Conflicting contexts: Midwives’ interpretation of childbirth through photo elicitation

IntroductionThis study seeks to explore midwives’ perceptions about childbirth and in particular their beliefs about normality and risk. In the current climate of increasing interventions during labour, it is important to understand the thought processes that impact on midwifery care in order to examine whether these beliefs influence midwifery clinical decision-making.Method12 Midwives who worked in a variety of metropolitan hospitals in Sydney, Australia were interviewed about how they care for women during labour. The study utilised an inductive qualitative design using photo elicitation during the interview process.ResultsSix themes emerged from the data that clearly indicated midwives felt challenged by working in a system dominated by an obstetric model of care that undermined midwifery autonomy in maintaining normal birth. These themes were: desiring normal, scanning the environment, constructing the context, navigating the way, relinquishing desire and reflecting on reality. Most midwives felt they were unable to practice in the manner they were philosophically aligned to, that is, promoting normal birth, as the medical model restricted their practice.DiscussionThe polarised views of childbirth held by midwives and obstetricians do little to enhance normal birth outcomes. Midwives in this study expressed frustration that they were unable to practice midwifery in a way that reflected their belief in normal birth. This, they cite is a result of the oppressive obstetric model prevalent in maternity care facilities in Sydney and the over use of technological interventions during childbirth.     

Impact of having a high-risk pregnancy on future postpartum contraceptive method choice

BackgroundTo compare the knowledge and preference of preconceptional contraception to future postpartum contraceptive method choice in high-risk pregnancies.Research questionDoes a high-risk pregnancy condition affect future postpartum contraceptive method choice?MethodWomen hospitalised at the High Risk Pregnancy unit of a tertiary research and training hospital were asked to complete a self-reported questionnaire that included demographic characteristics, presence of unintended pregnancy, contraceptive method of choice before the current pregnancy, plans for contraceptive use following delivery and requests for any contraceptive counselling in the postpartum period.FindingsA total of 655 pregnant women were recruited. The mean age, gravidity and parity of the women were 27.48 ± 6.25 years, 2.81 ± 2.15 and 1.40 ± 1.77, respectively. High-risk pregnancy indications included 207 (31.6%) maternal, 396 (60.5%) foetal and 52 (7.9%) uterine factors. All postpartum contraceptive choices except for combined oral contraceptives (COCs) usage were significantly different from preconceptional contraceptive preferences (p < 0.001). High-risk pregnancy indications, future child bearing, ideal number of children, income and education levels were the most important factors influencing postpartum contraceptive choices. While the leading contraceptive method in the postpartum period was long-acting reversible contraceptive methods (non-hormonal copper intrauterine device Cu-IUD, the levonorgestrel-releasing intrauterine system (LNG-IUS) (40%), the least preferred method was COCs use (5.2%) and preference of COCs use showed no difference between the preconceptional and postpartum periods (p = 0.202). Overall 73.7% of the women wanted to receive contraceptive counselling before their discharge.ConclusionA high-risk pregnancy condition may change the opinion and preference of contraceptive use, and also seems to affect the awareness of family planning methods.     

Sexual Behaviors,Sexual Health Practices,and Community Engagement Among Gay and Bisexually Identified Men Living in Rural Areas of the United States

Limited research has focused on the sexual behaviors of men who have sex with men (MSM) from rural communities. We examined the sexual and health-related behaviors of MSM living in rural areas of the United States in order to understand the sexual health repertoire of this population. A total of 5,357 participants living in rural settings were recruited online and completed an anonymous Internet-based survey that assessed sexual behaviors, condom use, and men’s engagement with various community activities and events. These data provide a greater understanding of sexual health profiles that exist among rural MSM and will help inform the design of effective programs for men in these often underserved communities.     

Life Satisfaction as a Distinguishing Indicator of College Student Functioning: Further Validation of the Two-Continua Model of Mental Health

The two-continua model of mental health contends that both psychological distress and psychological well-being make related-yet-distinct contributions to our understanding of human health and its relations with other quality of life outcomes. Using self-reported somatization, depression, and anxiety symptoms as indicators of psychological distress and self-reported life satisfaction as an indicator of psychological well-being, the present study classified participants into one of four mental-health-status groups—mentally healthy, mentally unhealthy, symptomatic yet content, or asymptomatic yet discontent—and investigated between-group differences across three key indicators of college student functioning: academic achievement, interpersonal connectedness, and physical health. Findings provide further validation for the two-continua model of mental health among college students, showing that, when considered in conjunction with clinical symptoms, life satisfaction serves as a distinguishing indicator of college students functioning across academic, social, and physical health domains—as well as a strong predictor of the absence or presence of clinical symptoms and comorbidity. Implications for theory, practice, and future research are discussed.     

Discount rates and risky sexual behaviors among teenagers and young adults

This article examines the relationship between personal discount rates and sexual behaviors in a sample of teenagers and young adults. We find that higher discount rates (an indication of less willingness to forego current consumption for future consumption) are significantly associated with a range of sexual behaviors, including ever having sex, having sex before age 16 years, and past or current pregnancy. These associations are consistent with previous studies showing a link between discounting and other, non-sexual health behaviors. JEL Classification D80 · D90 · I10     

Household Composition,Family Migration,and Community Context: Migrant Remittances in Four Countries*

Objectives. We study migrant remittances among households surveyed in Mexico, the Dominican Republic, Nicaragua, and Costa Rica, testing expectations derived from the new economics of labor migration (NELM) and from the historic‐structural approach. Methods. We applied logistic regression analyses to survey data collected by the Mexican Migration Project and the Latin American Migration Project, focusing on the contrast between Mexico and the Dominican Republic. Results. In Mexico, remittances seem to be associated with the patriarchal traditional family, but in the Dominican Republic we verified the opposite. Receipt of remittances is positively associated with degree of development among Mexican households, but the association is negative in the Dominican Republic. In addition, Mexican remittances are negatively associated with the number of businesses in the local community. Conclusions. In Mexico, as predicted by NELM, the cohesive patriarchal family ensures the flow of remittances as part of a household strategy of risk diversification. Dominican remittances, however, seem to be mostly determined by lack of opportunities and household need.     

Religion and World Change: Violence and Terrorism versus Peace

Our article portrays religion as a double-edged sword that can both encourage and discourage world change, and can facilitate both violent and peaceful activism. The article demonstrates how the meaning system approach to religion can shed light on the complicated relationship between religion and world change by illuminating the meaning of world change and the means to achieve it, inherent differences across religious groups, the complexity and malleability of religious meaning systems, and processes that can facilitate either the status quo or violent and peaceful activism. The article discusses context and personality variables that may determine whether religion supports world change and either violent or peaceful activism. It recommends intensive collaboration between researchers, policy–makers, and religious leaders in the contexts of national and international conflicts and religious terrorism.     

Hurricane Katrina: African American Children's Perceptions of Race, Class, and Government Involvement Amid a National Crisis

The devastation associated with Hurricane Katrina raised several issues related to race, class, and the government in the United States. We examined African American children's (a) knowledge of demographic characteristics of the victims, (b) beliefs about the role of race and class biases in the delayed relief efforts, and (c) views of the role and effectiveness of the government in response to the disaster. Overall, results indicated that older African American children were less likely to attribute the delayed relief to individual culpability, and slightly more likely to attribute it to racial discrimination, than were younger African American children. All youth believed in a strong, but nuanced, role of the government, but younger children were more likely to rate it as effective. Among those children who had discussed the disaster with a parent, children's attributions for the delayed relief were associated with their political views.     

The world population on the threshold of the 21st century

Global population trends are reviewed. The author rejects the idea that demographic factors exert a decisive affect on socioeconomic development, and maintains the Marxist-Leninist view that demographic trends are a reflection of socioeconomic systems. He suggests that the resources of the planet can support a larger population than it contains at present providing these resources are used rationally.