Changes in Emergency Department Practices After Implementation of a Standardized Heavy Menstrual Bleeding Guideline.

Objective: The aim of the study is to assess the effect of an emergency department (ED) standardized clinical guideline for adolescent heavy menstrual bleeding on the rate of return ED visits and ED provider history-taking and management of this condition.

Methods: This was a retrospective cohort study. Patients less than 18 years old presenting to a single academic children's hospital ED between 2010 and 2020 with a chief complaint of heavy menstrual bleeding were included.

Ghana abortion care-a model for others: analysis of the 2017 Ghana Maternal Health Survey.

Background: About 5% to 13% of maternal mortality is directly related to unsafe abortion care. Despite the cultural stigmatization of abortions, Ghana has progressive abortion laws, healthcare guidelines, and clinical outcomes.

Objective: Our study's primary aim was to characterize abortion outcomes in Ghana.

Ovarian Dermoid Cyst Trajectory in Premenarchal Girls.

Study Objective: Mature ovarian dermoid cysts (ODCs) are the most common benign ovarian tumors diagnosed in children. However, there is minimal data on management of ODCs in premenarchal patients. This study assesses characteristics associated with expectant (EM) vs surgical (SM) management in premenarchal patients and the growth rate of ODCs in EM patients at a single institution.

Understanding how COVID-19 affected black pregnant women early in the pandemic: A cross-sectional survey.

Objective: Previous research has shown that the COVID-19 pandemic significantly increased anxiety among pregnant women, and at the same time, COVID-19 has disproportionately affected communities of color in the United States. We sought to understand how self-identied Black pregnant women in the United States were affected in the early days of the COVID-19 pandemic.

Design: Cross-sectional, online survey distributed via social media SETTING: Online PARTICIPANTS: Non-probability, convenience sample of self-identified Black pregnant women in the United States between April 3 and 24, 2020 who responded to an online inquiry seeking women who were pregnant at the outset of the COVID-19 pandemic.

University Sexual and Gender-Based Violence Policies in Sub-Saharan Africa: Exploring Best Practices.

Aims: Addressing sexual and gender-based violence (SGBV) in educational settings across the globe, particularly in institutions of higher education, requires strong institutional framework and policy guidelines. Most research about university SGBV policies has focused on high-income countries with little or no recourse to universities in low- and middle-income countries. This policy analysis aims to analyze existing policies related to SGBV from select sub-Saharan African universities to provide guidance on best practices toward addressing SGBV at universities in Africa.

Contraceptive use by number of living children in Ghana: Evidence from the 2017 maternal health survey.

Background: There is a significant literature describing the link between parity and contraceptive use. However, there is limited knowledge about the disaggregation by parity of the type of contraceptives. In this study, we describe the use of contraceptives by parity among women of reproductive age in Ghana, focusing on use of highly effective methods (injection, pill, intrauterine device, implant, and sterilization).

Impact of employer-covered planned oocyte cryopreservation on decision-making for medical training.

Purpose: To characterize how employer coverage of planned oocyte cryopreservation (POC) might impact medical career decision-making.

Methods: A cross-sectional survey was distributed to all medical students at two large academic programs in December 2022 to better understand attitudes towards childbearing, POC, and how employer coverage of POC might influence future career decisions.

Results: Of the 630/1933 (32.

Measuring Sexual and Gender-Based Violence at the University of Cape Coast: Developing and Deploying a Campus Climate Survey.

Aims: Sexual and gender-based violence (SGBV) is a global public health crisis, impacting university youth around the world. The purpose of this study was twofold: (a) determine the best methodology for conducting a campus climate survey at the University of Cape Coast (UCC) in Ghana and (b) gather data on SGBV knowledge, attitudes, and behaviors from a representative sample of students.

Methods: This descriptive study included three phases: (a) develop a campus climate survey unique to UCC, (b) develop a sampling methodology, and (c) deploy the first ever campus climate survey at UCC.

Attitudes, experiences, and training on comprehensive abortion care: A nationwide survey of trainee physicians in Ghana.

This cross-sectional study assessed attitudes and experiences with abortion care among physician trainees in Ghana. Participants were 27 Obstetrics/Gynecology (OBGYN) residents and 138 house officers. An electronic survey evaluated attitudes, training, clinical experience, and technical skills with abortion care.

Contraceptive counseling in 2 urban cities in Ghana and the extent of shared decision-making.

Background: Increased use of contraception is associated with reduced maternal mortality worldwide; however, an unmet need remains high in many places, including Ghana. The quality of care provided by family planning practitioners influences contraceptive use; one way to improve the quality of care is to adopt a client-centered approach to counseling, including engaging in shared decision-making In Ghana, little is currently known about the extent of shared decision-making between clients and providers in contraceptive counseling encounters.

Objective: The purpose of this study was to explore the extent of shared decision-making during contraceptive counseling in 2 cities in Ghana.

Norethindrone dosing for adequate menstrual suppression in adolescents.

Objectives: We sought to study factors predictive of achieving menstrual suppression with norethindrone vs. norethindrone acetate in adolescents, as optimal dosing is unknown. Secondary outcomes included analyzing prescriber practices and patient satisfaction.

The potential impact of neighboring states' bans on abortion volume in a haven state.

Objectives: We explored the potential impact of abortion bans in neighboring states on Michigan's abortion volume.

Study Design: Using ArcGIS mapping software, we determined which counties in neighboring states had their closest out-of-state abortion clinic in Michigan. We estimated the change in abortions in Michigan occurring from neighboring states' residents, assuming complete bans in those states.

The Utility of Pelvic Ultrasounds in Adolescents Presenting to the Emergency Department with Abnormal Uterine Bleeding.

Study Objective: To analyze what factors influence a provider's decision to order a pelvic ultrasound (PUS) in the emergency department (ED) for adolescents with abnormal uterine bleeding (AUB), to determine if endometrial stripe (EMS) measurements are used in treatment decisions, and to evaluate if treatment outcomes differ based on EMS thicknesses.

Methods: Retrospective chart review of patients aged 11-19 presenting to the ED with AUB from 2006 to 2018. Those receiving a PUS were divided into three EMS groups: ≤5 mm, 6-9 mm, and ≥10 mm.

The relationship between estrogen and subsequent growth restriction among adolescents with heavy menstrual bleeding at menarche.

Objectives: We sought to evaluate the impact of estrogen-containing treatment for heavy menstrual bleeding (HMB) on subsequent height compared to progesterone-only or non-hormonal treatment when initiated at menarche.

Methods: We performed a retrospective chart review of adolescent females aged 10-15 years who presented to an institution-affiliated outpatient, inpatient, or emergency setting for management of HMB within three months of menarche. Growth records over a 2 year period starting at menarche were recorded, and comparisons made among patients treated with 1) estrogen, 2) progesterone, and 3) non-hormonal methods (controls).

Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospital.

Background: Delayed diagnosis of preeclampsia contributes to maternal morbidity and mortality. Patient-performed home blood pressure monitoring facilitates more frequent monitoring and earlier diagnosis. However, challenges may exist to implementation in low- and middle income-countries.

Give women what they want: contraceptive discontinuation and method preference in urban Ghana.

Background: Unmet need for contraception remains high in Ghana. Reducing the number of women who discontinue their contraceptive use is one way to decrease the number of women with an unmet need. In this study, we investigated factors associated with discontinuation among a cohort of Ghanaian women.

COVID-19 and Decision-Making for Pregnant Women: Taking or Relinquishing Control in Response to a Pandemic.

COVID-19 has uniquely impacted pregnant women. From the initial unknowns about its virulence during pregnancy, to frequent and rapidly changing hospital guidelines for prenatal care and delivery, pregnant women have felt intense uncertainty and, based on recent research, increased anxiety. This study sought to determine the impact COVID-19 had on women's birth plans.

Danger and sexuality: exploring negotiations in romantic and sexual relationships among university students in Ghana.

Gender inequalities and social mores normalise gender-based violence in many settings. The goal of this study was to gain a more in-depth understanding of romantic and sexual relationships, consent, and gender-based violence among university students in Ghana. We used focus group discussions to explore individual factors influencing romantic and sexual relationships among students enrolled at a university in the Central Region of the country to inform the development and tailoring of future interventions.

Financial Hardship Among Pregnant and Postpartum Women in the United States, 2013 to 2018.

Importance: Financial hardship affects health care access and health outcomes among peripartum women.

Objective: To evaluate the prevalence of financial hardship among peripartum women over time and by insurance type and income.

Design, Setting, And Participants: This cross-sectional study included peripartum women, defined as women aged 18 to 45 years who reported being currently pregnant or pregnant in the past 12 months, who participated in the National Health Interview Survey from 2013 to 2018.