Journal Of Midwifery & Women's Health[JOURNAL]
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103 papers
Can prepregnancy BMI be used to detect the risk of sarcopenia in Japanese pregnant women?
Miwa Y, Yasuda T, Fujimoto E … +1 more , Kubota K
Womens Health (Lond) · 2025 · PMID 41170603 · Full text
BACKGROUND: More than 20% of young Japanese women fall into the category of presarcopenia (only the skeletal muscle mass is below the sarcopenia criteria), and it has recently been pointed out that thinness in young adul...
BACKGROUND: More than 20% of young Japanese women fall into the category of presarcopenia (only the skeletal muscle mass is below the sarcopenia criteria), and it has recently been pointed out that thinness in young adult women may be associated with future problems related to sarcopenia (age-related muscle weakness). However, the problem of sarcopenia is related to skeletal muscle, and body mass index (BMI) cannot assess only skeletal muscle. OBJECTIVE: Prepregnancy BMI does not assess body composition and may not adequately assess the physical health of pregnant women. DESIGN: The study employed a longitudinal study design. METHODS: The purpose of this study was to examine the possibility that health problems caused by sarcopenia may be overlooked if pregnant women are classified using prepregnancy BMI. Fifty-one first-time mothers without underlying medical conditions (underweight (BMI < 18.5 kg/m, = 8), normal weight (18.5 kg/m < BMI < 25 kg/m, = 39) and obese (25 kg/m < BMI < 30 kg/m, = 4) groups) were included. Skeletal muscle index (SMI = (two upper limb muscle mass + two lower limb muscle mass)/height) and maximum voluntary isometric contraction of grip strength used in European and Asian sarcopenia diagnostic criteria were used to assess sarcopenia in mid- and late pregnancy. RESULTS: For the normal-weight and underweight groups in mid- and late pregnancy, 12%-16% of participants met the diagnostic criteria for sarcopenia according to grip strength (<18 kg), 14%-26% of participants met the diagnostic criteria for sarcopenia according to the SMI (<5.7 kg/m) and 4%-8% of participants met the diagnostic criteria for sarcopenia according to both grip strength and the SMI. CONCLUSION: Among the pregnant women who were classified as 'normal' based on their prepregnancy BMI, 12%-26% had sarcopenia. It is therefore suggested that pregnant women's health problems could be more appropriately assessed by body composition rather than by BMI classification.
Anemia and associated factors among women with cancer patients in Ethiopia: A systematic review and meta-analysis.
Zeleke AM, Ferede YA, Takele GA … +4 more , Beyene JA, Gonete YA, Abebe MT, Tassew WC
Womens Health (Lond) · 2025 · PMID 41126512 · Full text
BACKGROUND: Anemia is a major complication associated with cancer that can lead to various side effects in patients. It is caused by multiple factors and has a significant impact on public health. Although anemia frequen...
BACKGROUND: Anemia is a major complication associated with cancer that can lead to various side effects in patients. It is caused by multiple factors and has a significant impact on public health. Although anemia frequently occurs during cancer treatment and can affect the prognosis of female cancer patients, data are scarce regarding its prevalence and related factors among female cancer patients. OBJECTIVES: To assess methodologically the occurrence of anemia and its causes in female cancer patients in Ethiopia. DESIGN: Systematic reviews and meta-analyses. DATA SOURCES AND METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for this review. A total of 5249 articles were retrieved using Scopus, PubMed, Web of Science, Science Direct, and National Digital Library repositories from December 1, 2024, to May 30, 2025. In addition, searches were conducted on Google Scholar and from Ethiopian university research repositories, supplemented by manual reference checks. Data extraction were carried out using an Excel form and subsequently imported into STATA version 11for analysis. Techniques such as forest plots, Cochran's test, and subgroup analysis were utilized to evaluate heterogeneity among the included studies. Publication bias was examined through funnel plots and Egger's regression test. The random effects model was implemented to estimate the outcome variables. RESULTS: Twenty-one studies involving 8672 participants were included in this review. The overall pooled prevalence of anemia among women with cancer was 41.48% (95% confidence interval 34.10, 48.87). Advanced cancer stage (>2), use of high number of cycles of chemotherapy, and long duration of cancer (more than 12 months) were identified as significant determinants. CONCLUSIONS: The combined prevalence of anemia in female cancer patients was significant. Therefore, individuals displaying the aforementioned risk factors should be closely monitored. Preventive strategies are encompass optimizing nutritional status and addressing deficiencies in iron, folate, or vitamin B12. Healthcare providers properly align with the treatment protocols of cancer patients to effectively prevent complications arising from chemotherapy. Such alignment ensures a comprehensive approach to patient care, ultimately enhancing treatment outcomes and quality of life. The study is registered in the PROSPERO database under the number CRD42024569783.
Breaking barriers: A qualitative study exploring the social and cultural factors that influence HIV awareness and uptake of HIV prevention among women of African and Caribbean heritage in England.
Jones N, Bekaert S, Regisford D … +1 more , Shodunke NJ
Womens Health (Lond) · 2025 · PMID 41126510 · Full text
BACKGROUND: There have been impressive advancements made in preventing and treating HIV. However, the impacts have not been experienced equally across demographics in England. African born persons, in particular women of...
BACKGROUND: There have been impressive advancements made in preventing and treating HIV. However, the impacts have not been experienced equally across demographics in England. African born persons, in particular women of Black African ethnicity, continue to be disproportionately affected by HIV. HIV prevention campaigns have often overlooked social, cultural, and structural factors that shape access to HIV prevention. OBJECTIVES: This paper explores how women of African and Caribbean heritage understand HIV within their social networks, and how they perceive HIV and sexual health services. This insight is needed to develop more inclusive and effective approaches to HIV prevention. DESIGN: This study adopted a participatory action research framework, acknowledging lived experience as a basis of knowledge. METHODS: Focus groups and one-to-one interviews were used to collect qualitative data from a local community women's group between June 2021 and November 2021. In total, 23 women of African and Caribbean heritage participated in this study. Four women opted to take part in a one-to-one interview, and 19 women participated in one of five focus groups. Data were analysed using an applied thematic analysis. RESULTS: Three key themes emerged from the data. Fear of HIV derives from traumatic lived experiences, which have shaped trust in health care services in England and limited the acceptance of information about HIV treatment, such as U=U (Undetectable = Untransmittable). There was a low perception of HIV acquisition risk, shaped by personal circumstances and stigmatising beliefs. For those acknowledging they may be at risk of HIV acquisition attributed this to the behaviour of their male partners. Participating in this study provided a safe space for women to share their experiences of HIV, ask questions, and learn new information, revealing focus groups as an effective method of raising awareness and reducing stigma. CONCLUSIONS: Multiple factors shape the understanding of HIV and uptake of HIV prevention among women of African and Caribbean heritage. Local, community-specific, and participatory HIV prevention interventions are needed to understand and respond to these factors.
Utilization of postpartum family planning and associated factors among postpartum women attending five healthcare facilities in a rural district in Northern Uganda.
Madira E, Auma AG, Kabunga A … +7 more , Asiimwe MG, Acobi A, Namukwana B, Izaruku R, Acayo VC, Opio PP, Opio DO
Womens Health (Lond) · 2025 · PMID 40974222 · Full text
BACKGROUND: Postpartum women worldwide, despite wishing to delay or avoid pregnancies, often resume sexual activity without family planning, contributing to 121 million unintended pregnancies annually, particularly in su...
BACKGROUND: Postpartum women worldwide, despite wishing to delay or avoid pregnancies, often resume sexual activity without family planning, contributing to 121 million unintended pregnancies annually, particularly in sub-Saharan Africa. Postpartum family planning (PPFP) can prevent 71% of unintended pregnancies and reduce maternal and neonatal morbidity and mortality. However, uptake in Uganda is low, at 35%, and data on its use are scarce. Sociocultural barriers, limited access to quality healthcare, and systemic inequities further hinder uptake. OBJECTIVE: To assess the level of utilization of PPFP and the contributing factors among postpartum women attending health facilities in a rural district of Northern Uganda. METHODS: A descriptive cross-sectional study was conducted among 483 women within 12-month postpartum, recruited from 5 randomly selected health facilities between October and November 2022. Quantitative data were collected using interviewer-administered questionnaires. Data were analyzed using STATA version 17.0, with descriptive statistics and multivariate logistic regression performed at a 95% confidence interval (CI) to identify predictors of PPFP utilization. RESULTS: The utilization of PPFP was 41.61% (95% CI: 37.17-46.15). Independent predictors or contributing factors to PPFP utilization included education level (primary-adjusted prevalence ratio (APR): 0.753; 95% CI: 0.641-0.883; = <0.001), partner's age (APR: 1.203; 95% CI: 1.004-1.443; = 0.05), parity (APR: 0.755; 95% CI: 0.635-0.897; = 0.001), uncertainty about timing for next pregnancy (APR: 1.994; 95% CI: 1.09-3.646; = 0.03), and advice from friends about PPFP methods (APR: 1.358; 95% CI: 1.171-1.575; = <0.001).
Rates of fear of childbirth after previous cesarean section in Dire Dawa City, Ethiopia.
Kedir A, Bekele H, Tefera M
Womens Health (Lond) · 2025 · PMID 40751307 · Full text
BACKGROUND: Women's multidimensional expectations of pregnancy and childbirth can involve many emotions, from joy to fear. It is estimated that most women in Africa suffer from childbirth fear (20%-61.2%). However, to ou...
BACKGROUND: Women's multidimensional expectations of pregnancy and childbirth can involve many emotions, from joy to fear. It is estimated that most women in Africa suffer from childbirth fear (20%-61.2%). However, to our knowledge, no study has been conducted on fear of childbirth (FOC) in women who had a prior cesarean section, particularly in the study area. This study aimed to fill this gap by assessing the level of childbirth fear and identifying its contributing factors. METHODS: Institusional based cross-sectional study was conducted among 314 pregnant women with previous cesarean sections from selected public and private health facilities in Dire Dawa. FOC was assessed using the Wilma Delivery Expectancy Questionnaire (W-DEQ-A), which comprises 33 items rated on a 6-point Likert scale, ranging from low to severe FOC, and data were analyzed using multivariable ordinal regression. RESULTS: A total of 314 pregnant women participated in this study, with a response rate of 99.3%. Sixty-seven (21.3%, 95% confidence interval (CI): 17%-26%) moderate, 81 (25.8%, 95% CI: 21%-31%) high and severe 30 (9.6%, 95% CI: 6%-13%). The mean W-DEQ score was 54.35 ± 23.6. The mean score for FOC was 54.35 ± 23.6. Being unemployed (adjusted odds ratio (AOR) = 0.442; 95% CI: 0.225, 0.870), having previous pregnancy/labor-related indication for cesarean section (maternal/fetal; AOR = 0.085; 95% CI: 0.020, 0.360, AOR = 0.067; 95% CI: 0.015, 0.297), unplanned pregnancy (AOR = 0.137; 95% CI: 0.057, 0.326), current pregnancy complications (AOR = 4.581; 95% CI: 2.144, 9.788), recurrent cesarean section delivery (AOR = 0.393; 95% CI: 0.175, 0.880) and low and moderated social support of the women (AOR = 109.666; 95% CI: 33.230, 361.926) and (AOR = 5.252; 95% CI: 2.438, 11.314) were factors associated with severe FOC. CONCLUSION: In this study, a quarter of the women with previous cesarean section records suffer from a high degree of FOC. Thus, accommodating counseling during antenatal care visits is needed to address those women who are at a high risk of considerable childbirth fear and its health consequences.
Psychological care and mental health outcomes in women receiving termination of pregnancy in Rwanda: A cross-sectional study.
Musabwasoni MGS, Nyiringango G, Uwambaye P … +10 more , Mukeshimana M, Ngoga E, Uhawenimana TC, Musabirema P, Kaberuka G, Sezibera V, Klingberg-Allvin M, Rulisa S, Mukamana D, Bazirete O
Womens Health (Lond) · 2025 · PMID 40581958 · Full text
BACKGROUND: In Rwanda, legally induced termination of pregnancy (ToP) is permitted under specific conditions such as cases of rape, incest, being a minor, forced marriage or health-related issues. OBJECTIVES: To explore...
BACKGROUND: In Rwanda, legally induced termination of pregnancy (ToP) is permitted under specific conditions such as cases of rape, incest, being a minor, forced marriage or health-related issues. OBJECTIVES: To explore post-ToP mental health outcomes, the circumstances under which women seek ToP services and investigates their relationship with the presence or absence of psychological support. DESIGN: A quantitative approach using a cross-sectional design was used for this study. METHODS: Data collection recruited 305 women and girls who sought ToP services at eleven selected health facilities in Rwanda from June to August 2022. Life satisfaction, self-esteem, anxiety, and depression/grief were the outcome measures and were measured using the standardized tools. Binary logistic regression (adjusted odds ratios) was used to assess how the circumstances of seeking ToP and the presence or the absence of psychological support predicted mental health outcomes. RESULTS: The findings indicate that the primary reasons for seeking ToP services include rape, pressure from a partner and fear of missing educational opportunities. There was a strong association between circumstances such as rape and partner pressure with negative mental health outcomes. The study also revealed that only a small proportion of women who received post-ToP psychological support from family, community or healthcare providers, while the majority did not. The absence of psychological support was significantly linked to an increased likelihood of low self-esteem, anxiety, depression, and dissatisfaction with life. CONCLUSION: The circumstances under which women seek ToP services significantly impact their mental health post service provision. The findings underscore the critical role of post-ToP support in mitigating negative psychological outcomes. Hospitals should screen depression/grief and offer psychological care support for women undergoing ToP.
The influence of rurality on women's decision making and pregnancy choices following an unintended pregnancy: A systematic review.
Edwards G, Hooker L, Edvardsson K
Womens Health (Lond) · 2025 · PMID 40554767 · Full text
Almost half of all pregnancies worldwide and 34% of pregnancies in high-income countries are considered unintended. Several studies from high-income countries report that women from rural areas are more likely to continu...
Almost half of all pregnancies worldwide and 34% of pregnancies in high-income countries are considered unintended. Several studies from high-income countries report that women from rural areas are more likely to continue their unintended pregnancy and give birth, while urban women are more likely to have an induced abortion. To explore how rurality influences women's decision making and pregnancy choices following unintended pregnancy by examining the global trends for women who reside in rural areas of high-income countries. This study is a systematic review of qualitative, cross-sectional and mixed-methods studies. A systematic review of peer-reviewed literature, published from January 2000 through to March 2024, retrieved from five databases: CINAHL, Embase, MEDLINE, PsycINFO and PubMed. Restrictions were applied to obtain original research that has been undertaken in high-income countries. The review included studies featuring participants that were either rural women who experience an unintended pregnancy or health care professionals providing direct care to rural women. Nineteen studies met the inclusion criteria and were included in this review. Several factors that influenced rural women's decision making following an unintended pregnancy were identified: access to abortion services; role of health care professionals; temporal factors; social norms and stigma; social factors and determinants; culture, ethnicity and religion; reproductive coercion and abortion legislation. The Social-Ecological Model highlighted the levels of interaction, the role health care professionals, family members and the wider community in supporting or obstructing rural women's decision making. Rural women's pregnancy decision making and reproductive autonomy can be compromised by intimate partners, family members, health professionals and rural culture. Health professionals have a pivotal role in supporting and respecting rural women's decision making when seeking an abortion and ensuring that rural women have timely access to abortion care. Registration number: PROSPERO CRD 42023409917.
Virtually delivered lifestyle interventions for overweight and obese pregnant people: A systematic review.
Park T, Brickwood S, Buss K … +6 more , Tran V, Parsons D, Wisely K, Gillett K, Lavis H, Heaney S
Womens Health (Lond) · 2025 · PMID 40388534 · Full text
BACKGROUND: Gestational weight gain (GWG) impacts both foetal and maternal health outcomes, with excessive GWG in overweight and obese people further increasing the risk of complications for this population. Lifestyle ch...
BACKGROUND: Gestational weight gain (GWG) impacts both foetal and maternal health outcomes, with excessive GWG in overweight and obese people further increasing the risk of complications for this population. Lifestyle changes including consuming a healthy diet and physical activity are core strategies for management. Since 2020 and the emergence of the COVID-19 pandemic, use of telehealth has increased; however, little is known about the effectiveness of virtually delivered strategies for maintaining healthy gestational weight during pregnancy. OBJECTIVES: To describe the effect of virtually delivered lifestyle interventions on promoting healthy GWG and reducing maternal and foetal complications associated with excessive GWG, with the view to inform future clinical practice. DESIGN: This systematic review followed preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines and targeted quantitative studies assessing virtually delivered lifestyle interventions for maintaining healthy gestational weight for overweight and obese pregnant individuals aged 18 and older. DATA SOURCES AND METHODS: Six databases (MEDLINE, CINHAL, EMBASE, EMCARE, MIDIRS and APA PsycINFO) were searched using a rigorous search strategy. Data extraction investigated mode of telehealth delivery, intervention type and GWG outcomes. Quality appraisal was conducted using the Critical Appraisal Skills Programme tool and risk of bias was assessed using the Risk of Bias assessment (RoB-2). RESULTS: Nine studies met inclusion criteria and within those studies, six different telehealth modalities were identified. Interventions varied and included GWG tracking, step counts, diet and exercise goal setting. Effectiveness of studies was inconsistent, with five studies demonstrating lower GWG. CONCLUSION: Results suggest that lifestyle interventions delivered via telehealth may be effective at reducing excessive GWG. The development of targeted interventions integrated into obstetric guidelines aimed at reducing excessive GWG via telehealth platforms should be considered as a strategy not only for pandemic situations, but to increase antenatal care and service access. REGISTRATION: PROSPERO International Prospective Register on 26 January 2023 (CRD42023392095).
Determinants of cervical cancer knowledge and barriers to human papillomavirus vaccine uptake among female university students: A cross-sectional study.
Donkor A, Osei LP, Acquaah-Arhin EAK … +6 more , Suka PD, Kitson-Mills D, Adjei ANA, Ohemeng E, Ouedraogo S, Dzomeku VM
Womens Health (Lond) · 2025 · PMID 40294016 · Full text
BACKGROUND: Cervical cancer is the second most common female cancer in Ghana. Cervical cancer is preventable through knowledge, vaccination against the human papillomavirus (HPV), screening and treatment of precancerous...
BACKGROUND: Cervical cancer is the second most common female cancer in Ghana. Cervical cancer is preventable through knowledge, vaccination against the human papillomavirus (HPV), screening and treatment of precancerous lesions. OBJECTIVE: This study aimed to assess the determinants of cervical cancer knowledge and barriers to HPV vaccine uptake among female university students in Ghana. DESIGN: An anonymous, online cross-sectional study was conducted from 25 June to 22 September 2024. METHODS: The survey contained questions on demographic characteristics, cervical cancer risk factors, symptoms, HPV vaccination and barriers to vaccine uptake. Binomial logistic regression analysis was performed to predict the factors associated with knowledge of cervical cancer. A -value of less than 0.05 was considered statistically significant. RESULTS: A total of 1662 female university students responded to the online survey. The mean age of the respondents was 21.5 ± 2.03 years. Overall, the prevalence of inadequate knowledge of cervical cancer was 60.2%. The least recognised cervical cancer symptom was blood in the stool or urine (58.4%). Respondents who had a steady partner and living together had 3.59 times higher odds of inadequate knowledge of cervical cancer compared to respondents who were not dating. Muslim respondents had 2.13 times higher odds of inadequate knowledge of cervical cancer compared to Christian. Unvaccinated respondents had 3.85 times higher odds of inadequate knowledge of cervical cancer compared to those who had received the HPV vaccine. More than four-fifths (87.0%) of the respondents indicated that they had not been vaccinated against HPV. The major barriers to HPV vaccine uptake included: inadequate knowledge of the vaccine, fear of side effects, lack of knowledge about the vaccination site, fear of injection and doubts regarding the vaccine's efficacy. CONCLUSION: Improving access to cervical cancer awareness and HPV vaccination among university students is a critical public health goal to reduce the incidence of cervical cancer. It is important to promote a free national school-based HPV vaccination programme. Multi-component school-based educational interventions, including traditional methods such as lectures, group discussions and digital tools like web-based educational platforms should be implemented to improve cervical cancer knowledge among university students.
Fertility desire and associated factors among reproductive age women attending antiretroviral therapy at public hospitals in Eastern Ethiopia.
Abera L, Mengistu B, Hailu M … +2 more , Adem M, Tadesse D
Womens Health (Lond) · 2025 · PMID 40132141 · Full text
BACKGROUND: Human immune virus (HIV) remains a major cause of death in children and women worldwide. Women's desire to have children in the future has significant implications for the transmission of the human immune def...
BACKGROUND: Human immune virus (HIV) remains a major cause of death in children and women worldwide. Women's desire to have children in the future has significant implications for the transmission of the human immune deficiency virus to sexual partners and newborns. People living with HIV desire to have children, and counseling by their healthcare providers plays a critical role in ensuring planned pregnancies and minimizing mother-to-child transmission. However, in many settings, a large majority of HIV-positive women who desire more children do not discuss reproductive health and childbearing with their healthcare providers. The objective of this study was to assess fertility desire and associated factors among reproductive age women living with a HIV attending antiretroviral therapy (ART) in public hospitals in Eastern Ethiopia. DESIGN: Cross-sectional study. METHODS: A facility-based cross-sectional study was conducted on November 01-30, 2022 among 598 reproductive age women attending ART clinics in public hospitals in Eastern Ethiopia. A systematic random sampling technique was used to select the participants. Data were collected from five female nurses through face-to-face interviews using a structured and pre-tested questionnaire. Data were entered into Epi-Data 3.1 and analyzed using IBM SPSS version 24. Bivariate and multivariable logistic regression analyses were performed. Variables with a -value <0.25 in bivariate analysis were included in the multivariable logistic regression analysis. Variables associated with desire for fertility were declared at -value <0.05, with adjusted odds ratio (AOR) and 95% confidence intervals (95% CI). RESULTS: This study showed that 42.0% (95% CI: 31.7%-52.28%) of women had a desire for fertility. Women aged (15-24) (AOR = 2.52, 95% CI: 1.58-3.50), married women (AOR = 3.21, 95% CI 1.42-5.11), having no children (AOR = 1.94, 95% CI: 1.51-2.52), and desire to have children (AOR = 2.98, 95% CI: 1.84-4.12) were significantly associated with desire for fertility. CONCLUSION: This study revealed that a significant proportion of women desire fertility despite their positive status. Moreover, being young, married, having no child, and having a partner's desire to have children were factors associated with the desire for fertility.
Perceived factors contributing to teenage pregnancy and their perceived effects on teenage females health in eastern province of Rwanda.
Nshutiyukuri C, Uwingabire F, Musabwasoni MGS … +8 more , Rutayisire JB, Rutayisire R, Benimana I, Kaberuka G, Bazakare Ishimwe L, Kyame KB, Mutabazi L, Mukeshimana M
Womens Health (Lond) · 2025 · PMID 40100962 · Full text
BACKGROUND: Teenage girls in Rwanda, like in many other countries, continue to experience unintended pregnancies. Many adolescents exhibit inadequate knowledge regarding sexual and reproductive health, highlighting signi...
BACKGROUND: Teenage girls in Rwanda, like in many other countries, continue to experience unintended pregnancies. Many adolescents exhibit inadequate knowledge regarding sexual and reproductive health, highlighting significant gaps in its use specifically in developing regions including Rwanda. Despite the implementation of numerous prevention strategies in Rwanda, the prevalence of teenage pregnancy remains alarmingly high. The factors contributing to teenage pregnancy are diverse, and its consequences are far-reaching. OBJECTIVE: This study's primary objective is to examine participants' personal experiences with their own pregnancies, including the factors they perceive to have contributed to their pregnancies. Additionally, the study aims to investigate participants' views on the broader societal factors that they believe contribute to teenage pregnancy within their community or province. DESIGN: A cross-sectional study design was used. METHODS: A cross-sectional study was conducted in the Eastern Province of Rwanda, between January and December 2023. The sample included females aged 13-25 years who described their own pregnancies when they were between 13 and 19 years, as well as their perceptions about other pregnancies in their community. Data were collected using a structured questionnaire and analyzed through descriptive statistical methods. RESULTS: Teenage girls reported poverty and lack of knowledge as the leading causes of adolescent pregnancy, with a high percentage of them reporting that their pregnancies resulted from rape. The effects of teenage pregnancy on teenage female health include emotional and societal repercussions with a high prevalence of depression, suicidal thoughts, family rejection, and school dropouts. The scope of this study was limited to teenage mothers in Eastern province and all data came from their self-reporting. CONCLUSION: Poverty, lack of knowledge, and sexual violence/rape were the most frequently perceived causes of adolescent pregnancy reported by participants, with important consequences for the health and well-being of teenage girls and their children. Comprehensive teenage pregnancy preventive interventions involving men would address the root causes of teenage pregnancy and improve health literacy as regard to sexual and reproductive health. There is a need for an urgent governmental and private joint plan to reduce the burden of teenage pregnancy in Rwanda.
Factors associated with undernutrition among pregnant women in Chiro district, eastern Ethiopia.
Golla EB, Geremew H, Diro AT … +5 more , Abdisa S, Abate A, Admasu M, Ali MA, Gashaw G
Womens Health (Lond) · 2025 · PMID 40089871 · Full text
BACKGROUND: Undernutrition denotes inadequate intake of energy and nutrients to meet one's optimal needs. Pregnant women are at an increased risk of undernutrition due to the added nutritional demand for fetal growth and...
BACKGROUND: Undernutrition denotes inadequate intake of energy and nutrients to meet one's optimal needs. Pregnant women are at an increased risk of undernutrition due to the added nutritional demand for fetal growth and development. Updated evidence is important for monitoring progress and informing healthcare decisions. However, there is a paucity of evidence about the nutritional status of pregnant women in the rural communities of eastern Ethiopia, particularly in Chiro district. Therefore, this study aimed to assess the prevalence of undernutrition and its associated factors among pregnant women in Chiro district, eastern Ethiopia. METHODS: A community-based cross-sectional study was employed in Chiro district, from November 1 to 30, 2022, among 423 randomly selected pregnant women. The data were collected using face-to-face interviews and anthropometric measurements by trained research assistants. Bi-variable and multivariable logistic regressions were fitted to identify predictors of undernutrition by using STATA-14 statistical software. RESULTS: The overall prevalence of undernutrition was 40.9% (95% confidence interval (CI): 36.2%, 45.8%). Antenatal care (ANC) follow-up (adjusted odds ratio (AOR): 5.61, 95% CI: 3.01, 10.45), history of illness in the past 2 weeks (AOR: 4.25, 95% CI: 2.23, 8.12), khat chewing (AOR: 4.01, 95% CI: 2.12, 7.56), household food security (AOR: 5.84, 95% CI: 3.36, 10.14), and dietary diversity practice (AOR: 2.74, 95% CI: 1.47, 5.09) were factors associated with undernutrition. CONCLUSION: Four out of every 10 pregnant women in the study area were undernourished. ANC follow-up, illness in the past 2 weeks, khat chewing, household food security, and dietary diversity practice were significantly associated with undernutrition. Therefore, improving access to ANC services, strengthening nutritional counseling, and addressing food insecurity might reduce undernutrition among pregnant women.
"Infertility frightened me": Violence among infertile couples in Jordan.
Hall-Clifford R, Hamdan ZA, Bergenfeld I … +5 more , Bawadi H, Mowla W, Hamdaneh J, Salem HA, Clark CJ
Womens Health (Lond) · 2025 · PMID 40014755 · Full text
BACKGROUND: Women in couples experiencing infertility are at heightened risk for intimate partner violence (IPV) from husbands and domestic violence (DV) from family. Couples experiencing infertility in Jordan, a patriar...
BACKGROUND: Women in couples experiencing infertility are at heightened risk for intimate partner violence (IPV) from husbands and domestic violence (DV) from family. Couples experiencing infertility in Jordan, a patriarchal culture with high rates of IPV and DV, are particularly vulnerable. This article explores the gendered similarities and differences in the experiences of mental health, social support, exclusion, and IPV. OBJECTIVES: The objectives of this study are to understand both men and women's perspectives on their experiences of infertility and to develop intervention strategies to reduce IPV among married couples experiencing infertility. DESIGN: This study is a descriptive, observational study. METHODS: Through quantitative surveys and in-depth qualitative interviews, we examined key themes including: challenges to mental health and well-being; reproductive health and fertility care-seeking; experiences of shame, isolation, and discrimination; coping skills; sources of support; and challenges within spousal and family relationships. RESULTS: In this article, we analyze primary areas of gender discordance and discuss how gendered experiences can shape implementation of psychosocial support intervention programs to prevent IPV. Our findings provide important insight into facilitators and barriers to prevention of IPV in this vulnerable group. CONCLUSION: We conclude that providing both women and men with culturally appropriate support during fertility treatment-seeking can improve psychosocial health and couple functioning and ultimately to reduce the occurrence of IPV in this vulnerable population.
Knowledge and practices of emergency contraception use and associated factors among female undergraduate students in Northern Uganda: A cross-sectional study.
Acen BK, Obonyo I, Ocen T … +3 more , Arebo B, Auma AG, Beja H
Womens Health (Lond) · 2025 · PMID 39985758 · Full text
BACKGROUND: Emergency contraception (EC) can prevent up to 95% of unplanned pregnancies if used correctly. Despite efforts to enhance its accessibility, cost and cultural stigmas persist as formidable barriers. OBJECTIVE...
BACKGROUND: Emergency contraception (EC) can prevent up to 95% of unplanned pregnancies if used correctly. Despite efforts to enhance its accessibility, cost and cultural stigmas persist as formidable barriers. OBJECTIVE: This study assessed the knowledge and practices of EC use and determined the associated factors among the female undergraduate students of Northern Uganda. DESIGN: This was a descriptive, institutional-based cross-sectional study conducted among the female undergraduate students of Lira University in Northern Uganda. METHODS: Data were collected from 328 female undergraduates who were surveyed using self-administered questionnaires after obtaining informed consent from them. Data were analyzed using Statistical Package for Social Sciences (SPSS) and presented as frequencies and percentages, and binary and multiple logistic regressions were used to determine the association between the outcome variable and the independent variables. Results were presented as odds ratios with 95% confidence intervals, and associations were considered statistically significant at ⩽ 0.05. RESULTS: The response proportion was 328/334 (98%). Majority of the participants were 18-23 years old (233/328; 71.0%), had a consistent sexual partner (221/328; 67.4%), and unmarried (206/328; 62.8%). Almost all the participants (315/328; 96%) had heard about EC, where 150/328 (45.7%) learned about EC from health professionals and 135/328 (41.2%) learned about EC from family members and friends. The most well-known brand of EC was Postinor-2 (Levonorgestrel), as reported by 130/328(39.6%) participants. Of the study participants, 200/328 (61.0%) were knowledgeable about the correct timing of EC. Regarding practices of EC use, 214/328 (65.2%) used EC, of whom 122/214 (57.0%) acquired EC from the pharmacy, and most of the participants who had used EC used Postinor-2 (92/214; 43.0%). Of those who used EC, 175/214 (81.8%) used it to prevent unplanned pregnancy, and 182/214 (85.0%) participants used it with the correct timing. The factors that were associated with EC use were being a student who was studying at the Faculty of Health Sciences (adjusted odds ratio (AOR): 4.27, CI: 1.61, 10.09, ⩽ 0.003) and the absence of a consistent current sexual partner (AOR: 8.63, CI: 4.49, 16.59, ⩽ 0.00). CONCLUSION: Participants showed good EC knowledge and usage, but gaps persist. Factors like being a student who was studying at the Faculty of Health Sciences, and lack of a consistent current sexual partner correlated with EC use. Consistent education efforts are needed to address knowledge gaps, focusing on diverse EC forms, reliable information, and affordability. REGISTRATION: Not applicable.
Person-centered maternity care and satisfaction with post-abortion care: A facility-based cross-sectional survey in Northern Uganda.
Udho S, Ekung E, Namutebi DA … +8 more , Aryek-Kwe J, Rubaihayo A, Musinguzi M, Kigongo E, Penduka A, Nsaba Uwera YD, Opio B, Ogwal-Okeng J
Womens Health (Lond) · 2025 · PMID 39949209 · Full text
BACKGROUND: The experience of post-abortion care (PAC) is crucial to the quality of PAC services. However, there is limited literature on women's experience with PAC, particularly the aspects of person-centered maternity...
BACKGROUND: The experience of post-abortion care (PAC) is crucial to the quality of PAC services. However, there is limited literature on women's experience with PAC, particularly the aspects of person-centered maternity care (PCMC) and satisfaction with PAC services. OBJECTIVE: To examine the relationship between PCMC and satisfaction with PAC services. DESIGN: A facility-based analytical cross-sectional study. METHODS: A survey was conducted among 370 women aged 15-49 who sought PAC services at public health facilities in Lira city, Northern Uganda. Data were collected using a validated questionnaire. Data analysis included descriptive statistics, the Spearman correlation test, and multiple linear regression. RESULTS: The mean age of study participants was 26.1 (±6.3) years. The overall PCMC median score was 21.5 (interquartile range (IQR): 11) out of 36. The median scores for the sub-scales were as follows: 6 (IQR: 6-6) for dignity and respect out of 9; 9 (IQR: 5-13) for communication and autonomy out of 18; and 8 (IQR: 6-9) for supportive care out of 9. Satisfaction with PAC services' score ranged from 6 to 42, and the median satisfaction score was 30 (IQR range: 28-32). Bivariate analysis revealed a weak but significant correlation between the overall PCMC scale and satisfaction with PAC services ( = 0.21, < 0.001). Sub-scales of dignity and respect and communication and autonomy also had a weak but significant correlation with satisfaction with PAC services ( = 0.16, = 0.002, and = 0.21, < 0.001 respectively). In a linear regression model, communication and autonomy score was significantly associated with higher satisfaction with PAC score ( = 0.10; 95% confidence interval (CI): 0.01, 0.19; < 0.001). CONCLUSIONS: PCMC, particularly the aspects of communication between clients and providers and the promotion of clients' autonomy, is associated with higher satisfaction with PAC services. Efforts to increase clients' satisfaction with PAC should focus on strengthening communication between clients and providers and promoting clients' autonomy during care.
Association between women empowerment and contraceptive utilization in Ethiopia.
Abebe Y, Berhanu RD, Kajela L … +1 more , Bayane YB
Womens Health (Lond) · 2024 · PMID 39728394 · Full text
BACKGROUND: Women's empowerment is essential for achieving sustainable development goals. It involves enabling women to take control of their lives by giving them the agency, resources, and opportunities they need to mak...
BACKGROUND: Women's empowerment is essential for achieving sustainable development goals. It involves enabling women to take control of their lives by giving them the agency, resources, and opportunities they need to make their own choices and reach their full potential. If more women are empowered to use modern contraceptives, greater reductions in maternal mortality will follow. By understanding this association, we can identify key women empowerment dimensions that have an association with family planning utilization and consider ways forward to improve reproductive health outcomes for women. OBJECTIVE: This study aimed to investigate the association between women's empowerment and modern contraceptive utilization among married mothers in Ethiopia. DESIGN: A facility-based quantitative study was employed. METHODS: A facility-based quantitative cross-sectional study was employed among 305 mothers selected by systematic random sampling at Jimma Town Public Hospital from July 1 to August 31, 2022. The interviewer-administered questionnaire was used for data collection. The collected data were entered into EpiData Manager, version 4.6.0.6, and then exported to SPSS, version 26. Bivariate and multivariate logistic regression analyses were used to investigate the associations between the dependent and independent variables. RESULTS: Among a total of 305 study subjects, 301 were used in the analysis. Approximately 65% (95% CI = 59.8, 70.8) of the women utilized modern contraceptive methods. High general self-efficacy (AOR = 4.17; 95% CI = 2.11, 8.23), an internal locus of control (AOR = 3.92; 95% CI = 2.01, 7.65), labor work participation (AOR = 4.53; 95% CI = 1.99, 10.31), and enrollment in elementary education (AOR = 8.30; 95%; CI = 2.96, 23.27) have a statistically significant association with modern contraceptive utilization. CONCLUSION: Numerous dimensions of women's empowerment are significantly associated with modern contraceptive utilization. The dimension of women's empowerment needs considerable focus from stakeholders to empower women and enable them to utilize contraceptives and other maternal healthcare services.
Teenage mothers' perspectives, knowledge, and attitudes toward pregnancy and the utilization of sexual and reproductive health services in the Eastern Province of Rwanda.
Nshutiyukuri C, Uwingabire F, Musabwasoni MGS … +7 more , Rutayisire JB, Rutayisire R, Kaberuka G, Ishimwe Bazakare L, Benimana I, Mutabazi L, Mukeshimana M
Womens Health (Lond) · 2024 · PMID 39727286 · Full text
BACKGROUND: Adolescents worldwide engage in sexual activity, with the proportion rising gradually from the middle to late stages of adolescence. The incidence of early sexual initiation among female youth in sub-Saharan...
BACKGROUND: Adolescents worldwide engage in sexual activity, with the proportion rising gradually from the middle to late stages of adolescence. The incidence of early sexual initiation among female youth in sub-Saharan Africa is reported to be 46%. The increasing number of teenage pregnancies in Rwanda indicates that adolescents do not correctly use sexual and reproductive health services. In 2019, the Eastern Province of Rwanda documented 36% of all teenage pregnancies. Despite the availability of these services to youth through adolescent sexual and reproductive health (ASRH) focal persons, nurses, or midwives leading youth corners at the Health Center level, why they are not used remains unknown. OBJECTIVES: To explore teenage mothers' perspectives, knowledge, and attitudes toward pregnancy and the utilization of sexual and reproductive health services in the Eastern Province of Rwanda. DESIGN: Qualitative descriptive study. METHODS: A qualitative descriptive design combined with the theory of reasoned action was used to capture teenagers' unique perspectives on knowledge about teenage pregnancy and attitudes toward ASRH service utilization. An in-depth interview was used to collect data from 25 informants across 3 districts in the Eastern Province of Rwanda, followed by traditional content analysis. RESULTS: Three major themes emerged, including lack of knowledge about teenage pregnancy, unfavorable attitudes toward ASRH service utilization, and the perceived negative impact of teenage pregnancy, including disrupting education, limiting career opportunities, and posing health risks to both mothers and infants. CONCLUSION: While all young mothers were under pressure from the multitude of impacts of teenage pregnancy, parenthood, and social responsibilities, they had limited knowledge and selective utilization of ASRH services, mimicking potential gaps in education and mobilization of youth on available ASRH services with special emphasis on preventive components. Exploring the perceived enablers and challenges facing ASRH service utilization among the study population is necessary.
Factors affecting breastfeeding self-efficacy among mothers with preterm infants.
Nayebinia AS, Faroughi F, Asadi G … +1 more , Fathnezhad-Kazemi A
Womens Health (Lond) · 2024 · PMID 39676243 · Full text
BACKGROUND: Although challenges in breastfeeding are more common in mothers of preterm infants, maternal breastfeeding self-efficacy is a modifiable factor that may improve breastfeeding rates. OBJECTIVE: To evaluate the...
BACKGROUND: Although challenges in breastfeeding are more common in mothers of preterm infants, maternal breastfeeding self-efficacy is a modifiable factor that may improve breastfeeding rates. OBJECTIVE: To evaluate the factors affecting breastfeeding self-efficacy among mothers with preterm babies. DESIGN: A cross-sectional study. METHODS: This study was carried out using a double-stage cluster sampling method. In total, 360 mothers of preterm infants under 6 months of age were included. Data were collected using sociodemographic characteristics, Breastfeeding Self-efficacy Scale-Short Form (BSES-SF), multiple scales of perceived social support, and Depression, Anxiety, and Stress questionnaires. RESULTS: The results showed social support (15.6%), depression (12.2%), anxiety (11%), and stress (12.2%) contributed independently, and together they explained 25% of the variance in BSES-SF. The higher levels of social support (β = 0.283), lower levels of mental health problems (β = -0.340), having breastfeeding experience (β = -0.253), and higher gestational age at birth (β = 0.106) were significantly related to the high level of BSES-SF. CONCLUSION: These findings can help healthcare providers be aware of effective factors in improving breastfeeding self-efficacy. Increased access to counselors, active support for mothers after preterm labor, and increased support facilities for mothers with preterm delivery may be helpful to improve breastfeeding self-efficacy.
Lived experiences of intimate partner violence survivors during pregnancy and who had spontaneous abortions: A phenomenological study to inform survivor-centered strategies.
Gufue ZH, Hailu HT, Atsbaha AH … +3 more , Kiros BM, Tsegay EW, Mengesha MB
Womens Health (Lond) · 2024 · PMID 39623805 · Full text
BACKGROUND: Previous studies quantified that women who experienced intimate partner violence (IPV) had a higher risk of spontaneous abortion than women who did not experience IPV. However, there is limited evidence docum...
BACKGROUND: Previous studies quantified that women who experienced intimate partner violence (IPV) had a higher risk of spontaneous abortion than women who did not experience IPV. However, there is limited evidence documenting the experiences of women in Northern Ethiopia who have been subjected to partner violence and who had spontaneous abortions. This evidence is critical for policymakers looking to improve women's access to maternity care. OBJECTIVES: This study aimed to explore the lived experiences of IPV survivors during pregnancy who had spontaneous abortions in Northern Ethiopia. DESIGN: A phenomenological qualitative study design was used to explore the lived experiences of survivors of IPV who had spontaneous abortions. METHODS: A total of 16 interviews were conducted between April 23 and June 5, 2020. Eight in-depth interviews and eight key informant interviews were conducted with eligible mothers who received the required service, Adigrat General Hospital service providers, zonal women's affairs experts, and legal professionals. The purposive sampling technique was used to select study participants, and the sample size was determined using the information saturation principle. The data were analyzed through open coding and thematic content analysis. RESULT: The themes that emerged in this study included opinions toward IPV, mothers' and experts' experiences of partner support during pregnancy, attitudes toward IPV, and understanding of spontaneous abortion. Physical, emotional, sexual, and economic pressure were identified as the most common forms of IPV. Participants in the study believed that physical violence and stress were associated with spontaneous abortion. They also mentioned various strategies for preventing IPV, such as providing job opportunities for women, punishing perpetrators, and encouraging mutual tolerance. CONCLUSION: This study found that spontaneous abortion is linked to any type of IPV, including physical IPV during pregnancy. IPV is a community-supported event that necessitates strategies and legal frameworks to prevent and mitigate its effects.
Determinants of early resumption of postpartum sexual intercourse in sub-Saharan Africa: A systematic review and meta-analysis.
Belay HG, Yehuala ED, Asmer Getie S … +6 more , Ayele AD, Yimer TS, Berihun Erega B, Ferede WY, Worke MD, Mihretie GN
Womens Health (Lond) · 2024 · PMID 39610147 · Full text
BACKGROUND: The World Health Organization recommends that all postpartum women be examined for resumed sexual activity. Despite this, postpartum sexual health education and health promotion are not adequately incorporate...
BACKGROUND: The World Health Organization recommends that all postpartum women be examined for resumed sexual activity. Despite this, postpartum sexual health education and health promotion are not adequately incorporated into current maternal healthcare systems in low- and middle-income nations. There were variations in the prevalence and variables associated with early postpartum sexual intercourse across several studies. OBJECTIVES: The purpose of this systematic review and meta-analysis was to evaluate the pooled prevalence and associated factors for early postpartum sexual intercourse in sub-Saharan African countries. DATA SOURCES AND METHODS: Primary studies were identified using international databases such as Scopus, PubMed, Google Scholar, Embase, and CINAHL. The Newcastle‒Ottawa Scale quality assessment tool was used to evaluate the quality and strength of the included studies. STATA version 17 was used for the meta-analysis. The heterogeneity of the studies and publication bias was examined using statistics and Egger's regression test. Subgroup analysis decreased the underlying heterogeneity based on the study years and sample sizes. RESULTS: Seventeen primary articles were included in the meta-analysis with 8507 study participants. The pooled prevalence of early postpartum sexual resumption in sub-Saharan Africa was 39.41% (95% CI: 31.55%-47.27%). Primiparous (OR = 3.32; 95% CI: 2.26-5.90), spontaneous vaginal delivery (OR = 5.98; 95% CI: 1.74-20.51), formula feeding (OR = 2.24; 95% CI: 1.46-3.44), family planning (OR = 2.91; 95% CI: 1.89-4.49), husband pressure (OR = 4.99; 95% CI: 1.38-18.05), have no formal education (OR = 2.36; 95% CI: 1.49-3.76), and monogamy (OR = 4.18; 95% CI: 2.27-7.69) were significantly associated with early postpartum sexual resumption. CONCLUSION: Four out of 10 women had returned to sexual activity within 6 weeks of giving birth. This suggests that a large proportion of women are more vulnerable to unwanted pregnancies and sexual health problems. Sexual health education and counseling should be incorporated into standard postpartum care to increase contraceptive use and delay unplanned pregnancies.
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