ABSTRACT Introduction Self‐care interventions can improve access to healthcare, but their equitable implementation depends on addressing harmful gender norms and systemic barriers. This scoping review examines the relationship between women's autonomy and WHO‐recommended self‐care interventions for sexual health in the context of harmful gender norms and systemic health care barriers. Methods Using Arksey and O'Malley's framework, we searched databases for peer‐reviewed studies published between January 2019 and March 2025. From 8,814 records, 101 studies met inclusion criteria. Data were analyzed using the WHO self‐care framework and a gender‐transformative lens. Results Self‐care interventions provided women with privacy and control over health decisions, mitigating judgement and discriminatory health and health care experiences. However, harmful gender such as stigma around women's bodies and sexuality sometimes hindered uptake of self‐care interventions. Unintended consequences included increased gender‐based violence in certain partner‐mediated self‐testing contexts. Despite challenges, self‐care interventions fostered autonomy and self‐efficacy enabling women to manage their sexual health independently and navigate gendered barriers. Key enablers included counseling, community engagement, and equitable access to tools. Conclusions Self‐care interventions have transformative potential for improving women's sexual health and advancing gender equality. Addressing systemic barriers and mitigating risks is crucial for facilitating uptake and continuation of self‐care practices. A gender‐transformative approach integrating supportive services, equitable distribution models, and community‐based strategies can enhance accessibility, affordability, and acceptability of self‐care interventions. These findings provide insights for designing policy and programmatic interventions to advance women's sexual and reproductive health rights by addressing harmful gender norms and promoting equality goals.
ABSTRACT Objective Gestational Diabetes (GDM) is increasingly common and associated with adverse outcomes, yet awareness remains low in many settings. We examined factors associated with GDM awareness among low and middle‐income pregnant women in India. Methods Pregnant women were enrolled at a government hospital in Pune, India. Participants were asked if they had heard of diabetes and, if so, completed a 12‐item questionnaire assessing knowledge of GDM risk factors, testing and treatment, and consequences. Each correct response scored 1 point; scores of 0–4 were classified as poor awareness, 5–8 as fair, and 9–12 as good. Suboptimal awareness was defined as poor, fair, or no awareness. A multivariable logistic regression was used to assess risk factors for suboptimal awareness. Results Among 368 women, median age was 25 years (IQR 22–29), gestational age 20.4 weeks (IQR 16.5–24.0), BMI 22.8 kg/m 2 (IQR 20–26.9); 33% ( n = 122) were primigravid, 31% ( n = 114) living with HIV, and 11% ( n = 41) had GDM. Among 326 (89%) of women who were aware of diabetes, median GDM awareness score was 9 (IQR 7–10). Overall, 197/368 (54%) women had suboptimal awareness. On multivariable analysis adjusting for residence, gravidity, and BMI, living with HIV (aOR 1.7, 95% CI 1.0–2.8, p = 0.04) and lower socioeconomic status (aOR 1.9, 95% CI 1.1, 3.2) were independently associated with odds of suboptimal GDM awareness. Conclusions GDM awareness remains suboptimal among low‐income pregnant women in India, particularly among women with HIV. Targeted educational health interventions may improve awareness and reduce long‐term complications.
ABSTRACT Background Common mental health disorders (CMDs), comprising symptoms of anxiety and depression, during pregnancy are an important health concern since it is common and persistent, and has an unwavering impact on the pregnancy outcome. Several socio‐economic, demographic and psychological variables have been identified as predictors. Evidence on the prevalence and determinants associated with prenatal CMD is very limited in Bangladesh. This study aims to find the prevalence and associated predictors related to prenatal CMDs. Methods This study utilized cross‐sectional data originating from Demographic Heath Survey 2022 of 1172 pregnant women in Bangladesh. The frequency distribution of selected sample visualized by descriptive analysis as well as a bivariate analysis was performed to assess the percentage distribution of sample by prenatal CMDs. Finally, adjusted and unadjusted associations were measured between prenatal CMDs and selected covariates employing simple logistic and multivariable logistic regression, respectively. Results Of the 1172 pregnant women aged between 15 and 49 years allocated to the mental health module included in this study, 184 (15.7%) women experienced CMDs in pregnancy. The odds of prenatal CMD were significantly higher when the women faced any social barriers (AOR = 1.36, 95% CI: 0.95–1.95). CMD in pregnancy were also found to be significantly high when the pregnancy was not wanted by the women (AOR = 1.43, 95% CI: 0.97–2.10) and when the women was pressured to become pregnant (AOR = 2.48, 95% CI: 1.31–4.71). Conclusions Advanced maternal age, unwanted pregnancy, any barrier to healthcare, and pressure to become pregnant have been identified as the key determinants of CMDs among pregnant women in Bangladesh. It is recommended that policymakers integrate mental health awareness initiatives, mental health screening tests, and supportive measures into antenatal care frameworks. Timely identification and interventions are essential to improve both the physical and psychological well‐being of the mothers and their children.
ABSTRACT Objective To synthesise existing evidence on the association between premenstrual dysphoric disorder (PMDD) and sleep quality, and to examine how sleep disturbance relates to mood, cognition and daily functioning across the menstrual cycle. Methods This review followed PRISMA 2020 guidelines. OVID MEDLINE, Embase and the Cochrane Library were searched for English‐language studies published between January 2013 and December 2024. Eligible studies examined sleep in menstruating individuals with PMDD diagnosed by DSM criteria, prospective symptom charting, validated screening instruments or clinician assessment. Two reviewers independently screened records and resolved disagreements by consensus. Methodological quality was appraised using the Mixed Methods Appraisal Tool. Results Six studies published between 2015 and 2022, comprising 1081 participants across Taiwan, India and Canada met inclusion criteria. Poor sleep quality was consistently associated with greater PMDD symptom severity, co‐occurring with fatigue, insomnia, impaired emotional regulation and reduced executive functioning, particularly in the late luteal phase. Lifestyle factors and comorbid bipolar disorder were also associated with symptom expression. All studies were rated negatively for participant representativeness, and most used self‐reported sleep measures and observational designs, precluding conclusions regarding directionality. Conclusion Sleep disturbance is consistently associated with PMDD symptom burden and may warrant routine clinical assessment. Sleep‐targeted interventions represent a plausible adjunct to management, but higher‐quality longitudinal and interventional studies are required.
ABSTRACT Introduction For pregnant women who have already had a caesarean section, vaginal birth is the best alternative option. However, fewer women are birthing naturally these days following caesarean sections, which has led to a rise in the need for elective repeat caesarean procedures and the complications that come with it. Therefore, this study aimed to determine factors that influence vaginal birth following caesarean section among women undergoing labour trials in public hospitals of East Shoa Zone, Ethiopia. Methods An unmatched case‐control study was conducted on a total of 268 samples (89 cases and 179 controls). Pregnant women who had undergone one prior caesarean section and opted to try labour and deliver naturally for their current pregnancy were considered cases, whereas those who ended up having an emergency repeat caesarean section were considered controls. Cases were chosen in a sequential manner, and two controls were chosen at random after the cases. Data were collected using a structured interviewer‐administered questionnaire. Bivariate and multivariable logistic regressions were fitted. An adjusted odds ratio along with a 95% confidence interval (CI) was employed to identify significant association. Results Urban residency (AOR = 2.77; 95% CI: 1.54, 4.99), multiparity (AOR = 3.08; 95% CI: 1.47, 8.73), four or more prenatal visits (AOR = 1.49; 95% CI: 1.01, 3.53), a birth interval of less than 24 months (AOR = 3.36; 95% CI: 1.95, 7.24), a history of spontaneous vaginal birth (AOR = 2.30; 95% CI: 1.28, 4.15), a history of vaginal birth following a caesarean section (AOR = 2.58; 95% CI: 1.45, 4.61), and a cervical dilation of at least 5 cm at admission (AOR = 2.24; 95% CI: 1.14, 4.44) were found to be independent determinants of successful vaginal birth after a prior caesarean section. Conclusion Obstetric care providers should strongly consider mothers who have a history of vaginal delivery, have a cervical dilation of at least 5 cm at admission, have a birth interval of at least 24 months, are multiparous, and are young during counselling for the best selection of candidate women to avert the rising rate of CS and its associated morbidity. This study also advises women with a history of CS to have more frequent prenatal visits. During prenatal visits, counselling should be strengthened, and women should have full participation in the choice of delivery mode.
