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Abstract Background Breast imaging clinics in the United States (U.S.) are increasingly implementing breast cancer risk assessment (BCRA) to align with evolving guideline recommendations but with limited uptake of risk-reduction care. Effectively communicating risk information to women is central to implementation efforts, but remains understudied in the U.S. This study aims to characterize, and identify factors associated with women’s interest in and preferences for breast cancer risk communication. Methods This is a cross-sectional survey study of U.S. women presenting for a mammogram between January and March of 2021 at a large, tertiary breast imaging clinic. Survey items assessed women’s interest in knowing their risk and preferences for risk communication if considered to be at high risk in hypothetical situations. Multivariable logistic regression modeling assessed factors associated with women’s interest in knowing their personal risk and preferences for details around exact risk estimates. Results Among 1119 women, 72.7% were interested in knowing their breast cancer risk. If at high risk, 77% preferred to receive their exact risk estimate and preferred verbal (52.9% phone/47% in-person) vs. written (26.5% online/19.5% letter) communications. Adjusted regression analyses found that those with a primary family history of breast cancer were significantly more interested in knowing their risk (OR 1.5, 95% CI 1.0, 2.1, p = 0.04), while those categorized as “more than one race or other” were significantly less interested in knowing their risk (OR 0.4, 95% CI 0.2, 0.9, p = 0.02). Women 60 + years of age were significantly less likely to prefer exact estimates of their risk (OR 0.6, 95% CI 0.5, 0.98, p

Background: Breast imaging clinics in the United States (U.S.) are increasingly implementing breast cancer risk assessment (BCRA) to align with evolving guideline recommendations but with limited uptake of risk-reduction care. Effectively communicating risk information to women is central to implementation efforts, but remains understudied in the U.S. This study aims to characterize, and identify factors associated with women's interest in and preferences for breast cancer risk communication. Methods: This is a cross-sectional survey study of U.S. women presenting for a mammogram between January and March of 2021 at a large, tertiary breast imaging clinic. Survey items assessed women's interest in knowing their risk and preferences for risk communication if considered to be at high risk in hypothetical situations. Multivariable logistic regression modeling assessed factors associated with women's interest in knowing their personal risk and preferences for details around exact risk estimates. Results: Among 1119 women, 72.7% were interested in knowing their breast cancer risk. If at high risk, 77% preferred to receive their exact risk estimate and preferred verbal (52.9% phone/47% in-person) vs. written (26.5% online/19.5% letter) communications. Adjusted regression analyses found that those with a primary family history of breast cancer were significantly more interested in knowing their risk (OR 1.5, 95% CI 1.0, 2.1, p = 0.04), while those categorized as "more than one race or other" were significantly less interested in knowing their risk (OR 0.4, 95% CI 0.2, 0.9, p = 0.02). Women 60 + years of age were significantly less likely to prefer exact estimates of their risk (OR 0.6, 95% CI 0.5, 0.98, p < 0.01), while women with greater than a high school education were significantly more likely to prefer exact risk estimates (OR 2.5, 95% CI 1.5, 4.2, p < 0.001). Conclusion: U.S. women in this study expressed strong interest in knowing their risk and preferred to receive exact risk estimates verbally if found to be at high risk. Sociodemographic and family history influenced women's interest and preferences for risk communication. Breast imaging centers implementing risk assessment should consider strategies tailored to women's preferences to increase interest in risk estimates and improve risk communication. [ABSTRACT FROM AUTHOR]

The aim of this paper is to examine and analyze the perceptions and reactions of women regarding digital services and electronic wine lists in restaurants while making wine ordering decisions. Women make up a significant proportion of population, and that is why is important to comprehend their reactions and impressions of digital services and electronic wine lists in restaurants. The research was conducted with a specially designed questionnaire, involved the participation of 182 women from Croatia and Serbia who used digital services and electronic wine lists in restaurants. Collected answers were processed and analyzed using the Statistical Software for Social Sciences (SPSS) version 21.0. and applying Kolmogorov-Smirnov test, Levene’s test and Kruskal-Wallis H-test. Research results indicated differences among various demographic groups of women in terms of their perceptions of the educational and functional benefits of using electronic wine list in restaurants. Results showed that younger women, those who frequently visit restaurants and those with less knowledge of wine perceived greater benefits of using electronic wine list in restaurants. This paper enriches the relatively sparse literature on women’s preferences to digital services and wine purchasing behavior, providing valuable insights for restaurant managers and decision-makers regarding women’s preferences for electronic wine lists. [ABSTRACT FROM AUTHOR]

• All attributes carry significant weight in women's choices. • Effectiveness of first-line treatment is the most valued attribute. • A lower rate of surgical management comes close behind. • Women's preferences, i.e. attribute weights, are the result of a benefit-risk balance. Shared decision-making has become a hallmark of quality care and is increasingly spotlighted in practice guidelines. Little is known about women's views for treatment of less active ectopic pregnancy. What are the preferences of women for less active ectopic pregnancy treatment-related attributes? A discrete choice model with 8 attributes depicting ectopic pregnancy treatment including varying levels of first-line treatment effectiveness, length of hospitalization, cost, length of sick leave, of convalescence, need for surgical management, for emergency care during convalescence and for tube removal was used. Childbearing aged women, i.e. those who might experience an ectopic pregnancy in the future, were recruited. They were asked to choose between hypothetical treatments in 18 choice tasks with different levels of all treatment attributes. A conditional logit McFadden's choice model was performed. The main outcome measure was preference weights for less active ectopic pregnancy treatment-related attributes. A total of 5770 observations from 178 women were analysed. The attributes displaying the highest marginal impacts on women's decisions included: higher rate of first-line treatment effectiveness, lower rate of tube removal, lower rate of surgical management, shorter length of hospitalization and, to a lesser extent, but still significant, shorter length of convalescence, absence of risk of emergency care during convalescence and lower cost. Trade-offs made by women between the attributes of less active ectopic pregnancy treatment suggest that no treatment option, either medical or surgical, is an obvious preferred option. These results encourage the promotion of shared decision-making. [ABSTRACT FROM AUTHOR]

Abstract Aim The present study aimed to evaluate the status of WCC provided by Iranian midwives. Design A sequential explanatory mixed method study protocol. Methods The present study was conducted in three phases: quantitative, qualitative and mixed. The first phase is a cross‐sectional study that will be performed on midwives working in health centres, public and private hospitals in Iranian. The second phase is a qualitative study, in which purposeful sampling will be used, meaning that the midwives who are part of the extreme cases according to the results of quantitative phase and are willing and able to express their own experiences regarding WCC will be selected. Also, pregnant and parturient women under their cover will also be interviewed. Finally, in the mixed phase, we will use a combination of two quantitative and qualitative studies, a literature review and expert opinion using a Delphi method to provide strategies to improve and promote WCC in midwives. Results Achieving this goal is expected to provide positive outcomes such as strengthening the midwives professional relationship with women and reducing health care costs. No Patient or Public Contribution.

Aim: The present study aimed to evaluate the status of WCC provided by Iranian midwives. Design: A sequential explanatory mixed method study protocol. Methods: The present study was conducted in three phases: quantitative, qualitative and mixed. The first phase is a cross‐sectional study that will be performed on midwives working in health centres, public and private hospitals in Iranian. The second phase is a qualitative study, in which purposeful sampling will be used, meaning that the midwives who are part of the extreme cases according to the results of quantitative phase and are willing and able to express their own experiences regarding WCC will be selected. Also, pregnant and parturient women under their cover will also be interviewed. Finally, in the mixed phase, we will use a combination of two quantitative and qualitative studies, a literature review and expert opinion using a Delphi method to provide strategies to improve and promote WCC in midwives. Results: Achieving this goal is expected to provide positive outcomes such as strengthening the midwives professional relationship with women and reducing health care costs. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

There is low LARC uptake in Nigeria and not much is documented about Nigerian women's preferences for these products and how these preferences affect women's choices. Therefore, the purpose of this study is to provide empirical evidence on the decision-making behavior of Nigerian women regarding LARCs. Three hypothetical LARCs were presented. Informed by results obtained from the review of relevant literature and focus group discussion held with selected family planning services providers, the identified attributes were effect on weight, cost, LARC effectiveness and effect on bleeding patterns, each at three levels. A d-optimal design was used to construct nine choice sets. An additional choice set was included to conduct the test-retest stability test. The choice sets and other socio-demographic questions formed the discrete choice experiment questionnaire. A random sample of 150 eligible women was selected from women who enrolled and attended family planning clinics in public healthcare facilities in Ibadan, Nigeria through a three-stage sampling technique. Mixed logit modeling was used to obtain estimates of the parameters and willingness to pay (WTP) for each attribute was calculated. The test-retest stability result showed that 76.7% of the respondents responded in a consistent and rational manner. The women preferred LARCs that have no effect on their weights compared to LARCs that cause either slight weight loss or gain. Also, they preferred LARCs that offer 1/1000 level of effectiveness in a year. The most preferred attribute level, ‘women experience infrequent bleeding’, increases WTP by NGN 13,984.584 (USD 33.68) while the least preferred level, ‘women experience frequent/prolonged bleeding’, has a negative mean WTP (-NGN 19,598.378 (-USD 47.20)) indicating dispreference for the level. Furthermore, women derived higher utilities from very cheap LARCs. Evidence-based information on women's preferences regarding LARC usage would help policymakers in the deployment of strategies that would ensure that preferred LARCs are procured and made readily available to women.

In sub-Saharan Africa there is increasing focus on identifying women's trait preferences within crop breeding to enable gender-responsive product development. In the case of maize, breeding programs are ready to incorporate specific traits to increase gender-responsiveness but lack guidance on what these specific traits might be. We propose an inductive approach to determine a pathway towards increasing gender-responsiveness within maize breeding. A survey of 306 farmers was conducted to determine gender differences in maize varieties used together with key agronomic practices. Variety was a significant predictor of the gender of the plot manager and of the household head in contrast to previous surveys conducted in researcher-led on-farm trials. On-farm trials are conducted using pre-defined agronomic management practices and preferences identified at harvest are likely to centre around yield. This study highlighted significant differences in several agronomic practices used by female plot managers and female household heads. Although further studies are required to understand preferences associated with varietal choice, our results suggest that current researcher-led on-farm trials may not identify gender-specific trait preferences driving varietal choice. Furthermore, a trait-specific approach is not the only avenue towards increasing gender-responsiveness in maize breeding in southern Africa. The scope for increasing gender-intentionality in maize breeding could be expanded to incorporate selection environments more relevant to agronomic management practices used by female plot managers and households at advanced stages of the breeding pipeline. This approach could provide an immediate entry point to increase gender-intentional maize breeding in southern Africa. [ABSTRACT FROM AUTHOR]

• Among women at low risk of caesarean section, the preference for this delivery mode is low although caesarean section rates are high in the study hospitals. • Nulliparous women who had never given birth were more likely to prefer caesarean section than women with previous childbirth experience. • Preference for caesarean section is based on the fear of labour pain, which requires providing support to women during pregnancy and ensuring access to adequate analgesia during labour and childbirth. • Interventions must be encouraged in order to support women's preference and to provide evidence-based information to enable women to choose the most appropriate mode of delivery. To measure the proportion of women's preferences for CS in hospitals with high caesarean section rates and to identify related factors. A cross-sectional hospital-based postpartum survey was conducted. We used multilevel multivariate logistic regression and probit models to analyse the association between women's caesarean section preferences and maternal characteristics. Probit models take into account selection bias while excluding women who had no preference. Thirty-two hospitals in Argentina, Thailand, Vietnam and Burkina Faso were selected. A total of 1,979 post-partum women with no potential medical need for caesarean section were included among a representative sample of women who delivered at each of the participating facilities during the data collection period. The overall caesarean section rate was 23.3 %. Among women who declared a preference in late pregnancy, 9 % preferred caesarean section, ranging from 1.8 % in Burkina Faso to 17.8 % in Thailand. Primiparous women were more likely to prefer a caesarean section than multiparous women (β=+0.16 [+0.01; +0.31]; p = 0.04). Among women who preferred caesarean section, doctors were frequently cited as the main influencers, and "avoid pain in labour" was the most common perceived benefit of caesarean section. Our results suggest that a high proportion of women prefer vaginal birth and highlight that the preference for caesarean section is linked to women's fear of pain and the influence of doctors. These results can inform the development of interventions aimed at supporting women and their preferences, providing them with evidence-based information and changing doctors' behaviour in order to reduce the number of unnecessary caesarean sections. The QUALI-DEC trial is registered on the Current Controlled Trials website (https://www.isrctn.com/) under the number ISRCTN67214403. [ABSTRACT FROM AUTHOR]

This article describes the results of marketing research using conjoint analysis that was conducted to establish the preferences of contraceptives among women of reproductive age in Ukraine to further use the results for effective marketing decisions making in the pharmaceutical industry. It was established that the women`s choice differs significantly depending on their main socioeconomic characteristics: age, income level, and level of education. Priority contraceptives from hormonal, non-hormonal contraceptives, as well as contraceptive medical devices for different age groups of women, was identified. Alfred Marshall’s main economic law was confirmed and the existence of price elasticity according to preferences was established. The results obtained on women’s preferences for certain types of contraceptives will improve the level of compliance, women’s pharmaceutical safety and promote a balance between women’s needs and the capabilities of the contraception supply system. [ABSTRACT FROM AUTHOR]

Objectives: To investigate what women who have experienced vacuum extraction or second stage caesarean section (CS) would recommend as mode of birth in case of prolonged second stage of labour.Methods: A prospective cohort study was conducted in a tertiary referral hospital in Uganda. Between November 2014 and July 2015, women with a term singleton in vertex presentation who had undergone vacuum extraction or second stage CS were included. The first day and 6 months after birth women were asked what they would recommend to a friend: vacuum extraction or CS and why. Outcome measures were: proportions of women choosing vacuum extraction vs. CS and reasons for choosing this mode of birth.Results: The first day after birth, 293/318 (92.1%) women who had undergone vacuum extraction and 176/409 (43.0%) women who had undergone CS recommended vacuum extraction. Of women who had given birth by CS in a previous pregnancy and had vacuum extraction this time, 31/32 (96.9%) recommended vacuum extraction. Six months after birth findings were comparable. Less pain, shorter recovery period, avoiding surgery and the presumed relative safety of vacuum extraction to the mother were the main reasons for preferring vacuum extraction. Main reasons to opt for CS were having experienced CS without problems, CS presumed as being safer for the neonate, CS being the only option the woman was aware of, as well as the concern that vacuum extraction would fail.Conclusions: Most women would recommend vacuum extraction over CS in case of prolonged second stage of labour. [ABSTRACT FROM AUTHOR]

Objectives Currently maternity care organisation is developing worldwide. Therefore insight in the position of the midwife is important. The 'Midwife Profiling Questionnaire′ (MidProQ) measures women’s preferred perinatal care professional and their knowledge of midwives’ legal competences. MidProQ is based on the European legal framework and was tested in a pilot study. This study aims to determine its content and face validity. Study design. A two-phase validation study with a Delphi method questioning content experts (n = 10) on items relevance and clarity as well as its scale and face validity. Further semi-structured interviews were performed with lay experts (n = 10) to evaluate the questionnaire’s clarity, layout, phrasing and wording. Results After round one, most questions (42/47) were considered content valid for relevance and clarity (Item Content Validity Index 0.80–1.00). Scale (Scale Content Validity Index 0.92) and face validity (Face Validity Index 0.89) of the entire instrument was obtained. Five questions were revised until item content (0.83–1.00), scale content (0.92) and face validity (1.00) were appropriate. Lay experts’ suggestions for improving the readability and usability were taken into account. Conclusions We developed a valid instrument to elicit women’s preferred health professional for uncomplicated pregnancy, labour and childbirth and to determine their knowledge about midwives’ legal competences. Our instrument can be valuable in identifying knowledge gaps and improving the knowledge of the general population about the midwifery profession and maternity care. Finally, the MidProQ may improve research in the domain of maternity care culture, scale up midwifery and facilitate a more women-centred care. [ABSTRACT FROM AUTHOR]

Therapeutic outcomes of vaginal products depend not only on their ability to deliver drugs to or through the vagina but also on acceptability and correct use. Women’s preferences, in turn, may vary according to age and cultural backgrounds. In this work, an anonymous online survey was completed by 2529 Portuguese women to assess their preferences for physical characteristics and mode of application of vaginal products, according to age. Additionally, intention to use and misconceptions about these issues were assessed. The majority of women of all age groups would use vaginal products to treat or prevent diseases, upon medical prescription. Women preferred vaginal products to be odorless and colorless gels, creams and ointments composed by natural origin drugs/excipients and applied by means of an applicator. Although the majority of women would prefer not to insert any product in the vagina, intention to use for self and recommendation to use for others was associated with previous experiences with vaginal products. General concerns and misconceptions related to use of vaginal products were rare. These data may contribute to the development of products that women are more prone to use.

According to Hakim’s preference theory, women can be divided into three groups based on their work–family preferences: home-centered, adaptive and work-centered. Here it is argued that Hakim’s conceptualization of the adaptive women is unsatisfactory, as it does not take into considerationhowthe adaptive women want to combine work and family. The paper offers a reconceptualization of the adaptive group. Based on when women want to return to employment after childbirth, and how many hours they would like to work, three types of adaptive women are distinguished: the home-oriented adaptive women, the truly adaptive women and the work-oriented adaptive women. To demonstrate the fruitfulness of the reconceptualization, a cross-sectional descriptive study of women’s preferences over time is conducted by employing data from International Social Survey Programme. [ABSTRACT FROM PUBLISHER]

Objective: to explore women's preferences with regard to their preferred health professional during labour and childbirth in case of an uncomplicated pregnancy, and to gain insight into women's knowledge of the legal competences of midwives. Design: a descriptive observational study. Setting: Brussels metropolitan region, Belgium. Participants: women in their reproductive age, living in the Brussels metropolitan region, with Dutch or French as their first language (n = 830). Measurements: a ten-item standardized questionnaire 'Midwife Profiling Questionnaire' (MidProQ) was developed to determine which health professional respondents would prefer to assist them during labour and childbirth if there were no complications and to assess their knowledge about midwives' legal competences during pregnancy, labour and childbirth. Descriptive statistics were used to report the findings. To identify relationships between the socio-demographic variables of the women and her preferences, knowledge and opinion Chi² analysis were used. Findings: For 68.0% of the participants in an uncomplicated labour (n = 564) and 66.3% of the participants with an uncomplicated childbirth (n = 550), a midwife is the preferred health professional. Brussels women prefer an obstetrician in an uncomplicated labour (n = 730, 88%) and for uncomplicated childbirth (n = 756, 91.1%). Only 20.2% of the respondents (n = 168) consider midwives to play a central role in an uncomplicated pregnancy. The knowledge of Brussels women about midwives' legal competences during pregnancy, labour and childbirth is rather poor, especially in youngsters and women who have never given birth. Key conclusions: In general, for Brussels women, midwives are not the first preferred health professional for an uncomplicated labour or for childbirth, and they do not consider midwives to play a central role in an un- complicated pregnancy. The legal competences of midwives are not known very well, especially by youngsters and women who have never given birth. The Belgian medical model of maternity care and women's experiences affect their preferences and knowledge about the legal competences of midwives and their opinion about the central health professional in an uncomplicated pregnancy. Implications for practice: To enhance more women-centred care and initiate change in the current maternity care culture in Belgium, public education, structural changes in maternity services and strategies to inspire public opinion to initiate cultural change are suggested. Involvement of midwifery organisations, other health professionals in maternity services and policy-makers with women's groups and potential service users is key. [ABSTRACT FROM AUTHOR]

Historically, oral intake for women during labor has been limited to nothing by mouth or clear liquids only. These restrictions are based on the risk of aspiration during or after the administration of general anesthesia. While aspiration can be life threatening, older methods of anesthesia are rarely used in current intrapartum care, and evidence is inconclusive that withholding oral nutrition reduces the risk of gastric aspiration. Additionally, withholding oral nutrition may result in the development of ketosis and may potentially contribute to a woman's stress and dissatisfaction with the birth experience. The purpose of this Clinical Bulletin is to review the evidence related to this practice and provide recommendations to promote informed, shared decision making regarding oral intake during labor with women at low risk for gastric aspiration. [ABSTRACT FROM AUTHOR]

Objective: To determine the likelihood of participating in group prenatal care (GPC) and associated factors among low-risk women receiving traditional prenatal care from obstetricians, family physicians or midwives, and to determine factors associated with likelihood of participating. Methods: Prior to completing a self-administered questionnaire, a 2-min compiled video of GPC was shown to pregnant women receiving traditional prenatal care. Data were collected on opinions of current prenatal care, GPC, and demographics. Biologically plausible variables with a p value ≤0.20 were entered in the multivariable logistic regression model and those with a p value <0.05 were retained. Results: Of 477 respondents, 234 [49.2 %, 95 % confidence interval (CI) 44.6-53.6 %] reported being 'definitely' or 'probably likely' to participate in GPC. Women were more likely to participate in GPC if they had at least postsecondary education [adjusted odds ratio (aOR) 1.84, 95 % CI 1.05-3.24], had not discussed labour with their care provider (aOR 1.67, 95 % CI 1.12-2.44), and valued woman-centeredness ('fairly important' aOR 2.81, 95 % CI 1.77-4.49; 'very important' aOR 4.10, 95 % CI 2.45-6.88). Women placed high importance on learning components of GPC. The majority would prefer to be with similar women, especially in age. About two-thirds would prefer to have support persons attend GPC and over half would be comfortable with male partners. Conclusion: Approximately half of women receiving traditional prenatal care were interested in participating in GPC. Our findings will hopefully assist providers interested in optimizing satisfaction with traditional prenatal care and GPC by identifying important elements of each, and thus help engage women to consider GPC. [ABSTRACT FROM AUTHOR]

The article presents the research that explores on the preferences of pregnant women to establish the third-trimester ultrasound in Great Britain. The topics discussed include the importance of the third-trimester ultrasound scan, the rising numbers of infants who died of birth defects, and the significance of the non-clinical outcomes.

Objective:This study investigated women’s experience of care when undergoing termination of pregnancy for fetal anomaly (TOPFA) with a view to assisting healthcare professionals in providing optimum care to women.Background:Technological developments in antenatal screening and testing mean more women are given a prenatal diagnosis of fetal anomaly and confront the possibility of terminating the pregnancy. TOPFA is a psychologically significant life event, but there is limited evidence on how women perceive their termination care.Methods:A cross-sectional online survey was used to elicit qualitative data as part of a study examining women’s experience of the TOPFA procedure, in particular the choice of method. Women were asked to comment on what they had found helpful and unhelpful in their termination care. Participants were recruited from a national support organisation. A total of 361 women offered qualitative comments, which were analysed using thematic analysis.Results:Women’s experience of termination care varied. Five themes were identified as underpinning what women considered ‘good care’: being cared for in a timeframe and environment that feels right; receiving the right level of care; the role of healthcare professionals and support organisations; acknowledging women’s particular circumstances; and enabling women to make choices. Regarding the last theme, women particularly valued being offered a choice of termination method.Conclusions:The findings suggest that many women undergoing TOPFA perceived their care as lacking in some way. Recommendations on improving practice are made and areas of further research are suggested, which may deepen knowledge on how best to care for these women. [ABSTRACT FROM PUBLISHER]

Therapeutic outcomes of vaginal products depend not only on their ability to deliver drugs to or through the vagina but also on acceptability and correct use. Women's preferences, in turn, may vary according to age and cultural backgrounds. In this work, an anonymous online survey was completed by 2529 Portuguese women to assess their preferences for physical characteristics and mode of application of vaginal products, according to age. Additionally, intention to use and misconceptions about these issues were assessed. The majority of women of all age groups would use vaginal products to treat or prevent diseases, upon medical prescription. Women preferred vaginal products to be odorless and colorless gels, creams and ointments composed by natural origin drugs/excipients and applied by means of an applicator. Although the majority of women would prefer not to insert any product in the vagina, intention to use for self and recommendation to use for others was associated with previous experiences with vaginal products. General concerns and misconceptions related to use of vaginal products were rare. These data may contribute to the development of products that women are more prone to use. [ABSTRACT FROM AUTHOR]

Background. Despite an increasing international trend towards the implementation of antenatal screening programmes for Down syndrome, there is currently limited information relating to women’s choices or preferences for such screening. Information about women’s preferences for and insight into the potential value they may derive from any change to screening programme design are essential components of evidence-based policy decision-making. This paper reports on a choice experiment undertaken to examine the preferences of a sample of pregnant and non-pregnant women of childbearing age with respect to antenatal screening for Down syndrome in Northern Ireland, where the offer of screening is not universal and selective abortion on the grounds of fetal abnormality is legally inaccessible. Method. The choice experiment was conducted using an internet-based survey to obtain the preferences of a volunteer sample of 50 pregnant and 73 non-pregnant women for screening tests that varied according to six test characteristics or attributes derived from an earlier focused ethnographic study. These attributes were: source of screening information, time of test in pregnancy, accuracy of test results, cost of test as an ‘out-of-pocket’ expense, waiting time for test results, and risk of miscarrying a baby unaffected by Down syndrome as a result of subsequent diagnostic testing. Results. Pregnant and non-pregnant women prefer screening tests for Down syndrome offering results with accuracy levels of 90% and above, and where the risk of subsequent diagnostic procedure-associated miscarriage is 2% and below. Women preferred screening tests offering more accurate results over no risk of miscarriage. Pregnant women place more value than non-pregnant women on tests carried out during the first trimester. Conclusion. Policies for the implementation of antenatal screening programmes for Down syndrome must consider the preferences of pregnant and non-pregnant women to ensure that the needs of current and potential future service users are met. Effective pre-test counselling is essential to ensure that women understand the attributes of any screening test and its possible implications. [ABSTRACT FROM AUTHOR]

Background Today, options for bleeding-free lifestyle are actively promoted by the media, the pharmaceutical industry and health specialists. With regard to contraceptive counselling it is important to find out what women really want. Methods In the present study we collected information on women's attitudes towards monthly bleeding and preferences, if they could have the option to modify their individual bleeding pattern. Furthermore we evaluated the preferences with use of combined hormonal contraceptives (CHCs). Switzerland has never been surveyed before with regard to these issues. Questionnaires were distributed in our family planning clinic and two outdoor offices to clients aged 15 to 19 years, 25 to 34 years, and 45 to 49 years. Results Of 530 questionnaires, 292 were eligible for analysis. Around 50 of the participants would appreciate having fewer menstrual period-related symptoms. Some 37% preferred experiencing a monthly bleeding; 32% opted for every 2 to 6 months; and 29%, for no bleeding at all. This heterogeneous distribution did not differ between clients with and without menstrual symptoms. With regard to CHC use, predictable bleeding was rated as very positive and breakthrough bleeding as negative. Conclusion Contraceptive counsellors should be aware that women's wishes differ widely. Predictability of bleeding seems to be more important to them than postponing it. Chinese Abstract 摘 要 背景 如今媒体、药厂以及健康专家都在积极地倡导选择一种没有月经的生活方式。但是，在做避孕药咨询的时候，了解什么是妇女真正需要的才是至关重要的。 方法 在这项研究中，我们收集关于妇女对月经的态度，以及如果妇女有机会改变她们的月经模式，她们的选择信息。另外，我们评估了使用复方激素避孕药（CHCs）的妇女对月经模式的选择。以往在瑞士还未曾有人做过这方面的调查。在研究中，我们通过我们的计划生育门诊以及两个离苏黎世较近的妇科诊所向15-19岁，25-34岁，45-49岁这三个年龄段的妇女发放调查问卷。 结果 在发出的530份问卷中，有292份是有效的。50%的参加者希望月经期的相关症状是较轻的。37%的妇女希望每月有月经，32%的妇女倾向2-6个月一次，29%的妇女愿意没有月经。是否有月经期的症状并不会影响这种选择差异的分布。在使用避孕药的妇女中，可预测的出血被看做是避孕药最好的作用，而突破性的出血则被认为是最大的副作用。 结论 避孕药的咨询者需要意识到妇女对月经的要求是有很大差异的。对于避孕药的使用，可预测的出血模式比推迟月经更为重要。 [ABSTRACT FROM AUTHOR]

Background: Over the last three decades, cesarean section (CS) rates have been rising around the world despite no associated improvement in maternal and perinatal mortality and morbidity. The role of women's preferences for mode of delivery in contributing to the high CS rate remains controversial; however these preferences are difficult to assess, as they are influenced by culture, knowledge of risk and benefits, and personal and social factors. In this qualitative study, our objective was to understand women's preferences and motivational factors for mode of delivery. This information will inform the development and design of an assessment aimed at understanding the role of the women's preferences for mode of delivery. Methods: We conducted 4 focus group discussions (FGDs) and 12 in-depth interviews with pregnant women in Buenos Aires, Argentina in 4 large non-public and public hospitals. Our sample included 29 nulliparous pregnant women aged 18-35 years old, with single pregnancies over 32 weeks of gestational age, without pregnancies resulting from assisted fertility, without known pre-existing medical illness or diseases diagnosed during pregnancy, without an indication of elective cesarean section, and who are not health professionals. FGDs and interviews followed a pre-designed guide based on the health belief model and social cognitive theory of health decisions and behaviors. Results: Most of the women preferred vaginal delivery (VD) due to cultural, personal, and social factors. VD was viewed as normal, healthy, and a natural rite of passage from womanhood to motherhood. Pain associated with vaginal delivery was viewed positively. In contrast, women viewed CS as a medical decision and often deferred decisions to medical staff in the presence of medical indication. Conclusions: These findings converge with quantitative and qualitative studies showing that women prefer towards VD for various cultural, personal and social reasons. Actual CS rates appear to diverge from women's preferences and reasons are discussed. [ABSTRACT FROM AUTHOR]

The latent phase of labor can vary greatly in duration, and many women are uncertain about when to contact the maternity unit. The aim of this study was to elicit and value women's preferences for some aspects of labor management. A questionnaire was sent to 1,251 women who had recently given birth to their first child at one of 14 maternity units in Scotland. Discrete choice questions were used to measure women's preferences for five attributes of care: number of visits (assessments) before admission to the labor ward, time spent on the labor ward before delivery, mobility during labor, pain relief required, and mode of delivery. Responses were analyzed for the sample as a whole and for subgroups defined by recent experiences of labor. A total of 730 (58.4%) questionnaires were returned and analyzed. Women expressed a preference for fewer visits before admission, shorter times on the labor ward before delivery, mobility during labor, normal vaginal deliveries, and moderate forms of pain relief (Entonox and opiates). Subgroup analysis suggests that women's preferences for pain relief are influenced by their recent labor experience. The elicited preference values provide a means for estimating the tradeoffs women are willing to make between attributes of labor management. Women appear to dislike being turned away from the labor ward before admission for delivery. Extra visits before admission only appear to be a price worth paying if they result in reductions in the duration of time spent on the labor ward, reductions in the chance of being immobilized in hospital during labor, or a lower chance of requiring an instrumental or operative delivery. (BIRTH 38:1 March 2011) [ABSTRACT FROM AUTHOR]

Miscarriage is the most common complication of pregnancy, which creates a significant workload for health-care professionals. For decades, surgical evacuation of the uterus has remained the conventional treatment of first-trimester miscarriage. Recently, non surgical treatments have been introduced with increasing popularity. This review explores the evidence in support of expectant management of first-trimester miscarriage. It is safe, effective and well-tolerated by women. It enhances women's choice and control. It generates significant cost savings compared with the traditional surgical management. Accurate diagnosis, counselling, 24/7 telephone advice and follow-up are among the important aspects of expectant management. More studies are needed to develop methods for identifying miscarriages suitable for expectant management. [ABSTRACT FROM AUTHOR]

Objective: To elicit women's preferences for attributes of alternative management options for first-trimester miscarriage. Methods: A stated preference discrete-choice experiment was conducted among 1198 women with a confirmed pregnancy of less than 13 weeks gestation, who had been diagnosed with either an incomplete miscarriage or missed miscarriage/early fetal demise and who had been recruited as part of a randomized controlled trial (miscarriage treatment [MIST] trial) comparing expectant, medical, and surgical miscarriage. Six attributes, each with three or four levels, were used in the statistical design. An orthogonal main effects design was generated (i.e., a design where the attributes are independent of each other) and the choice sets devised according to the principles of minimum overlap and level balance. A cost attribute was included to allow estimation of willingness to pay (WTP) values. Three different questionnaires were designed such that women were asked their preferences for attributes of the two management options they had not been allocated to in the trial. Results: A total of 630 women completed the stated preference discrete-choice survey questionnaires: 189 out of 398 women (47.5%) allocated to expectant management, 223 out of 398 women (56.0%) allocated to medical management, and 218 out of 402 women (54.2%) allocated to surgical management. For each of the three discrete-choice survey questionnaires, women expressed a clear preference for decreased levels of all six attributes (time spent at the hospital receiving treatment, level of pain experienced, number of days of bleeding after treatment, time taken to return to normal activities after treatment, cost of treatment to women, and chance of complications requiring more time or readmission to hospital). For each of the three discrete-choice survey questionnaires, the highest valued attribute in terms of WTP was for a reduction in pain levels followed by time taken to return to normal activities after treatment. On aggregate, surgical management was valued more highly than expectant and medical management by women allocated to medical and expectant management, respectively, and medical management was valued more highly than expectant management by women allocated to surgical management. This held true regardless of the application of either hypothetical data for each attribute generated by the pretrial-designed discrete-choice experiment questionnaires or actual data for each attribute observed in the MIST trial. Conclusions: The preference results generated by this study suggest that many women undergoing management of first-trimester miscarriage would value being offered alternatives to expectant management. The data from this study should be considered by decision-makers in conjunction with the clinical and cost-effectiveness evidence base in this area as well as consideration of the budgets available to them for such services. [ABSTRACT FROM AUTHOR]

Background: Perinatal depression is associated with potential negative consequences for the mother and infant, and therefore efforts to improve treatment access and efficacy are warranted. The purpose of this study was to examine pregnant women’s preferences and attitudes about treatment for depression, and perceived potential barriers to accessing treatment. Methods: Data were collected by means of a questionnaire from a convenience sample of 509 predominantly well-educated, high-income, married women in the northeastern United States during the last trimester of pregnancy. Participants were queried as to treatment modalities in which they would most likely participate if they wanted help for depression, their attitudes toward psychotherapeutic and pharmacological treatments, and perceived barriers to receiving help. Results: Most women (92%) indicated that would likely participate in individual therapy if help was needed. Only 35 percent stated that they would likely take medication if recommended, and 14 percent indicated that they would participate in group therapy. The greatest perceived potential barriers to treatment were lack of time (65%), stigma (43%), and childcare issues (33%). Most women indicated a preference to receive mental health care at the obstetrics clinic, either from their obstetrics practitioner or from a mental health practitioner located at the clinic. Factors associated with acceptability of various depression treatments are presented. Conclusions: Understanding what prevents women from seeking or obtaining help for depression and determining what they prefer in the way of treatment may lead to improved depression treatment rates and hold promise for improving the overall health of childbearing women. (BIRTH 36:1 March 2009) [ABSTRACT FROM AUTHOR]

Objective: New human papillomavirus (HPV) DNA technologies for the detection and prevention of cervical cancer have led to exciting changes in cervical cancer screening worldwide. Their introduction, however, has left many women with unanswered medical and psychosocial HPV questions. This study considered the degree to which women''s own HPV questions were addressed in Australian cervical cancer screening patient information leaflets. Methods: Based on previous qualitative research that asked women to identify their own HPV information needs, categories of interest were identified and a coding framework was developed. Manifest content analysis was conducted by counting the number of times a category of interest was stated in the text of the patient information leaflets (n =75). Latent content analysis methodology was employed to assess the underlying and embedded meaning within the leaflets. Results: Women''s medical questions were addressed more frequently than psychosocial ones. Leaflets were designed for specific target audiences (Aboriginal, lesbian, older women, women with disabilities, HPV-specific, cervical cancer-specific and general Pap screening) and the type and amount of HPV information varied by group. Merging the manifest and latent results, we identified three broad themes for discussion: the medicalisation of women''s cervical screening experience, the purpose and target audience of cervical screening leaflets and HPV as a community versus women''s health issue. Conclusions: Women''s questions on HPV were inconsistently and often inadequately answered. Practice implications: In order that women''s information needs are met, more accurate and balanced representations of medical and psychosocial HPV information should be provided in patient information leaflets. [Copyright &y& Elsevier]

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Abstract: Human mate preferences are related to many morphological traits, such as female waist-to-hip ratio (WHR), body mass index (BMI), male height or facial symmetry. People also vary in preferences for sexual dimorphism in stature (SDS=male height/female height) between themselves and a potential partner. Here, we demonstrate that women adjust their preference for SDS not only in relation to their own height but also in relation to (1) the phase of menstrual cycle during which their preferences were studied and (2) the sexual strategy (short- versus long-term) they were asked to choose. Taller males (larger SDS) were preferred more often when women were in the follicular (i.e. fertile) phase of their menstrual cycle and when the partners were chosen for short-term relationships. These effects were independent of woman''s height. The results show that women in a potentially fertile phase of their menstrual cycle and when choosing a partner who might be less likely to invest in children select genes of taller males. [Copyright &y& Elsevier]

Background: Single-nucleotide polymorphism (SNP) gene test is a potential tool for improving the accuracy of breast cancer risk prediction. We seek to measure women's preferences and marginal willingness-to-pay (mWTP) for this new technology., Materials and Methods: We administered a discrete choice experiment (DCE) to English-speaking Singaporean women aged 40-69 years without any history of breast cancer, enrolled via door-to-door recruitment with quota sampling by age and ethnicity. DCE attributes comprise: 1) sample type (buccal swab and dried blood spot), 2) person conducting pretest discussion (specialist doctor, non-specialist doctor, and nurse educator), 3) test location (private family clinic, public primary-care clinic, and hospital), and 4) out-of-pocket cost (S$50, S$175, and S$300). Mixed logit model was used to estimate the effect of attribute levels on women's preferences and mWTP. Interactions between significant attributes and respondent characteristics were investigated. Predicted uptake rates for various gene testing scenarios were studied., Results: A total of 300 women aged 52.6±7.6 years completed the survey (100 Chinese, Malay, and Indian women, respectively). Sample type ( P =0.046), person conducting pretest discussion, and out-of-pocket cost ( P <0.001) are significantly associated with going for SNP gene testing. Women with higher income and education levels are more willing to pay higher prices for the test. Preferences in terms of mWTP across ethnic groups appear similar, but Chinese women have greater preference heterogeneity for the attributes. Predicted uptake for a feasible scenario consisting of buccal swab, pretest discussion with nurse educator at the hospital costing S$50 is 60.5%. Only 3.3% of women always opted out of the SNP gene test in real life. Reasons include high cost, poor awareness, and indifference toward test results., Conclusion: SNP gene testing may be tailored according to individual preferences to encourage uptake. Future research should focus on outcomes and cost-effectiveness of personalized breast cancer screening using SNP gene testing., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Choice of a medical or surgical method of termination for fetal anomaly (TFA) is advocated in national guidelines based on a similar risk profile. We investigated whether women are offered a choice of method, by surveying members of a UK parent support organisation. An online questionnaire was designed to examine respondents' experience of TFA. A total of 351 responses were included in the final analysis. TFAs after 24 weeks' gestation and selective reductions were excluded. Mean gestational age at TFA was 17 weeks; 14% (n = 50) were offered a choice of method, falling to 8% (n = 19) after 14 weeks' gestation. Overall, 78% (n = 275) underwent medical TFA with 88% stating they chose it because it was the only method offered; 60% (n = 30) of those offered a choice had a surgical TFA. Our survey suggests that women having TFA are not offered a choice of method. Service delivery should be improved to meet national guidance and women's needs.

Objective: Evaluate tools to help pregnant women with prior cesareans make informed decisions about having trials of labor., Design: Randomized comparative trial., Setting: A research assistant with a laptop met the women in quiet locations at clinics and at health fairs., Participants: Pregnant women (N = 131) who had one prior cesarean and were eligible for vaginal birth after cesarean (VBAC) participated one time between 2005 and 2007., Methods: Women were randomized to receive either an evidence-based, interactive decision aid or two evidence-based educational brochures about cesarean delivery and VBAC. Effect on the decision-making process was assessed before and after the interventions., Results: Compared to baseline, women in both groups felt more informed (F = 23.8, p < .001), were more clear about their birth priorities (F = 9.7, p = .002), felt more supported (F = 9.8, p = .002, and overall reported less conflict (F = 18.1, p < 0.001) after receiving either intervention. Women in their third trimesters reported greater clarity around birth priorities after using the interactive decision aid than women given brochures (F = 9.8, p = .003)., Conclusion: Although both decision tools significantly reduced conflict around the birth decision compared to baseline, more work is needed to understand which format, the interactive decision aid or paper brochures, are more effective early and late in pregnancy., (© 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.)