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Knowledge and practice of health workers towards maternal and child health in the Democratic Republic of the Congo: a cross-sectional study

The burden of maternal and child mortality is high in the Democratic Republic of the Congo (DRC). While health workers (HWs) with adequate knowledge and practice of maternal and child health (MCH) are crucial ...

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Vitamin D and reproductive disorders: a comprehensive review with a focus on endometriosis

Vitamin D is a fat-soluble steroid hormone that was initially known only for regulating calcium and phosphorus levels and maintaining bone health. However, it was later discovered that many organs express vita...

Contraceptive behavior of women in India after induced abortion

Putting an end to the silent pandemic of unsafe abortion is a major public health concern globally. Adoption of post-abortion contraception is documented as a significant contributor to reduce the number of un...

Understanding the meaning of the lived experience “maternal role” in women with multiple sclerosis and planning a supportive program: a combined exploratory study protocol

The maternal role is one of the most challenging yet rewarding roles that women experience in their lives. It begins when a woman becomes pregnant, and as the pregnancy progresses, she prepares to fulfill her ...

Curriculum-based sexual and reproductive health education: revealing its relevance for risky sexual behaviors among secondary school students in Mwanza, Tanzania

Secondary school students are vulnerable to risky sexual behaviors (RSBs) which may lead to adverse health consequences, such as teenage pregnancies and sexually transmitted diseases (STDs), including HIV/AIDS...

An implementation analysis of a quality improvement project to reduce cesarean section in Brazilian private hospitals

Brazil has one of the highest prevalence of cesarean sections in the world. The private health system is responsible for carrying out most of these surgical procedures. A quality improvement project called Ade...

This article is part of a Supplement: Volume 20 Supplement 2

Validation and measurement properties of the Male and Female Fertility Knowledge Inventories (MFKI and FFKI) in Iranian couples

One of the most important population challenges during the last three decades has been the significant decrease in the fertility rate worldwide. Since the validity and reliability of the Male and Female Fertil...

High uptake of menstrual health information, products and analgesics within an integrated sexual reproductive health service for young people in Zimbabwe

Despite being integral to women’s well-being, achieving good menstrual health (MH) remains a challenge. This study examined MH services uptake (including information, analgesics, and a choice of MH products - ...

Investigating the impact of couple counseling based on the CHARMS model on sexual quality of life and marital satisfaction of wives of men suffering from myocardial infarction: a study protocol

Cardiovascular diseases are a common chronic illness in adults, with implications for health and psychological well-being. These implications not only affect the patients themselves but also impact family memb...

Implementation and evaluation of the centering pregnancy group prenatal care model in pregnant women with diabetes: a convergent parallel mixed methods study protocol

Diabetes during pregnancy has negative effects on both mothers and their fetuses. To improve perinatal outcomes and women’s experience of care, the World Health Organization (WHO) suggests implementing health ...

Incorporation, adaptation and rejection of obstetric practices during the implementation of the “Adequate Childbirth Program” in Brazilian private hospitals: a qualitative study

The “Adequate Childbirth Program” (PPA) is a quality improvement project that aims to reduce the high rates of unnecessary cesarean section in Brazilian private hospitals. This study aimed to analyze labor and...

Sexual health literacy level and its related factors among married medical sciences college students in an Iranian setting: a web‑based cross‑sectional study

Sexual health literacy (SHL) leads to the development of personal ability, understanding, evaluation and use of information related to sexual health. The purpose of this study was to assess the sexual health l...

Birthweight trends and their explanatory factors in Hungary between 1999 and 2018: an analysis of the Hungarian Tauffer registry

The increasing birthweight trend stopped and even reversed in several high income countries in the last 20 years, however the reason for these changes is not well characterized. We aimed to describe birthweigh...

Sexual and reproductive health among forcibly displaced persons in urban environments in low and middle-income countries: scoping review findings

Most forcibly displaced persons are hosted in low- and middle-income countries (LMIC). There is a growing urbanization of forcibly displaced persons, whereby most refugees and nearly half of internally displac...

Geographic and socioeconomic inequalities in the coverage of contraception in Uttar Pradesh, India

Uttar Pradesh (UP) is the most populous state in India, with a historically lower level of family planning coverage than the national average. In recent decades, family planning coverage in UP has significantl...

Using mobile health in primiparous women: effect on awareness, attitude and choice of delivery type, semi-experimental

One of the reasons for the increase in cesarean section is the lack of knowledge of mothers in choosing the type of delivery. The present study aimed to determine the effect of education through pregnancy appl...

Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021

Eliminating unmet need for family planning by 2030 is a global priority for ensuring healthy lives and promoting well-being for all at all ages. We estimate the sub-national trends in prevalence of unmet need ...

The 100 top-cited articles in menopausal syndrome: a bibliometric analysis

Significant scientific research has been conducted concerning menopausal syndrome(MPS), yet few bibliometric analyses have been performed. Our aim was to recognise the 100 most highly cited published articles ...

Exploring the decision-making process of female genital cosmetic procedures in Iranian women and constructing and validating a results-based logic model for a healthy public policy: a study protocol

Female genital cosmetic procedures have grown rapidly in most parts of the world. Professional organizations have issued warnings about the complications and long-term consequences of these practices. To be ab...

Predictors of maternal health services uptake in West African region: a multilevel multinomial regression analysis of demographic health survey reports

Pursuant to studies, receiving the three key maternal health services (Antenatal Care, Skilled Delivery Service, and Postnatal Care) in a continuum could prevent 71% of global maternal deaths. Despite the West...

Impact of postpartum weight change on metabolic syndrome and its components among women with recent gestational diabetes mellitus

While postpartum weight changes may affect the levels of metabolic parameters, the direct effects of weight changes in the postpartum period on changes in the prevalence rates of metabolic syndrome and its com...

Acceptance and commitment therapy adapted for women with infertility: a pilot study of the Infertility ACTion program

Approximately one in six couples are currently infertile, defined as unable to achieve pregnancy despite 12 or more months of active attempts to conceive. Experiencing infertility has been disproportionately a...

Determinants and predictive model of failure of surgical repair of obstetric vesico-vaginal fistula in the Democratic Republic of the Congo

Surgical repair of obstetric fistula aims to restore the anatomical and functional integrity of the urinary tract, enabling affected women to regain their dignity and quality of life. However, such repairs can...

Study protocol for the implementation of Centering Patients with Fibroids , a novel group education and empowerment program for patients with symptomatic uterine fibroids

Black women and people with uteri have utilized collectivistic and relational practices to improve health outcomes in the face of medical racism and discrimination for decades. However, there remains a need fo...

Women’s preference for a vaginal birth in Brazilian private hospitals: effects of a quality improvement project

In 2015, a quality improvement project called “Adequate Childbirth Project” (PPA) was implemented in Brazilian private hospitals in order to reduce cesarean sections without clinical indication. The PPA is str...

Knowledge and perception of HPV vaccination among Lebanese mothers of children between nine and 17 years old

The human papillomavirus (HPV), a prevalent sexually transmitted infection, is linked to a wide range of diseases, with cervical cancer being the most common and serious one. HPV vaccination is crucial for pre...

Contextual determinants of generational continuation of female genital mutilation among women of reproductive age in nigeria: analysis of the 2018 demographic and health survey

Female genital mutilation (FGM) has negative health implications and has long been recognised as violating sexual rights. Despite the huge efforts expended on eradicating FGM, generational continuation of the ...

“You cannot stay with one person once you begin having sex at a young age”: the prevalence, correlates and effects of early sexual debut among children in Ghana

Children’s initiation of early sex has several negative implications on their sexual and reproductive health, growth and development. In Ghana, few studies on early sexual debut have focused on adolescents. Th...

Israeli students’ perceptions regarding sperm donation: dilemmas reflections with dominant demographic effect

Sperm donation has undergone significant medical and social transformations in recent decades. This study aimed to explore Israeli students’ perceptions towards sperm donation and investigate the potential inf...

Seeking information and services associated with reproductive health among rural Peruvian young adults: exploratory qualitative research from Amazonas, Peru

Sexual and reproductive health (SRH) literacy allows young adults to make informed decisions about health outcomes. In Peru, roughly one fifth of the population lives in rural areas, and little is known about ...

Caregivers’ concerns about the sexual and reproductive health of women with intellectual disability in Iran: a qualitative study

Women with intellectual disability (ID) have many sexual and reproductive problems. This study was conducted to explain the sexual and reproductive health considerations of women with ID from the perspective o...

Unraveling reproductive and maternal health challenges of women living with HIV/AIDS in Vietnam: a qualitative study

Human Immunodeficiency Virus (HIV) remains a significant public health concern worldwide. Women living with HIV/AIDS (WLHA) have the additional and unique need to seek sexual and reproductive health services. ...

Birth by caesarean section and semen quality in adulthood: a Danish population-based cohort study

The caesarean section (CS) rate has increased worldwide and there is an increasing public and scientific interest in the potential long-term health consequences for the offspring. CS is related to persistent a...

"I don't want my marriage to end": a qualitative investigation of the sociocultural factors influencing contraceptive use among married Rohingya women residing in refugee camps in Bangladesh

The timely provision of comprehensive contraceptive services to Rohingya women is impeded due to a lack of clarity and understanding of their traditional beliefs and cultural frameworks. Recognizing this chall...

The impact of gestational weeks of Coronavirus disease 2019 (COVID-19) infection on perinatal outcomes

To evaluate the relationship between coronavirus disease 2019 (COVID-19) infection at different time points during pregnancy and perinatal outcomes.

An integrated theory based-educational intervention to change intention to have a child: study protocol of a cluster randomized controlled trial

In high- and low-income countries, declining birth rates have become a global concern. Couples do not have enough information about the complications of delaying and reducing childbearing and this leads them t...

A comprehensive interventional program to improve the sexual function of women with endometriosis: a mixed-methods protocol study

Endometriosis is a chronic disease affecting 6–10% of women worldwide. Sexual dysfunction has been reported in a significant percentage of these patients. Thus, the present study will be conducted to design, i...

Ranking the dietary interventions by their effectiveness in the management of polycystic ovary syndrome: a systematic review and network meta-analysis

Polycystic ovary syndrome (PCOS) is a common condition in women, characterised by reproductive and metabolic dysfunction. While dietary approaches have been evaluated as a first-line treatment for patients wit...

To what extent did implementing a community-embedded intervention align with the goals and roles of stakeholders in adolescent sexual and reproductive health?

Adolescents’ sexual and reproductive health (SRH) needs are largely unmet due to poor access to SRH information and services. A multicomponent community-embedded intervention, comprising advocacy to policymake...

The psychosocial impact of male infertility on men undergoing ICSI treatment: a qualitative study

Male infertility is in 20–70% of cases the cause of a couple’s infertility. Severe forms of male infertility are best treated with Intracytoplasmic Sperm Injection (ICSI). The psychosocial impact of infertilit...

Influence of menstrual pain and symptoms on activities of daily living and work absenteeism: a cross-sectional study

To examine the prevalence of menstrual pain among women of reproductive age and its impact on their daily lives and professional responsibilities.

Development, implementation, and evaluation of the effectiveness of an intervention program to improve the sexual competence of young adult women about to get married: a protocol study

Having competence in initiating sexual interactions is one of the challenges of sexual health in any society. Given that the social, cultural, and religious background of some societies can prevent the acquisi...

Documentation of prenatal contraceptive counseling and fulfillment of permanent contraception: a retrospective cohort study

Barriers exist for the provision of surgery for permanent contraception in the postpartum period. Prenatal counseling has been associated with increased rates of fulfillment of desired postpartum contraception...

Acceptability of IV iron treatment for iron deficiency anaemia in pregnancy in Nigeria: a qualitative study with pregnant women, domestic decision-makers, and health care providers

Anaemia in pregnancy causes a significant burden of maternal morbidity and mortality in sub-Saharan Africa, with prevalence ranging from 25 to 45% in Nigeria. The main treatment, daily oral iron, is associated...

“They call me the ‘Great Queen’”: implementing the Malkia Klabu program to improve access to HIV self-testing and contraception for adolescent girls and young women in Tanzania

Adolescent girls and young woman (AGYW) comprise a significant proportion of new HIV infections and unintended pregnancies in sub-Saharan Africa yet face many barriers to accessing family planning and reproduc...

Reproductive autonomy and the experience of later-than-desired pregnancy: results from a cross-sectional survey of reproductive-aged women in Uganda

The focus of reproductive autonomy research has historically been on the experience of unintended pregnancy and use of contraceptive methods. However, this has led to the neglect of a different group of women ...

Explaining the experience of breastfeeding in women with gestational diabetes and designing and implementing an educational program based on planned behavior theory: a combined exploratory study protocol

Gestational diabetes is a type of carbohydrate intolerance that is diagnosed for the first time during pregnancy. Researches have shown that gestational diabetes is associated with many negative prenatal and b...

A loss-of-function variant in ZCWPW1 causes human male infertility with sperm head defect and high DNA fragmentation

Male infertility is a global health issue. The more causative genes related to human male infertility should be further explored. The essential role of Zcwpw1 in male mouse fertility has been established and t...

Menarche and reproductive health in Spanish Roma women from a reproductive justice perspective: a qualitative study

This study aimed to explore the perceptions of Roma women about their experience of menarche and reproductive health considering the principles of reproductive justice.

Women's voices and meanings of empowerment for reproductive decisions: a qualitative study in Mozambique

Women in Mozambique are often disempowered when it comes to making decisions concerning their lives, including their bodies and reproductive options. This study aimed to explore the views of women in Mozambiqu...

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Reaction to the 2024 Alabama Supreme Court ruling on IVF

Read the blog by Gwendolyn P. Quinn & Laura Kimberly on the Alabama Supreme Court ruling on IVF and what it means for women with cancer.

Engaging with African feminist interpretations of the Maternal

Read the blog by Ogochukwu Udenigwe on interpretations of motherhood and its relationship with patriarchal culture among African feminists.

Reproductive Health

ISSN: 1742-4755

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• Frontiers in Global Women's Health
• Quality of Life
• Research Topics

Climate, Gender, and Sexual and Reproductive Health - Intersectional Approaches and Evidence

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About this Research Topic

Climate change, gender, and sexual and reproductive health and rights (SRHR) are intrinsically linked. The climate crisis disproportionately impacts women and girls and magnifies social, economic, and cultural disparities in access to economic opportunities, education, and healthcare. Climate change is a risk multiplier for women and girls who bear the brunt of increasingly frequent climate events and shocks, often also lacking the resources and power to safely adapt. Women and girls, particularly in the global south, who are already more vulnerable to systemic inequities tend to also be the hardest hit by climate impacts. Extreme weather events, deforestation, and other environmental changes disrupt the lives and health of women and girls and increase their vulnerabilities. Climate shocks reshape women’s vulnerabilities and make them even more susceptible to sexual exploitation, early child marriage, gender-based violence, unwanted pregnancy, and sexually transmitted infections (STIs), with all associated outcomes on quality of life, morbidity, and mortality. Additionally, when health systems are not climate resilient, women and girls, particularly those who are most vulnerable, suffer the greatest impacts. There is an urgent need for evidence to better inform current and future strategies at the intersection of SRHR, gender, and SRHR. Building on the energy of COP28, there are calls to prioritize, promote, and increase data collection of gender-disaggregated data, and evidence generation at the nexus of climate, gender, and SRHR. In this call for papers, we welcome original research, case studies, policy analysis, and other evidence that can strengthen knowledge of what is needed to effectively promote more gender-just innovations and programs at the nexus of climate action, gender, and SRHR. We welcome research submissions that are gender-inclusive, particularly from climate-vulnerable settings and from the global south. Submissions can cover a range of topics, including: • Research on the direct or indirect impacts of climate change and climate mitigating interventions on women’s health, particularly SRHR and related quality of life, including evidence related to maternal health, family planning, safe abortion, SGBV, child marriage, STI and HIV/AIDS, etc. • Research on factors impacting women’s and girls' quality of life and SRHR access in humanitarian contexts following climate disasters. • Primary or secondary analysis of gender-disaggregated data on climate and SRHR outcomes, including data from nontraditional data sources (i.e. big data analytics) for identifying trends in SRHR in climate crisis settings. • Evaluation of effective measures to engender climate and SRHR education, resilient health systems, and/or more effective gender-responsive climate policies. • Case studies of successful community-level efforts to promote resilience and gender-just SRHR programs to mitigate the impacts of climate change. • Evaluations of efforts to bolster the resilience of healthcare systems to withstand climate-related disruptions, ensuring equitable access to SRHR services. • Analysis of impacts and/or approaches to implementing recognized frameworks for improving quality of care such as the WHO framework for climate resilient health for SRHR services. • Approaches and case studies to fostering more sustainable and inclusive decision-making in national and regional climate policies, funding, and interventions. • Other research and evidence to inform more gendered climate action and safeguard SRHR.

Keywords : Climate, gender, sexual and reproductive health, sexual and reproductive rights, intersectional approaches, climate change, environmental changes, health system, health policy

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30+ reproductive and sexual health research topics: a guide for nursing scholars, carla johnson.

• September 8, 2023
• Essay Topics and Ideas

Reproductive and sexual health is significant in healthcare, impacting individuals across their lifespans. For nursing scholars, comprehending these topics is vital for holistic patient care and overall well-being. This article delves into reproductive and sexual health research topics, giving nursing scholars insights into these sensitive subjects adeptly.

What You'll Learn

Understanding Reproductive and Sexual Health

Reproductive and sexual health covers various subjects, from family planning to sexually transmitted infections. It encompasses physical, emotional, and social aspects, demanding nursing scholars’ adeptness in offering respectful, compassionate care .

10 PICOT Questions in Reproductive and Sexual Health

• P: Adolescents seeking contraception knowledge; I: Introducing comprehensive sexual education; C: Traditional education; O: Lower teen pregnancies ; T: 2 years. Teens often lack contraceptive knowledge. Can comprehensive education reduce unintended pregnancies?
• P: Menopausal women; I: Offering hormone replacement therapy choices; C: No therapy; O: Better life quality, fewer symptoms; T: 6 months. Menopausal symptoms can disrupt life. Can hormone therapy choices alleviate these symptoms?
• P: Couples planning conception; I: Using fertility tracking apps; C: Traditional methods; O: Accurate fertile period identification; T: 1 year. Can fertility apps aid couples in conceiving?
• P: STI-diagnosed individuals; I: Partner notification strategies; C: No notification; O: Improved STI management, reduced transmission; T: 3 months. How effective is notifying and testing partners of STI-diagnosed individuals?
• P: Postpartum women; I: Offering contraception counseling ; C: Standard care; O: Increased contraception use; T: 6 weeks. Postpartum contraception is vital. Can counseling enhance postpartum contraception rates?
• P: LGBTQ+ youth in schools; I: Integrating inclusive sexual education; C: Traditional curriculum; O: Better understanding of diverse sexualities; T: 1 school year. Can inclusive education improve LGBTQ+ sexual education experiences?
• P: Elderly in care homes; I: Implementing sexual health discussions; C: No structured talks; O: Enhanced sexual well-being, reduced stigma; T: 6 months. Elderly sexual health needs attention. Can open discussions improve well-being?
• P: Individuals with disabilities; I: Providing accessible sexual health resources; C: Limited resources; O: Empowered choices, better sexual health; T: 1 year. Disabilities limit resources. Can tailored materials improve sexual health understanding?
• P: Reproductive-age women; I: Introducing telehealth for reproductive care; C: In-person consultations; O: Enhanced access, improved outcomes; T: 6 months. Reproductive care access is limited. Can telehealth bridge the gap?
• P: Inconsistent contraceptive users; I: Dual contraceptive method counseling; C: Single method advice; O: Fewer unintended pregnancies; T: 1 year. Inconsistent contraception usage can lead to pregnancies. Can counseling on dual methods help?

20 Reproductive and Sexual Health Research EBP Topics

• Assess online sexual education effectiveness for adolescents.
• Implement a peer-led contraception campaign on campuses.
• Evaluate cultural sensitivity training for sexual health discussions.
• Investigate postpartum sexual dysfunction’s mental health impact.
• Develop sexual education for long-term care.
• Compare contraceptives in preventing STIs.
• Examine religious beliefs and contraception choices.
• Explore telehealth for remote STI counseling.
• Assess reproductive health issues among transgender individuals.
• Investigate rural reproductive care barriers.
• Analyze sex education’s teenage pregnancy impact.
• Develop elder sexual health provider training.
• Evaluate mobile apps for youth sexual health awareness.
• Investigate knowledge’s effect on student behaviors.
• Assess comprehensive sexual education’s STI impact.
• Investigate reproductive health in marginalized communities.
• Develop school nurse adolescent sexual health training.
• Explore LGBTQ+ reproductive healthcare experiences.

20 Nursing Capstone Project Ideas for Reproductive and Sexual Health 

• Designing college sexual consent education.
• Creating diverse cultural sexual health guides.
• Intervention to reduce STI stigma.
• Investigating prenatal sex education’s impact.
• Sexual health toolkit for foster care adolescents.
• Linking sexual education to partner violence prevention.
• Support for fertility-challenged individuals.
• Sexual health education for intellectual disabilities.
• Empowering marginalized populations’ sexual health.
• Inclusive LGBTQ+ youth sexual health resources.
• Elder sexual health in nursing homes.
• Inclusive sexual education educator training.
• Online sexual health forum impact.
• Media influence on body image and satisfaction.
• Nurses discussing sexual health with chronic patients.
• Telehealth for remote sexual health services.
• Campus campaign for healthy relationships.
• Refugee reproductive healthcare access.
• Parent-adolescent sexual health communication.
• Nursing advocacy in comprehensive sexual education.

20 Reproductive and Sexual Health Research Topics

• Pornography’s impact on adolescent body perceptions.
• Cultural influences on immigrant contraceptive choices.
• Factors delaying STI treatment-seeking in young adults.
• Nurse practitioners’ LGBTQ+ sexual healthcare role.
• Sexual education impact on unintended pregnancies.
• Low-income women’s preconception care access.
• Transgender reproductive healthcare experiences.
• Parental views on school sexual education.
• Aging population sexual health discussions.
• Marginalized community reproductive health disparities .
• Hormonal contraception’s mental health implications.
• Abstinence-only education’s effects on youth behavior.
• Disabilities and sexual health understanding.
• Media influence on sexual attitudes.
• Ethics of older fertility treatments.
• Reproductive healthcare disparities and marginalized groups.
• Socioeconomics affecting contraception access.
• Reproductive healthcare in conservative societies.
• Intimate partner violence’s impact on sexual health .
• Media portrayal of sexuality’s societal effects.

30 Reproductive and Sexual Health Essay Topics for In-Depth Discussions

• Ethics of compulsory sexual education.
• Media’s effect on adolescent sexuality.
• Sexual autonomy and healthcare.
• Healthcare policies shaping access.
• Disabilities and reproductive care.
• Cultural norms influencing contraception .
• Abstinence-only education debate.
• Gender identity in reproductive care.
• Evolution of reproductive rights .
• Nursing elderly sexual health.
• Sexual education and violence prevention.
• Religion’s influence on healthcare.
• Media’s effect on body image.
• Ethical older fertility treatments.
• Healthcare policies and disparities.
• Access in conservative societies.
• Socioeconomic factors in contraception.
• Chronic illnesses and sexual health.
• Reproductive health in marginalized groups.
• Aging population’s sexual well-being.
• LGBTQ+ sexual education needs.
• STI transmission and education.
• Gender norms and behavior.
• Sexuality portrayal in media.
• Ethical implications of reproductive technology.
• Disabilities’ impact on sexual health.
• Media’s effect on sexual perceptions.
• Medical tourism’s reproductive impact.
• Intersection of sexuality and disabilities.
• Nursing advocacy in sexual education.

Nursing scholars possess the potential to influence reproductive and sexual health. By exploring projects, capstones, research, and essays, you contribute to a comprehensive understanding of these essential topics. Seek assistance from our expert writing services to ensure your academic success. Embrace your role as an advocate for sexual well-being, working towards a future where reproductive and sexual health is respected and promoted for all.

FAQs: Exploring Reproductive and Sexual Health for Nursing Students

Q1: What is the role of a nurse in sexual and reproductive health?

A1: Nurses play a pivotal role in providing comprehensive education, counseling, and care related to sexual and reproductive health. They empower individuals to make informed decisions and promote overall well-being.

Q2: What are the 4 pillars of reproductive health?

A2: The four pillars of reproductive health include the right to reproductive choices, access to quality reproductive healthcare services, sexual education , and eliminating discrimination and stigma surrounding reproductive and sexual health.

Q3: Why is reproductive health and sexual health important?

A3: Reproductive and sexual health is crucial for individual well-being, gender equality, and public health. It encompasses physical, emotional, and social aspects and is essential for family planning, disease prevention, and overall quality of life.

Q4: What is the concept of reproductive health and sexual health?

A4: Reproductive health focuses on the physical, emotional, and social well-being in all matters related to the reproductive system, while sexual health includes the physical, emotional, and psychological aspects of sexual well-being and relationships. Both concepts encompass rights, choices, and access to healthcare services.

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• Adolescent Sexual and Reproductive Health

Gender Based Violence

Gender disparities, maternal health.

• Men’s Sexual and Reproductive Health
• Pregnancy prevention: Family Planning/Unintended pregnancy and Abortion

Adolescent Sexual and Reproductive Health

Clinical correlates of mycoplasma genitalium in young women.

Maria Trent The primary aims of this study are to determine the rate and 12-month longitudinal clinical correlates of MG and TV infection among a sample of young pregnant women 13-29 years of age seeking reproductive health care in an urban hospital setting. The outcomes of this work will be critical for determining need for integration of MG testing in routine laboratory testing once available.

Evaluation of Sexual Health Curriculum for Health Students in Tanzania

Maria Trent As documented in the US Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior, training of health providers in sexual health care is critical to addressing a broad array of the nation's sexual and reproductive health concerns. Yet rigorous trials evaluating the effects of sexual health curricula on provider behavior are rare. In sub-Saharan Africa, an environment which has the highest rates of HIV, STI, teen pregnancy, unwanted pregnancy, unsafe abortion, child marriage of girls and sexual assault of boys in the world, and where female genital cutting, wife-beating, marital rape, criminalization of homosexuality, stigmatization of Lesbian, Gay, Bisexual and Transgender (LGBT) persons, myths about masturbation leading to dysfunction, and rates of sexual dysfunction in both men and women are common, we could find no formalized training of health providers in sexual health care. Sexual health education, even of health providers, is a sensitive issue in Africa. Consequently, a rigorous study of its effects is needed, if such education is to be widely adopted. Recently, at Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, we adapted a PAHO/WHO sexual health curriculum training for healthcare providers for implementation in Tanzania. Participants were 87 nursing, midwifery, and allied health science students. Pre-post evaluations show the curriculum to be highly acceptable, needed, and desired by students, feasible in implementation, and effective in improving student knowledge, attitudes, and skills in providing sexual health care to patients. The logical next step in this line of research is to conduct the first rigorous trial of a comprehensive sexual health training curriculum for health professionals in Tanzania. There are three specific aims. Aim 1 is to conduct a social ecological needs assessment of sexual health care delivery in Tanzania. To determine whether midwifery, nursing, medical, and allied health science students would benefit from one curriculum or separate curricula tailored by discipline, we will conduct focus groups (3 from each discipline). We will also conduct individual interviews with key informants to address structural and cultural issues. In Aim 2, we will further adapt our curriculum, ensure it is culturally tailored to the Tanzanian/sub-Saharan context, and pilot test it. Aim 3 is to evaluate the effectiveness of an African-based, culturally-appropriate, sexual health curriculum. We will conduct a randomized, controlled, single blinded trial of the curriculum against a waitlist control assessing effects on sexual health knowledge, attitudes, and counseling skills (n=206 students per arm; 412 in total). Hypotheses will test if the curriculum is effective, and whether it is more effective for one discipline than another. If effective, MUHAS has committed to implement the curriculum for all their health students. Given MUHAS is preeminent in health student education across Africa, the curriculum assessed in this study has high potential to be widely adopted as a new standard of training for health professionals across Africa.

Faith-based Adolescents Involved in Total Health

Terrinieka Williams Powell Focused on those areas of Baltimore where the adolescent pregnancy rates are the highest, this study aims to understand what is currently being done in the churches of those communities to address pregnancy prevention and to identify the potentials and barriers for effective interventions.

The Global Early Adolescent Study

Robert Blum, Caroline Moreau, Kristin Mmari, Saifuddin Ahmed, Lori Heise, Leah Keonig, Mengmeng Li, Mark Emerson The Global Early Adolescent Study (GEAS) seeks to understand how norms, attitudes and expectations about gender influence health outcomes and behaviors across the adolescent period. Building upon formative, mixed-methods research conducted in sixteen countries between 2014 and 2016, the GEAS has collected baseline data from over 13,000 adolescents on five continents since 2017. Additional survey topics include sexual and reproductive health, mental health, body comfort, school retention and empowerment. In four countries, the GEAS is used to evaluate the longitudinal impact of gender-transformative interventions carried out by Rutgers, Netherlands; Save the Children and the Institute of Women and Ethnic Studies. Participating GEAS sites include New Orleans, USA; Cuenca, Ecuador; Santiago, Chile; São Paolo, Brazil; Belgium; Indonesia; Shanghai, China; Kinshasa, DRC; Cape Town, South Africa; and Blantyre, Malawi. Results from the longitudinal GEAS will help to answer important questions about the formation and manifestations of gender inequality, its relationship to health and well-being and the interventions that are effective in promoting gender equality.

Current activities include efforts to improve awareness of and response to ethical issues in research and programming with adolescents living in vulnerable contexts the development of a special supplement using baseline GEAS focused on gender equality. At present, students are involved in manuscript development with partners in China, Ecuador, Bolivia and Malawi. For more information about the GEAS, including our global network of collaborators, recent reports and publications and open-access survey and training instruments, please visit the GEAS website.

Harriet Lane Clinic’s Title X Program

Arik V. Marcell Funded by the Office of Population Affairs, to provide reproductive health services to adolescents & young adults who are uninsured, underinsured or seeking confidential services and conduct quality improvement strategies to ensure providers are delivering quality family planning and sexual and reproductive health care services.

Technology Enchanced Community Health Nursing to Reduce Recurrent STIs after PID

Maria Trent This study examines the efficacy of a technology-enhanced community health nursing intervention on adherence to PID treatment recommendations and subsequent short-term sexually transmitted infection acquisition using a randomized controlled trial.

Community-partnered technology for partner violence prevention and response: MyPlanKenya

Michele Decker, Nancy Glass (School of Nursing) This initiative adapts and refines a safety planning “app” intervention for women in urban Kenya, followed by evaluation via randomized controlled trial. The app enables priority-setting for safety-related decisions and provides support and referrals to local resources. It harnesses community health volunteers (CHVs) as key lay professionals poised to play a critical role in partner violence prevention and response. With support from ideas42.

Continuum of Shelter and Housing Models for Victims of Intimate Partner Violence

Michele Decker, Charvonne Holliday With support from the National Institute of Justice, this initiative entails formative evaluation and evaluability assessment for leading models of housing stabilization for partner violence survivors, specifically rapid rehousing and transitional housing, in partnership with House of Ruth Maryland. Following a formative phase, we monitor health, safety, and well-being indicators among IPV survivors receiving housing support over a 6-month follow-up period, and evaluate readiness to support IPV survivors among housing providers.

Developing and Piloting A Gender-Based Violence Intervention Module to Reduce HIV Risk among Female Sex Workers (FSWs)

Michele Decker, Susan Sherman (Epi), Nancy Glass (School of Nursing) With support from the Johns Hopkins Center for AIDS Research (P30AI094189, PI Chaisson), this initiative uses a community-based participatory approach to develop and pilot test a brief violence intervention module to encourage violence-related harm reduction, provide social support related to violence victimization, and reduce related HIV risk behavior among women who trade sex or are sexually exploited.

Collaborative for Gender Equity and Empowerment in Education, Health and Labor Systems

Michele Decker, Lori Heise, Nancy Glass, Rosemary Morgan, Colleen Stuart, Toni Ungaretti, Vivian Lee This collaborative blends gender analysis with case studies and development and field testing of new indicators for gendered aspects of labor, education and health systems, in collaboration with academic and community partners.

Duration of Hormonal Contraceptive Use: Immune Responses & Vaginal Microbiota

PI: Dr. Khalil Ghanem – Co-investigator: Anne Burke This NIH-funded study investigates the impact of hormonal contraceptives on the vaginal microbiome. Use of postpartum IUDs and implants. This study evaluates outcomes in women who receive long-acting contraception in the immediate postpartum period.

Gender barriers to non-communicable disease prevention, treatment and management

Michele Decker, Rosemary Morgan, Nancy Glass This collaboration with World Health Organization applies gender analysis frameworks to non-communicable diseases via a scoping review of gender barriers to care, primarily in low and middle income countries.

Bob Blum, Caroline Moreau, Kristin Mmari, Saifuddin Ahmed, Lori Heise, Leah Keonig, Mengmeng Li, Mark Emerson The purpose of The Global Early Adolescent Study is to understand how gender norms influence sexual attitudes and relationship formation in early adolescence as well as subsequent sexual activity and contraceptive practices in older adolescence. Specifically, the study explores: 1) gender socialization in early adolescents; 2) how gender norms inform sexual and reproductive health (SRH) across adolescent years 3) how gender transformative interventions can improve SRH trajectories. The study takes place in 9 urban poor sites across 4 continents (South Africa, Malawi, DRC, Belgium, China, Indonesia, Chili, Brazil and the United States) and follows between 600 and 3000 young adolescents 10-14 years in each site over a 3 to 5 year period. This research provides empirical evidence testing gender pathways to SRH while guiding programs to overcome gender discrimination and promote women’s and girls’ wellbeing. To learn more please visit the GEAS page .

Antihypertensive Medication in Pregnancy: An Update from the 2011 WHO Recommendations for Prevention and Treatment of Preeclampsia and Eclampsia

Donna Strobino, Saifuddin Ahmed, Erika Werner (Brown Univ, school of Medicine), Mahua Mandal, Laina Gagliardi, and Roxanne Beltran The aim of this project is to update the science behind WHO recommended anti-hypertensive medications in pregnancy to prevent preeclampsia and manage hypertension and to estimates the prevalence of chronic hypertension, preeclampsia and all hypertensive disorders in pregnancy using data from population- based studies worldwide and facility based studies in resource poor settings. The study also using extant data to estimate unmet need and potential demand for antihypertensive medications in pregnancy in low resource settings.

Contraceptive Efficacy of a Novel Vaginal Ring

Anne Burke This is an upcoming NICHD-funded, prospective study evaluating use of a vaginal contraceptive ring in healthy women. Pharmacokinetics of oral contraceptives before and after bariatric surgery. This study compares pharmacokinetic and pharmacodynamic profiles of oral contraceptive use for women undergoing gastric bypass surgery.

Men's Sexual and Reproductive Health

Project connect baltimore.

Arik V. Marcell This is a CDC-funded program to evaluate school and community-based methods to engage males in HIV/STD testing and sexual and reproductive health care in Baltimore City by training youth-serving professionals on a web-based clinical services provider guide for male-specific clinical services (Y2CONNECT.org). If successful, this project will advance the field of male health promotion through its use of innovative approaches and technology that are easily transferable to a variety of settings and implemented at low cost

Technology Enchanced Community Health Nursing Study

Maria Trent The study involves 350 young women 13-21years old diagnosed with PID in Baltimore and randomize them to receive CHN clinical support using a single post-PID face-to-face clinical evaluation and SMS communication support. We hypothesize that repackaging the recommended CDC-follow-up visit using a technology-enhanced community health nursing intervention (TECH-N) with integration of an evidence-based STI prevention curriculum will reduce rates of short-term repeat infection by improving adherence to PID treatment and reducing unprotected intercourse and be more cost-effective compared with outpatient standard of care (and hospitalization). To learn more, please visit the Study Record Detail page .

Pregnancy Prevention: Family Planning/Unintended Pregnancy and Abortion

Advance family planning.

Duff Gillespie, Beth Fredrick Advance Family Planning (AFP) is an advocacy initiative established in 2009 at the William H. Gates Sr. Institute for Population and Reproductive Health. AFP aims to increase the financial investment and political commitment needed to ensure access to high-quality, voluntary family planning through collaborative, evidence-based advocacy aimed at working effectively with decision-makers. AFP is supported by the Bill & Melinda Gates Foundation, the David & Lucile Packard Foundation, and the William and Flora Hewlett Foundation.

Evidence of COVID-19’s Potential Impact on Inequities in Abortion Access

Suzanne Bell, Anne Burke,  Carolyn Sufrin

Results from a small study completed by Bloomberg School faculty and students found that COVID-19 potentially increased existing inequities related to abortion. The study looked at abortion service availability and care seeking experiences in the Washington, DC, Maryland, and Virginia region during the pandemic and found that financially disadvantaged groups were disproportionately negatively impacted.  More information is found in the facsheet,  

FP quality metrics in Maryland

Caroline Moreau, Anne Burke This project aims to test a framework for monitoring quality of care for family planning among all women of reproductive age in Maryland, using computerized data found in health insurance claims and electronic health record (EHR) systems

Measuring the incidence and safety of Abortion

Caroline Moreau, Suzanne Bell The PMA Abortion project aims to use the PMA platform to conduct research on Abortion in 3 geographies (Cote D’Ivoire, Nigeria, Rajasthan) to assess abortion prevalence and safety using both direct and indirect measures and to explore women’s access to care for abortion procedures.

PMA Agile: Monitoring family planning service delivery and use at the subnational level

Amy Tsui, Scott Radloff, Phil Anglewicz This project is being implemented in 13 urban sites in collaboration with research partners in Burkina Faso, DR Congo, India, Kenya, Niger and Nigeria. PMA Agile conducts quarterly surveys of health facilities and semi-annual surveys of clients to monitor change in service preparedness and quality as well as client satisfaction and their continued use of contraception.

Performance Monitoring in Action

Scott Radloff Performance Monitoring for Action or PMA for short (formerly PMA2020) is a Bill and Melinda Gates Foundation funded project, implemented in partnership with Jhpiego and a network of university and research institutions, that supports rapid-turnaround surveys to monitor progress in reproductive health indicators. The project was launched in 2013.

PMA implements cross-sectional and longitudinal surveys to fill a data gap – collecting information to understand the drivers of contraceptive use dynamics – information that is not currently measured by other large-scale surveys. While having a core family planning focus, the PMA platform can be used for data collection in other health topics. To date the platform has been used to collect data for guiding programs in abortion, adolescent sexual and reproductive health, women and girls’ empowerment, maternal and child health, nutrition, water and sanitation, menstrual hygiene management, neglected tropical diseases (schistosomiasis), sample vital registration systems, and primary health care.

The project employs a network of female resident enumerators recruited from near the selected survey clusters who are trained to use smartphones to gather survey data. The PMA platform has been deployed in 11 countries so far with plans to expand. Countries include Ghana, Democratic Republic of Congo, Ethiopia, Uganda, Burkina Faso, Niger, Nigeria, Indonesia, India, Cote d’Ivoire, and Kenya.

For more information please visit pmadata.org .

The predictive utility of unmet need and intentions to use contraception in Uganda

Amy Tsui, Scott Radloff, Saifuddin Ahmed The study team is assessing the predictive utility of a leading indicator, unmet need for contraception, and that of a less prominent one, future intention to use, as influencing contraceptive adoption, using data from a four-year panel follow-up of a national sample of Ugandan women.

Quality improvement to integrate HIV testing in the Harriet Lane Clinic’s Title X Program

Arik V. Marcell Funded by the Office of Population Affairs, the goal of this program is to integrate rapid HIV testing as part of Title X services and increase the proportion of clients receiving HIV test results and evaluate increased use using rapid Plan-Do-Study-Act cycles.

Women’s Reproductive Health

Contraception (birth control).

• Heart Defects and Women's Reproductive Health
• Hysterectomy

Female Genital Mutilation/Cutting

Infertility.

A woman’s reproductive system external icon is a delicate and complex system in the body. It is important to take steps to protect it from infections and injury, and prevent problems—including some long-term health problems. Taking care of yourself and making healthy choices can help protect you and your loved ones. Protecting your reproductive system also means having control of your health, if and when, you become pregnant.

Women’s health and women’s reproductive health are high priorities for CDC’s Division of Reproductive Health. Our goal is to improve women’s health from menarche through menopause. CDC/DRH activities focus primarily on research about the following:

There are several safe and highly effective methods of birth control available to prevent unintended pregnancy. These include intrauterine contraception, hormonal and barrier methods, and permanent birth control (sterilization). Using effective birth control methods can greatly reduce the chances of having an unintended pregnancy. CDC’s Division of Reproductive Health has a long history of conducting epidemiologic studies on the safety and effectiveness of contraceptive methods. Results from these studies have informed contraceptive practices.

We monitor prevalence and treatment of depression among women of reproductive age and postpartum depression. Depression is common. Often, trying to get pregnant, being pregnant, or the birth of a baby can increase the risk for depression. Also, many women don’t know that depression sometimes happens with other events, such as losing a baby or having trouble getting pregnant. Women may also feel depressed for many other reasons—some may not even know why. There are ways to help you feel better, such as counseling or other treatments. Talking to your health care provider is a good first step if you think you may suffer from depression.

Heart Defects and Women’s Reproductive Health

Get informed about contraception, preconception health, and pregnancy for people living with heart defects. If you’re living with a heart defect, you may need specialized medical care to manage your reproductive health and heart health.

Hysterectomy external icon

Hysterectomy is the surgical removal of a woman’s uterus. The uterus is the place where a baby grows when a woman is pregnant. Sometimes the cervix, ovaries, and fallopian tubes are also removed. Hysterectomies are very common—1 of 3 women in the United States has had one by age 60.

Female genital mutilation or cutting (FGM/C) is defined by the World Health Organization (WHO) as “all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons.” These procedures could mean piercing, cutting, removing, or sewing closed all or part of a girl’s or woman’s external genitals.

Infertility means not being able to get pregnant after 1 year of trying. If a woman is 35 or older, infertility is based on 6 months of trying to become pregnant. Women who can get pregnant but are unable to stay pregnant may also be considered infertile. About 10% of women (6.1 million) in the United States aged 15–44 years have difficulty getting pregnant or staying pregnant. CDC is committed to preventing infertility and its burden on women and families. We work with other federal agencies and nonprofit organizations providing data and evidence about infertility, including its causes and consequences.

Menopause external icon external icon

Menopause is a normal change in a woman’s life when her period stops. A woman has reached menopause when she has not had a period for 12 months in a row. This often happens between 45–55 years of age. Menopause happens because the woman’s ovary stops producing the hormones estrogen and progesterone.

Read more about some other common reproductive health concerns for women.

Find a Health Center external icon Health Resources Services Administration (HRSA) health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income.

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Reproductive Health

Understanding and promoting reproductive health has been a key research theme for NICHD since it was founded. Research conducted and supported by the institute continues to broaden available knowledge about the spectrum of reproductive health issues that affect all people.

NICHD continues to expand its research to improve reproductive health, including studies of the basic biology of typical and atypical reproductive system development, the mechanisms and management of gynecologic disorders and their timing, options that allow all people to manage their fertility, social and environmental influences on reproductive health, and identification of biomarkers for reproductive aging.

Visit any one of the following health topics to learn more about the institute's research efforts to related to reproductive health.

NICHD Health Topics Related to Reproductive Health

Bacterial Vaginosis

Contraception and Birth Control

Endometriosis

Fragile X-Associated Primary Ovarian Insufficiency (FXPOI)

High-Risk Pregnancy

Infertility and Fertility

Labor and Delivery

Maternal Morbidity and Mortality

Men's Reproductive Health

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Pregnancy Loss (Before 20 Weeks of Pregnancy)

Preterm Labor and Birth

Primary Ovarian Insufficiency (POI)

Puberty and Precocious Puberty

Sexually Transmitted Diseases

Urinary Tract Health

Uterine Fibroids

Women's Health

The future of sexual and reproductive health and rights

Resource date: Apr 2024

This short summary highlights key findings and recommended actions from the think piece on the future of sexual and reproductive health and rights (SRHR). It suggests that human development and resilience in a world of turbulence and change will hinge on fully realizing SRHR for everyone. As countries have diverse demographic trajectories, governments need to plan for change and adapt health systems to accommodate their demographic future, whether it will bring a rise in older persons, or a rise in the number of births and young people. There are more possibilities to realize this goal than ever before, including through technology. Yet careful consideration is required to manage multiple risks, from the climate crisis to digital privacy to rising population mobility. Health systems will need to adjust. Through new investments and human rights-based models of care, they can aim to uphold SRHR wherever people are and at every stage of life.

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• Sexual & reproductive health

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Putting science to work for the health of women

Advancing Women’s Health Research: From Policy to Action

Advancing women’s health research: from policy to action , by dr. janine a. clayton.

White House Actions to Advance Women’s Health Research

On March 18, 2024, President Joe Biden signed a new Executive Order (EO) that builds upon the White House Initiative on Women’s Health Research . The EO outlined strategies to improve women’s health research by integrating women’s health across the federal research portfolio, prioritizing funding, galvanizing new research on women’s midlife health, and assessing areas needing further support. ORWH Deputy Director Vivian Ota Wang, Ph.D., and I were honored to attend the historic signing, alongside NIH Director Monica Bertagnolli, M.D., and Deputy Director for Program Coordination, Planning, and Strategic Initiatives Tara A. Schwetz, Ph.D., and other NIH leaders. A key aspect of this initiative was the announcement of a new NIH-wide effort to invest $200 million in Fiscal Year 2025 specifically for interdisciplinary women’s health research. This substantial investment is aligned with the administration’s commitment to advancing our understanding of women’s health issues and developing targeted interventions and treatments.  

As part of the White House Initiative on Women’s Health Research, First Lady Dr. Jill Biden and I visited Research Triangle Park, home to North Carolina State University, Duke University, and the University of North Carolina at Chapel Hill, to promote the EO, specifically focusing on challenges women face in midlife like menopause and heart disease. Our collaborative efforts with renowned institutions and health care professionals emphasized the need to address disparities in health care, advocating for innovative research and health care solutions that prioritize women’s health.

Moreover, in alignment with the White House Initiative on Women’s Health Research, ORWH issued a NIH-wide Notice of Special Interest to highlight interest in receiving research applications focused on diseases and health conditions that predominantly affect women (e.g., autoimmune diseases, depressive disorders, Alzheimer’s disease and Alzheimer’s disease-related dementias, gender-based violence), present and progress differently in women (e.g., cardiovascular disease, HIV, reproductive aging and its implications), or are female specific (e.g., uterine fibroids, endometriosis, menopause). I strongly encourage applications incorporate an intersectional and/or multidimensional approach to gender-related social and structural variables, including race, ethnicity, socioeconomic status, and state and federal policies.  

Dr. Elizabeth Barr Named Associate Director for Interdisciplinary Research

Congratulations to Elizabeth Barr, Ph.D. on being named Associate Director for Interdisciplinary Research at ORWH. Dr. Barr joined ORWH in 2019, where she has coordinated efforts to advance intersectional health research on gender as a social and structural variable, managed the ORWH interprofessional education program, and led efforts to advance HIV research for women. Dr. Barr’s background is in gender and women’s studies, community-led HIV research, and reproductive justice. Dr. Barr completed her Ph.D. in communications, with training in science and technology studies, at the University of Wisconsin–Madison and her M.S. in women’s and gender studies at Towson University. Prior to joining ORWH, Dr. Barr led interdisciplinary, cross-sector projects to increase women’s engagement in clinical research and served on the faculties of Towson University and the University of Maryland, Baltimore County. Dr. Barr is widely respected in the field of interdisciplinary research as demonstrated by her accomplishments above, and we look forward to her continued contributions to ORWH!

Advisory Committee on Research on Women’s Health  

The 60th Meeting of the NIH Advisory Committee on Research on Women's Health (ACRWH), held on April 12, 2024, provided a forum for ACRWH members to give guidance and make recommendations on priority issues affecting women's health and sex differences research. Carolyn Mazure, Ph.D., White House Initiative on Women’s Health Research chair, provided an insightful update on the White House Women’s Health Research Initiative. Dawn Corbett, M.P.H., NIH inclusion policy officer, Office of Extramural Research, presented a comprehensive inclusion update on NIH clinical research. The event hosted a robust panel titled Middle-Life Health of Women and Menopause, of expert researchers that discussed how menopause can affect the health of women. The Office of Disease Prevention will host a Pathways to Prevention (P2P) workshop in 2025 to identify research gaps in the menopausal tradition and to promote well-being through midlife and beyond. Visit the ACRWH event page for the videocast recording.

HIV & Women Scientific Workshop

In March 2024, the NIH Office of AIDS Research (OAR) and ORWH hosted a two-day virtual workshop to review the state of the science on HIV and women and inform the future research agenda. The workshop, which is part of the OAR-ORWH joint HIV and Women Signature Program , featured a diverse array of HIV-related topics of relevance to women, girls, and gender-diverse people, including prevention, treatment, cure, and social and structural determinants of health. Aligned with the signature program’s focus on intersectional, data-driven, and equity-informed approaches to HIV and women, the workshop included community members on the organizing committee and community speakers on every panel. We were also happy to feature work from established and emerging investigators, highlighting opportunities for ongoing collaborations and connections. Over 700 people watched the workshop live, and it is archived via videocast for viewing on-demand.

National Minority Health Month

April marks National Minority Health Month (NMHM), a time to raise awareness about the importance of improving the health of racial and ethnic minority communities and reducing health disparities. The National Institute on Minority Health and Health Disparities celebrated this month with a series of events, including a Minority Health Walk, Run, Roll 5K and a Fireside Chat featuring the Honorable Louis W. Sullivan, M.D. Additionally, the Health and Human Services Office of Minority Health (OMH) has emphasized this year’s theme, “Be the Source for Better Health: Improving Health Outcomes Through Our Cultures, Communities, and Connections,” focusing on understanding how the unique environments, cultures, histories, and circumstances (known as social determinants of health) of racial and ethnic minority and American Indian and Alaska Native populations impact their overall health. I encourage you to learn more about health equity by using the resources made available online by OMH.

As we commemorate NMHM, I look forward to the upcoming release of the Health of Women of U3 Populations Data Book. This resource holds immense promise in offering valuable insights into the complex interplay of cultural, racial, socioeconomic, and geographical factors that can influence the health status of women. By highlighting the challenges these communities face, this data book emphasizes the urgent need for equitable health care practices to promote health equity for all.

Black Maternal Health Week

This year, we observed Black Maternal Health Week from April 11 to 17. This week serves as a crucial platform to spotlight and address the disparities in health outcomes experienced by Black mothers. Research and data have consistently shown stark racial and ethnic disparities in maternal mortality rates, with Non-Hispanic Native Hawaiian and Pacific Islander, Black or African American, American Indian, and Alaska Native women facing mortality rates two to four times higher than Non-Hispanic White women in pregnancy-related causes. Recognizing the urgent need for action, the Health Resources and Services Administration Maternal and Child Health Bureau has spearheaded a comprehensive campaign during Black Maternal Health Week aimed at raising awareness, fostering meaningful action, and advocating for positive change in Black maternal health. In response to the disparate maternal mortality rates, the IMPROVE initiative was developed to support research on how to reduce preventable maternal mortality, decrease severe maternal morbidity, and promote health equity. Central to this effort is a toolkit featuring a range of resources strategically designed to empower individuals and organizations, providing them with the tools necessary to amplify their initiatives, forge collaborations, and celebrate achievements in the ongoing quest for equitable maternal health care for Black mothers. It is imperative these efforts continue beyond this designated week, fostering sustained awareness, advocacy, and policy changes to ensure lasting improvements in Black maternal health outcomes.

Looking Forward

In line with ORWH’s mission to advance women in science careers, we launched a prize competition aimed at enhancing gender diversity among faculty members in higher education. This initiative underscores our commitment to breaking down barriers and fostering transformative change. The resulting NIH Prize for Enhancing Faculty Gender Diversity in Biomedical and Behavioral Science has not only encouraged innovative strategies but has also led to the development of a toolkit. This toolkit highlights best practices and links them with evidence of their impact, fostering a culture of accountability and innovation. For more information on how the toolkit was developed, click here .

Looking ahead, ORWH is excited to celebrate National Women’s Health Week by hosting the 8th Annual Vivian W. Pinn Symposium and the first ever NIH Women’s Health Roundtable event. The Vivian W. Pinn Symposium honors the first full-time director of the office, Vivian W. Pinn, M.D., and serves as a critical forum for experts across sectors to communicate and collaborate for the advancement of women’s health. The roundtable “ Future Directions in Menopause Research: Optimizing Midlife Health of Women ,” is scheduled for May 16, 2024, from 11 a.m. to 1 p.m. EDT. This event serves as the launch for the NIH Women’s Health Roundtable Series as part of the White House Women’s Health Research Initiative. The series will engage the extramural research community to bring greater awareness to female-specific health conditions, as well as diseases and conditions that present differently in women. I encourage all researchers, health care professionals, policymakers, and advocates to join us at this impactful roundtable as we collaborate to foster transformative discoveries and interventions in women's health. Your participation and insights are invaluable in driving positive change and advancing our collective mission to shape the future of women’s health research and improve outcomes for women.

The recent initiatives and collaborative efforts serve as a catalyst for continuous dialogue, innovation, and enhancing research. As we navigate the intricate landscape of health care disparities and societal complexities, ORWH’s commitment remains unwavering—to expand and accelerate women’s health research initiatives that generate new data and discoveries which will promote health equity. Together, we strive to create a future where health outcomes are improved for all populations of women, paving the way for more equitable, inclusive health care for everyone.

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Researchers hope new report fuels reproductive health care research involving minors

• Laura Bailey

EXPERT Q&A

A new report from Youth Reproductive Equity, a national collaborative of researchers and clinicians, outlines a research agenda to examine the impact of the Dobbs decision on minors.

The lead author of the report, “ Adolescence Post-Dobbs: A Policy-Driven Research Agenda for Minor Adolescents and Abortion ,” is Julie Maslowsky , associate professor at the University of Michigan School of Nursing and an affiliate of the Population Studies Center at the Institute for Social Research. She discusses details of the report.

To the best of your knowledge, what has happened to adolescents’ access to abortion and reproductive health care after the Supreme Court’s Dobbs decision overturned Roe v. Wade and the constitutional right to an abortion two years ago?

Prior to Dobbs, minors already faced many more legal and logistical barriers to abortion access than adults. Now, those barriers have increased. More than half of U.S. adolescents now live in a state with severely restricted or no abortion access. We don’t yet know the full impact of these restrictions on young people seeking abortion or on adolescents who are coming of age at this chaotic time. However, we know that even very young rape victims are unable to access abortion in restrictive states and that there has been a spike in the number of young people seeking permanent sterilization, with higher rates of sterilization in states with abortion bans. The impacts are already dire.

Why are minors underrepresented in abortion and reproductive health research studies and will this report address that?

The field of abortion research does not have a strong tradition of including minors in their studies. We identify six enduring and overarching challenges relating to infrastructure, oversight, and workforce composition and capacity that systematically hamper the field’s ability to produce actionable research evidence related to minors and abortion. We propose recommendations to address these challenges: researcher training; diversify the research workforce; encourage interdisciplinary expertise; eliminate roadblocks to approving research proposals involving minors; prioritize funding; and disseminate and translate research.

What impact does excluding minors have on policy and reproductive health?

Minors are disproportionately impacted by new abortion restrictions and are often targeted by restrictive state abortion policies or overlooked in protective policies. Minor abortion access is regulated by all the laws that impact adults as well as many minor-specific laws, which we review in our report. Even when minors can overcome legal obstacles, they face greater barriers related to cost, information and access than adults. Minor adolescents are in a vulnerable position legally. In political negotiations, minors’ rights are often restricted as a compromise in order to secure votes for abortion policies that apply to adults. Restricting the rights of minors sets a dangerous precedent for other marginalized groups.

What are the areas of adolescent reproductive health care policy and research that are most neglected or misunderstood by science?

Minors are systematically underrepresented in all areas of abortion research. We need to include them in all types of abortion-related studies.

Regarding minors and abortion and reproductive health care policies, are there areas that are more neglected or misunderstood by the public than others?

One common misunderstanding is that policies that require parents to be involved in a minor’s decision to have an abortion are protective. In fact, research shows that these policies cause harm to those youth for whom involving their parents is not possible or not safe. Several studies document evidence of delays in care-seeking after introduction of a parental involvement requirement, in particular for those traveling from out of state for care.

Delays are even more pronounced among those who cannot involve a parent and instead seek judicial bypass. For example, studies of minors seeking judicial bypass in Massachusetts and Illinois highlight that they obtain abortion care 5-6 days later than those who satisfy parental consent or notification requirements, sometimes pushing them past the 10-week limit for medication abortion and limiting their options for care. Judicial bypass has also been shown to cause emotional harm and trauma to young people seeking abortion and to not consistently function as a true alternative to parental involvement in some settings where requests for bypass are denied.

What are a few of the most compelling facts that researchers do know about minors and abortion that the public should know?

Abortion restrictions do not only impact minors who become pregnant or those who seek abortion care. Restricted access to reproductive health care is impacting all U.S. minors. The experience of adolescence itself has fundamentally changed: adolescents are thinking differently about many aspects of their lives: their relationships, where to live or go to college, how to vote, and what their future may look like. For example, recently, several studies have shown nationwide increases in the number of young people who are choosing to undergo permanent sterilization. These increases are larger in states with abortion bans.

Who will use this report and why would they want to use it?

The report’s target audiences are researchers, funders of research and individuals and organizations who help translate research evidence into policy. The recommendations of the report will help to shape research and funding portfolios and guide research questions to be more applicable to policy. The report is a comprehensive treatment of the issue, from why minors matter in the abortion debate and how they’re driving it, to what state policies currently impact minors’ abortion access (either by protecting or restricting it), to a specific research agenda focused on policy-driving data, to recommendations for building the field’s (and the nation’s) capacity to generate evidence-based policies for minors.

Co-authors include Laura Lindberg of Rutgers University and Emily Mann of the University of South Carolina.

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Integrating human rights into sexual and reproductive health research: Moving beyond the rhetoric, what will it take to get us there?

Posted on April 9, 2024 May 3, 2024

» Integrating human rights into sexual and reproductive health research: Moving beyond the rhetoric, what will it take to get us there?

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Authors: Sofia Gruskin, William Jardell, Laura Ferguson, Kristin Zacharias, Rajat Khosla

Date: February, 2021

Publication Link: https://www.tandfonline.com/doi/full/10.1080/26410397.2021.1881206 

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Researchers review findings and clinical messages from the Women’s Health Initiative 30 years after launch

Data from influential study underscore the importance of personalized and shared decision-making to support the health of postmenopausal women

WHAT: A new review in JAMA highlights key findings and clinical messages from the Women’s Health Initiative (WHI), the largest women’s health study in the United States. The WHI is supported by the National Institutes of Health’s National Heart, Lung, and Blood Institute (NHLBI), and was created to study factors that may reduce risks for cardiovascular disease, cancer, hip fractures, and other conditions in postmenopausal women. More than 68,000 women enrolled in clinical trials between 1993 and 1998 and were followed for up to 20 years.

After reviewing these long-term data, the researchers explain the primary findings:

Hormone therapy and menopause. The WHI study found that estrogen or a combination of estrogen and progestin, two types of hormone replacement therapies, had varying outcomes with chronic conditions, and the evidence does not support the use of these therapies to reduce risks for chronic diseases, such as heart disease, stroke, cancer, and dementia. The study was not designed to assess the effects of FDA-approved hormone therapies for treating menopausal symptoms, the benefits of which had been established before the WHI study began.

The authors reinforce the importance of women making shared decisions with physicians about the benefits or risks of taking hormone therapy during menopause. For example, women younger than age 60 with low-to-average risk for cardiovascular disease and breast cancer who want to take hormone therapy may experience greater health benefits than risks during early menopause to treat moderate-to-severe symptoms, such as bothersome hot flashes or night sweats.

Calcium and vitamin D supplements and bone fractures. A combined calcium and vitamin D supplement was not associated with reduced risks for hip fractures among postmenopausal women at average risk for osteoporosis, according to the study. However, the authors note that supplements can help fill nutrient gaps among women who do not meet the daily recommended intake for these nutrients . Therefore, women with questions about adequate intake and levels should consult with their healthcare provider.

Low-fat diets and cancer. A low-fat dietary pattern with at least five daily servings of fruits and vegetables and increased grains did not reduce the risk of breast or colorectal cancer. However, upon subsequent analyses during the follow-up period, researchers found that this type of eating pattern was associated with a reduced risk of death from breast cancer.

Findings from the clinical trials and study observations can vary based on multiple factors, such as age and underlying cardiovascular disease risks, so women ages 50 and older should work with their clinicians to make individualized and shared medical decisions, the researchers noted.

STUDY: Manson, JE, Crandall CJ, Rossouw JE, et al. The Women’s Health Initiative randomized trials and clinical practice: A review. JAMA ; 2024. Doi: 10.1001/jama.2024.6542.

WHO: Candice A. Price, Ph.D., program director of the epidemiology branch, located within the Division of Cardiovascular Sciences at NHLBI, is available to discuss this review.

About the National Heart, Lung, and Blood Institute (NHLBI):  NHLBI is the global leader in conducting and supporting research in heart, lung, and blood diseases and sleep disorders that advances scientific knowledge, improves public health, and saves lives. For more information, visit  www.nhlbi.nih.gov .

About the National Institutes of Health (NIH):  NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit  www.nih.gov .

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Arizona's now-repealed abortion ban serves as a cautionary tale for reproductive health care across the US

by Swapna Reddy and Mary Saxon, The Conversation

When the Arizona Supreme Court ruled on April 9, 2024, that the state's Civil War-era law banning nearly all abortions was enforceable , it brought into stark reality the potential impacts of leaving reproductive rights up to the states to regulate, and the related consequences for women's health.

The ruling, set to go into effect in late June 2024, will only remain active for a few months because Arizona lawmakers repealed the law on April 30 . Starting in the fall, a previous state law banning abortion after 15 weeks will be reinstated.

The rapidly changing legal landscape and conflicting information has fueled fear and confusion for women, families, hospitals, physicians and other health care providers , and had a chilling effect on abortion services.

We are a health policy expert who studies how laws and policies affect health outcomes , especially for women and children, and a soon-to-be health care lawyer who is focused on health law and policy.

After having studied how reproductive health care has been affected by the 2022 Dobbs decision that overturned Roe v. Wade, it's clear to us that the implications of bans like those in Arizona and dozens of other states go well beyond abortions. They include reduced availability of safe birthing services, pre- and postnatal care, pap smears, testing for sexually transmitted diseases, family planning, gynecological conditions and miscarriage management.

These downstream effects are not just predicted: They are already playing out in real time in states with the most restrictive reproductive rights laws across the nation.

Hobbling the medical workforce

Policies restricting abortion affect much more than access to abortion.

For one, these laws limit the supply of women's health specialists like obstetricians and gynecologists, or OB-GYNs. Medical students are less inclined to enter the specialty and more likely to avoid training positions, employment or both in states with restrictive or near-total bans. These states also have difficulty retaining existing OB-GYNs .

This impact on the availability and locations of future women's health specialists further exacerbates physician shortages , financial strains on families and racial and ethnic health disparities . The dampening effect on the workforce can also worsen the already dismal maternal mortality rates in rural and low-income communities of color .

Having a well-trained and adequate number of OB-GYNs is critical to promoting women's health. One survey of third- and fourth-year medical students found that 60% were unlikely to apply for residencies in states where abortion is illegal or heavily restricted.

The Association of American Medical Colleges found that there was a 5.2% decline in the number of fourth-year medical student applications for OB-GYN residencies in the 2022–2023 application cycle. This is a steeper decline than in 2021, the year before the Dobbs decision overturned Roe v. Wade.

Most alarmingly, applications to OB-GYN residencies in the 13 states with the most restrictive abortion laws dropped 11% between 2022–2023 , signaling a future disparity in the supply of women's health providers in those states.

Dobbs also affected the retention of OB-GYN residents in abortion-restrictive states: 17.6%, or more than 1 in 6, respondents said they are likely to reconsider where they will practice following their training. They also noted concerns about the potential lack of comprehensive OB-GYN training opportunities in these restrictive states for procedures related to miscarriages, ectopic pregnancies and more.

Reduced access to women's health care

The Dobbs decision has exacerbated the challenges that women of color and women in rural communities face in accessing women's health care. Black women account for nearly half of all abortions in the United States yet are more likely to live in a contraceptive desert —meaning areas where they lack access to a full spectrum of contraceptive options —and are less likely to be able to afford the cost of an abortion and associated travel expenses .

A national survey of OB-GYNs found that 70% report racial and ethnic inequities have worsened since Dobbs.

Even before Dobbs, many rural women had to travel more than 180 miles to get an abortion. As a result of state laws banning abortions, at least 66 clinics across 15 states ceased offering abortion services within the first 100 days after the Dobbs decision, leaving many women without access to critical reproductive health care.

As of December 2023, over a dozen states lack an abortion clinic . As more states continue to restrict abortion, these disparities will likely worsen.

Lesser-known downstream effects

As of April 2024, in five states, including Arizona, women cannot get a divorce if they are pregnant. This reality, paired with a lack of access to abortion services, can be deadly to pregnant women, who often experience increased rates of intimate partner violence. One study found that in states where abortion is restricted, homicides rates of pregnant women were 75% higher than in states where abortion is legal.

Nationally, maternal mortality rates have been increasing year after year, even before Dobbs. The U.S. has among the worst maternal mortality rates in the developed world and more than 10 times the rates of some developed nations such as Australia, Japan and Spain.

Stark disparities also exist within American maternal mortality rates: Black and Native women are disproportionately impacted compared to their white counterparts. In 2018, the maternal mortality rate in the U.S. was 17.4 deaths per 100,000 births; in 2021, the rate was 32.9 deaths per 100,000 births.

In 2018–2019, there were 26 deaths per 100,000 births in Arizona, a 43% increase from 2016–2017.

During this time frame, 89.9% of deaths were preventable . A pregnancy-related death is deemed preventable if a maternal mortality review committee determines that the death could have been averted through a reasonable change to the patient's care.

While extensive post-Dobbs maternal mortality data is not yet available, 64% of surveyed OB-GYNs report that maternal mortality has increased since the decision.

For Black and Native American women, the risk of maternal mortality is even higher. Nationally, in 2021, there were 69.9 deaths of Black mothers per 100,000 births , 2.6 times higher than for white women. Experts anticipate that the Dobbs decision and state restrictions will worsen this racial divide. The maternal mortality rate for Native American mothers has increased drastically in a 20-year period , from 14 to 49.2 deaths per 100,000 births. This trend is highly significant for a state like Arizona with its large Native population.

Health care access helps reduce maternal mortality

Limited access to maternal health care is a critical contributor to maternal mortality rates . Across the United States, approximately 12% of all births occur in counties with little to no access to maternal care , known as "maternity care deserts."

Women living in abortion-restrictive states are 62.2% more likely to have had no or late prenatal care compared to women living in states where abortion is not restricted. In Arizona, 6.7% of all births occur in counties that lack a hospital with an obstetric unit or obstetric providers.

Women who are forced to prolong their high-risk pregnancies due to abortion bans are at elevated risk of needing emergency maternity care. Without proper maternity care, many of these women will suffer severe complications, and in some cases, they will die.

In the early 1900s, famed women's rights activist Margaret Sanger stated , "No woman can call herself free who does not own and control her body."

These words continue to be tested via the political and legal battles taking place.

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