Women's Reproductive Health Research Articles

Impact of Covid-19 Pandemic upon Iraqi women’s Sexual and Reproductive Health at Primary Health Care Centers


 
 
 Objectives: The aim of this study was to assess the repercussions of the COVID-19 pandemic on the sexual and reproductive well-being of women.
 Methods: Employing a descriptive design with a correlational approach, the study was conducted between November 2021 and July 2022. The sample consisted of (180) women within the reproductive age range of 17 to 49 years. This non-probability 'purposive sample' was chosen deliberately. Data analysis was conducted using descriptive and correlational statistics.
 Results: The investigation divulged significant findings. A considerable proportion of women (55.6%) reported being unable to access contraception during the pandemic. Moreover, (45%) experienced unintended pregnancies amid the pandemic. Additionally, concerns linked to the pandemic led to a lack of follow-up visits for (73.3%) of participants. The study also highlighted the distressing issue of domestic violence during COVID-19: Over half of the women (51.1%) reported exposure to domestic violence, attributing it to prolonged periods of their husbands staying at home. Furthermore, (51.7%) noted an escalation in domestic violence, and (38.3%) revealed that their husbands showed inadequate concern for their sexual well-being.
 Conclusion: The COVID-19 pandemic detrimentally affected the sexual and reproductive health of women, manifested through challenges encountered during pregnancy, childbirth, postpartum phases, and family planning. Furthermore, a significant proportion of women faced an increased risk of domestic violence due to the pandemic and the extended presence of their husbands at home.
 
 

Perbandingan Keberagaman Makanan Berdasarkan Minimum Dietary Diversity For Women (MDDW) bagi Kesehatan Reproduksi Wanita

This study aims to analyze the comparison of food diversity based on the Minimum Dietary Diversity for Women (MDDW) for women's reproductive health. The method used is quantitative with a cross-sectional study approach. The results showed differences in food diversity among women of childbearing age in Kutacane City and Lawe Loning Aman Village, Southeast Aceh District. In conclusion, women of childbearing age in Kutacane City consume a variety of foods from more than five food groups compared to women of childbearing age in Lawe Loning Aman Village, who are less diverse in achieving minimum food intake. Therefore, it is hoped that health workers will provide education regarding food diversity in realizing women's reproductive health.
 
 Keywords: Diversity of Food, Reproductive Health, Women

A Case Report of Female Genital Schistosomiasis in a 29-Year-Old Patient From a Teaching Hospital in North-Eastern Nigeria

Schistosomiasis is a chronic parasitic infection that affects more than 220 million people worldwide, particularly in sub-Saharan Africa (SSA). One of the complications of urogenital Schistosomiasis is female genital Schistosomiasis (FGS) which is associated with the presence of S. haematobium eggs and related pathologies in the genitals of women living in or visiting schistosomiasis-endemic areas. FGS is a neglected and misdiagnosed gynaecological disease with un-specific clinical symptoms and signs. It adversely affects the quality of sexual and reproductive health of women and is a risk factor for HIV and HPV infections in affected women. Diagnosis of upper genital tracts FGS is mostly accidental from histological examination of excised tissues. This is a case description of a rare incidence of female genital Schistosomiasis of the upper genital tract in a 29-year-old, single woman from a Schistosomiasis-endemic area of Adamawa State, Nigeria who presented with a history of lower abdominal pain of a month duration and abdominal swelling. Physical examination revealed a pelvic mass of 16 weeks' gestation size and histological examination confirmed the presence of Schistosome ova in the excised ovarian cyst. Clinicians should have a high index of suspicion of female genital Schistosomiasis (FGS) in women and girls in Schistosomiasis-endemic areas. Deliberate programs for healthcare workers and outreach programs for the communities must be designed and implemented to raise awareness about genital Schistosomiasis.

Abortion law in Aotearoa New Zealand.

This article outlines the history of abortion law in Aotearoa New Zealand from colonial times to the present. The struggle for law reform has been long and difficult, with marches and rallies, protests and placard-waving, and firebombing of abortion clinics. Aotearoa New Zealand elections have been fought on this issue. Abortion was regulated here under the Crimes Act until 2020. Finally, after 150 years, procuring an abortion in Aotearoa New Zealand is no longer a crime, it is a women's healthcare issue along with others relating to women's reproductive health, including obstetric, contraceptive, sexually transmitted disease and other gynaecological care. The new law promotes autonomy, reproductive health, patient safety and health equity. The abortion struggle serves as an illustration of our changing political and social landscape, with a public move from conservative towards more liberal values. However, the issue continues to divide people, and events in the United States have shown how quickly change can occur, with their Supreme Court overturning Roe v Wade and states now banning abortions. We should not be complacent.

Benefits of Adolescent Women's Reproductive Health Records as a Basis for Screening Preconception Care: A Research and Development Study

The health status of women is one of the factors that can affect the status of pregnancy. To avoid risky pregnancies and produce healthy babies, it is very important for a woman to take care of her reproductive health. One of the efforts is to conduct early detection on a regular basis starting from the age of teenagers. This developmental research was carried out using the Four-D model, to obtain a simple early detection medium in preconception care. Sixty selected young women participated in a limited trial. Respondents who participate in a limited-scale trial will go through 3 stages. The data obtained were analyzed descriptively. The success of using the application as a function of simple screening media for preconception care reached 96.67%. It was identified that 57% of adolescent girls were detected to have health problems such as poor nutritional status and anemia. A total of 71.7% stated that this application applies very well on adolescent girls in order to keep them healthy as an initial step in preparation for pregnancy. As many as 73.3% of respondents stated that the developed application provided new knowledge related to preconception preparation. There is strong evidence that the resulting media performs well as a simple early detection tool for preconception care. Therefore, it needs to be refined to provide more optimal results.
 Keywords: screening, preconception, adolescent

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 Relationship between Body Mass Index and Menstrual Cycle of Female Students in SMK Negeri 2 Gorontalo

Introduction: The menstrual cycle is a regularly coordinated hormonal process in a woman's body which can be an indicator to describe a woman's reproductive health. Riskesdas (2018) shows that 11.7% of Indonesian youth experience menstrual cycle disorders. Body Mass Index (BMI) can be a factor that can interfere with the menstrual cycle, so the purpose of this study was to analyze the relationship between Body Mass Index (BMI) and the menstrual cycle in female students at SMK Negeri 2 Gorontalo.Method: This study used a cross-sectional design. The sample was selected using a probability sampling technique utilizing simple random sampling with a total sample of 173 people, the instruments used were scales and meters for body mass index data and menstrual cycle questionnaires. The study was conducted in November 2022. The relationship between BMI and the menstrual cycle was tested using the Spearman correlation test.Results: Out of 173 respondents whose data were analyzed, 128 respondents (74%) had a normal BMI, 19 respondents (11%) were underweight, and 26 respondents (15%) were overweight. Among the total respondents, 117 (67.6%) had a normal menstrual cycle, while 56 (32.4%) had an abnormal cycle. There were 14 respondents (10.9%) with normal BMI, 18 respondents (94.7%) with underweight BMI, and 24 respondents (92.3%) with overweight BMI who had an abnormal menstrual cycle. There was a significant correlation between BMI and menstrual cycle among female students of SMK Negeri Gorontalo, with a p-value of 0.019.Conclusion: significant association exists between BMI and menstrual cycle among SMK Negeri 2 Gorontalo female students. This study can serve as a recommendation for the school to provide information regarding reproductive health, particularly menstrual cycles.

The Relationship of Preconception and Early Pregnancy Isoprostanes with Fecundability and Pregnancy Loss.

Although redox stress likely plays an important role in reproductive health, the utility of peripheral biomarkers of oxidative stress, such as isoprostanes, during the periconception period remains underexplored. We evaluated the relationship between isoprostanes during preconception and gestational week 4 and women's reproductive health outcomes. The Effects of Aspirin in Gestation and Reproduction trial (2007-2011) enrolled 1228 women attempting pregnancy and followed them for up to 6 menstrual cycles and throughout pregnancy if they became pregnant. We measured creatinine-adjusted, log-transformed isoprostanes 8-iso-prostaglandin F 2α (8-iso-PGF2α), its metabolite 2,3-dinor-iPF2α-III, and stereoisomers 5-iso-PGF2α-VI and 8,12-iso-iPF2α-VI in urine during preconception and 4 weeks gestation. We evaluated pregnancy among participants in each menstrual cycle using human chorionic gonadotropin (hCG) and defined pregnancy loss as observed loss following positive hCG. We calculated fecundability odds ratios (FOR) and 95% confidence intervals (CI) using discrete-time Cox proportional hazards models and relative risk of pregnancy loss using adjusted log-binomial models. Higher preconception isoprostane levels were associated with lower fecundability [e.g., FOR = 0.89; 95% CI = 0.81, 0.97 per interquartile range (IQR) increase in 8-iso-PGF2α]. Among 797 pregnancies, isoprostane levels increased from preconception to 4 weeks gestation (e.g., mean difference = 0.12; 95% CI = 0.10, 0.14 ng/mL for 8-iso-PGF2α) and higher isoprostanes at 4 weeks gestation were associated with lower risk of pregnancy loss (e.g., RR = 0.79; 95% CI = 0.62, 1.00 per IQR increase in 8-iso-PGF2α). Preconception urinary isoprostanes may identify redox stress pathways associated with lower fecundability. However, the increase in isoprostanes into gestational week 4 and the associated lower risk of pregnancy loss may suggest confounding by latent factors in early pregnancy.

Adolescent Pregnancy and Child Marriage: Current Situation in Indonesia

Adolescent pregnancy and child marriage is a common public health problem worldwide.  It is one of the key issues concerning reproductive health of women not only in developing countries but also in developed countries, including Indonesia.  The international community is also aware that the problem of Adolescent pregnancy and child marriage is a very serious problem. The general implication is that women and children will be at risk in various aspects, related to unwanted marriages, forced sexual intercourse, pregnancy at a very young age, as well as an increased risk of transmission of HIV infection, other sexually transmitted diseases, and cervical cancer. The purpose of the article is to review current situation and issues on adolescent pregnancy and child marriage in Indonesia.Â

Co-creating sexual and reproductive health interventions with adolescents: the experience from Rajasthan

Despite a clear policy recognition of the need for special programmatic attention for adolescents to ensure access to sexual and reproductive health information and services, almost all existing programs in India face critical challenges in effectively delivering sexual and reproductive health information and services, which leads to early marriages and teenage pregnancies. Teenage pregnancies directly threaten women's sexual and reproductive health and well-being. States like Rajasthan with high adolescent pregnancy rates demand better solutions. IPE Global implemented project Udaan to reduce teenage pregnancies in the state, adopting a 360 degree approach. Improving Sexual and Reproductive Health was one of the critical components of the project, and a human-centred design method was adopted to co-create an effective sexual and reproductive health intervention relevant to the community. The human-centred design approach incorporated multiple steps, including formative research, iterations, prototyping and piloting. Five potential interventions emerged after a series of iterative explorations. The in-school SRH intervention has emerged as an excellent model of reaching adolescents effectively in culturally sensitive rural geographies in the evaluation of the pilot, which successfully covered over 10,800 adolescent boys and girls across 66 government high schools in the Bari block of Dholpur. An independent evaluation suggested a significant increase in the awareness of contraceptive methods in the intervention area from 24 per cent to 50 per cent. Contraceptive self-efficacy, a measure of girls' agency, increased by 18 per cent in the intervention area. Further, qualitative findings showed a significant improvement in SRH awareness and service utilization.

Contraceptive use among women seeking an early induced abortion in Sweden.

In spite of societal efforts to strengthen women's sexual and reproductive health in Sweden, many women have unmet contraceptive needs and the abortion rate remains high. The aim of this study was to investigate contraceptive use among abortion-seeking women. Swedish-speaking women seeking an induced abortion up to the end of gestational week 12 at seven hospitals filled out an anonymous paper questionnaire between January and June 2021. Data were analyzed using frequencies and cross-tabulations, and the Chi-square test was used to compare age-groups. Valid percentages are presented. In total, 623 women participated. Median age was 29 years and 13% were born outside the Nordic countries. In the year preceding the abortion, condoms (37%, n = 228) were the most commonly used contraceptive method, followed by short-acting reversible contraception (SARC) (35%, n = 213) and withdrawal (25%, n = 152). Around one in five (n = 113) had not used any method in the year preceding the abortion. Sixteen percent (n = 96) had changed contraceptive method in the last year. At the time around conception, 15% (n = 90) reported use of SARC and 2% (n = 12) of long-acting reversible contraception (LARC). Four out of 10 women (n = 268) reported non-use of contraception at the time around conception, with a higher proportion among adolescents (70%, n = 30, P = 0.001). Among the women who responded to why they had not used any method (n = 387), the main reasons were that they did not believe they could become pregnant at that time (37%, n = 144) or had negative experiences from using contraceptives (32%, n = 123). A majority (88%, n = 527) planned to use contraception after the abortion. Of the women who had decided on method, 55% (n = 271) planned to use LARC, and 38% (n = 188) planned to use SARC. The unmet need for contraception appears to be high among abortion-seeking women in Sweden. Many had discontinued contraception use during the last year, and the main reasons for avoidance were beliefs that one could not become pregnant and negative experiences of contraceptives. The underestimation of pregnancy risk indicates limited fertility awareness, thus our recommendation would be to strengthen the sexual and reproductive knowledge among this group.

Empowering Women’s Health: Transforming Maternal Health Care in India

An indicator of the reproductive health of women in an area is the maternal mortality rate. A lot of women in the reproductive age range pass away from difficulties during, during, or related to pregnancy, childbirth, or abortion. Maternal mortality, a critical indicator of a country's healthcare system and women's well-being, has been a persistent concern in India. The study examines the progress and strategies employed in reducing maternal mortality in India. The research explores the initiatives undertaken by the Indian government under the National Health Mission to address maternal health. The findings serve as a valuable resource for policymakers, healthcare professionals, and researchers striving to advance women's sexual and reproductive health rights while reducing maternal mortality globally.
 KEYWORDS: Maternal mortality, Reproductive health, women, India

Impact of vitamin B12 on the reproductive health of women with sickle cell disease: a narrative review.

Sickle cell disease (SCD) poses an increased risk of infertility, pregnancy complications and maternal and perinatal mortality among women of reproductive age. This risk is particularly higher for women in sub-Saharan Africa, where the disease burden is highest and access to comprehensive health care is limited, as well as in other countries with a high SCD prevalence due to migration. Disease modifying treatments for SCD could directly and indirectly harm the ovaries, potentially compromising quality and quantity of existing oocytes. Therefore, it is essential to explore alternative interventions, such as nutritional modifications that are less harmful and cost-effective in order to improve reproductive outcomes, and enhance the overall well-being of both mother and child in this population. Maintaining optimal levels of B12 may possibly provide benefits to the ovaries and pregnancy by decreasing homocysteine levels, increasing nitric oxide (NO) bioavailability, and promoting antioxidant and anti-inflammatory activities. Individuals living with SCD are more susceptible to vitamin B12 (B12) deficiency. However, there is a lack of clinical data investigating the relationship between systemic levels of B12, its supplementation, and reproductive outcome measures in SCD women. Therefore, this review aims to examine the current evidence regarding the impact of SCD on female reproductive health and the role of B12 in the reproductive biology of women living with SCD.

Scholarly activity following National Institutes of Health Women’s Reproductive Health Research K12 training—a cohort study

National Institutes of Health funding to address basic reproductive health for common female conditions remains disproportionately low, in part because of low success rates of grant applications by obstetrician-gynecologists. This study aimed to evaluate the scholarly productivity of individuals supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Women's Reproductive Health Research K12 career development award, created to advance careers of obstetrician-gynecologist physician-scientists. We performed a cohort study of individuals who completed at least 2 years of Women's Reproductive Health Research training by June 30, 2015, and had at least 5-year follow-up. Earliest training start date was December 1, 1998. Primary outcomes from public data sources (National Institutes of Health RePORTER, PubMed, iCite) were (1) number of total and R01 National Institutes of Health grants as principal investigator; (2) numbers of total and first and last author publications; and (3) median and highest publication impact factor measured by the relative citation ratio. Secondary outcomes from an email survey subcohort were total number of research grants, federally funded grants, and number of National Institutes of Health grants as coinvestigator; institutional promotions and academic appointments, national and National Institutes of Health leadership roles; and career and mentorship satisfaction. Outcomes were recorded at 5, 10, and 15 years postgraduation, and aggregate anonymized data were divided into 3 groups using Women's Reproductive Health Research completion dates: June 30 of 2005, 2010, and 2015. Temporal trends were assessed. Results were stratified by gender, number of awarded grant cycles (1-2 vs 3-4), and specialty type. Analyses used Fisher exact or Pearson chi-square tests, and Mantel-Haenszel tests of trend. The distribution of the cohort (N=178) by graduation completion date was: on or before June 30, 2005 (57 [32%]); July 1, 2005 to June 30, 2010 (60 [34%]); and July 1, 2010 to June 30, 2015 (61 [34%]). Most participants were female (112 [64%]) and maternal-fetal medicine trained (53 [30%]), followed by no fellowship (50 [28%]). Of the 178 participants, 72 (40%) received additional National Institutes of Health funding as a principal investigator, 45 (25%) received at least 1 R01, and 23 (13%) received 2 to 5 R01s. There were 52 (31%) scholars with >10 first author publications, 66 (39%) with >10 last author publications, and 108 (63%) with ≥25 publications. The highest relative citation ratio was a median of 8.07 (interquartile range, 4.20-15.16). There were 121 (71%) scholars with relative citation ratio ≥5, indicating >5-fold greater publication impact than that of other National Institutes of Health-funded scientists in similar areas of research. No differences by gender, institution, or temporal trends were observed. Of the full cohort, 69 (45.7%) responded to the survey; most self-identified as women (50 [73%]) and White (51 [74%]). Our findings suggest that the infrastructure provided by an institutional K award is an advantageous career development award mechanism for obstetrician-gynecologists, a group of predominantly women surgeons. It may serve as a corrective for the known inequities in National Institutes of Health funding by gender.

National medical eligibility criteria for contraceptive use 2023: focus on women's reproductive health: A review

Reproductive health care involves helping families in this area with the provision of the necessary information. This is recognized as a key step in improving the health of men, women and children and is a fundamental human right. Everyone has the right to have access to a correct understanding of reproductive health care, choice of contraceptive method and the opportunity to benefit from scientific progress in this area. Over the past 35 years, significant progress has been made in the development of new contraceptives: the content of hormones in combined oral contraceptives has significantly decreased, inert intrauterine contraceptives have been replaced by more progressive, levonorgestrel-containing ones including low-dose generation. Combined hormonal compounds were synthesized in the form of injections, patches and vaginal rings, progestogen implantable and injectable contraceptives. Women who use contraceptives must take into account the state of health (including the presence of endocrine pathology) in order to use them without harm to their health. Based on the World Health Organization Medical Eligibility Criteria for Contraceptive Methods 2015, the Russian Medical Eligibility Criteria for Contraceptive Methods 2023 is designed to become an important tool in daily practice of doctors.

Effect of intervention based on the 5A self-management model on the improvement of behaviors related to women's reproductive health after legal abortion

Legal abortion has adopted many beneficial measures to prevent the birth of fetuses with congenital anomalies and maintain the health of high-risk mothers. However, abortion has its own complications and, thus, most mothers need care in this regard. The aim of this study was to determine the effect of self-management model on behaviors related to the reproductive health of mothers after legal abortion. This clinical trial study was conducted on 72 women who had legal abortion with the permission from Isfahan forensic medicine. The intervention was conducted using the 5A self-management model. The control group received the usual health system cares. Data collection tool was a researcher-made questionnaire of behaviors related to reproductive health, which was completed before and two months after the intervention by the two groups. The total mean score of the behavior (P < 0.001) and its dimensions (Prevention of post-abortion complications with P = 0.01, Prevention of sexually transmitted infections, satisfactory sexual function and family planning with P < 0.001) in the intervention group two months after the outset of the intervention was significantly higher than before the intervention. The total mean score of the behavior (P < 0.001) and its dimensions (Prevention of post-abortion complications with P = 0.002, Prevention of sexually transmitted infections, satisfactory sexual function and family planning with P < 0.001) two months after the outset of the intervention in the intervention group was significantly higher than the control group. Based on the results, this educational model can be emphasized to promote reproductive health behaviors of women after abortion.Clinical trial protocol link: https://www.irct.ir/user/trial/55184/view.

SEX EDUCATION PADA USIA SEKOLAH DASAR (11-12 TAHUN) DI SD KANISIUS SENGKAN YOGYAKARTA

11-12 years old are the end period of children where children start to think logically,critically, creatively, and scientifically. Introducing sex to children is a must for educators and parents. The purpose of this activity is to provide education about reproductive health to adolescents, at SD Kanisius Sengkan Yogyakarta. The methods used were lectures, discussions and screening of educational videos on male and female reproductive organs, the impact of gadget addiction on watching pornography. This community service activity was carried out by a team of lecturers of the D III Nursing study program STIKES Wira Husada Yogyakarta, with a target of 95 students. As a result of this activity, students received information about reproductive health in men and reproductive health in women, as well as the impact of gadget addiction on pornographic content. The conclusion of this activity is that students know about reproductive health in adolescents and are expected to take care of themselves by applying healthy reproduction and avoiding addiction to pornographic content.

Obesity and Miscarriage.

Obesity affects nearly 40% of reproductive-aged women and has serious implications for women's overall and reproductive health. Women with an elevated body mass index (BMI) have higher rates of anovulation and irregular menses, lower success with fertility treatment, and significantly higher rates of pregnancy complications, such as hypertension/preeclampsia, gestational diabetes, and preterm delivery. Many studies have also shown an association between obesity and early pregnancy loss. However, the causal association between BMI and miscarriage has not been elucidated, likely due to the multifactorial effects that BMI may have on early pregnancy development. In addition, BMI as an isolated variable fails to capture other relevant confounding health risk factors, such as nutrition, physical activity, and insulin resistance. In this review, we will summarize the current literature demonstrating the association between BMI and miscarriage, highlight the research that attempts to explain the association, and finally provide data on therapeutic interventions to improve reproductive outcomes in women suffering from obesity and early pregnancy loss.

Key findings on women's reproductive health: the Korea Nurses' Health Study.

Key findings on women's reproductive health: the Korea Nurses' Health Study.

Peer Group Method Can Improve Adolescent Behavior in Prevention of Cervical Cancer

Cervical cancer is a disease that often attacks women's reproductive health. So we need a communityempowerment in the form of training of trainers to improve cervical cancer prevention behavior inadolescents with a peer group method approach. Facilitation activities include counseling on peer group learning methods, conducting training on improving behavior in preventing cervical cancer with the peer group method for adolescents. Activities carried out for one month, starting from planning, preparation, implementation and evaluation. This training was able to increase knowledge, attitudes and behavior in preventing cervical cancer in adolescents. It is recommended that participants who have been trained to be tutors are able to train their peers at school and in their neighborhood.