Providers’ perspectives of barriers experienced in maternal health care among Marshallese women

Problem

Pacific Islanders are disproportionately burdened by poorer maternal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care.

The influence of financial, human and social capital on Japanese men’s and women’s health in single- and two-parent family structures

Large-scale demographic changes have been occurring in Japan over the last few decades. During this time, the proportion of two-parent (nuclear) and single-parent families have doubled. Despite this rapid increase, the health of individuals in these family structures have received limited attention, as the focus has been directed towards the health of Japan’s aging society and the health implications related to the decline in multigenerational households. However, researchers and policy planners cannot afford to overlook issues that influence the health of men and women in single- and two-parent family structures, not only because these families have become increasingly common throughout the nation, but also because the western literature has indicated that the health of families are largely influenced by the gender-by-family structure divide. Through logistic regression models, using the 1999 Nationwide Family Survey, this paper examines how financial, human and social capital influences the likelihood of good health among men and women in single- and two-parent families. As was expected, key determinants in predicting good health amongst these four sub-groups of parents were found. While parents in two-parent families were the least influenced by various measures of capital, these same measures were found to be significant in predicting good health amongst fathers, and more so mothers, in single-parent families.

Women’s experiences of health care utilization in cases of early pregnancy loss: A scoping review

BackgroundApproximately 25% of pregnancies end in miscarriage, most occurring within the first trimester (<13 weeks). For many women early pregnancy loss has implications for short- and long- term mental health, and women’s well-being following early pregnancy loss is impacted by their experiences within the healthcare setting. To improve quality of care, it is crucial to understand women’s’ experiences within the healthcare system in cases of early pregnancy loss.QuestionsWhat does the research literature tell us about the experiences of early pregnancy loss within healthcare settings? Are these experiences positive or negative? ‘How can care improve for those experiencing early pregnancy loss?’MethodsA scoping review of the research literature was undertaken. Three research databases were searched for relevant articles published in English since 2009, with key words related to ‘Experience’, ‘Healthcare’ and ‘Early Pregnancy Loss’. A thematic analysis was undertaken to identify and summarize key findings emerging from the research literature.FindingsTwenty-seven (27) articles met our inclusion criteria. Three main themes were identified: (1) issues related to communication, (2) challenges within care environments, and (3) inadequacies in aftercare.DiscussionThe literature suggests that women’s experiences related to healthcare for early pregnancy loss are largely negative, particularly within emergency departments. Recommendations to improve women’s experiences should extend beyond attempts to improve existing care structures, to include emerging environments and providers.ConclusionWomen’s experiences identified within the literature provide further insights on what women are seeking from their care, and how care models can be improved.     

Modelling the impact of women’s education on fertility in Malawi

Many studies have suggested that there is an inverse relationship between education and number of children among women from sub-Saharan Africa countries, including Malawi. However, a crucial limitation of these analyses is that they do not control for the potential endogeneity of education. The aim of our study is to estimate the role of women’s education on their number of children in Malawi, accounting for the possible presence of endogeneity and for nonlinear effects of continuous observed confounders. Our analysis is based on micro data from the 2010 Malawi Demographic Health Survey, and uses a flexible instrumental variable regression approach. The results suggest that the relationship of interest is affected by endogeneity and exhibits an inverted U-shape among women living in rural areas of Malawi, whereas it exhibits an inverse (nonlinear) relationship for women living in urban areas.     

Measurement models of women’s autonomy using the 1998/1999 India DHS

Research concerning the relationship between female status and demographic behaviour has largely concluded that community level influences are most important, while status and autonomy at the individual level are far less so. This consensus, however, rests on an untested a priori typology of women’s status and tenuous assumptions about the measurement of defined status dimensions on the individual level. To better understand the potential influences of both community and individual elements it is necessary to take a step back and assess the validity of the constructs of autonomy used. This work uses a latent variable measurement modelling framework to test both the dimensionality of women’s status and the appropriateness of using simple additive index scaling in constructing measures of women’s status on the individual level using questions from the Demographic and Health Surveys status-of-women module in India for 1998/1999.     

The effect of women’s participation in the labour market on the postponement of first childbirth: a comparison of Italy and Hungary

This paper analyses the effect of increasing female participation in the labour market on the transition to first childbirth. Regional perspectives are considered to help us understand how postponement behaviour is changing over time and at different paces in each region. The analysis is based on the first wave of the Generations and Gender Survey of Italy and Hungary. We use a multilevel event history random intercept model to examine the effect of individuals’ positions in the labour market on the transition to motherhood, controlling for differences in macrolevel factors related to regional backgrounds in the two countries. The regional data for Italy came from the Italian National Statistical Institute, and for Hungary from our imputation developed from the time series available at the national and the regional levels (Hungarian Central Statistical Office, KSH). The postponement of first childbirth is strongly linked to the increasing involvement of women in paid work, but with opposite effects in the two countries. Even if we control for changes in women’s levels of education over time and for shifts in women’s aspirations and levels of attainment in the labour market, we find that being employed remains a risk factor for the postponement of the first birth among Italian women, and a strong protective factor among Hungarian women. At the contextual level, the variables that take into account the regional socio-economic changes provides evidence of important effects on individual behaviour among Italian women, and of only minor effects among Hungarian women. All of the regional breakdowns in both Italy and Hungary show that the postponement of motherhood goes hand-in-hand with the acceptance of deep cultural and socio-economic changes.     

Defend women’s rights and save the trees: a cross-national analysis of women’s immovable property rights and forest loss

Population and Environment - Since 1990, 420 million hectares of forest have disappeared worldwide with the majority being lost in low- and middle-income nations. Given this alarming trend, what...     

Public primary health care and children’s health in Brazil: evidence from siblings

The Family Health Program (Programa Saúde da Família) is an initiative of the Brazilian Ministry of Health designed to deliver free primary health care services within communities and households. The program was implemented by municipalities in different periods of time, creating variation in its availability among siblings of different ages. The empirical approach uses this variation to estimate the effect of the program on children’s health in Brazil, in an attempt to control for family and municipality unobserved factors possibly related to the program’s adoption. The results indicate that children for whom the Family Health Program was available in their municipalities during the prenatal period are healthier than children for whom the program was not available during the same period of their lives.     

The influence of wages on parents’ allocations of time to child care and market work in the United Kingdom

We use time-diary data on couples with children from the 2000 United Kingdom Time Use Survey to examine the impacts of own and partner’s wages on parents’ provision of child care and market work on weekdays and on weekends and holidays. We find that increases in partners’ wages increase women’s primary care on all days and decrease their market work on weekdays, while increases in women’s own wages increase their market work on weekdays. There is little evidence that men’s time use responds to changes in their own wages. However, an increase in men’s partners’ wages increases men’s passive child-care time on weekends and reduces their market-work time on weekends.

The influence of student characteristics and interpersonal teacher behaviour in the classroom on student’s wellbeing

Student wellbeing can be considered a major output indicator of quality of education. A positive classroom climate can contribute to a higher sense of wellbeing. Interpersonal relationships between teachers and students are an important aspect of the classroom climate. This study investigated how student wellbeing was predicted by student characteristics, interpersonal teacher behaviour and achievement. 594 students from 55 classes in 13 technical and vocational secondary schools were involved in this study. The results indicated that those students who attended school because they were highly motivated learners reported a higher sense of wellbeing than those who attended out of a sense of duty. It also appeared that student perception of interpersonal teacher behaviour predicted student wellbeing. As a case in point, when students viewed their language teacher as tolerant yet exacting discipline, a positive relationship was found with student wellbeing. Students also felt better when their mathematics teachers were less authoritarian, but the cooperative component was still important.     

Examining the rhythms of ‘urban elements’ on walking and driving routes in the city

ABSTRACT

The article follows Kevin Lynch’s renowned formulation of ‘urban elements’ to examine the mobilities, experiences and materialities on ordinary routes in the city. Utilizing route narratives and participant-produced visual data, the article focuses on various identifiable micro-temporalities and mobility rhythms on repeated walking and driving routes, building on Henri Lefebvre’s notion of ‘rhythmanalysis’. The article examines how a framework built around rhythm and urban elements can add to the analysis of contemporary urban sites from the perspectives of situated mobile contexts, noting sequences and polyrhythmia as central temporal characteristics in the body?environment relations.     

Development of a survey instrument to evaluate women’s experiences of their maternity care

BackgroundThe process of developing a survey instrument to evaluate women’s experiences of their maternity care is complex given that maternity care encapsulates various contexts, services, professions and professionals across the antenatal, intranatal and postnatal periods.AimTo identify and prioritise items for inclusion in the National Maternity Experience Survey, a survey instrument to evaluate women’s experiences of their maternity care in the Republic of Ireland.MethodsThis study used an adapted two-phase exploratory sequential mixed methods design. Phase one identified items for possible inclusion and developed an exhaustive item pool through a systematic review, focus groups and one to one interviews, and a gap analysis. Phase two prioritised the items for inclusion in the final item bank through a Delphi study and consensus review.FindingsFollowing iterative consultation with key stakeholder groups, a bank of 95 items have been prioritised and grouped within eight distinct care sections; care during your pregnancy, care during your labour and birth, care in hospital after the birth of your baby, specialised care for your baby, feeding your baby, care at home after the birth of your baby, overall care and you and your household.ConclusionRobust and rigorous methods have been used to develop a bank of 95 suitable items for inclusion in the National Maternity Experience Survey.     

The association between mistreatment of women during childbirth and postnatal maternal and child health care: Findings from “Birth in Brazil”

BackgroundThe mistreatment of women during pregnancy, childbirth, and the puerperium is a global public health problem besides being a violation of human rights. However, research exploring the consequences of mistreatment of women and newborns is scarce.QuestionTo shed light on this issue, we investigated the association between the mistreatment of women during childbirth and the subsequent use of postnatal health services by women and their newborns.MethodsWe used data from the study “Birth in Brazil”, a national hospital-based survey of puerperal women and their newborns, carried out in 2011/2012. This analysis involved 19,644 women. Mistreatment was a latent variable composed of seven indicators. We assessed the attendance of women and newborns to a review consultation following birth, and the timing of this appointment. We applied multigroup structural equation modeling (based on childbirth payment source) and considered separate analysis for women (vaginal births and0 caesarean-sections) and newborns.FindingsWe found a causal association between mistreatment during childbirth and decreased and/or delayed use of postnatal health services, for both women and their newborns. These results also revealed that women who use the public sector are affected more than those who pay for private healthcare.ConclusionMistreatment during childbirth has broader implications than “maternal mental health”, and it would be useful to understand that experience of care has vast implications for families. In Brazil, the mistreatment must be mitigated via the implementation of public policy. This is part of the path to dignified and respectful childbirth care for all women.     

Childbearing women’s experiences of the maternity care system in Australia during the first wave of the COVID-19 pandemic

BackgroundSubstantial changes occurred in Australian healthcare provision during the COVID-19 pandemic to reduce the risk of infection transmission. Little is known about the impact of these changes on childbearing women.AimTo explore and describe childbearing women’s experiences of receiving maternity care during the COVID-19 pandemic in Australia.MethodsA qualitative exploratory design using semi-structured interviews was used. Women were recruited through social media and self-nominated to participate in an interview. Maximum variation sampling was used. Twenty-seven interviews were conducted with women from across Australia. Data was analysed thematically.FindingsThree primary themes and nine sub-themes emerged: ‘navigating a changing health system’ (coping with constant change, altered access to care, dealing with physical distancing restrictions, and missing care), ‘desiring choice and control’ (experiencing poor communication, making hard decisions, and considering alternate models of care), and ‘experiencing infection prevention measures’ (minimising the risk of exposure and changing care plans to minimise infection risk).DiscussionThe substantial changes in care delivery for pregnant and postpartum women during the pandemic appear to have reduced woman-centred care. In most cases, care was perceived as impersonal and incomplete, resulting in a very different experience than expected; consequences included missing care. The presence of a known care provider improved women’s sense of communication, choice, and control.ConclusionThis study provides unique insight into the experiences of childbearing women across Australia. The importance of respectful woman-centred care cannot be forgotten during a pandemic. The findings may inform future service planning during pandemics and disaster situations.     

Witnessing a body in decline: Men’s and women’s perceptions of an altered physical appearance

ABSTRACT

There has been a tendency within the literature to ignore how men and women who are very ill and at the end of life perceive and experience their visibly altered bodies. This article aims to provide new insights about this matter. A qualitative research approach was adopted. In-depth interviews were conducted with 10 hospice patients, 20 family members, and 20 members of hospice staff. Findings reveal that because of masculine and feminine norms, physical appearance is more a matter of concern to women than to men who are close to death. This contradicts theories that suggest that patients experience a disinvestment on their sense of masculinity and femininity alongside the process of bodily deterioration and decay prior impending potential death.     

Unblurring the lines: a qualitative exploration of young women’s opinions on popular music

Music is an important part of the human experience, arguably contributing to identity and the formation of relationships and group memberships. However, the way women are portrayed in music has been identified as harmful and disempowering. Past research relating music to these trends has often failed to “give voice” to participants by asking them what think about the music they listen to, which is in itself disempowering. Therefore, the aim of this study was to gain an understanding of young women’s perspectives of popular music. Face-to-face, in-depth, semi-structured interviews were conducted with 10 young women. Causal layered analysis was used to deconstruct participants’ understandings of popular music. Findings revealed that for participants, music can both reflect and contribute to conflicting worldviews regarding women’s freedom of expression and sexual conservatism. Music also acted as a conduit for discussion of the social construction of women; participants articulated that female artists are seen rather than heard, reduced to body parts and commodified. Findings indicate that participants are cognizant of gendered power differences in music, rendering popular music in particular a mechanism for the oppression of women, but also a useful means to monitor and challenge problematic cultural attitudes directed at women.     

Pregnant adolescent women’s perceptions of depression and psychiatric services in the United States

Problem

Adolescent mothers and their children are at high-risk for depression and the associated negative educational, social, health, and economic outcomes.