Journal Of Midwifery & Women's Health[JOURNAL]
Sun
103 papers
Folic acid utilization and associated factors among pregnant women who attended public health facilities of illuababor zone, Southwest Ethiopia.
Erqu GA, Alemnew K, Zeleke AM … +4 more , Alemu SS, Fetene HB, Dessie WG, Ibrahim RM
Womens Health (Lond) · 2026 · PMID 42402790 · Publisher ↗
BackgroundThe protective period is the ideal time for folic acid supplementation to prevent neural tube defects. It supplements at least one month before conception up to three months after conception. World health organ...
BackgroundThe protective period is the ideal time for folic acid supplementation to prevent neural tube defects. It supplements at least one month before conception up to three months after conception. World health organization recommends 0.4 mg daily for women from preconception through the first trimester, yet utilization remains challenged.ObjectiveTo assess protective folic acid utilization and associated factors among women attending antenatal care units in Illuababor Zone public facilities.DesignInstitutional based cross-sectional study was conducted.MethodsThis study was conducted among 714 pregnant women attending antenatal care units in public health facilities of the Illuababor zone, selected through a systematic random sampling technique. The data were collected using a semi-structured interviewer-administered questionnaire. Bi-variate and multivariate logistic regression analyses were undertaken, and the association was declared at 95 CI and p-value less than 0.05.ResultsA total of 714 pregnant women participated in the study, resulting in a 97.4% response rate. Only 119 (17%), [95% CI: (14.0, 19.6)] women had utilized protective folic acid. Residence (AOR: 2.16, 95% CI: 1.38, 3.40), history of family planning utilization (AOR: 2.65, 95% CI: 1.23, 5.71), gravida (AOR: 2.07, 95% CI: 1.17, 3.64), gestational age of antenatal care booking (AOR: 8.77, 95% CI: 5.33, 14.45), and knowledge about folic acid (AOR: 2.99, 95% CI: 1.90, 4.71) were identified as significant predictors of folic acid utilization.ConclusionsFolic acid utilization in the protective period stands at just 17%. Key positive predictors are urban residence, prior family planning use, primigravida status, early first-trimester ANC booking, and strong knowledge of folic acid. Enhancing uptake demands multifaceted strategies addressing knowledge gaps and rural access barriers through targeted education and healthcare services.
Overcoming barriers and harnessing facilitators: Respectful maternity care in least-developed countries - a systematic review.
Yohannes E, Moti G, Chaka EE … +3 more , Gabriel L, Creedy DK, Hastie C
Womens Health (Lond) · 2026 · PMID 42308389 · Full text
BackgroundDisrespectful care violates women's rights, delays care-seeking and contributes to preventable adverse birth outcomes. Although Respectful Maternity Care (RMC) is a key strategy for improving maternal and neona...
BackgroundDisrespectful care violates women's rights, delays care-seeking and contributes to preventable adverse birth outcomes. Although Respectful Maternity Care (RMC) is a key strategy for improving maternal and neonatal health, evidence on factors affecting its implementation in least-developed countries remains poorly synthesised.ObjectiveTo assess the barriers and facilitators of RMC in low-income countries.DesignSystematic review synthesising evidence from qualitative and mixed-methods studies was conducted.Data sources and methodsA systematic search was conducted across major databases, including Scopus, Web of Science, PubMed, CINAHL, and Embase. Eligibility criteria were defined using the SPIDER framework. Studies published between 2015 and 2025 were included. Methodological quality was assessed using JBI SUMARI for qualitative studies and the QATSDD tool for mixed-methods studies. SPIDER framework was applied to support eligibility criteria. The review followed PRISMA guidelines. The data were synthesised using thematic analysis and applied to the Socio-Ecological Model.ResultsForty-eight studies conducted in least-developed countries were analysed, consisting of 36 qualitative studies and 12 mixed-methods studies. Barriers and facilitators to RMC were identified at individual (knowledge, attitude, skills), interpersonal, organizational (resources, infrastructures), policy (guidelines, education), and socio-cultural level (norms, cultures).ConclusionStrengthening RMC is crucial for reducing maternal and neonatal mortality. The review highlights the need for supportive policies, improved infrastructure, and targeted provider training. Future research should develop and validate context-specific RMC principles and indicators to strengthen providers' understanding and skills for practice in least-developed countries.RegistrationThe protocol was registered with PROSPERO (CRD42023443998).
Contraceptive use to delay first birth and its associated factors among married young women in rural parts of central Oromia, Ethiopia: A community-based cross-sectional study.
Gobena H, Workneh D, Teferu Z … +5 more , Mathewos B, Fantaye E, Birhanu M, Bekele G, Sorsa R
Womens Health (Lond) · 2026 · PMID 42240004 · Full text
BackgroundIn Ethiopia, young women's pregnancy is a serious public health issue that hurts the health outcomes of both the mother and child. However, no research has been done on the use of contraceptives to delay first...
BackgroundIn Ethiopia, young women's pregnancy is a serious public health issue that hurts the health outcomes of both the mother and child. However, no research has been done on the use of contraceptives to delay first birth and associated factors among married young women aged 15-24 in Ethiopia.ObjectivesThis study aimed to assess the contraceptive use to delay first birth and its associated factors among married young women in rural parts of central Oromia, Ethiopia, in 2024.DesignA community-based cross-sectional study design was employed.MethodsThe sample size for the study was 422 married young women. A census was conducted to obtain a sample frame, and a simple random sampling method was used to select the study participants. Data were collected using interviewer-administered structured questionnaires. The collected data were entered into EpiData version 4.6 and exported to SPSS version 23 for further analysis. Binary logistic regression analyses were performed to identify variables associated with contraceptive use to delay first birth, with a p-value of less than 0.05 considered significant.ResultsThe overall contraceptive use to delay first birth among married young women was 16.3%, with a 95% CI (12.8, 20.3). The following were found to be factors associated with the use of contraceptives to delay first birth among married young women: exposure to contraceptive information. [AOR=4.36; [95% CI: (2.14, 8.86)], p=0.001], a favorable attitude toward contraceptive methods (95% CI: (1.72, 7.31)), and p=0.001]; intention to use contraceptives [AOR=4.16; (95% CI: (1.96, 8.84); p < 0.001)]; perceived social approval [AOR=3.48; (95% CI: (1.65, 7.35)); p=0.001]; beliefs about contraceptive myths at the community level) [AOR=3.74; 95% CI: (1.82, 7.66); p < 0.001); and family planning counseling [AOR=5.19; 95% CI: (2.43, 11.08); p < 0.001) were among the significant variables associated with contraceptive use to delay first birth among young married women.ConclusionsThe contraceptive use to delay first birth among married young women was low. Healthcare providers, policymakers, and program designers should intensify their efforts to create awareness about the importance of contraceptive utilization among young married women to delay their first birth.
Testosterone: Vital to female physiology.
Faucett K, Giles LA, Sing E
Womens Health (Lond) · 2026 · PMID 42133924 · Full text
The vital role of testosterone in normal female physiology and wellbeing is largely ignored by researchers and healthcare providers. The lack of recognition of the importance of testosterone in female health creates a he...
The vital role of testosterone in normal female physiology and wellbeing is largely ignored by researchers and healthcare providers. The lack of recognition of the importance of testosterone in female health creates a health disparity. Androgens are the most abundant sex hormone in all humans, including females. However, the traditional view that testosterone is a male hormone and estrogen is a female hormone is not supported by scientific evidence. Emerging research shows that testosterone plays a crucial role in female reproduction, cardiovascular health, bone remodeling, muscle mass, and brain function. This article aims to review the literature on the physiological role of testosterone in females, the challenges in measuring testosterone levels, and the implications for female health. The authors conducted a review of the literature on testosterone in female physiology, including its biosynthesis, measurement, and effects on various bodily functions. There is a significant gap in research and understanding of the role of testosterone in female health. Barriers to recognizing the importance of testosterone include a male-centric medical system, the lack of standard reference ranges for testosterone during the menstrual cycle, and the general lack of understanding of endogenous testosterone in female endocrinology. There is a clear need for further research and clinical trials to address this health disparity.
Effect of perceived distance to health facility on antenatal care service use in Sub-Saharan Africa: Do socio-demographic characteristics modify these associations?
Bekele Y, Ngoma RL, Abeje G … +2 more , Erbas B, Batra M
Womens Health (Lond) · 2026 · PMID 42126298 · Full text
BackgroundAlthough perceived distance is a key factor in deciding and reaching healthcare, its impact on antenatal care (ANC) utilisation remains underexplored.ObjectiveThis study aims to examine the effect of perceived...
BackgroundAlthough perceived distance is a key factor in deciding and reaching healthcare, its impact on antenatal care (ANC) utilisation remains underexplored.ObjectiveThis study aims to examine the effect of perceived distance on ANC uptake, stratified by key maternal characteristics.DesignCross-sectional analysis based on demographic and health survey data (DHS).MethodsThis study analysed the demographic and health survey data of 26 sub-Saharan African countries, comprising 186,873 women who had given birth within the five years preceding the surveys. The exposure variable was perceived distance to a healthcare facility, categorised as "a big problem" or "not a big problem." Whereas the outcome variable was the number of ANC contacts, classified as no, one to three, four to seven and eight or more contacts. A Generalised Structural Equation Model (GSEM) with a multinomial logit link was employed to examine the association. Analyses were further stratified by socio-demographic characteristics.ResultsThe analysis revealed that women who perceived the distance as a major problem had 15% higher odds of receiving only 1-3 contacts (aOR = 1.15, 95% CI: 1.05, 1.25, p = 0.002), and 51% higher odds of receiving no ANC (aOR = 1.51, 95% CI: 1.35, 1.66, p < 0.001), compared to those receiving eight or more contacts. These associations were particularly pronounced among women with lower educational status (aOR=1.48, 95%CI: 1.29, 1.64), rural residents (aOR=1.55, 95%CI: 1.37, 1.74), low household income (aOR=1.47, 95%CI: 1.27,1.68), and younger age (aOR=1.55, 95%CI: 1.31, 1.80).ConclusionPerceived distance remains a significant barrier to the utilisation of antenatal care services in resource-limited settings. Strengthening health system responsiveness and addressing structural barriers, such as transportation infrastructures, through innovations like mobile antenatal care is vital to improving maternal health outcomes and advancing global health equity.
Perception of childbirth companion presence and its determinants among maternity care providers in Southwest Ethiopia: Mixed-method study.
Erqu GA, Gezimu W, Jiregna B … +2 more , Ferede YA, Zeleke AM
Womens Health (Lond) · 2026 · PMID 42068220 · Full text
BackgroundQuality of care is a key focus of the global maternal and newborn health agenda, especially during labor and delivery. Allowing a companion during labor and childbirth is an effective intervention that promotes...
BackgroundQuality of care is a key focus of the global maternal and newborn health agenda, especially during labor and delivery. Allowing a companion during labor and childbirth is an effective intervention that promotes quality of care; however, the practice is still low in Ethiopia. This study aimed to assess perceptions of childbirth companions and their determinants among maternity care providers working in public health facilities in southwest Ethiopia.DesignAn explanatory-sequential mixed-method study was conducted.MethodThis study was conducted from March 2024 to May 2024 among 481 maternity care providers. Quantitative data were collected using self-administered, semi-structured questionnaires and entered using Epi Data, then exported to SPSS for analysis. Bivariate and multivariate logistic regressions were performed to determine factors associated with perceptions of childbirth companions. Qualitative data were collected through interviews using a semi-structured guide, recorded, transcribed, translated, coded, and analyzed using thematic framework analysis.ResultOf the 481 participants, only 284 (59%) had positive perceptions toward childbirth companions. Above ten years of work experience (AOR = 2.11, 95% CI: 1.14-3.91), received training (AOR = 3.51, 95% CI: 2.25-5.48), recognizing the importance of companion (AOR = 3.77, 95% CI: 2.14-6.64), and having good awareness (AOR = 2.25, 95% CI: 1.43-3.53) were identified as factors affecting care providers' perceptions. The qualitative data revealed themes of awareness, perception, and barriers related to companionship.ConclusionNearly half of the respondents had positive perceptions of childbirth companions. Participants' experiences, training status, views on the importance of companionship, and awareness of companionship were statistically significant to their perceptions. Overcrowding in labor rooms and confidentiality issues were identified as barriers. This study calls for interventions, including strengthening providers' training and expanding labor ward resources to support companion presence.
Learning from the experiences of midwifery students and recent graduates in humanitarian and conflict-affected settings: A prospective cohort study protocol.
Tappis H, Iwu E, Abdullahi H … +3 more , Maina C, Mohammed A, Elnakib S
Womens Health (Lond) · 2026 · PMID 42033279 · Full text
BACKGROUND: Health workforce shortages are a serious impediment to the delivery of effective and person-centered care, particularly in conflict settings. Midwives are a critical cadre who can help avert maternal and chil...
BACKGROUND: Health workforce shortages are a serious impediment to the delivery of effective and person-centered care, particularly in conflict settings. Midwives are a critical cadre who can help avert maternal and child death, but face persistent barriers to education, employment, regulation, and professional development-challenges that are especially pronounced in conflict-affected areas. Few studies have systematically explored midwives' experiences in these settings. OBJECTIVES: The EQUAL midwifery cohort study was established to systematically examine midwives' educational and professional trajectories in Northeast Nigeria and in Central and Southeast Somalia, with the goal of identifying context-specific factors influencing retention, deployment and professional growth. DESIGN: Multiple cohorts of students and recent graduates will be enrolled, complete an intake survey, and be followed with additional surveys approximately 6 months after enrollment and then annually. Focus group discussions and in-depth interviews with a sub-set of participants will follow each round of surveys to expand on survey findings. METHODS AND ANALYSIS: Qualitative data analysis will focus on the lived experiences of participants, and how these experiences shape their professional identities and career trajectories. Survey analysis will assess levels of attrition, including withdrawal from training and exit from the profession post-graduation. Cox regression models will estimate hazard ratios and 95% confidence intervals for these outcomes, and median survival time in the profession will be calculated to determine when attrition is most likely. Risk factors for attrition during both training and professional practice will be examined. ETHICS: Ethical approval was obtained from John Hopkins Bloomberg School of Public Health, the Somali Research and Development Institute, and Yobe State Health Ministry of Health Ethics Committee. DISCUSSION: This research will offer insights into a critical yet under-explored segment of the global health workforce: early career midwives in conflict-affected settings. It serves as a proof-of-concept for the feasibility of longitudinal health workforce research in conflict-affected areas of Nigeria and Somalia, offering unprecedented evidence on the lived experiences and expressed needs of midwives to inform the improvement of midwifery education, working conditions, and support networks in these settings.
Relationship among fear of childbirth, sexual quality of life, and depression during pregnancy: A cross-sectional study.
Ashrafinia F, Jomeen J, Haji-Maghsoudi S … +4 more , Chen H, Kelley EL, Heydari O, Mirzaee Z
Womens Health (Lond) · 2026 · PMID 42033273 · Full text
BACKGROUND: Fear of childbirth (FOC) is a significant psychological concern that can adversely affect maternal well-being and childbirth outcomes. While various factors influencing FOC have been investigated, the influen...
BACKGROUND: Fear of childbirth (FOC) is a significant psychological concern that can adversely affect maternal well-being and childbirth outcomes. While various factors influencing FOC have been investigated, the influence of sexual quality of life (SQOL) has not yet been sufficiently researched. OBJECTIVE: This study aimed to examine the relationships among FOC, SQOL, and depression in pregnant women. DESIGN: A descriptive, cross-sectional study. METHODS: A cross-sectional study was conducted among 614 low-risk primiparous pregnant women aged 18-35 years in Kerman, Iran, between June 2022 and April 2023. Data were collected using the Wijma Delivery Expectancy/Experience Questionnaire Version A, the Edinburgh Postnatal Depression Scale, and the Female Sexual Quality of Life Questionnaire. A path analysis was conducted to examine the effects of SQOL, depression, and sociodemographic factors on FOC. RESULTS: The average age of the mothers was 26.9 ± 4.5 years, and that of the spouses was 29.9 ± 4.2 years. The average gestational age was 35 weeks. SQOL was not significantly correlated to FOC. In contrast, FOC was positively associated with depression ( < 0.001) and the age of the spouse ( = 0.008). The mother's age ( = 0.004) and the presence of chronic diseases ( < 0.001) were also significant negative predictors. In addition, maternal age was associated with better SQOL ( = 0.022), while depression ( < 0.001) and gestational age ( = 0.029) were significant negative predictors. CONCLUSION: Depression was a significant factor negatively related to both FOC and SQOL. Early detection and timely intervention for depression may reduce fear before labor and improve overall well-being during pregnancy.
Pregnancy management for incarcerated individuals with substance use disorder: Insights from North Carolina jails.
Falk I, Anderson A, Jackson J … +5 more , Stewart Z, Satterfield N, Hairston E, Larkin S, Knittel AK
Womens Health (Lond) · 2026 · PMID 41934195 · Full text
BACKGROUND: Pregnancy and substance use disorders (SUD) for incarcerated individuals often overlap, but their management varies greatly between jails. A better understanding of pregnancy management across jails is needed...
BACKGROUND: Pregnancy and substance use disorders (SUD) for incarcerated individuals often overlap, but their management varies greatly between jails. A better understanding of pregnancy management across jails is needed to better guide policy and practice recommendations. OBJECTIVES: To examine the current state of pregnancy management across North Carolina jails, including current practices, challenges, and gaps in pregnancy management in jails. DESIGN: This is a qualitative analysis within a mixed-methods study assessing the scope of perinatal incarceration and the capacity of North Carolina jails to manage perinatal SUD. METHODS: We conducted in-depth interviews with North Carolina jail staff using a semi-structured interview guide between October 2022 and September 2023. We used the ideal-type analysis approach to systematically compare pregnancy management and SUD management practices across facilities. RESULTS: We completed 26 interviews with jail staff. Pregnancy management approaches were unevenly distributed across three ideal types: (1) exclusive use of internal prenatal care resources ( = 2), (2) exclusive use of external prenatal care resources ( = 16), and (3) hybrid use of both internal and external prenatal care resources ( = 8). Within ideal types, SUD management was highly variable. CONCLUSION: The heavy reliance on external resources for prenatal and SUD care highlights the chronic underfunding and staffing challenges faced by these facilities. There is an urgent need for standardized policies governing prenatal care in jail facilities to help reduce disparities in care quality and ensure that all pregnant individuals receive adequate support, regardless of the jail's resources. Alternatives to incarceration during pregnancy should be prioritized.
Husband's knowledge on partner's reproductive rights and associated factors in Wolkite town, Central Ethiopia: A community-based cross-sectional study.
Nigatu S, Wasu W, Abera M … +3 more , Azene Z, Derebe T, Derribow AB
Womens Health (Lond) · 2026 · PMID 41919514 · Full text
BACKGROUND: Women's sexual and reproductive rights are crucial for achieving gender equality and promoting women's rights. Husbands' knowledge and involvement are key in helping women practice their sexual and reproducti...
BACKGROUND: Women's sexual and reproductive rights are crucial for achieving gender equality and promoting women's rights. Husbands' knowledge and involvement are key in helping women practice their sexual and reproductive health rights. Across East Africa, there are limited studies about husbands' knowledge of their partner's reproductive rights and their associated factors. Hence, this study aimed to determine husbands' knowledge of their partners' reproductive health rights. OBJECTIVE: To assess husbands' knowledge of their partners' reproductive rights and associated factors in Gurage Zone, Central Ethiopia, 2023. DESIGN: A community-based cross-sectional study was conducted among 632 husbands in Wolkite town from March to April, 2023. METHODS: Multi-stage stratified sampling, along with systematic random sampling techniques, was employed to select study participants. A structured, interviewer-administered questionnaire was utilized to gather the data, and then SPSS version 26 was employed for analysis. Bivariate and multivariable analyses were performed to identify variables associated with the husband's knowledge of his partner's reproductive rights using the binary logistic regression model. Statistical significance was declared at a -value <0.05. RESULTS: The overall good knowledge of partners' reproductive health rights was found to be 47.8% (95% confidence interval (CI): 43.8, 51.8). Age of the husbands 25-35 years (adjusted odds ratio (AOR): 2.7; 95% CI: 1.10, 6.6), below primary educational status (AOR: 2.4; 95% CI: 1.3, 4.3), primary educational status (AOR: 5.98; 95% CI: 3.10, 11.4), secondary educational status (AOR: 2.1; 95% CI: 1.01, 4.3), above secondary education status (AOR: 8.0; 95% CI: 4.3, 15.2), discussion with a partner (AOR: 3.2; 95% CI: 2.0, 5.2), and vehicle as a means of transport (AOR: 3.3; 95% CI: 2.2, 4.9) were statistically significant for good husbands' knowledge of partners reproductive health rights. CONCLUSION: These findings indicate that more than half (52.2%) of the study participants had a weak understanding of their partners' reproductive rights. So, counseling and education should be offered to husbands to enhance their knowledge of reproductive rights.
Management of tobacco smoking among pregnant women: A qualitative study with French midwives to inform local practice recommendations.
Alhage M, Arutkin M, Ceccaldi PF … +3 more , Josseran L, Ayoubi JM, Vallée A
Womens Health (Lond) · 2026 · PMID 41826255 · Full text
BACKGROUND: Smoking during pregnancy remains a major public health issue and a leading preventable cause of adverse maternal and fetal outcomes. In France, midwives play a central role in antenatal care and are key actor...
BACKGROUND: Smoking during pregnancy remains a major public health issue and a leading preventable cause of adverse maternal and fetal outcomes. In France, midwives play a central role in antenatal care and are key actors in smoking cessation support. However, little is known about how smoking cessation is managed in routine maternity care and how organizational and professional factors shape these practices. OBJECTIVES: To explore midwives' experiences in managing tobacco use during pregnancy, identify perceived barriers and facilitators in routine practice, and generate context-specific, practice-oriented recommendations to improve smoking cessation support within a maternity care setting. DESIGN: A qualitative study using individual semi-structured interviews. METHODS: Nine midwives working in a single French maternity unit participated in semi-structured interviews conducted between March and May 2023. Data were analyzed using a Framework analysis combining deductive coding informed by the capability, opportunity, and motivation-behavior (COM-B) model and the theoretical domains framework, with inductive refinement to capture emerging themes. Data saturation was assessed retrospectively. Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. RESULTS: Midwives described heterogeneous practices in smoking cessation support and reported multiple barriers to optimal care. Three main challenges emerged: limited prioritization of smoking during consultations, insufficient knowledge and confidence in smoking cessation management, and organizational constraints, including lack of time, absence of structured care pathways, and limited coordination with addiction services. Engagement in smoking cessation discussions was often conditional on perceived patient motivation. These findings informed the development of practice-oriented recommendations targeting training needs, organizational improvements, and supportive tools within the maternity unit. CONCLUSION: This study highlights how individual capabilities, organizational opportunities, and motivational factors interact to shape smoking cessation support in routine maternity care. By adopting an implementation-focused perspective, it identifies modifiable levers to strengthen midwives' capacity to address smoking during pregnancy. The recommendations proposed are exploratory and context-specific, intended to support local quality improvement initiatives rather than national guideline development.
The lived experiences and coping mechanisms of women with obstetric fistula in Ethiopia: A systematic review and meta-synthesis of qualitative evidence.
Abebe Y, Bekele D, Demissie R
Womens Health (Lond) · 2026 · PMID 41480925 · Full text
BACKGROUND: Obstetric fistula, a preventable consequence of prolonged obstructed labor, inflicts profound physical, psychological, and social suffering, leaving many women described as "living dead." In Ethiopia, where t...
BACKGROUND: Obstetric fistula, a preventable consequence of prolonged obstructed labor, inflicts profound physical, psychological, and social suffering, leaving many women described as "living dead." In Ethiopia, where the burden remains high, little is known about women lived experiences and coping strategies beyond clinical outcomes. This review was conducted to synthesize qualitative evidence, illuminate these challenges, and inform holistic interventions. OBJECTIVES: To synthesize available evidence on the lived experiences and coping mechanisms of women with obstetric fistula in Ethiopia. DESIGN: This study employed a qualitative meta-synthesis approach. DATA SOURCES AND METHODS: This review was conducted in accordance with the Joanna Briggs Institute systematic review and meta-synthesis methodological guidance and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. ATLAS.ti software, Version 25, Lumivero was used for analysis. A comprehensive literature search was performed across multiple databases up to May 25, 2025, including both published and unpublished studies examining the lived experiences of women with obstetric fistula. All eligible studies were critically appraised using the Critical Appraisal Skills Program to ensure methodological rigor. Data were systematically extracted and analyzed using thematic synthesis, and the results are presented through tables, narrative summaries, and illustrative diagrams, providing a coherent and evidence-based synthesis of women's experiences and coping mechanisms. RESULTS: Eight studies met the inclusion criteria, encompassing the diverse experiences of women with obstetric fistula in Ethiopia. Four major themes were developed: physical challenges such as pain, foot drop, odor, and urinary incontinence; psychological challenges including hopelessness, grief, and suicidal ideation; socioeconomic challenges like stigma, isolation, divorce, loneliness, social disintegration, and economic difficulties; and coping mechanisms such as self-isolation and wearing multiple layers of clothing. CONCLUSION: Women with obstetric fistula face intersecting physical, psychological, and socioeconomic burdens that erode dignity and social participation. Coping strategies such as self-isolation and layering clothes, while adaptive, often reinforce stigma and exclusion. These findings highlight the need for comprehensive interventions that go beyond surgical repair to include psychosocial support, stigma reduction, and economic reintegration programs. REGISTRATION: Registered with PROSPERO 2025 CRD420251064015.
Elite female Gaelic sports athletes' experience of urinary incontinence: A qualitative study.
Culleton-Quinn E, Bø K, Fleming N … +2 more , Cusack C, Daly D
Womens Health (Lond) · 2025 · PMID 41439500 · Full text
BACKGROUND: Urinary incontinence (UI) is known to be prevalent among elite female athletes. A need for additional sports-specific research has been identified, along with a need to understand female athletes' experience...
BACKGROUND: Urinary incontinence (UI) is known to be prevalent among elite female athletes. A need for additional sports-specific research has been identified, along with a need to understand female athletes' experience of UI. There is a dearth of research on elite Female Gaelic (Irish) sports players competing in national competitions. AIM: To investigate elite female Gaelic sports (Camogie and Football players) athletes' experiences of UI. DESIGN: A qualitative descriptive design using one-to-one interviews. METHODS: Following University ethics approval, purposive sampling was used to recruit elite female Gaelic sports athletes aged 18 years or older playing at the county level between November 2022 and August 2023. Data were analysed thematically using reflexive thematic analysis, a six-phase process. FINDINGS: Nine players consented to and completed an interview. Four key themes and nine sub-themes were generated. Four themes were: (1)'Oh, that happened me' (when and why of UI); (2) 'Then I can manage it that way' (what to do about UI); (3) 'It is frustrating. . . and it bothers me' (impact of UI) and (4) 'No one ever talked' (talking about UI). High-intensity and high-impact activities were identified by all players as triggers for UI, suggesting stress urinary incontinence. Strategies to manage UI were used by all nine players and included extra and frequent pre-match voiding, wearing protection, and modifying their clothing or fluid intake. Players minimised the extent of their UI; however, all spoke of experiencing either a physical or an emotional impact because of the UI. CONCLUSIONS: This study provided qualitative evidence on elite female athletes' experience of UI. Players used strategies to self-manage their UI, few spoke about, or sought help for their UI whilst many expressed a desire for education. Findings suggest a need for education programmes among players to include information about the condition of UI as well as available treatment options.
Older women's lived experience of ageism: Breast cancer screening beyond the targeted age range.
Adams J, Dickson-Swift V, Blackberry I … +1 more , Yuen E
Womens Health (Lond) · 2025 · PMID 41439492 · Full text
BACKGROUND: Ageism has been described as a form of prejudice of one age group against another and is experienced in a range of ways. Little is known about the impact of ageism on the health and well-being of older women....
BACKGROUND: Ageism has been described as a form of prejudice of one age group against another and is experienced in a range of ways. Little is known about the impact of ageism on the health and well-being of older women. Interacting within the healthcare system becomes more complex with age. This occurs because of increased comorbidity and changing perceptions of the ageing body. OBJECTIVES: This study aimed to explore the concept of ageism by reviewing older women's perceptions and experiences of accessing breast cancer screening. DESIGN: Drawing on data gathered by the same researchers, this study utilises a secondary qualitative analysis of primary data. METHODS: This study draws on a purposive sample of 60 women aged ⩾75 years who participated in an Australia-wide study conducted in 2022. In-depth individual interviews were audio-recorded, transcribed verbatim and imported into NVivo software (Version 15) to enable thematic analysis. Secondary analysis drew on a theoretical lens of ageing together with researcher reflection of ageism in society. RESULTS: Women in the study reported experiencing changes in their interaction with and perceptions of healthcare based on age. Perceptions of ageism were grouped into theoretical themes relating to micro, meso and macro concepts of ageism. Thematic headings included: ageing with self-determination and autonomy; meeting the changing health needs of older women and the invisible generation. Generational differences, health system experiences, societal influences and use of technology and online platforms were discussed. Results indicate that ageism may be based on both perception and experience. The impact on health and well-being of women aged ⩾75 years was variable and often modified by associated peer groups. CONCLUSION: Identifying and describing the multiple layers of ageism presents healthcare providers with an opportunity to understand how ageism is experienced by older women. This has implications for effective communication and care. Health messages designed to reach older women must be cognizant of both implicit and explicit forms of ageism. Establishing trust and avoiding reliance on online platforms as sources of information are important for this age group. Health promotion and prevention initiatives based on age-related criteria may contribute to notions of ageism.
Early resumption of sexual intercourse and associated factors among postpartum women in sub-Saharan Africa: Analysis of recent Demographic and Health Survey data (2019-2024).
Negussie YM, Kasu Gebrehana A, Asnake AA … +7 more , Seifu BL, Fente BM, Asebe HA, Melkam M, Tsega SS, Asmare ZA, Bezie MM
Womens Health (Lond) · 2025 · PMID 41408827 · Full text
BACKGROUND: Early resumption of sexual intercourse after childbirth poses significant health risks, including infections, unintended pregnancies, and adverse maternal outcomes. Despite the importance of postpartum sexual...
BACKGROUND: Early resumption of sexual intercourse after childbirth poses significant health risks, including infections, unintended pregnancies, and adverse maternal outcomes. Despite the importance of postpartum sexual health, it remains an overlooked issue, particularly in sub-Saharan Africa, where early sexual resumption is highly prevalent. OBJECTIVE: To examine the prevalence and factors associated with early sexual resumption among postpartum women in sub-Saharan Africa, providing insights to inform targeted interventions and policies to improve postpartum health. DESIGN: A community-based cross-sectional study design. METHODS: Data from the most recent Demographic and Health Survey conducted between 2019 and 2024 across sub-Saharan African countries were used. A total weighted sample of 65,292 postpartum women was included in the analysis. A multilevel mixed-effects model with robust Poisson regression was fitted to identify factors associated with early resumption of sexual intercourse. The deviance statistic was used to assess model fitness. In the multivariable regression analysis, adjusted prevalence ratios with 95% confidence intervals (CIs) were calculated to estimate the strength of associations, with statistical significance set at -value <0.05. RESULTS: The prevalence of early resumption of sexual intercourse was 65.27% (95% CI: 64.91, 65.64). Women's age, educational level, employment status, religion, wealth index, media exposure, family size, whether the child was alive, parity, a woman's desire for more children, and place of residence were statistically significant factors associated with the early resumption of sexual intercourse. CONCLUSION: About two in three postpartum women resumed sexual intercourse early after childbirth. Targeted postpartum counseling, family planning access, and media campaigns are crucial to raising awareness of early sexual resumption risks, particularly among those desiring more children, wealthier, and rural women. Psychosocial support for bereaved mothers and workplace policies supporting postpartum women can help reduce contributing pressures.
Knowledge, attitudes, and barriers to cervical cancer screening utilization among female healthcare professionals in the Tamale Metropolis.
Abdulai AM, Sisala IM, Issah I … +4 more , Kyiu C, Fatimata Y, Ibrahim MM, Wuni A
Womens Health (Lond) · 2025 · PMID 41395722 · Full text
BACKGROUND: Cervical cancer is one of the leading causes of morbidity and mortality among women globally, particularly in regions with limited access to preventive healthcare services. Despite the availability of effecti...
BACKGROUND: Cervical cancer is one of the leading causes of morbidity and mortality among women globally, particularly in regions with limited access to preventive healthcare services. Despite the availability of effective screening methods, uptake remains suboptimal among healthcare professionals. OBJECTIVES: This study assessed the knowledge, attitudes, and barriers to cervical cancer screening among female healthcare professionals at Tamale Teaching Hospital. DESIGN: An institution-based cross-sectional study was conducted among 221 female nurses, 27 female midwives, and 30 female medical doctors in the Tamale Metropolis from October to December 2024. METHODS: A total of 278 female healthcare professionals were recruited using a simple random sampling method to ensure a representative sample. Data were collected through structured questionnaires and analyzed using SAS JMP Pro Statistical Software version 17.1: JMP Statistical Discovery, LLC (a subsidiary of SAS Institute). RESULTS: Of the 278 respondents, more than half (58.6%) had good knowledge of cervical cancer and its screening methods. Factors associated with knowledge of cervical cancer were education ( = 0.002) and professional category ( = 0.039). Moreover, attitudes toward cervical cancer screening were generally positive, with 92.8% agreeing on its importance and 91.8% willing to encourage others to participate. However, the utilization of cervical cancer screening was low (33.1%). The most common barriers to screening utilization included having no reason (72.8%), tight schedules (71.1%), financial constraints (69.5%), and fear of screening outcomes (66.3%). CONCLUSION: Despite positive knowledge and attitudes toward cervical cancer screening, barriers hindered uptake. Workplace-based screening programs are needed to improve screening participation among female healthcare professionals.
Person-centered maternity care during childbirth and its predictors in Ethiopia: Systematic review and meta-analysis.
Kebede TN, Abebe KA, Alemaw Mengstie L … +5 more , Chekole MS, Getahun SA, Moltot Kitaw T, Tsegaw Taye B, Hailemeskel Beshah S
Womens Health (Lond) · 2025 · PMID 41293902 · Full text
BACKGROUND: Person-centered maternity care (PCMC) is a model that prioritizes respect, dignity, and responsiveness to each woman's needs, values, and preferences during childbirth. It promotes open communication and pers...
BACKGROUND: Person-centered maternity care (PCMC) is a model that prioritizes respect, dignity, and responsiveness to each woman's needs, values, and preferences during childbirth. It promotes open communication and personalized care, which is crucial for improving maternal satisfaction and increasing hospital-based deliveries. While recognized as a key element of quality maternal care, the implementation of PCMC varies across different countries. This review aims to assess the pooled mean score and key predictors of PCMC in Ethiopia. OBJECTIVES: This review aims to assess the pooled mean score and key predictors of PCMC in Ethiopia. DESIGN: Systematic review and meta-analysis. DATA SOURCES AND METHODS: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive search was performed in international databases, and registers including: PubMed, Cochrane Library, Google Scholar, , Scopus, Web of Science, and African Journals Online databases. The quality of included studies was evaluated using the Joanna Briggs Institute tool. Heterogeneity was measured with the statistic and its -value, and publication bias was examined through funnel plots and Egger's test. A random effects model was applied to compute the pooled mean score of PCMC, and adjusted β with results presented as 95% confidence interval (CI). RESULTS: Seven studies, involving 3383 women, were included in the review. The pooled mean PCMC score was 56.75% (95% CI: 55.08, 58.41). The highest scores were reported in Oromia (60.2) and Addis Ababa (59.2), while the lowest was in South Gondar (52.3). Key factors influencing PCMC included educational status (β: -2.7, 95% CI: -3.98, -1.45), complications during childbirth (β: -5.34, 95% CI: -7.24, -3.44), and time of delivery (β: -3.10, 95% CI: -4.10, -2.11). CONCLUSION: The pooled mean score of PCMC in Ethiopia is lower than in many other countries. Key determinants include women's education, complications during childbirth, and the timing of delivery. Addressing these factors is crucial for improving the quality of PCMC in Ethiopia.PROSPERO registration number:CRD42024603854.
A scoping review of research to address older women's health during and after incarceration.
Thimmesch A, Aponte C, Krueger KJ … +2 more , Knittel AK, Emerson A
Womens Health (Lond) · 2025 · PMID 41263542 · Full text
BACKGROUND: Older women with criminal legal system involvement (CLSI) are women who are currently or formerly incarcerated or under supervised probation. Older women (age >50) make up about 18% of jail or prison incarcer...
BACKGROUND: Older women with criminal legal system involvement (CLSI) are women who are currently or formerly incarcerated or under supervised probation. Older women (age >50) make up about 18% of jail or prison incarcerated females, about 20,000 individuals, and many more in community supervision. Older women with CLSI face disproportionate aging-related health challenges as a result of social determinants and life circumstances that wear away at health over the long term. Research on health in this group is rare, and even rarer for women after incarceration, potentially hindering the development of focused solutions to improve women's health and access to services. OBJECTIVE: To summarize the research and identify gaps in peer-reviewed research on health and health services use of older women (age <50) with CLSI, we conducted a scoping review following Arksey and O'Malley's six-step method. SOURCES OF EVIDENCE: Searches in PubMed, CINAHL, and EMBASE were conducted, followed by iterative reviews of titles, abstracts, and full-texts. ELIGIBILITY CRITERIA: Data-based studies, published January 2000 to January 2025, and focused on women with CLSI, age >50 years. CHARTING METHODS: We extracted data into a matrix to summarize study characteristics and thematic emphases, divergences, and gaps. RESULTS: Of 25 studies meeting criteria, 12 were qualitative-only; 13 included cross-sectional analyses of health survey or medical record data. We were unable to locate any experimental or longitudinal observational studies. Thematic emphases included physical, mental, and social health and health services use during and post-incarceration; coping strategies, strengths, and resources; and proposed solutions to mitigate health challenges. CONCLUSION: Despite a rising number of older women with CLSI and barriers to aging-related care in and after incarceration, research to understand older women's needs during and after incarceration is rare, and interventional study to meet them is almost non-existent.
What is the impact of lipid-lowering therapies on cardiovascular disease incidence among women with familial hypercholesterolaemia: A systematic review.
Hennessy C, Patton D, O'Connor T … +3 more , Watson C, Moore Z, Nugent L
Womens Health (Lond) · 2025 · PMID 41261814 · Full text
BACKGROUND: Familial hypercholesterolaemia (FH) is a genetic condition that significantly increases cardiovascular disease (CVD) risk, particularly in women. Lipid-lowering therapies (LLTs), such as statins and PCSK9 inh...
BACKGROUND: Familial hypercholesterolaemia (FH) is a genetic condition that significantly increases cardiovascular disease (CVD) risk, particularly in women. Lipid-lowering therapies (LLTs), such as statins and PCSK9 inhibitors, play a crucial role in reducing low-density lipoprotein cholesterol (LDL-C) and preventing CVD. However, women with FH often face disparities in diagnosis, treatment and outcomes. OBJECTIVES: To assess the effectiveness of LLT in reducing CVD incidence among women with FH and identify gaps in current treatment practices. DESIGN: Systematic review. DATA SOURCES AND METHODS: A comprehensive literature search was conducted in December 2024 across PubMed, EMBASE, Web of Science and CINAHL, guided by the PICO framework. Thirteen studies met the inclusion criteria; six were rated high quality using the Evidence-Based Librarianship tool. Due to heterogeneity in study design and outcomes, a narrative synthesis was performed. RESULTS: LLT, particularly statins, consistently reduced LDL-C levels and CVD incidence in women with FH. PCSK9 inhibitors and combination therapies offered additional benefit in high-risk cases. Up to an 80% relative risk reduction was observed in women who initiated early and sustained therapy. However, several studies reported that women were less likely to receive intensive LLT, had a delayed diagnosis and were 32% less likely than men to reach LDL-C targets. Data on premenopausal and menopausal women remain limited. CONCLUSION: LLTs are effective in reducing CVD risk in women with FH, yet treatment disparities persist. Addressing barriers such as adherence, hormonal influences and access to advanced therapies is essential. Personalised, gender-specific strategies are needed to close care gaps and improve outcomes for this high-risk population.
Severe maternal outcomes and their underlying causes in Ethiopia. Systematic review and meta-analysis.
Kebede TN, Abebe KA, Getahun WT … +5 more , Taye BT, Mengistu TD, Fente BM, Chekole MS, Moltot T
Womens Health (Lond) · 2025 · PMID 41208309 · Full text
BACKGROUND: Severe maternal outcomes (SMOs), including maternal deaths and life-threatening complications during pregnancy, childbirth, or within 42 days postpartum, reflect the quality of maternal healthcare services an...
BACKGROUND: Severe maternal outcomes (SMOs), including maternal deaths and life-threatening complications during pregnancy, childbirth, or within 42 days postpartum, reflect the quality of maternal healthcare services and highlight gaps in timely and effective interventions. Monitoring SMOs is crucial for improving maternal health systems, as it helps identify preventable factors, strengthen clinical practices, and inform policy decisions to reduce maternal morbidity and mortality. This study synthesizes existing evidence on the pooled incidence proportion of SMOs in Ethiopia and examines their underlying causes. OBJECTIVE: To estimate the pooled incidence proportion of SMOs and their underlying causes in Ethiopia. DESIGN: Systematic review and meta-analysis. DATA SOURCES AND METHODS: The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. A comprehensive search was conducted in PubMed, Cochrane Library, Google Scholar, Scopus, and Hinari using the CoCoPop strategy. Study quality was assessed using the Newcastle-Ottawa Scale. Heterogeneity was evaluated with the statistic, and publication bias was assessed using funnel plots and Egger's test. A random-effects model was applied to calculate the pooled incidence proportion with 95% confidence intervals (CIs). RESULTS: Thirteen studies, including 2451 SMO cases among 67,954 live births, were analyzed. The pooled incidence of SMOs was 41.74 per 1000 live births (95% CI: 29.58-53.89). The maternal mortality index was 10.53% (95% CI: 7.71-13.36). The leading causes of SMO were pregnancy-induced hypertension (PIH; 40.8%), obstetric hemorrhage (24.94%), uterine rupture (19.61%), severe systemic infection (11.65%), and early pregnancy complications (7.74%). CONCLUSION: The incidence of SMOs in Ethiopia is higher than in many other countries. PIH, obstetric hemorrhage, uterine rupture, severe systemic infection, and early pregnancy complications are the main contributing causes. Targeted, context-specific interventions that emphasize early detection, effective management, and prevention of these conditions could significantly reduce maternal morbidity and mortality. Strengthening healthcare infrastructure, improving access to quality emergency obstetric care, and enhancing community awareness and timely health-seeking behaviors are essential. Policymakers and program planners should prioritize resource allocation and capacity-building efforts tailored to these high-burden conditions to accelerate progress toward national and global maternal health goals.PROSPERO registration number:CRD42024629544.
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