Journal of women's health
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Journal of women's health · Jan 2025
Attitudes and Experiences Regarding Communication About Maternal Vaccination: Qualitative Findings from Non-Hispanic Black Pregnant People.
Comprehensive prenatal care incorporates recommended vaccines to help protect the mother, the pregnancy, and the infant from adverse health outcomes and severe illness from vaccine preventable diseases (VPDs). However, vaccinations during pregnancy remain underutilized, often influenced by concerns about vaccine safety and low perception of disease risk. Self-reported vaccine hesitancy among pregnant people in the United States has significantly increased in the last few years, and influenza and Tdap (tetanus, diphtheria, and pertussis) vaccination rates have declined. ⋯ While characteristics and perceptions associated with hesitancy to vaccinate during pregnancy are documented in existing literature, more information is needed on promising communication practices preferred by subgroups of pregnant persons, particularly Black pregnant people who have higher rates of illness from VPDs and greater risk of pregnancy-related complications. This article summarizes literature on the current landscape of prenatal vaccination, discusses qualitative findings from focus groups with non-Hispanic Black pregnant people, and describes promising practices for communicating with this group about vaccination. Promising practices include specifying the benefits of vaccination for both the pregnant person and the infant, outlining potential risks, and emphasizing the overall importance of vaccination during pregnancy, while also acknowledging that many non-Hispanic Black pregnant people may have health concerns they perceive as superseding vaccination.
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Journal of women's health · Jan 2025
Abortion After Pregnancy Occurrence with Contraceptive Use Among Veterans.
Objective: Many people report becoming pregnant while using contraception. Understanding more about this phenomenon may provide insight into pregnant people's responses to and healthcare needs for these pregnancies. This study explores the outcome (e.g., birth, miscarriage, abortion) of pregnancies among Veterans in which conception occurred in the month of contraceptive use. ⋯ In adjusted models, pregnancies occurring in the month of contraceptive use were significantly more likely to end in abortion (aOR: 1.76, 95% CI: 1.42-2.18) than live birth. Conclusions: Pregnancy while using contraception is common among Veterans; these pregnancies are more likely to end in abortion than live birth. Given widespread restrictions to reproductive health services across much of the United States, ensuring Veterans' access to comprehensive care, including abortion, is critical to supporting reproductive autonomy and whole health.
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Journal of women's health · Jan 2025
Trends in Pregnancy Outcomes in People with Sickle Cell Disease and Medicaid Insurance (2006-2018).
Background: Although the risk of pregnancy-related morbidity and mortality in people with sickle cell disease (SCD) is well established, limitations in data sources and heterogeneity in outcome reporting hinder the ability to make meaningful comparisons between historical and contemporary populations. This study used a national administrative claims database to compare pregnancy outcomes in people with SCD between 2006-2011 and 2012-2018. Materials and Methods: Pregnant females aged 16-44 years with SCD were identified from the Centers for Medicare and Medicaid Service Analytic eXtract, along with a control cohort of pregnant people. ⋯ When comparing infant deliveries in 2006-2011 to those occurring in 2012-2018, all pregnancy-related complications except preterm delivery, including maternal death, occurred at similar or higher frequencies in more recent years. Conclusions: Between 2006 and 2018, maternal death occurred in approximately 1 out of every 200 publicly insured people with SCD in the year following infant delivery. Our work confirms, on a national-level, that pregnancy-related outcomes in people with SCD in the United States have not improved with time, and that some complications have in fact increased in frequency.