To acknowledge International Women's Day on Mar. 8, this issue focuses on women's health and women in medicine. In addition to the Research articles highlighted on this page, we invite you to visit the News and Analysis section for an update on women's health research, a listing of Internet sites featuring women's health, a public health profile of ovarian cancer and a quick check of the "Pulse" of older women.
Medical career and parenting
FIGURE 1 Bibiana Cujec and colleagues have surveyed medical students, residents and physician teachers at the University of Saskatchewan to examine how career and parenting satisfaction varies by sex and level of training. At all levels of career stage women were more likely than men to be single, to be childless and to discourage their peers from becoming parents. Female physician teachers spent equal hours per week at work as their male counterparts (52 v. 58 hours) and more than twice as many hours per week on family and household work (36 v. 14 hours). Overall, physician teachers were most likely to recommend parenting to their peers. From their findings the authors conclude that the optimal time for parenthood appears to be after completion of medical training.
In an accompanying editorial Susan Phillips comments on how the solutions to juggling home and career are both obvious and elusive. She suggests that parents' psychological and time commitment to household work and parenting be equalized when both work outside the home, that the trend in the late 20th century of ever-expanding work hours be ended and that flexibility be fostered in the workplace to accommodate parenting.
See pages 637 and 663
The myth of rape
Why don't more women report sexual assault to the police? After reviewing the charts of 958 individuals seen between 1993 and 1997 by the Sexual Assault Service in Vancouver, Margaret McGregor and colleagues conclude that, among other factors, the presence of physical injury and the fact that the assailant was a stranger predicted police involvement. The authors are concerned that these results indicate that victims are influenced and inhibited by the perpetuated social myth that rape must involve physical injury by a stranger to be considered genuine.
See page 659
Neonatal hypernatremia and breast-feeding
FIGURE 2 The number of anecdotal reports of neonatal hypernatremia has been increasing. To explore a possible association with breast-feeding malnutrition, Verity Livingstone and colleagues reviewed the charts and interviewed the mothers of all neonates with a serum sodium level of more than 145 mmol/L who were seen at a Vancouver hospital or breast-feeding clinic during 1991-1994. Of the 21 cases identified, 5 of the mothers had failure of lactogenesis associated with postpartum blood loss, 7 had failure of galactopoiesis associated with inadequate breast stimulation, and 8 had inefficient milk removal associated with poor breast-feeding technique. The authors conclude that prenatal or early postpartum screening could have identified all of these factors.
See page 647
Self-collected Pap smears
FIGURE 3 Past sexual abuse, childhood trauma and fear of invasive procedures lead some women to cross their legs and say "No" to physician-collected Pap smears. Believing that these women might prefer to collect their own specimens, Ruth Elwood Martin ponders the problem and explores possible designs and techniques of self-collected cervical specimens. A design similar to the pet toothbrush might have potential, although the bristles would need to be reoriented.
See page 666
Footnotes
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March 7, 2000