Pub Date : 2025-12-01Epub Date: 2025-10-21DOI: 10.1016/j.srhc.2025.101157
Muazez KÜÇÜKKAYA , Büşra DOLKUN , Hüsniye DİNÇ KAYA
This study aimed to provide a descriptive synthesis of qualitative studies focusing on women’s experiences with genital aesthetic surgery and develop analytical themes. A systematic review and meta-synthesis. Thematic synthesis, one of the meta-synthesis methods, was used. The selection of articles is shown in PRISMA. Study quality was assessed using McMaster University Tool. Comprehensive searches were conducted across five electronic databases with no publication date limits for qualitative studies published up to 2024, with no publication date limitation. The database search retrieved 767 articles. Of these, 573 duplicates were eliminated, leaving 194 articles assessed for compliance with the research criteria. Although one article met the research criteria, it was excluded because it was categorized as commentary. Finally, 14 articles were included in the analysis. Fourteen studies meeting the inclusion criteria were included. Data analysis identified 12 subcategories, which were grouped into four main categories: “motivations,” “acceptance of genital aesthetic surgery,” “postsurgical experiences,” and “barriers and expectations.” This qualitative meta-synthesis highlights women’s motivations, experiences, and challenges related to genital aesthetic surgery.
{"title":"Women’s opinions and experiences of genital aesthetic surgery: A systematic review and meta-synthesis study","authors":"Muazez KÜÇÜKKAYA , Büşra DOLKUN , Hüsniye DİNÇ KAYA","doi":"10.1016/j.srhc.2025.101157","DOIUrl":"10.1016/j.srhc.2025.101157","url":null,"abstract":"<div><div>This study aimed to provide a descriptive synthesis of qualitative studies focusing on women’s experiences with genital aesthetic surgery and develop analytical themes. A systematic review and <em>meta</em>-synthesis. Thematic synthesis, one of the <em>meta</em>-synthesis methods, was used. The selection of articles is shown in PRISMA. Study quality was assessed using McMaster University Tool. Comprehensive searches were conducted across five electronic databases with no publication date limits for qualitative studies published up to 2024, with no publication date limitation. The database search retrieved 767 articles. Of these, 573 duplicates were eliminated, leaving 194 articles assessed for compliance with the research criteria. Although one article met the research criteria, it was excluded because it was categorized as commentary. Finally, 14 articles were included in the analysis. Fourteen studies meeting the inclusion criteria were included. Data analysis identified 12 subcategories, which were grouped into four main categories: “motivations,” “acceptance of genital aesthetic surgery,” “postsurgical experiences,” and “barriers and expectations.” This qualitative <em>meta</em>-synthesis highlights women’s motivations, experiences, and challenges related to genital aesthetic surgery.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101157"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-26DOI: 10.1016/j.srhc.2025.101160
Fatemah Shafaq, Jennifer Fenwick, Loretta Musgrave
Objective
To explore Australian Clinical Midwifery Educators’ perceptions of the barriers and enablers to facilitating midwifery students’ clinical learning experiences in perinatal loss and grief care.
Method
A qualitative descriptive design was used. Ten Clinical Midwifery Educators participated in semi-structured Zoom interviews. Data were analysed using thematic analysis.
Results
Seven themes emerged, five barriers and two enablers. Barriers included the low prioritisation of perinatal loss education, protective attitudes toward students and women, the emotional and practical challenges of teaching this sensitive topic, and the impact of busy clinical environments. Enablers included students’ emotional readiness and the role of universities as safe spaces to initiate learning and discussion. These findings highlight the complexity of preparing students for perinatal grief care and the need for systemic educational reform.
Conclusion
Graduating midwifery students often lack the knowledge, skills, and confidence to provide evidence-informed, woman-centred care in the context of perinatal loss and grief. Limited clinical exposure contributes to this gap, leaving students underprepared for emotionally complex care situations. Midwifery students require structured, supported exposure to perinatal loss care to build emotional resilience and clinical competence. A shift in mindset is needed to balance protection with preparation. Strengthening university curricula, enhancing collaboration with clinical settings, and prioritising mental preparedness are essential. Future research should examine the impact of pre-registration exposure on graduate midwives’ readiness to provide bereavement care.
{"title":"Navigating grief Pedagogy in Midwifery: Insights from interviews with clinical midwifery educators","authors":"Fatemah Shafaq, Jennifer Fenwick, Loretta Musgrave","doi":"10.1016/j.srhc.2025.101160","DOIUrl":"10.1016/j.srhc.2025.101160","url":null,"abstract":"<div><h3>Objective</h3><div>To explore Australian Clinical Midwifery Educators’ perceptions of the barriers and enablers to facilitating midwifery students’ clinical learning experiences in perinatal loss and grief care.</div></div><div><h3>Method</h3><div>A qualitative descriptive design was used. Ten Clinical Midwifery Educators participated in semi-structured Zoom interviews. Data were analysed using thematic analysis.</div></div><div><h3>Results</h3><div>Seven themes emerged, five barriers and two enablers. Barriers included the low prioritisation of perinatal loss education, protective attitudes toward students and women, the emotional and practical challenges of teaching this sensitive topic, and the impact of busy clinical environments. Enablers included students’ emotional readiness and the role of universities as safe spaces to initiate learning and discussion. These findings highlight the complexity of preparing students for perinatal grief care and the need for systemic educational reform.</div></div><div><h3>Conclusion</h3><div>Graduating midwifery students often lack the knowledge, skills, and confidence to provide evidence-informed, woman-centred care in the context of perinatal loss and grief. Limited clinical exposure contributes to this gap, leaving students underprepared for emotionally complex care situations. Midwifery students require structured, supported exposure to perinatal loss care to build emotional resilience and clinical competence. A shift in mindset is needed to balance protection with preparation. Strengthening university curricula, enhancing collaboration with clinical settings, and prioritising mental preparedness are essential. Future research should examine the impact of pre-registration exposure on graduate midwives’ readiness to provide bereavement care.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101160"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-12DOI: 10.1016/j.srhc.2025.101166
Caitlin Foley, Christine McCourt, Cassandra Yuill
Aim
This study aims to understand midwives’ perceptions of the Ockenden report.
Background
The Ockenden report was published following an inquiry into maternity services at Shrewsbury and Telford Hospitals NHS Trust. It reports multiple failings endemic at the Trust and concludes with 15 ‘Immediate and Essential Actions’ to be enacted across English maternity services. The report and its recommendations have resulted in changes to maternity practice throughout the UK.
Method
An exploratory qualitative study design, comprising semi-structured interviews with nine midwives between May and July 2023.
Results
Two overarching themes were identified; the context of the report, and the impact of the report, and within them five subthemes. These were: “We’ve seen it all before”; Change is complicated; A tool for change; Perception of midwifery; and Fuelling the obstetric paradigm. Midwives recognised the importance of the report and many of the concerns it raised and agreed there are significant problems within UK maternity care. However, there was also an expression of concern regarding the lack of evidence supporting some of the recommendations and how the report was impacting practice.
Conclusions
There are significant problems present in maternity practice in the UK. Inquiries may lead to important recommendations; however, they can be difficult to enact and may have unintended consequences. More research is needed looking into why meaningful change is difficult to achieve and how perinatal professionals interact with policy change.
{"title":"An exploration of midwives’ perceptions of the Ockenden review: a qualitative study","authors":"Caitlin Foley, Christine McCourt, Cassandra Yuill","doi":"10.1016/j.srhc.2025.101166","DOIUrl":"10.1016/j.srhc.2025.101166","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to understand midwives’ perceptions of the Ockenden report.</div></div><div><h3>Background</h3><div>The Ockenden report was published following an inquiry into maternity services at Shrewsbury and Telford Hospitals NHS Trust. It reports multiple failings endemic at the Trust and concludes with 15 ‘Immediate and Essential Actions’ to be enacted across English maternity services. The report and its recommendations have resulted in changes to maternity practice throughout the UK.</div></div><div><h3>Method</h3><div>An exploratory qualitative study design, comprising semi-structured interviews with nine midwives between May and July 2023.</div></div><div><h3>Results</h3><div>Two overarching themes were identified; the context of the report, and the impact of the report, and within them five subthemes. These were: “We’ve seen it all before”; Change is complicated; A tool for change; Perception of midwifery; and Fuelling the obstetric paradigm. Midwives recognised the importance of the report and many of the concerns it raised and agreed there are significant problems within UK maternity care. However, there was also an expression of concern regarding the lack of evidence supporting some of the recommendations and how the report was impacting practice.</div></div><div><h3>Conclusions</h3><div>There are significant problems present in maternity practice in the UK. Inquiries may lead to important recommendations; however, they can be difficult to enact and may have unintended consequences. More research is needed looking into why meaningful change is difficult to achieve and how perinatal professionals interact with policy change.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101166"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dalarna University (Sweden) and three Ukrainian universities in 2023 initiated a collaborative project to strengthen SRHR education in Ukraine through new curricula, an online platform, and peer-learning workshops. The objective of this commentary is to present the project’s approach, implementation, and outcomes, demonstrating how international academic collaboration can strengthen SRHR education and youth consultation services in the context of war and post-war reconstruction. Inspired by Sweden’s comprehensive sexuality education model, the project meets humanitarian needs while supporting reforms. Policy priorities include aligning with UNESCO guidance on sexuality education, integrating adolescent SRHR into healthcare financing, and expanding youth-friendly services.
{"title":"Advancing sexual and reproductive health and rights in wartime Ukraine through international collaboration","authors":"Kerstin Erlandsson , Valerie Marichereda , Viktoriia Borshch , Iryna Mogilevkina , Kateryna Nitochko , Larysa Klymanska , Liliia Klos , Inna Haletska , Maryna Klimanska , Tetiana Chaban , Halyna Herasym , Catrin Borneskog","doi":"10.1016/j.srhc.2025.101158","DOIUrl":"10.1016/j.srhc.2025.101158","url":null,"abstract":"<div><div>Dalarna University (Sweden) and three Ukrainian universities in 2023 initiated a collaborative project to strengthen SRHR education in Ukraine through new curricula, an online platform, and peer-learning workshops. The objective of this commentary is to present the project’s approach, implementation, and outcomes, demonstrating how international academic collaboration can strengthen SRHR education and youth consultation services in the context of war and post-war reconstruction. Inspired by Sweden’s comprehensive sexuality education model, the project meets humanitarian needs while supporting reforms. Policy priorities include aligning with UNESCO guidance on sexuality education, integrating adolescent SRHR into healthcare financing, and expanding youth-friendly services.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101158"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nurses and midwives are foundational to resilient health systems and achieving Universal Health Coverage, yet global policies often fail to reflect their distinct competencies, regulatory frameworks, and contributions. As the International Standard Classification of Occupations (ISCO) undergoes revision, a proposed sub-category—“nurse-midwives” under Midwifery Professionals—risks conflating these two professions. This commentary argues that such a classification threatens the integrity of health workforce data, undermines midwifery-led models of care, and compromises efforts to meet global targets for sexual, reproductive, maternal, newborn, and adolescent health. Drawing on the latest State of the World’s Nursing and Midwifery reports, we demonstrate how misclassification inflates midwifery coverage estimates and obscures persistent shortages. Furthermore, merging professions risks diminishing the autonomy and unique philosophy of midwifery, promoting over-medicalised care and diverting critical resources. We call for the preservation of nursing and midwifery as distinct, equally essential professions—each deserving of separate investment, regulation, and recognition. Only through accurate classification can we ensure accountable workforce planning, protect midwifery’s unique contributions, and advance person-centered, gender-equitable health systems worldwide.
{"title":"Preserving professional distinction: The risk of merging nurses and midwives and the imperative to strengthen both professions – A commentary","authors":"Malin Bogren , Alison McFadden , Paridhi Jha , Kerstin Erlandsson","doi":"10.1016/j.srhc.2025.101167","DOIUrl":"10.1016/j.srhc.2025.101167","url":null,"abstract":"<div><div>Nurses and midwives are foundational to resilient health systems and achieving Universal Health Coverage, yet global policies often fail to reflect their distinct competencies, regulatory frameworks, and contributions. As the International Standard Classification of Occupations (ISCO) undergoes revision, a proposed sub-category—“nurse-midwives” under Midwifery Professionals—risks conflating these two professions. This commentary argues that such a classification threatens the integrity of health workforce data, undermines midwifery-led models of care, and compromises efforts to meet global targets for sexual, reproductive, maternal, newborn, and adolescent health. Drawing on the latest State of the World’s Nursing and Midwifery reports, we demonstrate how misclassification inflates midwifery coverage estimates and obscures persistent shortages. Furthermore, merging professions risks diminishing the autonomy and unique philosophy of midwifery, promoting over-medicalised care and diverting critical resources. We call for the preservation of nursing and midwifery as distinct, equally essential professions—each deserving of separate investment, regulation, and recognition. Only through accurate classification can we ensure accountable workforce planning, protect midwifery’s unique contributions, and advance person-centered, gender-equitable health systems worldwide.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101167"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-09-23DOI: 10.1016/j.srhc.2025.101148
Irene Masini , Emily Frisch , Rana Andary , Elisabeth McCallum , Jonathan Steller , Jasmine Patel
Objectives
To evaluate the preferences for and knowledge of contraceptive-induced amenorrhea among a reproductive age predominantly Hispanic community in Southern California.
Methods
This cross-sectional study recruited English and Spanish speaking reproductively capable participants from three outpatient clinics associated with a large academic hospital. A validated survey assessed preferences and knowledge surrounding contraceptive-induced amenorrhea. Descriptive statistics, bivariate analyses using chi-squared tests, and multivariate regression were performed to evaluate the association between demographic variables and the desire for contraceptive-induced amenorrhea, as well as its perceived safety.
Results
Of 209 respondents (response rate: 78.9 %), 66.5 % were Hispanic and 48.8 % identified as Christian. A majority of participants (56.5 %) would not consider a contraceptive method that would induce amenorrhea. Furthermore, a majority of participants (64.1 %) believed that contraceptive-induced amenorrhea is harmful. Belief of harm due to contraceptive-induced amenorrhea was associated with avoiding contraception that could induce amenorrhea (p < 0.001). However, participants who were discontent with menstruation statistically preferred contraceptive-induced amenorrhea (p < 0.01). No significant association was found between race and preference for contraceptive-induced amenorrhea (p = 0.89) or understanding of its safety (p = 0.34).
Conclusions
The majority of our sample would not prefer contraceptive-induced amenorrhea and feared that amenorrhea would be harmful. Given the perceived harm of contraceptive induced amenorrhea may limit the use of highly effective methods for all races, educational initiatives aimed at reviewing safety may allow for more informed patient decision-making.
{"title":"Contraceptive-induced amenorrhea: An exploratory study of perceptions among a reproductive-age urban Southern California population","authors":"Irene Masini , Emily Frisch , Rana Andary , Elisabeth McCallum , Jonathan Steller , Jasmine Patel","doi":"10.1016/j.srhc.2025.101148","DOIUrl":"10.1016/j.srhc.2025.101148","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the preferences for and knowledge of contraceptive-induced amenorrhea among a reproductive age predominantly Hispanic community in Southern California.</div></div><div><h3>Methods</h3><div>This cross-sectional study recruited English and Spanish speaking reproductively capable participants from three outpatient clinics associated with a large academic hospital. A validated survey assessed preferences and knowledge surrounding contraceptive-induced amenorrhea. Descriptive statistics, bivariate analyses using chi-squared tests, and multivariate regression were performed to evaluate the association between demographic variables and the desire for contraceptive-induced amenorrhea, as well as its perceived safety.</div></div><div><h3>Results</h3><div>Of 209 respondents (response rate: 78.9 %), 66.5 <strong>%</strong> were Hispanic and 48.8 % identified as Christian. A majority of participants (56.5 %) would not consider a contraceptive method that would induce amenorrhea. Furthermore, a majority of participants (64.1 %) believed that contraceptive-induced amenorrhea is harmful. Belief of harm due to contraceptive-induced amenorrhea was associated with avoiding contraception that could induce amenorrhea (p < 0.001). However, participants who were discontent with menstruation statistically preferred contraceptive-induced amenorrhea (p < 0.01). No significant association was found between race and preference for contraceptive-induced amenorrhea (p = 0.89) or understanding of its safety (p = 0.34).</div></div><div><h3>Conclusions</h3><div>The majority of our sample would not prefer contraceptive-induced amenorrhea and feared that amenorrhea would be harmful. Given the perceived harm of contraceptive induced amenorrhea may limit the use of highly effective methods for all races, educational initiatives aimed at reviewing safety may allow for more informed patient decision-making.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101148"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-09-18DOI: 10.1016/j.srhc.2025.101146
Neelam Punjani , Shannon D Scott , Amber Hussain , Tammy Lu , Farah Bandali , Sheila McDonald , Lisa Allen Scott
Background
Parents play a pivotal role in delivering comprehensive sexuality education (CSE) to their children. While school-based programs have expanded in many settings, parents often face cultural, informational, and emotional barriers in engaging in open discussions about sexual health. These challenges are intensified in diverse societies such as Canada, where cultural values and personal beliefs vary widely. Despite the growing recognition of parental involvement in CSE, limited research has explored Canadian parents’ perspectives on sexuality education, particularly in multicultural contexts.
Methods
We employed a community-based participatory research (CBPR) approach to examine the experiences, beliefs, and barriers Canadian parents face in providing sexuality education. Six virtual focus group discussions (FGDs) were conducted with 30 parents of children aged 0–18 years. Participants were recruited through purposeful and snowball sampling to ensure diverse representation. Data was analyzed using inductive thematic analysis to identify key themes related to parents’ understanding, approaches, and needs regarding sexuality education.
Results
Three major themes emerged (1) The holistic nature of sexuality education, emphasizing the importance of emotional, psychological, and social aspects alongside biology; (2) Timing and approaches, revealing uncertainty around when and how to initiate these conversations and a preference for child-led, ongoing dialogue; and (3) Influences of society, media, and schools, highlighting external factors shaping children’s understanding and parents’ concerns over misinformation and inconsistent educational content. Parents also reported difficulties accessing age-appropriate, culturally relevant, and accessible educational resources.
Conclusion
Canadian parents face multifaceted challenges in navigating sexuality education, shaped by cultural taboos, lack of resources, and limited confidence in initiating these discussions. The findings underline the need for inclusive, parent-focused resources, training, and policies that support caregivers in delivering accurate and age-appropriate sexuality education. Strengthening partnerships between families, schools, and healthcare systems is essential to bridge knowledge gaps and promote healthy sexual development in youth.
{"title":"Bridging the Gap: Canadian Parents’ barriers and concerns in delivering sexuality education – A qualitative study","authors":"Neelam Punjani , Shannon D Scott , Amber Hussain , Tammy Lu , Farah Bandali , Sheila McDonald , Lisa Allen Scott","doi":"10.1016/j.srhc.2025.101146","DOIUrl":"10.1016/j.srhc.2025.101146","url":null,"abstract":"<div><h3>Background</h3><div>Parents play a pivotal role in delivering comprehensive sexuality education (CSE) to their children. While school-based programs have expanded in many settings, parents often face cultural, informational, and emotional barriers in engaging in open discussions about sexual health. These challenges are intensified in diverse societies such as Canada, where cultural values and personal beliefs vary widely. Despite the growing recognition of parental involvement in CSE, limited research has explored Canadian parents’ perspectives on sexuality education, particularly in multicultural contexts.</div></div><div><h3>Methods</h3><div>We employed a community-based participatory research (CBPR) approach to examine the experiences, beliefs, and barriers Canadian parents face in providing sexuality education. Six virtual focus group discussions (FGDs) were conducted with 30 parents of children aged 0–18 years. Participants were recruited through purposeful and snowball sampling to ensure diverse representation. Data was analyzed using inductive thematic analysis to identify key themes related to parents’ understanding, approaches, and needs regarding sexuality education.</div></div><div><h3>Results</h3><div>Three major themes emerged (1) The holistic nature of sexuality education, emphasizing the importance of emotional, psychological, and social aspects alongside biology; (2) Timing and approaches, revealing uncertainty around when and how to initiate these conversations and a preference for child-led, ongoing dialogue; and (3) Influences of society, media, and schools, highlighting external factors shaping children’s understanding and parents’ concerns over misinformation and inconsistent educational content. Parents also reported difficulties accessing age-appropriate, culturally relevant, and accessible educational resources.</div></div><div><h3>Conclusion</h3><div>Canadian parents face multifaceted challenges in navigating sexuality education, shaped by cultural taboos, lack of resources, and limited confidence in initiating these discussions. The findings underline the need for inclusive, parent-focused resources, training, and policies that support caregivers in delivering accurate and age-appropriate sexuality education. Strengthening partnerships between families, schools, and healthcare systems is essential to bridge knowledge gaps and promote healthy sexual development in youth.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101146"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intrauterine devices (IUDs) are highly effective long-acting reversible contraceptives (LARCs) with relatively low uptake in Australia. They are typically inserted in primary care settings by trained general practitioners. Most patients report some pain during this procedure, yet health care provider (HCP) perspectives on pain management during IUD insertions is not well understood.
Methods
Individual semi-structured online interviews were conducted in 2024 with 16 HCPs who have inserted at least one IUD (outside of a training context) since 2020, in Victoria, Australia. Data were thematically analysed.
Results
Four themes were identified: managing pain requires diverse and adaptable strategies, conflicts in duty of care, awareness of and response to patient’s expected and actual pain, and systemic barriers to pain management. Participants felt that a standardised approach to pain management for IUD insertions was unsuitable, and pain management for this procedure requires patient preparation and flexible pharmaceutical and non-pharmaceutical strategies. Maintaining patient-centred care whilst inserting the IUD and managing pain was challenging, particularly as participants observed discrepancies in verbal and non-verbal cues from patients. Clinical and structural barriers impacted their ability to provide this level of care.
Conclusion
Most participants expressed satisfaction with current pain management methods, and some pain was viewed as expected for this procedure, revealing a possible disconnect between provider and patient expectations. Findings indicate that updated clinical guidelines, funding that reflects the time and skill required to complete this procedure and improved access to IUD insertions under anaesthetic would better support HCPs in mitigating their patient’s pain.
{"title":"This might hurt: Healthcare provider’s experience of managing pain during intrauterine device insertions in Victoria, Australia","authors":"Hannah Wood , Cassandra Caddy , Henrietta Williams , Cathy Watson , Jacqueline Coombe","doi":"10.1016/j.srhc.2025.101153","DOIUrl":"10.1016/j.srhc.2025.101153","url":null,"abstract":"<div><h3>Background</h3><div>Intrauterine devices (IUDs) are highly effective long-acting reversible contraceptives (LARCs) with relatively low uptake in Australia. They are typically inserted in primary care settings by trained general practitioners. Most patients report some pain during this procedure, yet health care provider (HCP) perspectives on pain management during IUD insertions is not well understood.</div></div><div><h3>Methods</h3><div>Individual semi-structured online interviews were conducted in 2024 with 16 HCPs who have inserted at least one IUD (outside of a training context) since 2020, in Victoria, Australia. Data were thematically analysed.</div></div><div><h3>Results</h3><div>Four themes were identified: managing pain requires diverse and adaptable strategies, conflicts in duty of care, awareness of and response to patient’s expected and actual pain, and systemic barriers to pain management. Participants felt that a standardised approach to pain management for IUD insertions was unsuitable, and pain management for this procedure requires patient preparation and flexible pharmaceutical and non-pharmaceutical strategies. Maintaining patient-centred care whilst inserting the IUD and managing pain was challenging, particularly as participants observed discrepancies in verbal and non-verbal cues from patients. Clinical and structural barriers impacted their ability to provide this level of care.</div></div><div><h3>Conclusion</h3><div>Most participants expressed satisfaction with current pain management methods, and some pain was viewed as expected for this procedure, revealing a possible disconnect between provider and patient expectations. Findings indicate that updated clinical guidelines, funding that reflects the time and skill required to complete this procedure and improved access to IUD insertions under anaesthetic would better support HCPs in mitigating their patient’s pain.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101153"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-19DOI: 10.1016/j.srhc.2025.101156
W. Dechassa Heyi , P.M. Macharia , A. Asefa , L. Beňová , O.S. Olagunju , W. Mekonnen
Objective
Despite new recommendations for eight visits, four visits (ANC4+ ) remain low and inequitable in sub-Saharan Africa. Intra-urban estimates are often lacking to inform targeted interventions. This study applied small area estimation (SAE) to model the spatial variation of ANC4+ coverage in Addis Ababa city, Ethiopia.
Study design
Cross-sectional.
Methods
We analyzed data from women who had given a live birth in the five years preceding the 2016 Ethiopia Demographic and Health Surveys (DHS) in Addis Ababa city (∼5million population). In addition to covariates from DHS, we included auxiliary data on travel time to the nearest health facility . A Bayesian hierarchical spatial model was used to model ANC4+ coverage in the 10 sub-cities of Addis Ababa city, adjusting for covariates.
Result
Overall ANC4+ was 88.7 % (95 % CI: 84.2–92.1), with sub-city variation ranging from 80.6 % in Kolfe Keranio to 98.2 % in Nifas Silk Lafto. Eight of the ten sub-cities had ANC4+ coverage less than 90 %. Women less than 20 years (AOR = 0.30; 95 % CI: 0.99–1.16), with no education (AOR = 0.30; 95 % CI: 0.11–0.89), poorer wealth quintile (AOR = 0.40; 95 % CI: 0.19–1.04), and longer travel time (AOR = 0.90; 95 % CI: 0.82–0.99) were associated with lower ANC4+ utilization. Married women (AOR = 2.20; 95 % CI: 1.10–4.50) were associated with higher utilization of ANC4+.
Conclusion
Despite Addis Ababa’s relatively high overall ANC4+ coverage, significant differences at the sub-city level exist, with coverage still short of the 95 % global target. Targeted resource allocation and geographically informed policies are required to reduce these disparities.
{"title":"Geographic disparities in antenatal care utilization in Addis Ababa city, Ethiopia using demographic and health survey data: A small area estimation approach","authors":"W. Dechassa Heyi , P.M. Macharia , A. Asefa , L. Beňová , O.S. Olagunju , W. Mekonnen","doi":"10.1016/j.srhc.2025.101156","DOIUrl":"10.1016/j.srhc.2025.101156","url":null,"abstract":"<div><h3>Objective</h3><div>Despite new recommendations for eight visits, four visits (ANC4+ ) remain low and inequitable in sub-Saharan Africa. Intra-urban estimates are often lacking to inform targeted interventions. This study applied small area estimation (SAE) to model the spatial variation of ANC4+ coverage in Addis Ababa city, Ethiopia.</div></div><div><h3>Study design</h3><div>Cross-sectional.</div></div><div><h3>Methods</h3><div>We analyzed data from women who had given a live birth in the five years preceding the 2016 Ethiopia Demographic and Health Surveys (DHS) in Addis Ababa city (∼5million population). In addition to covariates from DHS, we included auxiliary data on travel time to the nearest health facility . A Bayesian hierarchical spatial model was used to model ANC4+ coverage in the 10 sub-cities of Addis Ababa city, adjusting for covariates.</div></div><div><h3>Result</h3><div>Overall ANC4+ was 88.7 % (95 % CI: 84.2–92.1), with sub-city variation ranging from 80.6 % in Kolfe Keranio to 98.2 % in Nifas Silk Lafto. Eight of the ten sub-cities had ANC4+ coverage less than 90 %. Women less than 20 years (AOR = 0.30; 95 % CI: 0.99–1.16), with no education (AOR = 0.30; 95 % CI: 0.11–0.89), poorer wealth quintile (AOR = 0.40; 95 % CI: 0.19–1.04), and longer travel time (AOR = 0.90; 95 % CI: 0.82–0.99) were associated with lower ANC4+ utilization. Married women (AOR = 2.20; 95 % CI: 1.10–4.50) were associated with higher utilization of ANC4+.</div></div><div><h3>Conclusion</h3><div>Despite Addis Ababa’s relatively high overall ANC4+ coverage, significant differences at the sub-city level exist, with coverage still short of the 95 % global target. Targeted resource allocation and geographically informed policies are required to reduce these disparities.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101156"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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