Educational Strategies to Help Students Provide Respectful Sexual and Reproductive Health Care for Lesbian,Gay, Bisexual,and Transgender Persons

Graduate medical, nursing, and midwifery curricula often have limited amounts of time to focus on issues related to cultural competency in clinical practice, and respectful sexual and reproductive health care for all individuals in particular. Respectful health care that addresses sexual and reproductive concerns is a right for everyone, including those who self‐identify as lesbian, gay, bisexual, or transgender (LGBT). LGBT persons have unique reproductive health care needs as well as increased risks for poor health outcomes. Both the World Health Organization and Healthy People 2020 identified the poor health of LGBT persons as an area for improvement. A lack of educational resources as well as few student clinical experiences with an LGBT population may be barriers to providing respectful sexual and reproductive health care to LGBT persons. This article offers didactic educational strategies for midwifery and graduate nursing education programs that may result in reducing barriers to the provision of respectful sexual and reproductive health care for LGBT clients. Specific ideas for implementation are discussed in detail. In addition to what is presented here, other educational strategies and clinical experiences may help to support students for caring for LGBT persons prior to entrance into clinical practice.     

Social Justice Considerations in Neonatal Care for Nurse Managers and Executives

This article presents the struggle between social justice and market justice within the current health care system, specifically issues affecting neonatal care. Community benefit is described and discussed as an aspect of social justice demonstrated by hospitals. The federal and state Children's Health Insurance Program also is discussed in relation to social justice and health care costs. Implications for managers and executives overseeing neonatal care are presented in relation to the economic and social issues.     

Reproductive Coercion and Women's Health

Given the epidemic proportion of those affected, the impact of gender‐based violence looms large in the study of women's health. One increasingly recognized facet of such violence is reproductive coercion, defined as behavior that interferes with autonomous decision‐making in areas of reproductive health. Although the body of literature illustrating the pathology of reproductive coercion is limited, growing data on harms to reproductive choice, health outcomes, and future pregnancies are a sobering appeal for greater publicity and information. This review explores existing knowledge regarding reproductive coercion, highlights areas of future study, and underscores how women's health care providers can better serve this population.     

Women's groups and professional organizations in advocacy for sexual and reproductive health and rights

After the International Conference on Population and Development (ICPD) in 1994 and the Fourth World Conference on Women in 1995, sexual and reproductive health and rights (SRHR) have improved in many countries, and been supported by awareness raised by women's health advocates, increasingly by youth groups, and also by organizations of health professionals. In the HIV/AIDS area, involvement of organizations of people living with HIV/AIDS is crucial to improve prevention and care. However, after victories during the 1990s, combating opposition by social and political conservatives has taken up much energy in recent years. Continuous advocacy to broaden acceptance of the fundamental importance of SRHR, their role in meeting the Millennium Development Goals, and the imperative to increase funding, is essential.     

Women's Health Care Minimum Data Set: pilot test and validation for use in clinical practice

Basic elements of the structure, process, and outcomes of midwifery practice have not been fully determined, particularly in the areas of women's gynecologic and primary health care. The American College of Nurse-Midwives (ACNM) supported the development of clinical data sets to describe structure, process, and outcomes of midwifery practice for use by clinical practitioners. The Woman's Health Care Minimum Data Set was developed using a panel of expert midwives and other women's health care professionals, as well as literature resources. Students of the Graduate Midwifery Program at Philadelphia University performed pilot testing of the Woman's Health Care Minimum Data Set as a service to the profession of midwifery while applying concepts learned in their research methods courses. Each student (n = 19) recruited a midwifery practice in which she had a clinical affiliation, and gathered data sets on the previous 30 consecutive women's health care encounters by CNMs or CMs (n = 569). Item analysis and refinement were done. Criterion-related validity and construct-related validity of the Woman's Health Care Minimum Data Set were explored through comparison with the medical record and through the testing of plausible hypotheses. The Woman's Health Care Minimum Data Set has the potential to be an important instrument in documenting and understanding the evolving nature of the practice of primary women's health care by midwives and other women's health care providers.