User:ReedNatalie/sandbox

Women's reproductive health in the United States
See also PCOS, ART

Add to the end of the Lead Section:

However, many issues still exist related to the accessibility of reproductive healthcare as well as the stigma and controversy attached to sexual health, contraception, and sexually transmitted diseases.

Pregnancy Complications in Women with PCOS (1.1.1 Sub-Subsection)

One in ten women of childbearing age in the U.S. are affected by Polycystic ovary syndrome (PCOS). Women with this condition are at a higher risk of experiencing complications during pregnancy. PCOS is a a medical condition compromised of hyperandrogegism, ovarian dysfunction and polycystic ovarian morphology (PCOM). The hormonal imbalance caused by PCOS can cause the egg to not properly develop or be released as would otherwise normally occur during ovulation in a healthy menstrual cycle. In the past, research of PCOS has been focused on diagnostics, symptoms, and effects such as infertility. Very little research has been done concerning complications than can result when a women with PCOS conceives. This is a very important condition to address as it can have major financial impacts on the lives of those diagnosed with PCOS. Currently, in the U.S. it can cost the healthcare system nearly four million dollar to treat women with PCOS, due to the many other conditions that PCOS can cause including: cardiovascular disease; pregnancy-induced hypertension and pre-eclampsia; miscarriage; infertility; and type 2 diabetes mellitus. There has also been some research conducted concerning the outcomes of the health of offspring born to mothers with PCOS. The results have proved inclusive, but they are thought to be at an increased risk of developing cardiovascular dysfunction and endocrine dysfunction.

Fertility Awareness Based Models (1.2.5 Sub-Subsection)
Fertility awareness based methods consist of non-hormonal or invasive contraceptive methods. These take the form of only having sex when a woman isn’t fertile, thus avoiding having sex during ovulation. Women can monitor her menstrual cycle pattern using calendar-based methods or symptoms-based methods. The most effective calendar-based method is the Standard Days Method, a method in which the woman doesn’t have sexual intercourse on days 8-19 of her cycle. One symptoms-based method is the TwoDay Method, a method where the woman checks for secretions twice a day and if she has had vaginal secretions that day or the day prior, she can potentially get pregnant. A second symptoms-based method is the Sympto-thermal method, which combines a woman’s observations of her vaginal secretions with the use of an electric hormonal fertility monitor which detects urine hormones. One benefit of using fertility awareness based method is that there are no side effects or health issues as no drugs or implants are used.

Assisted Reproductive Technology (1.1.2 Sub-Subsection)
Infertility is an increasingly common issue among women of reproductive age. The CDC estimates 6% of women between the ages of 15 and 44 in the U.S. cannot get pregnant after one year of trying. Along with medicine and surgery, one growing treatment for infertility is assisted reproductive technology (ART). ART describes any method in which both eggs and embryos are manipulated outside the woman’s body, of which in vitro fertilization (IVF) is the most common type. In 2015, 1.7% of all live births in the U.S. were the result of ART. While this method of conception is becoming more common, it is still a highly complex and debated issue. ART has been associated with many adverse health outcomes including an increased risk of birth defects, and a 1.71 increased risk of preeclampsia among women. Success rates for ART are improving yet vary significantly and are particularly dependent on age. For instance, for women younger than 35 the average success rate of ART in 2015 was 31% compared to 16% for those aged 38-40, and 3% for those over 44 years of age.

Race and Reproductive Health (1.4 Subsection)
In the United States, reproductive health disparities exist between white and minority women. Historical abuses and experimentation on Black women by medical professionals has led to greater distrust of the medical community. Additionally, current racial biases held by medical personnel affect medical care of Black and minority women. Compared to white women, the rate of HIV infection is disproportionately high in Black and Hispanic women. These groups account for 75% of infection among women. There is also a gap in contraceptive use between white and Black women. These disparities are partly due to lack of health insurance and financial costs. Comprehensive gynecological care can also help reduce the rates of HIV in minority women and increase contraceptive use. The lack of reproductive health is a contributing factor in higher rates of maternal mortality in the United States among minority women, especially among Black women. Black women are 3.3 times more likely than white women to die from pregnancy-related causes. This is partly due to lack of insurance before pregnancy and higher rates of chronic conditions, such as obesity and diabetes. Furthermore, there are disparities in the use and success of ART among racial and socio-economic groups given the high costs, limited access, and varied utilization. A review of all U.S. studies that considered race and ethnicity when reporting success rates for ART, found white women consistently had the highest success rates, followed by Hispanic and Asian women, and African American women.