Racial and ethnic differences in perceptions of campus climate related to sexual violence.

Objective: To assess perceptions of university institutional climate related to sexual violence and whether these differed by race/ethnicity. Participants: Matriculated undergraduates > age 18 (n = 1028). Methods: Students were invited via campus email to participate in an online survey. Results: Overall, only 20% agreed that the university is creating an environment in which unwanted sexual experiences seemed common or normal, but these findings differed by race. Black students were more likely than their white peers to feel the university is creating an environment in which unwanted sexual experiences seem common or normal (37.3% vs. 19.7%, p < .001) and creating an environment in which such instances were more likely to occur (33.3% vs. 13.4%, p < .001). Conclusions: Data suggest that while students generally perceive that the university is working to create a positive and safe climate, these perceptions vary by race. Further investigation is necessary to better understand the concerns of students of color.

Peripartum Considerations for the Transgender Parturient: A Case Report.

Despite efforts by medical and social activists, transgender parturients encounter barriers to adequate and gender-inclusive health care, resources, and support. We present a case of a 38-year-old transgender man presenting for induction of labor at term. Our case highlights the importance of multidisciplinary planning, appropriate gender-related language, and interventions that may ameliorate gender dysphoria during childbirth. Because some transgender men may desire childbirth, we recommend that health care providers become familiar with and respectful of the unique considerations for this patient population in the peripartum setting.

Maternal sedation during scheduled versus unscheduled cesarean delivery: implications for skin-to-skin contact.

BACKGROUND: Early maternal skin-to-skin contact confers numerous benefits to the newborn, but maternal sedation during cesarean delivery could have safety implications for early skin-to-skin contact in the operating room. We compared patient-reported and observer-assessed levels of sedation during unscheduled and scheduled cesarean deliveries. METHODS: Laboring women undergoing unscheduled cesarean delivery with epidural anesthesia, and scheduled cesarean delivery with spinal anesthesia were enrolled. Sedation levels, measured using patient-reported (1=least sedated to 10=most sedated) and observer-assessed (0=most sedated to 5=least sedated) scales, were evaluated at baseline and 15, 30, 45, and 60min following a T4 sensory level. The primary outcomes were patient-reported sedation at 45min and the areas under the sedation curves. RESULTS: Patient-reported levels of sedation were greater at 45min in laboring women undergoing unscheduled (median 7.5, IQR 5-9) versus scheduled cesarean delivery (median 4, IQR 3-6) (difference in medians 3.5, 99% CI 0 to 5). Observer-assessed sedation was not different between groups. The area under the time curve for patient-reported sedation was greater in the unscheduled group, median difference 162 score min (95% CI 52 to 255). The area under the time curve for observer-assessed sedation was greater in the unscheduled group, median difference 26 score min (99% CI 0 to 41). Times to skin-to-skin contact and breastfeeding were not different. CONCLUSIONS: Women undergoing unscheduled cesarean deliveries are more sedated than women undergoing scheduled cesarean deliveries. Skin-to-skin protocols for cesarean deliveries must consider maternal sedation and anesthesiologists should use sedating medications judiciously.