Pregnancy and birth cohort studies are essential for studying the social and biological determinants of human health, yet racial and ethnic minority populations are underrepresented due to low recruitment and retention rates. Remote data collection has potential to improve recruitment of underrepresented populations. The aims of this descriptive qualitative study were to explore the perspectives of pregnant and postpartum women about the barriers and facilitators to enrolling themselves, their child, and their partner in a longitudinal birth cohort study, identify data collection strategies to address barriers, and generate recommendations for future cohort studies. Online focus groups and in-person interviews in English and Spanish were conducted between August and November 2022 with pregnant and postpartum women. Participants were recruited from Black and Hispanic serving obstetric clinics and community-based health and social organizations to ensure a racially and ethnically diverse sample. Analysis was conducted using an inductive thematic approach. 60 women participated in 10 focus groups and 11 interviews. Five themes emerged: challenges in committing time and resources to a research study; utility of compensation and resources; fears that research procedures would negatively impact child; concerns regarding data privacy and children's consent; and benefits for their family, community, and society. Black participants voiced concern about historical discrimination in science and mistrust of research, but also wanted to increase Black representation in research for future generations. Spanish-speaking participants expressed hesitancy related to fear of child injury and misuse of data. Women felt their partners would be reluctant to participate, but that incentives such as parental education would be motivating. Participants liked the flexibility of remote data collection in easing logistical challenges to participation but also expressed importance of personal study contact for facilitating access to resources, enhancing trust in the research process, and motivating retention. Participants also expressed the importance of transparency in data collection procedures and communication on study progress. Leveraging technological advances in remote data collection may reduce some challenges to recruitment of women and families to birth cohort studies. However, building and maintaining trust among communities with engagement, transparency, and communication is critical for recruitment of underrepresented populations.

Language, both spoken and written, plays a critical role in shaping clinical communication, documentation, research integrity, and patient trust. In obstetric care, terminology must align with biological reality, uphold clinical accuracy, respect patient identity, and increasingly, comply with federal policy. As of January 2025, Executive Order 14,168 reframes gender-inclusive language as a threat to women's dignity, safety, and well-being, asserting that "efforts to eradicate the biological reality of sex fundamentally attack women" and it mandates sex-based language, reversing prior encouragement of gender-inclusive terminology. This shift has created ethical, operational, and legal tensions for clinicians, who must reconcile conflicting expectations from federal mandates, professional guidelines, and patient needs. Several institutions have already experienced funding losses due to noncompliance with evolving mandates, underscoring the stakes of aligning clinical language with policy. This manuscript examines the impact of these developments on obstetric language, drawing on legal frameworks, ethical principles, and professional standards. A PubMed analysis through 2024 reveals the continued predominance of "pregnant woman" (60%), increasing use of "pregnant patient" (20%), and a growing presence of inclusive terms (20%). While sex-based terminology facilitates regulatory compliance and clinical clarity, inclusive language may improve trust among gender-diverse populations. We propose a balanced context-sensitive framework, called Balanced Pregnancy Language, which aligns documentation and billing with federally mandated sex-based terms while allowing patient-preferred, inclusive language in clinical interactions and nonstructured documentation. The Balanced Pregnancy Language model preserves scientific clarity, ensures compliance, and supports ethical commitments to respect patient autonomy. Given recent federal shifts affecting documentation standards and data collection practices, the Balanced Pregnancy Language model offers a balanced and ethically grounded solution. It enables clinicians to meet sex-specific regulatory requirements while respectfully affirming patient identity, thereby preserving both institutional integrity and the ethical delivery of care.

The landmark Roe vs Wade Supreme Court decision in 1973 established a constitutional right to abortion. In June 2022, the Dobbs vs Jackson Women's Health Organization Supreme Court decision brought an end to the established professional practice of abortion throughout the United States. Rights-based reductionism and zealotry threaten the professional practice of abortion. Rights-based reductionism is generally the view that moral or ethical issues can be reduced exclusively to matters of rights. In relation to abortion, there are 2 opposing forms of rights-based reductionism, namely fetal rights reductionism, which emphasizes the rights for the fetus while disregarding the rights and autonomy of the pregnant patient, and pregnant patient rights reductionism, which supports unlimited abortion without regards for the fetus. The 2 positions are irreconcilable. This article provides historical examples of the destructive nature of zealotry, which is characterized by extreme devotion to one's beliefs and an intolerant stance to opposing viewpoints, and of the importance of enlightenment to limit zealotry. This article then explores the professional responsibility model as a clinically ethically sound approach to overcome the clashing forms of rights-based reductionism and zealotry and to address the professional practice of abortion. The professional responsibility model refers to the ethical and professional obligations that obstetricians and other healthcare providers have toward pregnant patients, fetuses, and the society at large. It provides a more balanced and nuanced approach to the abortion debate, avoiding the pitfalls of reductionism and zealotry, and allows both the rights of the woman and the obligations to pregnant and fetal patients to be considered alongside broader ethical, medical, and societal implications. Constructive and respectful dialogue is crucial in addressing diverse perspectives and finding common ground. Embracing the professional responsibility model enables professionals to manage abortion responsibly, thereby prioritizing patients' interests and navigating between absolutist viewpoints to find balanced ethical solutions.

Abstract Introduction Birth trauma can affect physical, mental, and sexual health of post-partum individuals. Objective Our aim is to review the effects of birth trauma on maternal mental and sexual wellness in minority women. Methods In this literature review, we first defined birth trauma through the DSM-5 and its connection between patient treatment. We then analyzed the impacts of physical birth trauma on sexual wellness in women, with a focus on perineal tearing, dyspareunia, and return to sexual activity postpartum. Along with birth traumas impact on postpartum mental health conditions such as post-traumatic stress and depression. We analyzed further data regarding the causes of maternal mortality, reviewing prevalence of mental health conditions, suicide, and preventability of these deaths. We then analyzed data regarding reporting discrimination faced by minority women, prevalence of minority maternal and baby mortality, and complication rates. Results Data show that birth trauma negatively affects maternal mental and sexual health. Factors contributing to birth trauma can be described as interpersonal, psychological, or physical. Physical birth trauma can result from third- or fourth-degree perineal tears which has been linked to increased risk for dyspareunia. Dyspareunia, low libido, and other sexual issues can be challenging for women postpartum. Any degree of vaginal or perineal trauma can cause such sexual health issues. Additionally, overall sexual function can decline during pregnancy making it challenging to return to previous levels of sexual function with associated physical trauma. Birth trauma can cause various psychological effects such as post-traumatic stress, depression, or other mental health conditions. Taking preventative measures to ameliorate birth trauma can increase maternal mental and sexual wellness. It also is important to note the disparities faced by minority women in obstetrics. Minority women are at a higher risk for experiencing a negative birthing process. In general, minority communities face challenges in accessing the necessary resources to mitigate birth trauma or receive sufficient mental and sexual health care. In addition, many minority communities stigmatize mental and sexual health, preventing them from accessing the care they need. Since underserved, minority women have more morbidity and mortality associated with pregnancy and delivery than other populations of women, they are more subject to adverse outcomes, including compromised sexual function. Conclusions Acknowledging racism and stigmas in obstetrics is necessary for establishing culturally competent and equitable healthcare. This is important for creating a safe and positive environment for mothers during the birthing process, lessening the chances of birth trauma, and therefore improving overall maternal mental and sexual wellness post-partum. Disclosure No.

INTRODUCTION: The Human Microbiome Project (2007–2016) has contributed to the characterization of the microbiome and its relationship to health and disease processes. This information is only beginning to be fully understood. The aim of this study was to assess the general knowledge about the microbiome in the lay population. METHODS: A five-question survey was administered to the general population who attended Rutgers Day 2023, an informational open house showcasing the activities of Rutgers University. The survey was distributed by our study personnel. RESULTS: A total of 148 useable surveys were collected. We found that 73% of respondents had heard of the microbiome. Respondents were most aware of the gut microbiome (95.2%), followed by skin (51.4%), mouth (48.6%), and nose (45.9%). Respondents recognized microbiome altering factors as follows: dietary effects (89.2%), antibiotics (79.7%), exercise (60.8%), soap (42.6%), and pets (39.2%). Relationship to disease states was recognized for weight (83.1%), diabetes (72.0%), and heart disease (62.8%). Almost 20% of respondents took a probiotic, most often for gut health. However, 8.8% felt the microbiome influenced hair and eye color, and 13.5% thought it was influenced by music. CONCLUSION: This brief survey confirmed that there is a general awareness of the microbiome in the lay population, but a deficit of knowledge in many areas. Despite this, almost one in five respondents used a probiotic. As further microbiome research and its ability to affect disease becomes available, accurate and evidence-based information needs to be distributed to the community.

Abstract Introduction Genital tucking is a practice performed by some transgender women and gender nonconforming individuals to reduce or conceal the contour of the penis and testicles. A variety of genital tucking techniques exist that are used to achieve an individual’s desired appearance. The penis and scrotum may be moved into the perineal area or between the buttocks. Some individuals may additionally reposition the testicles upward into the inguinal canals. Typically, these techniques are reinforced through the use of compression underwear, a specialized supportive undergarment termed a gaff, or adhesive tape. Despite the important role genital tucking plays in gender expression and affirmation, little, if any, research currently exists on the prevalence of tucking practices, the techniques employed, and its effects on anogenital health. Dermatological injury due to genital tucking encompasses a broad range of complications and may be largely avoidable if correct anogenital care and tucking methods are implemented. Objectives The purpose of this study is to present key findings generated from a review of available literature on anogenital dermatological conditions and their association with genital tucking. Data are presented on genital tucking techniques, associated health risks with emphasis on dermatological considerations, as well as suggested physician preventative counseling. Methods PubMed was searched for publications corresponding to the areas of interest (moisture-associated skin damage, medical adhesive-related skin injury, anogenital care techniques). Research from primary publications, consensus statements, and literature reviews were included. Findings were synthesized and applied to the context of genital tucking practices. Results As certain tucking practices expose the anogenital skin to excessive moisture, friction, and adhesive products, dermatological complications are a significant concern. Individuals who tuck may experience medical adhesive-related skin injury which includes mechanical injury (e.g., skin tears, blistering), dermatitis (e.g., hypersensitivity reactions), and other injuries such as maceration and folliculitis. Moreover, genital tucking may predispose individuals to intertriginous dermatitis, an inflammatory skin condition that occurs due to friction and trapped moisture within skin folds. Predisposing risk factors to skin injury that may disproportionately affect transgender individuals who tuck include dehydration, exposure to estrogen hormone therapy, and immunodeficiency. Prevention of adverse outcomes related to tucking should include counseling and regular surveillance of the anogenital area. Patients should be counseled on the selection and use of absorbent, natural fabrics as well as the safest and most effective adhesive tapes. Applying barrier and drying agents before tucking and employing proper adhesive removal techniques should be recommended to further reduce risk of anogenital skin injury and infection. Conclusions This review was the first of our knowledge to discuss the practice of genital tucking, the associated dermatological risk factors, and the critical role physicians play in caring for and counseling patients on tucking practices. Genital tucking preventative counseling and routine examination of the affected area may improve anogenital health of individuals who engage in this practice. Disclosure No.

Objectives The United States maternal mortality (MM) rate is the highest amid developed/industrialized nations, and New Jersey's rate is among the highest. Healthcare professionals, public health officials, and policy makers are working to understand drivers of MM. An interactive data visualization tool for MM and health-related information (New Jersey Maternal Mortality Dashboard [NJMMD]) was recently developed. Methods NJMMD is an open-source application that uses data from publicly available state/federal government sources to provide a cross-sectional, high-level depiction of potential relationships between MM and demographic, social, and public health factors. Results MM rates or ratios (maternal deaths/1,000 women aged 15-49 years or 100,000 live births, respectively) are available by year (2005-2017), age (5-year [15-49] periods), and race/ethnicity (non-Hispanic White, Black, or Asian; Hispanic; or other), and by contextual social determinants of health (percent insured; percent covered by Medicaid; difference in nulliparous, term, singleton, vertex Cesarian birth rate from New Jersey goal; number of obstetrician/gynecologists or midwives per capita; and poverty rate). Bar graphs also can be produced with these variables. Conclusions NJMMD is the first publicly available, interactive, state-focused MM tool that takes into account the intersection of social and demographic determinants of health, which play important roles in health outcomes. Trends and patterns in variables associated with MM and health can be identified for New Jersey and each of its 11 counties, and inform areas of focus for further analysis. Outputs may enable researchers, policy makers, and others to develop appropriate interventions and be better positioned to set benchmarks, allocate resources, and evaluate outcomes.

Abstract This systematic review and meta-analysis assessed the risk of inadequate prenatal care and pregnancy outcome among incarcerated pregnant individuals in the United States. PubMed/MedLine, Embase, ClinicalTrials.gov and Web of Science were searched from inception up to March 30th, 2022. Studies were included if they reported the risk of inadequate prenatal care and/or pregnancy outcomes among incarcerated pregnant individuals in the United States jails or prisons. Adequacy of prenatal care was quantified by Kessner index. The random-effects model was used to pool the mean differences or odds ratios (OR) and the corresponding 95% confidence intervals (CIs) using RevMan software. Nine studies were included in the final review. A total of 11,534 pregnant individuals, of whom 2,544 were incarcerated while pregnant, and 8,990 who were matched non-incarcerated pregnant individuals serving as control group, were utilized. Compared to non-incarcerated pregnancies, incarcerated pregnant individuals were at higher risk of inadequate prenatal care (OR 2.99 [95% CI: 1.60, 5.61], p<0.001) and were more likely to have newborns with low birthweight (OR 1.66 [95% CI: 1.19, 2.32], p=0.003). There was no significant difference between incarcerated and matched control pregnancies in the rates of preterm birth and stillbirth. The findings of the current systematic review and meta-analysis suggest that incarcerated pregnant individuals have an increased risk of inadequate prenatal care. Considering the limited number of current studies, further research is indicated to both assess whether the risk of inadequate prenatal care has negative impact on prenatal outcomes for this population and to determine the steps that can be taken to enhance prenatal care for all pregnant individuals incarcerated in the United States prisons.