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Biomedical subjects

Carol J Rowland Hogue

Publications and source records attributed to Carol J Rowland Hogue.

7 recordsLinked to original sources
PubMed2006

Circumstances of pregnancy: low income women in Georgia describe the difference between planned and unplanned pregnancies.

INTRODUCTION AND BACKGROUND: The United States has a higher rate of unintended pregnancies than many other developed countries despite the availability of effective contraception. Using Azjen's Theory of Planned Behavior and Luker's Theory of Contraceptive Risk Taking this qualitative study explores the reasons for the high rate of unintended pregnancy among low income women in Georgia. METHODS: Six focus groups (N=39) were conducted at county health department clinics. Women were recruited at the clinics to participate in a discussion of Pregnancy and Motherhood. All English or Spanish speaking women between the ages of 18 and 49 were eligible for participation. RESULTS: Three dimensions of pregnancy planning emerged-the decision to have a child, taking specific behaviors to increase the likelihood of conception, and making plans to care for a child. Planned pregnancies may occur when a couple or a woman decides that they are ready to have a child, but also occur in less stable situations that pose risks for the family and the child. Unplanned pregnancies may be welcomed or be unwanted depending on the circumstances. Women perceive advantages and disadvantages to planned and unplanned pregnancies. DISCUSSION: There are major differences between the definition and values of planned and unplanned pregnancies promoted by public health practitioners and those of the women in our study. This suggests the need for research on the circumstances in which pregnancies occur, as well as targeted interventions and policies that help women and men define and achieve the circumstances in which they would like to bear and rear children.

Adolescent↗
PubMed2005

Stress model for research into preterm delivery among black women.

The disparity between black and white infant mortality rates increased over the last decade, despite overall improvement in infant survival. Because most black infant deaths are related to preterm delivery, the discovery of the cause of premature birth in general and excess premature birth for black infants in particular is of paramount importance for reproductive health research. Substantial theoretic support exists for maternal stress as a risk factor for preterm birth. Traumatic events early in life may sensitize the adult to contemporary stresses and increase her vulnerability to stress-induced neuroendocrine or infection/inflammatory pathways to early parturition. In addition, an individual may prematurely age as a result of cumulative stress or a major traumatic event. This "stress age," which is synonymous with the concept of weathering and similar to the concept of allostatic load, may affect parturition through chronic conditions (such as hypertension) and in poorly understood pathophysiologic mechanisms that are related to increased chronologic age. One potential measure of stress age is maternal serum dehydroepiandrosterone sulfate. Maternal stress is a potential explanatory factor for excess preterm delivery among black women because of their exposure to racism-associated stress. However, few studies have addressed this question, and results are mixed. Future etiologic research must take into account the complexities of the measurement of stress age and past and current exposures to stress, which includes internalized racism and interpersonal racism.

Black People↗
PubMed2004

Whither FIMRs?

The FIMR evaluation team has made a significant contribution, both to knowledge about the FIMR process and to the science of public health functions evaluation. Considering the findings presented in this issue, as well as this author's assessment of the infant mortality reduction field, future FIMR efforts must strengthen the independent efforts of Community Action Teams so that their respective communities can hold the FIMR process accountable for measurable reduction in infant mortality rates. To achieve this, Community Action Teams must be continually educated in evidence-based program interventions and be provided with adequate data for goal setting and progress monitoring.

Child Health Services↗
PubMed2002

Successful assisted reproductive technology: the beauty of one.

In 1999, the approximately 90,000 in vitro fertilization procedures accounted for 98% of all types of assisted reproductive technologies in the United States. Since 1992, when Congress recognized a public health interest in reporting accurate and timely information about pregnancy success rates for infertility treatments, success has been defined as a live birth after an assisted reproductive technology cycle, regardless of the number of live-born infants per delivery. Because of pressures to achieve success, often more than one pre-embryo is transferred per cycle, frequently resulting in multifetal pregnancy reduction or multiple births. Twin and higher order births associated with assisted reproductive technology have increased significantly since 1980. Although births resulting from assisted reproductive technology amount to less than 1% of all live births, they now account for about a third of all twin births and more than 40% of triplets and higher number births in the United States. Although multiple births fit the current definition of success, they create much higher risks for maternal and infant morbidity and mortality, contributing to more than $640 million in excess initial hospital costs during the year 2000 alone. With recent improvements in assisted reproductive technology procedures that increase the likelihood of delivery after the transfer of just one pre-embryo per cycle, it is time to re-examine how success is measured. Assisted reproductive technology success should be redefined to be the proportion of cycles resulting in a singleton, live birth.

Female↗
PubMed2002

Toward a strategic approach for reducing disparities in infant mortality.

The United States' international ranking for infant mortality slipped from 19th in the 1980s to 27th in 1997. This slippage may be related to the segregation of priorities that occurred early in the 1990s, when national concern was diverted from infant mortality to minority health. To rekindle concern about infant mortality to the level of effective action, public health professionals must refocus the public's attention on assuring that all women are provided adequate education and services to help them avoid unintended pregnancies, that all pregnant women receive services in appropriate facilities, and that the causes of preterm deliveries are discovered. Effective action in these areas would not only improve infant mortality overall; it would also reduce racial and ethnic disparities in infant health.

Family Planning Services↗
PubMedDate not supplied

Riskier than we thought: revised estimates of noncontracepting women risking unintended pregnancy.

OBJECTIVES: Risk-taking is defined as non-use of contraception among sexually active women who do not desire pregnancy. The published National Survey of Family Growth (NSFG) definition of risk of unintended pregnancy includes sterilized women and women relying on partner sterilization in the statistic. However, this inclusion skews percentages of risk-taking women to appear smaller than is realistic since sterilized women face minimal risk of pregnancy. The objective of this study was to obtain realistic estimates, of risk-taking behavior to identify groups at special need for improved services. METHODS: In calculating risk-taking statistics, sterilized women and women relying on partner sterilization are removed from both the numerator and denominator. The numerator includes all non-contracepting women who believe that they are fecund. The authors calculated the proportion of risk-taking women for various age, ethnic, and marital status groups. RESULTS: Overall, 14.0% of sexually active, fecund women are risk-taking. Except for teenagers, who do not use sterilization, the proportions of risk takers are higher than the NSFG estimates of proportion of women at risk of unintended pregnancy in all groups. Differences in risk estimates ranged from 0.4% to 10.7%, with the greatest differences seen among formerly married and Hispanic black women. CONCLUSIONS: These results indicate that published NSFG percentages of adult women at risk of unintended pregnancy underestimate risk-taking behavior for groups previously thought to be at lower risk of unintended pregnancy.

Adolescent↗