Women’s experiences of decision-making and attitudes in relation to induction of labour: A survey study

BackgroundRates of induction of labour have been increasing globally to up to one in three pregnancies in many high-income countries. Although guidelines around induction, and strength of the underlying evidence, vary considerably by indication, shared decision-making is increasingly recognised as key. The aim of this study was to identify women’s mode of birth preferences and experiences of shared decision-making for induction of labour.MethodAn antenatal survey of women booked for an induction at eight Sydney hospitals was conducted. A bespoke questionnaire was created assessing women’s demographics, indication for induction, pregnancy model of care, initial birth preferences, and their experience of the decision-making process.ResultsOf 189 survey respondents (58% nulliparous), major reported reasons for induction included prolonged pregnancy (38%), diabetes (25%), and suspected fetal growth restriction (8%). Most respondents (72%) had hoped to labour spontaneously. Major findings included 19% of women not feeling like they had a choice about induction of labour, 26% not feeling adequately informed (or uncertain if informed), 17% not being given alternatives, and 30% not receiving any written information on induction of labour. Qualitative responses highlight a desire of women to be more actively involved in decision-making.ConclusionA substantial minority of women did not feel adequately informed or prepared, and indicated they were not given alternatives to induction. Suggested improvements include for face-to-face discussions to be supplemented with written information, and for shared decision-making interventions, such as the introduction of decision aids and training, to be implemented and evaluated.     

Are pregnant women with asthma receiving guideline-recommended antenatal asthma management? A survey of pregnant women receiving usual care in Australia

BackgroundAsthma affects 12.7% of pregnant women in Australia. Key recommendations for asthma management during pregnancy include: 4–6 weekly review of lung function, medications, written asthma action plan, inhaler device technique, current asthma control and triggers; smoking cessation and vaccination advice. It is unknown if these key recommendations are provided to pregnant women with asthma in Australia.AimTo explore usual antenatal asthma management (usual care) in Australia and the inclusion of key recommendations.MethodPregnant women with asthma were invited to complete an online survey distributed in 2 antenatal clinics and via social media platforms from July 2017-Jan 2019.ResultsThe survey was completed by 142 pregnant women with asthma. 87(61%) were enrolled in an asthma management clinical trial and were therefore not receiving ‘usual’ care. Data presented is from 55(39%) women receiving usual care at survey completion. Of these women, 36% did not have their asthma reviewed during their pregnancy, 31% had a written asthma action plan, 11% had lung function assessed, 38% had an asthma medication review and 35% had their inhaler technique reviewed. 65% were not questioned about their asthma symptoms, 85% were not asked about asthma triggers, 96% were not given information about vaccinations and 95% did not receive smoking cessation information.ConclusionsOverall, the key recommendations for antenatal asthma management were not always provided for this sample of pregnant women receiving usual care. Improved knowledge and implementation of these key recommendations by health professionals may alter this situation and improve maternal and infant outcomes.     

How are women with a disability identified in maternity services in Australia? A cross-sectional survey of maternity managers

BackgroundWomen with a disability have poorer perinatal outcomes, but little is known about the prevalence of women with a disability accessing maternity services, how they are identified and what care and services are available. Estimates suggest that nine percent of women of childbearing age have a disability.AimTo explore how public maternity services in Australia identify pregnant women with a disability, what (if any) routine disability identification questions are used, and to examine availability and adequacy of services for women.MethodsCross-sectional online survey of maternity managers in Australian public hospitals.FindingsThirty-six percent (70/193) of eligible hospitals responded including all states and territories. Overall, 71 % routinely asked women about disability status (usually as part of routine history taking), however there was wide variation in how this was asked. Most (63 %) did not have standardised documentation processes and two thirds (65 %) were unable to estimate the number of women with a disability seen at their hospital. Most (68 %) did not offer specialised services, with only 13 % having specialised training for staff in disability identification, documentation and referral pathways. Only a quarter of respondents felt that there were adequate services for women with a disability related to maternity care.ConclusionThis is the first study to explore disability identification in maternity services in Australia. How women were asked was highly varied and documentation not standardised. National guidelines on disability identification for women accessing maternity services should be developed and collection of disability identification data should be routine.     

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.     

Striving for Prestige in Samoa: A Comparison of Men,Women, and Fa’afafine

ABSTRACT

In numerous non-Western cultures around the world, a small but meaningful proportion of individuals occupy alternative gender categories beyond the man/woman binary. A substantial body of past research has shown that feminine, same-sex attracted males in Samoa—a nonbinary gender known as fa’afafine—are more altruistic toward their nieces and nephews than are Samoan men and women. The present study examined the degree to which these kin-directed altruistic tendencies of fa’afafine are motivated by striving for prestige, and hence demonstrating value, within their family. Results showed that cisgender men and women do not differ in the degree to which they seek familial recognition of their altruistic behavior toward nieces and nephews. However, compared to men, fa’afafine sought significantly more acknowledgment of this altruism. These results illustrate one proximate cognitive mechanism for the elevated kin-directed altruism of fa’afafine and highlight the importance of the sociocultural context in which these motivations develop.     

Women’s and men’s negative experience of child birth—A cross-sectional survey

Background

A negative birth experience may influence both women and men and can limit their process of becoming a parent.

Women’s Empowerment in the Context of Millennium Development Goal 3: A Case Study of Married Women in Ghana

This paper assesses women’s empowerment in Ghana in the light of the Millennium Development Goal 3. Data for the study were drawn from the 2008 Ghana Demographic Health Survey with an analytic sample of 1,876 married women aged 15–49. Using binary logistic regression in determining the factors that influence women empowerment, this paper examines the relationship between wealth and women’s involvement in household decision-making in the context of healthcare, large household purchases, daily house hold purchases and mobility. The findings show that wealthier married women were significantly more likely to be involved in decision-making on their own healthcare (OR = 2.14, p ≤ 0.001). Also, age, tertiary education and employment significantly shaped the involvement of married women in household decision-making in Ghana. Surprisingly, married women in the Upper East region (the second poorest) were significantly more likely to be involved in three measures of decision-making except for decisions on large household purchases relative to those in the Greater Accra region (the capital). Policies oriented towards an increase in accessibility to tertiary education, employment equity and the creation of income generating activities for women would enhance women’s empowerment in Ghana.     

Literature Review on the Issue of Peasant Workers in China, 2006

The issue of peasant workers has always been an important concern and emphasis of the government and a hot topic for debate and research in academia. In 2006,     

Who is at risk of burnout? A cross-sectional survey of midwives in a tertiary maternity hospital in Melbourne,Australia

BackgroundBurnout is an occupational phenomenon with the potential to affect a person’s physical and mental health, job satisfaction and quality of work. There is evidence of burnout occurring in the midwifery profession, but inadequate data on the prevalence of, and the factors associated with, burnout.AimIdentify the prevalence of burnout in a population of midwives and explore what individual and workforce characteristics, and what occupational stressors, were associated with burnout.MethodsA cross-sectional survey of permanently employed midwives was conducted in a tertiary maternity service in Melbourne, Australia in 2017. Data collected included individual and workforce-related characteristics and occupational stressors. Burnout was explored using the Copenhagen Burnout Inventory. Univariate and multivariate analyses were conducted to ascertain associations between respondents’ characteristics, stressors, and burnout levels.FindingsA total of 257/266 midwives (97%) responded. There were significant levels of exhaustion and fatigue among respondents; 68% of midwives were experiencing personal burnout, 51% work-related burnout, and 10% were experiencing client-related burnout. Being aged ≤ 35 years, and/or having inadequate support was associated with personal and work-related burnout. Having inadequate acknowledgement was associated with client-related burnout.ConclusionHealth services need to understand the risk factors for burnout among midwives, identify and support groups that are most vulnerable, and address areas that are amenable to intervention. In our context this means ensuring midwives receive adequate acknowledgement and support, particularly younger midwives. These findings need to be tested in other settings to help inform a broader understanding and ensure the sustainability of the midwifery profession.     

“Paper,face-to-face and on my mobile please”: A survey of women’s preferred methods of receiving antenatal education

BackgroundAntenatal education prepares women for childbirth and can be delivered face-to-face, in hard-copy and electronically. Smartphones allow access to online learning and internet searching is common among pregnant women. It is unclear which mode of health information delivery women prefer.AimThis study aimed to investigate how women at one Local Health District (LHD) preferred to receive health information during pregnancy and the early postnatal period.MethodsWe developed a survey to gather data on women’s preferences for educational information. Women who were discharged from one LHD, in NSW Australia, were invited, in 2019, to participate in a simple 14 question survey, either online or in hard copy format.FindingsIn total, 685 women completed the survey which represented a 40% response rate over a period of two months. The survey revealed women commonly used smart phones, or other devices, to source information. Despite this, most women preferred to receive antenatal education via non-electronic methods. Of note many participants felt underprepared for the post-birth period. The method of survey completion, whether hardcopy or online, aligned with individuals’ preferences for information delivery.ConclusionNon-electronic methods of education delivery were the preferred method for most women, and this was consistent across all educational, cultural and socioeconomic levels. Women sought information online, or through apps, but these options did not always meet their knowledge needs, especially regarding the postnatal period. We recommend that hospitals continue to provide information in a variety of modes, as exclusively electronic methods may marginalise groups of women.     

A Survey Experiment of Women’s Attitudes About Intimate Partner Violence Against Women in Rural Bangladesh

According to the Demographic and Health Surveys (DHS) in poorer countries, 50 % of women of reproductive age report that wife hitting or beating is justified. Such high rates may result from structural pressures to adopt such views or to report the perceived socially desirable response. In a survey experiment of 496 ever-married women aged 18–49 years in rural Bangladesh, we compared responses to attitudinal questions that (1) replicated the 2007 Bangladesh DHS wording and portrayed the wife as transgressive for unstated reasons with elaborations depicting her as (2) unintentionally and (3) willfully transgressive. The probabilities of justifying wife hitting or beating were consistently low for unintended transgressions (.01–.08). Willful transgressions yielded higher probabilities (.40–.70), which resembled those based on the DHS wording (.38–.57). Cognitive interviews illustrated that village women held diverse views, which were attributed to social change. Also, ambiguity in the DHS questions may have led some women to interpret them according to perceived gender norms and to give the socially desirable response of justified. Results inform modifications to these DHS questions and identify women for ideational-change interventions.     

Australian women’s perceptions and practice of sleep position in late pregnancy: An online survey

BackgroundGoing-to-sleep in the supine position in later pregnancy (≥28 weeks) has been identified as a risk factor for stillbirth. Internationally, public awareness campaigns have been undertaken encouraging women to sleep on their side during late pregnancy.AimThis study aimed to identify sleep practices, attitudes and knowledge in pregnant women, to inform an Australian safe sleeping campaign.MethodsA web-based survey of pregnant women ≥28 weeks’ gestation conducted from November 2017 to January 2018. The survey was adapted from international sleep surveys and disseminated via pregnancy websites and social media platforms.FindingsThree hundred and fifty-two women participated. Five (1.6%) reported going to sleep in the supine position. Most (87.8%) had received information on the importance of side-sleeping in pregnancy. Information was received from a variety of sources including maternity care providers (186; 66.2%) and the internet (177; 63.0%). Women were more likely to report going to sleep on their side if they had received advice to do so (OR 2.3; 95% CI 1.0–5.1). Thirteen (10.8%) reported receiving unsafe advice, including changing their going-to-sleep position to the supine position.DiscussionThis indicates high level awareness and practice of safe late-pregnancy going-to-sleep position in participants. Opportunities remain for improvement in the information provided, and understanding needs of specific groups including Aboriginal and Torres Strait Islander women.ConclusionFindings suggest Australian women understand the importance of sleeping position in late pregnancy. Inconsistencies in information provided remain and may be addressed through public awareness campaigns targeting women and their care providers.     

“There is a Massacre of Women”: Violence Against Women,Feminist Activism,and Hashtags in Turkey

Abstract

In academic and popular debates about sexualisation, the “mainstreaming of sex in the West” is a common catchphrase. As noted by post-colonial and critical race scholars, categories such as “the West” remain powerful discursive ideas shaping how both researchers and researched border and construct race, difference, and sexuality. However, there is very little research that employs a post-colonial analysis of young people’s negotiations of sexualised media, most particularly studies that elucidate how the oppositional frameworks of colonial discourse sets up normative and “othered” subjectivities. In order to address this gap, I turn to Stuart Hall’s classic paper The West and the Rest to reflect on a project undertaken in South Australia with young people from a broad range of cultural backgrounds. In a fascinating set of reflections, the young people present a powerful set of challenges to the binary of the West and the Rest through their narratives on sexualised media. Taken together, these complex and sometimes contradictory narratives remind us of the problems associated with talking in generalised and universalising ways about “sexualisation in the West.”     

A narrowing gap? Trends in the childlessness of professional women in Australia 1986–2006

This paper examines whether the gap in fertility between women with higher education and in professional occupations and other women has narrowed or widened over time in Australia. Using data from the Australian Census of Population and Housing 1986, 1996 and 2006, the paper focuses on levels of childlessness. Both working women (using occupational categories) and all women (using educational attainment) aged between 20 and 44 were examined. Focusing particularly on women working in, or qualified for, some selected high-prestige professions (doctors, lawyers, dentists and vets), as well as on women with other tertiary qualifications and working in other professional or managerial occupations, the findings suggest that, between 1986 and 2006, childlessness has grown at a slower rate for women with tertiary education than for all women, although women with tertiary education continue to have the highest proportion of childlessness. Our findings for working women were similar, with women working in selected prestigious occupations having the highest rates of childlessness of all working women, but with this growing at a slower rate than was the case overall.