Journal of women's health
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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
Impact of Race, Ethnicity, Insurance, and Procedural Timing on Sterilization Method.
Objective: This study aims to determine if race, ethnicity, insurance status, or procedural timing is associated with type of sterilization procedure. Methods: A retrospective cohort study was performed. The study population included women who underwent elective sterilization at one institution from January 2010 to December 2020. ⋯ On multivariate analysis, both non-Hispanic Black (odds ratio [OR] 0.54 95% confidence interval [CI] 0.32-0.89) and Asian (OR 0.23 95% CI 0.06-0.72) individuals were less likely to have salpingectomy (SL) when compared with non-Hispanic White individuals. On sensitivity analysis for procedures after January 1, 2016, non-Hispanic Black (OR 0.31 95% CI 0.17-0.56), Hispanic (OR 0.31 95% CI 0.14-0.66), and Asian (OR 95% CI 0.04-0.54) individuals were less likely to have when compared with non-Hispanic White individuals. Conclusion: Tubal ligation is more frequently performed in our health system, and we identified critical disparities in performance of SL for sterilization.
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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.
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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.