Reproductive Behavior Of Women Research Articles

Counseling on The Importance of Maintaining Women's Reproductive Health

Maintaining women's reproductive health behavior is something that is very important for every woman from childhood, adolescence, to adulthood. This is because the female reproductive organs are organs that function as a place for menstrual blood to exit, a place for fetal development and sexual intercourse. Many reproductive health problems can arise from not maintaining women's reproductive health, one of which is cervical cancer. Therefore, the author conducted counseling on the importance of maintaining women's reproductive health to PKK mothers in Pasar VI Kualanamu Village with the aim of increasing the knowledge of PKK mothers about the importance of maintaining women's reproductive health, so that later the information conveyed is expected to have a positive impact on the village about maintaining women's reproductive health, where it is known that PKK mothers are organizations that work directly with residents, especially women in the village. During the counseling, the method used was the lecture method. With 28 counseling participants. Counseling was carried out in several stages, including the activity process stage and the evaluation stage. This counseling activity was carried out on May 8, 2024 at the multipurpose building of Pasar 6 Kualanamu Village, Beringin District. From the results obtained, it is known that the percentage value of achievement in the final questionnaire of participants after counseling is mostly in the high to moderate range classification. From these data, it shows that the counseling carried out in Pasar 6 Kualanamu Village was able to increase the knowledge of counseling participants consisting of PKK mothers, with this it is hoped that the information conveyed will have a positive impact on the village about maintaining women's reproductive health, where it is known that PKK mothers are an organization that works directly with residents, especially women in the village.

Beyond Milk and Nurture: Breastfeeding's Powerful Impact on Breast Cancer.

Breast cancer (BC) stands as a global concern, given its high incidence and impact on women's mortality. This complex disease has roots in various risk factors, some modifiable and others not. Understanding and identifying these factors can be instrumental in both preventing BC and improving survival rates. Remarkably, women's reproductive behaviors have emerged as critical determinants of BC susceptibility. Numerous studies have shed light on how aspects including age of menarche, first pregnancy and menopause along with number of pregnancies, hormone replacement therapies, can influence one's risk of developing BC. Furthermore, the act of breastfeeding and its duration have shown an inverse relationship with BC risk. This review delves into the biological and molecular mechanisms associated with breastfeeding that contribute to BC protection. It highlights the role of endocrine processes triggered by suckling stimulation, the gradual onset of lactational amenorrhea, delayed weaning, reduced lifetime menstrual cycles, chromosomal repair mechanisms, and immunological events throughout the lactation cycle. These insights provide a potential explanation for the protective effects conferred by breastfeeding against breast carcinomas.

The Descent of Ireland’s ‘Fallen Women:’ The Relationship Between the Catholic Church, Irish Nationalism, and the Control of Women’s Reproduction through Mother and Baby Homes and Magdalen Laundries

In recent decades, Ireland has grappled with its relationship with the Catholic Church, which has long exerted social, political, and moral authority over the young nation. Scandals of physical, sexual, and psychological abuse at the hands of clergy have surfaced, distorting the Church's legacy in Ireland. Mother and baby homes and Magdalen laundries are just two of the many institutions operated by Church officials where individuals endured severe abuse at the hands of religious orders. Mother and baby homes and Magdalen Laundries serve as a yet another historical manifestation of authorities' control of women's reproductive behavior. These two institutions penalized illegitimate births by incarcerating thousands of young women – some pregnant, some not – throughout the 20th century in Ireland. This paper analyzes how the historical framework under which these systems developed, as well as the relationship between the Church's control of women's reproductive behavior and national identity in post-Independence Ireland. 

Exploring Muslim Women's Reproductive Health Needs and Preferences in the Emergency Department.

Objective: We explored individual Muslim women's reproductive healthcare experiences, preferences, beliefs, and behaviors in the emergency department (ED) and in general. Methods: This was a qualitative study conducted at a community ED using semi-structured interviews with a piloted interview guide. We interviewed participants awaiting care in the ED with the following criteria: female gender; English or Arabic speaking; aged ≥18years; and self-identified as Muslim. We conducted interviews in both English and Arabic until thematic saturation was reached. Transcripts were coded using an iteratively developed codebook, maintaining intercoder agreement greater than 80%. We used an inductive thematic analysis to identify themes, and results were interpreted in the context of interview language and patient's age. Results: We interviewed 26 Muslim-identified female ED patients. We found that cultural representation and sensitivity among ED staff mitigated discrimination and promoted inclusion for Muslim ED patients. However, assumptions about Muslim identity also impacted the participants' healthcare. Most participants endorsed a preference for a female clinician for their reproductive healthcare in general, but not necessarily for other areas of medicine. Clinician cultural concordance was not always preferred for participants in the ED due to fears about the loss of confidentiality. Marital status impacted beliefs about reproductive and sexual health in the context of Muslim identity. Overall, family planning was acceptable and encouraged in this patient population. Conclusion: The themes elucidated in this study may guide clinicians in developing culturally sensitive practices when providing reproductive healthcare to the Muslim population.

The EMeRGE theory of emerging adult-aged women's sexual and reproductive health self-management: A grounded theory study.

To explore how emerging adult-aged women self-manage their sexual and reproductive health and to generate a grounded theory of these self-management processes. Grounded theory methods using a constructivist approach. Between September 2019 and September 2020, 18- to 25-years-old women (n = 13) were recruited from a 4-year university, a 2-year community college, and neighbourhoods surrounding the institutions of higher education. Individual interviews were transcribed verbatim and qualitatively analysed using a constant comparative method and inductive coding. The theory purports that core processes of sexual and reproductive health self-management used by the women in this study included both passive and (re)active processes. These processes expanded upon and/or maintained the women's accessible sexual and reproductive health knowledge, behaviour and beliefs, defined as the sexual and reproductive health repertoire. The processes appeared to be cyclical and were often initiated by a catalysing event or catalyst and resulted in conversations with confidantes, or trusted individuals. A catalyst was either resolved or normalized by expanding or maintaining the sexual and reproductive health repertoire. The resulting theory, EMeRGE Theory, offers insight into the complex and cyclical processes emerging adult-aged women use to simultaneously develop and adapt their foundational sexual and reproductive health knowledge, behaviours and beliefs. This explication of emerging adult-aged women's sexual and reproductive health self-management processes can be used by nurses and nurse researchers to better address this population's unique health needs. The EMeRGE Theory provides valuable guidance for future exploratory and intervention research aimed at improving the health and well-being of emerging adult-aged women. The authors adhered to the Consolidated Criteria for Reporting Qualitative studies (COREQ) in preparation of this publication. No patient or public contribution.

The Definition of Social Loneliness and Social Well-Being of Russian Women

The study is dedicated to the study of the problem of social loneliness. The theoretical and methodological base determines the significance of this phenomenon for modern society. In this regard, the issue of gender segregation in determining the factors of increasing social loneliness is extremely acute, since to a greater extent the marital and much less reproductive behavior of women can be associated precisely with the process of avoiding social loneliness as a social phenomenon, which requires clarification of these factors of the demographic development of society. Questions of studying social loneliness are also raised in the context of the need to preserve traditional family constructs. Modern social forms of avoiding social loneliness often form prerequisites for the distortion of family tradition and transform family and social forms of interaction. The article presents assessments of the phenomenon of social loneliness in the minds of women on the basis of a study. Social loneliness is considered in the context of women’s marital and reproductive behavior. At the same time, a comparison is made of the concepts of “social loneliness” and “happiness” within the considered subsample, differentiated by gender. The definitions of the concepts of “female happiness” and “index of happiness” are given, a scale of assessments of the happiness index in the interval between two antagonistic terms is given, and the index is calculated for the considered subsample. The results are based on the author’s empirical all-Russian research conducted in the spring of 2022 (N=2500, in the gender distribution, the sample population of women was 43% – 1075 people). The sample was defined as continuous, random, and at the last stage nested, since only one gender group was taken within the framework of this article – women. The results of the study are aimed at finding ways to reduce the risks of the formation of destructive socio-psychological constructs in women’s perception of themselves and the world through the prism of social loneliness, and also contribute to the development of recommendations for the development of sustainable family constructs of the traditional type.

Application of hysteroscopy in female fertility preservation.

Under the background of the trend in late marriage and the relaxation of family planning policy, the reproductive behavior of women has changed and the proportion of elderly pregnant women has increased progressively year by year. Thus the female fertility preservation is particularly important. As the cradle of life, uterine malformation and uterine cavity diseases may have adverse effects on embryo implantation and development. Several common intrauterine diseases, such as uterine submucosal fibroids, endometrial polyps, intrauterine adhesions, uterine malformation, cesarean scar diverticulum, and embryo residues, may affect female fertility. Hysteroscopy is the gold standard for the diagnosis and treatment for intrauterine diseases. With the progress in science and technology, the refinement of hysteroscopy instruments and the promotion of transvaginal endoscopic technology, hysteroscopy will yield brilliant results in female fertility preservation. The knowledge and training related to hysteroscopy should be continuously promoted and popularized, so that it can be mastered by more clinicians and applied in clinical practice to benefit more female patients.

CULTURAL BELIEFS AND PRACTICES REGARDING MATERNAL HEALTH: A CASE STUDY OF RURAL AREAS OF PUNJAB

People are strongly influenced by practices and beliefs whether they are based on custom or tradition, and these beliefs are difficult to change just by requesting scientific evidence. Traditional beliefs are more focused on pregnancy and childbirth than other aspects of life, making women more susceptible to them. This research study mainly focused on cultural beliefs which are contributing in determining the reproductive life of women in Pakistan particularly of rural areas. This research used a hybrid technique for data processing and interpretation. This approach mixed both qualitative and quantitative methods, and required researchers to seek and explain reality in its natural setting. Field data collection was carried out in Punjab's area; Jampur which is the tehsil headquarters in District Rajanpur, Punjab, Pakistan. Married women having at least one child were selected through purposive sampling. It was concluded that women in Jampur preferred to follow indigenous food habits, advised by their elders, during pregnancy. Women depend on their husbands or mother-in-law regarding maternal healthcare decisions. According to health professionals, the maternal health depends on the education and social status of families. The ordinary Pakistani woman will continue to endure a high risk of maternal death and would leave behind stories of misery, prejudice, and vulnerability if social and cultural practises are not addressed in broad integrated policies aiming at improving maternal health in the area. Findings of this study will be helpful for the health service providers to arise with worthwhile mechanisms to make their services women-friendly and accessible to the youth. Likewise, this study will also contribute to an in-depth understanding of the processes underlying social identities in shaping women's reproductive health-seeking behaviors. The study will be helpful for organizations that are working for maternal health and population welfare such as National Institute of Population Studies (NIPS) and also for policy-making bodies, including national health policymakers and Pakistan population policymakers. Keywords: Maternal health, Cultural Beliefs, Motherhood, Indigenous healing, Maternal food habits.

Women's reproductive traits and ischemic stroke: a two-sample Mendelian randomization study.

We conducted a Mendelian randomization (MR) study to disentangle causal associations between women's reproductive behaviors and ischemic stroke (IS) and investigate the roles of two modifiable risk factors (body mass index (BMI) and educational attainment (EA)) in these associations. Using summary-level data from large-scale genome-wide association studies, we performed univariable MR to examine whether there is genetic evidence that women's reproductive traits are causally associated with IS and its subtypes. Multivariable MR and MR mediation analysis were used to investigate whether BMI and EA are common mechanisms or mediators for these associations. A set of sensitivity analyses were conducted to test valid MR assumptions. We observed consistent and statistically significant associations across female and sex-combined analyses for earlier age at first birth (AFB) and age at first sexual intercourse (AFS) with a higher risk of IS and large-artery atherosclerotic stroke (LAS) risk in the primary analysis. The odds ratios of IS per 1 SD increase in genetically predicted early AFB and AFS were 0.93 (95% CI, 0.86-0.99; p=0.046) and 0.83 (95% CI, 0.70-0.97, p=0.020), respectively. Further analyses indicated that BMI played a shared role in AFS and IS/LAS while EA played a shared role in AFS/AFB and IS/LAS as well as a mediator in the path from AFS to IS/LAS. These findings may inform prevention strategies and interventions directed toward relative women's reproductive behaviors and IS. Future studies are warranted to explore other factors related to EA which are responsible for these causalities.

Religiosity and Young Unmarried Women's Sexual and Contraceptive Behavior: New Evidence From a Longitudinal Panel of Young Adult Women.

Drawing on weekly panel data from the Relationship Dynamics and Social Life study, we investigate the relationship between religiosity and young Christian women's premarital intercourse, hormonal contraceptive use, and condom use for a period of up to 2.5 years. Mediation analyses reveal what explains the relationship between baseline religiosity and young women's subsequent reproductive behaviors, with consideration for their normative environments, moral order and learned competencies, attitudes, and anticipated guilt after sex. Results indicate that the more religious a young woman is, the less likely she is to have intercourse and to use hormonal contraception in a given week. However, when having intercourse and not using a hormonal method, the more religious a young woman is, the more likely she is to use condoms. Religiosity's relationship to these behaviors operates largely through women's reproductive attitudes, anticipated feelings of guilt after sex, and past sexual or contraceptive behaviors. Together, these findings highlight the complex relationship between religiosity and premarital sex and contraceptive use, elucidate key pathways through which religiosity operates, and draw attention to the often overlooked role of sexual emotions.

Impact of Kin on Women’s Fertility in Bangladesh

The society of Bangladesh is kin oriented. The patriarchal relations along with the bondage with matrilineal kith and kin influences its overall socio-economic life of the people of Bangladesh. Specially, the rural societies of the country exhibit it is psychological and emotional attachment with the patrilineal families. However, women of rural Bangladesh combine their membership with a dual identity and make a wise use of it. Thus, families and kin relations have impact on the life and living of the individuals. In the context of Bangladesh, the reproductive behaviour of the woman has been shaped according to her social positioning, post marital residence, decision making status and wealth. This research contributed to understand the reasoning of the reproductive behaviour of the rural women and discussed on the influence of kin in determining age of fertility, gap between children and survival of the child. The research argues that the influence of close kins in women’s fertility and childcare is inevitable in Bangladesh. Thus, women’s maternal health security is much shaped through her relationships, which are often placed secretly. In depth interviews among 45 the married women of rural society have been conducted to explore their experiences with kin relations regarding reproductive decisions and persuasion. Social Science Review, Vol. 38(1), June 2021 Page 53-68

Would you make money giving birth?: Tax allowances and economic assistance as measures of population policy in Serbia

This article addresses the issue of childbirth postponement in Serbia. The paper examines the interaction of demographic and socioeconomic factors as relevant indicators of demographic development. In the case of seven municipalities in the Srem region, the authors sought to determine the causes of putting off childbirth and examine the attitudes of the female population, considering their decision not to give birth. The paper pursues to provide answers to the problems of the postponement of childbirth phenomenon, the economic resources needed for birth, the importance of the institutional framework and the changing role of women in society, which directly affect women's reproductive behavior. Research findings can be integrated into development strategies, which include both population policy and family planning measures, from the level of an individual to the extent of the community.

Pregnancy, childbirth and health of female labour migrants from Central Asia in Russia

The research note contains an analysis of data on health, pregnancy, and childbirth experience among female labour migrants arriving in Russia from Central Asia. Empirically, the study bases on the data of three surveys conducted in 2015, 2017, and 2020. In total, the surveys contain information on 2,028 migrants from Tajikistan, Kyrgyzstan, and Uzbekistan living in Russia. The analysis proves that with gradual feminization of labour migration from Central Asia, pregnancy and childbirth in a significant part of labour migrants take place in risky living conditions; the existing system of maternal health protection for migrants in Russia needs modernization. Compared to earlier studies on this topic, the survey data showed a higher proportion of female migrants who had got pregnant and gave birth in Russia along with a lower proportion of migrants who terminated pregnancy. These differences may indicate a change in the reproductive behaviour of women who come to work in Russia from the countries of Central Asia. The presented note shows the need for in-depth studies of the reproductive behaviour of labour migrants in Russia, as well as the development of national migration statistics, which should become gender sensitive.

Distance employment and parenthood: women's opinions

The article examines the relationship between two processes: development of distance employment and changes in women's parenting and reproductive behavior. The hypothesis of social effectiveness of the distance format of paid work for women was tested. It was hypothesized that the distance format allows women to perform parenting and social functions more successfully, that the opportunity to work remotely might influence a woman's positive decision to have more children. The empirical basis was formed on the data from a survey of Russian women of fertile age, conducted in May-June 2019. The sample is quota-based, including control by settlement types (megalopolis, city, village), and all Federal Districts of Russia are covered. The article contains descriptive statistics structurally describing the obtained results. A high level of women's readiness to work remotely was revealed. The motivation to telecommuting was higher among respondents who had similar work experience, as well as among women in younger age groups and living in megalopolises. Women's subjective perceptions of the qualitative changes that can occur in connection with the possibility of working remotely are summarized. On the whole, positive effects on parenting and social aspects of women's lives are found to prevail: more time will be available for child development and education; the frequency of visits to cultural and entertainment events with children will increase; the quality of home meals and everyday life will improve. The descriptive evidence confirms the relationship between telecommuting and women's reproductive behavior. The availability of telecommuting can be considered within the system of factors stimulating fertility.

An Open Secret: The History of Unwanted Pregnancy and Abortion in Modern Bolivia

In An Open Secret, historian Natalie Kimball “wrestles with an uncomfortable and slippery notion—that of unwanted pregnancy (embarazo no deseado)” (p. 113). The book's thesis—that the material and affective conditions that lead a person to regard their pregnancy as unwanted often elude conventional categorization—destabilizes several assumptions around reproductive behavior in urban Bolivia between 1952 and 2010. Kimball's oral histories with El Alto and La Paz residents in the early 2000s demonstrate how few women reflect on their pregnancies in such circumscribed terms. The causes of reproductive behavior are quickly revealed as too nuanced for frameworks of choice and rights as well as some of the structural observations on which feminist scholars have typically relied. Rather, in Bolivia, where abortion remains almost completely illegal, bearing a child is tied as closely to interpersonal and financial networks as to legal and political systems. More familiar is Kimball's argument that pregnant people have always looked for ways to negotiate their reproductive lives and have utilized political openings to achieve expanded, though limited, access to reproductive health care.According to state data from 2008, over one-third of pregnancies in contemporary Bolivia are unwanted, and most of these are carried to term. Yet the majority of Kimball's interlocutors described continuing their pregnancies not as an outcome of choosing to do so but as an obligation or necessity. Moreover, those who went on to have children expressed ambivalence but not complete regret. These layered responses guide the organization of An Open Secret. After tracing the history of reproductive policy in Bolivia, Kimball examines accounts of reproduction and abortion from medical personnel, police, and religious officials—many of whom have maintained public disapproval of abortion—before assessing women's own complex perceptions of their pregnancies. The following two chapters probe women's experiences with reproductive health care after the 1952 national revolution and into the military dictatorship and the democratic opening, respectively, which while markedly different were not entirely distinct. After the revolution, women “pushed the boundaries” of the state's pronatalist policies by continuing to terminate pregnancies (p. 149). Following the democratic opening in 1982, Bolivian women's groups organized for reproductive health-care access. Their activism and increased international support for abortion care were impetuses for the extension of public health insurance to cover pregnancy loss and expanded access to biomedical contraceptive support. Chapter 6 examines how legal mechanisms have failed both to prosecute people who have obtained illegal abortions and to facilitate access to legal abortions.Kimball's primary contributions come with their use of oral history as both a source and a lens through which to view the archive. Their conversations with 121 Bolivian women and men highlight the state's ongoing interest in reproduction and the role of structural forces on women's reproductive behavior, their “perceptions of what future was desired or possible” (p. 7). Even more, Kimball demonstrates the power of the social and affective on reproductive behavior. Their fieldwork never assumes the primacy of the individual woman; rather, each interlocutor represents a network of people, commitments, and judgments that make terminating a pregnancy possible or not. Kimball illustrates how the disruptions and especially the continuities of these interpersonal and systemic webs have influenced Bolivian women's experiences of their own pregnancies over the past half century.Beyond contributing to the growing number of country studies of reproductive politics and governance in Latin America, An Open Secret adds to examinations of the lives of urban Indigenous peoples and medical pluralism during neoliberalism. Particular moral frameworks abound in the adjacent and “inextricably linked” El Alto and La Paz; the majority Indigenous and poor populations encounter more pronounced antiabortion stigma amid the religious and patriarchal dynamics of urban Bolivia than in the surrounding rural areas (p. 18). Moreover, Bolivia's recent incorporation of some Indigenous health-care methods into the national health system and women's continual utilization of Andean birth control and abortifacients offer a unique context in which to trace the relationship between biomedical and Indigenous health systems.An Open Secret makes a case for narrative accounts as essential data for interpreting statistical and archival studies about how individuals navigate the complex avenues of reproduction. Moreover, Kimball's use of oral history elevates the intimate experiences of women as explicitly political. The book's lack of concise conclusions is not so much a problem of the text as it is reflective of the realities of this still forward-thinking task. Kimball must err on the side of subject anonymity in a climate in which abortion is stigmatized and piece together stories that often must necessarily remain secret. Rather than detracting from the argument, these impasses add weight to a main point of Kimball's argument, that “women's experiences matter simply because they occur” (p. 3).

Typical socio-economic behavioural orientations of women in the Tatarstan labour market

The article presents the results of a study aimed at determining the behavioral trajectories of women as a significant demographic segment, differentiated by gender, and identifying its significance for the process of formation and transformation of the market mechanism of the labor market in the Republic of Tatarstan. Forecasts of the impact of modern strategies of women’s labor behavior are substantiated from the standpoint of their determinant as a factor of demographic self-determination. In this regard, the strategies of women’s labor behavior identified by the authors allow to form a conceptually and methodologically justified model for managing the labor market mechanism in Tatarstan, including in relation to predictive decisions of a preventive policy for managing the market mechanism in order to optimize the use of the female labor force, creating demographically favorable conditions for increasing the number of qualified labor force, reduction of social tension and growth of socio-economic activity of the population in relation to the formation, distribution and use of labor force. The analysis of the obtained data allowed to identify four types of the correlation of the reproductive behavior of women and the strategy of labor activity chosen by them. The main types of labor behavior of women in the Republic of Tatarstan were identified as materially oriented, “health-caring”, “family-centered” and professionally oriented. The women interviewed in the study determine their reproductive strategies in accordance with the peculiarities of their self-realization in life, as well as with predetermined behavioral attitudes. Most women lack independence in issues of reproductive self-regulation. Consequently, in the choice of the nature and amount of work, most likely, women will not be completely self-sufficient. The authors also found that most women are focused on creating a family and having children. Thus, the main strategy of work behavior for them will be to combine work with childcare. However, it is worth noting that there are also a large number of young girls who belong to the “professional orientation” group and participate in primary and secondary professional integration. The results of the study led to the conclusion that the younger generation of women in the Republic of Tatarstan is focused to a greater extent on labor activity than on reproductive on

Impact of social networks on the choice of place of delivery among ethnic women in Bangladesh

ObjectivesThis study aims at exploring the present situation of the delivery place and the impact of social networks on the choice of delivery place among the ethnic women in Bangladesh. MethodsData were collected through face to face interviews using a structured questionnaire from a sample of 205 married ethnic - Garo and Mandai - women in Madhupur Upazilla of Tangail district. A stepwise binary logistic regression analysis is run to explain the impact of social networks on the choice of delivery place (the place where the women actually did deliver a baby) of ethnic women in Bangladesh. ResultsDescriptive statistics show that of the total deliveries 37.7% among Garo- and 13% among Mandai women take place in institutions (hospitals and clinics). The regression model reveals that next to ethnicity and husband's occupation, network size has a significant positive relationship, while reproductive health-related constraints have a significant negative relationship with the choice of delivery place of ethnic women. Based on these, this study suggests that if the social networks of ethnic women increase, the probability of their institutional delivery may increase. ConclusionThe personal social networks of ethnic women may motivate them on their choice of institutional delivery in Bangladesh. This finding may contribute to the development of pathways to stimulate ethnic women's reproductive health behaviour in the developing countries context.

Epidemiological Analysis of Outcomes of Small Obstetric Operations

Relevance Тhe Priorities in the field of the state demographic policy of our country are to improve the reproductive health of the population, improve the system of obstetric care and the quality of medical care. An urgent problem is the quality of life of women in the postpartum period after injuries of the soft tissues of the birth canal and the use of obstetric in natural delivery (episiotomy, vacuum extraction of the fetus, the imposition of obstetric forceps, manual placental separation and manual examination of the uterine cavity). High rates of non-communicable complications confirm the need for further study of long-term effects and ways to improve the quality of care for women in the postpartum period. There is insufficient information on the dynamics of health indicators in the postpartum period, on the relationship of violations with various socio-hygienic, behavioral, medical and organizational factors acting in relation to the woman in this period. Obstetric operations and soft tissue injuries of the birth canal are also a risk factor for the development of purulent-septic infections in the postpartum period. For a comprehensive analysis of the factors determining reproductive behavior in women during rehabilitation, it is necessary to assess the effectiveness of measures in the postpartum period, the risks of long-term consequences for women after small obstetric operations. Aims. Summarize the available literary data and present modern views on the problem of the quality of life of women in the postpartum period after obstetric operations with natural delivery. Materials and methods. Analysis of publications on the quality of life in the postpartum period in the databases PUBMED, E-Library, Google Scholar, etc. from 2013 to 2019. The study includes sources in Russian and English, containing information on the frequency of various obstetric benefits for natural delivery, infectious and non-infectious complications after their implementation. Results. Birth canal Injuries (ruptures of the cervix, vaginal walls, perineum and vulva) account for up to 40% of cases [1,2]. Noted that in nulliparous they occur in 73%, while the performance of obstetric benefits (episiotomy, forceps, vacuum extraction) reach 90%. The frequency of perineal ruptures of the III degree ranges from 0.4 to 5% [3]. The frequency of ruptures of the perineum I-II degree does not have an official form of accounting and registration, also refers to injuries of the birth canal. According to official statistics, the frequency of application of vacuum extraction of the fetus in the European countries ranges from 2.8% to 16.7% of the total number of births, and in our country according to the Department of monitoring, analysis and strategic development of health, Ministry of health of the Russian Federation, the frequency of execution of vacumm extraction of the fetus and the imposition of obstetric forceps is the 11.04 and 0.56 per 1000 births. The number of women who have had these situations in childbirth is very high. At this stage, epidemiological monitoring of the postpartum period of women is reduced to monitoring infections in the field of surgery and predictors of the development of the infectious process. However, given the multifactorial nature of the problem, monitoring the quality of life in the postpartum period after these operations remains without due attention. First of all, they note negative changes after obstetric operations, such as a feeling of pain when walking, sitting, lifting weights. Unpleasant sensations in the sutures remain in the postpartum period for 2–3 weeks after discharge. After 3–4 weeks, the feeling of pain is replaced by itching and burning, which also gives discomfort to the woman. The situation is complicated by the lack of women's psychological support in this matter from the doctor. Many patients are afraid to address and ask questions about personal feelings and sexual life at the reception. Sexual dysfunction may be formed after performing obstetric benefits or injuries to the soft tissues of the birth canal, actually should be regarded as maternal morbidity. The introduction of epidemiological surveillance of the psychophysiological state of women after small obstetric operations will allow timely work with patients about the features of the postpartum period, to increase the percentage of satisfaction with the quality of services provided in obstetric institutions. The study of risk factors for the development of non-infectious diseases in women after childbirth allows us to calculate the degree of effectiveness of the planned medical and social measures for the prevention of negative consequences. Conclusions: The Development and implementation of epidemiological surveillance of women who have received obstetric benefits or had soft tissue injuries of the birth canal will allow to form an understanding of the rules and tactics of postpartum management, as well as to improve the quality of life of women during rehabilitation.

Dynamics of indexes of reproduction and selection in three generations of the urbanized population

Aim. Due to the fact that women's reproductive behavior has been changing with the development of civilization, from natural uncontrolled fertility in the early stages of human development to reproductive technologies in our time, the aim of this work was to study the direction and intensity of natural selection index and changes of the quantitative characteristics of reproduction in women residents of Kharkiv in three successive generations. Methods. Material was collected in 1990 and 2017. The obstetric and gynecological history of the inhabitants of Kharkiv was studied. The first generation included 589 women who were born in 1900–1925, 244 women born in the period 1928–1955, made up the second generation, 288 women who were born in 1956–1979, were assigned to third generation. Results. The total selection index is reduced from 0.56 in the first generation to 0.29 and 0.28 in the second and third generations, respectively. Over the eighty-year period, the differential fertility rate has decreased. The percentage of women with pathological pregnancies increased from 4.9 in the first generation, to 22.5 in the second and 18.4 in the third generation. Conclusions. The total selection index in the Kharkiv population into three successive generations has decreased by half: from 0.56 to 0.28, the index of differential mortality has decreased by almost four times.
 Keywords: reproductive characteristics, Kharkov population, Crow's index, selection, generations.

A mixed methods study exploring methadone treatment disclosure and perceptions of reproductive health care among women ages 18–44 years, Los Angeles, CA

IntroductionOpioid use disorder (OUD) and methadone treatment are increasing among women ages 18–44 years old, a population with unique healthcare needs. Despite this increase, there is little research on the healthcare experiences of women with OUD, particularly experiences with reproductive healthcare. MethodsWe designed a sequential, mixed-methods study in three Los Angeles methadone clinics. In the first phase, we conducted in-depth interviews with women in methadone treatment (n = 22) (September–December 2016). After thematic coding and analysis, we designed and administered a survey to understand patterns in women's experiences and reproductive health knowledge, attitudes, and behavior (n = 50) (January–April 2018). We conducted descriptive statistics, then integrated the quantitative and qualitative findings to contextualize and understand perceptions and experiences with healthcare providers among women in methadone treatment. ResultsWe found that women experienced and anticipated that providers would treat them poorly when they disclosed that they were in methadone treatment for OUD. Women's actual experiences with disclosure, shared in in-depth interviews, varied by whether they had disclosed their status intentionally or inadvertently. Approximately one-third (37%) of survey respondents thought a healthcare provider would scold them if they became pregnant; however, all who had been pregnant in the past while on methadone (n = 11) reported disclosing methadone treatment during pregnancy to their provider. Under a quarter of all women (22%) said having a healthy pregnancy while on methadone was likely or very likely. These perceptions were reinforced by negative experiences with providers, or, in many cases, women in the survey reported that they had never discussed the recommendations for a healthy pregnancy while on methadone with a healthcare provider. DiscussionWomen experience and anticipate experiencing negative interactions with their healthcare providers if and when they disclose their methadone treatment. These perceptions and experiences impact subsequent treatment seeking and disclosure. The majority of women did not discuss pregnancy with healthcare providers. To improve quality of care, healthcare providers can provide a safe space for women to disclose methadone treatment through nonjudgmental communication that intentionally alleviates stigma. Additionally, healthcare providers should understand medical guidelines and laws/policies around methadone during pregnancy and communicate this understanding to all patients who may wish to become pregnant or who are at risk for unintended pregnancy.