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To assess pregnancy‐related care and outcomes for women with pre‐gestational, Type 1 diabetes.

The study was a prospective, population‐based, clinical audit in Scotland. A total of 273 and 179 pregnancies in two 12‐month audit periods (during 1998/99 and 2003/04 respectively) were examined.

In both years, antenatal care for women with diabetes was well organised by dedicated multi‐professional teams. Provision of formal pre‐pregnancy clinics increased (1998, four of 22 maternity units; 2003, six of 20 units). Pregnancies documented as “planned” (1998/99, 116/273, or 42.5 per cent; 2003/04, 105/179, or 58.7 per cent; p=0.001) and periconceptual folic acid supplementation, 5 mg daily (1998/99, 40/273, or 14.7 per cent; 2003/04, 71/179, or 39.7 per cent; p<0.0001) increased over time. In both years, women whose pregnancies progressed to delivery attended early for antenatal care (median eight weeks' gestation) and had meticulous monitoring of diabetic control and foetal wellbeing. In the recent year, fewer women had hypoglycaemia during pregnancy (1998/99, 86/212, or 43.9 per cent; 2003/04, 47/160, or 29.4 per cent; p<0.0001). In both years, macrosomia was common (mean z scores: 1.57 in 1998/99 and 1.64 in 2003/04; standard deviations above a reference population mean) and perinatal mortality appeared higher than for the Scottish population (27.9/1,000 in 1998/99 and 24.8/1,000 in 2003/04). There was a (non‐significant) fall in congenital anomaly rate (1998/99: 13/215 births, or 60/1,000; 2003/04, 6/161 births, or 24.8/1,000).

Re‐audit after a five‐year interval showed that periconceptual care and pregnancy planning for Scottish women with Type 1 diabetes has improved. Although pregnancy outcomes remain poorer than for the general Scottish population, the apparent reduction in congenital anomalies is encouraging.

Adolescent pregnancy stands as a societal challenge, compelling young individuals to prematurely discontinue their education. Conversely, an expansion of high school education can potentially diminish rates of adolescent pregnancy, given that educational attainment stands as the foremost risk factor influencing sexual initiation, the use of contraceptive methods during initial sexual encounters and fertility. The aim of this paper is to analyze the impact of the implementation of the public educational policy introducing full-time schools (FTS) for high schools in the state of Ceará, Brazil, on early pregnancy rates.

Using the difference-in-differences method with multiple time periods, we measured the average effect of this staggered treatment on the treated municipalities.

The main result indicates a reduction of 0.849 percentage points in the teenage pregnancy rate. Concerning dynamic effects, the establishment of FTS in treated municipalities results in a 1.183–1.953 percentage point decrease in teenage pregnancy rates, depending on the timing of exposure. We explored heterogeneous effects within socioeconomically vulnerable municipalities, yet discerned no impact on this group. Rigorous tests confirm the robustness of the results.

This paper aims to contribute to: (1) the consolidation of research on the subject, given the absence of such research in Brazil to the best of our knowledge; (2) the advancement and analysis of evidence-based public policy and (3) the utilization of novel longitudinal data and methodology to evaluate adolescent pregnancy rates.

Policing requires atypical work hours. The present study examined associations between shiftwork and pregnancy loss among female police officers.

Participants were 91 female officers with a prior history of at least one pregnancy. Shiftwork information was assessed using daily electronic payroll work records. Any prior pregnancy loss (due to miscarriage) was self-reported. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for main associations.

On average, the officers were 42 years old, had 14 years of service, and 56% reported a prior pregnancy loss. Officers who worked dominantly on the afternoon or night shift during their career had 96% greater odds of pregnancy loss compared to those on day shift (OR = 1.96, 95% CI:0.71–5.42), but the result was not statistically significant. A 25% increase in percent of hours worked on night shift was associated with 87% increased odds of pregnancy loss (OR = 1.87, 95% CI:1.01–3.47). Associations were adjusted for demographic and lifestyle factors. Objective assessment of shiftwork via electronic records strengthened the study. Limitations include small sample size, cross-sectional design and lack of details on pregnancy loss or the timing of pregnancy loss with regard to shiftwork.

The present study is preliminary and cross-sectional.

With considerable further inquiry and findings into this topic, results may have an impact on police policy affecting shift work and pregnant police officers.

Implication on the health and welfare of police officers.

To our knowledge, there are no empirical studies which associate shiftwork and pregnancy loss among police officers. This preliminary study suggested an association between shiftwork and increased odds of pregnancy loss and points out the need for further study.

Past research suggests that whether pregnancies are wanted, unwanted, or mistimed may influence breastfeeding behavior. The purpose of this chapter is to develop a more precise understanding of this relationship. Specifically, this chapter asks three questions: first, do pregnancy intentions matter most in sustaining breastfeeding for long or for short durations postpartum; second, at what time postpartum are rates of breastfeeding discontinuation most differentiated by pregnancy intentions; and third, how does poverty (measured here by Medicaid receipt) moderate the relationship between pregnancy intentions and breastfeeding duration.

Logistic regression analysis of survey data from a national sample representative of US mothers is used to determine the relationship of pregnancy intentions to whether breastfeeding continues for various durations and through various intervals after birth. Interaction terms between pregnancy intentions and mother’s Medicaid status are used to test for relationships specific to poor or nonpoor mothers between pregnancy intentions and breastfeeding duration.

Results show that pregnancy timing matters most for sustaining breastfeeding for durations past 6 months and that differences in rates of breastfeeding discontinuation between mothers with wanted, unwanted, and mistimed pregnancies are most pronounced in the 3–7 months postpartum period. In addition, findings show that Medicaid recipients (but not nonrecipients) are less likely to exclusively breastfeed for 6 months when their pregnancies are mistimed.

The literature on fundamental causes of health disparities typically suggests that poverty impairs access to resources necessary for effective planning to achieve desirable health outcomes. This study’s results, however, show that planning of pregnancies is more critical for poor mothers to sustain exclusive breastfeeding. Further research is needed to explain this relationship. The results also suggest that policy interventions to help mothers with unplanned pregnancies to sustain breastfeeding should target the period from 3 to 7 months postpartum.

These findings can help shape policies for facilitating the continuation of breastfeeding for durations recommended by health authorities and advance our understanding of the effects of poverty on health behaviors.

Can one describe the ‘natural’ process of pregnancy as ‘harm’, even when negligently brought about? What does that harm consist of? Offering a contextual analysis of the English judiciary's characterisation of wrongful pregnancy, this paper demonstrates from a feminist perspective that the current construction of pregnancy as a ‘personal injury’ is deeply problematic. Forwarding an alternative account, this paper argues for law to embrace a richer notion of autonomy that will better resonate with women's diverse experiences of reproduction, and articulate the importance of autonomy in the reproductive domain: notably, women gaining control over their moral, relational and social lives.

Purpose: Miscarriage is commonly understood as an involuntary, grieve-able pregnancy outcome. Abortion is commonly understood as a voluntary, if stigmatized, pregnancy outcome that people do not typically grieve. This chapter examines a nexus of the involuntary and voluntary: how people who chose abortion following observation of a serious fetal health issue make sense of their experience and process associated emotions.

Design: The author draws on semi-structured interviews with cisgender women who had an observed serious fetal health issue and chose to terminate their pregnancy.

Findings: Findings highlight an initial prioritization of medical knowledge in pregnancy decision-making giving way, in the face of the inherent limits of medical knowability, to a focus on personal and familial values. Abortion represented a way to lessen the prospective suffering of their fetus, for many, and felt like an explicitly moral decision. Respondents felt relief after the abortion as well as a sense of loss. They processed their post-abortion emotions, including grief, in multiple ways, including through viewing – or intentionally not viewing – the remains, community rituals, private actions, and no formalized activity. Throughout respondents’ experiences, the stigmatization of abortion negatively affected their ability to obtain the care they desired and, for some, to emotionally process the overall experience.

Originality/Value: This chapter offers insight into the understudied experience of how people make sense of a serious fetal health issue and illustrates an additional facet of the stigmatization of abortion, namely how stigmatization may complicate people’s pregnancy decision-making process and their post-abortion processing.

Starting from an event occurring in 2018, I consider burials of abortive remains as a battleground for reproductive governances. Public debate on pregnancy loss is often intertwined with the abortion debate. In Italy this association caused a considerable delay in implementing practices recommended by international guidelines on pregnancy loss. In this essay, I analyse burial regulations and the ways in which they are enforced asking what is at stake when the State, the regions, the Catholic Church, healthcare and cemetery professionals and women undergoing a termination or a pregnancy loss decide what to do with bodily remains. What is the meaning of these peculiar dead bodies? How are they publicly named? What are the effects of the actions performed on fetal remains over the lived experiences of women and couples with different reproductive histories? Who has the right to make decisions over these peculiar bodies and relationships?

Based on a long-term ethnography on abortion and pregnancy loss in Italy, I explore the inherent complexity of these questions, arguing that burial practices conflict with abortion rights when they signify the body unequivocally, separating it from social and intimate relationships, fixing its identity and determining the conditions for its recognition. Human flesh, sociologically understood (Memmi, 2014), is both material and symbolic: a fluctuating reality that takes on different meanings and affects over time within relationships.

Turkish mothers’ interactions with medical authorities during pregnancy and childbirth have developed in a context of risk discourses produced by biomedical experts with surveillance justified by these discourses. Giving meaning to pregnancy and childbirth through the search for the reduction of risks is a reflexive part of Turkish mothers’ everyday life.

This research paper aims to discuss a study examining how pregnancy and childbirth are socially constructed, how increased medicalization is experienced by Turkish mothers, and how they assign meaning to pregnancy and childbirth. A phenomenological research was designed using depth interviews with 10 Turkish mothers with children aged 0–6 years, living in Istanbul who had high education and welfare levels.

The findings shed light on Turkish mothers’ subjective experiences and how medicine as a profession shapes these experiences. With the medicalization of pregnancy and childbirth, how the trust toward the experts, the knowledge of preparation for maternity in an appropriate and responsible manner have become functional for Turkish mothers to create a sense of ontological security are examined.

Racial/ethnic minority, low-income teens represent a significantly underserved group in terms of reproductive health care including birth control and prenatal care. This paper provides patients’ perspectives through analysis of in-depth interviews with 51 African American teen mothers about their reproductive health care and focuses on the influence of gender ideologies and behavior expectations on teens’, and their perceptions of their mothers’, decisions around these issues. The findings suggest that attention to cultural influences of gender on teens’ decisions around sexuality and reproduction is critical to our theoretical and practical approaches to expanding health care services to underserved populations.

In the contemporary US, pregnant women must navigate competing ideas about their bodies, including expectations for weight gain. Given that there are few social spaces where women may gain weight without disapproval, pregnancy represents a period when women are allowed to put on weight. However, gaining weight means doing so within the context of the obesity “epidemic” and increased medical surveillance of the body. To explore how women navigate the medicalization of pregnancy weight, I draw on data from in-depth interviews with 40 pregnant and recently pregnant women. Findings indicate that women reframe the meaning of pregnancy weight as “baby weight,” rather than body weight. This allows them to view it as a temporary condition that is “for the baby,” while holding two concurrent body images – a pregnant and a non-pregnant version of themselves. Women also resist the quantification of their maternity weight, either by not keeping track or not looking at scales in the doctor’s office. Doing so prevented baby weight from turning back into body weight – a concrete and meaningful number on the scale. Such resistance to quantification is often accomplished with the help of doctors and healthcare professionals who do not explicitly discuss weight gain with their patients. These findings suggest that women rely on a variety of strategies to navigate the medicalization of pregnancy weight, and provides another lens through which to understand how and why women may make similar choices about other medicalized aspects of their pregnancy (or pregnancy experiences).