Addressing policy barriers to paternal involvement during pregnancy.

Efforts to reduce infant mortality in the United States have failed to incorporate paternal involvement. Research suggests that paternal involvement, which has been recognized as contributing to child development and health for many decades, is likely to affect infant mortality through the mother's well-being, primarily her access to resources and support. In spite of that, systemic barriers facing the father and the influence on his involvement in the pregnancy have received little attention. The Commission on Paternal Involvement in Pregnancy Outcomes (CPIPO) has identified the most important social barriers to paternal involvement during pregnancy and outlined a set of key policy priorities aimed at fostering paternal involvement. This article summarizes the key recommendations, including equitable paternity leave, elimination of marriage as a tax and public assistance penalty, integration of fatherhood initiatives in MCH programs, support of low-income fathers through employment training, father inclusion in family planning services, and expansion of birth data collection to include father information.

Improving research, policy and practice to promote paternal involvement in pregnancy outcomes: the roles of obstetricians-gynecologists.

PURPOSE OF REVIEW: To review current research, policy, and practice on paternal involvement in pregnancy outcomes and suggest recommendations to improve paternal involvement in pregnancy and childbirth. RECENT FINDINGS: Although much has been written about fathers' influence on child health and development, little is known about the expectant father's role in pregnancy and childbirth. Recent studies have demonstrated the importance of paternal involvement during pregnancy, but more research is needed to identify specific contributions expectant fathers make and their impact on reducing infant mortality and associated risk factors during pregnancy and childbirth. SUMMARY: Obstetricians-gynecologists can play a greater role in promoting research, policy and practice to improve paternal involvement in pregnancy and childbirth.

The moral imperative of reproductive rights, health, and justice.

Reproductive health (abortion, contraception, sex education, and assisted reproductive technologies) is being eroded by regressive laws and policies shaped by political conservatism, both domestically and internationally. Framing this aspect of women's health care as immoral, abortion opponents claim a moral high ground that results in a deference by reproductive health advocates who fail to raise moral arguments in rebuttal to these assertions, unnecessarily. This paper argues that reproductive rights, health, and justice are human rights-based and, hence, are moral frameworks that can and should be used to effectively counter pernicious reproductive health policies.

Domestic violence screening in pregnancy.

PURPOSE: Domestic violence is an important health concern that has been shown to have adverse effects on maternal and neonatal outcomes. The objectives of this study were to compare the prevalence of prenatal screening for domestic violence in a hospital-based resident clinic setting with screening practices in private obstetric offices in Honolulu, Hawai'i and to explore physician attitudes towards domestic violence screening during pregnancy. METHODS: A retrospective chart review was conducted at Queen's Medical Center in Honolulu, Hawai'i in women who delivered between 2003 and 2004. A 6 item written survey was also given to all attending and resident physicians with obstetric privileges. Descriptive statistics including frequency measures were generated and chi square tests were used to compare categorical variables. RESULTS: A total of 270 charts were reviewed. There was a statistically significant difference (p < 0.01) between the number of antepartum patients from the resident clinic (2.4 percent) and antepartum patients from private obstetric practices (39.3 percent) that were screened for domestic violence. While the majority of respondents (77.6%) to the domestic violence survey were aware that the American College of Obstetricians and Gynecologists recommends domestic violence screening in pregnancy most respondents (69.0 percent) indicated that they "never or rarely" screened their patients for domestic violence. CONCLUSION: Despite professional recommendations and an awareness of these recommendations, between 2003 and 2004, routine prenatal screening for domestic violence was markedly lacking for patients in this study population.

Vasectomy: the other (better) form of sterilization.

Male sterilization (vasectomy) is the most effective form and only long-acting form of contraception available to men in the United States. Compared to female sterilization, it is more efficacious, more cost-effective, and has lower rates of complications. Despite these advantages, in the United States, vasectomy is utilized at less than half the rate of female sterilization. In addition, vasectomy is least utilized among black and Latino populations, groups with the highest rates of female sterilization. This review provides an overview of vasectomy use and techniques, and explores reasons for the disparity in vasectomy utilization in the United States.