“If I'm Not Allowed to Put My Family First”: Challenges Experienced by Women Who Are Caregiving for Family Members with Dementia

ABSTRACT

In this study of 26 employed, West Texas women care-givers, we found that women worried that they would not be able to give their family members the care they deserved because of the multiple demands placed on them. Women actively negotiated working conditions to achieve flexibility. Women who did not have access to flexibility often changed jobs until they had working conditions that provided it. Work provided a respite and a chance to feel some measure of control. In spite of the importance of work to them, these women paid costs for balancing both roles.     

Working in caseload midwifery care: The experience of midwives working in a birth centre in North Queensland

BackgroundPregnancy, birth and child rearing are significant life events for women and their families. The demand for services that are family friendly, women focused, safe and accessible is increasing. These demands and rights of women have led to increased government and consumer interest in continuity of care and the establishment in Australia of birth centres, and the introduction of caseload midwifery models of care.AimThe aim of this research project was to uncover how birth centre midwives working within a caseload model care constructed their midwifery role in order to maintain a positive work–life balance.MethodsA Grounded Theory study using semi-structured individual interviews was undertaken with seven midwives who work at a regional hospital birth centre to ascertain their views as to how they construct their midwifery role while working in a caseload model of care.FindingsThe results showed that caseload midwifery care enabled the midwives to practice autonomously within hospital policies and guidelines for birth centre midwifery practice and that they did not feel too restricted in regards to the eligibility of women who could give birth at the centre. Work relationships were found to be a key component in being able to construct their birth centre midwifery role. The midwives valued the flexibility that came with working in supportive partnerships with many feeling this enabled them to achieve a good work–life balance.ConclusionThe research contributes to the current body of knowledge surrounding working in a caseload model of care as it shows how the birth centre midwives construct their midwifery role. It provides information for development and improvement of these models of care to ensure that sustainability and quality of care is provided to women and their families.     

“You’re a ‘high-risk’ customer”: A qualitative study of women’s experiences of receiving information from health professionals regarding health problems or complications in pregnancy

BackgroundExperiencing complications in pregnancy is stressful for women and can impact on fetal and maternal outcomes. Supportive encounters with health professionals can reduce the worry women experience. Further research is needed to understand women’s perspectives on communicating with their healthcare providers about their concerns.AimThis study explored women’s experiences of receiving information about pregnancy complications from healthcare providers and their interactions with multiple professionals and services during pregnancy.MethodsThis was a qualitative interpretive study. Semi-structured interviews were conducted with 20 women experiencing pregnancy complications recruited from antenatal services at two hospitals in Sydney. Inductive thematic analysis was used to analyse the data.FindingsWomen had a range of reactions to their diagnoses, including concern for their baby, for themselves and for their labour. Most women reported that communication with healthcare providers was distressing, they were not listened to and staff used insensitive, abrupt language. Women were also distressed by delays in education, receiving contradictory information and having to repeatedly share their stories with different health professionals. In some cases, this damaged the therapeutic relationship and reduced trust towards healthcare providers. Midwives were generally preferred over doctors because they had a more woman-centred approach.ConclusionTo improve women’s experiences of care for pregnancy complications, it is critical to improve the communication skills of maternity service providers. Women’s need for information, resources and support can best be provided by continuity of care with a named health professional, for example, a midwife working within an integrated multidisciplinary antenatal service model.     

"My mind's made up": assumptions and decision-making in accounts of caregiving women

In this qualitative study, rural women caregivers for elderly relatives or friends were interviewed about their decision-making. Women deliberating decisions differed from women implementing decisions in how they perceived their caregiving tasks and in their experience of stress. The difference in deliberative and implemental accounts suggests that mindset is a mediating factor for the women in the present study. Women in the process of implementing decisions regarding caregiving described their experiences in a more positive light and reported less stress. Deliberating decisions regarding caregiving, however, was likely to color the experience of caregiving, leaving the caregiver feeling vulnerable, doubtful about herself, and more stressed.     

Determinants of fertility and the unmet need for family planning in Indonesia

Indonesia's fertility has declined to an average of slightly more than 3 children/woman. The islands of Java and Bali have the lowest birth rates. Indonesia's family planning program has been a model of innovation, flexibility, and community involvement, and has been effective in reducing fertility, changing family preferences, and increasing contraceptive use. Fertility decline is also determined by factors other than contraceptive use, as provinces in Jakarta and East Java has low fertility and low contraceptive use. Recent research by Suyono and Palmore found that among cohorts of women in Jakarta lowest fertility rates were explained by greater nonexposure to pregnancy in an unmarried state or by a divorced or widowed status, and by infecundity. In East Java, fertility determinants were the same with the possible addition of lower coital frequency. The study estimated nonexposure due to marriage, infecundity, and contraceptive use. Policy considerations, however, are concerned with the exposed state of the percentage of time women are currently married, fecund, not using contraceptive, and sexually active. Suyono and Palmore also calculated the percentage of time spent in the exposed state by province. The estimates ranged from 12% in Yogyakarta to 25% in West Java and the Outer Islands. Exposed was further divided into groups with a manifest, latent, and no current need. Women with a manifest need for family planning are those who are aware of their contraceptive needs to stop or postpone childbearing and not using. Manifest need was highest in high fertility areas: 12% in Central Java, 13% in West Java, and 12% in the Outer Islands. Programs targeting these women should focus on wider availability of information and services. Women with latent needs are unaware of their need for family planning and are not using contraception. These women were also concentrated in high fertility areas. The percentage of years spent in the latent unmet need state was estimated at 23-24% in West Java and the Outer Islands. Program emphasis should be on education and motivation to show how family size can be controlled. Women with current need can be educated toward future acceptance.     

The language of (in)visibility: using in-between spaces as a vehicle for empowerment in the family

Drawing on 40 in-depth interviews with sexually nonconforming Latinas, this work looks at how these women negotiate family and achieve empowerment both through visibility and invisibility. This work explores the experiences of Latinas who verbally articulated their sexual nonconformity to their families as well as those who chose to maintain their relationships tacit. I offer that study participants found empowerment and agency not only through verbal articulation but also through tacit relationships and that sexually nonconforming Latinas inhabited an "in-between space" with their families that gave them the flexibility to pursue or not pursue visibility as they desired.     

Gender,power, and population change

This report describes fertility and mortality trends in developing countries and discusses how gender is defined and measured in some countries. The discussion relies on case studies and country statistics to reveal how gender shapes the lives of all people in all societies. Gender is defined as the different roles women and men play in society. Gender is manifested in institutional structures, power relations, and culturally determined behavior. In no society do women and men share equal roles. The effects of inequality for women are manifested differently between countries. The 1994 International Conference on Population and Development in Cairo established the goal of gender equality. Educational enrollment and illiteracy are two measures of gender inequality that affect opportunities in society for advancement, power, and status. Girls are less likely to be enrolled in school than boys and more likely to have higher absenteeism rates. In China, absenteeism of girls is actually increasing under reforms. Marriage practices may devalue the investment in girls' education. Women experience different working conditions: they work longer hours, are paid less or not at all, and hold lower-status jobs. The exceptions are found in the Philippines and Brazil, where women hold more professional jobs than men. Women carry multiple responsibilities that consume time and prevent greater involvement in public life. Dowry and brideprice can constrain family relations. Women generally have fewer inheritance rights. Few women hold high-level public office positions or parliamentary seats. The extent to which gender inequality is reflected in demographic processes depends upon the gap in power in education, employment, and income. The relationship between gender and demographic processes is a central topic currently being researched.     

Shanghai adopts family planning regulations

These Regulations, adopted by the Municipal People's Congress of Shanghai on 14 March 1990, do the following: a) strictly prohibit any units and individuals from identifying the sex of a fetus without medical reasons; b) add 1 additional week to the marriage leave of couples who marry at the age set for late marriage (25 for males and 23 for females); c) add 15 days of maternity leave for women who give birth at the age set for late birth (24) and 3 days for their spouses; d) impose a fine equal to 3 to 6 times their average annual income if a couple have an unplanned birth (calculated on the basis of their income 2 years before the birth); and e) subject a couple who have an unplanned birth to disciplinary action by their working units if they work for others or by the administrative department of industry and commerce if they are self employed. Second births are allowed if a first child "can not become normal because of nonhereditary diseases," if both husband and wife are single children, or if a "remarried couple had only one child before their remarriage." The Regulations provide that "the improvement of birth quality and good upbringing of children should be promoted, advice on heredity should be provided, and premarital examinations [should] be conducted." They also stipulate that "A woman should terminate her pregnancy or undergo a sterilization operation if both husband and wife (or either of them) have [a] hereditary or other disease not medically suitable for birth." The provisions of these Regulations prohibiting prenatal sex selection were reported in Annual Review of Population Law, Vol. 17, 1990, Section 240.     

Desired family size in Thailand: Are the responses meaningful?

Data for both rural and urban women in Thailand indicate that the large majority of respondents are able to provide numerical responses to questions on desired family size. Although there is evidence that some women tend to rationalize the number of children they have when stating the number they would want if they were recently married, the vast majority of respondents prefer a number which is different from the number of living children they had at the time of the interview. Women who had already reached or exceeded their desired number were almost universal in stating they wanted no additional children, whereas only a minority of women who had yet to reach their desired family size said they wanted no more children. Finally, the proportion of women who practiced family planning is substantially greater among women who had already achieved or exceeded their desired family size than among women who had fewer than their desired number. The results thus suggest that, in Thailand at least, responses to family size preferences need to be interpreted with caution but nevertheless can be of use to the population analyst.     

Comprehensive understanding of "truth of China's family planning practices"

This is an account of the tour by 25 U.S. Congressmen to the Peoples' Republic of China in November 1986 to determine the degree of coercion in the family planning program. 1st, the delegates attended a conference in Beijing, introducing the family planning program in China, lead by the minister of the China State Family Planning Commission. Then they had talks with researchers at the Population Research Centre. The group split up and some inspected the Nanjing Institute of Family Planning Management. Others went to Shanghai and visited the International Peace Hospital of Maternity and Child Care. 2 delegates travelled to a rural community in Jiangsu Province. Thus, the congressmen and women got a wide exposure of central authorities and local organizations. A spokesman for the Education, Science, Culture and Public Health Committee emphasized that the few incidents of coercion were exceptions, contrary to policy, and greatly spectacularized in the western press. Some cases were merely a variety of management style, and were dealt with by admonition. Women usually go for abortions on their own request. Those who have unplanned births are subject to social pressure and taxation. China's population policy must be respected as it is designed to meet her particular needs.     

Women’s experiences of infant feeding support: Findings from a cross-sectional survey in Victoria,Australia

ObjectiveTo evaluate new mothers’ experiences of infant feeding support.DesignA postal survey developed for this study was sent to all new mothers in ten local government areas in Victoria, Australia when their baby was six months of age. Questions explored infant feeding methods, feeding support services, and experiences of infant feeding support. This survey made up one component of the Supporting breastfeeding In Local Communities (SILC) cluster randomised controlled trial.Findings997/4127 women (24%) completed the survey between 15 April 2013 and 31 July 2013. Women received infant feeding support from multiple sources, including professionals, family members, and peers. Overall, 88% reported receiving adequate infant feeding support. Women who reported not receiving adequate infant feeding support were less likely to be giving any breast milk at six months compared to those reporting adequate support (OR = 0.59; 95% CI 0.40, 0.88). Adjusting for breastfeeding intention and parity did not alter the association (Adj. OR = 0.60; 95% CI 0.40, 0.90). Women were most satisfied when they received accessible, available, consistent professional infant feeding support provided in a non-judgemental and reassuring way. Women were dissatisfied when there were barriers restricting access to support, or when they received conflicting advice or support that made them feel guilty, pressured or judged.Key conclusionsRegardless of infant feeding method, women wanted accessible, non-judgemental support. Given that receiving adequate support was associated with more breast milk feeding at six months, care providers should ensure accessible infant feeding support is available to all new mothers.     

Geographic mobility of scientists: Sex differences and family constraints

Women scientists are much more likely than men scientists to be in two-career marriages. This study examines the argument that the higher prevalence of two-career marriages among women scientists presents a significant impediment to their geographic mobility. Three hypotheses are developed and tested. First. scientists in two-career families are less likely to migrate than scientists in one-career families. Second, the effect of two-career marriages on the probability of migration differs with gender; women are affected more negatively. Third, the effect of children on the probability of migration differs with gender; women are affected more negatively. The empirical work uses a data set of doctoral scientists extracted from the 5% Public Use Microdata Sample from the 1990 census. The first two hypotheses are not confirmed by the empirical results. but we find evidence supporting the third. Family constraints on women scientists’ careers generally appear to be weak. but become acute when they have children.     

Two earner family migration A search theoretic approach

This paper represents the first attempt to model the two earner family decision to migrate using a joint search theoretic approach. In so doing, the paradox of a couple whose members would both migrate if single but decide not to migrate because they are married to each other is discovered and explained. Furthermore the impact of the rising number of working women and reentry of wives into the labor force on the extent and regional pattern of migration is discussed. Extensions to the model are addressed, as well as future avenues of research, both theoretical and empirical. It is suggested that the search theoretic approach, not previously applied to models of family migration, is the most appropriate.     

中国西部大开发中的妇女发展问题

妇女既是西部大开的受益者,也是实施大开发战略需依靠的重要力量,研究西部大开发战略应考虑妇女的视角,研究妇女在西部大开发中的地位和作用,以及大开发对妇女发展自身的影响,在此基础上来确立西部大开发战略中的妇女发展策略。根据国际妇女与发展的实践经验和我国西部地区妇女发展的现实,本文认为,在制定西部大开发战略的具体行动计划时,必须强化性别意识,充分考虑妇女的特殊需要和妇女的特殊利益,并使之反映在发展计划之中,以体现富民为本的发展原则;要把培养和提高妇女参与西部大开发的能力作为中心任务之一;为妇女提供充分参与西部大开发的机会。     

The role of support person for Ngaanyatjarra women during pregnancy and birth

BackgroundThis study took place in a remote community on the Ngaanyatjarra Lands, Western Australia. Ngaanyatjarra women's cultural practices have been subject to erosion during the past 70 years. Women are now expected to birth hundreds of kilometres from home and, due to financial barriers, without family support. Older women lament their lack of input into, and control of, contemporary birthing services.Research questionIn order to provide culturally appropriate maternity services we asked: What issues would the Ngaanyatjarra women of the community like to see resolved in the area of antenatal and birthing services?Participants and methodsEligible participants were any Ngaanyatjarra women of the study community who had birthed at least once. We utilised a participatory research methodology. 36 women were interviewed.FindingsThis paper discusses one finding related to support for child-bearing women. The role is important in many ways. Ngaanyatjarra women did not traditionally have their support persons with them during labour and birth, nor do they necessarily expect them to be present in current times. Most women do, however, wish to have a support person with them during antenatal checkups and when they travel to town to await birth.ConclusionAboriginal women from remote communities should be able to have a support person with them when they access regional birthing services, but the nature of this role must not be assumed. A culturally appropriate service has input from the community, provides options and respects choices.     

Nepal survey shows that "family planning saves lives"

This article presents the results of the Nepal Family Health Survey (NFHS) conducted from January through June 1996. Data on fertility, family planning, and maternal and child health were collected from 8429 ever-married women aged 15-49 years. These women provided information on 29,156 children. Using the method of regression analysis, findings reveal those factors, such as young mothers, large families, and short birth intervals, substantially increase under-five mortality risks. However, socioeconomic factors have only a limited effect on under-five mortality. Statistics have suggested that much of the urban/rural differences in mortality have been due to factors closely related to residence, mother's level of education and economic status. In addition, although positive effects of interventions (antenatal and postpartum checkups, tetanus immunization and assistance at delivery by a traditional birth attendant) have been documented, statistical results show that few children in Nepal are receiving the benefits of maternal health care. In conclusion, results of the 1996 NFHS show that delaying, spacing, and limiting births can substantially reduce infant and child mortality.     

Coresidence With Husband’s Parents,Labor Supply,and Duration to First Birth

This article investigates the time to first birth, treating coresidence with husband’s parents and labor supply as endogenous and using representative data on Taiwanese married women born during 1933–1968. We use a full-information maximum likelihood estimator for a duration model with endogenous binary variables. Results controlling for endogeneity suggest that both coresidence and working are associated with a delay in childbearing, reversing the effect of coresidence on the timing of first birth but not that of working. Women in earlier cohorts tend to choose coresidency and not working, and an increasing number of women from later cohorts choose to do both or to work only.     

Junior partners: Women's contribution to family income in Canada

This research examines the degree of financial contribution of married women to their overall family income. This phenomenon is analyzed from the point of view of sex-role/human capital orientations. The sex-role position argues that regardless of women's social, economic and education background their financial input to household economy will always be less than fifty percent because women's financial opportunities are impeded by sex-role configurations and expectations. The human capital thesis explains women's apparent inability to contribute more than half of the family income as a function of their lower human capital; that is, education, professionalization and training in the labour market. Individual data pertaining to thirty-year old married women, taken from the 1981 Canadian census, are examined. Generally, we find support for the positions: Women with relatively high human capital assmulation contribute significantly to overall household income, but invariably that contribution is less than 50 percent of total family income. On average, all women contribute 22 percent of their families annual income, while working women provide approximately 33 percent of the total. This analysis demonstrates what appears to be a pervasive phenomenon in industrial nations: married women are generally junior economic partners within the family. The extent of junior partnerships, however, is somewhat conditioned by women's human capital resources.     

Level of choice in older women’s decisions to retire or continue working and associated well-being

Retirement is a complex life transition. Women’s retirement, like their work lives, may be further complicated, for example, by family or financial obligations; they may feel forced to retire or to continue working or feel they have the choice to do so. This study examines the role of voluntary versus involuntary retirement or continued work participation among retirement-age women; specifically, the relationships between choice, work status, and well-being. Compared to women forced to retire, women who chose retirement or continuing to work had higher levels of life satisfaction. Findings highlight the importance of examining retirement within the life course context.     

中国城市居民劳动供给行为特征

经过40多年的改革开放和计划生育政策实施,我国城市居民家庭规模、家庭财富、受教育程度等影响劳动供给行为的因素均发生了巨大变化。这种变化对就业政策的制定和相关福利政策的实施都有较大影响。运用来自29个省市6675个城市家庭、8771个居民的调查数据对我国城市居民劳动供给行为进行了研究。结果表明:我国城市居民劳动供给曲线整体上呈现向右上方倾斜的特征,随着工资上涨,劳动者工作时间随之增长,但是工资弹性仅有0.52,处于缺乏弹性的区间;分类型看,女性、户主、受教育程度较低者工资弹性较大,对工资变动更加敏感;女性、户主、受教育程度较高者收入弹性更大,对收入变动更加敏感;分年龄阶段看,18—30岁的新生代劳动力工作时间受工资和非工资收入影响均不显著,31—45岁的劳动力比45岁以上劳动力工资弹性和收入弹性更高,对工资和非工资收入更加敏感。本文的研究结果对细化实施就业政策和制定相关福利政策具有一定启示作用。