Sexual & Reproductive HealthCare RSS feed: Current Issue. A new peer-reviewed journal dedicated to the sexual and reproductive health of women and men. The journal aims to serve its readers as an authoritative resource of disseminating significant sexual and reproductive health related scientific information. Our key audience is the academic, practising, educational and service user including: •midwives •maternity care and neonatal nurses •maternity service users •obstetricians •neonatologists •pediatricians •health sociologists and economists •biologists and psychologists with an interest in maternal and infant research •policy makers in sexual and reproductive health The journal welcomes original papers in all aspects of sexual and reproductive health including: •family planning and counseling •management of pregnancy •labour and delivery •breast feeding and post-natal care •many other aspects of aspects of sexual health including contraception, abortion, sexually transmitted diseases and HIV prevention •issues related to the menopausal and post-menopausal years The journal publishes the following types of paper: original research articles, reviews, short communications, letters to the editor. Please see the Guide for Authors for specific details including online submission at http://ees.elsevier.com/srhc . Why have we launched this new title? Research in the area of sexual and reproductive health is growing internationally, particularly among midwives. In a global perspective there is a huge interest in women's health, which is mirrored in the millennium goals of the UN as well as in international declarations and agreements. Sexual & Reproductive HealthCare aims to take on the role as a contributor of new knowledge and evidence to representatives of the health care sector and society. The journal will present studies demonstrating sexual and reproductive health matters from a multifaceted perspective where the connection between these questions and the individuals' rights will be illuminated.http://www.srhcjournal.org/?rss=yesElsevier Inc.en © 2010 Elsevier B.V. All rights reserved. Sexual & Reproductive HealthCare1877-575613August 2010 © 2010 Elsevier B.V. All rights reserved. healthpermissions@elsevier.comhttp://www.srhcjournal.org/article/PIIS1877575610000297/abstract?rss=yesOn June 7–9 the second Women Deliver conference was held in Washington DC, USA. More than 3000 global leaders working in the field of sexual and reproductive health gathered for the event. The conference focused on sharing solutions that could help us achieve the Millennium Development Goals on maternal and reproductive health. One of the conclusions from the conference is that gender equity and education are key ingredients for improving maternal health. In most developing countries, girls and women are the poorest and most vulnerable in the population, due to entrenched inequalities. Health is a human right, and effective and simple interventions can save a lot of lives.Leadership at all levels is needed to make a change in maternal, neonatal, and child healthIngela Wiklund10.1016/j.srhc.2010.06.005Sexual & Reproductive HealthCare 1, 3 (2010)2010-08-01Sexual & Reproductive HealthCare2010-08-0113S1877-5756(10)X0003-9Commentary7777http://www.srhcjournal.org/article/PIIS1877575610000236/abstract?rss=yesAbstract: Objective: To gain an understanding of the experiences of pregnant women at risk of having a preterm birth (PTB) who were attending a specialist preterm antenatal clinic and to elicit their views on treatment to prevent PTB.Study design: A qualitative interpretive approach was adopted, utilizing focus groups and one-to-one interviews. The semi-structured interview schedule focused on two main areas; risk and treatment for preterm birth. Fourteen pregnant women were recruited from a preterm antenatal clinic at a major tertiary referral centre in the North West of England. All interviews were audio recorded, with consent, and transcribed verbatim before carrying out thematic analysis.Results: Analysis revealed 3 main themes. Women struggled with ‘balancing the risks’ associated with the threat of preterm birth, they developed ‘personal coping strategies to survive the pregnancy’ and they watched as the strain made their ‘whole family crumble’.Conclusion: Women’s journey through pregnancy after a previous PTB experience is one of emotional and physical endurance. Women embrace the ‘high risk’ identity as it offers the opportunity for regular assessment and clinical reassurance. However, emotional and psychological needs must also be addressed to reduce stress and anxiety. By setting mutually agreed short term goals, significant milestones can be reached so that women feel they are successfully progressing through a high risk pregnancy through a series of ‘baby steps’.Women’s views of high risk pregnancy under threat of preterm birthEdiri Tsekiri O’Brien, Siobhan Quenby, Tina Lavender10.1016/j.srhc.2010.05.001Sexual & Reproductive HealthCare 1, 3 (2010)2010-08-01Sexual & Reproductive HealthCare2010-08-0113S1877-5756(10)X0003-9Research articles7984http://www.srhcjournal.org/article/PIIS1877575610000248/abstract?rss=yesAbstract: Objective: The objective was to investigate how ultrasound screening for Down syndrome (DS) in the first trimester, compared with a routine ultrasound examination in the second trimester, affected Maternal–Fetal Attachment (MFA) in mid-pregnancy.Method: This study of 2026 pregnant women was a sub-study of a larger RCT aiming at evaluating the effect of fetal screening for Down syndrome (DS) by means of an ultrasound scan, including measuring fetal nuchal translucency in gestational weeks 12–14. Women were randomly allocated either to the intervention or to a control group where routine care with an ultrasound scan in gestational week 17–20 was offered. Data were collected by questionnaires before randomization and in gestational week 24. MFA was measured by a modified version of the Cranley Maternal–Fetal Attachment Scale (CMFAS).Results: The mean score of MFA was 3.50 in the intervention group and 3.44 in the control group (p=0.04). The mean scores on all subscales were slightly higher in the intervention group, but only statistically significant regarding “Differentiation of self from fetus” (p=0.01).Conclusion: Ultrasound screening for DS in the first trimester may have a modest positive effect on MFA in mid-pregnancy, compared with a ultrasound scan in the second trimester.Effect of first-trimester ultrasound screening for Down syndrome on maternal–fetal attachment – A randomized controlled trialS. Georgsson Öhman, U. Waldenström10.1016/j.srhc.2010.05.002Sexual & Reproductive HealthCare 1, 3 (2010)2010-08-01Sexual & Reproductive HealthCare2010-08-0113S1877-5756(10)X0003-9Research articles8590http://www.srhcjournal.org/article/PIIS1877575610000261/abstract?rss=yesAbstract: Objective: Lifetime prevalence of infertility among couples is approximately 10–15%, but studies addressing their health behavior are few. Our aim was to describe health and life style of Finnish men and women who had experienced infertility. Design: Cross-sectional survey. Setting: Finland. Population and methods: Data from a population-based survey (n=7021) was utilized. Life style of infertile men (n=289) and women (n=155) were compared to other men and fertile women. Main outcome measures: Life style (dietary factors, use of alcohol, physical activity), reproductive factors, other diseases and symptoms. Results: After adjusting for age, area and education, infertile women under 50years consumed more polyunsaturated fat (OR 1.23, 95% CI 1.03–1.46), less saturated fat (OR 0.83, 95% CI 0.74–0.92) and had experienced more hangovers during previous year (OR 1.02, 95% CI 1.00–1.05) than fertile women. Infertile men under 50years consumed more total fat (OR 1.06, 95% CI 1.03–1.10), polyunsaturated fat (OR 1.20, 95% CI 1.05–1.37) and monounsaturated fat (OR 1.17, 95% CI 1.06–1.28) compared to other men. Infertile men did not consume more alcohol nor smoke more cigarettes but reported more often allergies than fertile men. Infertile women also had Chlamydia trachomatis infection, benign tumor in their uterus and intestinal disease more often than fertile women. Infertile women over 50years were more often current smokers than fertile women, but the differences in other age-groups were not significant. Conclusions: Women with infertility experience reported more diseases and less use of oral contraceptives than other women, possibly reflecting reasons to infertility. Since both infertility and unhealthy use of alcohol are an increasing public health issues in western societies, more attention should be paid towards life style, especially alcohol use of infertile women.Health and life style among infertile men and womenM. Revonta, J. Raitanen, S. Sihvo, P. Koponen, R. Klemetti, S. Männistö, R. Luoto10.1016/j.srhc.2010.06.002Sexual & Reproductive HealthCare 1, 3 (2010)2010-08-01Sexual & Reproductive HealthCare2010-08-0113S1877-5756(10)X0003-9Research articles9198http://www.srhcjournal.org/article/PIIS187757561000025X/abstract?rss=yesAbstract: Objectives: To investigate the hormonal contraceptive practices of female university students aged ⩽25 years, their menstrual bleeding frequency, and interest in contraceptive regimens that reduce menstrual frequency or duration.Study design: A 20-item questionnaire was distributed to female students at Griffith University, Gold Coast campus. This included questions relating to: demographics, menstrual bleeding frequency, current contraceptive practices, and interest in future oral contraceptive regimens that reduce menstrual bleeding frequency and duration.Main outcome measures: Determination of hormonal contraceptive practices and menstrual bleeding frequency undertaken by the sample population.Results: Eight hundred and fifty one participants completed the questionnaire, ∼2/3rds of respondents are currently using a hormonal contraceptive (66% of all respondents), with the oral contraceptive pill (OCP) being most common. Most women (73%) reported monthly menstruation, although 16% indicated that they sometimes missed their monthly period, with bleeding every two months. Of all OCP users, approximately 2/3rds have skipped their monthly period at some time, the most common reasons being for convenience (89%). Approximately 70% of respondents were interested in OCP regimens that reduced frequency or duration of menstruation.Conclusion: OCP use is popular amongst Australian university women, with many being interested in the concept of using the OCP to delay menstruation. Given this interest and the availability of hormonal contraceptives that reduce menstrual frequency and duration, assessing the impact of reduced menstrual blood loss on iron stores may be warranted.Hormonal contraceptive practices in young Australian women (⩽25 years) and their possible impact on menstrual frequency and iron requirementsAlecia J. Greig, Michelle A. Palmer, Lynne M. Chepulis10.1016/j.srhc.2010.06.001Sexual & Reproductive HealthCare 1, 3 (2010)2010-08-01Sexual & Reproductive HealthCare2010-08-0113S1877-5756(10)X0003-9Research articles99103http://www.srhcjournal.org/article/PIIS1877575610000182/abstract?rss=yesAbstract: Background: Increasing the uptake of long acting reversible contraception (LARC) is part of the UK strategy to reduce the number of unintended pregnancies. The subdermal contraceptive implant is a safe and effective option however lack of skilled providers can be a barrier to its use. We conducted a pilot study to investigate whether insertion during the first part of medical termination of pregnancy rather than after completion would be acceptable to patients and whether, being a progestogen, this has any effect on the efficacy of medical termination with mifepristone and misoprostol.Methods: Prospective observational study comparing outcomes in patients who chose the subdermal implant for contraception, inserted during the first part of medical termination of pregnancy, against patients who chose an alternative method of contraception commenced after the termination was complete; 39 patients in each group.Results: The efficacy of medical termination of pregnancy in patients in the implant group was 89.7% compared to 97.4% in controls (p=0.3584). Patients in the implant group tended to require more doses of misoprostol to complete the termination than controls. The incidence of complications was very low in both groups.Conclusions: Implant insertion earlier in the treatment process was acceptable to patients and none changed their minds about their decision for termination. The efficacy of medical termination was slightly reduced in those in the implant group. Larger controlled studies are needed to investigate whether this is a true effect and whether increasing the uptake of LARC actually reduces the number of repeat terminations.The contraceptive implant for long acting reversible contraception in patients undergoing first trimester medical termination of pregnancyE. Church, S. Sengupta, K.V. Chia10.1016/j.srhc.2010.02.002Sexual & Reproductive HealthCare 1, 3 (2010)2010-08-01Sexual & Reproductive HealthCare2010-08-0113S1877-5756(10)X0003-9Research articles105109http://www.srhcjournal.org/article/PIIS1877575610000224/abstract?rss=yesAbstract: Background: Adolescents in Uganda carry a heavy burden of reproductive health problems. Different environment creates different problems.Objectives: To study the prevalence of STI and to compare social and behavioral risk factors for Neisseria gonorrhoea (NG) and Chlamydia trachomatis (CT) among sexually experienced young women in one urban and one rural area in Uganda.Methods: Consenting, sexually experienced women, below 20 years, visiting two different youth clinics were asked about social background, genital symptoms and sexual experiences. Vaginal samples were taken for NG and CT and analyzed by PCR.Results: The prevalence of NG and/or CT was 20 (6.8%) in the urban and 23 (7.8%) in the rural study site, a non-significant difference. The rural women were often in marital union, 25.3% compared to 12.2% of the urban women (OR 2.4, 95% CI 1.6-3.8) and had experienced more pregnancies and had more children. Their partners were often more than 10 years older. More urban women (42.2%) knew their HIV status compared to rural women (16.2%), OR 2.1 (1.6–2.7), reported more condom use and more sexual partners.Conclusions: Marital status and few sexual partners does not appear to protect young rural women from sexually transmitted infections (STIs), implying that male sexual behavior may have an important impact on women’s risk to be infected.STI-prevalence and differences in social background and sexual behavior among urban and rural young women in UgandaElisabeth Darj, Florence M. Mirembe, Eva-Britta Råssjö10.1016/j.srhc.2010.03.001Sexual & Reproductive HealthCare 1, 3 (2010)2010-08-01Sexual & Reproductive HealthCare2010-08-0113S1877-5756(10)X0003-9Research articles111115