Family planning: knowledge, attitude and practice of childbearing women in rural areas]

Knowledge, attitude, and practice (KAP) of family planning techniques, is seen as potentially a very effective means for promoting the fundamental principles, objectives, and practices of family planning. In September 1983, a 2-part survey was conducted in the northeast rural area of Hubei province, China, to learn how much local women knew about birth control techniques, devices, available information, and services, as well as personal attitudes and apprehensions toward family planning. The data, based on the ages and educational backgrounds of the surveyed women, are analyzed. The 2nd part of the survey measured the difference in attitudes between women and men regarding the desired number and sex of offspring. While 99% of the surveyed women supported family planning, many expressed a strong desire to learn more about family planning, particularly as related to government policies.     

我国生育政策对二孩生育间隔影响的分层模型研究

我国不同生育政策类型地区二孩生育间隔的差异,既受到地区经济、社会和生育政策的影响,又受到育龄妇女个人和家庭因素的影响。分层模型结果表明,地区间生育间隔差异占我国二孩生育间隔总差异的30．54％。我国生育政策对不同政策类型地区二孩生育间隔差异的影响程度基本在20％以下,不同地区经济和社会发展的不平等状况是导致地区间二孩生育间隔差异的主要原因。     

On Postponement and Birth Intervals

Much of the literature on fertility transition presumes that birth control is practiced either to limit family size or to space births. This article argues that women also use birth control to postpone pregnancy. Postponement is not synonymous with spacing. It arises when women delay their next birth for indefinite periods for reasons unrelated to the age of their youngest child, but without deciding not to have any more children. Postponement has a distinctive impact on the shape of birth‐interval distributions that differs from the impacts of family size limitation, birth spacing, or a mixture of the two behaviors. Some populations, such as that in South Africa, have developed fertility regimes characterized by birth intervals far longer than can be accounted for by birth spacing. Postponement of further childbearing that eventually becomes permanent may be an important driver of the transition to lower fertility in sub‐Saharan Africa.     

Family Practices,Holiday and the Everyday

Holidays are central to the rhythm of everyday family practices and consumption, and are often depicted, within both academic literature and consumer marketing, as a defining moment in contemporary family life. To date, academic accounts of the experiences of travel and tourism have been mostly developed outside of the realm of everyday family practices and intimate relations. In this paper, therefore, we advance an interpretation of family holidays as a constituent of everyday family practices. To do this, we bring together three distinct yet interrelated conceptual frameworks: those of family practices, holiday and the everyday. Presenting and analysing data collected from ethnographic research with six families and exploring the themes of anticipation and utopian family practices, we identify how the notion of family holidays can be used a conduit for realising not only relationality between family members but also as a means of easing out the tensions and aspirations of everyday family life, a way to perfect the everyday and also to make it more palatable.     

Applying information to improve family planning in Gaoping County]

The scientific management method of improving family planning through information has produced a low birth rate and natural increase rate in Gaoping County, China, since 1976. In order to promote good family planning, Gaoping County incorporated the scientific management method with the establishment of an information network that included information banks, files, and newspaper columns. The officials of Gaoping County focused their efforts on women most susceptible to unplanned childbirth, e.g., women uneducated in birth control and prenatal care. The women were divided into groups according to their educational needs, e.g., women who were hesitant toward birth control, women who used birth control, women who never reproduced, and women who were newly married. By educating these women to the aspects of planned childbirth, prenatal testing, prenatal care, and contraceptives, Gaoping County effectively promoted good family planning in the areas of birth control and family health. The following statistics are the results of incorporating the scientific management system in family planning of Gaoping County. In 1983, the birth rate in Gaoping County was 11.3%, a 2.8% decline from 1982; the mortality rate decreased 0.2% to a rate of 7.6%; and the natural increase rate decreased 2.6% to a rate of 3.7%. The planned birth rate in 1983 was 90.1% and the rate of 1 child per couple was 91%. This was an increase from the 1982 rates of 21.3% and 25.2%, respectively. From January 1984 to June 1984 the planned birth rate reached 97.2%. These statistics are evidence of the positive results in using information in family planning.     

Contraceptive use at first intercourse among Jewish women in Israel, 1962–1988

Using data from the 1987–1988 Study of Fertility and Family Formation,this study examines the family planning practices of Jewish Israeli womenwho first had intercourse between 1962 and 1988. The overwhelming majorityof women reported using no contraception at first intercourse, and among those who did practice birth control approximately half relied on modern techniques. While the likelihood that Israeli women used contraception at first sex changed little between 1962 and 1988, there has been a marked shift towards the adoption of efficient methods of birth control. Moreover, factors which promote female empowerment, including education and military service, have been positively associated with contraceptive use at first intercourse. Among those women who practiced contraception at first intercourse, those from Africa and Asia have been especially likely to make use of inefficient methods such as withdrawal.     

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.     

Breastfeeding practices in women with type 1 diabetes: A discussion of the psychosocial factors and policies in Sweden and Australia

BackgroundWomen with type 1 diabetes (T1DM) face many challenges during their pregnancy, birth and in the postnatal period, including breastfeeding initiation and continuation while maintaining stable glycaemic control. In both Sweden and Australia the rates of breastfeeding initiation are high. However, overall there is limited information about the breastfeeding practices of women with T1DM and the factors affecting them. Similarities in demographics, birth rates and health systems create bases for discussion.AimThe aim of this paper is to discuss psychosocial factors, policies and practices that impact on the breastfeeding practices of women with T1DM.FindingsSwedish research indicates that the overall breastfeeding rate in women with T1DM remains significantly lower than in women without diabetes in the first 2 and 6 months after childbirth with no differences in exclusive breastfeeding. Breastfeeding initiation and continuation among women with T1DM in Sweden has been shown to be influenced by health services delivery, supportive breastfeeding polices and socio-economic factors, particular perceived support from social networks and health professionals.ConclusionThere is limited research on the impact of attitudes towards breastfeeding, emotional and social well-being and diabetes-related stress on the decision of women with T1DM to initiate and continue to breastfeed for at least 6 months. A more comprehensive understanding of the breastfeeding practices and psychosocial factors operating during the first 6 months after birth for women with T1DM will be instrumental in the future design of interventions promoting initiation and continuation of breastfeeding in Sweden, Australia and elsewhere.     

The perceptions and practices of Thai health professionals providing maternity care for migrant Burmese women: An ethnographic study

BackgroundAcross the globe, many women including economic and humanitarian migrants receive inadequate antenatal care. Understanding the difficulties that migrant women encounter when accessing maternity care, including the approach of health professionals, is necessary because inadequate care is associated with increasing rates of morbidity and mortality. There are very few studies of migrant women’s access to and experience of maternity services when they have migrated from a low- to a middle-income country.AimTo examine the perceptions and practices of Thai health professionals providing maternity care for migrant Burmese women, and to describe women’s experiences of their encounters with health professionals providing maternity care in Ranong Province in southern Thailand.MethodsEthnography informed the study design. Individual interviews were conducted with 13 healthcare professionals and 10 Burmese women before and after birth. Observations of interactions (130 h) between health care providers and Burmese women were also conducted. Data were analysed using thematic analysis.FindingsThe healthcare professionals’ practices differed between the antenatal clinics and the postnatal ward. Numerous barriers to accessing culturally appropriate antenatal care were evident. In contrast, the care provided in the postnatal ward was woman and family centered and culturally sensitive. One overarching theme, “The system is in control’ was identified, and comprised three sub-themes (1) ‘Being processed’ (2) ‘Insensitivity to cultural practices’ and, (3) ‘The space to care’.Discussion and conclusionsThe health system and healthcare professionals controlled the way antenatal care was provided to Burmese migrant women. This bureaucratic and culturally insensitive approach to antenatal care impacted on some women’s decision to engage in antenatal care. Conversely, the more positive examples of woman-centered care evident after birth in the postnatal ward, can inform service delivery.     

Service station established at villages and towns in Fufeng County pushed forward the family planning program there]

In 1985 the 15 villages and towns of Fufeng County, Shanxi Province, established service stations to promote family planning. The County invested over 90,000 yuan in an x-ray machine, operation table and necessary medical supplies. The service stations provided fluoroscopy, surgical and propaganda rooms. The purpose of each station, staffed by female physicians and family planning cadres, was to develop contraceptive birth control, teach eugenics, and counsel women. The establishment of service stations obviously proved significant and useful, as seen from the following data: for the years 1983-85, the county birth rate fell 2%; the multiple child rate dropped 7.7%; the birth control rate rose by 12.6%; the sterilization rate rose by 1.3%. By October 1986, these figures showed even more improvement. The success of the service stations was also due to: taking its services to the people, their homes, and their workplace; making family planning work a service, rather than a management; systematizing family planning work and making it available at all times.     

Perinatal psychosocial assessment of women of refugee background

BackgroundWomen of refugee background may be particularly vulnerable to perinatal mental illness, possibly due to increased exposure to psychosocial stressors associated with their forced migration and post-resettlement adjustment.AimThis study aimed to compare psychosocial risk factors reported by women of refugee background receiving maternity services at a public hospital, to those reported by Australian-born women in the same hospital. It further aimed to examine the referrals offered, and accepted, by the women of refugee background reporting psychosocial risk factors for perinatal mental illness.MethodsA retrospective hospital record review was conducted to compare the antenatal and postnatal psychosocial risk factors of 100 women of refugee background and 100 Australian-born women who gave birth at a public hospital in Victoria between 1 July 2015 and 30 April 2016, and who had completed the Maternity Psychosocial Needs Assessment.FindingsWomen of refugee background were more likely than Australian-born women to report financial concerns and low social support at antenatal assessment, but were less likely to report prior mental health problems than Australian-born women at either assessment point. Both groups reported low rates of family violence compared to published prevalence rates. Of the women of refugee background assessed antenatally, 23% were offered referrals, with 52% take-up. Postnatally, 11.2% were offered referrals, with 93% take-up.Discussion/conclusionThis study showed elevated rates of psychosocial risk factors among women of refugee background, however, possible under-reporting of mental health problems and family violence raises questions regarding how to assess psychosocial risk factors with different cultural groups. Lower antenatal referral take-up suggests barriers to acceptance of referrals may exist during pregnancy.     

Another Child? Fertility Ideals,Resources and Opportunities

Low fertility in most developed countries has prompted policy concern in relation to labour market supply, pensions, and expenditure on health and welfare services as well as policy debate about both the cost of children and the opportunity costs of parenthood. The extent to which family policy interventions can be effective in slowing or reversing fertility decline is much debated. This paper, based on a fertility module of the Scottish Social Attitudes Survey 2005, examines the current fertility, and ideal and expected fertility of a nationally representative sample of 455 parents of reproductive age and focuses on whether they plan to have another child. It compares the characteristics of those who intend to have another child with those who do not, and how parents with one child differ from those with more children. It addresses three questions about family size: (1) fertility ideals, (2) resources and the economic implications of childbearing, and (3) opportunities for childbearing and the effects of a late start on fertility expectations. It concludes that, despite a sustained period of low fertility in Scotland, childbearing ideals are robust and explanations of low fertility must derive from difficulties in realising those ideals. Difficulties in realising fertility aspirations are associated less with resources than with opportunities for childbearing, especially the timing of first birth. Those who delay their first birth are less likely to realise their ideal family size, and their lower fertility is associated with the opportunity costs of childbearing in terms of foregone qualifications, careers and earnings.     

Relative Cohort Size,Relative Income,and Married Women's Labor Force Participation: United States, 1968–2010

Relative cohort size—the ratio of young adults to prime‐age adults—and relative income—the income of young adults relative to their material aspirations—have experienced substantial changes over the past 40 years. Results here show that changes in relative cohort size explain about 60 percent of the declines in women's starting wage—both relative and absolute—in 1968–82, and 97 percent of its increase in 1982–2001. Relative income is hypothesized to affect a number of behavioral choices by young adults, including marriage, childbearing, and female labor force participation, as young people strive to achieve their desired standard of living. Older family income—the denominator in a relative income variable—increased by 59 percent between 1968 and 2000, and then declined by 9 percent. Its changes explain 47 percent of the increase in the labor force participation of white married women in their first 15 years out of school between 1970 and 1990, and 38 percent of the increase in hours worked in the same period. The study makes use of individual‐level measures of labor force participation and employs the lagged income of older families in a woman's year‐state‐race‐education group to instrument parental income and hence material aspirations.     

Unmarried Motherhood: Recent Trends,Composition, and Black-White Differences

The National Survey of Family Growth (1982) is used to examine the extent to which racial differences in premarital birth rates can be explained by differences in parents' socioeconomic status, family structure, and residential characteristics. The findings document a large diversity in premarital births within both populations. Black women from high-risk backgrounds are three times more likely to have a premarital birth than black women from low-risk backgrounds. Racial differences in premarital births arise because (1) black women are more likely to come from high-risk backgrounds and (2) black women from low-risk backgrounds are more likely to have a premarital birth than white women with similar characteristics. There are similar rates of premarital births by race among persons from high-risk backgrounds.     

To grasp the family planning program early, carefully and surely according to the law of reproduction]

China's February 1982 Directive on Improving Family Planning Work stipulated that family planning should be incorporated into national economic and social planning by understanding it early, carefully, and surely according to the law of reproduction. Understanding family planning early means to implement the policy of birth control as a primary goal, to plan early for births, and to carry out birth control measures, i.e., formulating a plan is the basis of understanding early. For example, the following must be considered when mapping out a plan for 1983: the number of fertile women who wanted children but who remained childless for 3 years of marriage; those who conceived late in 1982 and will deliver in 1983; the number of newlyweds over 23 years of age who have not planned a pregnancy; those with 1 child over 4 years who due to unusual circumstances will have a 2nd child; the number of people planning marriages before March 1983. The next step is to make arrangements, which include submitting individual requests, getting permission from communes and approval from the general public, and delivering contraceptives to the homes of newlyweds and mothers. 9 months after arrangements are completed, adjustments must be made, e.g., those who were unsuccessful in their plan to conceive this year will try the next year. To understand carefully is to understand the concept, circumstances, and data of family planning and thus be able to administer it scientifically. This means primarily controlling fertile women who are newlyweds, mothers of 1 child, and mothers of multiple children. To understand surely is to conform to the organization, concept, policy, planning, and measures of family planning. This means training basic level birth control cadres in population theory and methods of family planning. In addition, it means persuading the masses to be enthusiastic, diligent, fearless, understanding, and to show initiative toward family planning.     

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.     

Family size in successive generations: The effects of birth order,intergenerational change in lifestyle,and familial satisfaction

Studies of family size in successive generations have found a small but persistently positive effect of size of family of orientation. Recent work has suggested that this relationship may be influenced by birth order, intergenerational change in lifestyle, and familial satisfaction. Data from a 24-year longitudinal study of women in Pennsylvania indicate that number of siblings does influence size of family of procreation. More important, this relationship is stronger among women who were first-born that later-born, stronger for those not experiencing intergenerational change than for those who changed, and stronger among those who at age 16 were satisfied with their parental family than for those who were dissatisfied.     

Birth Intervals and Health in Adulthood: A Comparison of Siblings Using Swedish Register Data

A growing body of research has examined whether birth intervals influence perinatal outcomes and child health as well as long-term educational and socioeconomic outcomes. To date, however, very little research has examined whether birth spacing influences long-term health. We use contemporary Swedish population register data to examine the relationship between birth-to-birth intervals and a variety of health outcomes in adulthood: for men, height, physical fitness, and the probability of falling into different body mass index categories; and for men and women, mortality. In models that do not adjust carefully for family background, we find that short and long birth intervals are clearly associated with height, physical fitness, being overweight or obese, and mortality. However, after carefully adjusting for family background using a within-family sibling comparison design, we find that birth spacing is generally not associated with long-term health, although we find that men born after very long birth intervals have a higher probability of being overweight or obese in early adulthood. Overall, we conclude that birth intervals have little independent effect on long-term health outcomes.     

Family limitation among the Old Order Amish

Summary This paper shows that the Indiana Amish, a high-fertility Anabaptist population, regulate their marital fertility according to their family finances. We linked demographic data from the Indiana Amish Directory with personal property tax records at 5, 15 and 25 years after marriage and found fertility differences by occupation and wealth. Correlations between family size and wealth at the beginning, middle and end of childbearing years were positive. Wealthier women exhibited higher marital fertility, had longer first birth intervals, were older at the birth of their last child, and had larger families than poorer women. Over the past 30 years, marital fertility has remained constant among older women; but birth rates among younger women have been rising rapidly.