The ‘fallacy of normalcy’: A content analysis of women's online post-childbirth health-related support

BackgroundOnline forums have changed traditional sources of seeking help because they provide an anonymous and non-judgemental environment particularly suited for women with post-childbirth problems.QuestionWhat support is given to mothers who have posted questions about post-childbirth morbidities?MethodsA total of 333 messages posted on a post-childbirth online forum were loaded into NVIVO 12 Pro and were analysed using content and thematic analysis. Content analysis identified the major health problems, and thematic analysis was used for identifying motivations and the support offered.FindingsSeventeen different health problems were discussed on posts, with a strong emphasis on pelvic problems, followed by mental health concerns. The key motivation for seeking online help identified using ‘typology of advice solicitation’ was request for opinion or information (48.85%). The two main support themes were: peer to peer support (82%) and normalisation (not always appropriate) of post-childbirth problems (18%). Most of the support offered was emotional (56.9%) followed by practical (22.7%) and informational support (20.4%).DiscussionPostpartum adjustment of post-childbirth experiences can be supportive but if ill-informed may provide a barrier to safe and reliable health care.ConclusionWe recommend women have access to online forums moderated by healthcare providers who can notify participants when a problem requires support from a relevant health professional opinion.     

Forming relationships in Australia: Qualitative insights into a process important to human wellbeing

Drawing on in-depth interviews conducted during 2002–03 for the Australian Family Formation Decisions (AFFD) Project, this paper probes the relationship formation experiences of 115 women, men and couples of family-forming age living in eastern Australia. Contemporary relationship formation is characterized by a mixture of ambivalence and resignation to having limited control over the process on the one hand (if it happens it happens), and urgency on the other, especially among women seeking to fulfil maternal ambitions in their thirties after prioritizing other things earlier in their adult lives. For most the process of partnering involves trial and error, with timing — finding someone whose expectations of a relationship match one's own — posing a major challenge. It gives rise to a common phenomenon, the ‘too soon syndrome’, where relationships with many positive attributes are abandoned because one party perceives the other as too keen to ‘settle down’, and/or himself or herself as not ready to do so. The paper also examines impediments to partnering, including traditional ones like shyness; negative trial-and-error experiences; the demands of study and career establishment; pursuit of agendas emphasizing travel and enjoyment; sole parenthood; and parental marriage breakdown. A framework is provided by Beck's (1992) concept of reflexive modernization, and his associated proposition that life has become highly individualized with an emphasis on creating do-it-yourself biographies.     

Seeking and Processing Information for Health Decisions among Elderly Chinese Singaporean Women

Information behavior includes activities of active information seeking, passive acquisition of information, and information use. Guided by the Elaboration Likelihood Model, this study explored elderly Singaporean women’s health information behavior to understand how they sought, evaluated, and used health information in everyday lives. Twenty-two in-depth interviews were conducted with elderly Chinese women aged 61 to 79. Qualitative analysis of the interview data yielded three meta-themes: information-seeking patterns, trustworthiness of health information, and peripheral route of decision making. Results revealed that elderly women took both systematic and heuristic approaches to processing information but relied on interpersonal networks to negotiate health choices.     

试论女性求职心理弱势的成因与调适

如今女性求职难是一个普遍的社会问题。对此,我们虽然可以从社会,文化和历史诸背景中找到其原因,但女性自身存在的种种弱点更不可忽视。为了适应和利用求职氛围中的千变万化,女性必须丢掉自卑感,树立自信心,努力对自己的弱势心态进行合理调适,不断提高自身的心理素质,从而对于顺利求职将起到重要的促进作用。     

Seeking safer sexual spaces: queer and trans young people labeled with intellectual disabilities and the paradoxical risks of restriction

Young lesbian, gay, bisexual, and transgender (LGBT) people labeled with intellectual disabilities have unique sexual health needs that are not being met. Denial by others of their right to pleasure and the exercise of heightened external control over their sexuality are commonplace. Current research indicates that these youth are at heightened risk for compromised sexual health. This study aimed to explore the ways in which social and environmental conditions influence vulnerability to adverse sexual health outcomes for this population. We used a community-based research approach to conduct qualitative interviews and focus groups with 10 young LGBT people (aged 17-26) labeled with intellectual disabilities. Participants reported multiple limitations on their autonomy that resulted in having sex in places where they did not feel comfortable and were unlikely to practice safer sex. Attempts by authority figures to protect youth through limits on their autonomy may be unintentionally leading to negative sexual health outcomes.     

The maternity experiences of women seeking asylum in high-income countries: a meta-ethnography

ProblemThe maternity care experiences and perinatal outcomes of women seeking asylum in high-income countries (HICs) are poorer than the general population of pregnant women in that HIC. There is a paucity of literature on the maternity experiences of women seeking asylum in HICs.BackgroundThere is an increasing number of women seeking asylum in HICs due to escalating violence and human rights abuses. Asylum-seeking women are a distinct group whom are likely to have different needs to refugees or migrants as a result of their undocumented status.AimThis literature review aimed to explore the emotional, physical and health information needs of women seeking asylum in the perinatal period in HICs, to provide insights to better address their maternity needs.MethodA meta-ethnography described by Noblit and Hare, was applied to analyse the studies, to reflect the voices of women seeking asylum, hosted in HICs in their perinatal period.FindingsEight studies were included in the review. The overarching theme was ‘just having to survive.’ Four sub-themes were revealed which highlighted the vulnerability of asylum-seeking women. They included: ‘I was never sure if I had understood’, ‘feeling ignored and alone’, ‘ongoing dislocation and recurrent relocation’ and ‘knowing there’s someone who cares for you’.DiscussionImproved maternity care for women seeking asylum requires culturally appropriate respectful maternity care and supportive strategies such as consistent access to language services.ConclusionIt is recommended that future research is targeted to explore the maternity experience of women seeking asylum in HICs, such as Australia.     

Desperately Seeking Sameness

The Internet offers a plethora of venues for autobiographical self-representation: webcams, personal websites, blogs. There is much research on self-representation online, whereas very little research has focused on the consumption of online self-representation. This article focuses on the act of reading diary blogs. Who are the actual readers of a specific blog and what values do they place on the event of reading? What draws them to the diary site in the first place and what mechanisms make them return? To attempt to uncover the reading practices involved for readers of diary weblogs I have conducted an explorative web survey on “how/when/why we read weblogs” on four independent diary blog sites kept by women in their 30s. The consumption of these blogs seem to be severely circumscribed by notions of sameness: based on gender, age, place of living, race/ethnicity, educational level. Readers report being drawn to the diary blog for the rhythm of serial autobiographical consumption and the possibilities of identification. They report looking for “likeness” in the first place. The lure of identification might always have led readers to autobiographical writing. Yet, these diary weblog readers, who in the main self-identify as female, report feeling heightened senses of identification by the proximity in time between the scenes of production and the scenes of consumption and by the deferral of the notion of an ending. This article explores the discursive connections made between the serial, the longitudinal, the consistent, and the construction and consumption of recognizable female selves.     

Women's Sexual Identity Patterns: Differences Among Lesbians,Bisexuals, and Unlabeled Women

To better understand women with same-sex attractions who do not identify as lesbian or bisexual (i.e., unlabeled women), we examined differences and similarities among self-designated lesbian, bisexual, and unlabeled women. Two hundred eight non-heterosexual women ranging in age from 18 to 69 years (85% identified as White) completed an online survey examining indicators of sexual orientation and beliefs and self-perceptions associated with sexual identity. Compared to lesbians, unlabeled women reported the weakest collective sexual identities and, along with bisexuals, they were less likely to view sexual orientation as fixed, being more focused on the “person, not the gender.” Unlabeled women reported the greatest likelihood that their sexual identity would change in the future. These findings highlight the complexity of women's sexual identities and question the adequacy of categorical approaches.     

Maternal Health Care Seeking Behavior in a Post-Conflict HIPC: The Case of Rwanda

Rwanda is one of nine post-conflict heavily indebted poor countries (HIPC) of the world. There was a worsening of health indicators since the early nineties on account of conflict. In light of this, we examine factors affecting maternal health care seeking behavior in Rwanda using three rounds of Rwanda Demographic and Health Survey (RDHS) data (1992, 2000, and 2005). We find that progress towards increasing the share of assisted deliveries has been slow. There has been no significant increase in the proportion of women seeking antenatal care. This could partially explain why a large proportion of women continue to deliver at home without professional assistance. Further, women who gave birth in the 5 years preceding the 2000 RDHS are less likely to deliver in a health facility than those who gave birth in the 5 years preceding the 1992 RDHS. We do not find such a result for the year 2005. We also find that women are more likely to deliver at home with professional assistance in 2000 and 2005 compared to 1992.     

Facing Age: Women Growing Older in an Anti-Aging Culture,by Laura H. Clarke

This is a pilot study exploring intimacy and self esteem in older black women. Twenty six married, urban, non-institutionalized African American women over the age of 60 were interviewed in this investigation. Information concerning their intimate relationships with their spouses and its relationship to their self esteem was gathered. Subjective passages are examhed to accent these relationships. These women were, generally, open about the quality of the relationship between themselves and their spouses. They reported relatively high levels of intimate relations. In particular they described the sub-factors of intimacy such as affection, friendship and a sense of empathy to be positively associated with self esteem. Interestingly, higher frequency of sexual intercourse was seen to be negatively associated with self esteem for these older women. Implications of these findings are discussed.     

Survey sheds new light on marriage and sexuality in the Philippines

The Young Adults Fertility and Sexuality Study (YAFS-II) was conducted in 1994 by interviewing 10,879 men and women aged 15-24 years in households on dating, marriage, and onset of sexual activity in the Philippines. In addition, screening data were collected on all households visited and on the 959 sampled local communities. Direct questions on premarital sex revealed that at least 52% of married women had sex before marriage. Among married respondents, 57% of men and 51% of women reported having had sex with their spouse before they were married. Only 3% of the women had additional premarital partners vs. 37% of the men. Questions on premarital sex and social patterns showed that about 20% of the single women and 28% of the single men had been in a serious relationship by the time they were 17. By age 20, 44% of the single women and 63% of the single men had been in a serious relationship, while the respective figures by age 24 were 60% and 68%. Altogether 24% of the women and 10% of the men described themselves as married. 34% of all women who either eloped or lived with their spouses had been married in church by the time of the survey, 23% had had civil ceremonies, and 41% designated their marital status as cohabitation. With regard to the risk of HIV/AIDS and other sexually transmitted diseases, 25% of the 24-year old men who never had a girlfriend reported sexual experience and 22% of those still single at age 24 reported that they had visited a commercial sex worker. Marital status was not the best basis for providing family planning services, and the provision of reproductive health services to young people living in consensual union would reduce accidental pregnancy.     

Large gaps in the quality of healthcare experienced by Swedish mothers during the COVID-19 pandemic: A cross-sectional study based on WHO standards

Background and ProblemExisting healthcare systems have been put under immense pressure during the COVID-19 pandemic. Disruptions in essential maternal and newborn services have come from even high-income countries within the World Health Organization (WHO) European Region.AimTo describe the quality of care during pregnancy and childbirth, as reported by the women themselves, during the COVID-19 pandemic in Sweden, using the WHO ‘Standards for improving quality of maternal and newborn care in health facilities’.MethodsUsing an anonymous, online questionnaire, women ≥18 years were invited to participate if they had given birth in Sweden from March 1, 2020 to June 30, 2021. The quality of maternal and newborn care was measured using 40 questions across four domains: provision of care, experience of care, availability of human/physical resources, and organisational changes due to COVID-19.FindingsOf the 5003 women included, n = 4528 experienced labour. Of these, 46.7% perceived a poorer quality of maternal and newborn care due to the COVID-19. Fundal pressure was applied in 22.2% of instrumental vaginal births, 36.8% received inadequate breastfeeding support and 6.9% reported some form of abuse. Findings were worse in women undergoing prelabour Caesarean section (CS) (n = 475). Multivariate analysis showed significant associations of the quality of maternal and newborn care to year of birth (P < 0.001), parity (P < 0.001), no pharmacological pain relief (P < 0.001), prelabour CS (P < 0.001), emergency CS (P < 0.001) and overall satisfaction (P < 0.001).ConclusionConsiderable gaps over many key quality measures and deviations from women-centred care were noted. Findings were worse in women with prelabour CS. Actions to promote high-quality, evidence-based and respectful care during childbirth for all mothers are urgently needed.     

“His” and “Hers”: Meeting the Economic Bar to Marriage

Scholars have suggested that low-income parents avoid marriage because they have not met the so-called economic bar to marriage. The economic bar is multidimensional, referring to a bundle of financial achievements that determine whether couples feel ready to wed. Using the Building Strong Families data set of low-income parents (n = 4,444), we operationalized this qualitative concept into a seven-item index and examined whether couples who met the economic bar by achieving the majority of the items were more likely to marry than couples who did not. Meeting the bar was associated with a two-thirds increase in marriage likelihood. The bar was not positively associated with cohabitation, suggesting that it applies specifically to marriage. When we examined different definitions of the bar based on whether the mother, father, or both parents contributed items, all variants were associated with marriage, even if the bar was based on the mother’s economic accomplishments alone. When mothers contributed to the economic bar, they reported significantly higher relationship quality. Our results reinforce the importance of the multidimensional economic bar for marriage entry, highlighting the role of maternal economic contributions in low-income relationships.     

Experiences of Ex-Ex-Gay Individuals in Sexual Reorientation Therapy: Reasons for Seeking Treatment,Perceived Helpfulness and Harmfulness of Treatment,and Post-Treatment Identification

Therapy meant to change someone’s sexual orientation, or reorientation therapy, is still in practice despite statements from the major mental health organizations of its potential for harm. This qualitative study used an inductive content analysis strategy (Patton, 2002) to examine the experiences of thirty-eight individuals (31 males and seven females) who have been through a total of 113 episodes of reorientation therapy and currently identify as gay or lesbian. Religious beliefs were frequently cited as the reason for seeking reorientation therapy. Frequently endorsed themes of helpful components of reorientation therapy included connecting with others and feeling accepted. Harmful aspects of reorientation therapy included experiences of shame and negative impacts on mental health. Common reasons for identifying as LGB after the therapy included self-acceptance and coming to believe that sexual orientation change was not possible. The findings of this study were consistent with recommendations by the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation (2009), which concluded that helpful aspects of reorientation therapy could be achieved through affirmative treatment methods while avoiding potential harms that may be associated with reorientation therapy. Limitations of the findings, including a small, self-selected sample, are discussed.     

The experiential knowledge of migrant women about vulnerability during pregnancy: A woman-centred mixed-methods study

ProblemWithin maternity care policies and practice, pregnant migrant women are regarded as a vulnerable population.BackgroundWomen’s experiential knowledge is a key element of woman-centred care but is insufficiently addressed in midwifery practice and research that involves migrant women.AimTo examine if pregnant migrant women’s experiential knowledge of vulnerability corresponds with sets of criteria of vulnerability, and to explore how migrant women make sense of vulnerability during pregnancy.MethodsA sequential two-phased mixed-methods study, conducted in the Netherlands, integrating survey data of 89 pregnant migrant women and focus group data obtained from 25 migrant mothers - living in deprived areas according to the Dutch socio-economic index.ResultsCriteria associated with vulnerability were reported by 65.2% of the participants and 62.9% of the participants reported adverse childhood experiences. On a Visual Analogue Scale, ranging from 0 (not vulnerable) to 10 (very vulnerable), participants self-reported sense of vulnerability showed a mean score of 4.2 (±2.56). Women’s experiential knowledge of vulnerability significantly correlated with the mean sum score of clinical criteria of vulnerability (r .46, p .002) and with the mean sum score of adverse childhood experiences (r .48, p < .001). Five themes emerged from the focus group discussions: “Look beyond who you think I am and see and treat me for who I really am”, “Ownership of truth and knowledge”, “Don’t punish me for being honest”, “Projection of fear” and “Coping with labelling”.ConclusionPregnant migrant women’s experiential knowledge of vulnerability is congruent with the criteria. Calling upon experiential knowledge is an attribute of the humane woman-midwife relationship.     

Taking the reins: A grounded theory study of women's experiences of negotiating water immersion for labour and birth after a previous caesarean section

BackgroundWomen seeking a vaginal birth after a caesarean section (VBAC) frequently want to keep their subsequent labour and birth free from intervention. Water immersion (WI) during labour is potentially an effective tool for women having a VBAC for its natural pain-relieving properties. However, negotiating access to WI can be difficult, especially in the context of VBAC.AimTo explore women's experiences of negotiating WI for labour and birth in the context of VBAC.MethodologyThis Grounded Theory study followed Strauss and Corbin's framework and analytic process. Twenty-five women planning or using WI for their VBAC labour or birth were recruited from two midwifery practices and a social media group across Australia. Participants were interviewed during pregnancy and/or postnatally.Findings‘Taking the reins’, the core category explaining the women’s experiences of assuming authority over their birth, comprised five categories: ‘Robbed of my previous birth experience’; ‘My eyes were opened’; ‘Water is my tool for a successful VBAC’; ‘Actioning my choices and rights for WI’, and ‘Empowered to take back control’. ‘Wanting natural and normal’ was the driving force behind women’s desire to birth vaginally. Two mediating factors: Having someone in your corner and Rules for birth facilitated or hindered their birth choices, respectively.ConclusionThe women became active participants in their healthcare by seeking information and options to keep their birth experience natural and normal. Support from other women and advocacy in the form of continuity of midwifery care was crucial in successfully negotiating WI for their VBAC when navigating the complex health system.     

Psychosocial adversities at work are associated with poorer quality marriage-like relationships

The characteristics of work have an impact on individuals?? personal lives, including on health and close personal relationships. Previous research into the negative spillover effects from work to marital quality has predominantly examined structural job characteristics, such as job hours and shift work. This study used data from a large representative community sample of midlife (aged 40?C44 at baseline) employed persons in marriage-like relationships (n?=?2,054) to investigate the relationship between psychosocial job characteristics and relationship quality. Data from three waves of the Personality and Total Health (PATH) Through Life Survey were analysed. The results show that all psychosocial job adversities (high job demands, low job control, and job insecurity) were independently associated with lower levels of positive support from partners for both men and women. In addition, there was a linear relationship between the number of psychosocial adversities reported and lower levels of positive support from partners. These findings are relevant to policy makers in the areas of employment and family services. They identify the potential broader social costs of adverse psychosocial characteristics at work. This study sets the scene for further longitudinal research to examine the causal links between psychosocial job quality and relationship quality.     

Remarriage in later life: older women's negotiation of power, resources and domestic labor

Using data from in-depth interviews with 24 community-dwelling women aged 52-90, this paper analyzes the remarriage experiences of older women in contrast to their first marital relationships. The women's accounts of their experiences in their first and later life marriages are examined in terms of the negotiation of power, resources, and domestic labor. While first marriages were frequently characterized by incompatibility, alcoholism, abuse, and infidelity, second marriages were viewed as the marriages the women wished they had had in the first place or as relationships that met their later life needs. The women's lived experiences are discussed in terms of the changing cultural norms pertaining to gender roles, marriage, and divorce.     

It takes a virtual village: Childbearing women's experience of a closed Facebook support group for mothers

BackgroundChildbearing women engage in large public pregnancy and parenting forums, primarily for the purpose of seeking information and advice. There is an absence of research related to women's engagement in closed and private online mothers’ groups.AimThe aim of this study was to explore the experiences of participation and support for members within a closed online mothers’ group.MethodA qualitative study using in-depth interviews. Reflexive thematic analysis was used to analyse the data.FindingsThis study demonstrated that a closed online mothers’ group enabled a group of childbearing women to overcome isolation and form sustained, evolving and supportive friendships within a small, private and trusted group. The technology allowed women to engage and share at a level much deeper than what they would in “real life”. The depth of sharing was enhanced in a closed online mothers’ group due to a smaller, private audience of trusted friends. Virtual support felt safer than face-to-face support as information could not impact one's real world reputation, and communication was able to be controlled. This was particularly helpful to women experiencing social difficulties or isolation.ConclusionThis study has provided a unique and rare insight into the private world of closed online mothers’ groups. As a virtual village, this closed group enabled childbearing women to form a small community with members sharing responsibility and working for the wellbeing and benefit of all. By encouraging, locating and establishing similar groups, maternity health professionals may assist women to access their own ‘virtual village’.