One in seven of the approximately 2.2 million Department of Defense active duty military personnel are women. Among active duty servicewomen, about 40% are under 26 years old, and almost half are young, lower ranking enlisted personnel. This article will include a review of the literature on military women's health topics such including contraception access, pregnancy, and pregnancy outcomes after environmental exposures. In these early adult years, contraception use may not be consistent, leading to higher rates of unintended pregnancy that is similar to their civilian counterparts, but it may affect troop readiness. Women who become pregnant after deployment must be evacuated from theater. Complications in pregnancy that require immediate intervention, such as ectopic pregnancy, may be more difficult to diagnose and manage if far away from comprehensive medical services. Environmental exposures may affect the pregnancy outcome, or may produce delayed responses for future childbearing. Women face other gynecologic choices including menstrual suppression while deployed. Many of these issues have not been fully studied, sample sizes are small or methodological flaws exist in the analysis limiting conclusions that can be drawn. Further research with greater rigor, larger sample sizes, and careful design are needed to address many of these questions.

INTRODUCTION Core data are crucial for detailing an accurate profile of the midwifery workforce in the United States. The American College of Nurse-Midwives (ACNM) and the American Midwifery Certification Board, Inc. (AMCB), at the request and with support from the US Health Resources and Services Administration (HRSA), are engaged in a collaborative effort to develop a data collection strategy (the Midwifery MasterFile) that will reflect demographic and practice characteristics of certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States. METHODS Two independent datasets, one collected by ACNM in 2012 and one by AMCB in 2013, were examined to determine key workforce information. ACNM data were collected from the online Core Data Survey sent to ACNM members. AMCB data were extracted from information submitted online by applicants seeking initial certification in 2013 and applicants seeking to recertify following 5 years of initial certification. RESULTS The ACNM 2012 survey was partially or fully completed by 36% (n = 2185) of ACNM members (N = 6072). AMCB respondents included 100% of new certificants (N = 539) and those applying for recertification in 2013 (n = 1323) of the total 11,682 certificants in the AMCB database. These two datasets demonstrate that midwives remain largely white, female, and older in age, with most engaged in clinical midwifery while employed primarily by hospitals and medical centers. Differences were reported between the ACNM membership and AMCB certification datasets in the numbers of midwives holding other certifications, working full-time, attending births, and providing newborn care. DISCUSSION The new collaboration among HRSA, ACNM, and AMCB, represented as the Midwifery MasterFile, provides the opportunity to clearly profile CNMs/CMs, distinct from advanced practice registered nurses, in government reports about the health care workforce. This information is central to identifying and marketing the role and contribution of CNMs/CMs in the provision of primary and reproductive health care services.

Journal of Midwifery & Women's HealthVolume 60, Issue 2 p. 125-127 Commentary The United States Midwifery Education, Regulation, and Association Work Group: What Is It and What Does It Hope to Accomplish? Katherine Camacho Carr CNM, PhD, Corresponding Author Katherine Camacho Carr CNM, PhDAddress correspondence to Katherine Camacho Carr, CNM, PhD, Seattle University College of Nursing, 901 12th Avenue, Seattle, WA 98122. E-mail: kcarr@seattleu.eduSearch for more papers by this authorCathy Collins-Fulea CNM, MSN, Cathy Collins-Fulea CNM, MSNSearch for more papers by this authorCara Krulewitch CNM, PhD, Cara Krulewitch CNM, PhDSearch for more papers by this authorGinger Breedlove CNM, PhD, Ginger Breedlove CNM, PhDSearch for more papers by this author Katherine Camacho Carr CNM, PhD, Corresponding Author Katherine Camacho Carr CNM, PhDAddress correspondence to Katherine Camacho Carr, CNM, PhD, Seattle University College of Nursing, 901 12th Avenue, Seattle, WA 98122. E-mail: kcarr@seattleu.eduSearch for more papers by this authorCathy Collins-Fulea CNM, MSN, Cathy Collins-Fulea CNM, MSNSearch for more papers by this authorCara Krulewitch CNM, PhD, Cara Krulewitch CNM, PhDSearch for more papers by this authorGinger Breedlove CNM, PhD, Ginger Breedlove CNM, PhDSearch for more papers by this author First published: 17 March 2015 https://doi.org/10.1111/jmwh.12306Citations: 5Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume60, Issue2March/April 2015Pages 125-127 ACNM Members ACNM Members: Click here to log in RelatedInformation

OBJECTIVE:To estimate the rate of vaginal implant exposure associated with biologic grafts and permanent mesh used for pelvic organ prolapse (POP) surgery, to describe treatments used for these complications, and to estimate response rates to these treatments. The secondary aims were to describe the operative and perioperative complications. METHODS:This was a retrospective analysis of female members of Kaiser Permanente Southern and Northern California and Hawaii who underwent POP surgeries with biologic grafts and permanent mesh between September 2008 and May 2010. Inpatient and outpatient electronic medical records were reviewed for postoperative adverse events. RESULTS:During the 21-month period, 1,282 women, mean age of 62 years (±10 standard deviation), median parity of 3 (interquartile range 2-4), and median body mass index of 28 (interquartile range 24-30) underwent prolapse repairs with 1,484 implants with a mean follow-up time of 358 days (±276 standard deviation). Vaginal exposures occurred more often with permanent mesh (53/847 [6%]) than biologic grafts (10/637 [1.6%]) (P<.001). Resolution of vaginal exposure after the first treatment occurred in 24 of 63 (38%), whereas 39 of 63 (62%) required multiple treatments. Surgical excision was performed in 20 of 63 (32%) exposures. Permanent mesh exposures were more likely to require surgical excision (20/53 [38%]) than biologic graft exposures (zero of 10) (P=.02). CONCLUSION:Vaginal exposure occurred more frequently with permanent mesh than biologic graft, may require multiple treatments, and occasionally require surgical excision. LEVEL OF EVIDENCE:: II.

Intimate partner homicide-suicide (IPH-IPS) among women during the childbearing years leaves irreversible outcomes that are devastating and have lasting repercussions for surviving children, families, and communities. An estimated one-third of all intimate partner homicides of women aged 15 to 50 end in suicide. The purpose of this study was to describe the temporal trends and characteristics of both victims of IPH-IPS. Data were collected using a retrospective, cross-sectional analysis of medical examiner records for women aged 10 to 50 in Maryland, during 1994-2003. Seventy-five IPH-IPS incidents were identified over the 10-year period. Of those, 94.7% were a female homicide followed by a male suicide. The average rate of IPH-IPS was 0.52 per 100,000 women aged 10 to 50. About half of the couples were within 5 years of the age of each other, married or separated and the same race. Eleven percent of the women were pregnant/1-year postpartum when they died. The findings presented represent a significant public health problem that has a unique pattern compared with other populations studied. Understanding this problem involves a more comprehensive assessment of both victims. There is a need for a national surveillance system that identifies IPH-IPS events and provides information on both victims that includes individual and relationship characteristics.

Alcohol is a potent teratogen in humans, and prenatal alcohol exposure is a leading preventable cause of birth defects and developmental disabilities. The term fetal alcohol syndrome (FAS) refers to a pattern of birth defects found in children of mothers who drank during pregnancy. FAS has four criteria: maternal drinking during pregnancy, a characteristic pattern of facial abnormalities, growth retardation, and brain damage (often manifested by intellectual difficulties or behavioral problems). As surveillance and research have progressed, it has become clear that FAS is but a rare example of a wide array of defects that can occur from exposure to alcohol in utero. At least 1 in 10 women will continue to consume alcohol during pregnancy, putting their fetuses at risk for the effects of alcohol exposure. Nurses are in a key position to provide care and conduct research that will contribute to the prevention of the adverse effects of prenatal alcohol exposure during the preconception and perinatal periods, as well as deal with the negative outcomes of exposure in the developing infant. Many areas have yet to be evaluated. Screening tools and interventions have been developed and tested, mostly in majority cultures. Culturally sensitive instruments must be generated and validated for high-risk groups such as Native Americans. Fetal alcohol biomarkers and genetic research are new and need considerably more work. Effective "no drinking during pregnancy" campaigns for high-risk groups must be created and tested. Nurses are well placed to conduct research that will describe the effects at social, behavioral, and biological levels; develop middle-range theories targeted at preventing the drinking behavior and optimizing care of affected children after birth; and generate and test effective interventions that enhance prevention strategies in the 21st century.

Adverse drug-drug interactions can occur between active and/or inactive ingredients in different formulations. The occurrence of a disulfiram reaction that developed postpartum following a 7-day course of metronidazole is presented. The case is presented, followed by a discussion of the mechanism of action and treatment. Recommendations for prevention of adverse drug effects are reviewed.

Homicide has remained the third leading cause of death among girls aged 10 to 19 for more than a decade. Recent research indicates that pregnant or postpartum teens are three times more likely to be victims of homicide compared to their nonpregnant counterparts. These findings portray a compelling picture that leads the authors to investigate the relationship between homicide and pregnancy among teens in Maryland. The purpose of this study is to compare women whose deaths had been evaluated by the medical examiner and who had evidence of pregnancy to women without evidence of pregnancy, with a particular focus on adolescents; 329 (17.7%) adults and 66 (32.7%) adolescents were victims of homicide. Adolescent homicide victims were 3.7 (1.2 to 11.8) times more likely to be pregnant compared to adult homicide victims. The rate of homicide was nearly double in all women who were pregnant. Further research is necessary to evaluate factors associated with these risks so that the future generation and society are protected.

Journal of Midwifery & Women's HealthVolume 47, Issue 3 p. 204-206 SCIENCE UPDATES First published: 24 December 2010 https://doi.org/10.1016/S1526-9523(02)00245-3Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume47, Issue3May‐June 2002Pages 204-206 ACNM Members ACNM Members: Click here to log in RelatedInformation

Journal of Midwifery & Women's HealthVolume 47, Issue 1 p. 64-64 Health risks and psychosocial outcomes of early childbearing: a review of the literature Roberta Wilson SNM, Roberta Wilson SNM Frontier School of Midwifery and Family Nursing, Hyden, KentuckySearch for more papers by this author Roberta Wilson SNM, Roberta Wilson SNM Frontier School of Midwifery and Family Nursing, Hyden, KentuckySearch for more papers by this author First published: 24 December 2010 https://doi.org/10.1111/j.1542-2011.2002.tb03424.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume47, Issue1January‐February 2002Pages 64-64 ACNM Members ACNM Members: Click here to log in RelatedInformation

Various models of community research have been employed to assess community health needs and address community health problems. Infant mortality remains a problem in urban minority communities throughout the United States. This article compares various community research models with a three-tiered community involvement model used in Washington, D.C., an urban, predominantly African American community with one of the worst rates of infant mortality in the nation. The research design incorporated community input throughout the research design process, resulting in a better understanding of issues and problems associated with infant mortality within the community setting. The use of the model improved community participation in the research process, facilitating improved health initiatives.