comprised 28 % of the transition house population. Thematic analysis resulted in the identification of three key themes: life at home and in the community, living in the transition house, and starting a new life. While policies, accessibility, privacy, support and outreach could be improved, the transition houses offered safety and security for women across the lifespan. Recommendations for research, policy and practice are included to ensure that transition houses offer a welcoming, suitable, and supportive environment for women in midlife and older.

Relationship between professional antenatal care and facility delivery: an assessment of Colombia

The determinants of maternal and child health have been the recurrent topics of study in developing countries. Using the Demographic and Health Survey (2010) of Colombia, this study aimed to identify the determinants for professional antenatal care and institutional delivery, taking into account the interdependence of these two decisions, which we consider using a bivariate probit model. This study found that when certain factors affecting both the decision to seek prenatal care and giving birth in a hospital are neglected, the results of the estimates are inefficient. Estimates show that the effects of education, parity, regional location and economic status on institutional delivery tend to be underestimated in a univariate probit model. The results indicate that economic status, level of education, parity and medical-insurance affiliation influenced the joint likelihood of accessing professional antenatal care and delivering in a health facility. An important finding is that mothers with a higher level of education are 9 percentage points more likely to access these two health services compared with mothers who are illiterate. Another observed finding is the regional disparities. The evidence indicates that mothers in the Pacific Region, the poorest region of Colombia, are 6 percentage points less likely to access such services. Thus, the results indicate that the Colombian health policy should emphasize increasing the level of schooling of mothers and establish health facilities in the poorest regions of the country to ensure that women in need are provided with social health insurance.

Understanding the Needs of Women Considering Risk-Reducing Salpingo-oophorectomy

Because of the significantly increased lifetime risk of ovarian cancer associated with inheritance of a germline mutation in the BRCA1/2 genes, women with a deleterious mutation are recommended to undergo risk-reducing salpingo-oophorectomy at age 35 years or once child-bearing is complete. Significant time is often spent by nurses trained in genetics providing counseling to improve the decision-making process. The decision to undergo surgery is complex and laden with several sources of uncertainty. We conducted a qualitative study among female carriers of deleterious BRCA1/2 mutations to address these uncertainties. Twelve qualitative interviews were conducted with women who had received a positive BRCA1/2 test result to explore their understanding of ovarian cancer risk, prevention options, and resource needs. Qualitative content analysis was performed. Significant information gaps in level of risk, other factors associated with ovarian cancer, and details of prophylactic oophorectomy were identified. Personal experience with cancer colored the degree of risk perception associated with the inherited mutation. Fear of the adverse effects of surgical menopause, both physiological and psychosocial, was common. Women expressed interest in hearing from other women facing the same decision. Women facing the decision to undergo risk-reducing salpingo-oophorectomy have several information gaps and unmet needs despite comprehensive counseling. Based on our findings, we make specific recommendations that will guide nursing practice and future research.

Abstract ADV08: Bridging the gaps in service.

Abstract Susan's Rally is a Houston based 501c3 organization that started as a group supporting breast cancer research and has expanded to support services provided for those with all types of cancer. What began as a fun road rally for Bruce and Susan Roberson morphed into a fun-raising event for cancer after Susan was taken by breast cancer. For 17 years, Bruce and his friends have continued the rally in her honor and now the proceeds from the rally, golf tournament, and auctions are used to fight the disease and assist with providing patients support services. Susan's Rally has raised over a million dollars in cash and in-kind donations utilizing all volunteer labor. Except for a few office supplies, postage and printing, all of Susan's Rally dollars go to fight cancer and support patients. Some of the programs supported included MD Anderson Patients Support Network, research at the Christus Stehlin Foundation for Cancer Research, provide diagnostic imaging for uninsured women at The Rose, counseling at Y-Me, and assists with making available low-cost short-term housing at The Sojourn House-Apartment, homes for cancer patients. In 2012 Susan's Rally also began funding “Dia De la Mujer community health festivals providing free breast exams, HIV testing an pap smears for women in need. Citation Format: Mary Kay Dauria. Bridging the gaps in service. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr ADV08. doi:10.1158/1538-7445.AM2013-ADV08

Communication and Information Needs of Women Diagnosed With Ovarian Cancer Regarding Treatment-Focused Genetic Testing

To identify women's information and communication preferences about treatment-focused genetic testing (TFGT) in the ovarian cancer context. A qualitative interview study. Two familial cancer services and a gynecologic oncology clinic at a major teaching hospital in Australia. 22 women diagnosed with ovarian cancer who had either advanced disease and had previously undergone TFGT (n = 12) or had been diagnosed in the previous 6-20 weeks with ovarian cancer and had not undergone TFGT (n = 10). Participants were interviewed individually about actual and hypothetical views of TFGT. The interviews were transcribed and organized into themes using qualitative analysis software. Most women wanted to be informed about TFGT prior to their surgery for ovarian cancer. The majority preferred to receive the information verbally; slightly more women preferred their medical oncologist to deliver the information compared to a genetic specialist or oncology nurse. Women preferred the focus of pretest information to be on them and their treatment. Women diagnosed with ovarian cancer want information about genetic testing early with focus placed on the potential benefits of genetic testing on treatment. The findings of this study provide much-needed guidance to oncology nurses and other oncology healthcare professionals about when, what, and how information about TFGT should be delivered to patients diagnosed with ovarian cancer. Supportive patient education materials now need to be developed to assist these women in making informed decisions about genetic testing. Knowing that women do want TFGT, how they want it presented and by whom, and the content and level of detail that women want means that TFGT can now be presented as an option to women newly diagnosed with ovarian cancer, which may influence firstline treatment. The findings also provide the knowledge required to prepare education tools to assist oncology nurses involved in frontline care.

Health care Needs of Women Immediately Post‐Incarceration: A Mixed Methods Study

This study examined the health status of women with a recent history of incarceration and explored if/how women were accessing health care resources at the time immediately following release. This mixed methods study utilized two phases: (1) a quantitative survey; and (2) qualitative interviewing. Thirty-four women (18years of age and older, released from incarceration in the last 12months) participated in the quantitative phase; 11 of those completed the qualitative interviews. In phase 1, data were collected on demographics, health history, health status, and health-promoting behaviors. In the second phase, semi-structured interviews were used. Women in the study reported below average health status compared with the general population. The major health issues identified by participants included specific health problems affected by incarceration, mental health needs, routine health promotion and maintenance, recovery from substance abuse as a major health concern, and social and environmental barriers to care. Women leaving jail or prison have significant and complex health care needs. This period of transition appears to be an opportune time to offer support, services, and other health-promoting interventions.

Vietnamese Women's Struggle to Access Antiretroviral Drugs in a Context of Free Treatment

This qualitative study aims to explore how HIV positive women living in a northern province of Vietnam experience seeking antiretroviral (ARV) treatment in the public health system, and how they address obstacles encountered along the way. Despite the fact that antiretroviral drugs were freely provided, they were not always accessible for women in need. A variety of factors at the population and health system level interacted in ways that often made access to ARV drugs a complicated and time-consuming process. We have suggested changes that could be made at the health system level that may help facilitate women's ability to access treatment.

Lived Experiences of the Choice on Termination of Pregnancy Act 92 of 1996: Bridging the Gap for Women in Need

The Choice on Termination of Pregnancy Act 92 of 1996 embodies a laudable and liberal ideal, namely that the course of a woman’s life does not have to be determined by her reproductive capacity. Instead, she has the right to free, non-therapeutic termination of pregnancy in a safe environment, a right which exists up to the end of the second trimester. Dignity, equality, and security of the person are therefore the foundation stones of the right. However, this is not the case for women with limited means who have no choice but to rely on the public provision of termination-of-pregnancy services. Studies of women’s lived experiences of the implementation of the Act show that there are barriers to accessing termination-of-pregnancy procedures that need to be removed if they are to enjoy this right fully. Not least of these barriers is the state’s failure to fulfil its s 27 obligations in terms of the Constitution of the Republic of South Africa, 1996, as well as its far-reaching inaction in engaging with the implementation of the Act. Numerous other barriers exist at the provider and community level. Only through the removal of such barriers and with the state’s fulfilment of its obligations will it be possible to translate the provisions of the Act into their envisaged implementation, thus guaranteeing all women in South Africa (regardless of socio-economic standing) the right to safe and quality termination of pregnancy that is accompanied by dignity, equality and security of the person.