Obstetrics and gynecology clinics of North America
-
Obstet. Gynecol. Clin. North Am. · Mar 2019
Review(At Least) Once in Her Lifetime: Global Cervical Cancer Prevention.
Cervical cancer disproportionately burdens lower-resourced settings, in which nearly 90% of cervical cancer and cervical cancer-related deaths occur. Targeting human papillomavirus (HPV) by prophylactic HPV vaccination in young adolescent girls and HPV-based screening in mid-adult women offers the most cost-effective strategy to reduce cervical cancer burden worldwide and mitigate the health disparities in cervical cancer burden between low-resourced and high-resourced settings. Political and social will, along with the necessary financial investments, will be necessary to realize the opportunity for significant global reductions in the cervical cancer burden. Perfect cervical cancer prevention (total eradication) is practically and financially unrealistic.
-
Obstet. Gynecol. Clin. North Am. · Mar 2017
ReviewAddressing Health Care Disparities Among Sexual Minorities.
There is evidence of health disparities between sexual minority and heterosexual populations. Although the focus of lesbian, gay, bisexual, and transgender health research has been human immunodeficiency virus/acquired immunodeficiency syndrome and sexually transmitted infection among men who have sex with men, there are health disparities among sexual minority women. Using the minority stress framework, these disparities may in part be caused by individual prejudice, social stigma, and discrimination. To ensure equitable health for all, there is urgent need for targeted culturally sensitive health promotion, cultural sensitivity training for health care providers, and intervention-focused research.
-
Obstet. Gynecol. Clin. North Am. · Mar 2017
ReviewReassessing Unintended Pregnancy: Toward a Patient-centered Approach to Family Planning.
Underserved women, especially those with low incomes and from racial and ethnic minorities, experience a disproportionate share of unintended pregnancies in the United States. Although unintended pregnancy rates are general markers of women's health and status, they may not accurately capture women's experiences of these pregnancies or their social circumstances. A patient-centered approach to family planning optimizes women's reproductive preferences, is cognizant of historical harms and current disparities, and may more comprehensively address the issue of unintended pregnancy. Clinicians, researchers, and policy makers can all adopt a patient-centered approach to help underserved women regain their reproductive autonomy.
-
Obstet. Gynecol. Clin. North Am. · Mar 2017
ReviewHearing the Silenced Voices of Underserved Women: The Role of Qualitative Research in Gynecologic and Reproductive Care.
In order to provide effective evidence-based health care to women, rigorous research that examines women's lived experiences in their own voices is needed. However, clinical health research has often excluded the experiences of women and minority patient populations. Further, clinical research has often relied on quantitative research strategies; this provides an interesting but limited understanding of women's health experiences and hinders the provision of effective patient-centered care. This article defines qualitative research and its unique contributions to research, and provides examples of how qualitative research has given insights into the reproductive health perspectives and behaviors of underserved women.
-
Obstet. Gynecol. Clin. North Am. · Mar 2017
ReviewIs There a Shortage of Obstetrician-Gynecologists?
Projections of supply and demand for obstetricians-gynecologists suggest a current minimal or modest shortage that will worsen in the future. The US adult female population is expected to increase by more than 20% by 2045 and represents a key driver for increased demand for health care services. ⋯ The gradual increase in proportion of ob-gyns who are women coincides with desires for more work-life balance and earlier retirement from clinical practice. As the supply of advanced practice providers of women's health services grows, the need for more ob-gyns could be less to meet the projected demand.