Statistical modeling of selected aspects of the childbearing process with application to world fertility survey countries∗

The childbearing process should be monitored in developing countries experiencing high population growth rates and high levels of maternal and infant mortality. A mathematical model for estimation of certain aspects of the childbearing process, which requires only data on age‐specific fertility rates, is developed. Synthetic maternal childbearing indices, namely, mean ages at first and last birth, length of reproductive life span, inter‐birth spacing, and proportion of childless women, in addition to the well‐known mean age at childbearing, for the WFS countries are obtained using the proposed model. The indices are free from age truncation effects, and, under certain assumptions, provide information about a cohort's completed fertility before the women stop reproducing. The effects of women's residence and education on fertility are also examined.     

Who is holding the baby? Women's experiences of contact with their baby immediately after birth: An Australian population-based survey

BackgroundSeeing and holding their baby immediately after the birth is the pinnacle of the childbearing process for parents. Few studies have examined women's experiences of seeing and holding their baby immediately after birth. We investigated women's experiences of initial contact with their newborns using data from an Australian population-based survey.MethodsAll women who gave birth in September/October in 2007 in two Australian states were mailed questionnaires six months following the birth. Women were asked three questions about early newborn contact including where their baby was held in the first hour after birth and whether they were able to hold their baby as soon and for as long as they liked. We examined the association between model of maternity care and early newborn contact stratified by admission to SCN/NICU.ResultsThe majority (92%) of women whose babies remained with them reported holding their babies as soon and for as long as they liked in the first hour after birth. However, for women whose babies were admitted to SCN/NICU only a minority (47%) reported this. Women in public models of care (with the exception of primary midwifery care) whose babies remained with them were less likely to report holding their babies as soon and for as long as they liked compared to women in private care.ConclusionOur findings suggest that there is potential to increase the proportion of mothers and fathers who get to hold their baby immediately after the birth by modifying birth suite and operating room practices.     

Determinants of Engagement in Paid Work Following Social Security Benefit Receipt Among Older Women

ABSTRACT

Work behavior among older men approaching or following retirement has received considerable research attention over the past two decades, but research on older women's work behavior is still in its incipient stage. Based on data from the 1982 New Beneficiary Survey (NBS) and the 1991 New Beneficiary Follow-up (NBF), this study analyzes the extent and determinants of employment among women who received their first Social Security benefits between 1980 and 1981. More than one fourth of the women continued to work or rejoined the labor force following their first Social Security benefit receipt. Financial need was found to be the primary reason for and the most significant determinant of women's continuing work or (re)entry into the labor force. But the level of education, health, spouse's work status, and previous work history were also found to be significant determinants of the likelihood and duration of their employment following Social Security receipt.     

Using Changes in Life Satisfaction and Health to Predict the Survival Status Among Older Men and Women in Taiwan

Despite policies aimed at decreasing old-age income inequality, such as Social Security and Supplemental Security Income, research consistently finds that later-life poverty is highly concentrated among women. While the early-life economic disadvantages of motherhood are well established, little work has examined whether these disadvantages persist into later life. Life course research consistently demonstrates the relationship between early-life choices and later-life inequality, but few studies have examined whether the reproductive phase of a woman's life is associated with her later-life income. Using data from the 2003 wave of the National Longitudinal Survey of Mature Women cohort, this research examines whether women's age at first birth and parity are associated with her later-life income within the context of marriage. From a set of multivariate analyses, I find that despite a marginal statistically significant effect, substantively for the women in this cohort the effects of childbearing are not particularly consequential for later-life income. The results suggest that as women age the economic penalties associated with motherhood are less important to financial well-being than are other factors.     

Female fertility history and mid-late-life health: Findings from China

China’s middle-aged and older women suffer from poorer health than men. Using national baseline data from the China Health and Retirement Longitudinal Study (CHARLS), a survey conducted from 2011 to 2012, this article applies logistic models to investigate the association between female fertility history (parity, early childbearing, late childbearing) and middle-aged and late-life health. We find that parity is related to the mid-late-life health of women. Women with four children or more are more likely to suffer from activities of daily living (ADL) impairment and poorer self-rated health than those with one to three children. Early childbearing is associated with ADL impairment; however, the correlation is mediated by socioeconomic status. Early childbearing is related to self-rated health in later life by an indirect-only mediation effect via educational attainment and personal income.     

Absent and Problematic Men: Demographic Accounts of Male Reproductive Roles

Both men and women are important actors in bringing children into life, yet demographic studies on reproduction have tended to focus on women alone. The aims of this article are: 1) to describe why men have attracted limited interest as subjects of such research; 2) to evaluate existing research on men's roles in developing countries; and 3) to suggest directions for future research on male reproductive roles. Men, once neglected, are now included in research on fertility but from a narrow, overly problem‐oriented perspective. A review of the literature, however, raises questions about the adequacy of a problem oriented approach. The authors argue that demography should focus on men not only as women's partners, but also as individuals with distinct reproductive histories. In situations, now increasingly common, where the links between marriage and childbearing erode, the differences in men's and women's reproductive experiences and the costs and benefits of parenting will become more salient for future research.     

Childbearing traditions of Indian women at home and abroad: An integrative literature review

BackgroundThe percentage of overseas-born mothers giving birth in Australia has increased to 31.5% in 2012 and Indian women represent 10% (the highest proportion). It is important for midwives in Australia to be aware of the childbearing traditions of Indian women and how these influence Indian women birthing in Australia.AimTo explore childbearing practices in India and Indian women's experience of giving birth abroad; and to discuss the relevant findings for midwives working with Indian women in Australia.MethodAn integrative literature review was employed. 32 items, including 18 original research articles were thematically reviewed to identify commonly occurring themes relating to Indian women's childbearing traditions.FindingsFive themes relating to traditional childbearing practices of women birthing in India were identified. These themes included diversity and disparity; social context of childbirth and marriage; diet based on Ayurveda; pollution theory and confinement; and finally, rituals and customs.ConclusionIndian women giving birth abroad and by implication in Australia experience a transition to motherhood in a new culture. While adjusting to motherhood, they are also negotiating between their old and new cultural identities. To provide culturally safe care, it is essential that midwives reflect on their own culture while exploring what traditions are important for Indian women.     

U.S. women at work

Women made up 43% of the U.S. labor force in 1980, up from 29% in 1950, and 52% of all women 16 and over were working or looking for work compared to 34% in 1950. The surge in women's employment is linked to more delayed marriage, divorce, and separation, women's increased education, lower fertility, rapid growth in clerical and service jobs, inflation, and changing attitudes toward "woman's place." Employment has risen fastest among married women, especially married mothers of children under 6, 45% of whom are now in the labor force. Some 44% of employed women now work fulltime the year round, but still average only $6 for every $10 earned by men working that amount. This is partly because most women remain segregated in low paying "women's jobs" with few chances for advancement. Among fulltime workers, women college graduates earn less than male high school dropouts. Working wives were still spending 6 times more time on housework than married men in 1975 and working mothers of preschool children are also hampered by a severe lack of daycare facilities. Children of working women, however, appear to develop normally. Equal employment opportunity and affirmative action measures have improved the climate for working women but not as much as for minorities. The federal income tax and social security systems still discriminate against 2 income families. Woman's position in the U.S. labor force should eventually improve with the inroads women are making in some male-dominated occupations and gains in job experience and seniority among younger women who now tend to stay in the labor force through the years of childbearing and early childrearing, unlike women in the 1950s and 1960s.     

The Changing Institutional Context of Low Fertility

Using data for 1960–97 for 22 low fertility countries, we document a dramatic change in the association of fertility levels to women's levels of labor force participation. Until the 1980s, this association had been strongly negative. However, during the 1980s itbecame positive, and since 1990 strongly positive. We also document an emerging positive association of the country-level total fertility ratio (TFR) and nonmarital ratio (e.g., the proportion of births to unmarried women). We argue that these transformed associations reflect societal level responses that, in some contexts, have eased the incompatibility between mother and worker roles, and loosened the link betweenmarriage and childbearing. These arguments imply that societal responses to mother/worker incompatibility exert substantial influence on fertility levels in low fertility countries.     

Aging in a Foreign Country: Voices of Iranian Women Aging in Canada

ABSTRACT

Older Iranian women, who immigrated to Canada in later adulthood, experience unique issues as they age. In order to better understand this experience, in-depth, personal and semi-structured interviews were conducted with five immigrant/refugee Iranian women who immigrated to Canada in their later life. Analysis revealed that although each woman's story conveyed individual differences and idiosyncrasies, all the stories highlighted the critical interweaving of the aging experience and the immigration experience: neither experience could be understood in isolation of the other; each aspect gave meaning to the other experience. Two interrelated messages dominated the women's stories: first was the importance of each woman's immigration story for grounding her experience of the aging process in Canada. Second, each woman's personal story suggested that the immigration experiences were accorded priority for accounting for her experiences in Canada. Specifically, cultural identity (i.e., social class, education, religious affiliation and immigration status) offered a valuable cloak for overshadowing the force of the aging process and the aging process emerged as an elusive force that lurked in the background without ever being fully acknowledged or given power in their lives. The implications of these findings in relation to theory development on intersectionality and professional practice are discussed.     

Survey of women's perceptions of information provided in the prevention or treatment of iron deficiency anaemia in an Australian tertiary obstetric hospital

BackgroundThere is limited literature to understand the perceptions of Australian women regarding the information provided by healthcare professionals relating to the prevention and treatment of iron deficiency anaemia in pregnancy.AimTo establish an insight into the key themes and trends within a tertiary obstetric hospital related to the provision of dietary advice and use of iron supplements in pregnancy.MethodsA prospective patient survey of pregnant women and women up to 4 weeks postnatal attending hospital.FindingsOf the 110 women who participated, 73.6% were provided with information on iron rich foods and 67% made dietary changes. Eighty percent of women were advised to take oral iron and 65.5% of women were taking it at the time of the survey. In women who had independently ceased oral iron, 41.7% failed to inform their healthcare professional. In the women who did inform their healthcare professional 89.5% received advice to help overcome the reason that led to cessation. The main causes included forgetfulness and side effects. Women were less likely to require intravenous iron if oral iron was commenced early.ConclusionsCompliance with recommended oral iron is variable within a population of pregnant women. Women are provided with information on a range of issues relating to the prevention and treatment of iron deficiency anaemia; yet there is a disparity between the information provided and the resulting action. Further research should focus on targeted measures to improve understanding and compliance with treatment from the both women's and health professionals perspective.     

Delayed childbearing in the U.S.: facts and fictions

Between 1970-82, the proportion of 1st births in the US to women 25 and older rose from 19-36% and the proportion of women still childless at ages 25-34 increased by 56% at about the same time. Although a sharp contrast with the baby boom era of the 1950s and 1960s, todays's epidemic of delayed childbearing is similar to patterns earlier in the 20th century. As then, much is due to delayed age at marriage, but baby boomers now in the their late 20s and early 30s are also delaying childbirth after marriage. The trend stems in part from their economic difficulties as they compete in a tight job market caused both by their large numbers and a turbulent economy. But it is also related to women's increasing education and, in turn, increasing opportunities in and commitment to the labor force, which can be expected to encourage a delayed childbearing even after prospects brighten for young people. Although a diverse group, most of today's delayed childbearers are white, highly educated, 2-career couples. Adequate daytime care for preschool children is a prime concern. Although more employers now offer childcare assistance and flexible work schedules to working parents, the juggle between jobs and childraising can be a strain. On the plus side are delayed childbearers' greater maturity and generally higher incomes, which can ease potential problems created by parent-child age differences as their children grow up. Businesses have been quick to respond to the new market of older, affluent, 1st-time mothers. New methods of treating of circumventing infertility and prenatal detection of chromosomal birth defects can now help overcome potential biological problems that may concern women who choose to delay childbearing past age 30.     

Evolving Fertility Goals and Behaviors in Current U.S. Childbearing Cohorts

In the post-Recession era, U.S. fertility rates have continued to fall. It is unclear if these declines are driven by shifts in fertility goals or growing difficulty in achieving goals. In this paper, we construct synthetic cohorts of men and women to examine both cross-cohort and within-cohort changes in fertility goals using multiple cycles of the National Survey of Family Growth. Although more recent cohorts exhibit lower achieved fertility at younger ages than earlier cohorts at the same age, intended parity remains around two children, and intentions to remain childless rarely exceed 15 percent. There is weak evidence of a growing fertility gap in the early 30s, suggesting more recent cohorts will need considerable childbearing in the 30s and early 40s to “catch up” to earlier goals, yet low-parity women in their early 40s are decreasingly likely to have unfulfilled fertility desires or intentions to have children. Low-parity men in their early 40s, though, are increasingly likely to intend children. Declines in U.S. fertility thus seem to be largely driven not by changes in early-life fertility goals so much as either a decreasing likelihood of achieving earlier goals or, perhaps, shifts in the preferred timing of fertility that depress period measures.     

Women are key players in the economies of East and Southeast Asia

In 1996, the East-West Center's Program on Population investigated the links between population change and economic growth in Japan, South Korea, Taiwan, Singapore, Thailand, and Indonesia. This document discusses the findings pertaining to women's changing marriage and childbearing patterns, education attainment, and labor force participation as well as changes in family life. In eastern and southeastern Asia, women are delaying marriage and having fewer children as a result of their overwhelming acceptance of modern contraception. Concurrently, women's secondary school enrollment has increased dramatically since 1960, and women have accounted for steadily increasing proportions of total labor force growth. Economic development has led to fewer women employed in agriculture and more in clerical positions. Women continue to be marginalized in low-paying manufacturing jobs and to lose these jobs more frequently than do men. Women's labor force participation continues to be dependent upon their child care responsibilities, but women are beginning to combine both activities with the help of live-in grandparents. Women have made an important contribution to economic growth in Asia. Policies should address job discrimination against married women, wage discrimination, the problems faced by young women who leave home for employment in the manufacturing and service sectors, and the lack of child care facilities.     

Women's frequency of alcohol consumption prior to pregnancy and at their pregnancy-booking visit 2001–2006: A cohort study

BackgroundWith evidence of offspring harms and concern for younger women's drinking behaviours, this study uses a hospital cohort to trend the use and changes in women's reported alcohol consumption.AimsTo examine (i) the trend of women's reported alcohol consumption over time, (ii) whether any increases in the frequency of alcohol consumption prior to a pregnancy are accompanied by increases in the frequency of alcohol consumption in pregnancy and (iii) the characteristics of women consuming alcohol at these times.MethodsMidwives collected routine data on 19,699 women between 2001 and 2006. Data on women's alcohol use prior to pregnancy and at their pregnancy-booking visit were analysed using a non-parametric test for trend and with bivariate and multivariate tests adjusting for possible confounders.FindingsThe proportion of women reporting at-least weekly alcohol use prior to pregnancy was 25.4% and 5.9% at their pregnancy-booking visit. A significant linear increase over time (p < 0.001) was found in the rate of women aged 20 years and older reporting at-least weekly alcohol use prior to pregnancy. Tertiary-educated women were more likely to consume alcohol at-least weekly prior to pregnancy. Women aged less than 20 years were less likely to report at-least weekly alcohol use at both time points. Having more children and Asian ethnicity were associated with a lower risk of at-least weekly alcohol use at these times.ConclusionThe majority of women reduce their alcohol consumption once they learn they are pregnant, with some evidence this trend may have increased in recent years.     

Childbirth experience in women participating in a continuity of midwifery care project

BackgroundContinuity models of care are rare in Sweden, despite the evidence of their benefit to women and babies. Previous studies have shown certain factors are associated with a positive birth experience, including continuity of midwifery care.AimThe aim was to investigate women's childbirth experiences in relation to background data, birth outcome and continuity with a known midwife, in a rural area of Sweden.MethodsAn experimental cohort study. Participating women were offered continuity of midwifery care in pregnancy and birth, during selected time periods. Data were collected in mid-pregnancy and two months after birth. The Childbirth Experience Questionnaire was used to determine women's birth experiences.ResultA total of 226 women responded to the follow-up questionnaire. Not living with a partner, fear of giving birth, and a birth preference other than vaginal were associated with a less positive birth experience. Having had a vaginal birth with no epidural, no augmentation and no birth complication all yield a better birth experience. Women who had had a known midwife were more likely to have had a positive birth experience overall, predominantly in the domain Professional support.ConclusionsThe results of this study showed that women who received care from a known midwife in labour were more likely to have a positive birth experience. The results also pointed out the benefits of a less medicalized birth as important for a good birth experience, and that some women may need extra support to avoid a less positive birth experience.     

The Future Labor Force of an Aging Taiwan: The Importance of Education and Female Labor Supply

This study uses multi-state cohort component projections and detailed vital statistics data to project the future Taiwanese population by age, sex, and education up to 2050. These are the first education-specific population projections for Taiwan, and they reveal how young highly educated cohorts during the next decades will replace older cohorts with lower levels of educational attainment. The results of the population projections enter our estimation of the future composition of the Taiwanese labor force. Incorporating education as an extra dimension in labor force projections allows us to make inferences about the quality of future labor supply in a rapidly aging Taiwan and the leverage of expanding economic activity across the life course, particularly of women. At present, women’s economic activity above age 25 in Taiwan is significantly lower than men’s and also much lower than women's in Western developed nations. Some of the expected adverse economic consequences of population aging can likely be alleviated by having a more educated and consequently more productive labor force. The overall results and conclusions of our study, though based on the Taiwanese context, apply to other Asian economies with rapidly aging populations and currently comparatively low levels of female labor force participation as well.     

Maternal mental health in Australia and New Zealand: A review of longitudinal studies

AimThe aim of this paper is to describe the factors that impact on the mental health of Australian and New Zealand (NZ) women in the perinatal period (pregnancy and the year following birth), and to determine the impact of perinatal mental health on women's subsequent health by summarising findings from prospective longitudinal studies conducted in Australia and NZ.MethodsA systematic search was conducted using the databases, Scopus, Medline, PsychInfo and Health Source to identify prospective longitudinal studies focused on women's social and emotional health in the perinatal period. Forty-eight papers from eight longitudinal studies were included.ResultsThe proportion of women reporting depressive symptoms in the first year after birth was between 10 and 20% and this has remained stable over 25 years. The two strongest predictors for depression and anxiety were previous history of depression and poor partner relationship. Importantly, women's mood appears to be better in the first year after birth, when compared to pregnancy and five years later. Becoming a mother at a young age is by itself not a risk factor unless coupled with social disadvantage. Women report a high number of stressors in pregnancy and following birth and the rate of intimate partner violence reported is worryingly high.ConclusionMidwives have an important role in the identification, support and referral of women experiencing mental health problems. As many women do not seek help from mental health services, the potential for a known midwife to impact on women's mental health warrants further examination.     

The Gendered Division of Labor in Parental Caretaking:

Public ideology dictates that families take responsibility for the care of their frail and vulnerable members. Women more than men are the unpaid, informal caregivers of family members. This gendered division of labor is examined by using the U.S. Survey of Income and Program Participation. Differences between metropolitan and nonmetropolitan sons' and daughters' parental caregiving activities are examined in order to contrast areas having more traditional, conventional or conservative values with those adopting more feminist values. Results show that in addition to daughters performing the vast majority of tasks, there is a difference between the types of care provided by metropolitan and nonmetropolitan daughters. Nonmetropolitan daughters tend to perform more caregiving tasks considered to be traditional "women's work" while metropolitan daughters perform significantly more tasks considered to be nontraditional for women. The fmdings suggest that providing care is due more to socialization to gender roles than to women's supposed natural or biological tendencies for "nurturing."     

Who decides the position for birth? A follow-up study of a randomised controlled trial

BackgroundPhysical benefits are suggested for women and their babies when women adopt an upright position of their choice at birth. Available care options during labour influence women's impressions of what intrapartum care is. This indicates that choice of birth positions may be determined more by midwives than by women's preferences.QuestionThe aims of this study were to investigate factors associated with adherence to allocated birth position and also to investigate factors associated with decision-making for birth position.MethodAn invitation to answer an on-line questionnaire was mailed.FindingsDespite being randomised, women who gave birth on the seat were statistically significantly more likely to report that they participated in decision-making and that they took the opportunity to choose their preferred birth position. They also reported statistically significantly more often than non-adherers that they felt powerful, protected and self-confident.ConclusionsMidwives should be conscious of the potential impact that birth positions have on women's birth experiences and on maternal outcomes. Midwives should encourage women's autonomy by giving unbiased information about the birth seat. An upright birth position may lead to greater childbirth satisfaction. Women's experience of and preferences for birth positions are consistent with current evidence for best practice.