Journal of midwifery & women's health
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J Midwifery Womens Health · Jan 2008
Injury: a major cause of pregnancy-associated morbidity in Massachusetts.
Hospital visits (inpatient, observation, and emergency department) for injury occurring during pregnancy and 1 year postpartum (the pregnancy-associated period) were examined to determine groups at risk for injuries. The dataset included maternally linked vital records and hospital visit data for a population-based cohort of women residing in Massachusetts who delivered between 2002 and 2003 (n = 100,051). Injury morbidity (injury visits with International Classification of Diseases, Ninth Revision, Clinical Modification codes 800-999.99 or selected E-codes) was evaluated by individual woman- and visit-based analyses. ⋯ More than 4% of women had a motor vehicle collision, which was the leading cause of injury. The risk for injury was significantly higher among women who were adolescents (relative risk [RR] = 1.88; 95% confidence interval [CI], 1.78-1.98), black non-Hispanic (RR = 1.88; 95% CI, 1.80-1.97), those who had public insurance (RR = 2.50; 95% CI, 2.41-2.56), or those who had less than a high school education (RR = 2.48; 95% CI, 2.39-2.58) when compared with referent groups. Clinical guidelines for preconception and pregnancy-associated periods should include recommendations for injury history assessment and preventative counseling for women.
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J Midwifery Womens Health · Sep 2007
ReviewSexually compulsive/addictive behaviors in women: a women's healthcare issue.
Sexually compulsive/addictive behavior is a pattern of sexual behaviors that cause distress and/or impairment of social functioning. It is marked by obsessive thoughts, compulsive behaviors, and the individual's inability to stop the behaviors despite negative consequences. ⋯ Sexually compulsive/addictive behavior is associated with a number of health consequences, including sexually transmitted infections, unwanted pregnancies, abortions, and violence. It is important for providers to have an understanding of the addiction process, assessment, diagnosis, and interventions for these women.
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J Midwifery Womens Health · Jul 2007
Long-acting and permanent contraception: an international development, service delivery perspective.
Recent scientific findings about long-acting and permanent methods of contraception underscore their safety, effectiveness, and wide eligibility for individuals who desire them. This has led to new guidance from the World Health Organization to inform national policies, guidelines, and standards for service delivery. ⋯ The health, development, and equity rationales that historically have underpinned and energized the international family planning effort remain valid and relevant today. Despite the other compelling challenges faced by the international health community, the need to make family planning services more widely available is pressing and should remain a priority.
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Management of the third stage of labor has been an issue of discussion, concern, and continued debate for the past two decades. Despite the many strategies employed and the divergent approaches to care and philosophies espoused, there has not been a significant, consistent reduction in the postpartum hemorrhage rates reported in industrialized countries in recent times. This article explores the strategies that have been and are currently being used in an effort to reduce the risk of postpartum hemorrhage.