Surgical sexism in Canada: structural bias in reimbursement of surgical care for women.

Background: It is well established that female physicians in Canada are reimbursed at lower rates than their male counterparts. To explore if a similar discrepancy exists in reimbursement for care provided to female and male patients, we addressed this question: Do Canadian provincial health insurers reimburse physicians at lower rates for surgical care provided to female patients than for similar care provided to male patients?

Methods: Using a modified Delphi process, we generated a list of procedures performed on female patients, which we paired with equivalent procedures performed on male patients. We then collected data from provincial fee schedules for comparison.

Trajectories of Dyspareunia From Pregnancy to 24 Months Postpartum.

Objective: To identify distinct trajectories of dyspareunia in primiparous women and examine biopsychosocial risk factors of these trajectories.

Methods: This was a prospective cohort of 582 first-time mothers. Participants completed validated measures of dyspareunia at 20-24 (baseline) and 32-36 weeks of gestation and at 3, 6, 12, and 24 months postpartum.

Comparing Self-Reported Pain During Intercourse and Pain During a Standardized Gynecological Exam at 12- and 24-Month Postpartum.

Background: There is limited information about the physical indicators and biopsychosocial predictors of self-reported pain during intercourse and pain during a gynecological examination at 12- and 24-month following childbirth.

Aim: This longitudinal study aimed to (i) Compare the findings from gynecological exams at 12- and 24-month postpartum for women with minimal vs clinically significant pain during intercourse; (ii) Assess the biomedical and psychosocial correlates of self-reported pain during intercourse and the vestibular pain index (VPI) from the cotton-swab test at 12- and 24-month postpartum; (iii) Establish the relationship between self-reported pain during intercourse and the cotton-swab test.

Methods: Women (N = 97 at 12 months postpartum and N = 44 at 24-month postpartum) recruited from a local women's hospital completed online surveys in their first trimester of pregnancy and at 12- and 24-month postpartum to assess pain during intercourse and biopsychosocial variables.

Raisonnement clinique : Avortement septique à Neisseria meningitidis.

Le choc septique post-avortement est une cause mondiale importante de mortalité maternelle, mais on l'observe rarement dans les pays développés. Nous décrivons ici un cas d'avortement septique associé à un nouvel agent pathogène : Neisseria meningitidis. Une femme multipare de 30 ans s'est trouvée en choc septique après un avortement spontané incomplet.

Clinical Conundrum: Neisseria meningitidis Septic Abortion.

Septic shock after abortion is an important cause of global maternal mortality but is rarely encountered in developed countries. We describe a case of septic abortion with a novel associated pathogen: Neisseria meningitidis. A 30-year-old multiparous woman presented in septic shock after an incomplete spontaneous abortion.

Biopsychosocial predictors of trajectories of postpartum sexual function in first-time mothers.

Objective: The postpartum period is a vulnerable time for sexual health, yet the relationship between biopsychosocial factors and sexual function over time remains unclear. Our aim was to identify trajectories of postpartum sexual function in first-time mothers (N = 646) and examine associations with biopsychosocial factors.

Methods: Biopsychosocial factors were assessed at delivery and 3 months postpartum.

Obstetrical Anal Sphincter Injuries (OASIS): Prevention, Recognition, and Repair.

Objective: To review the evidence relating to obstetrical anal sphincter injuries (OASIS) with respect to diagnosis, repair techniques and outcomes. To formulate recommendations as to patient counselling regarding route of delivery for subsequent pregnancy after OASIS.

Options: Obstetrical care providers caring for women with OASIS have the option of repairing the anal sphincter using end-to-end or overlapping techniques.