The Effects of Condom Availability on College Women’s Sexual Discounting

College students commonly engage in risky sexual behaviors, such as casual sexual encounters and inconsistent condom use. Discounting paradigms that examine how individuals devalue rewards due to their delay or uncertainty have been used to improve our understanding of behavioral problems, including sexual risk. The current study assessed relations between college women’s sexual partners discounting and risky sexual behavior. In this study, college women (N = 42) completed two sexual partners delay discounting tasks that assessed how choices among hypothetical sexual partners changed across a parametric range of delays in two conditions: condom availability and condom unavailability. Participants also completed two sexual partners probability discounting tasks that assessed partner choices across a parametric range of probabilities in condom availability and unavailability conditions. Additionally, participants reported risky sexual behavior on the Sexual Risk Survey (SRS). Participants discounted delayed partners more steeply in the condom availability condition, but those differences were significant only for those women with three or fewer lifetime sexual partners. There were no consistent differences in discounting rate across condom availability conditions for probability discounting. Sexual partners discounting measures correlated with risky sexual behaviors as measured by the SRS, but a greater number of significant relations were observed with the condoms-unavailable delay discounting task. These findings suggest the importance of examining the interaction of inconsistent condom use and multiple partners in examinations of sexual decision-making.     

Women’s Self-Care in the Reproductive Age: An Essential Agenda

Archives of Sexual Behavior -     

Tobacco Use Among Married Women in Nepal: The Role of Women’s Empowerment

This study documented the prevalence and correlates of tobacco use among women of reproductive age in Nepal using nationally representative data. We utilized the 2006 Nepal Demographic and Health Survey that interviewed 10,793 women and 4,397 men. We analyzed the couple’s data or households (N = 2,600) in which both husband and wife were interviewed. We examined the effects of women’s empowerment—measured by education, employment, intra-household decisions, and age—on their tobacco use controlling for other individual and household characteristics. Women’s empowerment had mixed effects on tobacco use. While women’s education was inversely associated with their tobacco use, their age, employment and ability to make intra-household mobility decisions were positively associated with smoking. Women with primary and beyond primary education were 48 and 92 % less likely to smoke compared to women with no education, respectively. Tobacco use among women increased dramatically with age from 8 % in teen years to 42 % in their forties. A 1 year increase in age increased the odds of tobacco use by 6 %. Women whose husbands smoked were twice as likely to smoke. Nepal should not only restrict tobacco use in public places by implementing its Tobacco Control and Regulatory Act of 2010 but also focus on encouraging smoke-free homes by increasing awareness about the health consequences of tobacco use and secondhand smoke among populations most likely to smoke that include nearly all men, employed women, women with low levels of education, women whose spouses smoke and those who are 30 and above in age. Additionally, a long term goal should be to ensure at least 5th grade of education for all girls.     

Women’s Private Conversations about Abortion: A Qualitative Study

Abortion is a relatively frequent experience, yet public discourse about abortion is contentious and stigmatizing. Little literature is available on private conversations about abortion, which may be distinct from public discourse. We explored private discourse by documenting the nature of women’s discussions about abortion with peers in a book club. We recruited thirteen women’s book clubs in nine states. Participants (n = 119) read the book Choice: True Stories of Birth, Contraception, Infertility, Adoption, Single Parenthood, & Abortion, and participated in a book club meeting, which we audio-recorded and transcribed. Data collection occurred between April 2012 and April 2013. In contrast to public discourse of abortion, private discourse was nuanced and included disclosures of multiple kinds of experiences with abortion. Participants disclosed having abortions, considering abortion as an option for past or future pregnancies, and supporting others through an abortion. Distinguishing between public and private discourse enabled us to identify that an “abortion experience” could include personal decisions, hypothetical decisions, or connection with someone having an abortion. The book club atmosphere provided a rare opportunity for participants to explore their relationship to abortion. More research is needed to understand the role of private discourse in reducing abortion stigma.     

Women’s Reproductive Health in Slum Populations in India: Evidence From NFHS-3

The urban population in India is one of the largest in the world. Its unprecedented growth has resulted in a large section of the population living in abject poverty in overcrowded slums. There have been limited efforts to capture the health of people in urban slums. In the present study, we have used data collected during the National Family Health Survey-3 to provide a national representation of women’s reproductive health in the slum population in India. We examined a sample of 4,827 women in the age group of 15–49 years to assess the association of the variable slum with selected reproductive health services. We have also tried to identify the sociodemographic factors that influence the utilization of these services among women in the slum communities. All analyses were stratified by slum/non-slum residence, and multivariate logistic regression was used to analyze the strength of association between key reproductive health services and relevant sociodemographic factors. We found that less than half of the women from the slum areas were currently using any contraceptive methods, and discontinuation rate was higher among these women. Sterilization was the most common method of contraception (25%). Use of contraceptives depended on the age, level of education, parity, and the knowledge of contraceptive methods (p < 0.05). There were significant differences in the two populations based on the timing and frequency of antenatal visits. The probability of ANC visits depended significantly on the level of education and economic status (p < 0.05). We found that among slum women, the proportion of deliveries conducted by skilled attendants was low, and the percentage of home deliveries was high. The use of skilled delivery care was found to be significantly associated with age, level of education, economic status, parity, and prior antenatal visits (p < 0.05). We found that women from slum areas depended on the government facilities for reproductive health services. Our findings suggest that significant differences in reproductive health outcomes exist among women from slum and non-slum communities in India. Efforts to progress towards the health MDGs and other national or international health targets may not be achieved without a focus on the urban slum population.     

Effects of Religious Veiling on Muslim Men’s Attractiveness Ratings of Muslim Women

Hijab and other Islamic veiling clothing are important social and political symbols for Muslim women’s identity. Although recently there has been a large body of literature on the social and political aspects of hijab in Western countries, there has been no investigation of the origin and function of veiling itself. This article hypothesized that religious veiling, which eliminates the estrogen-induced body curves of reproductive age women, decreases men’s perceptions of women’s physical attractiveness, thereby serving mate guarding functions against rival men. To test this hypothesis. Measures of the motivational appeal and self-reported perceived attractiveness of women exhibiting different degrees of veiling were obtained from 80 Muslim male participants. The results showed that men were more motivated to view women exhibiting the less veiling and rated them more attractive than those women whose bodily curves were less apparent. These results support veiling serving a mate guarding function and reinforcing the marital bond.     

Peer Reviewed: Reproductive Health Surveillance in the US-Mexico Border Region, 2003-2006: The Brownsville-Matamoros Sister City Project for Women’s Health

Introduction

High birth and immigration rates in the US-Mexico border region have led to large population increases in recent decades. Two national, 10 state, and more than 100 local government entities deliver reproductive health services to the region''s 14 million residents. Limited standardized information about health risks in this population hampers capacity to address local needs and assess effectiveness of public health programs.

Methods

We worked with binational partners to develop a system for reproductive health surveillance in the sister communities of Matamoros, Tamaulipas, Mexico, and Cameron County, Texas, as a model for a broader regional approach. We used a stratified, systematic cluster-sampling design to sample women giving birth in hospitals in each community during an 81-day period (August 21-November 9) in 2005. We conducted in-hospital computer-assisted personal interviews that addressed prenatal, behavioral, and lifestyle factors. We evaluated survey response rates, data quality, and other attributes of effective surveillance systems. We estimated population coverage using vital records data.

Results

Among the 999 women sampled, 947 (95%) completed interviews, and the item nonresponse rate was low. The study sample included 92.7% of live births in Matamoros and 98.3% in Cameron County. Differences between percentage distributions of birth certificate characteristics in the study and target populations did not exceed 2.0. Study population coverage among hospitals ranged from 92.9% to 100.0%, averaging 97.3% in Matamoros and 97.4% in Cameron County.

Conclusion

Results indicate that hospital-based sampling and postpartum interviewing constitute an effective approach to reproductive health surveillance. Such a system can yield valuable information for public health programs serving the growing US-Mexico border population.     

The Association of Women’s Empowerment with Stillbirths in Nepal

Introduction

Globally, 2.6 million stillbirths occur each year. Empowering women can improve their overall reproductive health and help reduce stillbirths. Women empowerment has been defined as women’s ability to make choices in economic decision-making, household and health care decision-making. In this paper, we aimed to evaluate if women’s empowerment is associated with stillbirths.

Methods

Data from 2016 Nepal Demographic Health Surveys (NDHS) were analysed to evaluate the association between women’s empowerment and stillbirths. Equiplots were generated to assess the distribution of stillbirths by wealth quintile, place of residence and level of maternal education using data from NHDS 1996, 2001, 2006, 2011 and 2016 data. For the association of women empowerment factors and stillbirths, univariate and multivariate analyses were conducted.

Results

A total of 88 stillbirths were reported during the survey. Univariate analysis showed age of mother, education of mother, age of husband, wealth index, head of household, decision on healthcare and decision on household purchases had significant association with stillbirths (p < 0.05). In multivariate analysis, only maternal age 35 years and above was significant (aOR 2.42; 1.22–4.80). Education of mother (aOR 1.48; 0.94–2.33), age of husband (aOR 1.54; 0.86–2.76), household head (aOR 1.51; 0.88–2.59), poor wealth index (aOR 1.62; 0.98–2.68), middle wealth index (aOR 1.37; 0.76–2.47), decision making for healthcare (aOR 1.36; 0.84–2.21) and household purchases (aOR 1.01; 0.61–1.66) had no any significant association with stillbirths.

Conclusions

There are various factors linked with stillbirths. It is important to track stillbirths to improve health outcomes of mothers and newborn. Further studies are necessary to analyse women empowerment factors to understand the linkages between empowerment and stillbirths.

     

Women’s Preferences for the Location of Abortion Services: A Pilot Study in Two Chicago Clinics

Between July and December 2006, 209 women at a university-based primary care center and a freestanding abortion clinic completed a verbally administered questionnaire in which they were asked their preference for the location of early abortion services. Sixty women seeking primary care services at the university-based clinic and 149 women seeking first-trimester abortion services at an abortion clinic completed the questionnaire. Sixty-seven percent (67%) of women surveyed at the university-based primary care facility and 69% at the abortion clinic indicated a preference for abortion services from their regular health care provider. A statistically significant association (P = 0.002) was found between comfort speaking with a regular health care provider about pregnancy prevention and preference for the provision of abortion services from a regular health care provider. Women may feel more comfortable undergoing an early abortion procedure with a provider with whom they have an established relationship. The integration of early abortion services into primary care practice may increase continuity of care among women seeking an abortion.     

The Effects of Antenatal Depression and Women’s Perception of Having Poor Health on Maternal Health Service Utilization in Northern Ghana

Maternal and Child Health Journal - To examine the effects of antenatal depression and women’s perceived health during the antenatal period on maternal health service utilization in rural...     

Traditional Christian Values and Women’s Reproductive Rights in Modern Russia—Is a Consensus Ever Possible?

Recently in Russia, abortion rights have been attacked. For decades, Russian women could have an elective abortion up to week 12 of pregnancy; between 12 and 22 weeks, medical or social grounds were required for an abortion.In mid 2011, a group of Parliamentarians teamed up with Russian Orthodox Church activists and announced their desire to ban abortions, and the new version of the health law with restricting amendments was introduced: a mandatory waiting period, physicians’ conscientious objection, and limiting the social indications for late-term abortion.Evidence indicates that restricting legislative changes based on “traditional” values could significantly limit women’s reproductive choices (e.g., access to abortion), a setback to women’s rights to exert control over their bodies and their lives.UNTIL RECENTLY, RUSSIAN law guaranteed women freedom in relation to reproduction and reproductive health. However, this right has been slowly but steadily undermined. The forces behind this trend are actively seeking to dramatically change current legislation.In May 2006, in his annual address to the Federal Assembly, President Vladimir Putin made a passionate statement about the dire demographic situation in Russia. He identified Russia’s decreasing population as a possible national security threat and as the most acute issue now facing the country. With total fertility rates estimated to be approximately 1.3 to 1.4 and a rapidly growing aging population, Russia’s demographic trends are similar to those of other European countries. However, unlike other European countries, Russia has far higher mortality rates, particularly among the male population. In Russia, approximately 45% of males who reached age 15 years in 2009 are not expected to survive to age 60 years. The immediate outcome of these troubling trends has been a decline in the size of the population: by 2009, Russia’s population had declined to 143 million,1 down from 148.6 million in 1993, a loss of 5.6 million people.Other demographic, socioeconomic, and reproductive health indicators for Russia are as follows:

• Life expectancy at birth (2011): 75.61 for women, 64.04 for men2;
• Percentage of population younger than 15 years (2010): 15.083;
• Population below income poverty line of US $1 per day: 13.3% of the population live below subsistence level (first quarter 2012)4;
• Health expenditure per capita per year (2010): US $9984;
• Main ethnic groups (2010): Russian (80.9%), Tatar (3.87%), Ukrainian (1.41%), Bashkir (1.15%), Chuvash (1.05%), Chechen (1.04%), other (< 1%; 10.58%)5;
• Main religions (2010): Russian Orthodox (41%), Atheist (12.9%), Muslim (6.5%), other than Orthodox Christians (4.1%)6;
• Main languages (2010): Russian (99.41%), many indigenous and minor groups (< 50 000 people) apart from Russian using their ethnic languages7;
• Maternal mortality odds ratio (per 100 000 live births; 2010) = 34 [95% confidence interval = 26, 42]8; and
• Abortion rates (2008): 32.2 per 1000; (2010): 28.1 per 1000.9

Many experts attribute the decline in the population to the devastating socioeconomic conditions accompanying the transition from socialism to a market economy. A different and significantly more popular explanation attributes low fertility rates to the legacy of Soviet policies that altered the population’s “normative need to have children.” Focusing on the moral obligations of members of the Russian society rather than on their economic hardships, this interpretation supported state policies aimed at strengthening family values to increase fertility rates. Reintroducing “the normative need for children” into women’s reproductive strategies and rewarding women for fulfilling their moral and social duties, conservative experts claim, would strengthen the importance of family as a valuable social institution and would change population dynamics regardless of people’s material conditions. The proponents of this argument state that new policy proposals and government attempts to alter current population dynamics significantly underestimate fundamental changes in fertility and marriage patterns taking place in contemporary Russian society.Russian feminist activists emphasize gender inequalities as the main reason for population decline. These activists remain skeptical of current government attempts to address the demographic situation. They stress, instead, the importance of policies that promote more equal parenting roles and the improvement of the child care system. However, the opinions of Russian feminists are seldom acknowledged in Russia.In 2007, following President Putin’s address to the nation, the Russian government launched its new, high-priority “Demographic Policy for the Russian Federation—Present to 2025.” This focused on providing incentives for women to have more children. The policy included monetary incentives for a second child and each child thereafter. That policy was almost exclusively built around a one-time monetary measure—“maternal capital,” a sum of 365 000 Russian Rubles (US$13 000), with a yearly inflation adjustment, paid to women who give birth to a second, or subsequent, child. Despite these new government incentives to drive up birth rates, the results have not been as promising as expected. Fertility rates have remained low, and a high rate of abortions is found among Russian women. The number is slowly decreasing, but it still totals nearly 1 million annually.For many decades, the law on abortions in the Soviet Union, including Russia, was very liberal. Russian women could request an abortion until week 12 of pregnancy. Between weeks 12 and 22, an abortion could be done only on medical or so-called social grounds, as defined by the Ministry of Health. For the first time in 2003, the government dramatically limited the number of permissible grounds. For instance, it eliminated the right to a second-trimester abortion for reasons of social vulnerability (i.e., when the parents are unemployed or imprisoned or have limited financial means). In 2007, the government emphasized moral values and a pronatalist approach and has continued to attack abortion rights for medical and social reasons, although, in practice, the share of abortions made for those reasons has never represented more than two to three percent of all abortions.In the past, it was not uncommon for some conservative politicians in the State Duma (Russian Parliament) to sponsor legislation further restricting women’s rights for abortion. On several occasions, it was proposed that married women should require explicit permission from their husbands. It was further proposed that abortions should be completely banned, except in life-threatening situations. There was even a proposal to recognize that human life begins from the moment of conception and that abortion should therefore be considered as homicide. None of these proposals has been adopted or even gone to a vote. All were rejected by the Health Care Committee of the Duma. However, in 2010 to 2011, the situation changed. A working group to explore restrictions on abortion was formed under the auspices of the State Duma’s Women, Family and Children Issues Committee. The head of this committee, together with a group of Parliamentarians, has teamed up with clerical groups, which are antiabortion, anti–sex education, and anti–birth control. Most are affiliated with the Russian Orthodox Church, which is highly politically influential in modern Russia. For 18 months, the working group has been focusing on measures to restrict women’s access to abortion. This included removing a woman’s existing rights and vesting them, instead, with her legal guardians (i.e., her husband and the government). Since its inception, individual members of the working group speaking at Christian events have publicly expressed their wish to completely ban abortions in Russia.In mid 2011, the Duma started debating a revised health law. Dmitry Medvedev, the former president (2008–2012), expressed his full support for proposed new legislation, which was to be adopted by the end of 2011. Debates on abortion focused on antichoice proposals. Detractors pointed out that antichoice measures would do nothing to tackle Russia’s prevailing problems. The supporters of antiliberal measures typically proclaim themselves as defenders of traditional Christian values. Although they typically do nоt hesitate to accuse women seeking abortions of being murderers, absent from their rhetoric is any mention of sexual abuse. The proposals fail to recognize, or even discuss, the high incidence of rape in Russia and its implications. That the incidence of rape in Russia has never even been seriously researched is indicative of the nature of the problem. Note, also, that the government does nothing to ensure that Russian physicians comply with recommendations from the World Health Organization (WHO) for abortions, despite having access to modern methods and equipment. In the framework of “Strategic Assessment of the Quality of Care in Abortion and Contraception Services” project, a survey was conducted in 2009 by the WHO, the Russian Ministry of Health and Social Development (MOHSD), and the nongovernmental partners, such as Russian Association for Population and Development (RAPD). The assessment concluded that Russian physicians often make mistakes leading to completely unnecessary complications when performing established abortion procedures and lack knowledge about contraception counseling. Unfortunately, the survey results were not officially endorsed by the MOHSD and were not used for the development of further plans for improvements in contraception provision and abortion services.On the contrary, it is of concern that authors of legislative amendments to the new health law have failed to include measures to prevent unwanted pregnancies or contraception. Numerous contributors to the draft legislation, especially from within the church, are strictly opposed to any modern methods of contraception, including all forms of hormonal contraception, emergency contraception, and intrauterine devices. Rigorous, well-conducted studies reported that providing information about, and access to, contraception is the best way to reduce unplanned pregnancies and abortions. The American College of Obstetricians and Gynecologists (in 2009) found that reducing unplanned pregnancies clearly contributes to lowering both the rates of unsafe abortion and the overall level of abortion.10 Despite this, in supporting their proposals with so-called facts, antichoice speakers are able to submit to the media misleading data and statements, whereas the opinions of genuine experts, whose views may run counter to government thinking, are not published by state-controlled mass media.Conservatives who advocate stripping women of their rights claim that it will raise fertility rates, ignoring that demographers can prove that achieving this goal by restricting abortions is impossible. For instance, in 2009, a Guttmacher Institute survey of 197 countries found that restricting access to legal abortion does not reduce the number of women trying to end unwanted pregnancies.11 Abortion rates are about equal when comparing world regions, regardless of legislation. In the countries where abortion is severely restricted, it often costs women their health and lives. Evidence from demographers who have conducted research in Romania indicates that restricting abortions does not increase birthrates or contribute to the general health of the population.There is a high risk that bad examples from Russia could negatively influence neighboring countries. Antichoice proposals have already been noted in the Ukraine and in Central Asian countries. These could lead to changes in abortion laws; changes that have been inspired by a Russian example based on dubious moral and religious justifications rather than rational thinking based on sound scientific knowledge.The members of the previously mentioned working group together with influential church groups and officials from MOHSD strongly objected to proposals made by the State Duma’s Health Care Committee. They were able to force the head of the committee, Olga Borzova, to change the Health Care Committee position twice to accommodate the demands of these lobbyists. Three meetings, held with the Russian Orthodox Church officials, led to the inclusion of several restricting changes into the draft legislation (e.g., a waiting period should be applied to all terminations of pregnancies, a psychological consultation should be obligatory, and a physician’s objections based on conscience will be permissible).A group of pro-choice nongovernmental partners prepared an alternative set of evidence-based amendment proposals. These were aimed at addressing real, rather than imaginary, problems to help women rather than attack them. Women pro-choice advocates wished to expose falsehoods spread by those wishing to restrict women’s reproductive rights and to persuade the government not to adopt antichoice amendments. A public campaign was organized by grassroots pro-choice activists and feminist groups led by the pro-choice “Rowan Bunch” coalition. They mobilized expertise and human resources to counter the attack on women’s rights. Their proposed alternative amendments were rejected.Proposed amendments restricting abortion rights were voted on in November 2011. They were accepted with the overwhelming support of Duma representatives. The new federal law on the Protection of the Health of the Citizens of Russian Federation was enacted in January 2012. Article 56 includes a mandatory waiting period before performing an abortion: a 48-hour waiting period is required during the 4th to 7th or 11th to 12th weeks of pregnancy, and a 7-day waiting period is required between weeks 8 and 11. The waiting period is deemed to run from the date the woman was referred to a medical facility and the termination itself.According to the Abortion Toolkit developed by the International Planned Parenthood Federation,12 it is a false assumption that women need time, after having received counseling, to make a well-reasoned decision about whether to terminate a pregnancy. In fact, mandatory delays are intended to discourage abortion rather than to address health issues. In general, a woman requesting abortion has already made up her mind. Further delays are obstacles for women because they may entail increased expense, travel difficulties, and medical risks.13Evidence indicates that psychological counseling related to abortion is being used to force women to continue pregnancy to term against their will. For example, in 2009, the Guidelines on Psychological Pre-Abortion Counseling were published by the Ministry of Sports, Tourism, and Youth Policy of the Russian Federation, Federal Agency for Youth Affairs.14 In this publication, abortion is treated as “a murder of a living child.” A woman willing to undergo abortion is assessed here as being “mistaken and deluding herself,” whereas pregnancy and childbearing are treated as a woman’s destiny. The authors of the guidelines recommends that psychologists show patients graphic movies on abortion. In 2010, MOHSD issued an official letter recommending this publication to women’s health care facilities.15 It may have been helpful if the recently published and evidence-based document WHO Safe Abortion Guidance: Updates and Recommendations 2012 had been issued earlier. This publication recommends that women who have made a decision to have an abortion before seeking care should not be subjected to mandatory counseling.16 This may have influenced Russian Parliamentarians’ decision.Although the law’s new rules adversely affect women seeking abortion, women from rural areas are faced with particularly difficult circumstances. The Heinrich Böll Foundation reported:

The introduction of the compulsory waiting period still is substantially harmful, especially for women living in small towns and rural areas, since an additional visit to the doctor means for them having to go to another or bigger city, and for working women who cannot easily get time off their jobs to visit the doctor multiple times on different days. Meanwhile, the access to women’s health clinics is in practice quite restricted because of their insufficient numbers: even in capitals such as Moscow and Saint-Petersburg, in some districts women have to sign up to see a gynecologist 2–4 weeks in advance. Given that, even though the additional 2 or 7 days of wait required by the new law may sound relatively innocent, they will unavoidably turn into weeks if not months.17

Apart from restrictions concerning abortion on request implemented at the beginning of 2012, the Russian government issued an order limiting acceptable social grounds for late-term abortion from four (if a woman was deprived or limited of parental rights; if a woman was incarcerated as a result of committing a crime; if a pregnancy occurred as a result of rape; and if she was married to a totally or partially disabled person, or if she was divorced or her husband died during the pregnancy)18 to just one (namely, if a pregnancy resulted from a crime stipulated by Article 131 of the Russian Criminal Code, i.e., rape).19 Even incest is not recognized as a social ground for late-term abortion.Another new legal restriction on abortion allows for a physician’s conscientious objection. A physician may refuse to perform an artificial termination of pregnancy provided he or she puts his or her refusal in writing to an appropriate superior, such as the head of the medical facility in question. A suitable alternative physician can then be allocated to the case.Evidence indicates that proposed legislative changes will significantly limit women’s access to abortion, may prevent the early termination of pregnancy, and will likely lead to a rise in instances of criminal abortion. Even under previous, less restrictive laws, these accounted for up to five percent of maternal deaths in Russia. Changes in legislation will compromise women’s autonomy. Restrictions will represent a major setback to women’s rights to exert control over their bodies and their lives. Unlike, for instance, the European Union, which has real support for families and laws to promote gender equality and equity, the demographic situation is not likely to magically change in Russia, given the prevailing restrictive politics.It is in the intention of RAPD, the leader in the field of sexual and reproductive health and rights in Russia, to monitor the status of abortions in Russia. We look forward to the release of the new Order (Poryadok) by the Ministry of Health because this is supposed to include the newly endorsed WHO Recommendations on Abortion.16 This could help influence the provision of abortions in Russia, but it will not be able to counter recently promulgated legislative barriers.     

Association of Comorbidity with Disability in Older Women: The Women’s Health and Aging Study

There is substantial evidence that physical disability results from chronic diseases and that the number of chronic diseases is associated with the presence and severity of disability. There is some evidence that interactions between specific diseases are of import in causing disability. Beyond arthritis, however, little is known of the disease pairs that may be important to focus on in future research. This study explores the associations between multiple disease pairs and different types of physical disability, with the objective of hypothesis development regarding the importance of disease interactions. The study population comprised a representative sample of 3841 women 65 years and older living in Baltimore, screened for participation in the Women’s Health and Aging Study. The study design was cross-sectional. An interviewer-administered screening questionnaire was administered regarding self-reported physical disability in 15 tasks of daily life, history of physician diagnosis of 14 chronic diseases, and MiniMental State examination. Task difficulty was empirically grouped into six subsets of minimally overlapping disabilities, with a comparison group consisting of those with no difficulty in any task subset. Multiple logistic regression models were fit assessing the relationship of major chronic diseases and of interactions of disease pairs with each disability subtype and with any disability, adjusting for confounders. Fourteen percent of the population reported mobility difficulty only; 5%, upper extremity difficulty only; 9%, both of these difficulties but no others; 7%, difficulty in higher function but not self-care tasks; 7%, self-care task difficulty but not higher function tasks; and 15%, difficulty in both higher function and self-care (weighted data). Almost all in the latter three groups had difficulty, as well, in mobility or upper extremity tasks. In regression models, specific disease pairs were synergistically associated with different types of disability. For example, important disease pairs that recurred in their associations with different disability types were the presence of arthritis and visual impairments, arthritis and high blood pressure, heart disease and cancer, lung disease and cancer, and stroke and high blood pressure. In addition, the type of disability that a disease was associated with varied, depending on the other disease that was present. Finally, when interactions were accounted for, many diseases were no longer, in themselves, independently associated with a given type of disability. Partitioning disability into six subtypes was more informative in terms of associations than was evaluating a summary category of “any disability.” These findings provide a basis for further hypothesis development and testing of synergistic relationships of specific diseases with disabilities. If testing confirms these observations, these findings could provide a basis for new strategies for prevention of disability by minimizing comorbid interactions.     

The Exposure Effects of Online Model Pictures and Weight-Related Persuasive Messages on Women’s Weight-Loss Planned Behaviors

This study examined how exposure to pictures of women with different body sizes (thin, obese), physical attractiveness levels (attractive, unattractive), along with exposure to weight-related messages (pro-anorexia, anti-anorexia) embedded in a fashion website affected female participants’ planned behavior toward weight loss. Participants exposed to attractive model pictures showed higher intentions, attitudes, and subjective norms to lose weight compared with unattractive models. Additionally, participants exposed to thin and attractive model pictures indicated the highest attitudes and self-efficacy to lose weight, whereas those exposed to thin and unattractive model pictures indicated the lowest. Furthermore, weight-related messages moderated the effect of model appearance (body size and attractiveness) on controllability of weight-loss activities. However, website pictures’ body size differences had no main effects on planned behavior toward weight loss. These effects are discussed in the light of social comparison mechanisms.     

Are There Differences in the Impact of Partner Violence on Reproductive Health Between Postpartum Women and Women Who Had an Elective Abortion?

The aim of this study was to determine if the effects of intimate partner violence (IPV) in the previous 12 months (current IPV) on newborn’s health, pregnancy outcomes and couple’s reproductive behaviours were different for postpartum (PP) women as compared to women who had undergone an elective abortion (EA) in Trieste (Italy). This study is part of an unmatched case–control study. The major findings are that current IPV was positively associated with previous stillbirth among both groups of women, but the association was only marginally significant. Among EA women only, current IPV was significantly associated with previous miscarriages (adjusted odds ratio, 2.41; 95 %CI, 1.13–5.14). In both groups of women, current IPV was associated with a lack of joint couple decision making about contraception; however, the magnitude of this effect was higher among PP women. This study reveals that IPV was associated with poor obstetrical history among both groups of women. But the associations of current IPV with previous EA and couple reproductive behaviours were stronger among PP women.     

Peer Reviewed: Characteristics of Young Women Who Gave Birth in the US-Mexico Border Region, 2005: The Brownsville-Matamoros Sister City Project for Women’s Health

Introduction

Childbearing during adolescence and young adulthood is associated with adverse effects on health and quality of life. Lowering birth rates among young women is a binational priority in the US-Mexico border region, yet baseline information about birth rates and pregnancy risk is lacking. Increased understanding of the characteristics of young women who give birth in the region will help target high-risk groups for sexual and reproductive health services.

Methods

We examined data on reproductive health characteristics collected in hospitals from 456 women aged 24 years or younger who gave birth from August 21 through November 9, 2005, in Matamoros, Tamaulipas, Mexico, and Cameron County, Texas. We calculated weighted percentages and 95% confidence intervals (CIs) for each characteristic and adjusted odds ratios (AORs) for Matamoros and Cameron County women by using multiple logistic regression techniques.

Results

Numbers of births per 1,000 women aged 15 to 19 years and 20 to 24 years were similar in the 2 communities (110.6 and 190.2 in Matamoros and 97.5 and 213.1 in Cameron County, respectively). Overall, 38.5% of women experienced cesarean birth. Matamoros women reported fewer prior pregnancies than did Cameron County women and were less likely to receive early prenatal care but more likely to initiate breastfeeding. Few women smoked before pregnancy, but the prevalence of alcohol use in Cameron County was more than double that of Matamoros. In both communities combined, 34.0% of women used contraception at first sexual intercourse.

Conclusion

Despite geographic proximity, similar ethnic origin, and comparable birth outcomes, young Mexican and US women showed different health behavior patterns. Findings suggest possible pregnancy prevention and health promotion interventions.