Women’s Autonomy and Unintended Pregnancy Among Currently Pregnant Women in Bangladesh

This paper examines the net effect of women's autonomy on their pregnancy intention status among currently pregnant Bangladeshi women. This study is based on data from the Bangladesh Demographic Health Survey, 2007 (BDHS). A subset of interviews from currently pregnant women (718) were extracted from 10,146 married women of reproductive age. The BDHS 2007 used a pre-tested, structured questionnaire to collect sociodemographic, women's empowerment, and pregnancy information. Associations between unintended pregnancy and explanatory variables were assessed using bivariate analysis. Logistic regression was used to assess the net effect of women's autonomy on current pregnancy intention status after controlling for other variables. Results indicate that women's autonomy is a significant predictor of unintended pregnancy after adjusting for other factors. A unit increase in the autonomy scale decreases the odds of unintended pregnancy by 16%. Besides autonomy, our results also indicate that current age, number of children ever born, age at marriage, religion, media access, and contraceptive use exert strong influences over unintended pregnancy. Women who have ever used contraceptives are 82% more likely to classify their current pregnancies as unintended compared with women who are non-users of contraceptives. Improvement in women's autonomy and effective and efficient use of contraceptives may reduce unintended pregnancies as well as improve reproductive health outcomes.     

Does Obesity Increase Sexual Dysfunction in Women?

This study was conducted to determine the prevalence of sexual dysfunction among women with obesity who are otherwise healthy and applied to the diet center of a hospital located in Ankara, the capital city of Turkey. The sample included 203 volunteers. Data were collected using the personal data form developed by the authors and the female sexual dysfunction inventory (FSFI). The mean age of the participants was 41.17 ± 8.38 years old. Of the participants, 48.7 % were elementary school graduates, 60.6 % were housewives, 64.0 % had the body mass index (BMI) score between 30.00 and 34.99, and the mean BMI score of the participants was 34.73 ± 4.86. Of the participants, 44.3 % stated that being over-weight had adversely affected their sexual life at a score of 6 points or more. Twenty point two of the participants received information regarding sexuality. It is remarkable that health care professionals were found to be the least frequently referred (3 %) resource regarding sexuality. The mean FSFI score of the participants was 27.36 ± 4.80. Severe dysfunction were observed in 12.8 % of the participants. Moreover, all domains of sexual function were dysfunctional. Female sexual function in the present study was not found correlated with several variables, such as the level of education, work status, menopausal status, and knowledge of sexuality. In conclusion, in order to improve women with obesity’s health and well-being diet to lose weight as well as sexual counseling are to be recommended.     

Women’s Patterns of Participation in Mammography Screening in Denmark

The objective of the study is to analyse individual women’s participation patterns in mammography screening in Denmark. The study is set in the capital of Copenhagen and the county of Fyn representing around 95,000 women aged 50–69. The Central Population Register (CPR) was used to define the total target group, and supply information on migrations and deaths. Invitation and participation data came from the mammography screening programmes in Copenhagen (1991–1999) and Fyn (1993–2001), containing personal identification number, data on invitation date, participation and examination date for each screening round. In Copenhagen the coverage went from 70.5% in the first round to 63.1% in the fourth round, and the equivalent data for Fyn is 84.6% in the first round and 82.8% in the fourth round. Of the women eligible for at least three invitation rounds, 52.6% in Copenhagen and 76.4% in Fyn were faithful users, i.e. had participated in all screenings they were invited to. The conclusion is that the programme participation rates tend to overestimate the protection of the individual women covered by the programme. Behind the urban–rural gradient in programme participation is an even greater gradient in programme protection.     

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.     

Are Gestational Diabetes Mellitus and Preconception Diabetes Mellitus Less Common in Non-Hispanic Black Women than in Non-Hispanic White Women?

Based on their higher risk of type 2 diabetes, non-Hispanic blacks (NHBs) would be expected to have higher gestational diabetes mellitus (GDM) risk compared to non-Hispanic whites (NHWs). However, previous studies have reported lower GDM risk in NHBs versus NHWs. We examined whether GDM risk was lower in NHBs and NHWs, and whether this disparity differed by age group. The cohort consisted of 462,296 live singleton births linked by birth certificate and hospital discharge data from 2004 to 2007 in Florida. Using multivariable regression models, we examined GDM risk stratified by age and adjusted for body mass index (BMI) and other covariates. Overall, NHBs had a lower prevalence of GDM (2.5 vs. 3.1 %, p < 0.01) and a higher proportion of preconception DM births (0.5 vs. 0.3 %, p ≤ 0.01) than NHWs. Among women in their teens (risk ratio 0.56, p < 0.01) and 20–29 years of age (risk ratio 0.85, p < 0.01), GDM risk was lower in NHBs than NHWs. These patterns did not change with adjustment for BMI and other covariates. Among women 30–39 years (risk ratio 1.18, p < 0.01) and ≥40 years (risk ratio 1.22, p < 0.01), GDM risk was higher in NHBs than NHWs, but risk was higher in NHWs after adjustment for BMI. Associations between BMI and GDM risk did not vary by race/ethnicity or age group. NHBs have lower risk of GDM than NHWs at younger ages, regardless of BMI. NHBs had higher risk than NHWs at older ages, largely due to racial/ethnic disparities in overweight/obesity at older ages.     

Communication and Cultural Issues in Providing Reproductive Health Care to Immigrant Women: Health Care Providers’ Experiences in Meeting Somali Women Living in Finland

Communication problems due to language and cultural differences between health care professionals and patients are widely recognized. Finns are described as more silent whereas one concurrent large immigrant group, the Somalis, are described as more open in their communication. The aim of the study was to explore physicians-nurses/midwives’ communication when providing reproductive and maternity health care to Somali women in Finland. Four individual and three focus group interviews were carried out with 10 gynecologists/obstetricians and 15 nurses/midwives from five selected clinics. The health care providers considered communication (including linguistic difficulties), cultural traditions, and religious beliefs to be problems when working with Somali women. Male and female physicians were generally more similar in communication style, interpersonal contacts, and cultural awareness than the nurses/midwives who were engaged in more partnership-building with the Somali women in the clinics. Despite the communication and cultural problems, there was a tentative mutual understanding between the Finnish reproductive health care professionals and the Somali women in the clinics.     

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.     

Women’s Autonomy and Maternal Health-Seeking Behavior in Ethiopia

This paper examines the net effect of women’s autonomy on their health seeking behavior in Ethiopia. We hypothesize that women with higher autonomy are more likely to seek health care during pregnancy and delivery than those with lower autonomy. The paper also examines whether the autonomy-health utilization relationship is influenced by individual (education, work status, religion) and, household (wealth and rural–urban residence) level factors, all of which are important for both autonomy and health-care utilization. Results indicate that women’s autonomy remains significant even after adjusting for other individual and household variables. Besides autonomy, our results highlight other individual and household level influences on the health seeking behaviors of women in Ethiopia. Results also demonstrate the need to look beyond individual level factors when examining the health seeking behaviors of women in Ethiopia. The statistical significance of some individual-level measures, such as education means it cannot be used as proxy for women’s autonomy. This calls for policy makers not only to empower women, but also provide them with better formal education.     

Reexamining Individual Differences in Women’s Rape Avoidance Behaviors

A growing number of investigators explore evolutionary psychological hypotheses concerning the avoidance of rape using self-report measures of behavior. Among the most recent and most ambitious, is the work of McKibbin et al. (2011). McKibbin et al. presented evidence supporting their predictions that such behaviors would vary according to the individual’s physical attractiveness, relationship status, and proximity to kin. In addition, McKibbin et al. predicted, but failed to find evidence, that age would exercise a similar influence. We question McKibbin et al.’s position on both theoretical and empirical grounds, arguing that (1) two of their predictions do not rule out alternative explanations, and (2) their key supporting findings may well be artifacts of their measurement instrument, the Rape Avoidance Inventory (RAI). Employing new empirical evidence derived from a broader sample of U.S. women, we simultaneously tested McKibbin et al.’s predictions and compared the RAI to alternative dependent measures. We found that McKibbin et al.’s substantive predictions were not supported, and suggest that there may be limits to the utility of the RAI beyond one specific demographic category.     

Women’s autonomy and reproductive health-care-seeking behavior in Ethiopia

This paper investigated the potential importance of women’s autonomy in reproductive health-care-seeking behavior of women in Ethiopia. Data from the 2011 Ethiopian Demographic and Health survey (DHS), which involved a total of 16,515 women, were analyzed. A weighted sub-sample of married women and women who had a live birth were included in analyses on family planning and antenatal care. Women’s autonomy was measured by participation in decision making, attitudes toward wife beating, and whether getting permission to seek medical care was a big problem. Nearly 54% of women participated in all major household decisions, and 69% said getting permission to go for medical care was not a large problem. Women’s participation in domestic decision making was significantly positively associated with use of family planning (adjusted odds ratio [aOR]: 1.37, 95% confidence interval [CI]: 1.17–1.62), and antenatal care (aOR: 1.36, 95% CI: 1.13–1.64) after adjusting for the effects of socio-demographic variables. Moreover, greater women’s education, paid employment, exposure to media, and better household economic status were related to both use of family planning and antenatal care. Improving women’s autonomy will help to attain both gender equality and improved use of health services.     

Changes in Overall Diet Quality in Relation to Survival in Postmenopausal Women with Breast Cancer: Results from the Women’s Health Initiative

Background

Lifestyle factors are important for cancer survival. However, empirical evidence regarding the effects of dietary changes on mortality in breast cancer survivors is sparse.

Women in jail: is substance abuse treatment enough?

OBJECTIVES: This study examined the self-reported needs of women in jail who indicated a need for drug abuse services. METHODS: A total of 165 interviews were conducted of women held in a large, urban county jail in Ohio in May 1999. RESULTS: Drug-abusing women were more likely to report a need for housing, mental health counseling, education, job training, medical care, family support, and parenting assistance when released from jail. CONCLUSIONS: The provision of drug abuse treatment referrals to women in jail may not break the continual cycle of drug use and incarceration if other needs cannot be addressed.     

Does Pilates-Based Exercise Improve Postural Alignment in Adult Women?

A randomized, controlled trial was conducted to determine the effect of Pilates-based exercise on postural alignment. Seventy-four adult women (mean age ± SD, 34.9 ± 16.4 years) were randomized to a Pilates-based mat class (n = 40) or a control group (n = 34). Pilates-based exercise participants were taught the Initial Mat of Body Control Pilates for 6 months, twice a week, for 60 minutes per session; the control group received no exercise intervention. Repeated measurements were performed at baseline, 3 months, and 6 months of the frontal alignment of the thoracolumbar spine, shoulder, and pelvis, and sagittal alignment of the head and pelvis. No differences were found in either group, over time, on frontal alignment of the thoracolumbar spine and pelvis. The experimental group showed significant improvements in frontal alignment of the shoulder and sagittal alignment of the head and pelvis at 6 months. The Pilates-based exercise enhanced some parameters of the postural alignment of women, as measured by frontal alignment of the shoulder and sagittal alignment of the head and pelvis. The significant improvement in sagittal alignment of the head may imply that 6 months of Pilates-based exercise enhances sagittal alignment of the cervical or thoracic spine.     

Women’s knowledge about heart disease: Differences among ethnic and cultural groups in the Israeli Women’s Health in Midlife Study

Abstract

The current investigation aimed to assess levels of knowledge about risk factors for heart disease among midlife Israeli women, and to evaluate the relationship of knowledge to personal risk factors and vulnerability to heart disease. Face-to-face interviews with women aged 45–64 years were conducted during 2004–2006 within three population groups: long-term Jewish residents (LTR), immigrants from the former Soviet Union, and Arab women. The survey instrument included six knowledge statements relating to: the risk after menopause, family history, elevated cholesterol level, diabetes, obesity, and warning signs of a heart attack. The findings showed wide disparities in knowledge by educational level and between immigrants and LTR, after taking into account personal risk factors and education. Personal risk factors were not significantly related to the knowledge items, except for personal history of cardiovascular disease, which was associated with knowledge about “warning signs of a heart attack” and “family history.” Women who perceived themselves as more vulnerable to heart disease were more likely to identify several risk factors correctly. These findings stress the need to increase knowledge about heart disease, especially among less educated and minority women, and to emphasize the risk of patients’ personal status by health providers.     

A Non-Randomized Controlled Trial for Reducing Postpartum Depression in Low-Income Minority Women at Community-Based Women’s Health Clinics

Maternal and Child Health Journal - To analyze an intervention that delivered tailored clinic staff training on postpartum depression (PPD) followed by awareness raising and social support aimed at...     

Work–Family Trajectories and the Higher Cardiovascular Risk of American Women Relative to Women in 13 European Countries

Objectives. To investigate whether less-healthy work–family life histories contribute to the higher cardiovascular disease prevalence in older American compared with European women.Methods. We used sequence analysis to identify distinct work–family typologies for women born between 1935 and 1956 in the United States and 13 European countries. Data came from the US Health and Retirement Study (1992–2006) and the Survey of Health, Aging, and Retirement in Europe (2004–2009).Results. Work–family typologies were similarly distributed in the United States and Europe. Being a lone working mother predicted a higher risk of heart disease, stroke, and smoking among American women, and smoking for European women. Lone working motherhood was more common and had a marginally stronger association with stroke in the United States than in Europe. Simulations indicated that the higher stroke risk among American women would only be marginally reduced if American women had experienced the same work–family trajectories as European women.Conclusions. Combining work and lone motherhood was more common in the United States, but differences in work–family trajectories explained only a small fraction of the higher cardiovascular risk of American relative to European women.Life expectancy is shorter in the United States than in many Western European countries. Older Americans are also more likely to report poorer health and to suffer chronic conditions, particularly American women.1,2 Explanations for this so-called US health disadvantage include differences in the prevalence of smoking and other behavioral risk factors, rates of disease and injury, financial barriers to health care access, and psychosocial stress.2–6 Although higher smoking prevalence histories among older women in the United States is one of the driving explanations,3 none of these factors fully accounts for the female US health disadvantage.Lives of American women changed substantially in the second half of the previous century. Female labor force participation increased more in the United States than in many European countries,7 and marriage rates decreased more rapidly for US women as a result of a higher fraction of American women never marrying as well as higher divorce rates.8,9 By contrast, although fertility rates declined in all countries,10 they declined less in the United States than in many European countries, leaving more American women facing the prospect of combining work and family roles, often in the context of lone motherhood.Women who are married, employed, and have children are generally healthier than their unmarried, nonemployed, and childless counterparts.11,12 Whereas the role accumulation theory suggests that combining family and work roles is beneficial for women’s health, the multiple role theory poses that combining these roles may increase levels of stress, which has a negative impact on health.13 These negative impacts may, however, depend on the availability of supportive policies that enable parents to combine work with family roles.We hypothesized that work–family trajectories may be differentially related to cardiovascular health in the United States than in Europe, as a result of the different work–family policy environment in the United States and Europe. If combining family and work roles is beneficial for a woman’s health, women experiencing a more family-friendly policy environment such as that in Europe may benefit more from role accumulation, resulting in better cardiovascular health. If combining roles is detrimental for a woman’s health, American women may experience more strain from work–family stress than European women as a result of a less supportive policy environment in the United States.The aim of this study was to assess whether less-healthy work–family life histories among American women have contributed to their cardiovascular health disadvantage in older age relative to women in 13 European countries. We used unique retrospective data for 13 European countries and the United States to construct full life histories and work–family trajectories, and linked them to stroke and heart disease outcomes in older ages. We examined the association between work–family trajectories and late-life cardiovascular outcomes and assessed whether the distribution and risks associated with these work–family trajectories explain why older American women have higher stroke and heart disease prevalence than older women in Europe.