Breastfeeding and employment: A propensity score matching approach

ABSTRACT

It is well established within the scholarship on work and the family that many women experience difficulty juggling work and family responsibilities. Challenges to breastfeeding after giving birth are a specific manifestation of this work–family conflict. Many women report that they are unable to continue breastfeeding upon return to paid work. In this article, I analyze a subsample of 746 women from the United States Infant Feeding Practices Survey II to assess the effect of new mothers’ employment status and workplace characteristics on breastfeeding duration. This research reveals that new mothers who return to paid employment within three months of giving birth breastfeed an average of five fewer weeks than new mothers who do not return to paid work for three months or more. In addition, among mothers who return to paid work within three months, full-time workers breastfeed an average of more than 15 fewer weeks than part-time workers. These substantial differences in the duration of breastfeeding suggest that women face significant obstacles to combining paid work and mothering in the postpartum period.     

Modernization and the Demographic Transition: Cross-Sectional and Longitudinal Analyses of a Revised Model

Abstract

We specify a revised model of the demographic transition which accounts for national fertility levels and changes over the past two decades. The model includes cultural, geographic, demographic and family planning program variables, in addition to a measure of national socio-economic modernization. Using crude birth rates for 117 countries, we operationalize and then apply the revised model to 1974 rates, and then test a longitudinal model of 1955–59 to 1974 change in rates. A final model for 81 less developed nations from the original set of 117 countries includes a measure of family planning program effort. Including this highly significant measure in a model of 1955–59 to 1974 change results in further evidence favoring modification of the traditional demographic transition model. Implications for the future course of fertility in underdeveloped countries are discussed.     

Who Does What When Partners Become Parents:

Forty-seven couples who were first-time parents were assessed in late pregnancy and again at 6 and 18 months postpartum. Fifteen couples not yet decided about having a baby were assessed at equivalent times. Actual involvement in household, decision-making, and childcare roles was determined by responses to a 36-item "Who Does What?" questionnaire. Psychological involvement in parent, partner, and worker roles was also determined, as was each partner's satisfaction with behavioral and psychological involvement in each domain. On the basis of global analyses, previous studies have suggested that new parents adopt more traditional roles. Item analyses indicated that men's and women's roles change in both traditional and nontraditional ways during the transition to parenthood, depending on the item and the time of assessment. Measures of individual and couple adaption were also obtained: self-esteem, parenting stress, and marital satisfaction. Men's involvement in family tasks was correlated with their own or their wives adaption in pregnancy but became linked with adaptation at 6 months postpartum. However, at 18 months after birth husbands' involvement in family tasks was correlated only with wives' adaptation. For both parents, satisfaction with family task arrangements becomes correlated with self-esteem, parenting stress and marital quality after childbirth; these measures of adaptation are more closely linked with role satisfaction than with actual sharing of family work.     

Geburten aus geplanten und ungeplanten Schwangerschaften – Die Relevanz von Bildung,Arbeitslosigkeit und PartnerschaftChildren from Planned and Unplanned Pregnancies: The Importance of Education,Unemployment and Partnership

Micro theories on fertility such as the economic theory of family frame fertility behaviour in industrialized countries as a decision. Predictions of these theories have been tested in numerous empirical studies. This research widely ignores that childbirth may also result from unintended pregnancies. We discuss how education, educational and labour market participation as well as partnership status influence unplanned and planned pregnancy in Germany. To test our hypotheses, we use data from the Socio-Economic Panel Study, collected between 2001 and 2013. The focus is on the planning status of pregnancies leading to a first or third birth. Data on women are analysed with event history models for competing risks. Contrary to arguments of high opportunity costs, graduates show an above-average probability of planned pregnancies. Unemployed women, who should have lower opportunity costs, do not have an increased probability of planned pregnancies; instead their first children are more often unplanned. Consensual unions, which are less serious but offer the same opportunities for sexual activity as marriages, have the highest rate of unplanned pregnancies. The overall findings make clear that future surveys and empirical research might benefit from taking intentions into account, which would enable more rigorous testing of fertility theories.     

Socio-Demographic Characteristics of Contraceptive Users in Ghana

ABSTRACT

This paper describes the social and demographic characteristics of contraceptive users in Ghana, using the Ghana Demographic and Health Survey (GDHS) data (1993). Analysis has revealed that contraceptive use among women is quite low. Women's age, marital status, educational level, and place of residence are some of the factors that relate significantly to contraceptive use. The reasons most frequently cited for non-use of a modern birth control method are the desire to have children, lack of knowledge, and health concerns. The data show little motivation among women to practice family planning. Suggestions for effective family planning are provided.     

The relationship of modernity of sex roles to pregnancy planning

This study investigates the relationship of women's role modernity to pregnancy planning. The subjects were 59 married primiparous women aged 18 to 33 who had given birth in a metropolitan midwestern hospital. Over 1/2 the sample had some college eduction. The pregnancy planning variable is operationalized as the implementation of family planning goals. Subjects who desired pregnancy and actively attempted to conceive are considered to be planners. In contrast, nonplanners are defined as women who preferred to avoid pregnancy but were not successful and women who did not actively seek or avoid pregancy. The modernity of sex roles variable is operationalized through use of the Scanzoni instrument. This instrument is constructed from a series of items that measure 3 social positions related to sex roles in the family context: those of wife, husband and mother. The instrument is modified in this investigation, leaving 21 5-point scale items to be included in the data analysis. Smallest space analysis of the inter-item correlation matrix demonstrate that the social positions of wife and husband do not clearly reflect different aspects of sex role modernity. A comparison of the average inter-item correlation for the variables within each social position with the average inter-item for the variables across the positions reveals that the dimensions proposed by Scanzoni are not empirically different. In light of these findings, further exploratory data analysis of all items was conducted to discern which items do empirically cluster together. Scanzoni's 21 sex role items were submitted to principal component factor analysis; 3 factors emerged. 1) wife-husband equlity; 2) flexibility in role integration; and 3) values regarding primary role. 3 new sex role modernity values were created to correspond to the 3 factors and were then used to explore the relationship between sex role modernity and pregnancy planning. Chi square analyses were not statistically significant. Therefore, the hypothesis that women at the extremes of the modernity continuum would be more likely to plan than women who fall in the middle, was rejected. Although no relationship between the sex role factors and pregnancy planning was found, 6 of the Scanzoni items, when linearly combined, manifested a strong relationship to planning: 1) wife's emotional nature; 2) wife's most important task is caring for husbands and kids; 3) wife takes job if not satisfied with wife/mom role; 4) wife gives up job if inconveniences husband/kids; 5) wife's job as important as husband's job; 6) women's pay equal to man's. Although 4 of these items load on the sex role factors, it is unclear whether they are truly reflective of these factors.     

Labor force participation and fertility: a study of married women in Bangladesh

Most researchers support the notion that a direct negative relationship exists between married women's labor force participation and fertility behavior, yet female employment shows no consistent, general relationship with declining fertility at individual and societal levels. Specific conditions under which employment lowers fertility are therefore explored for the case of Bangladesh. The economic, sociological, and world-system theoretical approaches to the relationship and empirical studies in developing countries including Bangladesh are reviewed. 1975-76 Bangladesh Fertility Survey data on births, deaths, nuptiality, and family planning knowledge and practice for 5772 currently married women of 6513 ever married women under 50 sampled are subjected to multivariate analysis for the study. Analysis revealed that women's modern and traditional occupation as well as higher and secondary education significantly lower their fertility, and that higher age, Islamic religion, use of modern contraceptives, and husband's occupation in transitional and modern sectors have significant positive effects on fertility. The correlation between higher fertility and contraceptive use may be due to women's delay in practicing family planning until reaching desired parity and/or high infant mortality driving women to cease practice in order to replace lost offspring. Future research should be conducted with larger samples and also consider occupations of both husbands and wives. Societal attitudes about women's education should be reformed in support of opening rural schools for women. With 90% of women residing in rural areas and women with traditional occupations having lower fertility, more traditional sector opportunities for women in cottage industry and agriculture production are also recommended, and would help balance skewed urban growth and hypertrophication of the tertiary sector. Finally, motivational efforts should be focused upon encouraging younger instead of older married couples to limit fertility.     

The implications of the demographic transition theory for fertility change in Nigeria

Data on educated urban women in Nigeria demonstrate the effect women's education and urbanization has on reproductive behavior, marriage, family formation, and family relationships. Available health services contribute to a fall in infant mortality, but most services are in urban areas. Further, people of high socioeconomic status who have access to modern health services are more concerned about public health problems than those in the low group. Urbanization occurs at a rate of about 11%/year. In Lagos, people with primary education delay marriage 1-2 years longer than those who have no education. Further, 71% of uneducated people in Ibadan who were = or + 38 years old were in a polygynous marriage compared to 38% of educated people in the same age group. The actual and desired family size in Nigeria ranks amoung the highest in the world. In addition, only 20% of the total population use modern contraceptives and usage is highest in Lagos and Ibadan. Most acceptors are educated urban middle class who use contraceptives to space births instead of the traditional spacing methods of postpartum abstinence and prolonged lactation. Eventually more and more urban middle class women will use contraceptives to prevent births. 1% of these acceptors are demographic innovators, however. Further they begin to use contraceptives at high parities. Still child mortality among them is lower than others. Since the late 1970s, as people are being exposed to Western culture, the economy has improved, mortality has fallen, more children attend schools, yet fertility has grown substantially in urban and rural areas. With the expansion of Western education to females, the changing pattern of life style of the educated urban middle class, and increase of women in nontraditional professions, expectations and needs of children will change. Around 2000 Nigeria will begin its demographic transition from high to low fertility.     

Prevalence and Risk Factors for Dyspareunia and Unsatisfying Sexual Relationships in a Cohort of Primiparous and Secondiparous Women After 12 Months Postpartum

ABSTRACT

Dyspareunia is a common short-term pregnancy complication, rarely lasting longer than 1 year after delivery. Our study aims to determine postpartum dyspareunia prevalence and its impact on women's sexual health. In this retrospective study, we asked 602 women about dyspareunia and the quality of sexual intercourse through telephone interviews. The influence of dyspareunia on the quality of sexual intercourse and couple relationship is scored on a 4-point verbal scale according to its severity. Data were analyzed by R (version 2.8.0), considering significant p < .05. Nearly 100% of women (99.9%) resumed their sexual activity; 16.2% of them reported dyspareunia significantly compromising their sexual intercourse and couple relationships. In univariate analysis, severe perineal tears are associated with persistent dyspareunia (p < .05). By multivariate analysis, postpartum dyspareunia results independently influenced by operative delivery, previous dyspareunia, recurrent urogenital infections and urge incontinence (p < .05), as well as by the Kristeller maneuver and partoanalgesia (p = .084) in the case of women who had a vaginal delivery. Dyspareunia significantly compromises women's sexual health postpartum, mostly caused by perineal trauma by means of delivery management and recurrent urogenital infections.     

The role of need for contraception in the evaluation of interventions to improve access to family-planning methods

A nonrandomized experiment carried out in Jharkhand, India, shows how the effects of interventions designed to improve access to family-planning methods can be erroneously regarded as trivial when contraceptive use is utilized as dependent variable, ignoring women's need for contraception. Significant effects of the intervention were observed on met need (i.e., contraceptive use by women who need contraception) but not on contraceptive use (i.e., contraceptive use by women who may or may not need contraception). Met need captures the woman's success in overcoming barriers to access to family planning, whereas contraceptive use confounds this construct with risk of pregnancy and fertility desires. Exceptions to this rule are identified.     

Erotophobia‐erotophilia and sexual behavior during pregnancy and postpartum

This research examined the relation of erotophobia‐erotophilia, the disposition to respond to sexuality with negative‐to‐positive affect, and sexual behavior during pregnancy and postpartum. During late pregnancy, 50 couples responded to questionnaire assessments of their erotophobia‐erotophilia and sexual behavior; during the postpartum period, 25 of these couples responded to a follow‐up assessment of their sexual behavior following the birth of their child. Results indicated that eroto‐philic (versus erotophobic) women showed more sexual interest, activity, and satisfaction during pregnancy; they reported more sexual interest and an earlier resumption of coitus in the postpartum period; and they were more likely to breastfeed their child. Erotophilic (versus erotophobic) men reported more sexual activity both during pregnancy and the postpartum period, and they were more likely to have been present at the delivery of their child. Results are discussed in terms of confirming and broadening the construct validity of erotophobia‐erotophilia and in terms of applications for identifying and assisting those who may be likely to experience sexual difficulties during pregnancy and the postpartum period.     

Education and changing reproductive behavior in Ghana

It has recently been posited by several researchers that a fertility transition is under way in Ghana. Such fertility decline would be the first instance on the west coast of Africa. Data from the 1988 Ghana Demographic and Health Survey allows closer assessment of this earlier speculation. Review of the data suggests that earlier assertions of the existence of fertility transition were premature and hastily drawn from fragmented evidence. Little evidence exists to support any hypothesis of a fertility turnaround in ghana. The findings are, however, cautiously optimistic with some indication that continued increases in the proportion of women with some secondary education may yet induce a fertility transition in the country. The author notes the lack of individual motivation to reduce fertility in Ghana and questions the merit of continuing family planning programs in such an atmosphere. Measures to reach men in family planning messages and to expand the level of women's education are recommended. Success in reducing fertility in Kenya as a result of increasing women's education is noted.     

Women's status and fertility in the Sudan

This paper summarizes the history of women's education in Sudan; data on the relationship between their educational levels and fertility; and data on the relationship between fertility and women's employment. In general, the data point to an inverse relationship between the education of women and fertility. This relationship exists when considering the education of husbands. In terms of employment, women who report no work experience have the highest fertility, those who are self-employed or are family workers have an intermediate level of fertility, while those women who work for others have the lowest level of fertility. Education appears to be more closely associated with fertility than employment. The author concludes that as the status of women shifts to perceptions based on education and gainful employment, fertility will decline. However, in the Sudan, strong traditional values, based on women's roles related to childbearing and childrearing, will continue to sustain a relatively high fertility rate. (author's)     

Couple Attitudes and Agreement Regarding Pregnancy Wantedness in the Philippines

We compare husbands' and wives' views of the wantedness of their most recent pregnancy in the Philippines, a country where relatively high levels of unintended fertility persist. This research is an extension of earlier work that looked separately at individual men's and women's responses. We analyze survey data for 369 couples and find that those most at risk of experiencing a pregnancy that neither spouse wanted tended to be higher parity couples, those who were more fatalistic, those who were practicing Catholics who attended religious services frequently, and those among whom the husband was the sole breadwinner. Higher parity women and older women were also more apt to experience a pregnancy that was wanted by only 1 spouse. Women who had difficulty discussing sexual matters with their husbands were more likely than other women to have a pregnancy that their husbands wanted but they did not.     

Multiple Perspectives of Teams’ Experiences of a New Zealand Wraparound Process

Since it was first introduced in the 1980s, Wraparound has been defined as ‘a philosophy,’ ‘an approach,’ and ‘a service’ which is designed to work with youth and families with high and complex needs. Wraparound is most commonly understood as an intensive, individualised care planning process. It aims to achieve positive outcomes through a structured, creative, and individualised team planning process, which results in effective and more relevant plans for the youth and family. The purpose of this qualitative study was to explore the experiences of Wraparound facilitators, caregivers, youths, and team members to gain a multi‐perspective insight into the process. Sixteen families and Wraparound teams participated in the study which resulted in 56 semi‐structured interviews being conducted involving 16 Wraparound facilitators (some facilitators were interviewed more than once because they served multiple families who participated in the study), 16 caregivers, eight youth, and 16 team members (one person from the team, i.e., teacher, social worker, or mentor). Thematic analysis gave seven themes organised into three broad domains: (1) key elements of the Wraparound process including the Wraparound facilitator, Wraparound's philosophies and principles, and the supportive nature of the process; (2) the outcomes achieved throughout the process including family empowerment and hope, improved family dynamics and relationships as well as individual parent and youth change; and (3) the challenges and feedback respondents identified through the process, which included personal and systemic challenges, improved transition, and continuity of care, role clarity, and accessibility of the service. Overall, the findings from this study support Wraparound as an effective process for youth and their families, identify the importance of key aspects of the process, and suggest some improvements to increase the efficacy of and accessibility to the process.     

“Minutes to Midnight”: Problems and Promises

Abstract

This paper assesses the relative impact of direct and indirect determinants of marital fertility in Pakistan, where the vast majority of women do not use any method of fertility regulation. Data came from the 1990/91 Pakistan Demographic and Health Survey, and models were estimated for women aged 15–49, 15–24, 25–34 and 35–49. The younger cohort may be the vanguard of change; change which may be masked by investigating only the conventional 15–49 age group. Findings indicate that unlike the older cohorts, the younger cohort does not have negative and significant relationships between education, employment and fertility; and, that the current use of family planning is positive and significant with fertility for the 35–49 cohort only. These findings suggest that there is a threshold or minimum number of children that a woman must produce before determinants such as current use of family planning, education and employment impact fertility.     

Regional Contexts and Family Formation: Evidence from the German Family Panel

Substantial regional variation in marriage and fertility patterns continues to exist in Germany. Following a multilevel approach, we exploit longitudinal data from the German Family Panel (pairfam), enhanced by an array of district-level variables, to investigate the extent to which spatial variations in men’s and women’s family formation behaviors result from differences in population composition or from ‘true’ contextual effects. Our multilevel analyses provide evidence for only small—if any—contextual effects on individuals’ family formation behaviors (except for a continuation of significant differences between East and West Germany). However, we still find indication that (1) regional economic circumstances matter in determining individuals’ fertility intentions as well as their transition to first marriage, (2) regional milieus are associated with individuals’ fertility, and that (3) selective family migration takes place. While it seems that social interaction rather than differences in local opportunity structures plays a role here, more research is needed to further substantiate this conclusion.     

The Effect of Contraceptive Knowledge on Fertility: The Roles of Mass Media and Social Networks

This study examines the effect of contraceptive knowledge on fertility during the period when Taiwan’s family planning programs were in effect. This study contributes to previous studies by directly measuring individual’s contraceptive knowledge and fertility, as well as applying an instrumental variable approach to gauge the effect of contraceptive knowledge on fertility. The results indicate that mass media and social networks play important roles in disseminating contraceptive knowledge. This study finds that women transform their knowledge into behavior—that is, contraceptive knowledge reduces fertility, no matter which fertility metric is measured (life-time fertility or probability of giving birth).     

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.