Women’s experiences of decision-making and attitudes in relation to induction of labour: A survey study

BackgroundRates of induction of labour have been increasing globally to up to one in three pregnancies in many high-income countries. Although guidelines around induction, and strength of the underlying evidence, vary considerably by indication, shared decision-making is increasingly recognised as key. The aim of this study was to identify women’s mode of birth preferences and experiences of shared decision-making for induction of labour.MethodAn antenatal survey of women booked for an induction at eight Sydney hospitals was conducted. A bespoke questionnaire was created assessing women’s demographics, indication for induction, pregnancy model of care, initial birth preferences, and their experience of the decision-making process.ResultsOf 189 survey respondents (58% nulliparous), major reported reasons for induction included prolonged pregnancy (38%), diabetes (25%), and suspected fetal growth restriction (8%). Most respondents (72%) had hoped to labour spontaneously. Major findings included 19% of women not feeling like they had a choice about induction of labour, 26% not feeling adequately informed (or uncertain if informed), 17% not being given alternatives, and 30% not receiving any written information on induction of labour. Qualitative responses highlight a desire of women to be more actively involved in decision-making.ConclusionA substantial minority of women did not feel adequately informed or prepared, and indicated they were not given alternatives to induction. Suggested improvements include for face-to-face discussions to be supplemented with written information, and for shared decision-making interventions, such as the introduction of decision aids and training, to be implemented and evaluated.     

Parenting and children’s negative emotionality,self‐regulation,and academic skills: The moderating role of fathers’ residency

We examined whether fathers’ residency modified the associations among mothers’ supportiveness, father involvement, children’s negative emotionality during toddlerhood and children’s academic skills in pre‐kindergarten via children’s self‐regulation. Participants were 2,291 mothers (M_age = 23.24 years) and children (M_age = 14.99 months at Wave 1; 50.7% girls) in the Early Head Start Research and Evaluation Project. Results revealed distinctive associations by fathers’ residency: self‐regulation mediated the association between mothers’ supportiveness and academic skills only in resident‐father‐families. Self‐regulation mediated the association between negative emotionality and academic skills only in nonresident‐father‐families. The findings highlight the family processes of mothers, fathers, and children in low‐income family contexts that contribute to children’s academic skills, and how those family processes may vary by fathers’ residency status.     

Using complexity theory in kinship practice

This reflective discussion draws on data from a collaborative enquiry into kinship or family and friends practice. It introduces perspectives from complexity and chaos theory as a way of re‐examining the challenges of kinship practice. The discussion highlights the enduring challenges for practitioners, not least, managing anxiety and uncertainty, sustaining continuity and containment, becoming experienced and taking account of the complex developmental needs of the children and their families. The discussion particularly raises questions about appropriate settings for practitioners to undertake such a demanding area of child and family social work.     

First-time mothers’ birth beliefs,preferences, and actual birth: A longitudinal observational study

Problem

Birth preferences, such as mode and place of birth and other birth options, have important individual and societal implications, yet few studies have investigated the mechanism which predicts a wide range of childbirth options simultaneously.

包头市人口再生产与人口转变研究

1949年到2009年期间,包头市出生人数经历了出生人数增长阶段、出生人数持续阶段、出生人数减少阶段和出生人数回落回升阶段;出生率经历了第一高峰阶段、第一低谷阶段、第二高峰阶段、第二低谷阶段和第三高峰阶段;死亡人数经历了死亡人数增长阶段、死亡人数减少阶段、死亡人数持平阶段、死亡人数抬升阶段和死亡人数回落回升阶段;死亡率经历了下降阶段、徘徊阶段和起伏阶段;人口再生产类型的转变过程确定为传统型阶段→过渡类型阶段→现代型阶段;60多年的人口再生产类型转变的梳理,为包头市今后人口与计划生育工作提供了继续稳定低生育水平、解决低生育水平下的人口问题启示。     

中国出生人口性别比问题探析

出生人口性别比问题,已经不仅仅是个简单的人口比例问题。出生人口性别比失衡问题将会引起一系列的社会问题。20世纪80年代以来,我国出生人口性别比失衡问题越来越凸显出来,不仅在时间上,而且是区域上也表现得很明显。本文将对我国出生人口性别比失衡这一现象进行描述,阐述这一问题的原因,并对解决这一问题提出相关的对策,这对我国出生人口性别比的研究具有重要的理论和现实意义。     

Home birth and the National Australian Maternity Services Review: too hot to handle?

Background

In February 2009 the Improving Maternity Services in Australia – The Report of the Maternity Services Review (MSR) was released, with the personal stories of women making up 407 of the more than 900 submissions received. A significant proportion (53%) of the women were said to have had personal experience with homebirth. Little information is provided on what was said about homebirth in these submissions and the decision by the MSR not to include homebirth in the funding and insurance reforms being proposed is at odds with the apparent demand for this option of care.

Method

Data for this study comprised 832 submissions to the MSR that are publicly available on the Commonwealth of Australia Department of Health and Aging website. All 832 submissions were downloaded, coded and then entered into NVivo. Content analysis was used to analyse the data that related to homebirth.

Findings

450 of the submissions were from consumers of maternity services (54%). Four hundred and seventy (60%) of the submissions mentioned homebirth. Overall there were 715 references to home birth in the submissions. The submissions mentioning homebirth most commonly discussed the ‘Benefits’ and ‘Barriers’ in accessing this option of care. Benefits to the baby, mother and family were described, along with the benefits obtained from having a midwife at the birth, receiving continuity of care and having a good birth experience. Barriers were described as not having access to a midwife, no funding, no insurance and lack of clinical privileging for midwives.

Conclusion

Many positive recommendations have come from the MSR, however the decision to exclude homebirth from these reforms is perplexing considering the large number of submissions describing the benefits of and barriers to homebirth in Australia. A concerning number of submissions discuss having had or having considered an unattended birth at home due to these barriers. Overall there is the belief that not enabling access to funded, insured homebirth in Australia is a violation of human rights. It appears that homebirth was considered by the MSR as ‘too hot to handle’ and by dismissing it as a minority issue the government sought to avoided dealing with homebirth as a ‘sensitive and controversial issue.’     

Fathers' birth experience in relation to midwifery care

The aim was to identify the proportion of fathers having a positive experience of a normal birth and to explore factors related to midwifery care that were associated with a positive experience.

Background

Research has mainly focused on the father's supportive role during childbirth rather than his personal experiences of birth.

Methods

595 new fathers living in a northern part of Sweden, whose partner had a normal birth, were included in the study. Data was collected by questionnaires. Odds Ratios with 95% confidence interval and logistic regression analysis were used.

Results

The majority of fathers (82%) reported a positive birth experience. The strongest factors associated with a positive birth experience were midwife support (OR 4.0; 95 CI 2.0–8.1), the midwife's ongoing presence in the delivery room (OR 2.0; 1.1–3.9), and information about the progress of labour (OR 3.1; 1.6–5.8).

Conclusion

Most fathers had a positive birth experience. Midwifery support, the midwife's presence and sufficient information about the progress of labour are important aspects in a father's positive birth experience. The role of the midwife during birth is important to the father, and his individual needs should be considered in order to enhance a positive birth experience.