RESUMO
On June 24, 2022, the US Supreme Court's decision in Dobbs v Jackson Women's Health Organization marked the removal of the constitutional right to abortion in the USA, introducing a complex ethical and legal landscape for patients and providers. This shift has had immediate health and equity repercussions, but it is also crucial to examine the broader impacts on states, health-care systems, and society as a whole. Restrictions on abortion access extend beyond immediate reproductive care concerns, necessitating a comprehensive understanding of the ruling's consequences across micro and macro levels. To mitigate potential harm, it is imperative to establish a research agenda that informs policy making and ensures effective long-term monitoring and reporting, addressing both immediate and future impacts.
Assuntos
Decisões da Suprema Corte , Saúde da Mulher , Feminino , Humanos , Gravidez , Aborto Induzido/legislação & jurisprudência , Aborto Induzido/ética , Aborto Legal/legislação & jurisprudência , Acessibilidade aos Serviços de Saúde/legislação & jurisprudência , Estados Unidos , Saúde da Mulher/legislação & jurisprudência , Direitos da Mulher/legislação & jurisprudênciaRESUMO
Objectives: We aimed to describe obstetrics and gynecology (OBGYN) trainees' anticipation of how the Dobbs v. Jackson Women's Health Organization (Dobbs) U.S. Supreme Court decision may affect their training. Methods: A REDCap survey of OBGYN residents and fellows in the United States from September 19, 2022, to December 1, 2022, queried trainees' anticipated achievement of relevant Accreditation Council for Graduate Medical Education (ACGME) training milestones, their concerns about the ability to provide care and concern about legal repercussions during training, and the importance of OBGYN competence in managing certain clinical situations for residency graduates. The primary outcome was an ACGME program trainee feeling uncertain or unable to obtain the highest level queried for a relevant ACGME milestone, including experiencing 20 abortion procedures in residency. Results: We received 469 eligible responses; the primary outcome was endorsed by 157 respondents (33.5%). After correction for confounders, significant predictors of the primary outcome were state environment (aOR = 3.94 for pending abortion restrictions; aOR = 2.71 for current abortion restrictions), trainee type (aOR = 0.21 for fellow vs. resident), and a present or past Ryan Training Program in residency (aOR = 0.55). Although the vast majority of trainees believed managing relevant clinical situations are key to OBGYN competence, 10%-30% of trainees believed they would have to stop providing the standard of care in clinical situations during training. Conclusions: This survey of OBGYN trainees indicates higher uncertainty about achieving ACGME milestones and procedural competency in clinical situations potentially affected by the Dobbs decision in states with legal restrictions on abortion.
Assuntos
Ginecologia , Internato e Residência , Obstetrícia , Decisões da Suprema Corte , Humanos , Obstetrícia/educação , Ginecologia/educação , Feminino , Estados Unidos , Inquéritos e Questionários , Adulto , Masculino , Competência Clínica , Educação de Pós-Graduação em Medicina , Saúde da Mulher/legislação & jurisprudência , Gravidez , AcreditaçãoAssuntos
Aborto Induzido , Estruturas Embrionárias , Assistência ao Paciente , Saúde Reprodutiva , Técnicas de Reprodução Assistida , Saúde da Mulher , Humanos , Alabama , Ativismo Político , Estados Unidos , Aborto Legal/legislação & jurisprudência , Aborto Induzido/legislação & jurisprudência , Assistência ao Paciente/normas , Saúde da Mulher/legislação & jurisprudência , Saúde da Mulher/normas , Saúde Reprodutiva/legislação & jurisprudência , Saúde Reprodutiva/normas , Técnicas de Reprodução Assistida/legislação & jurisprudênciaAssuntos
Armas de Fogo , Violência por Parceiro Íntimo , Função Jurisdicional , Segurança , Saúde da Mulher , Feminino , Humanos , Armas de Fogo/legislação & jurisprudência , Violência por Parceiro Íntimo/legislação & jurisprudência , Violência por Parceiro Íntimo/prevenção & controle , Saúde da Mulher/história , Saúde da Mulher/legislação & jurisprudência , Segurança/história , Segurança/legislação & jurisprudência , Função Jurisdicional/históriaRESUMO
This study assesses changes in online telemedicine requests to self-manage abortions with medications before vs after the Dobbs v Jackson Women's Health Organization Supreme Court decision overturning Roe v Wade.
Assuntos
Abortivos , Aborto Induzido , Autogestão , Decisões da Suprema Corte , Telemedicina , Feminino , Humanos , Gravidez , Aborto Induzido/legislação & jurisprudência , Aborto Induzido/estatística & dados numéricos , Aborto Legal/legislação & jurisprudência , Aborto Legal/métodos , Aborto Legal/estatística & dados numéricos , Autogestão/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Saúde da Mulher/legislação & jurisprudência , Saúde da Mulher/estatística & dados numéricos , Abortivos/administração & dosagem , Abortivos/uso terapêutico , Estados Unidos/epidemiologiaRESUMO
Resumo Estudo qualitativo com abordagem de História Oral Temática, com o objetivo de compreender a atenção à saúde da mulher na visão de mulheres sem filhos, considerando as políticas públicas em saúde. Utilizou-se a técnica de snowball para definição das 19 mulheres participantes, sem filhos, idade entre 18 e 90 anos, que conheçam ou utilizem políticas públicas de saúde. As narrativas foram recolhidas por meio de entrevistas, com um roteiro semiestruturado, e submetidas ao método de análise de narrativas. Dentre os achados, encontram-se os discursos e as representações da maternidade, produzidos e veiculados nas políticas públicas de saúde, nas quais estão implícitas as características biológicas femininas na fragmentação do corpo feminino em útero e peito. Destaca-se ainda a percepção das mulheres sem filhos de que os programas e políticas de saúde, ao se concentrarem nos aspectos reprodutivos, reafirmam o ideal feminino de mulher-mãe, negligenciando outros aspectos e desconsiderando a mulher que escolhe a não maternidade. As representações do feminino concentram-se no corpo, alvo do poder, vinculando a condição de ser mulher à maternidade, baseado num determinismo biológico. Faz-se necessário reelaborar essas políticas, considerando as transformações no papel feminino e a liberdade de escolha da mulher na contemporaneidade.
Abstract Qualitative study with a Thematic Oral History approach, aiming to understand women's health care from the point of view of childless women, considering public health policies. The snowball technique was used to define the 19 participating women, without children, aged between 18 and 90 years, who know or use public health policies. The narratives were collected through interviews, with a semi-structured script, and submitted to the narrative analysis method. Among the findings, there are the discourses and representations of motherhood, produced and conveyed in public health policies, in which the biological characteristics of women are implicit in the fragmentation of the female body into uterus and breast. Also noteworthy is the perception of childless women that health programs and policies, by focusing on reproductive aspects, reaffirming the female ideal of a woman-mother, neglecting other aspects and disregarding the woman who chooses no maternity. The representations of the feminine focus on the body, the target of power, linking the condition of being a woman to motherhood, based on biological determinism. It is necessary to re-elaborate these policies, considering the transformations in the female role and women's freedom of choice in contemporary times.
Assuntos
Humanos , Feminino , Gravidez , Saúde da Mulher/legislação & jurisprudência , Assistência Integral à Saúde/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Útero , Sistema Único de Saúde , Brasil , MamaRESUMO
BACKGROUND: Nearly 8 million annual deaths occurring globally are attributable to tobacco use. Among more than 356 million smokeless tobacco (SLT) users in 140 countries, 82% reside in Southeast Asia with the vast majority being in India and Bangladesh. According to the Global Adult Tobacco Survey -2 data, 21.4% of adults in India consume SLT, among them 29.6% are men and 12.1% women. SLT has received less attention compared to its smoked counterparts in the public health measures to curb tobacco use. Though women are a sizable proportion of users, majority of the awareness building measures as well as governmental policies do not target them. This review aims to highlight these gaps objectively with constructive suggestions to enable a changed strategy to reduce tobacco consumption. AIM: (1) To critically review the gender sensitivity of tobacco control measures in India, (2) to conduct a comparative analysis of gender responsive strategies in India with those in smokeless tobacco high burden countries and (3) to make practical, feasible recommendations to enhance gender responsiveness of tobacco control measures in India in general and smokeless tobacco in particular. METHODOLOGY AND RESULTS: Following a comprehensive literature review to capture key information on gender responsiveness/sensitivity of strategies for tobacco control publications in English within the last 20 years, our search yielded 35 papers and reports from India describing policies relevant to SLT and women. Public health approach to tobacco control in general was found to be gender blind. CONCLUSION: It is evident that tobacco and smokeless tobacco related information and awareness activities need to focus more on women with improved messaging strategy to make it easily understandable and tailor the same to address the immediate and delayed health concerns. This much needed change would receive impetus with revisions in Governmental tobacco control policies, implementation and uptake.
Assuntos
Política de Saúde/tendências , Sexismo/tendências , Abandono do Uso de Tabaco/métodos , Uso de Tabaco/legislação & jurisprudência , Tabaco sem Fumaça/estatística & dados numéricos , Feminino , Humanos , Índia/epidemiologia , Uso de Tabaco/epidemiologia , Saúde da Mulher/legislação & jurisprudênciaAssuntos
Política de Saúde/legislação & jurisprudência , Serviços de Saúde da Mulher/tendências , Saúde da Mulher , Feminino , Política de Saúde/história , História do Século XX , História do Século XXI , Humanos , Saúde Reprodutiva/história , Saúde Reprodutiva/legislação & jurisprudência , Saúde da Mulher/história , Saúde da Mulher/legislação & jurisprudência , Saúde da Mulher/tendências , Serviços de Saúde da Mulher/história , Serviços de Saúde da Mulher/legislação & jurisprudência , Direitos da MulherRESUMO
Reproductive health care is crucial to women's well-being and that of their families. State and federal laws restricting access to contraception and abortion in the United States are proliferating. Often the given rationales for these laws state or imply that access to contraception and abortion promote promiscuity, and/or that abortion is medically dangerous and causes a variety of adverse obstetric, medical, and psychological sequelae. These rationales lack scientific foundation. This article provides the evidence for the safety of abortion, for both women and girls, and encourages readers to advocate against restrictions.
Assuntos
Saúde Mental , Direitos Sexuais e Reprodutivos/legislação & jurisprudência , Saúde da Mulher/legislação & jurisprudência , Aborto Induzido/legislação & jurisprudência , Adolescente , Adulto , Anticoncepção , Feminino , Ginecologia , Humanos , Obstetrícia , Gravidez , Saúde Reprodutiva/legislação & jurisprudência , Estados UnidosRESUMO
The Violence Against Women Act (VAWA) is frequently questioned about its success, especially during times of its reauthorization. While federal, state, local, and private organizations have funded a significant amount of research through VAWA since its inception, questions remain as to whether the field has the evidence to make a concrete judgment about its success. The purpose of this article is twofold. First, we review the Act and its subsequent reauthorizations. Second, the article addresses issues related to VAWA's success. We consider whether it is possible to answer Moore Parmley's question posed in 2004, p. 1,428: " . . . on the anniversary of the VAWA, will we be able to say with any confidence that the Act helped to prevent violence against women?"
Assuntos
Violência de Gênero/legislação & jurisprudência , Legislação como Assunto , Estupro/legislação & jurisprudência , Maus-Tratos Conjugais/legislação & jurisprudência , Saúde da Mulher/legislação & jurisprudência , Feminino , Violência de Gênero/prevenção & controle , Humanos , Violência por Parceiro Íntimo/legislação & jurisprudência , Violência por Parceiro Íntimo/prevenção & controle , Masculino , Estupro/prevenção & controle , Maus-Tratos Conjugais/prevenção & controleRESUMO
The year 2019 marked the 25th anniversary of the passage of the landmark legislation, the 1994 Violence Against Women Act (VAWA). As we reflect on the Act, it is important to examine how the VAWA influenced the response to violence against women. This guest editors' introduction provides a preview of five articles devoted to a special issue of Violence Against Women. The articles highlight key aspects of VAWA. With H.R. 15851 awaiting consideration by the Senate, we suggest that perhaps now is an appropriate time to assess the Act's impact.
Assuntos
Violência Doméstica/legislação & jurisprudência , Violência de Gênero/legislação & jurisprudência , Violência por Parceiro Íntimo/legislação & jurisprudência , Legislação como Assunto , Estupro/legislação & jurisprudência , Saúde da Mulher/legislação & jurisprudência , Violência Doméstica/prevenção & controle , Feminino , Violência de Gênero/prevenção & controle , Humanos , Violência por Parceiro Íntimo/prevenção & controle , Masculino , Estupro/prevenção & controleRESUMO
One of the goals of the Violence Against Women Act (VAWA) was to improve law enforcement responses to sexual and domestic violence by providing funding to expand prevention, enhance investigations, and increase victim services. Since VAWA's enactment, police responses to these crimes have evolved, including officer responses to victims and offenders, and various agency operations. This article highlights some noteworthy changes in law enforcement related to facilitating victim reporting, enhancing victim advocacy and services, crime reduction and investigative tools, supplementing personnel and training, and encouraging multiagency collaborations as a result of VAWA.
Assuntos
Violência Doméstica/legislação & jurisprudência , Violência por Parceiro Íntimo/legislação & jurisprudência , Aplicação da Lei , Legislação como Assunto , Polícia , Estupro/legislação & jurisprudência , Saúde da Mulher/legislação & jurisprudência , Crime , Vítimas de Crime , Feminino , Humanos , MasculinoRESUMO
The Violence Against Women Act (VAWA) is the signature federal legislative accomplishment of the anti-violence movement and has ensured that criminalization is the primary response to intimate partner violence in the United States. But at the time of its passage, some anti-violence activists, particularly women of color, warned that criminalization would be problematic for a number of reasons, a caution that has borne fruit in the 25 years since VAWA's passage. This article critiques the effectiveness of criminalization as anti-domestic violence policy and imagines what a non-carceral VAWA could look like.
Assuntos
Violência Doméstica/legislação & jurisprudência , Violência de Gênero/legislação & jurisprudência , Violência por Parceiro Íntimo/legislação & jurisprudência , Legislação como Assunto , Políticas , Saúde da Mulher/legislação & jurisprudência , Crime , Violência Doméstica/prevenção & controle , Feminino , Violência de Gênero/prevenção & controle , Humanos , Violência por Parceiro Íntimo/prevenção & controle , Masculino , Prisões , Estados UnidosRESUMO
The Violence Against Women Act (VAWA), originally passed in 1994, was successfully reauthorized in 2000, 2005, and 2013. Over time, VAWA altered the environment for many victims who had previously suffered in silence. This article focuses on how VAWA impacted American Indian (AI) and Alaska Native (AN) victims of dating and domestic violence. AI and AN women experience these crimes at a rate higher than the national average, yet they are often denied justice due to the interplay of federal and state laws and tribal sovereignty. VAWA affirmed tribes' sovereign authority to exercise criminal jurisdiction over non-Indians who commit crimes against AI and AN victims on tribal lands. This article also discusses future steps to enhance justice reforms.
Assuntos
Indígena Americano ou Nativo do Alasca , Governo , Legislação como Assunto , Justiça Social , Violência/legislação & jurisprudência , Saúde da Mulher/legislação & jurisprudência , Violência Doméstica/legislação & jurisprudência , Feminino , Violência de Gênero/legislação & jurisprudência , Humanos , Indígenas Norte-Americanos , Masculino , Abuso Físico/legislação & jurisprudência , Estupro/legislação & jurisprudênciaRESUMO
This article reviews two types of community-based approaches to addressing sexual assault that survivors may encounter-sexual assault nurse examiners and victim advocates from nonprofit community agencies-and highlights ways that the Violence Against Women Act (VAWA) and its reauthorizations have influenced this work. We also review information on the intersections of the work of these providers with police and prosecutors and include how these relate to survivors' experiences. We conclude with thoughts that look forward to future research on these issues emphasizing authentic engagement of practitioners and survivors in the research process.
Assuntos
Serviços de Saúde Comunitária , Enfermagem Forense , Violência de Gênero , Legislação como Assunto , Defesa do Paciente , Estupro , Saúde da Mulher , Vítimas de Crime , Feminino , Violência de Gênero/legislação & jurisprudência , Humanos , Aplicação da Lei , Masculino , Enfermeiras e Enfermeiros , Organizações sem Fins Lucrativos , Polícia , Estupro/legislação & jurisprudência , Sobreviventes , Saúde da Mulher/legislação & jurisprudênciaAssuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Direitos Humanos/normas , Mortalidade Materna , Cuidados de Enfermagem/normas , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Saúde da Mulher/normas , Adulto , Betacoronavirus , Brasil , COVID-19 , Feminino , Direitos Humanos/legislação & jurisprudência , Humanos , Pandemias/estatística & dados numéricos , SARS-CoV-2 , Saúde da Mulher/legislação & jurisprudênciaRESUMO
Federal law often avoids setting minimum standards for women's health and reproductive rights issues, leaving legislative and regulatory gaps for the states to fill as they see fit. This has mixed results. It can lead to state innovation that improves state-level health outcomes, informs federal health reform, and provides data on best practices for other states. On the other hand, some states may use the absence of a federal floor to impose draconian policies that pose risks to women's and maternal health. Health reforms at the federal level must trod carefully to enable state innovation, while imposing foundational safeguards for promoting women's health nationwide.
Assuntos
Mortalidade Materna , Direitos Sexuais e Reprodutivos , Saúde da Mulher/legislação & jurisprudência , California , Feminino , Humanos , Ohio , Governo EstadualRESUMO
In 2015, UN member states committed to eliminate female genital mutilation (FGM) by 2030 as part of the Sustainable Development Agenda. To reach this goal, interventions need to be targeted and guided by the best available evidence. To date, however, estimates of the number of girls and women affected by FGM and their trends over time and geographic space have been limited by the availability, specificity and quality of population-level data. We present new estimates based on all publicly available nationally representative surveys collected since the 1990s that contain both information on FGM status and on the age at which FGM occurred. Using survival analysis, we generate estimates of FGM risk by single year of age for all countries with available data, and for rural and urban areas separately. The likelihood of experiencing FGM has decreased at the global level, but progress has been starkly uneven between countries. The available data indicate no progress in reducing FGM risk in Gambia, Guinea-Bissau, Mali and Guinea. In addition, rural and urban areas have diverged over the last two decades, with FGM declining more rapidly in urban areas. We describe limitations in the availability and quality of data on FGM occurrence and age-at-FGM. Based on current trends, the SDG goal of eliminating FGM by 2030 is out of reach, and the pace at which the practice is being abandoned would need to accelerate to eliminate FGM by 2030. The heterogeneity in trends between countries and rural vs urban areas offers an opportunity to contrast countries where FGM is in rapid decline and explore potential policy lessons and programmatic implications for countries where the practice of FGM appears to remain entrenched.