Journal of women's health
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Journal of women's health · Jun 2021
Incidence and Group Comparisons of Harassment Based on Gender, LGBTQ+ Identity, and Race at an Academic Medical Center.
Background: A key recommendation from the landmark National Academies report called for research examining experiences of underrepresented and/or vulnerable groups, including people of color and sexual- and gender-minority people. We examine the prevalence of gender policing harassment (GPH), heterosexist harassment (HH), and racialized sexual harassment (RSH), by gender, LGBTQ+, race, and department grouping, which has not been previously examined in academic medicine. Materials and Methods: All faculty (n = 2723), fellows, residents, and first through third year medical students (n = 1822) at the University of Michigan Medical School (UMMS) who had been working at the organization for at least 1 year were invited to complete a 20-minute online survey. ⋯ Conclusions: Less-studied forms of harassment are common within academic medicine and are perpetrated from various sources. Identity-based harassment should be investigated further to gain a comprehensive understanding of its impact within academic medicine. Clinical Trial Registration Number not applicable.
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Journal of women's health · Jun 2021
Severe Maternal Morbidity, Race, and Rurality: Trends Using the National Inpatient Sample, 2012-2017.
Background: Severe maternal morbidity is related to maternal mortality and an important measure of maternal health outcomes. Our objective was to evaluate differences in rates of severe maternal morbidity and mortality (SMM&M) by rurality and race, and examine these trends over time. Materials and Methods: It involves the retrospective cohort study of delivery hospitalizations from January 1, 2012 to December 31, 2017 from the National Inpatient Sample. ⋯ Rates of SMM&M increased from 2012 to 2017, especially among urban patients. Conclusions: Women in the most urban and most rural counties experienced higher odds of SMM&M, and these relationships differed by race. These findings suggest particular areas for clinical leaders and policymakers to target to reduce geographic and racial disparities in maternal outcomes.
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Journal of women's health · Jun 2021
Randomized Controlled Trial Multicenter StudyThe Effect of Follow-Up Contact on Recovery After Benign Hysterectomy: A Randomized, Single-Blinded, Four-Arm, Controlled Multicenter Trial.
Background: The objective of this trial was to analyze the effect of follow-up programs using standard follow-up protocol and structured coaching on recovery after hysterectomy in an enhanced recovery after surgery setting. Materials and Methods: A randomized, four-armed, single-blinded, controlled multicenter trial comprising 487 women was conducted at five hospitals in the southeast region of Sweden. The women were allocated (1:1:1:1) to Group A: no planned follow-up contact; Group B: a single, planned, structured, broadly kept, follow-up telephone contact with the research nurse the day after discharge; Group C: planned, structured, broadly kept follow-up telephone contact with the research nurse the day after discharge and then once weekly for 6 weeks; and Group D: as Group C, but with planned, structured, coaching telephone contact. ⋯ The occurrence of unplanned telephone contact was significantly lower (by nearly 30%) in the women who had structured coaching. Conclusion: Follow-up contact, including coaching, did not seem to expedite the postoperative recovery in HRQoL or reduce the sick leave after hysterectomy, but the coaching seemed to reduce unplanned telephone contact with the health care services. ClinicalTrial.gov (NCT01526668).
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Journal of women's health · Jun 2021
North American Physician Practice Patterns in the Management of Anticoagulation in Pregnancy.
Background: During pregnancy and in the postpartum period women are at increased risk of venous thromboembolism (VTE) owing to hypercoagulability and mechanical issues, as well as nonpregnancy conditions including inherited and acquired thrombophilia. Although guidelines exist for the use of thromboprophylaxis in this setting, there are differences in the specifics of the recommendations among expert societies. We assessed the current practice patterns of North American providers in the prevention of pregnancy-associated VTE in women with thrombophilia. ⋯ There was consistent use of a prophylactic dose of low-molecular weight heparin (LMWH) ante- and postpartum for individuals with low-risk thrombophilia and past estrogen-provoked VTE but a lack of a consensus of anticoagulant (AC) use and dose in individuals with higher risk thrombophilia. There was variability in the dose selection and monitoring of AC when using induction versus spontaneous labor, with 47% of providers switching from LMWH to unfractionated heparin for those not having a scheduled delivery, and there were differences in the duration of postpartum prophylaxis based upon delivery mode. Conclusion: In this survey of North American experienced specialists' responses to a variety of commonly encountered scenarios of thrombophilia and pregnancy and the management of AC were not always consistent with published guidelines.
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Journal of women's health · Jun 2021
Prenatal and Postpartum Experience, Knowledge and Engagement with Kegels: A Longitudinal, Prospective, Multisite Study.
Introduction: Urinary incontinence (UI) increases during pregnancy and continues into the postpartum period. Continued UI impacts women's comfort and affects aspects of their everyday lives. Kegel exercises have been found to decrease the incidence and severity of UI. ⋯ Consistent education is needed for all women. Education and support should be individualized. Future research is needed to identify techniques that motivate women to routinely perform Kegel exercises.