Reproductive Health最新文献

Background: Fertility centre websites are a key sources of information on medically assisted reproduction (MAR) for both infertile people and the general public. As part of a global fertility market, they are also a window to attract potential future patients. They give formal and practical information but in the way the information is displayed, they also convey social representations, and in particular, gender representation in its intersectional dimension. The objective is to analyse the sex, class and race representations regarding reproduction and parenthood that are embedded in the content of fertility centre websites in eight European countries.

Methods: The 5 most visible fertility centres that appeared in the first places on Internet search were selected for each country under study, except for one country which has only three fertility centres. In total, 38 fertility centre websites were considered for a thematic analysis using an iterative approach and a comprehensive perspective.

Results: Each centre details its services and techniques according to the legal provisions in force in its country. However, on all the websites studied, the fertility centres demonstrate a strong gendered representation. The logos generally depict women or parts of their bodies, as do the photos, which mainly show white women with light eyes. The description of the causes of infertility and the techniques offered by the centres also highlights gender differences. Sperm donation, where MAR is reserved for heterosexual couples, is included among the techniques for women with the comment that it will enable them to fulfil their dream of becoming mothers.

Conclusions: MAR, and through it the project of having a child and procreative work, is presented as a matter for white, cisgender and heterosexual women, thus fueling stratified reproduction and limiting reproductive justice. The research team formulated guidelines for fertility centres to encourage them to adopt a more inclusive approach in terms of sex, social class and race, so that the diversity of infertile people feel involved and welcome in these centres, to avoid misperceptions about infertility in the general population and to reinforce autonomy and justice in reproductive matters.

Background: We aimed to assess the attitude of unmarried girls towards virginity, and its determinants, comparing three age cohorts (born in the 70s, 80s, and 90s) in the city of Tabriz in northwestern Iran.

Methods: We conducted a cross-sectional survey among 700 girls residing in Tabriz in 2021 employing a population-based cluster sampling based on health clinics and households. We collected data using a pilot-tested instrument, which comprised socio-demographic questions, and statements to assess attitudes towards virginity and its importance, the meaning of virginity, ways of losing virginity, and perception of the hymen. The data was analyzed using SPSS, version 21. Analysis of variance and independent t-test was used for bivariate analysis and linear regression was used to identify the determinants of the attitude. A p value under 0.05 was considered statistically significant.

Results: Only about one-third (35.2%) of unmarried girls considered preserving virginity as an important issue for girls before marriage in current days. About 27% were uncertain and about 38% believed it was unimportant. The importance of virginity (score range 7-35) was significantly greater for girls born in the 70s than for girls born in the 80s and 90s (p < 0.05). In the multivariate linear regression model, the determinants of the importance of virginity were older age, greater religious affiliation, living with both parents and lower consumption of the internet and social networks for sexual information.

Conclusions: This study indicates significant shifts in sexual attitudes among young females which may have important implications for marriage age and the culturally and age-appropriate sexual health interventions of young people.

Background: Despite decades of a call to action to engage men in reproductive health, men are often left out of programs and interventions. In India, where half of pregnancies are reported as unintended, patriarchal gender norms and still dominant patterns of arranged marriages make engaging men in family planning and strengthening couples communication critical in increasing reproductive autonomy and helping young couples meet their reproductive goals. This study explores the feasibility and acceptability from the men's perspective of the pilot of a gender transformative intervention for newly married couples in India.

Methods: A pilot study was conducted of TARANG, a 4 month intervention for newly married women, with light touch engagement of husbands (4 sessions). A total of 41 husbands participated in the pilot, and we collected baseline knowledge and endline feasibility and acceptability data from them, along with in depth qualitative interviews with 13 men. The study was conducted in June 2023-January 2024.

Results: Men had low levels of knowledge about biology, family planning, with the majority of men reporting that no one had provided them information about these topics. Most men wanted to delay the first birth by at least 2 years, yet less than a quarter had discussed childbearing plans with their partner or engaged in family planning methods. While all men reported high acceptability (satisfaction and usefulness), feasibility (participation) was low, with only 43% attending 2 or more sessions. Main barriers to participation included commitments due to work and migration. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community.

Conclusions: Men in these rural communities are not receiving the information that they need to meet their reproductive goals, however, they greatly desire this information and ways to improve relationships with their new wives. Such an intervention appears to have the potential to help change norms and spread information in the community and provide men with positive, life affirming feelings. Providing information through technology could address barriers to in-person engagement. TRIAL REGISTRATION CLINICALTRIALS.GOV : 03/13/24.NCT06320964.

Background: The single-child issue is a significant contributor to population decline, which adversely affects both parents and children. Despite government-approved incentives, the single-child problem remains a major population challenge. This study was conducted to explore the perceptions and experiences of single-child couples regarding childbearing incentives.

Methods: This qualitative study used conventional content analysis and was performed on 21 single-child couples in Mashhad, North East Iran, selected through purposive sampling from urban health centers. Data were collected using semi-structured interviews until saturation was reached. The data were analyzed using the Elo and Kyngas (J Adv Nurs 62(1):107-15, 2008. 10.1111/j.1365-2648.2007.04569.x) method with MaxQDA10 software.

Results: Two generic categories emerged from the data analysis including (1) "Advertising and providing information as an influencing factor to encourage childbearing", which included two subcategories of "Attention to the key lever of advertising" and "Necessity of adopting advertising policies and creating a culture of respecting maternal role", and (2) "Focusing on effective incentive policies", which consisted of three subcategories of "Adopting incentive policies to reduce people's financial problems", "Avoiding punitive policies" and "Need to adopt incentive policies for working women and elites".

Conclusions: Incentive policies should focus on the culture building of the general public, implementing effective incentive policies, and addressing economic challenges, particularly for specific groups such as working women and higher education students. In addition, a public mobilization effort is needed to effectively implement population laws.

Background: There is growing recognition of obstetric violence in health facilities across the globe. With nearly one in three pregnant women living with HIV in South Africa, it is important to consider the influence of HIV status on birth experiences, including potential experience of obstetric violence as defined by the Respectful Maternity Care Charter. This qualitative analysis aims to understand the factors that shape birth experiences of women living with HIV, including experiences at the nexus of HIV status and obstetric violence, and how women react to these factors.

Methods: Data were collected in a Midwife Obstetric Unit in Gugulethu, Cape Town, South Africa, through 26 in-depth interviews with women living with HIV at 6-8 weeks postpartum. Interviews included questions about labor and early motherhood, ART adherence, and social contexts. We combined template style thematic analysis and matrix analysis to refine themes and subthemes.

Results: Participants described a range of social and structural factors they felt influenced their birth experiences, including lack of resources and institutional policies. While some participants described positive interactions with healthcare providers, several described instances of obstetric violence, including being ignored and denied care. Nearly all participants, even those who described instances of obstetric violence, described themselves as strong and independent during their birth experiences. Participants reacted to birth experiences by shifting their family planning intentions, forming attitudes toward the health facility, and taking responsibility for their own and their babies' safety during birth.

Conclusions: Narratives of negative birth experiences among some women living with HIV reveal a constellation of factors that produce obstetric violence, reflective of social hierarchies and networks of power relations. Participant accounts indicate the need for future research explicitly examining how structural vulnerability shapes birth experiences for women living with HIV in South Africa. These birth stories should also guide future intervention and advocacy work, sparking initiatives to advance compassionate maternity care across health facilities in South Africa, with relevance for other comparable settings.

Background: The high psychological burden of rape, together with complications such as pregnancy and chronic conditions, is associated with an increase in mental disorders. Social cognitive theory (SCT) is an important health theory that views behavior as dynamic and influenced by environmental, behavioral and individual factors. The aim of the present research is to determine the effect of an educational intervention on post-traumatic stress disorder and social cognitive theory constructs in women who have experienced sexual assault.

Methods/design: This study is randomized, double-blind clinical trial research that will be conducted on 40 women with experience of sexual. In this research, by the intervention program based on social cognitive theory include" awareness, self-efficacy, outcome expectations and environment. Written consent will be obtained from the participants to participate in the research. Participants in the intervention group will be taught about health, hygiene, psychology and stress reduction methods in group or individual sessions according to their preference in 6 sessions of 60 min each, one session per week. A post-test will be conducted for both groups.

Discussion: This study provides comprehensive data on the effect of providing an educational intervention using the social cognition Theory. Social cognitive theory focuses on how patterns of behavior are learned and how they function in interaction between the individual and the environment. It seems that the use of this theory in designing the content of educational interventions can be useful and practical.

Trial registration: The trial is prospectively recorded at the IRCT registry (Trial ID: IRCT20230926059526N1. Date recorded: 18/10/2023.

Background: Unintended teenage pregnancies are associated with greater health and socio-economic risks for teenage mothers and newborns. In Kenya, the government has declared a target for ending teenage pregnancy by 2030. However, the prevalence of teenage pregnancy has only decreased slightly, demonstrating the need for further efforts. Understanding teenage mothers' own experiences and perspectives is necessary to design appropriate interventions.

Methods: A community-based qualitative study was conducted from March to May 2023. Two focus group discussions were conducted with community health volunteers and the mothers of teenage girls. Semi-structured interviews were conducted on the case histories of 19 teenage mothers and 18 key informants. Thematic analysis was subsequently performed using MAXQDA 2022.

Findings: Four major reasons emerged for unintended teenage pregnancies: (1) lack of knowledge or awareness about the human reproductive system, (2) lack of knowledge about family planning (FP), (3) financial challenges, and (4) low access to FP. At the study site, cultural norms and stereotypes, such as "infertility caused by FP," "freedom of sex by promoting FP," and "cultural taboos on having sex before marriage and talking about sexuality," were observed as barriers in promoting FP to teenagers. In addition, teenagers from low socio-economic backgrounds were found to be more vulnerable because they can be easily exploited by men who can afford to provide for some of their basic needs. Regarding the influences of unintended teenage pregnancy on teenage mothers' lives, the 19 cases were classified into four categories: (1) dropping out of school, (2) financial challenges, (3) changing relationships with parents, and (4) no major influence. Crucially, unintended teenage pregnancies negatively influenced most study participants. Continuing education, supportive parental attitudes, positive perceptions of the relationship with the child's father, and having future perspectives were identified as factors mitigating the negative influences.

Conclusions: Strengthening culturally appropriate comprehensive sexuality education and the school re-entry policy with a supportive environment may prevent unintended teenage pregnancy and mitigate its negative influences. As financial challenges can be both a reason for and a negative influence of unintended teenage pregnancy, economic empowerment interventions are necessary.