输卵管吻台术后四十二天妊娠一例分析

输卵管吻合术是绝育术后输卵管再通的主要方法。本文对一例输卵管吻合手术后42天妊娠的分析,说明了遵守术后注意事项的重要性,以避免术后宫外孕和生殖道感染发生。     

How do health professionals support pregnant and young mothers in the community? A selective review of the research literature

BackgroundThe cultural phenomenon of “teenage pregnancy and motherhood” has been socially constructed and (mis)represented in social and health care discourses for several decades. Despite a growing body of qualitative research that presents an alternative and positive view of young motherhood, there remains a significant gap between pregnant and young women's experience of young motherhood and current global health and social policy that directs service delivery and practice.AimThis paper aims to heighten awareness of how a negative social construction of young motherhood influences global health and social policy that directs current community health models of practice and care for young mothers in the community.DiscussionThere is clear evidence on the vital role social support plays in young women's experience of pregnancy and motherhood, particularly in forming a positive motherhood identity. This discussion paper calls us to start open and honest dialogue on how we may begin to re-vision the ‘deficit view’ of young motherhood in order to address this contradiction between research evidence, policy discourse and current practice and service provision. Qualitative research that privileges young women's voices by considering the multidimensional experiences of young motherhood is an important step towards moving away from universally prescribed interventions to a non-standard approach that fosters relational and responsive relationships with young mothers that includes addressing the immediate needs of young mothers at the particular time.     

Facilitators and barriers to substance-free pregnancies in high-income countries: A meta-synthesis of qualitative research

BackgroundPrevious studies have associated substance use (alcohol, illicit drugs and smoking) to negative pregnancy outcomes, including higher risk of stillbirth.AimThis study aims to identify facilitators and barriers reported by women to remain substance free during pregnancy.MethodsA systematic search was conducted in six databases from inception to March 2019 and updated in November 2020. Qualitative studies involving pregnant or post-partum women, from high-income countries, examining women’s experiences of substance use during pregnancy were eligible. Meta-ethnography was used to facilitate this meta-synthesis.FindingsTwenty-two studies were included for analysis. Internal barriers included the perceived emotional and social benefits of using substances such as stress coping, and the associated feelings of shame and guilt. Finding insensitive professionals, the lack of information and discussion about risks, and lack of social support were identified as external barriers. Furthermore, the social stigma and fear of prosecution associated with substance use led some women to conceal their use. Facilitators included awareness of the health risks of substance use, having intrinsic incentives and finding support in family, friends and professionals.DiscussionPerceived benefits, knowledge, experiences in health care settings, and social factors all play important roles in women’s behaviours. These factors can co-occur and must be considered together to be able to understand the complexity of prenatal substance use.ConclusionIncreased clinical and community awareness of the modifiable risk factors associated with substance use during pregnancy presented in this study, is necessary to inform future prevention efforts.     

Midwives and sexual violence: A cross-sectional analysis of personal exposure,education and attitudes in practice

BackgroundAround one in three women experience sexual violence during their lifetime. They may need trauma-sensitive maternity care that takes sexual trauma triggers into account. Midwives are similarly likely to have experienced sexual violence in their lifetime. It is unknown whether midwives with a personal sexual violence history have a different professional approach to the topic than their colleagues without such history.AimTo explore whether midwives with a personal sexual violence history are more likely to have received or need education about sexual violence and whether they approach sexual violence differently in practice.MethodsAn exploratory online survey was conducted amongst practicing midwives in high resource countries. Odds ratios were calculated for differences between midwives with and without a personal sexual violence history.FindingsOf the 288 participating midwives, 48.6% disclosed a personal sexual violence history. Midwives with a personal sexual violence history showed higher uptake of post-graduate education (OR 2.05, 95% CI 1.23–3.44), more accurate prevalence estimation (OR 3.42, 95% CI 2.10–5.57) and more confidence to identify sexual violence history (OR 1.94, 95% CI 1.19–3.15). We found no differences in requiring future education, screening practices, other aspects of confidence or time and discomfort barriers.ConclusionsAs fellow survivors, midwives with a personal sexual violence history have a unique standpoint towards sexual violence in maternity care practice that may make them more sensitive to the issue.     

“I’d like an abortion please”: rethinking unplanned pregnancy narratives in contemporary American cinema

Released in 2014 and 2015, respectively, the American indie films Obvious Child and Grandma each feature a central protagonist who is dealing with an unplanned pregnancy and is pursuing an abortion. These pro-choice narratives not only challenge Hollywood cinema’s repetitive depiction of unplanned pregnancies that result in motherhood, but they critique the dominant political and societal discourses surrounding abortion and women who choose to terminate pregnancies. Tracing the history of cinematic portrayals of unplanned pregnancy, and reflecting upon how post-feminist culture has positioned the notion of choice, this paper notes the significance of Obvious Child and Grandma as films that not only feature abortion as a central theme, but utilize comedy in their navigation of a controversial subject. Furthermore, this paper argues that in their frank and positive engagement with termination as a potential resolution to an unplanned pregnancy, these films offer important attempts to destigmatize the subject of abortion.     

Pregnancy Acceptance,Parenting Stress,and Toddler Attachment in Low‐Income Black Families

Questionnaire items tapping feelings about pregnancy were administered to 173 young, low‐income primiparous Black mothers who either were pregnant or had delivered within the past year. A factor analysis indicated that 11 items together measured mothers’ acceptance of the pregnancies that resulted in the births of their first children. Links to mothers’ later parenting stress, warmth, and their toddlers’ attachment security were explored. Pregnancy acceptance was a negative predictor of one aspect of maternal parenting stress (distress resulting from feelings that parenting is burdensome) and a positive predictor of toddler attachment security. It did not, however, predict another aspect of parenting stress (feelings that interactions with children are not enjoyable) or maternal warmth.     

The Effects of State Alcohol and Pregnancy Policies on Women’s Health and Healthy Pregnancies

US states have enacted a wide range of laws to address health challenges associated with alcohol use during pregnancy. Some have taken punitive approaches that restrain women’s behavior, and some have taken supportive approaches aimed at improving women’s health and supporting healthy pregnancies. In this article we report on a study of implementation of supportive and punitive policies when both types of policies operate simultaneously in the same jurisdiction. Effects of mixed use laws on multiple stakeholder groups, especially pregnant and postpartum women, are studied. We conclude by identifying how our findings can be extended for future comparative state research.     

The Relationship Context: Its Effects on Low-Income Women's Desire for a Baby

Little is known about the influence of relationship characteristics on a woman's desire for a baby with her partner. This study addresses that gap, using data from a study of 1,114 low-income women in the southeast who were in a relationship. Controlling for sociodemographic factors, women who were in more established relationships, who had not had a previous child with their partner, or who had higher expectations of their partner were generally more likely to want a baby with him. In investigating women's childbearing desires, it is important to consider not only individual characteristics but also women's relationship characteristics.     

Modeling Exposure to Air Pollution from the WTC Disaster Based on Reports of Perceived Air Pollution

We examined the utility of a newly developed perceived air pollution (PAP) scale and of a modeled air pollution (MAP) scale derived from it for predicting previously observed birth outcomes of pregnant women enrolled following September 11, 2001. Women reported their home and work locations in the four weeks after September 11, 2001 and the PAP at each site on a four-point scale designed for this purpose. Locations were geocoded and their distance from the World Trade Center (WTC) site determined. PAP values were used to develop a model of air pollution for a 20-mile radius from the WTC site. MAP values were assigned to each geocoded location. We examined the relationship of PAP and MAP values to maternal characteristics and to distance of home and work sites from the WTC site. Both PAP and MAP values were highly correlated with distance from the WTC. Maternal characteristics that were associated with PAP values reported for home or work sites (race, demoralization, material hardship, first trimester on September 11) were not associated with modeled MAP values. Relationships of several birth outcomes to proximity to the WTC, which we previously reported using this data set, were also seen when MAP values were used as the measure of exposure, instead of proximity. MAP developed from reports of PAP may be useful to identify high-risk areas and predict health outcomes when there are multiple sources of pollution and a "distance from source" analysis is impossible.