Women's stories of birth: a suitable form of research evidence?

In the past one to two decades, midwifery care has taken a new direction, which encompasses a valuing of women's birth experiences. This move has been contingent upon, and congruent with the adoption of 'woman centred' care and a renewed emphasis on normal birth. In line with these developments, women's stories and anecdotes of birth and midwives stories of experience increasingly form the basis of presentations at midwifery conferences and forums. Overall, this philosophical realignment, which commenced in Australia in the early 1990s, has been applauded by many midwives in terms of a greater valuing of the wishes and experiences of childbearing women and as being consistent with a greater promotion of normal birth. Nonetheless, it also gives rise to several questions, regarding the suitability of this form of research evidence. In a bid to answer some of those questions, this paper aims to evaluate the use of stories and anecdotal evidence within midwifery. First, an overview is presented of the way in which stories of pregnancy and birth appear in the literature. Secondly, the value of stories as evidence is critiqued and, finally, the ratio of story based publications, compared to traditional research methodologies, is reviewed. This review aims to address an area poorly attended in the literature and asks specifically: Are women's birth stories a suitable form of research evidence in midwifery?     

Jack’d,a Mobile Social Networking Application: A Site of Exclusion Within a Site of Inclusion

User-generated smartphone applications have created a new level of virtual connectivity for gay males, one in which users can create profiles and meet other users as nearby or as far away as possible. For those within close proximity, the other users can be considered their “virtual neighbors.” Although the applications are theoretically designed to be places of inclusion and not exclusion, where any gay male with economic means can download an application, many profiles have been created that exclude other users. Through an examination of profiles on one such application, Jack’d, exclusion is found in the way users celebrate and reinforce ideas of traditional masculinity and denigrate and reinforce stereotypic ideas of femininity embodied by some gay men. Jack’d, and other user-generated smartphone applications, can be read as virtual neighborhoods where one is excluded based on their gender performance.     

Lighting the Pathway to Adulthood Experience of a teacher from a rural primary school

The Model Primary School is a rural school located in a region joining the town and country in Jiamusi City,Heilongjiang Province.Sex education is a new idea and has never been taught there before. Two years ago,I had my first experience teaching a sex education class.During the first class,I blushed with embarrassment and found it difficult to talk about     

From a Number-Centered Officer to a Quality of Care Advocator: A Personal Story

My colleagues have presented at the Conference the Chinese initiative to reorient its family planning program from a demographic driven to a quality of care approach since 1995. I was responsible on behalf of China's State Family planning Commission (SFPC) for the quality of care experiment among the 11 pilot counties/districts until my retirement in 1999. While I devoted myself in the late 1990s to advocate the concept of the quality of care in China, I was in fact the person very much e…     

Adolescent Health Education from the Eyes of a Journalist

In 2000,the China Family Planning Association(CFPA)in collaboration with the Program for Appropriate Technology in Health (PATH)began an adolescent health education program in China. The keys to starting the program,to people's surprise, were the"goalkeepers"such as decision-makers,teachers and parents.     

Model Head of a Family Planning "Central Household

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Ageing of a giant: a stochastic population forecast for China, 2006–2060

This paper presents a stochastic population forecast for China with a special emphasis on population ageing. The so-called scaled model for error was used to quantify the uncertainty attached to the population predictions. Data scarcity was a major problem in the specification of the expected error of the population forecast. Therefore, the error structures estimated for European countries were used with some modifications, taking into account the large size and heterogeneity of the Chinese population. The stochastic forecast confirms the expectation of extremely rapid population ageing during the first half of the twenty-first century in China. The old age dependency ratio (OADR) will certainly increase. Simply maintaining the current demographic rates (no international migration) would drive the OADR to 0.42 in 2060, four times the current level. Including expected declines in mortality and net outmigration in the projection would increase the median OADR in 2060 to 0.59, with a 80% prediction interval of [0.47, 0.75]. In particular, the oldest-old population will grow much faster than any other age group. This development has major implications for policy-making in China.

Is There a Trade-Off Between Economic Efficiency and a Generous Welfare State? A Comparison of Best Cases of `The Three Worlds of Welfare Capitalism’

A crucial debate in policy-making as well as academiccircles is whether there is a trade-off betweeneconomic efficiency and the size/generosity of thewelfare state. One way to contribute to this debate isto compare the performance of best cases ofdifferent types of state. Arguably, in the decade198594, the US, West Germany and the Netherlands were best cases best economic performers in whatEsping-Andersen (1990) calls the three worlds ofwelfare capitalism. The US is a liberalwelfare-capitalist state, West Germany a corporatiststate, and the Netherlands is social democratic in itstax-transfer system, although not its labor marketpolicies. These three countries had rates of economicgrowth per capita as high or higher than other richcountries of their `type, and the lowest rates ofunemployment.At a normative or ideological level the three types ofstate have the same goals but prioritise themdifferently. The liberal state prioritises economicgrowth and efficiency, avoids work disincentives, andtargets welfare benefits only to those in greatestneed. The corporatist state aims to give priority tosocial stability, especially household incomestability, and social integration. The socialdemocratic welfare state claims high priority forminimising poverty, inequality and unemployment.Using ten years of panel data for each country, weassess indicators of their short (one year), medium(five year) and longer term (ten year) performance inachieving economic and welfare goals. Overall, in thistime period, the Netherlands achieved the bestperformance on the welfare goals to which it gavepriority, and equalled the other two states on most ofthe goals to which they gave priority. This resultsupports the view that there is no necessary trade-offbetween economic efficiency and a generous welfarestate.The three panel studies are the American Panel Studyof Income Dynamics (PSID), the German Socio-EconomicPanel (GSOEP) and the Dutch Socio-Economic Panel(SEP). They all have samples of over 15,000 and arethe only national panels to have run for tenconsecutive years or more, so making it possible toassess the longer term performance ofwelfare-capitalist states.     

Comparison of breastfeeding in rural areas of Sweden and Australia – a cohort study

BackgroundBreastfeeding rates in Sweden and Australia appears to be decreasing in both countries. National statistics shows that 87% of infants in Sweden and 73% in Australia receive any breastfeeding two months of age.AimTo compare women's experiences of breastfeeding in Sweden and Australia and to identify factors associated with breastfeeding two months after birth.MethodsA cohort study in two rural hospitals in mid Sweden (n = 300) and north-eastern Victoria in Australia (n = 91) during 2007–2009. Participants responded to questionnaires in mid pregnancy and two months after birth. Crude and adjusted odds ratios with a 95% confidence interval were used to detect differences between women in both cohorts.FindingsWomen in Sweden (88.3%) were more likely to report any breastfeeding of the baby two months after birth (OR 2.41; 95% CI: 1.33–4.38) compared to women in Australia (75.8%) but were less satisfied with breastfeeding support and information. The most important factor associated with breastfeeding at two months postpartum for the Swedish women was to have received sufficient information about breastfeeding on the postnatal ward (OR 2.3; 95% CI 1.41–4.76) while for the Australian women receiving the best possible help when breastfeeding for the first time was most important (OR 4.3; 95% CI 1.50–12.46).ConclusionThe results indicate that Swedish women were more likely than their Australian counterparts to breastfeed the baby two months after birth. The findings demonstrated the importance of sufficient information and help when breastfeeding is initiated.     

A Structural Equation Model Estimation of the Role of Social Vulnerability as a Predictor of People’s Feelings of Unsafety

Social Indicators Research - People’s perception of insecurity is linked to a wide range of factors and up-to-date sources stress the impact of socially constructed concerns on feelings of...     

Latent Possibility for a Change of the Fertility Behaviors of Rural－Urban Migrants

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China Has a Population of 1.2058 Billion with Household Registration

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What is natural fertility? The modelling of a concept

The value and importance of the concept of natural fertility have been widely debated since Henry's work in the late 1950s. Whereas Henry regarded natural fertility largely as a useful concept for model building, Coale-Trussell demonstrated that this concept could also be used to analyze patterns of age-specific fertility. The set of age-specific marital fertility schedules assembled by Henry and then used by Coale and Trussell involved largely small populations drawn from disparate sources. Nonetheless, from this diverse and fragmentary data, Henry was able to construct a standard of natural fertility which, in the operational form developed by Coale-Trussell, has proved remarkably general in its application and utility. This in turn suggests that the physiological forces shaping fertility are exceedingly strong, especially the incidence of physiological sterility. There appears to be no single universal pattern of natural fertility. Rather, there is a set of closely related age profiles, the exact shape of which is determined by specific behavioral and social factors that influence childbearing. The increase in physiological sterility with age serves to give an upper limit to fertility at each age, while other factors determine how close a given population comes to that maximum. Although no society has ever demonstrated Henry's ideal notion of a purely physiological fertility pattern, the effect of the intervening factors is often weak. In terms of the Coale-Trussell model, maximum likelihood estimation offers the most informative method of implementation and a time series for 1 population is more readily interpretable than a cross-section comparing several populations.     

“I am a fat baby,who moved to a fat child,who moved to a fat teenager,who moved to a fat adult”: Women’s reflections of a lifetime of body and weight concern

The present study explored how women aged 50–65 years reflect and make meaning of a lifetime of body and weight struggles. Seven purposefully selected women with longstanding body image challenges participated in interviews and reflected on their perceptions, thoughts, and emotions around their body and weight since childhood. Findings revealed consistent and consuming concerns about the body; prevalent body-related self-conscious emotions; influential social experiences that impact physical self-perceptions; and enduring impacts of weight bias, stigma, and discrimination. Collectively, these findings provide support for the stability of body disturbances and highlight the need to explore the unique body-related narratives of women in midlife.     

What is natural fertility? The remodeling of a concept

This paper applies three log-linear models to Louis Henry's original 1961 natural fertility data in order to test various assumptions leading to ways of obtaining a standard natural fertility schedule through explicit modeling. "The models specify that births follow an independent Poisson distribution for each age interval of each population. All parameters are estimated through an iterative maximum-likelihood procedure." The author suggests that the model selected provides better estimates of the standard natural fertility function than previous models.     

Guilty until proven innocent? – The Assumption of Care of a baby at birth

BackgroundThis paper provides an overview of the history of child protection, the associated law and the 2008 amendments to the Child and Young Persons (Care and Protection) Act 1998 in relation to the Assumption of Care at birth Practice.ObjectiveTo explore the current practice of an Assumption of Care (AOC) where a newborn baby is removed from his/her mother at the time of birth, particularly focussing on the impact of the AOC on midwives.DiscussionAssumption of Care practices in NSW raise significant issues for midwives in relation to the midwifery codes of ethics and conduct and importantly, to their ability to work in ways that honour a “woman-centred care” philosophy. When midwives are exposed to conflict between workplace and personal or professional values such as the practice of AOC cognitive dissonance can occur.ConclusionsFurther research is required to understand the impact of current Assumption of Care. Broader research to not only look at effect on the midwife but also on other health professionals involved and the women who personally experience the removal of their baby at the time of birth. Consideration must also be given to ways of working with vulnerable families to enhance the acceptability and efficacy of maternity services and with associated agencies will decrease the need for Assumption of Care at birth.     

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.     

Is the Study of Happiness a Worthy Scientific Pursuit?

This paper critiques the view that the study of happiness is not a worthy scientific pursuit. The happiness set point and hedonic treadmill theories denote the complexity of increasing happiness levels due to genetic limitations and adaptation, however, there is mounting evidence to suggest that with the use of appropriate measures and specific interventions aimed at fostering strengths and virtues, happiness can be increased. Furthermore, the benefits of investigating methods for increasing happiness include improvements in physical, psychological and social health and well-being. It is concluded that approaching human needs from a top down or holistic standpoint where individuals can use their strengths to overcome life’s challenges, is beneficial to health and well-being. Hence, the study of happiness is a worthy scientific pursuit.