Journal of women's health
-
Journal of women's health · Dec 2024
"No One Really Prepares You": Lived Experiences of Women Division Chiefs in Academic Medicine.
Objectives: Although women have comprised at least 50% of medical school classes for decades, women remain underrepresented in leadership positions. Although the proportion of women division chiefs in the U. S. academic medical centers is small, it is growing. ⋯ The following major themes emerged: (1) Most women are externally motivated to seek out the division chief role, (2) formal preparation or leadership development prior to taking on the section chief role is lacking, (3) leaders (both men and women) who sponsor and mentor women facilitate their success, and (4) women leaders face specific challenges including promotion delays and lack of recognition of their authentic leadership styles. We found the following minor themes: (1) Lack of formal onboarding to the division chief role; (b) positive influence of women in senior leadership roles within the institution; and (c) barriers to leadership roles include feeling undervalued in preceding leadership roles, navigating parenthood, and need for broader sponsorship. Conclusion: Opportunities to support the continued growth of women division heads include more deliberate recruitment and succession planning; a structured, formal onboarding process; acceptance of authentic leadership styles; and more practical ways to support parenting.
-
Journal of women's health · Dec 2024
Change in Postpartum Visit and Contraception Rates Pre-COVID-19 to Post-Lockdown in Six U.S. Federally Qualified Health Centers.
Background: Postpartum care, including contraception, benefits maternal health and decreases mortality, which increased in the United States with COVID-19. Pandemic disruptions to postpartum health care access in vulnerable populations are not well understood. We utilize electronic health record (EHR) data for prenatal patients (n = 2,265) at six urban Federally Qualified Health Centers (FQHCs) from one year prepandemic (January 1, 2019) through one year after the first stay-at-home orders ("lockdown") (March 31, 2021). ⋯ After adjustment, PPV and contraception decreased by 9.3 percentage points (-13.1, -5.4), while PPV only was stable (-0.4 [-4.3, 3.6]). Conclusions: These findings suggest a substantial impact of the COVID-19 pandemic on postpartum care in FQHCs and community health centers. Supply and demand drivers require further examination to inform strategies to improve postpartum care access and subsequent maternal health outcomes.
-
Journal of women's health · Dec 2024
Evaluating the Effect of Depression, Anxiety, and Post-Traumatic Stress Disorder on Anti-Müllerian Hormone Levels Among Women Firefighters.
Objective: To assess whether depression, anxiety, and post-traumatic stress disorder (PTSD) are associated with serum anti-Müllerian hormone (AMH) levels. Study Design: We used data from a sample of women firefighters from the Fire Fighter Cancer Cohort Study. Participant demographics, reproductive history, and self-reported clinical diagnosis of anxiety, depression, and PTSD were collected with serum for AMH analysis at enrollment. ⋯ When individuals with concurrent PTSD were excluded, the association between anxiety ceased to be statistically significant (26.7%Δ, 95% CI: -17.9, 92.6). Conclusion: A history of clinically diagnosed anxiety or PTSD was associated with statistically significantly lower AMH levels. This association offers insight into the potential biological mechanisms through which mental health conditions may influence reproductive health.
-
Journal of women's health · Dec 2024
Severe Maternal Morbidity and Other Perinatal Complications Among Black, Hispanic, and White Birthing Persons With and Without Physical Disabilities.
Background: People with physical disabilities are at increased risk of adverse perinatal outcomes, including severe maternal morbidity (SMM). Risks may be even greater for disabled people in minoritized racial or ethnic groups, but little is known about this intersection. Methods: We analyzed linked hospital discharge and vital records data from California, 2008-2020. ⋯ For most other outcomes, risks were also largest for disabled Black birthing persons, followed by disabled Hispanic birthing persons. Conclusions: Black and Hispanic people with physical disabilities are highly likely to experience SMM and are at increased risk for other complications and adverse outcomes. Efforts are needed to understand underlying causes of these disparities and develop policies and practices to eliminate them.