The Perfect Storm: How Pro-Abortion Activists in the Netherlands Incite Social Change From International Waters

This project is a sociological ethnography of the Women on Waves foundation, founded in 1999 by Dr. Rebecca Gomperts. As an international non-profit organization, they employ a direct action method: sailing to countries where abortion is illegal and providing safe abortion access. Local women board the ship that then travels 12 miles to international waters, where Dutch law applies, and the abortion pill can be administered legally. Using a feminist perspective, I interviewed five of the women at the organization in addition to the ship’s captain in order to understand the ideological beliefs about the reproductive rights that have inspired and motivated the organization’s mission. I examine their personal stories by critically looking at how they speak about their activism and the significance of these memories in their lives. I approach my study of the organization after a comprehensive summary of the history of abortion legalization in the Netherlands, specifically looking at pro-abortion feminist activism in the 1970s. Within the historical and socio-cultural framework of Dutch society, I discuss the history of the Women on Waves foundation and then provide a portrait of each interview. I also analyze the interviews as a collective group through thematic trends. I have come to the conclusion that through creative strategies, daring actions, and fervent passion, their ship will continue to help women everywhere to attain access to safe abortion and accurate reproductive health information

Predicting Venous Thromboembolism in Obese Pregnant Women in a National Study

Venous thromboembolism (VTE) in pregnancy and postpartum is a leading cause of maternal morbidity and mortality in developed countries, where obesity is a known risk for this complication. Current guidelines vary in which patients qualify for VTE prophylaxis, precluding a uniform approach for management. The purpose of this study was to derive a risk prediction model for VTE in obese pregnant women. We performed a retrospective cohort analysis using the Consortium on Safe Labor (CSL) database. The CSL includes detailed information from the electronic medical record for \u3e200,000 deliveries from 19 hospitals across the United States from 2002 through 2008. Women ages 16-45 who were pregnant with singletons and had an obese body mass index (BMI\u3e30kg/m2) were included in our study population. Maternal characteristics and preexisting conditions as well as pregnancy-related conditions and complications were analyzed to identify differences between those had a VTE and those who did not. Multivariable logistic regression was used in order to identify predictors of VTE. Of the 83,500 women who met inclusion criteria, on average women were 27.8 ± 6.0 years old, 38.6 ± 2.21 weeks gestation, with BMI of 35.8 ± 5.45 kg/m2, and cesarean delivery (CD) incidence of 35.2%. The racial makeup of our cohort was 45.1% Caucasian, 27.2% African American and 20.2% Hispanic women. 109 women (0.13%) experienced a VTE event. Independent predictors of VTE in our final multivariable predictive model included: mode of delivery, BMI, pregestational diabetes, chronic heart disease, preeclampsia, blood transfusion (intrapartum or postpartum), prenatal history of thromboembolic disorder, and postpartum maternal length of stay. A receiver operating characteristic curve was developed to assess the model; area under the curve was 0.826. We developed a strong predictive model using a large, retrospective database to distinguish risk of VTE in obese pregnant women, which may provide the foundation for future protocol development of obstetrical thromboprophylaxis in obese women

Developing a model for predicting venous thromboembolism in obese pregnant women in a national study

© 2020 Elsevier Ltd Introduction: Venous thromboembolism (VTE) in pregnancy and postpartum is a leading cause of maternal morbidity and mortality in developed countries, where obesity is a known risk for this complication. Current guidelines vary in which patients qualify for VTE prophylaxis, precluding a uniform approach for management. We sought to derive a risk prediction model for VTE in obese pregnant women. Materials and methods: We performed a retrospective cohort analysis using the Consortium on Safe Labor (CSL) database. Women ages 16–45 who were pregnant with singletons and had an obese body mass index (\u3e30 kg/m2) were included in our study population. Multivariable logistic regression was used in order to identify predictors of venous thromboembolism. Results: Of the 83,500 women who met inclusion criteria, on average women were 27.8 years old, 38.6 weeks gestation, with body mass index of 35.8, and cesarean delivery incidence of 35.2%. 109 women (0.13%) experienced a VTE event. Independent predictors of VTE in our final multivariable predictive model included: mode of delivery, body mass index, pregestational diabetes, chronic heart disease, preeclampsia, blood transfusion (intrapartum or postpartum), prenatal history of thromboembolic disorder, and postpartum maternal length of stay. A receiver operating characteristic curve was developed to assess the model; area under the curve was 0.826. Conclusions: We developed a strong predictive model using a large, retrospective database to distinguish risk of VTE in obese pregnant women, which may provide the foundation for future protocol development of obstetrical thromboprophylaxis in obese women

Blood type association with bleeding outcomes at delivery in a large multi-center study

© 2019, Springer Science+Business Media, LLC, part of Springer Nature. Postpartum hemorrhage is a leading cause of maternal death globally. Recent studies have associated Type-O group to increased risk of bleeding. We aimed to determine if women with Type-O blood are at higher risk of PPH. This is a retrospective cohort analysis of a multi-center database included women admitted to labor and delivery from January 2015 to June 2018. All deliveries resulting in live birth were included. Association between Type-O and non Type-O were examined using chi-square test and fishers exact test. Prevalence of postpartum hemorrhage, estimated blood loss, drop in hematocrit and red blood cell transfusion were compared. The matched sample included 40,964 Type-O and the same number of no Type-O. The overall prevalence of postpartum hemorrhage was 6.4%, and there was no difference in the prevalence of PPH among Type-O compared to non Type-O (6.38% vs. 6.37% respectively; p = 0.96). There was no difference in hematocrit drop and estimated blood loss between Type-O and non Type-O in all deliveries. However, in cesarean delivery there was a significant difference in blood loss among the two groups. Finally, Type-O had 1.09-fold increased risk for transfusion compared to non Type O (95% CI 0.9–1.34). There is an association between Type-O group and risk of bleeding in women undergoing cesarean delivery. More prospective studies, taking into account coagulation profile, platelet count and tissue factors, are needed to draw a conclusion on whether ABO system can be considered a heritable risk of postpartum hemorrhage