Socially disadvantaged women's views of barriers to feeling safe to engage in decision-making in maternity care

BackgroundAlthough midwifery literature suggests that woman-centred care can improve the birthing experiences of women and birth outcomes for women and babies, recent research has identified challenges in supporting socially disadvantaged women to engage in decision-making regarding care options in order to attain a sense of control within their maternity care encounters.ObjectiveThe objective of this paper is to provide an understanding of the issues that affect the socially disadvantaged woman's ability to actively engage in decision-making processes relevant to her care.Research designThe qualitative approach known as Interpretative Phenomenological Analysis was used to gain an understanding of maternity care encounters as experienced by each of the following cohorts: socially disadvantaged women, registered midwives and student midwives. This paper focuses specifically on data from participating socially disadvantaged women that relate to the elements of woman-centred care-choice and control and their understandings of capacity to engage in their maternity care encounters.FindingsSocially disadvantaged women participants did not feel safe to engage in discussions regarding choice or to seek control within their maternity care encounters. Situations such as inadequate contextualised information, perceived risks in not conforming to routine procedures, and the actions and reactions of midwives when these women did seek choice or control resulted in a silent compliance. This response was interpreted as a consequence of women's decisions to accept responsibility for their baby's wellbeing by delegating health care decision-making to the health care professional.ConclusionThis research found that socially disadvantaged women want to engage in their care. However without adequate information and facilitation of choice by midwives, they believe they are outsiders to the maternity care culture and decision-making processes. Consequently, they delegate responsibility for maternity care choices to those who do belong; midwives. These findings suggest that midwives need to better communicate a valuing of the woman's participation in decision-making processes and to work with women so they do have a sense of belonging within the maternity care environment. Midwives need to ensure that socially disadvantaged women do feel safe about having a voice regarding their choices and find ways to give them a sense of control within their maternity care encounters.     

The Impact of Flexible Working Arrangements on Work–life Conflict and Work Pressure in Ireland

Recent rapid economic growth in Ireland has been accompanied by a strong surge in the number of women in employment, and this has led to a significant increase in the proportion of dual‐earner families. These changes have brought the issue of reconciliation between work and care commitments to the fore. Flexible working arrangements in firms have been identified as one important means of balancing work and other commitments. In this article we investigate the relationship between four flexible working arrangements; flexitime, part‐time hours, working from home and job sharing, and two key employee outcomes; work pressure and work–life conflict, using data from the first national survey of employees in Ireland in 2003. Our results show that while part‐time work and flexitime tend to reduce work pressure and work–life conflict, working from home is associated with greater levels of both work pressure and work–life conflict. We conclude that it is important to distinguish between flexible working arrangements to discover their potential for reducing work pressure and work–life conflict.     

Using best available science to protect critical areas in Washington state: challenges and barriers to planners

Urban development has profound impacts on ecological patterns and processes making the scientific information required for developing environmental ordinances central for mitigating these negative ecological impacts. Washington State requires that planners use the best available science (BAS) to formulate land use ordinances as part of the state’s Growth Management Act (GMA). We present empirical findings describing challenges to planners in defining “best available science” and using BAS to create local ordinances that balance development needs with natural resource protection. We interviewed city and county planners (and their consultants) in western Washington to determine what they find useful about BAS, whether or not BAS is applicable to their jurisdictions, and what constraints they experience in reviewing and using BAS to create or update their land use ordinances. Our results suggest that applying the BAS requirement is particularly difficult in urban areas. Specifically, planners had difficulty applying results from research conducted in systems dissimilar to their urban landscapes. These challenges to planners were exacerbated by (1) a lack of resources and (2) political tensions among stakeholders with competing values in urban settings. We conclude with recommendations for improving the consideration of science in statewide land-use planning.     

Farming and environmental discourses: A study of the depiction of environmental issues in a German farming newspaper

Maintaining the natural environment is increasingly seen as an essential aspect of agriculture in Europe, and conservation is promoted as an element of the farmer's role. It is therefore important to understand how farmers are reacting to this. In this study, the discourses relating to environmental issues used in a regional German farming newspaper are examined. The aim was to consider the arguments to which individual farmers are exposed when they read the newspaper and at the same time to examine the discourses used by the farming union in their promotion of farmers' interests. It was found that there were many interwoven arguments, which included traditional agricultural discourses as well as the newer environmental ones. It was clear that different aspects of agricultural and environmental issues were highlighted where they appeared to be beneficial to farmers' interests. Furthermore, it was found that in the promotion of the use of renewable resources, which was portrayed as being in the interest of farmers, the discourses used contrasted with those being used to defend farmers from accusations of environmental neglect or damage.     

Statistical inference for α-series process with the inverse Gaussian distribution

Statistical inferences for the geometric process (GP) are derived when the distribution of the first occurrence time is assumed to be inverse Gaussian (IG). An α-series process, as a possible alternative to the GP, is introduced since the GP is sometimes inappropriate to apply some reliability and scheduling problems. In this study, statistical inference problem for the α-series process is considered where the distribution of first occurrence time is IG. The estimators of the parameters α, μ, and σ² are obtained by using the maximum likelihood (ML) method. Asymptotic distributions and consistency properties of the ML estimators are derived. In order to compare the efficiencies of the ML estimators with the widely used nonparametric modified moment (MM) estimators, Monte Carlo simulations are performed. The results showed that the ML estimators are more efficient than the MM estimators. Moreover, two real life datasets are given for application purposes.     

“I am a fat baby,who moved to a fat child,who moved to a fat teenager,who moved to a fat adult”: Women’s reflections of a lifetime of body and weight concern

The present study explored how women aged 50–65 years reflect and make meaning of a lifetime of body and weight struggles. Seven purposefully selected women with longstanding body image challenges participated in interviews and reflected on their perceptions, thoughts, and emotions around their body and weight since childhood. Findings revealed consistent and consuming concerns about the body; prevalent body-related self-conscious emotions; influential social experiences that impact physical self-perceptions; and enduring impacts of weight bias, stigma, and discrimination. Collectively, these findings provide support for the stability of body disturbances and highlight the need to explore the unique body-related narratives of women in midlife.     

Presence and process of fear of birth during pregnancy—Findings from a longitudinal cohort study

Background

The prevalence of fear of birth has been estimated between 8–30%, but there is considerable heterogeneity in research design, definitions, measurement tools used and populations. There are some inconclusive findings about the stability of childbirth fear.