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Grace KT, Jeffers NK, Tringali T, Farley CL. The Changing Landscape of Gendered Language in Pregnancy and Birth: Editors' Experiences. J Nurs Educ 2024:1-4. [PMID: 38916860 DOI: 10.3928/01484834-20240423-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND The revision of a textbook covering prenatal and postnatal care provided our editorial team with an opportunity to critically examine language choices and incorporate gender-inclusive language. METHOD Guided by scientific evidence, professional recommendations, editorials, and a deep respect for the humanity of our clients, we undertook this task with humility and determination. RESULTS This article describes the societal and clinical imperative for this change, the strategies and resources we used to make these changes, and our experiences in discussing these changes and coming to consensus with contributing authors. CONCLUSION Challenges are discussed, as well as recommendations for authors and editors. [J Nurs Educ. 2024;63(X):XXX-XXX.].
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Dol J, Campbell-Yeo M, Leahy-Warren P, Hambly LaPointe C, Dennis CL. Bibliometric analysis of published articles on perinatal anxiety from 1920 to 2020. J Affect Disord 2024; 351:314-322. [PMID: 38290588 DOI: 10.1016/j.jad.2024.01.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION Trends and gaps in perinatal anxiety research remain unknown. The objective of this bibliometric review was to analyze the characteristics and trends in published research on perinatal anxiety to inform future research. METHODS All published literature in Web of Science on perinatal anxiety from January 1, 1920 to December 31, 2020 were screened by two reviewers. VOSViewer was utilized to visualize linkages between publications. Bibliometric data were extracted from abstracts. RESULTS The search strategy identified 4561 publications. After screening, 2203 publications related to perinatal anxiety were used for the visualization analysis. For the bibliometric data, 1534 publications had perinatal anxiety as a primary focus. There were 7910 different authors, over half named only once (55.5 %), from 63 countries. 495 journals were identified, with over half (56.0 %) publishing only one article. Most articles were published between 2011 and 2020 (75.9 %). In terms of perinatal timing, over half (54.2 %) published on antenatal anxiety. Only 6.0 % of studies reported on perinatal anxiety in fathers and 56.5 % also reported on perinatal depression. LIMITATIONS Web of Science was solely used, and manual screening of each publication was required. CONCLUSION This bibliometric analysis found: (1) perinatal anxiety is a growing field of research, with publications increasing over time; (2) there is variation in authors and journals; (3) over half of the publications focus on antenatal anxiety; (4) paternal anxiety is understudied; and (5) only 6 % of publications came from low and lower-middle income countries. Gaps related to maternal postnatal anxiety and paternal perinatal anxiety exist.
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Affiliation(s)
- Justine Dol
- IWK Health, Halifax, Nova Scotia, Canada; Dalhousie University, Nova Scotia, Canada.
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Nova Scotia, Canada
| | | | | | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada; Lunenfeld-Tannenbaum Research Institute, Sinai Health, Ontario, Canada
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Peters JR, Stumper A, Schmalenberger KM, Taubman AJ, Eisenlohr-Moul TA. Improving rigor through gender inclusivity in reproductive psychiatric science. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 16:100194. [PMID: 37560411 PMCID: PMC10407113 DOI: 10.1016/j.cpnec.2023.100194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 08/11/2023] Open
Abstract
Accurately defining the individuals that research involves and generalizes to is critical for rigorous and reproducible science. In reproductive psychiatry, which historically focuses on the impact of the menstrual cycle, pregnancy, and menopause on mental health, this means moving beyond characterizing samples and relevant populations as "women" in favor of language that precisely identifies the physiological characteristics pertinent to the research being conducted and accurately reflects the varied genders represented in those populations. Concrete recommendations are provided for precise use of sex and gender terminology and gender inclusivity throughout the scientific process, including study conceptualization, etiquette in research environments, recruitment, methods, and dissemination. Recommendations are discussed in depth and presented in a checklist format for ease of use by research teams. Suggested items for assessing gender and relevant sex-related physiology in the context of reproductive psychiatry are also provided.
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Affiliation(s)
- Jessica R. Peters
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA
| | - Allison Stumper
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA
| | - Katja M. Schmalenberger
- Department of Psychiatry, University of Illinois at Chicago, 912 S. Wood Street, M/C 913, Chicago, IL 60612, USA
| | - Andy J. Taubman
- Youth Pride Inc, 743 Westminster St, Providence, RI 02903, USA
| | - Tory A. Eisenlohr-Moul
- Department of Psychiatry, University of Illinois at Chicago, 912 S. Wood Street, M/C 913, Chicago, IL 60612, USA
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Garrett SB, Simon MA. The Social Contexts of Birthing People with Public- and Private-Payer Prenatal Care: Illuminating an Understudied Aspect of the Patient Experience. Health Equity 2022; 6:898-908. [PMID: 36636111 PMCID: PMC9811847 DOI: 10.1089/heq.2021.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 12/14/2022] Open
Abstract
Purpose In pursuit of more equitable and person-centered health care, patients and professional medical societies increasingly call for better clinician understanding of patients' perspectives and social contexts. A foundational but understudied aspect of patients' social contexts are the ideas they encounter about health-related behaviors. We investigated this aspect of the social contexts of birthing people, comparing those with public versus private insurance to discover setting-specific insights. Methods Based on ethnographic fieldwork, we created an original survey featuring 29 statements about 12 prenatal, perinatal, and postpartum health behaviors (e.g., drinking alcohol, epidural use, breastfeeding). Participants were 248 individuals receiving prenatal care in Northern California in 2009-2011, split evenly between public- and private-payer coverage. Participants reported whether they were familiar or unfamiliar with each statement. Results Ninety-eight percent of all participants had heard contradictory ideas about ≥1 health behavior (mean=3.9 behaviors for public- and 5.4 for private-coverage respondents). For 20 of the 29 behavior-related ideas, exposure varied significantly by coverage type. Among other differences, public-coverage respondents were much more familiar with ideas related to risk and constrained autonomy (e.g., that serious perinatal complications are common; that new mothers should try to breastfeed even if they do not want to). Conclusions Birthing people are exposed to a wide range of ideas about health behaviors, many of which vary by the structural systems in which they are embedded. Understanding and engaging this complexity can help clinicians to provide more respectful, person-centered, and equitable maternity care.
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Affiliation(s)
- Sarah B. Garrett
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA.,*Address correspondence to: Sarah B. Garrett, PhD, Philip R. Lee Institute for Health Policy Studies, 490 Illinois Street, Floor 7, San Francisco, CA 94158, USA,
| | - Melissa A. Simon
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Schnell A. Successful Co-Lactation by a Queer Couple: A Case Study. J Hum Lact 2022; 38:644-650. [PMID: 35795891 DOI: 10.1177/08903344221108733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION With cultural and social evolution and improvements in reproductive technology, an increasing number of babies are born to lesbian, gay, bisexual, transgender, intersex, queer and/or questioning, and asexual and/or ally parents. As parental roles and gender expression become more expansive, the role of breastfeeding a baby must naturally also expand to include the option of sharing of breastfeeding among parents, called co-lactation (Bamberger & Farrow, 2021). In most cases, co-lactation involves a gestational parent and a non-gestational parent. If a non-gestational parent desires to produce milk for the purpose of breastfeeding, they do so by inducing lactation. While interest in and research about induced lactation are developing quickly, little information is currently available about co-lactation. MAIN ISSUE A couple identifying as queer presented with concerns about inducing lactation in the non-gestational parent, as well as seeking assistance in managing a successful sharing of the breastfeeding relationship. MANAGEMENT Breast massage, milk expression, acupuncture, hormone therapy, and galactagogues, including domperidone, goat's rue, and malunggay (moringa oleifera) were used to initiate and establish lactation by the non-gestational parent. Parents shared the breastfeeding relationship equally and carefully managed milk expression when the other parent was breastfeeding to maintain or increase lactation. CONCLUSION With professional lactation support, commitment to a lactation plan, responsive parenting, and strong communication and cooperation between parents, two parents were able to successfully co-lactate for more than a year. Breastfeeding was shared equally and supplementation of breastfeeds was rarely needed.
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Affiliation(s)
- Alyssa Schnell
- International Board Certified Lactation Consultant®, St. Louis, MO, USA
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Palmquist AE, Asiodu IV, Tucker C, Tully KP, Asbill DT, Malloy A, Stuebe AM. Racial Disparities in Donor Human Milk Feedings: A Study Using Electronic Medical Records. Health Equity 2022; 6:798-808. [PMID: 36338802 PMCID: PMC9629910 DOI: 10.1089/heq.2022.0085] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The aim of this study was to evaluate differences in the use of pasteurized donor human milk (PDHM) by maternal race-ethnicity during postpartum hospitalization using electronic medical records (EMRs). MATERIALS AND METHODS A retrospective cohort study of all live-born infants at our academic research institution from July 1, 2014, to June 30, 2016, was conducted. EMR data were used to determine whether each infant received mother's own milk (MOM), PDHM, or formula. These data were stratified based on whether the infant received treatment in the Neonatal Critical Care Center. Generalized estimating equation models were used to calculate the odds of receiving PDHM by maternal race-ethnicity, adjusting for gestational age, birth weight, insurance, preferred language, nulliparity, and mode of delivery. RESULTS Infant feeding data were available for 7097 infants, of whom 49% were fed only MOM during their postpartum hospitalization. Among the 15.9% of infants admitted to neonatal critical care, infants of non-Hispanic Black (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.31-0.72), Hispanic (OR 0.65, 95% CI 0.36-1019), and Other (OR 0.63, 95% CI 0.32-1.26) mothers had lower rates of PDHM feedings than infants of non-Hispanic White mothers in the adjusted models. Among well infants, the use of PDHM was lower among non-Hispanic Black and Hispanic mothers (OR 0.25, 95% CI 0.18-0.36, and OR 0.38, 95% CI 0.26-0.56) compared with non-Hispanic White mothers. CONCLUSIONS Inequities in exclusive human milk feeding and use of PDHM by maternal race-ethnicity were identified. Antiracist interventions are needed to promote equitable access to skilled lactation support and counseling for PDHM use.
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Affiliation(s)
- Aunchalee E.L. Palmquist
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Address correspondence to: Aunchalee E.L. Palmquist, PhD, MA, IBCLC, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB-7445, Chapel Hill, NC 27599-7400, USA.
| | - Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, University of California, San Francisco, California, USA
| | - Christine Tucker
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kristin P. Tully
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Angela Malloy
- Momma's Village of Fayetteville, Fayetteville, North Carolina, USA
| | - Alison M. Stuebe
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Rioux C, Weedon S, London-Nadeau K, Paré A, Juster RP, Roos LE, Freeman M, Tomfohr-Madsen LM. Gender-inclusive writing for epidemiological research on pregnancy. J Epidemiol Community Health 2022; 76:823-827. [PMID: 35764388 DOI: 10.1136/jech-2022-219172] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023]
Abstract
People who have a uterus but are not cisgender women may carry pregnancies. Unfortunately, to date, academic language surrounding pregnancy remains largely (cis) woman-centric. The exclusion of gender-diverse people in the language of pregnancy research in English is pervasive. In reviewing a random sample of 500 recent articles on pregnancy or pregnant populations across health research fields, we found that only 1.2% of articles used gender-inclusive language (none of them in epidemiology), while the remaining 98.8% used (cis) woman-centric language. First and foremost, recent recommendations highlight the need to include trans, non-binary and gender-diverse people in study design. Meanwhile, there remains a lack of awareness that all research on pregnancy can contribute to inclusiveness, including in dissemination and retroactive description. We explain how the ubiquitous use of (cis) woman-centric language in pregnancy-related research contributes to (1) the erasure of gender diversity; (2) inaccurate scientific communication and (3) negative societal impacts, such as perpetuating the use of exclusionary language by students, practitioners, clinicians, policy-makers and the media. We follow with recommendations for gender-inclusive language in every section (ie, introductions, methods, results, discussions) of epidemiological articles on pregnant populations. The erasure of gender-diverse people in the rhetoric of research about pregnant people can be addressed immediately, including in the dissemination of results from ongoing studies that did not take gender diversity into consideration. This makes gender-inclusive language a crucial first step towards the inclusion of gender-diverse people in epidemiological research on pregnant people and other health research more globally.
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Affiliation(s)
- Charlie Rioux
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Scott Weedon
- Department of English, Texas Tech University, Lubbock, Texas, USA
| | - Kira London-Nadeau
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
- Sainte-Justine Hospital Pediatric Research Centre, Montreal, Quebec, Canada
| | - Ash Paré
- School of Social Work, McGill University, Montreal, Quebec, Canada
| | - Robert-Paul Juster
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Quebec, Canada
- Montreal Mental Health University Institute Research Centre, Montreal, Quebec, Canada
- Centre on Sex*Gender, Allostasis, and Resilience, Montreal, Quebec, Canada
| | - Leslie E Roos
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Harvard University Center on the Developing Child, Cambridge, Massachusetts, USA
| | - Makayla Freeman
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Lianne M Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada
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Farrow A. Letters to the Editor: Lively Discussions are Needed, but Not Ones That Erase Transgender People. J Hum Lact 2022; 38:523-524. [PMID: 35582992 DOI: 10.1177/08903344221098404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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9
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A Trauma-Informed and Gender-Inclusive Medical Nomenclature. Obstet Gynecol 2022; 140:115-120. [DOI: 10.1097/aog.0000000000004803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/10/2022] [Indexed: 11/25/2022]
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10
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Dodgson JE, Smith PH, Bamberger ET. Operationalizing the Journal of Human Lactation's Gendered Language Policy. J Hum Lact 2022; 38:221-226. [PMID: 35272528 DOI: 10.1177/08903344221082598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Paige Hall Smith
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC, USA
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Calvert K, Leathersich S, Howat P, Van Der Wal S. Time to make some noise about a quiet revolution. Aust N Z J Obstet Gynaecol 2022; 62:336-338. [PMID: 35396853 DOI: 10.1111/ajo.13530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
'Tomorrow belongs to those who can hear it coming' David Bowie. Language is a living entity that moves and changes. Use of gender-neutral language in medical literature is increasingly common. It is time for obstetricians and gynaecologists in Australia and New Zealand to interrogate their own bias and desire to maintain the status quo, and to consider reasons for change.
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Affiliation(s)
- Katrina Calvert
- Director of Postgraduate Medical Education, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Sebastian Leathersich
- RANZCOG Training Registrar, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Paul Howat
- Consultant Obstetrician and Gynaecologist, Divisional Director, Northern Health, Melbourne, Victoria, Australia
| | - Sarah Van Der Wal
- Consultant Obstetrician and Gynaecologist, Bendigo Health, Bendigo, Victoria, Australia
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Morton EK, McKenzie SK, Cooper A, Every-Palmer S, Jenkin GLS. Gender and intersecting vulnerabilities on the mental health unit: Rethinking the dilemma. Front Psychiatry 2022; 13:940130. [PMID: 36226107 PMCID: PMC9548606 DOI: 10.3389/fpsyt.2022.940130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Gender is routinely pitched as a key determinant of vulnerability for staff and residents on acute mental health inpatient units. Since the 1960's mixed gender units have become more prominent in Western health systems, yet questions remain around the configuration of these units, including how to ensure emotional and physical safety of those living and working in them. METHODS This paper draws on a large study of the lived experiences of 42 staff and 43 service users from different acute mental health units in New Zealand. We conducted thematic analysis of interview data from four units with diverse architectural layouts to identify key themes central to decisions around gender and spatial design. RESULTS Key themes emerged around gender-related trauma histories, safety perceptions and vulnerabilities, accommodation of gender-diverse and non-binary mental health service users, and gender-specific needs and differences. A further theme, of it goes beyond gender emphasized that there are many other non-gender attributes that influence vulnerability on the unit. CONCLUSIONS While findings emphasize the need for safe places for vulnerable people, trauma-informed care, access to staff who "understand," and recreation that is meaningful to the individual, we question if the dilemma of gender-separation vs. gender-mixing is an outmoded design consideration. Instead, we argue that a flexible, person-centered approach to provision of care, which values autonomy, privacy, and safety as defined by each service user, and that promotes choice-making, obviates a model where gender accommodations are fore. We found that a gender-exclusive narrative of vulnerability understates the role of other identifiers in dynamics of risk and vulnerability, including age, physicality, past violence, trauma history, mental unwellness, and substance use. We conclude gender need not be a central factor in decisions around design of prospective built unit environments or in occupational and clinical decisions. Instead, we suggest flexible spatial layouts that accommodate multiple vulnerabilities.
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Affiliation(s)
| | - Sarah K McKenzie
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Amy Cooper
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
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Affiliation(s)
- Joan E Dodgson
- Editor in Chief, Journal of Human Lactation, Honeoye Falls, NY, USA
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Bamberger ET, Farrow A. Gendered and Inclusive Language in the Preparation of Manuscripts: Policy Statement for the Journal of Human Lactation. J Hum Lact 2021; 37:227-229. [PMID: 33663263 DOI: 10.1177/0890334421995103] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Ethan T Bamberger
- 7712 Associate Editor, Journal of Human Lactation, Hartford, CT, USA
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- JHL Editorial Team are Sara Gill, PhD, Kathleen Marinelli, MD, Ellen Chetwynd, PhD, Laura Duckett, PhD, and Joan Dodgson, PhD
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