The dwelling space of postnatal care

BackgroundThis paper considers the dwelling space of postnatal care, how being-there feels for the woman going through the experience of matrescence. The research takes a hermeneutic approach and draws on philosophical notions from Heidegger. Question: ‘What is the nature of the dwelling space of valued postnatal care?’.MethodsAppropriate ethics approval was gained. Participants were midwives, nurses, women, and other relevant stakeholders. There were 4 focus groups involving 11 participants and 19 individual interviews. Data collection was conducted over a one week period by a team of three researchers. An interview schedule had been organised by the administrator at the Centre. Participants chose whether to come to the centre to be interviewed, or be interviewed in their own homes. Most interviews were an hour. All interviews were tape recorded and transcribed, with the participant's permission. Data was analysed through a hermeneutic process set in the context of related literature.FindingsWhen women are invited into a dwelling space that strengthens them they feel ‘mothered’: being listened to, have their needs anticipated, and are cared for in a loving manner. In such a way they grow confidence. A child health nurse reported the difference such care made to on-going mothering at home.Implications for practiceAll women deserve a dwelling space in their early days of matrescence. Small birthing centres perhaps achieve such care and ambience more easily than large institutional units. Nevertheless, wherever the place, practices need to be enabled that foster the spirit of dwelling.     

Australian primary maternity units: Past,present and future

Primary maternity units are commonly those run by midwives who provide care to women with low-risk pregnancies with no obstetric, anaesthetic, laboratory or paediatric support available on-site. In some other countries, primary level maternity units play an important role in offering equitable and accessible maternity care to women with low-risk pregnancies, particularly in rural and remote areas. However there are very few primary maternity units in Australia, largely due to the fact that over the past 200 years, the concept of safety has become inherently linked with the immediate on-site availability of specialist medical support.The purpose if this paper is to explore the various drivers and barriers to the sustainability of primary maternity units in Australia. It firstly looks at the historical antecedents that shaped primary level maternity services in Australia, from the time of colonisation to now. During this period the space and management of childbirth moved from home and midwifery-led settings to obstetric-led hospitals. Following on from this an analysis of recent political events shows how Australian government policy both supports and undermines the potential of primary maternity units. It is important that researchers, clinicians and policy makers understand the past in order to manage the challenges facing the development and maintenance of midwifery-led maternity services, in particular primary maternity units, in Australia today.     

Impact of Mode of Display and Message Content of Responsible Gambling Signs for Electronic Gaming Machines on Regular Gamblers

Harm-minimization strategies aim to reduce gambling-related risks; however, minimal evidence supports the effectiveness of current strategies involving the placement of warning signs in gambling venues and on electronic gaming machines (EGMs). This qualitative replication study evaluated the differential effect of pop-up messages compared to static signs and the content of messages on EGMs on recall, thoughts, and behaviors assessed during the session and at 2-week follow-up. In Study 1, 127 regular EGM gamblers (male = 97, mean age = 20.3) recruited from a university student population attended a laboratory where they were randomly assigned to play a computer-based simulated EGM analogue displaying signs that differed by (a) mode of presentation (pop-up and static) and (b) message content (informative, self-appraisal, and control/blank). In Study 2, an identical methodology was used but included the use of a simulated EGM within an in vivo gaming setting with 124 regular EGM players (male = 81, mean age = 44.1). Results from both studies showed that pop-up messages were recalled more effectively than static messages immediately and at 2-week follow-up. Pop-up messages reportedly had a significantly greater impact on within-session thoughts and behaviors. Messages encouraging self-appraisal resulted in significantly greater effect on self-reported thoughts and behaviors during both the experimental session and in subsequent EGM play. These findings support the effectiveness of pop-up messages containing self-appraisal messages as an appropriate harm-minimization initiative.     

Evolving Narratives About Childhood Sexual Abuse: Challenging the Dominance of the Victim and Survivor Paradigm

This research project explored the ongoing process of constructing a narrative, following childhood sexual abuse. Twenty‐two men and women aged 25–70 were interviewed about their childhood sexual experiences with adults using narrative inquiry methodology. These experiences occurred in different social and historical contexts, when the theoretical understandings and treatment of the issue of child sexual abuse were significantly different from the present. Many factors made disclosure even more difficult then than it is now including: respect for authority; rigid gender roles; the taboo surrounding sexual issues; lack of supportive adults; and lack of language to describe what was happening. Participants told four differing narratives about their experiences: narratives of silence; narratives of ongoing suffering; narratives of transformation; and narratives of transcendence. These narratives were examined in relation to the changing social and historical context and the current dominance of the victim and survivor paradigm in the child sexual abuse literature.