Representações sociais sobre o planejamento reprodutivo entre mulheres em gravidez não planejada / Social representations of reproductive planning among women with unplanned pregnancies / Representaciones sociales sobre la planificación reproductiva de las mujeres con embarazo no planificado

Objetivo: conhecer as representações sociais sobre o planejamento reprodutivo entre mulheres em gravidez não planejada na Estratégia Saúde da Família. Método: estudo qualitativo, orientado pela Teoria das Representações Sociais, realizado com 15 gestantes, entre abril e maio de 2019. Utilizou-se a entrevista semiestruturada. Os dados foram organizados por meio do Discurso do Sujeito Coletivo, com auxílio do software DSCsoft©. Protocolo de pesquisa aprovado pelo Comitê de Ética em Pesquisa. Resultados: as representações sociais das mulheres em gravidez não planejada evidenciadas pelo Discurso do Sujeito Coletivo foram representadas por oito ideias centrais, a saber: "eu não me preveni, nem ele", "nós nos prevenimos", "eu comprava", "pegava no posto", "construir uma família", "ter esse acesso", "estou por fora" e "eu sei que é disponível". Conclusão: as representações sociais nos discursos das mulheres em gravidez não planejada estavam pautadas no desconhecimento acerca do planejamento reprodutivo, dos anticoncepcionais disponíveis e seu uso correto.

Objective: to understand the social representations of reproductive planning among women with unplanned pregnancies in the Family Health Strategy. Method: qualitative study, guided by the Theory of Social Representations, carried out with 15 pregnant women between April and May 2019. Semi-structured interviews were used. The data was organized using the Discourse of the Collective Subject, with the aid of DSCsoft© software. Research protocol approved by the Research Ethics Committee. Results: the social representations of women with unplanned pregnancies as evidenced by the Collective Subject Discourse were represented by eight central ideas, namely: "I didn't prevent myself, nor did he", "we prevented ourselves", "I would buy it", "I would get it at the health center", "build a family", "have this access", "I am not aware" and "I know it is available". Conclusion: the social representations in the women's speeches about unplanned pregnancies were based on a lack of knowledge about reproductive planning, the contraceptives available and their correct use.

Objetivo: conocer las representaciones sociales sobre la planificación reproductiva de las mujeres con embarazo no planificado en la Estrategia Salud de la Familia. Método: estudio cualitativo, basado en la Teoría de las Representaciones Sociales, realizado con 15 mujeres embarazadas, entre abril y mayo de 2019. Se utilizaron entrevistas semiestructuradas. Los datos fueron organizados mediante el Discurso del Sujeto Colectivo, con ayuda del software DSCsoft©. El protocolo de investigación fue aprobado por el Comité de Ética en Investigación. Resultados: las representaciones sociales de las mujeres con embarazo no planificado reveladas por el Discurso del Sujeto Colectivo fueron representadas por ocho ideas centrales, a saber: "yo no me cuidé y él tampoco", "nos cuidamos", "yo los compraba", "los buscaba en el centro de salud", "construir una familia", "tener acceso", "no participo" y "sé que está disponible". Conclusión: las representaciones sociales en los discursos de las mujeres con embarazo no planificado se basaron en la falta de conocimiento sobre la planificación reproductiva, en los anticonceptivos disponibles y su uso correcto.

A Review of Concordance and Quality in Clinical Guidelines for Hormonal Contraceptives to Mitigate Drug-Drug Interactions in Women With Epilepsy.

PURPOSE: Concomitant use of hormonal contraceptive agents (HCAs) and enzyme-inducting antiepileptic drugs (EIAEDs) may lead to contraceptive failure and unintended pregnancy. This review identified and evaluated concordance and quality of clinical treatment guidelines related to the use of HCAs in women with epilepsy (WWE) receiving EIAEDs. METHODS: Relevant clinical guidelines were identified across four databases and were independently evaluated for quality utilizing the AGREE-II protocol instrument. Quality in this context is defined as the rigor and transparency of the methodologies used to develop the guideline. Guidelines were further assessed in terms of concordance and discordance with the latest body of knowledge concerning the use of hormonal contraception in the presence of EIAEDs. RESULTS: A total of n = 5 guidelines were retrieved and evaluated. Overall guideline scores ranged from 17% to 92%, while individual domain scores ranged from 0% to 100%. Contraceptive guidelines consistently recommended the use of intrauterine systems and long-acting injectables in the presence of EIAEDs, recommended against the use of oral, transdermal, and vaginal ring contraceptives, and differed regarding recommendations related to implants. Guidelines agreed regarding recommendations that women treated with EIAEDs should receive intrauterine systems and long-acting injectables; however, the suggested frequency of administration of injectable contraceptives differed. The use of intrauterine systems in this population is supported by evidence, but there is uncertainty surrounding the use of long-acting injectables and contraceptive implants. CONCLUSIONS: To mitigate the risk of unintended pregnancy and its consequences, recommendations related to implants and long-acting injectable contraceptives should be evidence-based.

The association of higher thyroid stimulating hormone levels in the normal range with unexplained infertility: A cross-sectional study.

Background: Since thyroid hormones have an essential role in energy production, early development of the human placenta, embryo development, and implantation, abnormalities in thyroid function can significantly affect pregnancy outcomes. Objective: The present study aimed to investigate the effect of higher thyroid-stimulating hormone (TSH) levels in the normal range in euthyroid women with unexplained infertility. Materials and Methods: In this cross-sectional study, we evaluated the data for 300 euthyroid women aged between 18 and 39 yr with normal TSH levels ( ≤ 5 mIU/L) referred to Yazd Reproductive Sciences Institute, Yazd, Iran from December 2018-March 2021 in 2 groups: the case group (with unexplained infertility) and the control group (with male factor infertility). Finally, age, body mass index, and serum levels of TSH were extracted from participants' medical records and compared between groups. Results: The mean age and TSH level of participants were 31.52 ± 3.52 yr and 1.24 ± 2.59 mIU/L, respectively. 142 women (47.3%) had TSH < 2.5, and 158 women (52.7%) had TSH ≥ 2.5 mIU/L. The women with unexplained infertility had significantly higher TSH levels than controls in the same normal range (0.62 vs. 0.64 mIU/L, p < 0.001). Although a more significant proportion of women in the case group had TSH levels > 2.5 mIU/L, we did not find a significant association between TSH levels and age or body mass index. Conclusion: Women with unexplained infertility have a higher level of serum TSH in the normal range ( ≥ 2.5 mIU/L) than the control group. So, the effect of TSH treatment on these women should be considered.

Factors associated with oocyte recovery rates during in-vitro fertilization among Nigerian women.

Introduction: the availability of oocytes is fundamental to in vitro fertilization (IVF). The factors associated with optimal or suboptimal oocyte recovery rates (ORR) in low-resource settings are not well known. This study aimed to determine the factors associated with ORR by comparing demographic and IVF cycle data of women undergoing IVF in our Centre. Methods: this was a prospective study of 110 infertile women undergoing IVF at Nisa Premier Hospital, Abuja Nigeria, from October 2020 to September 2021. All women had reached the stage of oocyte retrieval or further, after receiving ovarian stimulation with our routine protocols. Treatment was monitored by serial transvaginal ultrasonography. The oocyte retrieval procedures were performed under conscious sedation, 36 hours after the ovulatory trigger. Optimal ORR was when eggs were obtained from at least 80% of follicles punctured. Sub-optimal ORR was when it was less than 80%. Data analyses utilized SPSS statistical software and a p-value of < 0.05 was considered significant. Results: the mean age of all women was 34.1±4.9 years. Sixty-nine women (62.7%) had sub-optimal ORR while 41 (37.3%) had optimal ORR. Six women (5.5%) had no oocytes retrieved. Significantly more women with sub-optimal ORR were obese (70.6 vs 29.4%) and had higher follicle-stimulating hormone (FSH) levels (8.11 vs 6.34 miu/ml), p-value- 0.039. Women with sub-optimal ORR had higher mean prolactin levels (17.10 ± 13.93 miu/ml) than women with optimal ORR 11.43 ± 6.65 miu/ml), p-value- 0.019). Significantly more oocytes (5.99 vs 10.37, p-value 0.001), and MII oocytes (5.78 vs 7.56, p-value 0.035) were retrieved in women with optimal than sub-optimal ORR. The duration of stimulation, total amounts of gonadotropins administered, and fertilized oocytes were not significantly different among both groups (p-value >0.05). Conclusion: this study has shown the factors associated with ORR in our setting to be basal FSH, prolactin, and obesity.

Frequency of urinary incontinence and attitudes towards urinary incontinence of women in Mersin, Turkey.

Objectives: Urinary incontinence (UI) is the involuntary loss of urine or the inability to control urination. The International Continence Society defines UI as any complaint of involuntary loss of urine. UI is a very important health problem that affects women's quality of life. It can lead to a decrease in women's self-confidence and prevent them from participating in social activities. This study was conducted to investigate the prevalence of UI in women living in Turkey, the factors affecting it, and women's attitudes toward UI. Methods: This descriptive and cross-sectional study included 903 women who applied to 17 family health centers in Mersin, Turkey, between May 10th to June 10th 2019 for any reason. The data of the study were obtained using the descriptive information form and the Urinary Incontinence Attitude Scale (UIAS). Data analysis was performed with SPSS-21 using percentiles, mean±standard deviation, and Pearson chi-square tests. Results: According to the results obtained, 28.9% of the women had UI problems, more than half (54.6%) of the women with UI did not present to a health institution for this problem, and 54.8% did not receive any treatment. In addition, the frequency of experiencing UI was higher in those with a chronic disease (59.2%) than in those without any chronic disease, and the difference was significant. Conclusion: The demographic and fertility characteristics of the women influenced the frequency of experiencing UI. In addition, among the women participating in the study, those with negative attitudes toward UI experienced more UI problems. There should be greater efforts to raise awareness among women on this subject.

Exploring the uptake of sexual and reproductive health services for lesbians and bisexual women in Bulawayo, Zimbabwe. A quantitative enquiry.

Background: Sexual and reproductive healthcare is essential for all individuals, including LGBTQ+ individuals. However, lesbians and bisexual women often lack tailored services, leading to underutilization. This study aimed to assess the availability and uptake of sexual and reproductive health services for lesbian and bisexual Bulawayo women. Methods: A cross-sectional study surveyed 67 lesbian and bisexual women recruited through the Voice of the Voiceless Organization. The participants completed a structured questionnaire on available services, factors influencing their uptake, and access challenges. Cross-tabulation was used to examine the associations between variables. Data were analyzed using Microsoft Excel and STATA Version 15 S.E. Results: Most respondents were bisexual women aged 35 years. Cross-tabulations revealed significant associations between delayed or avoided services and the absence of specific services for lesbians and bisexual women as well as the presence of gender identity nondiscrimination policies. Conclusion: Sexual and reproductive health programs play a vital role in meeting lesbian and bisexual women's needs. Improving service uptake requires strengthening the linkages between clinics and sexual health education programs, providing lesbian and bisexual women-friendly clinical services, and ensuring access to comprehensive information.

"It Will Always Feel Worse Because it Comes with That Added 'Betrayal'": Intersectionality Praxis and Black Young Women Survivors' Perspectives on Cultural Betrayal Trauma Theory.

Because of interlocking oppressions of racism and sexism (e.g. intersectionality), Black women's experiences of high rates of sexual violence are often ignored. A critical Black feminist framework, cultural betrayal trauma theory (CBTT) examines within-group violence in the Black community, which has compounding harm due to inequality. Though quantitative research has found support for CBTT, Black young women survivors' perspectives have not been examined. Therefore, the purpose of the current exploratory study was to engage in intersectionality praxis to qualitatively examine Black young women survivors' perspectives on CBTT through structured thematic analysis and coding based on theory. Respondents (N = 37; 18-30 years), provided their thoughts on CBTT following participating in a quantitative study. With most survivors in agreement that cultural betrayal in trauma is harmful, a key theme was community orientation in understanding both the harm and healing of cultural betrayal trauma. Black young women survivors' resonance with CBTT, as well as their recommendations for community-level solidarity and healing have important implications.

Digital body image interventions for adult women: A meta-analytic review.

Although many women experience body dissatisfaction, treatment options that prevent the onset of more serious conditions are limited in accessibility. As such, digital interventions may be an appropriate alternative resource to address restricted treatment options. This study provides statistical syntheses of the evidence for digital body image interventions for non-clinical adult women. A systematic literature search identified 19 studies (N = 2424) that tested the effect of a digital body image intervention compared to a control condition. Study results were synthesised using random effects models, and small to medium statistically significant effect sizes indicated that digital interventions were beneficial in increasing overall global satisfaction (g = 0.43) and reducing cognitive body dissatisfaction (g = 0.36). These meta-analytic findings provide evidence for the efficacy of digital body image interventions for non-clinical adult women. Intervention type was not found to be a statistically significant moderator, which may suggest that a range of intervention types can produce similar reductions in body dissatisfaction. Overall, digital body image interventions may be a feasible option to alleviate body dissatisfaction, particularly for women who may be unable to access conventional treatment.

Dr. Kadambini Ganguly (1861-1923): A Pioneer in Indian Medicine.

Dr. Kadambini Ganguly was a trailblazing Indian physician and social reformer. As one of the first female graduates and practitioners of Western medicine in India, she broke numerous barriers in a field dominated by men. Her contribution to medicine, particularly in women's healthcare, and her engagement in social reform through the Brahmo Samaj and the Indian National Congress, caused significant progress toward gender equality and social justice. This article looks back on her academic accomplishments, medical career, social activism, and lasting legacy, emphasizing her profound influence on medicine and society in India.

The Effect of IVF Treatments for Infertility on Occupational Balance.

The utilization of assisted reproductive technologies (ART), including in vitro fertilization (IVF), has doubled in the past decade. The occupational balance of women undergoing infertility and its treatments is unknown. A qualitative study to investigate the occupational balance of women undergoing IVF for infertility was completed. Ten women currently undergoing or having undergone IVF were interviewed. Thematic analysis was used to analyze the effect of IVF on occupational balance. Three themes emerged, tunnel vision, it's all on me, and I'm not enough, highlighting the challenges faced by women during the IVF journey that affect their occupational balance. Participants reported a lack of occupational balance due to the intense focus on IVF, overwhelming responsibilities, inadequate support, anxiety, depression, and self-doubt. Comprehensive, holistic support and intervention are necessary to address the occupational well-being of women undergoing IVF and can be provided by OTPs.

The Effect of Infertility Treatments on Occupational BalanceThis qualitative research study examines the effect of in vitro fertilization (IVF) on occupational balance or the perception of having the right amount, proportion, and variation among productive, restorative, and leisure occupations, for women experiencing infertility. Ten women aged 33­45 years, who were currently undergoing or had recently undergone IVF, were interviewed. Interviews revealed three key themes: tunnel vision, it's all on me, and I'm not enough. Participants reported a lack of occupational balance due to the intense focus on IVF, high levels of stress, and lack of support. The study highlights the importance of comprehensive support and intervention to address the emotional and occupational well-being of women undergoing IVF. Occupational therapy practitioners can play a crucial role in promoting occupational balance and well-being in this population.

Embodiment of structural vulnerability: illness experiences among Somali refugee women in urban displacement.

OBJECTIVES: Forced migration and its subsequent sequelae have caused refugees to face significant adversities throughout the displacement process, making them susceptible to significant health issues. Refugees displaced in Africa are a group especially vulnerable to poor health outcomes, experiencing a documented decline in overall physical and mental health status and rise in mortality from non-communicable diseases (NCDs). Despite the heightened health risks experienced by Somali refugees, particularly women, research into their complex illness experiences and co-/multimorbid health conditions is scarce, leaving a gap in our understanding of the multifaceted health challenges of this population. DESIGN: Using structural vulnerability theory, this study explores how the broader host context shapes illness experiences for Somali refugee women in Kenya. Specifically, we describe the factors associated with illness experiences of urban Somali refugee women and how this compares with women with other similarly situated identities, such as Somali Kenyan women, other/non-Somali refugees, and Kenyan women. In-depth interviews were conducted with 43 women in Eastleigh, Kenya. RESULTS: Using hybrid thematic analysis, the emergent themes were grouped into three distinct domains: (1) multimorbid, complex illness experiences, (2) embodiment of structural vulnerability, and (3) distinct/shared vulnerability among refugee/non-refugee women. Results suggest that illness experiences of displaced refugee women are inextricably linked to traumatic experiences before displacement, as well as the experiences of transmigration stressors and the hostile socio-legal dynamics encountered post-displacement. CONCLUSIONS: Our findings also have implications for the need to consider intersectional identities when examining for differential exposure to structural risks and the susceptibility to poor health experiences as well as supports the need for urgent change and improvement in systems of social protection and basic care for refugees experiencing prolonged displacement.

Changes in ageing women's sexual subjectivity as seen from a life course perspective: security, caring, and desire.

This article explores the sexual subjectivity of women of post-reproductive age who seek partners on dating apps. The existing literature highlights the sexual subjectivity and agency of older women as contested and not sufficiently investigated. Even less research has been conducted on changes in the sexual subjectivity of women born in the USSR in the 1960s, with the liberalisation of sexual behaviour. The study is based on 45 interviews with women aged 55 years and over, who were born in the USSR and who now live in Israel, Finland and Russia. In the article, we examine sexual subjectivity as presented in the interviews from a life course perspective. We explain theoretically and empirically how changes in sexual subjectivity are expressed in the light of age and socio-cultural context constraints. Three life stories highlight the accumulation of experience and turning points, such as divorce and migration. They illustrate very different pathways in changing sexual subjectivity, yet all contain three Leitmotifs: desire, security and caring. The expression of post-reproductive female desire can be related to the need to feel secure and enjoy mutual care in sexual relationships. We show that these Leitmotifs shape and are shaped by women's identifications as both sexual objects and subjects, and explore how they relate to different sexual cultures and variations in the socio-sexual positioning of women in Israel, Finland, and Russia.

The Landscape of Pain Medicine for Women Physicians: A Perspective.

BACKGROUND: The gender bias in academic anesthesiology is well known. Women are not only a minority in the field but also underrepresented in leadership positions. Reported reasons for this underrepresentation include barriers to career advancement, lack of mentorship, and differences in compensation, among others. Interventional pain, a competitive procedural subspecialty of anesthesiology, sees the trickle-down effects of this disparity. According to a report from the ACGME that sorted medical subspecialties by number of female trainees, pain medicine ranked in the bottom quartile across all disciplines from 2008-2016. OBJECTIVES: To better understand the landscape for women physicians in the field of pain medicine, we undertook this investigation to review the knowledge about the topic and what questions remain unanswered. STUDY DESIGN: This study is a review of the current literature and aims to summarize and describe the landscape of pain medicine for women physicians. SETTING: All literature review and manuscript preparation took place at the Yale University School of Medicine. METHODS: We performed a comprehensive search using the PubMed, Scopus, and Cochrane databases for the combined terms "gender disparity," "pain medicine," and "anesthesiology," limiting our search to the year 2000 onward for the most recent literature on the topic. Our initial search retrieved 38 articles. All relevant articles pertaining to this perspective piece were collated. The available literature is discussed below. RESULTS: Women are underrepresented in interventional pain. The grim scarcity of female pain physicians is unlikely to improve soon, since while the number of Accreditation Council for Graduate Medical Education pain fellowship programs continues to grow, women trainees comprise only between 22-25% of all pain medicine fellows. Additionally, although studies have compared the numbers of male interventional pain faculty to their female counterparts in academic hospitals and shown the ratio to range from 71.84-82% to 18-28.52%, respectively, no studies have truly explored the landscape for women physicians in private practice. Patients prefer and have better experiences with physicians who are racially and ethnically like themselves. In fact, the preference for and the lack of female clinicians have been associated with delayed pursuit of care and adverse health outcomes. The consequences of the burnout and attrition caused by the gender disparity, especially in a field like pain medicine, cannot be understate. LIMITATIONS: The review might not have been comprehensive, and relevant studies might not have been included. CONCLUSION: While the gender disparity in academia is well documented for both anesthesiology and pain medicine, the reasons for this disparity have not been fully explored. Moreover, it is also unknown whether the minority of female physicians who select pain medicine as a subspecialty gravitate toward an academic or a private-practice path. To address the existing gender disparity, it is necessary to explore the landscape of interventional pain medicine in both academic and private practices and understand pain physicians' beliefs and sentiments regarding their subspecialty.

Barriers and facilitators to healthcare utilisation by Arab sexual minority women migrants in the USA.

Limited research on sexual minority women migrants demonstrate that they face elevated rates of mental health problems compared to their heterosexual and male counterparts, and less is known about their healthcare seeking behaviours. This study aimed to identify barriers and facilitators to mental and physical healthcare utilisation among first-generation (foreign-born) Arab sexual minority women migrants in the USA and to assess whether Penchansky and Thomas' theory of access can be used to understand their healthcare utilisation behaviours. We conducted 20 semi-structured interviews via Zoom. Employing community-engaged research methods, four advisors, Arab sexual minority women migrants and a mental health service provider, assisted in recruitment and thematic data analysis providing a rich and nuanced understanding of study findings. Five main themes demonstrated the pivotal role of cultural humility from providers and access to medical insurance in shaping healthcare-seeking decisions. Difficulties finding therapists and navigating the referral process and wait times encouraged participants to seek care outside of the USA in their Arab countries of origin. Stigma and social support further influenced participants' decisions to seek mental healthcare. The study findings inform policy and practice to foster the development of inclusive healthcare services grounded in cultural humility and to develop support groups specifically for Arab sexual minority women migrants to the USA.

Aflatoxin M1 levels in urine and breast milk of lactating mothers in Kuala Lumpur, Malaysia.

Aflatoxins are carcinogens that can contaminate food and affect various body organs especially liver and kidney. When consumed, aflatoxin B1 (AFB1) is partially metabolised into aflatoxin M1 (AFM1), which is excreted in the urine.Breast milk may also contain AFM1 due to maternal dietary intake from contaminated food. This cross-sectional study aimed to determine the levels of AFM1 in both urine and breast milk among breastfeeding mothers (n = 256). The mother's demographic information was collected during recruitment. Mothers were then scheduled for an appointment to provide a morning urine sample along with five to ten mL samples of breast milk. AFM1 levels in both samples were analysed using an enzyme-linked immunosorbent assay (ELISA). Spearman's rho and Chi-square were used to determine the associations between mean levels of AFM1 in urine and breast milk. Findings show 68.0% of urine samples were contaminated with AFM1 (mean levels = 0.08 ± 0.04 ng/mL), while 14.8% of breast milk samples had AFM1 (mean levels = 5.94 ± 1.81 ng/kg). Urine AFM1 levels were not significantly associated with AFM1 levels in breast milk (p > 0.05). This study can act as a baseline for future research examining long-term aflatoxin exposure among both mothers and infants.

Awareness of urinary incontinence in pregnant women as a neglected issue: a cross-sectional study.

Background: Pregnancy and labor are independent risk factors for the development of urinary incontinence (UI). Although UI is common during pregnancy, it is a health problem mostly neglected by pregnant women. The high prevalence of UI in pregnancy and its effects on the postpartum period justifies the need to determine the knowledge and attitudes of pregnant women regarding the prevention and management of UI. It is necessary to increase the awareness of pregnant women about UI, educate, consultant, and integrate pelvic floor muscle training into prenatal care services. This study aims to determine the UI awareness of pregnant women and their knowledge and attitudes in this context. Methods: This cross-sectional study was conducted with 255 pregnant women in a university hospital in Turkey between March and September 2020. Data were collected using the Incontinence Knowledge Questionnaire (PIKQ) and Urinary Incontinence Attitude Scale (UIAS). Results: The UI prevalence was 51% during pregnancy. The mean score of PIKQ was 8.07±2.64, and only 6.3% of participants correctly answered all the questions regarding UI. The mean score of UIAS was 42.33±3.48. A positive correlation was found between UI knowledge and attitude score (r=0.35, p=0.00). Conclusions: The results showed that although UI is prevalent during pregnancy, pregnant women's knowledge of UI is poor. Nearly half of pregnant women need information. They tend to display positive attitudes towards UI, but not sufficient to improve their health-seeking behavior. Strategies should be developed to increase pregnant women's awareness of UI and to encourage them health-seeking behaviors for the prevention/management of UI during prenatal visits.

The Phenomenon of Human Migration on the Breastfeeding Practices of Migrant Women: A Scoping Review.

Human migrations and different migratory flows have been as old as the practice of breastfeeding (BF). The reasons for migrating, the conditions, and its protagonists are so diverse, often constituting situations of vulnerability and risk for health decision-making at both the individual and collective levels. The relationship between BF and human migration is totally dynamic and includes multiple factors, which is why there is a need to characterize territorially its prevalence rate and variability depending on the context. The migration profiles that can be configured from factors, such as schooling, employment, the host country's health system, and support networks, among others, have heterogeneity between countries that make it necessary to identify them. This study is an in-depth review of the report on the practice of BF in migrant women. The Arksey and O'Malley method was used to perform the PubMed and SciELO searches. The search terms were "exclusive breastfeeding (EBF)," "breastfeeding," "migrant women," and "human migration," and original articles published in English, Spanish, and Portuguese were included. Of the 43 selected articles, differences were found between the various migrant groups, in variables such as socioeconomic level, education, access to health services, maternal knowledge, father factor, culture, and intention to breastfeed. The heterogeneity of the practice of BF between countries, as well as in intraregional migratory flows, establishes different protective or risk factors depending on where the phenomenon develops and its conditions.

COVID-19 Vaccination Acceptance During Pregnancy in Europe.

Pregnant women have been shown to have a higher risk of SARS-CoV-2 infection. Vaccination against the infection is the most effective strategy for preventing both severe disease and related complications. Nevertheless, vaccination hesitancy among pregnant women is an important issue affecting vaccine uptake and a major challenge for Public Health, as high rates of hesitancy can lead to complete refusal of vaccination, with health implications not only for the mother but also for the fetus. Based on the above, this review aims to capture the rates of vaccination against COVID-19 in pregnancy among European countries, from August 2020 to May 2022, as well as to highlight the predictive factors of its acceptance among pregnant women in these countries. The review of the available literature found that in Europe the acceptance of vaccination against COVID-19 among pregnant women varies with rates ranging from 21.3% to 87% for at least one dose and from 29.5% to 82.7%, for two doses of vaccine. Higher maternal education level, older age at pregnancy, previous vaccination against influenza and pertussis, positive attitude towards vaccines, and acceptance of vaccines during pregnancy are the most frequently reported positive predictors that are associated with higher vaccination rates. The information obtained from this study can contribute in the future, during epidemics or pandemics that may occur, to the development of targeted medical and communication strategies for the effective promotion of vaccination programs and the greatest possible coverage of the population, especially those belonging to vulnerable groups such as pregnant women.

"I will find the best method that will work for me": navigating contraceptive journeys amongst South African adolescent girls and young women.

BACKGROUND: Given that South Africa has one of the highest rates of pregnancy amongst adolescent girls and young women (AGYW) globally, the provision of contraceptives to this group has been a key focus in recent years. Pregnancy prevention involves an on-going continuum of decision-making around contraceptive method choice, uptake, use, experience, continuation, and discontinuation. METHODS: This paper presents analysis of data from a cross-sectional survey with 2376 AGYW, as well as qualitative in-depth interviews (IDIs) with 54 AGYW, inclusive of contraceptive journey narratives. We examine the preferences, valued characteristics, choices, beliefs, understandings and experiences of choosing and using contraceptives amongst AGYW in two South African communities characterised by high rates of pregnancy. RESULTS: These findings shed light on the preferences towards, beliefs about, and experiences of choosing, using and discontinuing contraceptive methods amongst this population, with survey data suggesting that the most popular methods were the injection, followed by the implant, and then the oral pill. Findings illustrate the complexity and dynamic nature of contraceptive decision-making and the varied embodied and lived experiences of contraceptive use, and how these are impacted by contraception service provision. CONCLUSIONS: Our findings show that contraception experiences of each individual are cumulative, and comprise a continuum of method initiation, use, discontinuation, method switching and on-going circular decision-making influenced by multiple social, structural, contextual and interpersonal factors, combined with shifting preferences, values and needs. To maximise the use of contraceptives amongst South African AGYW, it is necessary to provide responsive contraception service provision to reflect the changing contexts and preferences of users, in order to ensure that pregnancy prevention needs are catered for throughout their reproductive life course.