Women

The initial presentation of COVID-19 to the world left many in the medical community perplexed about its true nature and potential impact on individuals. Many investigations into the pathology of the virus resulted from this; however, studies were limited in the obstetric community, especially in high-risk communities. Each pandemic wave (Alpha, Delta, Omicron) had different transmission rates and inflicted different COVID-19 severity levels among those infected. This study aimed to determine if the effects of COVID-19 on maternal and infant outcomes varied by pandemic waves. This is an observational cohort study utilizing women enrolled in a COVID-19 pregnancy study. A review of 374 electronic medical records of women who received care at the University of Mississippi Medical Center after testing positive for SARS-CoV2 was conducted. During the Alpha pandemic wave, women contracted COVID-19 significantly earlier in pregnancy; however, higher rates of COVID-19 infection occurred during the Omicron pandemic wave. During the Delta pandemic wave, more women were morbidly obese and were likely to deliver significantly earlier, and, when compared to infants born during the Omicron pandemic wave, the infants born during the Delta wave weighed significantly less. The effects of COVID-19 on high-risk pregnant patients may deviate from previous reports, indicating a need for further investigation of the biological and social factors that may lead to these differences. Studies into the effects of COVID-19 in pregnancy remain limited and this study provides valuable insight into how varying COVID-19 strains affected a high-risk obstetric community. Full article

The world of science is increasingly looking for answers to the question of how specific dietary components affect the risk of chronic diseases and assessing their potential to alleviate the severity of individual diseases. This research concerns both the assessment of the benefits of using individual dietary components and those of nutritional models. Endometriosis, due to its chronic and inflammatory nature, is also a topic of interest among scientists, who seek to support its course through proper nutrition. In endometriosis, great interest is focused on dietary patterns such as an anti-inflammatory diet, a gluten-free diet, a low-FODMAP diet, or a Mediterranean diet. An anti-inflammatory diet primarily focuses on fresh vegetables, fruits, seeds, nuts, whole grain products, and healthy sources of protein and fats, including mono- and polyunsaturated fatty acids, eliminating highly processed products, meat products, trans fats, and refined sugars. It is believed that this type of diet may contribute to reducing the severity of endometriosis symptoms and help reduce inflammation. The aim of the review is to identify the main trends in the field of diets supporting the treatment of endometriosis in the last 5 years. Full article

Gender-based violence (GBV) is an age-long issue plaguing societies all over the globe. Over the years, GBV perpetrated against women has been justified and legitimized by patriarchal and hegemonic masculine structures. This study explored the role of hegemonic masculinities and transnational cultural conflicts in creating a suitable environment for GBV against women newcomers from the continent of Africa. The study gathered perspectives of African immigrants and of the service providers working in immigrant-serving organizations. The paper adopts a qualitative approach and hinges on the transnationalism framework. This framework argues that immigrants maintain connections while transitioning to their destination countries. In such processes, immigrants carry with them their beliefs about cultural norms and hegemonic masculinity, of their country of origin. A total of 13 women immigrants and 20 service providers were purposively recruited to participate in the semi-structured interview. The interviews were recorded and transcribed verbatim. The data were analyzed thematically and organized using Nvivo version 12. Findings show that African immigrant women in Canada disproportionately bear the burden of GBV due to hegemonic masculinities. The construction of masculinity in immigrant populations is heavily reliant on the communities of origin. As such, the prevailing systems during and post migration such as—unstable residency status, fear of deportation, fear of social and family sanctions and stigmatization, economic dependence on their spouses, and fear of retaliation from their spouses creates an environment that supports toxic masculinity. The study recommends comprehensive and culturally sensitive programmes and services to support African immigrants affected by hegemonic masculinity and GBV. Full article

Many gender differences in mental and physical health, along with accompanying social needs have been reported by those suffering with schizophrenia. The goal of this review is to explore the literature on migrant and culturally diverse women suffering with schizophrenia to develop and implement effective strategies in specialized clinics. In general, we found higher rates of mental health symptoms among migrant and refugee women when compared to men. Several factors contribute to this vulnerability, suggesting that women may experience more pre- and post-migration-related trauma. In clinical populations, migrant status, region of origin, age at the time of migration, migration with family or alone, and migration to join family determine the risk of schizophrenia and the clinical course of the illness. Refugee migrant women have a higher risk of schizophrenia than non-refugee migrants and native-born populations. Migration is associated with poor access to mental health services; low social support, lack of awareness of services, and language barriers may mediate this association. These findings call for specific assessments on migrant women, interventions (e.g., focus groups), and improvement in current programs. In our clinics, we have recently incorporated assessment and intervention strategies that may be effective in our programming. Full article

Women who receive substance use treatment have a particular classification of sensitivity to European drugs and drug use (according to the EMCDDA). The average level of women’s treatment is lower than men’s across Europe, while women’s abandonment is higher than men’s. The purpose of this study was to examine the factors associated with problems for women who use drugs, analyzing several psychological and social factors (gender, substance use, mental health, source of economic support, legal status, and abuse). Methodology: This was a quantitative study. Data on 2179 people receiving rehabilitation treatment were obtained from the EuropASI survey. The dependent variables in this study were (1) a patient’s known history of addiction and mental illness; (2) primary drug use; (3) drug use in their lifetime and the past month; (4) mood in their lifetime and the past month, physical condition, and sexual abuse history; (5) mental illness in their lifetime and the past month (including suicide attempts); (6) legal status in their lifetime and the past month; (7) and source of income in the past month and (8) and the number of patients. The factor of gender was taken as a dichotomous variable (male–female). The confidence interval used was 95%. Results: In summary, we found that women had consumed more alcohol, used more drugs, and suffered more from depression, anxiety, and suicidal ideation than men, both during their lifetimes and in the past month. In addition, women were more likely than men to be stigmatized for prostitution because their financial support came mainly from colleagues, friends, and family, as well as from prostitution. Finally, women had experienced more violence (emotional, physical, and sexual) during their lifetimes and in the last month than men. Conclusion: There appears to be a need to develop a comprehensive treatment network for addictive behaviors from a multifactorial perspective, including harm reduction, psychosocial support, and recovery programs; furthermore, targeting specific groups with special needs, such as women, especially those with mental health problems, women with alcoholism, and abused women, it also seems important to develop adaptive recovery programs within addictive behavior treatment networks. Full article

According to the United Nations Population Fund, approximately every two minutes, a woman dies, totalling approximately 800 deaths per day for reasons related to a maternal causes. Therefore, within the Sustainable Development Goals of the 2030 Agenda, the goal is to reduce the global maternal mortality rate to less than 70 deaths per 100,000 live births by 2030. We aim to analyse strategies to reduce maternal mortality in the context of the Sustainable Development Goals, identify barriers that hinder their implementation, and analyse the impact of the COVID-19 pandemic on their achievement. We performed a scoping review of the following databases and distributors of specialised information in the health area: PubMed, Medes, Lilacs, Cuiden, Cinahl, Scopus, SciELO, and websites of the United Nations (UN), United Nations Population Fund (UNFPA), and Cooperanda. A total of 24 articles were reviewed. The results obtainded determined that reviewed studies agree that despite efforts to reduce maternal mortality, significant social and structural barriers still exist in developing countries that slow the implementation of strategies to protect maternal health, especially in the most at-risk populations, and the improvement of the health system. The main strategy consists of increasing the number of deliveries attended by qualified personnel, which is the greatest indicator of progress in reducing maternal mortality. To conclude, Economic, social, and political barriers remain in developing countries in the context of the Sustainable Development Goals. The intervention that has shown the most success is the attendance of deliveries by qualified personnel. It is essential to prioritise maternal care, triangular cooperation, and effective connection between the different Sustainable Development Goals. Full article

Childhood abuse is a significant factor in the development of borderline personality disorder (BPD) and many physical health disorders, including polycystic ovary syndrome (PCOS) and fibromyalgia. This study aimed to examine the prevalence of PCOS and fibromyalgia in women with BPD compared to the general population. Additionally, it compared the prevalence of these conditions in women who experienced different types of childhood abuse (emotional, physical, or sexual). Participants were identified from the Multidisciplinary Alfred Psychiatry research centre’s Women’s Mental Health Clinic database, including 150 women diagnosed with BPD. Clinicians collected information on PCOS, fibromyalgia, and trauma history. Results showed higher rates of PCOS (17.3%) and fibromyalgia (8.7%) in women with BPD compared to general population samples. Emotional abuse was associated with the highest PCOS prevalence (22.8%), while co-occurring physical, sexual, and emotional abuse was linked to the highest fibromyalgia prevalence. These findings highlight the significant prevalence of PCOS and fibromyalgia in women with BPD and their association with childhood abuse. Full article

Family planning (FP) services are crucial interventions for improving maternal and child health outcomes and promoting gender equity. However, ensuring equitable access to these services remains a significant challenge, particularly in countries like Pakistan, where sociocultural norms, economic disparities, and geographic barriers hinder FP uptake. This study utilized spatial analysis techniques, including hotspot analysis, to investigate geographic disparities in FP uptake in Pakistan using data from Pakistan Demographic and Health Surveys (PDHS) conducted in 2006–2007 and 2017–2018. ArcMap 10.1 was used for spatial analysis and Stata 12.0 for statistical analysis. Results revealed significant spatial variations in FP uptake, with urban areas exhibiting higher uptake rates than rural regions. Hotspot analysis identified dynamic changes in contraceptive prevalence rates (CPR), with significant clustering in some regions and dispersion in others. It also identified areas with high unmet need, low intention to use FP services, and preference for family size (>3 children), highlighting the need for targeted behavioral change interventions. This innovative spatial approach provides nuanced insights for policymakers and program planners to develop targeted interventions based on localized data to improve FP service delivery, mitigate disparities, and ultimately advance efforts to improve maternal and child health outcomes. The application of geospatial analysis is an effective tool for enhancing program planning, evaluation, and resource allocation in diverse geographical contexts. Full article

Women undergoing breast surgery with axillary lymph node dissection continue to experience complications in the ipsilateral upper limb, impacting their daily lives and quality of life. This study aims to evaluate the relationship between quality of life (overall and specific) and the functional capacity of patients undergoing breast surgery with lymph node clearance before and after implementing a rehabilitation program. This short-term quasi-experimental study included 48 women, and the design did not include control groups. Data collection involved a sociodemographic and clinical characterization questionnaire, the Disabilities of the Arm, Shoulder and Hand questionnaire, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and Breast Cancer questionnaires. The study revealed a significant negative association between all general functional subscales and the functionality of the ipsilateral upper limb, except for emotional (p 0.941) and cognitive (p 0.927) functional scales. The functional capacity of the ipsilateral upper limb following surgery influences the quality of life of women undergoing breast surgery. The study concluded that monitoring the quality of life is essential to underscore the importance of providing access to rehabilitation to minimize or eliminate these changes, thus contributing to a better quality of life for these women. Full article

Women’s pregnancy increases the odds of developing anxiety, depression, and low self-esteem. Physical activity can reduce the severity of maternal mental disorders and postpartum symptoms. The aim was to evaluate self-esteem, anxiety, and physical activity patterns among healthy pregnant women during three gestational trimesters (GTs). A longitudinal prospective study involving 248 Portuguese pregnant women, monitored for a year during all GTs, was conducted. Self-reported questionnaires were used to collect personal and obstetric data, and Rosenberg’s Self-Esteem Scale, Zung Anxiety Scale, and a Pregnancy Physical Activity Questionnaire were applied. A total of 152 women presented valid follow-up data considered for analysis. All test scores do not present normality (p < 0.001). Over the gestational trimesters, the Zung anxiety scores did not show a significant change between GTs. However, the self-esteem values reduced significantly from 1st to 2nd GT: (1st GT = 43.94 (±9.94) [95%CI: 42.37 to 45.53]; 2nd GT = 27.27 (±9.64) [95%CI: 25.74 to 28.81]; 3rd GT = 25.71 (±10.52) [95%CI: 24.04 to 27.39]; p < 0.001), remaining stable in the last GT. Moderate to vigorous (2nd GT = 73.43 (±88.69) [95%CI: 59.34 to 87.54]; 3rd GT = 65.05 (±82.65) [95%CI: 51.92 to 78.19]; p = 0.008), vigorous (1st GT = 0.45 (±3.95) [95%CI: 0.83 to 2.08]; 2nd GT = 1.63 (±3.52) [95%CI: 1.07 to 2.19]; 3rd GT = 0.81 (±2.16) [95%CI: 0.46 to 1.15]; p = 0.0475), and light (2nd GT = 101.68 (±48.77) [95%CI: 93.93 to 109.44]; 3rd GT = 98.42 (±49.05) [95%CI: 90.62 to 106.22]; p < 0.001) physical activity levels were significantly reduced throughout the GTs, but the time spent in sedentary activities did not change. In this follow-up study, it was possible to identify a critical point in the 2nd GT, when the drastic reduction in physical activity levels coincided with periods of lower self-esteem scores. However, anxiety levels do not seem to change over GTs. Full article

Taking into account the growing increase in the political and social interest in childbirth, it is critical to identify and explore the instruments that allow and enhance its humanization today. The use of vocalization seems to be a powerful and empowering tool for a positive birthing experience when used by women in labour. A scoping review will be developed to map the evidence and knowledge about women’s vocalization in the first and second stages of labour using the Joanna Briggs Institute methodology. The search will be carried out on the Web of Science, EBSCOhost Research Platform (selecting Academic Search Complete, MedicLatina, Cinahl plus with full text, Medline with full text), Willey Online Library, PubMed and Scopus. The National Register of Theses and Dissertations and the Open Scientific Repository of Portugal will also be taken into account. Three reviewers will conduct data analysis, extraction and synthesis independently. The outcomes pretend to be a source for identifying the use of vocalization by women in labour, in order to guide further research on the subject. This study was prospectively registered with the Open Science Framework on the 21 May 2024, with registration number DOI 10.17605/OSF.IO/Z58F4. Full article

Intimate Partner Violence (IPV) is a risk factor for depressive disorders and other harms to women and their pregnancy. There is a need for longitudinal evidence to assist with understanding the subgroups of women including those from refugee background affected by IPV. We recruited women at their prenatal visit from three antenatal clinics in Australia (January 2015–March 2016). A total of 1335 women, 650 (48.7%) born in Australia and 685 (51.3%) from refugee backgrounds, completed baseline assessment; then, Time 2 follow-up was at 6 months and Time 3 follow-up was at 24 months post birth. The WHO Intimate Partner Violence (IPV) measure was used. Latent class growth analysis grouped individuals based on trajectories of IPV across three time points. A three-step process identified characteristics associated with respective latent class membership. Similar three-class solutions were observed across both cohorts, composed of Limited IPV (64% and 48% Australian-born and refugee background, respectively); Changing IPV (31%; 46%)—various combinations of IPV categories across time; Combined IPV (4%; 6%)—IPV at all time points, all transitioning to the combined physical and psychological abuse category at Time 3. Older age, fewer children, being in a couple, having a better partner, family and friend relationships, fewer partner trauma events, and fewer living difficulties emerged as protective factors for the changing and combined categories, with a distinct pattern for the refugee cohort. The findings assist with understanding and defining of the highest risk group for targeting interventions to prevent IPV, and the unique protective factors across the two IPV-affected classes for women born in Australia and those who arrived as refugees. Full article

In Ghana, some pregnant women may not seek antenatal care due to the unavailability of such services in their communities, although preventive service can help reduce maternal mortality with high-quality care. This study aimed to understand the antenatal care opinions of Ghanaian mothers who sought antenatal care, the barriers they faced, and their suggestions for improvement in antenatal care in Ghana. This study’s data were collected in the Central and Ashanti regions in Ghana from June 2023 to January 2024. Four hundred and fifty mothers in Ghana who indicated that they had given birth within the last 10 years of the data collection period took part in the study. Our findings revealed that 93.6% of Ghanaian mothers perceived their antenatal care to be of good quality due to proper examinations, friendly provider–patient interactions, reassurance, fair treatment, and proper education, whereas 6.5% of Ghanaian mothers perceived their care to be of poor quality due to long wait times, impersonal interactions, inadequate facility resources, and barriers to communication. For Ghanaian mothers to receive better outcomes for themselves and their children, it is worth improving healthcare facilities, healthcare provider preparedness, local transportation, and addressing financial constraints to go from suboptimal to optimal health services. Full article

The human papillomavirus (HPV) is implicated in nearly all cases of cervical cancer. While most HPV infections resolve spontaneously, persistent infections can lead to high-grade lesions and cancer. Traditionally, cervical screening has relied on cervical cytology, but since 2016, HPV mRNA testing has been integrated to enhance the detection of high-grade lesions (CIN2+) in women with normal cytology. This study, conducted at the Department of Clinical Pathology at UNN from 2016 to 2019, evaluates the impact of HPV mRNA testing on quality assurance, with follow-up adhering to national guidelines through December 2022. Among 98,648 cervical samples analyzed, 61,635 women exhibited normal cytology. Of these, 752 (1.2%) tested positive for HPV mRNA, specifically targeting HPV types 16, 18, and 45. Upon the re-evaluation of the index cytology, 70.7% of these women retained normal cytology findings, while biopsies identified high-grade lesions (CIN2+) in 34% and severe lesions (CIN3+) in 14%. Notably, older women constituted a larger portion of the normal cytology group but a smaller percentage of those testing positive for HPV and exhibiting significant lesions. This underscores the effectiveness of HPV mRNA testing in promptly identifying high-grade lesions, highlighting its potential to significantly reduce cervical cancer incidence through targeted re-evaluation of a small, at-risk population. Full article

Women have unique experiences with mental health challenges that require relevant strategies and interventions that effectively support their mental health. Empowerment interventions that vary in nature and format have the potential to play a key role in supporting women’s mental health. The purpose of this scoping review is to outline empowerment interventions targeting improvement in the mental health of women living in Canada.A search was undertaken using major databases including Medline, Cumulative Index for Nursing and Allied Health Literature (CINAHL), PsycINFO, and the Cochrane Library for studies published between 2013 and 2023. A total of 243 articles were identified, from which 12 were ultimately included in this review. All included studies were conducted in Canada but were diverse in design, setting, and sample size. A total of four types of interventions were identified including mental health and emotional awareness, reading, peer support, and skill building and engagement. The findings of the review inform key insights for mental health care and service providers to focus on sustainable outcomes for women’s mental health. The findings also guide the need for a systematic review to appraise the existing empowerment interventions for women’s mental health outcomes. Full article

This study addresses the problem of psycho-verbal violence experienced by women seeking divorce in Tehran (Iran’s capital) and aims to investigate the influence of cultural capital on the occurrence of this form of violence. The study surveyed 207 women aged 20 to 60 seeking divorce in Tehran using random sampling. The data were collected using questionnaires developed by the researchers and focused on cultural capital and cases of psycho-verbal violence against women. Pearson’s correlation coefficient test and regression multivariant analyses were used for statistical analysis. The results indicate a significant inverse relationship between women’s cultural capital and psycho-verbal violence against women, encompassing embodied cultural capital, objectified cultural capital, and institutionalized cultural capital (p < 0.001). Regression analyses revealed that the incidence of psycho-verbal violence experienced by women decreases when embodied cultural capital increases first, followed by objectified and institutionalized capital. Conversely, an increase in the number of children correlates with an increase in psycho-verbal violence. Full article

Menstruation-related symptoms in young women are associated with lifestyle factors such as stress. This study aimed to examine menstrual conditions, menstruation-related symptoms, and types of stress in Japanese female students from their first to second years of university and the association between menstruation-related symptoms and stress levels. This prospective longitudinal cohort study utilized a self-reported web survey with the Menstrual Distress Questionnaire (MDQ) at three timepoints (2, 8, and 14 months) following admission and continuing into the second year. Data from 33 out of 102 students, who were followed throughout the study period, were used for analysis. Results indicated a trend towards changes in menstrual regularity, with the lowest (48.5%) at timepoint 1 and the highest (72.7%) at timepoint 3, and significant changes in perceived bleeding amount. Stress related to study and academic performance was consistently highest, with significant differences across timepoints. Intra-menstrual MDQ scores were highest at timepoint 1, with significant variations in impaired concentration severity across timepoints. Significant correlations were found between the MDQ scores and stress related to health and personality at all timepoints, and to future prospects, friendships, study, and academic performance at different timepoints. In short, stress related to academic performance, along with a strong correlation between MDQ scores and specific stress types, such as health and personality, was observed across all timepoints. This implies the need to provide new students with health education regarding menstruation and stress management before specific timepoints. Full article

This study investigates the effectiveness of inclusion measures for women with disabilities at a public university in southern Spain, aiming to understand their needs and experiences. Utilizing a gender perspective, the research engaged 12 women from various university roles in semi-structured interviews, later analyzed using NVivo 20, and organized into categories assessing institutional resources, working/academic conditions, and the interplay of disability and gender. Findings indicate that, despite no direct discrimination based on sex, the patriarchal social framework still fosters gender and inclusion gaps. Peer support emerges as a protective factor, whereas obstacles such as resource scarcity, access challenges, and a lack of awareness about disability measures pose risks. The study highlights the need for enhanced visibility of inclusive measures and the development of agile, individualized policies. It underscores the importance of raising awareness, particularly about non-visible disabilities, through educational initiatives. Full article

Maternal health is a critical public health issue worldwide, with Sub-Saharan Africa (SSA) facing severe challenges in maternal mortality and morbidity. Despite global efforts, progress in SSA remains slow. The Sustainable Development Goals highlight the need for urgent action in this area. Value-based healthcare presents a promising approach to enhance maternal health in SSA by maximising health outcomes for mothers and newborns, enriching patient experiences and efficient resource use. However, the impact and implementation of value-based healthcare in Sub-Saharan Africa’s maternal health sector are not well studied. To evaluate the effectiveness and value of value-based healthcare interventions in improving maternal health outcomes in Sub-Saharan Africa. A systematic review was carried out drawing on articles from six databases published between 2000 and 2024. The results suggest that VBHC can significantly improve maternal health, evidenced by successful implementations like obstetric units in Sierra Leone and integrated care in South Africa, which improved outcomes and cost-effectiveness. The success of value-based healthcare interventions hinges on addressing access to quality care, infrastructure, and socioeconomic barriers. Further research is essential to confirm value-based healthcare efficacy in SSA and guide policy for better maternal health outcomes. Full article