Diagnosis of Pregnancy

Abstract

Contraceptive failure is a growing problem, especially on the college campus. Because of this, college health care providers are treating more and more college women not only for pregnancy-related problems, but women that present to the health center with other health complaints and are pregnant as well.

For these reasons, the diagnosis of pregnancy must always be entertained by all health care providers treating young women. Pregnancy must always be excluded before any tests or procedures are done that may be teratogenic. This is not only important for optimal health care, but also for medical-legal reasons.

This paper presents four unusual presentations of pregnancy and reviews the guidelines for diagnosis of pregnancy.     

Assimilation effects beyond the labor market: time allocations of Mexican immigrants to the US

I use the American Time Use Survey from 2003 to 2012 to analyze, from a gender and marital status perspective, how the time Mexican immigrants devote to market work, household production, personal care, and leisure activities compare to the corresponding time allocations of US natives. Furthermore, I estimate the effect of duration of residence in the US on the immigrants overall patterns of time use. Time diary evidence indicates that, upon arrival to the US, Mexican immigrant men devote more time to market work and commuting than comparable non-Hispanic natives, regardless of their marital status. On the other hand, Mexican immigrant women devote the same amount of time to these activities as the non-Hispanic reference groups, irrespective of the marital status. In addition, the trend data show that immigrant men decrease their paid work with years since migration while immigrant women increase it. Estimates indicate that, for married immigrant men there is a tradeoff between market work and household work, whereas for single immigrant men the tradeoff is between market work and leisure. Finally, Mexican immigrant women relinquish mostly passive leisure and sleep time to meet demands of family and market work.     

Educational Progress and Parenting Among Mexican Immigrant Mothers of Young Children

This study examined the potential for educational investments in Mexican immigrant mothers to enhance their management of their children's pathways through the educational system in the United States, which often disadvantages them. We tested this hypothesis with data on 816 Mexican immigrant women and their children from the Early Childhood Longitudinal Study–Kindergarten Cohort (ECLS‐K). The results suggest that mothers who pursued their own schooling over a 4‐year period, regardless of whether they obtained a degree, increased their engagement with their children's schools during that same period. The results appear to be robust to a wide range of factors that select women into continuing education.     

Battered Immigrant Mexican Women's Perspectives Regarding Abuse and Help-Seeking

SUMMARY

A qualitative, pilot study employing in-depth ethno-graphic interviews was conducted to examine perceptions and attitudes towards abuse and the help-seeking behaviors of a sample of ten battered immigrant Mexican women. Findings indicated that participants' attitudes about seeking help were influenced more by cultural factors (e.g., gender-role expectations, famialism) than by psycho-social stres-sors (e.g., immigrant status, financial dependency). Children's welfare played a salient role in women's decisions about seeking help, both as a deterrent and a motivating factor. Women's attitudes about their own abuse were more tolerant than their attitudes about hypothetical situations involving others. Changes in women's attitudes about abuse reflected changes only after some type of intervention had taken place. The majority of the women in the sample had misconceptions or were uninformed about shelters. Suggestions for further research and intervention with this population and a model of internal and external determinants of help-seeking behavior are presented.     

Reunification outcomes among Mexican immigrant families in the child welfare system

This study examined reunification outcomes among Mexican immigrant families involved in the child welfare system, and compared characteristics of Mexican-origin and non-immigrant children involved in the child welfare system. An exploratory retrospective longitudinal design using administrative data from two counties in Northern California was utilized. The quantitative sample (N = 2152) included children entering the foster care system for 8 or more days between January 1, 2001 and December 31, 2007 in the two participating counties. Child welfare administrative data (CWS/CMS) were merged with eligibility data (CalWIN) in order to obtain parent and child place of birth and citizenship status. Quantitative measures drawn from the merged CWS/CMS and CalWIN dataset included the following: demographic characteristics, immigrant characteristics, case characteristics and reunification outcomes. Results indicated that a significantly higher proportion of Mexican immigrant families (70.7%) were reunified than non-immigrant families (43.1%). Significant correlates of reunification among Mexican immigrant families included the following: mothers with authorized citizenship status (vs. unauthorized citizenship status), mothers whose primary language was Spanish (vs. English), and children with two or fewer placements (vs. three or more placements). Differences between Mexican-origin and non-immigrant children were that Mexican-origin children were older on average than non-immigrant children, and they were more likely to experience physical abuse, sexual abuse or emotional abuse; they were also more likely to be placed in foster care or a group home (vs. relative care). Implications for social work practice and policy are discussed.     

The Child Care Arrangements of Preschool-Age Children in Immigrant Families in the United States

This study examined the child care arrangements of children in immigrant families. Using data from the Survey of Income and Program Participation (SIPP), the study found great diversity in the child care arrangements of children according to their nativity status. Children in immigrant families, especially those in low‐income immigrant families, were found less likely to use centre‐based child care. Mexican, Asian, and other Hispanic children are also less likely to use centre‐based child care. Because quality centre‐based child care has been shown to benefit preschool‐age children and help prepare them for school, both scholastically and psychologically, less use of centre‐based child care among children in immigrant families compared to children in non‐immigrant families is a potentially troubling finding. Public policies promoting greater access to and more use of centre‐based child care, especially for low‐income immigrant families and two‐parent immigrant families, may make a significant difference to their children's long‐term adaptation, and their children's school readiness and achievement.     

Why Do Women Want Children? The Case of Hong Kong,China: A Lowest-Low Fertility Context

ABSTRACT

Governments in low fertility countries tend to tackle low birth rates by addressing macro-level factors rather than the meaning that having a child holds for men and women. Yet whether or not an individual decides to have a child depends in part on what they think having a child will mean for their lives. This study examines the meanings that constitute reasons for wanting a child among a sample of middle-class, married, Hong Kong Chinese women who wanted children. These women were living in Hong Kong when it had one of the lowest total fertility rates in the world and the lowest in its history. Using semi-structured, in-depth interviews, it finds that for these women, to have a child makes one’s family complete; is the next stage of life; provides happiness, fun, and enjoyment; brings care and company in old age; and children are “lovely” and “cute.” Governments concerned about low birth rates can use research on what having a child means for women to improve policy so as to make having a child more attractive, and to create messages that hold greater appeal to women.     

Parent Conflict as a Mediator Between Marianismo Beliefs and Depressive Symptoms for Mexican American College Women

Abstract

Objective: The purpose of this study is to examine how marianismo is related to the depressive symptoms of Mexican American women with family conflict as a mediator. Participants: During January of 2010, 170 Mexican American women college students in a southern, Hispanic-serving institution were sampled. Methods: A mediation analysis was conducted to determine if parent conflict mediates the relationship between marianismo values and depressive symptoms. Results: Results from Barron and Kenny's¹ mediation analysis method, in conjunction with a Sobel² test indicated that parent conflict significantly mediated the relation between marianismo and depressive symptoms. Conclusion: Findings and implications of the mediation will be discussed for the mental health and treatment of Mexican American women college students.     

Safe Motherhood in the Context of Nepal

ABSTRACT

Nepal ranks low on the Human Development Index and has a high maternal mortality rate. Various factors contribute to the high rate of maternal mortality and include a shortage of health care professionals, limited access to basic maternal health care, poverty, illiteracy, women's low social status, a poorly developed transportation system, a limited communication system, political conflict, and a diverse population. Interviews with pregnant women, observational data, and national statistics provide the basis for suggestions provided by the author. These include upgrading and opening new maternal care facilities, integrating midwives into local health services, providing education on women's health needs during pregnancy, and improving public awareness of the availability of maternal care services.     

Assessing Capacity to Change in High‐Risk Pregnant Women: A Pilot Study

Pre‐birth risk assessment is a process by which circumstances affecting an unborn child can be identified and support for mother and infant embedded. This mixed methods study describes a community‐based pre‐birth assessment and care pathway that utilised the Parents Under Pressure (PuP) programme to assess parenting capacity and provide support pre‐ and post‐birth for ‘at risk’ women. Sixty‐eight pregnant women referred to children's social care services were allocated to the pre‐birth assessment and care pathway (n = 35) or to routine care (n = 33). Standardised measures of psychological distress, social support and alcohol measured change for the women in the assessment and care pathway. Twenty women who provided pre‐ and post‐data reported significant improvements on all measures except alcohol use. Safeguarding outcomes at 12 months were obtained for both groups using administrative data. Forty‐two per cent of the infants whose mothers received the pre‐birth assessment and care pathway showed an improvement in child protection status compared to 14 per cent of the routine care infants. Safeguarding status deteriorated or stayed the same in 52 per cent of the routine cases compared to 26 per cent of those receiving the pathway. Qualitative data revealed that the pathway was acceptable and helpful to service users and service providers. Copyright © 2017 John Wiley & Sons, Ltd.

‘Describes a community‐based pre‐birth assessment and care pathway that utilised the Parents Under Pressure (PuP) programme’

Key Practitioner Messages

• The current project found that a community‐based pre‐birth assessment and care pathway with high‐risk pregnant women was feasible and acceptable for practitioners and service users.
• The pathway began mid‐pregnancy and support was provided following the birth of the infant for up to 12 months.
• Over 40 per cent of infants whose mothers were allocated to the pre‐birth risk assessment pathway showed improvements in child safeguarding status at 12 months.

     

Gender differences in immigrant health: the case of Mexican and Middle Eastern immigrants

This article draws on theories of gender inequality and immigrant health to hypothesize differences among the largest immigrant population, Mexicans, and a lesser known population of Middle Easterners. Using data from the 2000-2007 National Health Interview Surveys, we compare health outcomes among immigrants to those among U.S.-born whites and assess gender differences within each group. We find an immigrant story and a gender story. Mexican and Middle Eastern immigrants are healthier than U.S.-born whites, and men report better health than women regardless of nativity or ethnicity. We identify utilization of health care as a primary mechanism that contributes to both patterns. Immigrants are less likely than U.S.-born whites to interact with the health care system, and women are more likely to do so than men. Thus, immigrant and gender health disparities may partly reflect knowledge of health status rather than actual health.     

Race‐Ethnic Differences in Nonmarital Fertility: A Focus on Mexican American Women

We use the National Survey of Family Growth to identify race‐ethnic differences in nonmarital fertility, paying particular attention to Mexican American women. On the basis of a sample of 9,054 White, Black, and Mexican American women, we use event history methods to explore the role of family background, a woman’s own employment and school enrollment, and cohabitation on nonmarital fertility. We additionally determine whether these relationships vary by socioeconomic background. The above factors are all significantly related to the risk of a nonmarital birth and reduce Mexican American–White differentials. Interestingly, higher fertility within cohabiting unions among Mexican American women, despite lower levels of cohabitation, contributes to their higher nonmarital fertility relative to White women.     

Dynamics of Social Support

Abstract

This study challenged the current conceptualization of social support as a static process and attempted to explore how the sources and types of social support unfolded over time during mainland Chinese immigrant women's first year of resettlement in Hong Kong. A longitudinal qualitative method was used and 15 immigrant women were recruited. In-depth interviews using a semi-structured interview guide were conducted at three-monthly intervals. Results supported our view on the “stages within stage” assumption of the resettlement period of the migration-integration process. In the first quarter of resettlement, immigrant women mobilized a great deal of instrumental and information support from family members and kin to resolve survival issues such as finances, housing and childcare. However, the demand for instrumental support declined over time, and the need for emotional support appeared to peak at the second stage of the resettlement period. Fellow immigrant women were found to be the most significant providers of information, emotional and social companionship support to immigrant women throughout the resettlement period while the supporting roles of husbands and kin diminished. Lastly, immigrant women were less inclined to seek help from formal networks and rarely sought support from neighbors and co-workers. Socio-economic and cultural reasons were used to explain these differential support patterns during immigrants' first year of resettlement in Hong Kong, and implications for social work practices were discussed.     

Social geography and continuity effects in immigrant women's narratives of negative interactions

ObjectivesThe purpose of this study was to examine the role of social geography and continuity in ethnic identity in shaping immigrant women's exposure and reactions to interpersonal problems in old age.MethodsMore than 100 hours of semistructured, in-person interviews were conducted with 19 immigrant Japanese women about their views of interpersonal relationships including problems they experienced living in the Midwestern region of the United States.ResultsInterpersonal problems reported focused on exposure to a specific type of issue among a specific group: gossip within the immigrant community. Spatial distance from country of origin, desire for continuity to ethnic identity, and intragroup variation among Japanese residents in the Midwest were factors that resulted in an inability to terminate interpersonally troubled ties.DiscussionImmigrants' interpersonal problems are deeply connected to spaces and places lived and the human need for continuity. Contextual approaches are needed in gerontology to further understanding about negative interactions in late life across the population of older adults.     

The globalization of care work: Neoliberal economic restructuring and migration policy

Abstract

Significant scholarly research has focused on the ‘globalization of care work’, or how care has been distributed and redistributed in an international system where immigrant workers provide care in wealthier countries. We argue that nation-states, through a range of contradictory policies and bilateral agreements, explicitly create and reinforce the redistribution and internationalization of care work. We show how economic restructuring has helped create both demand for and a supply of immigrant care workers, while migration policies have played a key role in shaping migration flows. We examine two dyads of sending and receiving flows: Morocco/France and Poland/Germany. These cases share both similarities and differences, which allows us to consider how the global political and economic processes shaping the international division of care work play out in different contexts.     

Traumatic Responding in Children Exposed to Domestic Violence

Abstract

The present cross-cultural study summarizes the traumatic responses of Mexican, Mexican American, and non-Mexican American children who were residents of three shelters for battered women in Monterrey Mexico, McAllen Texas, and Ft. Worth Texas. Sixty-eight mothers reported on their children's (n = 90) individual and total traumatic symptoms. Findings revealed very slight differences in individual responses with no overall trauma symptom differences. Multiple regression analyses revealed that mothers' experiences of physical, and sexual abuse predicted greater trauma responses in children. Implications for practice with children and mothers in shelters for battered women are highlighted.     

Extended Family Integration Among Euro and Mexican Americans: Ethnicity,Gender, and Class

This article compares the extended family integration of Euro and Mexican American women and men and assesses the importance of class and culture in explaining ethnic differences. Using National Survey of Families and Households II data (N = 7,929), we find that ethnic differences depend on the dimension of integration. Mexican Americans exhibit higher rates of kin coresidence and proximity, but lower rates of financial support than Euro Americans. Two additional differences exist only among women: Mexican American women are more likely than Euro American women to give household or child care help. As to the explanation for these differences, social class is the key factor; cultural variables have little effect. Our findings support a theoretical framework attending to intersections among ethnicity, gender, and class.     

Birth weight and mothers' adverse employment change

Low birth weight has been linked at the aggregate level to unemployment rates and at the individual level to subjective distress. We hypothesize that maternal underemployment, including unemployment, involuntary part-time work, and low wage work predicts decreased birth weight. The relationship of birth weight to maternal employment changes during pregnancy was studied prospectively in 1,165 singleton first births in the National Longitudinal Survey of Youth data set. Controlling for other significant risk factors, women who shifted from adequate employment to underemployment had significantly lighter babies. Plausible mediators of this relationship were explored, including prenatal health care, gestational age, and mother's weight gain, with results varying by type of underemployment. Two interactions also suggested that underemployment reduced the beneficial effect of mother's weight gain on birth weight. These findings were partially replicated for low birth weight (< 2,500 grams), indicating the medical significance of the effect.     

Immigration and the Family Circumstances of Mexican‐Origin Children: A Binational Longitudinal Analysis

Using data from the birth cohort of the Early Childhood Longitudinal Study (n = 1,200) and the Mexican Family Life Survey (n = 1,013), this study investigated the living arrangements of Mexican‐origin preschool children. The analysis examined children's family circumstances in both sending and receiving countries, used longitudinal data to capture family transitions, and considered the intersection between nuclear and extended family structures. Between ages 0–1 and 4–5, Mexican children of immigrants experienced significantly more family instability than children in Mexico. They were more likely to transition from 2‐parent to single‐parent families and from extended family households to simple households. There were fewer differences between U.S. children with immigrant versus native parents, but the higher level of single parenthood among children of natives at ages 0–1 and the greater share making transitions from a 2‐parent to a single‐parent family suggest ongoing erosion of children's family support across generations in the United States.     

Everyday Restriction: Central American Women and the State in the Mexico‐Guatemala Border City of Tapachula

Media coverage and emerging scholarship have brought increasing international attention to the urgent humanitarian crisis facing Central American transmigrants as they navigate landscapes of violence in Mexico. While stories of Central American immigrants who remain in Mexico are largely absent from this coverage, there is arguably a “Central Americanization” occurring on the southern border through this permanent settlement. Central Americans choosing to establish themselves in the border state of Chiapas do so in a socio‐spatial and political context defined by the introduction of “progressive” state‐ and national‐level migration policies on the one hand and the persistence of discrimination and violence on the other. We know little about the implementation of these policies on the ground, namely how they are applied and the impacts they have on the immigrant experience in Mexico. To begin to fill this gap, this paper focuses on the experiences of Central American immigrant women living in the Mexico‐Guatemala border city of Tapachula. Employing a feminist geopolitical lens, which encourages conducting research and analysis at diverse scales, it examines their everyday interactions with low‐ to mid‐level representatives of the Mexican state as they seek to avail themselves of their legal and social citizenship rights, and the impacts of these interactions on their livelihoods. This article argues that low‐ to mid‐level officials’ actions reveal the importance of a form of extra‐official, subtle, yet pervasive regulation through which immigrant women are denied rights they are entitled to, inducing negative impacts to their livelihoods, which I term everyday restriction.