Journal of women's health
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Journal of women's health · Dec 2021
Racial/Ethnic Differences in Socioeconomic Status and Medical Correlates of Trial of Labor After Cesarean and Vaginal Birth After Cesarean.
Objectives: Black and Latinx women have higher rates of trial of labor after cesarean (TOLAC) compared with White women, but lower rates of vaginal birth after cesarean (VBAC). This study examined potential racial/ethnic differences in correlates of TOLAC and VBAC. Materials and Methods: The analytic sample includes term, singleton hospital births to women with one prior cesarean in birth certificate data for 2016. ⋯ Overweight and obesity were associated with lower probability of VBAC, but the magnitude of this association was smaller for Black and Latinx women than for White women. Conclusions: More research is needed to elucidate the underlying decision-making processes that lead to these associations. Future work should focus on ensuring equity in access to VBAC-supportive providers and hospitals and fostering informed decision-making after a prior cesarean.
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Journal of women's health · Dec 2021
Crowdsourcing the Public's Perception and Systematic Review of Nipple Inversion and Its Repair.
Background: Nipple inversion is a common condition seen in 10% of females. Patients often present with physical insecurities and difficulty breastfeeding and would be best counseled initially by a primary care provider. We examined the body of literature and public perception of nipple inversion to provide a patient-centered perspective of the condition and its repair. ⋯ Conclusion: Nipple inversion may be more common than previously reported. The majority of people would consider surgical correction, advice someone with nipple inversion to undergo repair for breastfeeding, and consult online resources for more information. Methodological and reporting limitations of existing evidence limit conclusions regarding the superiority of operative techniques with regard to patient satisfaction and breastfeeding outcomes.
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Purpose: Pathological worry is a major feature of anxiety in the peripartum, and we sought to examine the factor structure, validity, and reliability in the peripartum of a scale used to measure worry in the general population (the Penn State Worry Questionnaire, PSWQ). Materials and Methods: Pregnant/postpartum women (N = 295) were followed at up to six visits, which included completion of the PSWQ and other psychological scales. Principal components analysis, descriptive statistics, paired t-tests, chi-square tests, and mixed linear regression models were used to evaluate scale reliability and validity. ⋯ Conclusions: The PSWQ correlated well with all psychological scales, especially TRAIT anxiety. Worry appears to be a major component of perinatal anxiety, and the PSWQ may be a valuable tool for more precise specification of the clinical phenotypes of perinatal anxiety. Limitations include a study population that was largely Caucasian and well educated, so study results require replication in a more diverse population.
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Background: Our aim was to evaluate trends of childbearing during medical training, evaluate issues of infertility, and measure institutionalized barriers to childbearing among women physicians. Materials and Methods: Attendees of a national women physician's leadership conference (Brave Enough Women Physicians Continuing Medical Education Conference) were surveyed during the conference using Qualtrics© (2019 Qualtrics, Provo, UT), in September 2019. Survey data included demographics, training level, and medical specialty. ⋯ Demands of training (72.9%) and long work hours (61.5%) were the most cited factors in delaying having children as reported by women physicians. Conclusions: This study reported several barriers related to fertility, family planning, and reproductive health among women physicians. Our results highlight the need for a paradigm shift in fertility awareness and institutional support for childbearing during medical training, postgraduate training programs, and in practice for women in medicine.
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Journal of women's health · Dec 2021
Douching or Perineal Talc Use and Prevalent Fibroids in Young African American Women.
Background: Black women are at an increased risk of developing fibroids, but the cause is unclear. Douching and perineal talc use are common lifestyle exposures among Black women, and may be risk factors for fibroid development. Materials and Methods: This cross-sectional study consisted of Black women 23-35 years of age in the metropolitan Detroit area (n = 1693) without prior diagnoses of fibroids and intact uteri. ⋯ This association was seen with both large and small total fibroid volume [OR (95% CI) volume ≤2:00 cm3: 1.23 (0.81-1.86)] and [OR (95% CI) volume ≥2:00 cm3: 1.39 (0.93-2.09)]. Conclusion(s): Our results suggest that perineal talc use is associated with increased fibroid prevalence. Additional research is warranted to investigate perineal talc in relation to fibroid risk in a prospective setting and to conduct laboratory work on potential tumorigenic effects of talc in the myometrium.