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.     

'Is anybody listening?' The experiences of widowhood for older Australian women

This paper discusses preliminary findings from participants in the baseline survey of the Australian Longitudinal Study on Women's Health (Women's Health Australia: WHA) who reported their marital status as widowed. A total of 12,624 women, aged 70-75 years, completed a self-administered 260-item questionnaire, and 4335 of these women were widowed. Many of these women provided additional qualitative comments about their health, social and financial circumstances after the death of their spouse. This paper presents a thematic analysis of the qualitative comments and builds on the findings of the quantitative analysis of baseline data. The aims of this part of the study are to examine the short- and long-term effects of widowhood on the health and wellbeing of older women and to explore the process of change they experience after the death of a spouse. Preliminary findings suggest that, as a key life event, widowhood has an initial negative impact on the health and wellbeing of older women, but in the long term it may be accompanied by a positive shift into a new life phase.     

“Open to all and everybody”? The Irish Film Board: accounting for the scarcity of women screenwriters

Despite the many social and cultural changes that have occurred in Irish society since the Irish Film Board was re-established in 1993, the Irish film industry remains strongly male dominated. Specifically, Irish women constitute a minority of produced screenwriters and writer/directors. This article contributes to an understanding of the discursive resources that key decision makers in the Irish Film Board draw upon in order to talk about gender. A number of interpretative repertoires are used to rationalize its position in relation to the dearth of women screenwriters, four of which are examined here: evasion and deflection; gender neutrality; project-led funding; and a difficulty making sense of entrenched gender issues, articulated here as “I don’t know.” Within the respondents’ repertoires an ideological dilemma can be identified in the conceptualization of gender as both relevant and irrelevant.     

Canada’s evacuation policy for pregnant First Nations women: Resignation,resilience, and resistance

Background

Aboriginal peoples in Canada are comprised of First Nations, Métis, and Inuit. Health care services for First Nations who live on rural and remote reserves are mostly provided by the Government of Canada through the federal department, Health Canada. One Health Canada policy, the evacuation policy, requires all First Nations women living on rural and remote reserves to leave their communities between 36 and 38 weeks gestational age and travel to urban centres to await labour and birth. Although there are a few First Nations communities in Canada that have re-established community birthing and Aboriginal midwifery is growing, most First Nations communities are still reliant on the evacuation policy for labour and birthing services. In one Canadian province, Manitoba, First Nations women are evacuated to The Pas, Thompson, or Winnipeg but most – including all women with high-risk pregnancies – go to Winnipeg.

Falling short of dietary guidelines – What do Australian pregnant women really know? A cross sectional study

Background

Maternal diets are not consistent with dietary guidance and this may affect the health of mothers and their infants. Nutrition knowledge and motivation may be important factors.

A paradise for LGBT rights? The paradox of Belgium

How is it that a small country such as Belgium, with its reputation of relative conservatism, has jumped to the forefront of LGBT-friendly nations when it comes to the extension of rights to, and implementation of government policies for, its LGBT population? The analysis offered here focuses on a combination of six causes: the impact of wider secularization processes; the political history and culture of the country; the organization of especially the Flemish LGBT movement and reasons for its political effectiveness; mainstream social trends in national scapegoating hierarchies; the overall media environment; and the window of opportunity opened by the political landslide of 1999.     

Facilitators and barriers to pregnant women’s participation in research: A systematic review

Background

Although there is consensus among many that exclusion of pregnant women from clinical research should be justified, there is uncertainty as to whether and why pregnant women themselves would be willing to participate even if they were found to be eligible. The objective was to identify the reasons why pregnant women participate in clinical research and thereby to distinguish between facilitators and barriers.

Can concern for the long-term care of older parents explain son preference at birth in India?

This study examines whether concern for the long-term care of older parents is the primary reason for son preference in India. Controlling for important socioeconomic factors that are believed to affect son preference, we find that concern for long-term care is the principal cause of son preference in India. Sons serve as the primary caregivers to elderly parents, while daughters are mostly engaged in caring for parents-in-law. This trend is more acute in rural than in urban areas. Our study also finds a strong implication of the filial relationship for the long-term care of elderly parents.     

Personal networks and the incomes of men and women in the United States: Do personal networks provide higher returns for men or women?

Despite the many studies focusing on the relationship between social networks and labor market outcomes, few have examined differences in returns to personal networks by gender. Informed by the Social Resources Theory, this study tests whether various types of employment job search networks provide greater returns for males or females. Of the few studies examining gender differences, some find that the benefits of social networks are specific to males; others maintain that they also extend to females, and others argue that the benefits are greater for females than males. There are several limitations of the studies focusing on gender and social networks within the labor market. Such studies have not employed nationally representative datasets. They also neglect important distinctions between various types of personal networks. In this study, these limitations are rectified. A nationally representative dataset, the 2002 General Social Survey, is employed to address how personal networks operate for men and women within the US labor market. Additionally, various types of personal networks are employed to enable a more nuanced approach than previous research. The study provides evidence that social networks provide higher returns to women than men, as women receive returns from their networks while men do not.     

Midwives’ experiences of using the Mindfetalness method when talking with pregnant women about fetal movements

BackgroundInformation given to pregnant women about fetal movements is important in maternity care and decreased fetal movements is associated with fetal growth restriction and stillbirth. The fetal movement pattern is different for every fetus and women perceive different types of movements. Mindfetalness is a self-assessment method for a woman to use to become familiar with her unborn baby’s fetal movement pattern.AimWe aimed to explore midwives’ perceptions about informing pregnant women about fetal movements and their experiences of working with Mindfetalness in their daily work.MethodsA web-questionnaire was distributed to midwives who participated in a randomized controlled trial evaluating Mindfetalness, a method for the observation of fetal movements. In total, 67 maternity clinics in Stockholm, Sweden, were randomized to Mindfetalness or routine care. Of the 144 midwives working in maternity clinics randomized to Mindfetalness, 80% answered the questionnaire.FindingsThe midwives thought that the leaflet about Mindfetalness was supportive in their work when informing women about fetal movements and the majority wanted to continue to distribute the leaflet when the trial ended. The midwives also expressed that the study increased their own knowledge about fetal movements. Women embraced the information about Mindfetalness positively and appreciated the written material. The midwives thought that talking about fetal movements in maternity care is an important but challenging task.ConclusionMindfetalness is a useful tool to use in maternity clinics when informing pregnant women about fetal movements. The written information was appreciated by both pregnant women and midwives.