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Women's Gynecological and Reproductive Health—Issues and Challenges

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 9902

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Special Issue Editor

Dr. Dell Horey

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Guest Editor

Department of Public Health, School of Psychology & Public Health, La Trobe University, Melbourne, VIC 3086, Australia
Interests: women’s sexual health; women’s reproductive health; health service disruptions; inequalities in health; health outcomes; COVID-19 pandemic; climate change; vulnerability

Special Issue Information

Dear Colleagues,

Despite gains over the past two decades, progress in social and health outcomes for women has stalled or been eroded in recent years, as outlined in the latest report on gender equality and progress towards the United Nation’s Sustainable Development Goals. The COVID-19 pandemic has contributed to unsettling setbacks in women’s sexual and reproductive health, and urgent attention is needed to address issues contributing to inequalities across the globe. Along with the pandemic, the growing impact of climate change also means that women face disproportionate challenges to their health in the contemporary world. It is critical to understand the nature, complexity and extent of these challenges as well as the types of strategies that must be put in place to overcome them, if we are to improve and sustain the future health and wellbeing of all women. This Special Issue offers an opportunity to raise the relationships between women’s sexual and reproductive health and the issues affecting our social and physical environments. Topics in this issue could look at: the impact of health service disruption, such as delayed breast and cervical cancer screening; reproductive health, food insecurity and access to safe drinking water; barriers and facilitators of women’s education, family planning and access to abortion services; support for perinatal bereavement, including access to natural environments; women’s status and sexual health; body image and ageing women.

Dr. Dell Horey
Guest Editor

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Keywords

women’s sexual health
women’s reproductive health
health service disruptions
inequalities in health
health outcomes
COVID-19 pandemic
climate change
vulnerability

Published Papers (5 papers)

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Research

15 pages, 559 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on Women’s Perinatal Mental Health: Preliminary Data on the Risk of Perinatal Depression/Anxiety from a National Survey in Italy

by Laura Camoni, Fiorino Mirabella, Antonella Gigantesco, Sonia Brescianini, Maurizio Ferri, Gabriella Palumbo, Gemma Calamandrei and on behalf of the Perinatal Mental Health Network

Int. J. Environ. Res. Public Health 2022, 19(22), 14822; https://doi.org/10.3390/ijerph192214822 - 10 Nov 2022

Cited by 7 | Viewed by 2491

Abstract

Increasing evidence suggests that during the COVID-19 pandemic, anxiety and depression during the perinatal period increased. The aim of the study is to estimate the prevalence of risk for both maternal depression and anxiety among women attending 18 healthcare centres in Italy during the SARS-COV-2 pandemic and to investigate the psychosocial risks and protective factors associated. It was divided into a retrospective phase (2019, 2020, and the first nine months of 2021) and a prospective phase (which began in November 2021 and it is still ongoing), which screened 12,479 and 2349 women, respectively, for a total of 14,828 women in the perinatal period. To evaluate the risk of anxiety and depression, the General Anxiety Disorder-7 (GAD-7), the Edinburgh Postnatal Depression Scale (EPDS), and an ad hoc form were used to collect sociodemographic variables. In the prospective study, the average age of the women is 31 (range 18–52) years. Results showed that the percentage of women who had EPDS score ≥9 increased from 11.6% in 2019 to 25.5% in the period ranging from November 2021 to April 2022. In logistic regression models, the variables associated with the risk of depression at a level ≤0.01 include having economic problems (OR 2.16) and not being able to rely on support from relatives or friends (OR 2.36). Having the professional status of the housewife is a lower risk (OR 0.52). Those associated with the risk of anxiety include being Italian (OR 2.97), having an education below secondary school level (OR 0.47), having some or many economic problems (OR 2.87), being unable to rely on support from relatives or friends (OR 2.48), and not having attended an antenatal course (OR 1.41). The data from this survey could be useful to determine the impact of the SARS-COV-2 pandemic on women and to establish a screening program with common and uniformly applied criteria which are consistent with national and international women’s mental health programs. Full article

(This article belongs to the Special Issue Women's Gynecological and Reproductive Health—Issues and Challenges)

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16 pages, 367 KiB

Open AccessFeature PaperArticle

Mistreatment of Women during Childbirth and Associated Factors in Northern West Bank, Palestine

by Ibtesam Medhat Mohamad Dwekat, Tengku Alina Tengku Ismail, Mohd Ismail Ibrahim, Farid Ghrayeb and Eatimad Abbas

Int. J. Environ. Res. Public Health 2022, 19(20), 13180; https://doi.org/10.3390/ijerph192013180 - 13 Oct 2022

Cited by 4 | Viewed by 1789

Abstract

Mistreatment of women during childbirth is a clear breach of women’s rights during childbirth. This study aimed to determine the prevalence and associated factors of mistreatment of women during childbirth in the north of West Bank, Palestine. A cross-sectional study was conducted among 269 women within the first 16 weeks of their last vaginal childbirth to understand the childbirth events by using proportionate stratified random sampling. An Arabic valid questionnaire was used as a study instrument. Simple and multiple logistic regression analyses were conducted to determine the factors associated with each type of mistreatment. The mean age of the women was 26.5 (SD 4.77) years. The overall prevalence of mistreatment was 97.8%. There were six types of mistreatment. Nine factors were significantly associated with the occurrence of one or more types of mistreatment. Delivery at a public childbirth facility was associated with all of the six types (aAdjOR: 2.17–16.77; p-values < 0.001–0.013). Women who lived in villages (aAdjOR 2.33; p-value = 0.047), had low education (aAdjOR 5.09; p-value = 0.004), underwent induction of labour (aAdjOR 3.03; p-value = 0.001), had a long duration of labour (aAdjOR 1.10; p-value = 0.011), did not receive pain killers (aAdjOR: 2.18–3.63; p-values = 0.010–0.020), or had an episiotomy or tear (aAdjOR 5.98; p-value < 0.001) were more likely to experience one or more types of mistreatment. With every one-hour increase in the duration of labor, women were 1.099 times more likely to experience a failure to meet the professional standard of care. Women were less likely to experience mistreatment with increasing age. Women with increasing age (aAdjOR: 0.91–0.92; p-values = 0.003–0.014) and parity (aAdjOR 0.72; p-value = 0.010) were less likely to experience mistreatment. Awareness of women’s fundamental rights during childbirth, making the childbirth process as normal as possible, and improving the childbirth facilities’ conditions, policies, practices and working environment may decrease mistreatment occurrence. Full article

(This article belongs to the Special Issue Women's Gynecological and Reproductive Health—Issues and Challenges)

10 pages, 353 KiB

Open AccessArticle

Attention to Women’s Sexual and Reproductive Health at the Street Outreach Office

by Nayara Gonçalves Barbosa, Thaís Massita Hasimoto, Thamíris Martins Michelon, Lise Maria Carvalho Mendes, Gustavo Gonçalves dos Santos, Juliana Cristina dos Santos Monteiro and Flávia Azevedo Gomes-Sponholz

Int. J. Environ. Res. Public Health 2022, 19(17), 10885; https://doi.org/10.3390/ijerph191710885 - 01 Sep 2022

Cited by 2 | Viewed by 1598

Abstract

The aim of study was to understand care strategies for homeless women, focusing on aspects of sexual and reproductive health from the perspective of Street Outreach Office strategy professionals. This is a qualitative study carried out in a large city in the countryside of São Paulo, Brazil. Data were collected from December 2020 to April 2021 through semi-structured interviews, and the results were obtained through content analysis and thematic modality. Nine health professionals participated in this study, and the analysis of the interviews allowed identifying three thematic categories: (i) being female and sex on the streets (violence and oppression); (ii) gynecology as a gateway to comprehensive care for homeless women; and (iii) pregnancy, puerperium and motherhood in the context of the streets. This study contributes to the reflection of professional practices within the Street Outreach Office, allowing the understanding of challenges in assisting homeless women, aiming to raise awareness of professionals and services that make up the health care network. Full article

(This article belongs to the Special Issue Women's Gynecological and Reproductive Health—Issues and Challenges)

12 pages, 366 KiB

Open AccessArticle

Management of Female Genital Mutilation/Cutting-Related Obstetric Complications: A Training Evaluation

by Kim Nordmann, Ana Belén Subirón-Valera, Mandella King, Thomas Küpper and Guillermo Z. Martínez-Pérez

Int. J. Environ. Res. Public Health 2022, 19(15), 9209; https://doi.org/10.3390/ijerph19159209 - 28 Jul 2022

Cited by 5 | Viewed by 1651

Abstract

Although female genital mutilation/cutting (FGM/C) is a prevalent practice in Liberia, healthcare workers lack the capacity to provide adequate care for FGM/C survivors. Therefore, Liberian nurses, physician assistants, midwives and trained traditional midwives were trained in sexual, obstetric and psychosocial care for FGM/C survivors in 2019. Through questionnaires, we assessed knowledge acquisition, trainee attitudes towards FGM/C care and acceptability to implement WHO-endorsed recommendations. The questionnaires were analyzed using descriptive statistics for quantitative data and an inductive approach for qualitative data. A total of 99 female and 34 male trainees participated. Most trainees perceived FGM/C as harmful to women’s health, as a violation of women’s rights and showed a willingness to change their clinical practice. While 82.8% (n = 74/90) perceived their role in advocating against FGM/C, 10.0% (n = 9/90) felt that they should train traditional circumcisers to practice FGM/C safely. The pre-training FGM/C knowledge test demonstrated higher scores among physician assistants (13.86 ± 3.02 points) than among nurses (12.11 ± 3.12 points) and midwives (11.75 ± 2.27 points). After the training, the mean test score increased by 1.69 points, from 12.18 (±2.91) points to 13.87 (±2.65) points. The trainings successfully increased theoretical knowledge of FGM/C-caused health effects and healthcare workers’ demonstrated willingness to implement evidence-based guidelines when providing care to FMG/C survivors. Full article

(This article belongs to the Special Issue Women's Gynecological and Reproductive Health—Issues and Challenges)

13 pages, 351 KiB

Open AccessArticle

Mifepristone (RU-486^®) as a Schedule IV Controlled Drug—Implications for a Misleading Drug Policy on Women’s Health Care

by Yi-Ping Hsieh, Yun-Ju Wang, Ling-Yi Feng, Li-Tzy Wu and Jih-Heng Li

Int. J. Environ. Res. Public Health 2022, 19(14), 8363; https://doi.org/10.3390/ijerph19148363 - 08 Jul 2022

Viewed by 1654

Abstract

Background: Mifepristone (RU-486) has been approved for abortion in Taiwan since 2000. Mifepristone was the first non-addictive medicine to be classified as a schedule IV controlled drug. As a case of the “misuse” of “misuse of drugs laws,” the policy and consequences of mifepristone-assisted abortion for pregnant women could be compared with those of illicit drug use for drug addicts. Methods: The rule-making process of mifepristone regulation was analyzed from various aspects of legitimacy, social stigma, women’s human rights, and access to health care. Results and Discussion: The restriction policy on mifepristone regulation in Taiwan has raised concerns over the legitimacy of listing a non-addictive substance as a controlled drug, which may produce stigma and negatively affect women’s reproductive and privacy rights. Such a restriction policy and social stigma may lead to the unwillingness of pregnant women to utilize safe abortion services. Under the threat of the COVID-19 pandemic, the US FDA’s action on mifepristone prescription and dispensing reminds us it is time to consider a change of policy. Conclusions: Listing mifepristone as a controlled drug could impede the acceptability and accessibility of safe mifepristone use and violates women’s right to health care. Full article

(This article belongs to the Special Issue Women's Gynecological and Reproductive Health—Issues and Challenges)

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