Search

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2009.03.012 Byline: Jared W. Parrish (a)(c), Alan R. Katz (a), John S. Grove (a), Jay Maddock (a), Sue Myhre (b) Keywords: contraception; emergency; risk; student; women's health clinic Abstract: The purpose of this study was to identify unique characteristics for seeking emergency contraception (EC) among sexually active unmarried women who attended a university-based women's health clinic (WHC). Author Affiliation: (a) Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Manoa, HI (b) University Health Services, University of Hawaii at Manoa, Manoa, HI (c) MCH-Epidemiology DPH, Anchorage, AK Article History: Received 1 August 2008; Revised 3 December 2008; Accepted 6 March 2009 Article Note: (footnote) Authorship and contribution to the manuscript is limited to the 5 authors indicated. There was no outside funding or technical assistance with the production of this article., Cite this article as: Parrish JW, Katz AR, Grove JS, et al. Characteristics of women who sought emergency contraception at a university-based women's health clinic. Am J Obstet Gynecol 2009;201:22.e1-7.

BackgroundThe Alaska Native (AN) population has endured multiple historical traumatic events. This population has poorer health outcomes on nearly all factors compared with Alaska non-Natives with more than 75% reportedly being physically assaulted in their lifetime, and child sexual abuse nearly 6 times the national average.ObjectiveThis article describes the Pathway to Hope (PTH) program, which is an indigenous approach to ending silence and denial related to child sexual abuse and encourages multigenerational healing.DesignPTH was developed by ANs who believe that each community is unique, thus strategies for ending denial and support for healing must be woven from the historical context, cultural strengths of individual communities. Strengths-based solutions built on truth, honesty, compassion and shared responsibility for healing and protecting today's children have been profound and successful.The PTH curriculum addresses child sexual abuse from a historical perspective; that the higher rates of sexual abuse among certain Tribes, regions and communities is linked in part to years of victimisation, but may also be perpetuated by internalised oppression and lateral violence among Tribal members.ResultsData suggest that community-based dialogue and wisdom of Native elders and spiritual leaders paired with readiness of community service providers are necessary for sustained change. At all levels, this Indigenous model for learning, sharing, helping and healing brings hope for an end to denial and silence about child sexual abuse for Native people.ConclusionThe PTH program utilises the wisdom and values that have sustained Native people for generations. Ending silence and denial about child sexual abuse and building upon strengths have assisted many Indigenous communities begin the journey toward wellness. Through the PTH, communities have taken steps to accept the challenges associated with establishing safety for children, supporting child victims in healing and to holding offenders accountable.