Parity-specific fertility intentions and uncertainty: the United States, 1970 to 1976

A theoretical and analytic model of fertility intentions is proposed which treats “don’t know” responses and other uncertain responses as distinct from more firm intentions. Methodologically, these analyses show that “don’t know” responses need not be treated as missing data, but instead are both valid and meaningful responses. Furthermore, eliminating these uncertain respondents would have the negative effects of distorting across survey comparisons in intentions due to shifts in aggregate uncertainty, reducing the likelihood of accurately detecting shifts in fertility intentions, and lessening the representatives of the sample analyzed. Substantively, in conjunction with Morgan (1981), these results show that the sharp 1965–76 decline in the likelihood of intending more births at parities 2 through 5 occurred as women halted childbearing at minimal acceptable levels and postponed further childbearing. With time (or age), this delayed fertility became fertility about which the respondent was uncertain and, finally, fertility foregone. Since 1970, similar shifts are observed at parities 0 and 1, perhaps foreshadowing an increase in voluntary childlessness and one-child families.     

Women who experience feelings of aversion while breastfeeding: A meta-ethnographic review

ProblemLimited literature is available about women who wish to breastfeed but experience unexpected feelings of aversion in reaction to their infant suckling at the breast while breastfeeding.BackgroundBreastfeeding benefits mothers, infants and society yet breastfeeding rates continue to fall below recommendations in part due to inadequate tailored support after hospital discharge. Influences on breastfeeding are complex and include many physiological, psychosocial and cultural factors.AimTo better understand the experience of women who have feelings of aversion during breastfeeding by synthesising the existing literature.MethodsMEDLINE, CINAHL, PsycINFO, Maternity and Infant Care databases were searched for relevant literature published between 2000 to 2019. Using Covidence software, five qualitative research studies were identified. Studies were then analysed using meta-ethnographic qualitative synthesis.FindingsFeelings of aversion during breastfeeding were described as visceral and overwhelming; leading to feelings of shame and inadequacy. This synthesis identified five findings; a central conceptual category of “it’s such a strong feeling of get away from me” with four key metaphors translated from this central conceptual category: “I do it because I feel it is best for my baby”, “I can’t control those feelings”, “I should be able to breastfeed my son and enjoy it”, and “I’m glad I did it”. This phenomenon may negatively affect a women’s sense of self and impact on the mother-infant relationship.ConclusionSome women who want to breastfeed can experience feelings of aversion while breastfeeding. The feelings of ‘aversion’ while breastfeeding can inhibit women from achieving their personal breastfeeding goals.     

“Open to all and everybody”? The Irish Film Board: accounting for the scarcity of women screenwriters

Despite the many social and cultural changes that have occurred in Irish society since the Irish Film Board was re-established in 1993, the Irish film industry remains strongly male dominated. Specifically, Irish women constitute a minority of produced screenwriters and writer/directors. This article contributes to an understanding of the discursive resources that key decision makers in the Irish Film Board draw upon in order to talk about gender. A number of interpretative repertoires are used to rationalize its position in relation to the dearth of women screenwriters, four of which are examined here: evasion and deflection; gender neutrality; project-led funding; and a difficulty making sense of entrenched gender issues, articulated here as “I don’t know.” Within the respondents’ repertoires an ideological dilemma can be identified in the conceptualization of gender as both relevant and irrelevant.     

Sexual Orientation and Sexual Health Care Needs: A Comparison of Women Beneficiaries in Outpatient Military Health Care Settings

ABSTRACT

The objectives of this study are to compare the sexual concerns, interest and experiences in discussing these concerns with their doctor for women of “Only Men” and “Some to Only Women” sexual orientation. A survey was mailed to women patients from two military outpatient settings, with 1,196 women responding. Of eligible respondents (N = 1,170), 90% reported “Only Men” and 10% reported “Some to Only Women” sexual orientation. Sexual concerns varied by sexual orientation, while interest and experience in discussing sexual concerns and desire for physicians to initiate the topic differed minimally. Women with “Some to Only Women” sexual orientation have both similar and differing sexual concerns compared to “male-only” oriented women. Larger primary care patient-based studies of sexual health care needs of sexual minorities are needed.     

Use of a Telephone Screener to Identify a Probability Sample of Gays,Lesbians, and Bisexuals

Abstract

Objectives. To examine public response to a telephone screener used to identify a probability sample of lesbians, gays, and bisexuals.

Methods.A telephone screener was designed to provide a representative sample of self-identified lesbians, gays, and bisexuals (LGB) in the 30 central cities of the 15 largest Consolidated Metropolitan Areas.

Results. Of 14,458 households contacted, 11,612 completed at least part of the survey. Of these, only 2.6% refused or responded “don't know” to the sexual orientation screener question. Respondents from the northeast were more reluctant to answer than respondents from the west.

Conclusions. The use of a screener on a national telephone survey to screen households for self-identified lesbian, gay, and bisexual adults was a successful way to generate a representative sample.     

Aboriginal women in rural Australia; a small study of infant feeding behaviour

BackgroundAboriginal women in rural areas have lower rates of breastfeeding than Australian averages. The reasons for this are poorly understood. Aboriginal people experience higher morbidity and increased rates of chronic disease throughout the life cycle. The protective effects of sustained breastfeeding could benefit rural Aboriginal communities.ObjectiveTo explore the factors impacting upon infant feeding choices in a rural Aboriginal Community.MethodsSemi-structured interviews were conducted with eight Aboriginal rural dwelling first time mothers. These women received a continuity of midwife and Aboriginal Health Worker model of care. Interviews were also undertaken with five Aboriginal Health Workers and two Aboriginal community breastfeeding champions. The analysis was integrated with a conventional literature review and was further developed and illustrated with historical literature. Indigenist methodology guided the study design, analysis and the dissemination of results.ResultsThree key themes were identified. These were “I’m doing the best thing for…” which encompasses the motivations underpinning infant feeding decisions; “this is what I know…” which explores individual and community knowledge regarding infant feeding; and “a safe place to feed” identifying the barriers that negative societal messages pose for women as they make infant feeding decisions. It appears loss of family and community breastfeeding knowledge resulting from colonisation still influences the Aboriginal women of today.DiscussionAboriginal women value and trust knowledge which is passed to them from extended family members and women within their Community. Cultural, historical and socioeconomic factors all strongly influence the infant feeding decisions of individuals in this study.ConclusionsEfforts to normalise breastfeeding in the culture of rural dwelling Aboriginal women and their supporting community appear to be necessary and may promote breastfeeding more effectively than optimal professional care of individuals can do.     

Rhetoric and Etiological Beliefs About Sexuality: Reader Responses to Cynthia Nixon’s New York Times Interview

In 2012, the U.S. actress Cynthia Nixon was quoted in the New York Times Magazine as having stated that “for me, it [being gay] is a choice. I understand that for many people it’s not, but for me it’s a choice, and you don’t get to define my gayness for me.” The interview attracted international media attention and public criticism by lesbian and gay activists. This article suggests a rhetorical approach to understanding etiological beliefs and provides a discursive analysis of 198 online comments by readers of Pink News, a gay news Web site that reported on Nixon’s controversial interview. This article explores common arguments used in readers’ comments about Nixon and examines the rhetorical construction of sexuality. The analysis examines three themes within the data. First, biological essentialism was treated by many readers as common knowledge; second, readers suggested that only bisexuals have “choice”; and, third, it was suggested by both Nixon’s critics and her supporters that counterarguments colluded with homophobia. The article suggests that there is an ideological dilemma whereby both “born-this-way” and “choice” arguments can be understood as colluding with anti-gay prejudice.     

The experiential knowledge of migrant women about vulnerability during pregnancy: A woman-centred mixed-methods study

ProblemWithin maternity care policies and practice, pregnant migrant women are regarded as a vulnerable population.BackgroundWomen’s experiential knowledge is a key element of woman-centred care but is insufficiently addressed in midwifery practice and research that involves migrant women.AimTo examine if pregnant migrant women’s experiential knowledge of vulnerability corresponds with sets of criteria of vulnerability, and to explore how migrant women make sense of vulnerability during pregnancy.MethodsA sequential two-phased mixed-methods study, conducted in the Netherlands, integrating survey data of 89 pregnant migrant women and focus group data obtained from 25 migrant mothers - living in deprived areas according to the Dutch socio-economic index.ResultsCriteria associated with vulnerability were reported by 65.2% of the participants and 62.9% of the participants reported adverse childhood experiences. On a Visual Analogue Scale, ranging from 0 (not vulnerable) to 10 (very vulnerable), participants self-reported sense of vulnerability showed a mean score of 4.2 (±2.56). Women’s experiential knowledge of vulnerability significantly correlated with the mean sum score of clinical criteria of vulnerability (r .46, p .002) and with the mean sum score of adverse childhood experiences (r .48, p < .001). Five themes emerged from the focus group discussions: “Look beyond who you think I am and see and treat me for who I really am”, “Ownership of truth and knowledge”, “Don’t punish me for being honest”, “Projection of fear” and “Coping with labelling”.ConclusionPregnant migrant women’s experiential knowledge of vulnerability is congruent with the criteria. Calling upon experiential knowledge is an attribute of the humane woman-midwife relationship.     

Attitudes Toward Homosexuality in China: Exploring the Effects of Religion,Modernizing Factors,and Traditional Culture

Using the zero-inflated model and nationally representative sample data from the Chinese General Social Surveys 2013, this study systematically explored the effects of religion, modernizing factors, and traditional culture on attitudes toward homosexuality in China. The findings indicate that most Chinese people generally hold conservative attitudes toward homosexuality, as approximately 78.53% of the respondents believed that “same-sex sexual behavior is always wrong.” Modernizing factors (i.e., education, exposure to Internet information, and liberal inclinations) predicted greater tolerance for homosexuality, whereas Islamic beliefs negatively influenced respondents’ attitudes toward homosexuality. In contrast to the findings of the existing literature, Christian beliefs and traditional culture did not have significant effects on attitudes toward homosexuality. These findings may contribute to the literature by not only quantitatively testing the applicability of several factors identified in most Western studies of this topic but also providing new knowledge of attitudes toward homosexuality in the social context of China.     

Shared learning on an international clinical placement: Promoting symbiotic midwifery practice knowledge

AimThe aim of this study was to explore the experiences of shared learning between Australian and Balinese midwifery students during a two-week clinical placement in Bali Indonesia.BackgroundCultural safety in midwifery is a key concept that is underpinned by the provision of holistic quality midwifery care to all women. Therefore, culturally safe midwifery care identifies, protects and promotes women’s individual cultures and is a key concept that is fostered in midwifery education. To educate culturally safe midwives, international placements to resource limited countries have become more common within midwifery education programs.MethodsThis study used a qualitative research design with a convenience sampling design. The participants were enrolled in midwifery courses in a University in the Northern Territory of Australia (n = 9), a Balinese private midwifery school (n = 4) and a Balinese public midwifery school (n = 4). Thematic analysis was used to analyse the data.FindingsThe findings were categorised into major themes under the headings of “Learning together despite differences”; “Cultural differences”, “Communication, Resources”, and “Recommendations for future placements”.ConclusionThis study provides a valuable insight into how shared learning increases students’ midwifery knowledge and is fundamental in understanding cultural differences that could be applied to students’ clinical midwifery practice.     

“I Am Chelsea Manning”: Comparison of Gendered Representation of Private Manning in U.S. and International News Media

ABSTRACT

On August 22, 2013, Bradley Manning released a statement requesting to be referred to as female. In the following days, the news media discussed whether language should shift toward a female representation. Using quantitative content analysis and qualitative contextual analysis, this study analyzed whether U.S. and international newspapers (N = 197) acknowledged Manning’s request to be referred to as “Chelsea” in the two weeks after the statement. Results suggest that the mainstream press was hesitant in shifting toward a female representation. A comparison of international and U.S. newspapers suggests that the U.S. press lagged behind international coverage using a female depiction.     

“Some University Lecturers Wear Gay Pride T-shirts. Get Over It!”: Denials of Homophobia and the Reproduction of Heteronormativity in Responses to a Gay-Themed T-shirt

ABSTRACT

This article explores an incident involving a gay pride T-shirt, printed with the slogan “Some people are gay. Get over it!,” that I wore during a university lecture, and students’ predominantly negative responses to it. I use the lens of modern prejudice research, particularly discursive psychological approaches to modern prejudice, to interpret the students’ responses to a qualitative survey about their views on the T-shirt. They related strong feelings of upset and anger, particularly because I had—in their view—implicitly accused them of being homophobic. They passionately refused this supposed accusation on the grounds that “everything’s equal now” and “gay people are no different from us.” I argue that the ideological themes of cultural heterosexism and compulsory heterosexuality provide a productive framework for making sense of the students’ responses, as they sanction a rational neoliberal subject who is both non-homophobic and inculcated into heteronormativity.     

Homosexual not Homogeneous: A Motivation-Based Typology of Gay Leisure Travelers Holidaying in Cape Town,South Africa

ABSTRACT

The gay traveler, a segment of the lesbian, gay, bisexual, and transgender (LGBT) travel market, is perceived to be a homogeneous market segment as a result of the assumption that gay men have a unique “homosexual lifestyle.” This assumption is problematic as it conceals many other important variables, and it may hinder effective destination marketing. A Web-based electronic survey was completed by 469 gay male travelers, and attribute-based benefit segmentation was carried out by applying a hierarchical cluster analysis using Ward’s procedure with Euclidean distances. The typology is based on the push and pull framework; the motivations of travelers were assessed both in terms of their socio-psychological motivations and destination attributes of Cape Town. The typology empirically suggests that gay travelers are not homogeneous, and that sexuality influences the travel behavior of a minority of gay men. Consequently, not all gay travelers or activities by these travelers can be labeled as “gay” tourism.     

“Does the voice in your head get kinder as you get older?” Women’s perceptions of body image in midlife

ABSTRACT

This study aimed to identify attitudes and reactions toward physical changes in midlife women. A Facebook thread, presenting a series of comments related to an initial statement, instigated by a radio program was analyzed. The thread contained 87 responses to the question “Does the voice in your head get kinder as you get older?” Content analysis revealed positive (56%) and negative (40%) comments and four themes: physical changes with aging, the decreased importance of physical appearance, the importance of sociocultural influences, and the invisibility of women in midlife. Findings revealed both positive and negative body image experiences in women related to midlife and have implications for prevention.     

Epidurals during normal labour and birth — Midwives’ attitudes and experiences

BackgroundMidwives have their own beliefs and values regarding pain during childbirth. Their preferences concerning labour pain management may influence women’s choices.AimTo gain a deeper understanding of midwives’ attitudes and experiences regarding the use of an epidural during normal labour.MethodsA qualitative approach was chosen for data collection. Ten in-depth interviews were conducted with midwives working in three different obstetric units in Norway. The transcribed interviews were analysed using Malterud’s systematic text condensation.FindingsThe analysis provided two main themes: “Normal childbirth as the goal” and “Challenges to the practice, knowledge, philosophy and experience of midwives”. Distinctive differences in experiences and attitudes were found. The workplace culture in the obstetric units affected the midwives’ attitudes and their midwifery practice. How they attended to women with epidural also differed. An epidural was often used as a substitute for continuous support when the obstetric unit was busy.DiscussionMidwives estimate labour pain differently, and this might impact the midwifery care. However, midwives’ interests and preferences concerning labour pain management should not influence women’s choices. Midwives are affected by the setting where they work, and research highlights that an epidural might lead to a focus on medical procedures instead of the normality of labour.ConclusionMidwives should be aware of how powerful their position is and how the workplace culture might influence their attitudes. The focus should be on “working with” women to promote a normal birth process, even with an epidural.     

A complex and demanding situation – Midwifery preceptors and midwifery students’ experiences of teaching and learning prevention of severe perineal trauma

BackgroundMany high-income countries have seen an increase in severe perineal trauma. Teaching strategies and conditions for learning during the active second stage of labour are scarcely described.AimTo describe midwifery preceptors and midwifery students’ experiences’ of teaching and learning how to manage the second stage of labour, with the specific aim of preventing severe perineal trauma.MethodsA qualitative study with focus group discussions and individual in depth-interviews with preceptor midwives (n = 23) and student midwives (n = 10). Data were analysed by qualitative content analysis.Results“A complex and demanding situation with mutual need for feedback, reflection and safety” was the overall theme describing the conditions. Three sub-themes were identified. “Adapting to a unique situation” refers to the difficulty of teaching and learning the aspects needed to prevent severe perineal trauma, and to provide care during this stage. “Hindering and limiting circumstances” describes teaching strategies that were perceived negatively, and how midwifery students tried to adapt to the preceptors rather than the birthing women. “A trustful and communicative relationship” describes the importance of the relationship between the student and the preceptor, where communication was a central, but not obvious part.ConclusionAn increased awareness among preceptors is needed to optimize teaching strategies, enabling the students to focus on learning the art of the second stage of labour; supporting the woman, preventing severe perineal trauma and ensuring the safety of the unborn baby. Future research should address how existing prevention models can include training to increase preceptors’ confidence in teaching.     

Utilization of Health Care Among Female-to-Male Transgender Individuals in the United States

ABSTRACT

Female-To-Male (FTM) transgender individuals were approached at a conference and several peer support groups in the United States and asked to complete a short questionnaire regarding their medical care. Results from the 122 completed questionnaires indicated that a high number of respondents were taking testosterone (n = 106) and had some gender-confirming surgery (n = 68). Seventy percent of respondents rated their overall quality of health care “good” or “excellent.” A surprising finding was the low number (7%) reporting diagnoses of polycystic ovarian syndrome–the incidence of which has been reported elsewhere as high as 50%. Also notable were the high levels of employment, insurance, knowledge of standards of care, and access to providers, contrasting with reports from studies involving predominantly Male-To-Female (MTF) individuals. Finally, FTM's usage of transition-related medical resources can vary, but many within this study are foregoing genital surgery.