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Book part
Publication date: 22 November 2019

Katherine M. Johnson, Richard M. Simon, Jessica L. Liddell and Sarah Kington

There has been substantial interest in US cesarean rates, which increased from 5% of deliveries in the 1970s to nearly one-third of births by the mid-2000s. Explanations…

Abstract

There has been substantial interest in US cesarean rates, which increased from 5% of deliveries in the 1970s to nearly one-third of births by the mid-2000s. Explanations typically emphasize individual risk factors (e.g., advanced maternal age, increased BMI, and greater desire for control over delivery) of women giving birth, or address institutional factors, such as the medicalization of childbirth and the culture of liability leading physicians to practice defensive medicine. We focus here on another non-medical explanation – childbirth education (CBE). CBE is an important, underexplored mechanism that can shape women’s expectations about labor and birth and potentially lead them to expect, or desire, a cesarean delivery as a normalized outcome. We analyze data from three waves (2002, 2006, 2013) of the Listening to Mothers national survey on US women’s childbearing experiences (n = 3,985). Using logistic regression analysis, we examined both mode of delivery (vaginal versus cesarean), and attitudes about future request for elective cesarean among both primiparous and multiparous women. Despite previous research suggesting that CBE increased the likelihood of vaginal delivery, we find that CBE attendance was not associated with likelihood of vaginal delivery among either primiparous or multiparous women. However, both primiparous and multiparous women who attended CBE classes were significantly more likely to say they would request a future, elective cesarean. Furthermore, these effects were in the opposite direction of effects for natural birth attitudes. Our findings suggest that contemporary CBE classes may be a form of “anticipatory socialization”, potentially priming women’s acceptance of medicalized childbirth.

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Article
Publication date: 1 January 1970

Suphawadee Panthumas, Wirin Kittipichai, Kanittha Chamroonsawasdi and Pimsurang Taechaboonsermsak

Maternal identity (MI) is the attainment of maternal role adaptation. Though the role of the motherhood is expected to be achieved, teenagers, who are still developing…

Abstract

Purpose

Maternal identity (MI) is the attainment of maternal role adaptation. Though the role of the motherhood is expected to be achieved, teenagers, who are still developing their personal identity, do not always clearly identify or align with their role of motherhood. The purpose of this paper is to determine the structural relationship among a set of variables, infant temperament (IT), strain (ST), social support (SS), self-esteem (SE) and balanced family functioning (BF) influencing MI and to test the model using the empirical data.

Design/methodology/approach

A cross-sectional survey was conducted among 353 primiparous Thai teenagers of infants aged 4–12 months. A self-administered questionnaire comprised six scales with Cronbach’s α coefficients ranging from 0.81 to 0.93. The structural equation modeling method was employed to test the validity of the model undertaken using Mplus Software.

Findings

The model fit the empirical data well (χ2/df=2.17, CFI=0.92, TLI=0.91, RMSEA=0.06, SRMR=0.05). The MI could explain 62 percent of the variance through its set of variables. Three antecedents, i.e. IT, ST and SS, had a direct effect while SE and BF had an indirect effect on MI. The IT had the highest total effect on the MI, while ST was a mediator among other study antecedences concerning the MI.

Originality/value

The model adequately fit the data among teenage mothers one-year postpartum. Promoting MI should strongly diminish strain and encourage positively perceived infant temperament, self-esteem, social support and balanced family functioning.

Details

Journal of Health Research, vol. 33 no. 4
Type: Research Article
ISSN: 2586-940X

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Article
Publication date: 11 January 2011

Ann‐Kristin Sandin‐Bojö, Linda J. Kvist, Marie Berg and Bodil Wilde Larsson

The aim of this study is to describe how Swedish women, planned for vaginal birth, perceive the quality of intrapartal care that they receive and the subjective importance…

Abstract

Purpose

The aim of this study is to describe how Swedish women, planned for vaginal birth, perceive the quality of intrapartal care that they receive and the subjective importance they ascribe to their care.

Design/methodology/approach

The study was nested within a Swedish national survey of intrapartal care. The women whose care was investigated were invited to participate in the current study by the midwife who attended the birth. A total of 1,173 women agreed to answer a questionnaire about “quality of general care” and “quality of specific intrapartal care” at two months postpartum. The questions were posed in two ways, the perceived reality (PR) of care given and the subjective importance (SI) the women ascribed to this care.

Findings

A total of 739 women (63 percent) returned their questionnaires. Scores for PR and SI for “quality of general care“ were in the main high (PR range 2.98‐3.81; SI range 2.85‐3.85, out of a possible 4) and also for “quality of specific intrapartal care” (PR range 3.15‐3.86; SI range 3.23‐3.86, out of a possible 4). A total of 12 items showed statistically significantly higher scores for SI than for PR. Of the women, 81 percent agreed fully or mostly that the birth of their child was a positive experience.

Originality/value

The way in which women answer questions about intrapartal care reflects the way in which the questions are posed. This study therefore has asked not only how care was perceived but also what importance individual women ascribed to different areas of their care. The questionnaire used in this study allows identification of areas where “what is, could be better”.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 1
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 September 2000

Kennedy Nyabuti Ondimu

Anaemia during pregnancy is an important contributor to maternal mortality and morbidity in Kenya. A prospective study was conducted in Kisumu District, a region…

Abstract

Anaemia during pregnancy is an important contributor to maternal mortality and morbidity in Kenya. A prospective study was conducted in Kisumu District, a region characterized by high incidences of maternal and infant mortality, to determine the levels and prevalence of maternal complications. Four health facilities were purposely selected to act as sentinel centres from urban and rural clusters. All the obstetric‐related cases were recorded between January and July 1997, and the outcomes of the pregnancies were recorded. Details on the respondents socioeconomic, demographic, biomedical and environment characteristics were also recorded. A total of 1,455 cases were recorded, of which 59 percent experienced obstetric‐related complications. Of those with complications, 22 percent were suffering from severe anaemia. Among other things, the study reveals that anaemia prevalence is determined by maternal and environmental factors. These include poor pregnancy care, illness during pregnancy, socioeconomic conditions of the mother and the sanitary conditions of the household. Policy measures aimed at managing anaemia should seek to address all these factors.

Details

International Journal of Health Care Quality Assurance, vol. 13 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Content available
Article
Publication date: 7 April 2021

M. Mazharul Islam and Mohammed Shahjahan

The aim of this study was to explore the reasons for preferring home as a birth delivery place and identify the socio-economic and cultural factors influencing the choice…

Abstract

Purpose

The aim of this study was to explore the reasons for preferring home as a birth delivery place and identify the socio-economic and cultural factors influencing the choice of delivery place in rural Bangladesh.

Design/methodology/approach

The data for the study come from a community-based cross-sectional study conducted among 464 mothers in a rural sub-district of Bangladesh in 2019. Respondents were selected randomly from the frame listing all mothers with inclusion criteria, using a two-stage cluster sampling design. Data were collected through a face-to-face interview. Both descriptive and inferential statistics and logistic regression models were used for data analysis.

Findings

The results indicate a very high rate (58%) of home delivery. About 20% mothers never received ANC visit. Preference for home delivery was high (63%). Mothers with no education, aged 30 and above, multi-parity, low wealth status, lack of knowledge about institutional delivery, no or <4 ANC visits, received no advice about the delivery place, no pregnancy complications, decision about health care, and prior plan for home delivery were identified as significant predictors of home delivery. Cost of services, cultural practices and attitude towards health facility, lack of a female delivery assistant, perceived fear of caesarian section, poor quality of services, and lack of knowledge about maternity services appeared as important barriers for institutional delivery.

Originality/value

Based on primary data from a rural area, this study would help understand reasons and factors affecting home delivery and developing an appropriate strategy for the improvement of institutional delivery and maternity care services in Bangladesh.

Details

Journal of Health Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0857-4421

Keywords

Content available
Article
Publication date: 28 May 2020

Didem Kaya and Funda Evcili

Fear of birth may cause perinatal complication, increased risk of intervention and need for analgesia, delayed mother–infant attachment process and deterioration of spouse…

Abstract

Purpose

Fear of birth may cause perinatal complication, increased risk of intervention and need for analgesia, delayed mother–infant attachment process and deterioration of spouse relationship. The purpose of this study was to determine the affecting factors and childbirth fears of Turkish pregnant women.

Design/methodology/approach

This is a descriptive research type. The sample of this study consisted of 78 pregnant women who met the inclusion criteria and agreed to participate in this study. This study was carried out in a family health center and university hospital in a city in Turkey. Data were collected with Personal Information Form and Wijma Expectancy/Experience Scale-A Version (W-DEQ A).

Findings

The mean scores of pregnant women from W-DEQ A version were 75.60 ± 9.48. In 65.4% of pregnant women, fear of severe birth, 20.5% fear of clinical birth and 14.1% of children had a fear of moderate birth. W-DEQ A version, the third trimester, unplanned pregnancies, lack of knowledge of the level of inadequate birth and more than eight pregnancies in pregnancy, the total score of pregnant women was found to be higher (p < 0.05).

Research limitations/implications

The limitation of this study is its small sample size. Further studies with larger sample sizes are needed.

Practical implications

It was determined that one-fifth of the sample group experienced birth fear at the clinical level and childbirth fear level is associated with unplanned pregnancies, lack of knowledge. In antenatal period, the pregnant woman should be encouraged to express her feelings and thoughts about the labor and give information about the labor.

Social implications

Cognitive and behavioral education programs can be structured to cope with fear of birth for pregnant women at risk.

Originality/value

This research is original. This study presents data on Turkish women. The data can also be used to evaluate intercultural differences.

Details

Journal of Health Research, vol. 34 no. 5
Type: Research Article
ISSN: 0857-4421

Keywords

Content available
Article
Publication date: 26 May 2021

Mulugeta Meles Dibabi, Alemu Tamiso Debiso and Kaleb Mayisso Rodamo

The purpose of this study was to examine adverse outcomes associated with cesarean deliveries and to assess potential confounding factors.

Abstract

Purpose

The purpose of this study was to examine adverse outcomes associated with cesarean deliveries and to assess potential confounding factors.

Design/methodology/approach

A hospital-based cross-sectional study was conducted from September 1−30, 2019 using mixed methods of data collection. Multistage sampling was used to draw the eligible study participants. The sample size was calculated using the single population proportion formula. A systematic random sampling technique was used to draw the sample size. 180 original medical records were excluded because of having missed information, leaving 1,618 women as the study population. We used the questionnaire adapted from the Ethiopian Demographic and Health Survey to collect quantitative data and analyzed using SPSS version 22, while thematic analysis for qualitative measures was used to generate themes regarding associated perspectives of participants from a community.

Findings

More than 383 women delivered by cesarean section. 20% of the mothers with the mean age at birth of 26.1 ± 4.8 experienced adverse outcomes. Adjusted odds ratio (AOR) was used to measure the association of determinants and was 2.95 (95% CI 1.19–7.29) for nonuse of antenatal care, 3.18 (95% CI 1.43–6.94) for nonuse of prophylaxis, 4.28 (95% CI 1.58−11.61) for history of medical illness and 7.09 (95% CI 1.19−45.59) for use of substandard operation set up compared with their counterparts.

Research limitations/implications

Strengths of the study include the finding of the study are reliably reported in mixed study methods examining hospital-based institutional and personal risk factors and exploring the whole community's perspectives. However, the important limitations of the study indicate that the study poses a number of challenges related to studying design, therefore there was not sufficient evidence of causality to draw conclusions from the findings. In addition, the study was conducted at a single hospital so that it is not convenient to generalize the findings of the study for setting different in social and economic status.

Originality/value

Based on the findings, attention has been drawn to healthcare personnel to provide training and consultation services for pregnant women and for health care administration to ensure standard set up for operation.

Details

Journal of Health Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0857-4421

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Book part
Publication date: 19 November 2018

Nuurshiraathal Firdaws Abd Rani and Asmak Ab Rahman

Purpose – Women are more susceptible to specific health risks such as breast cancer, cervical cancer, and risk during pregnancy and childbirth. These can affect women’s…

Abstract

Purpose – Women are more susceptible to specific health risks such as breast cancer, cervical cancer, and risk during pregnancy and childbirth. These can affect women’s well-being and also need to be managed to avoid financial loss. Takaful operators in Malaysia have been offering special takaful products for women. Women can mitigate exposure to these risks through insurance. This study examines the risks faced by Malaysian women and the coverage they are offered by Islamic insurance.

Methodology/approach – The study used a qualitative methodology involving documentary evidence and interviews with four Islamic insurance agents and four product development officers from four Islamic insurance providers in Malaysia.

Findings – Among the risks faced by women are female-specific illnesses, the cost of expensive treatments, crime-related accidents or loss, social or career risks and privatisation policy. Due to these risks, women are in need of female-specific takaful products to reduce risk and protect themselves.

Originality/value – Specific takaful products for women are crucial to protect them from risks, improving their well-being and increasing their participation in the nation’s economic and social development.

Details

New Developments in Islamic Economics
Type: Book
ISBN: 978-1-78756-283-7

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Article
Publication date: 1 April 2002

Luís Cláudio Benevenuto, Luciléia Granhen Tavares Colares and Maria das Graças Tavares do Carmo

The purpose of this research was to verify the changes in the body weight of breastfeeding women, using the anthropometric and the bioelectrical impedance (BIA) methods…

Abstract

The purpose of this research was to verify the changes in the body weight of breastfeeding women, using the anthropometric and the bioelectrical impedance (BIA) methods. The sample was formed by 30 women who were exclusively breastfeeding their children, with an average age of 27.9±4.4 years old, followed up during four appointments in a public hospital of Rio de Janeiro, Brazil. The anthropometric data showed a significant reduction of body weight during the studied period. Regarding skinfolds, we observed a greater loss in the lower part of the abdominal region, in the suprailiac region and in the thigh. The same occurred to the body circumferences. Resistance values remained unaltered, thus indicating that the total body water content was preserved. We concluded that the significant reduction of body weight was mainly due to the mobilization of the fat tissue, being unrelated to changes in the body water content. In addition, we verified how important it is to associate different methods to assess the change of body weight during breastfeeding.

Details

Nutrition & Food Science, vol. 32 no. 2
Type: Research Article
ISSN: 0034-6659

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Article
Publication date: 8 February 2016

Kim Clark, Shelley Beatty and Tracy Reibel

Achieving maternity-care outcomes that align with women’s needs, preferences and expectations is important but theoretically driven measures of women’s satisfaction with…

Abstract

Purpose

Achieving maternity-care outcomes that align with women’s needs, preferences and expectations is important but theoretically driven measures of women’s satisfaction with their entire maternity-care experience do not appear to exist. The purpose of this paper is to outline the development of an instrument to assess women’s perception of their entire maternity-care experience.

Design/methodology/approach

A questionnaire was developed on the basis of previous research and informed by a framework of standard service quality categories covering the spectrum of typical consumer concerns. A pilot survey with a sample of 195 women who had recent experience of birth was undertaken to establish valid and reliable scales pertaining to different stages of maternity care. Exploratory factor analysis was used to interpret scales and convergent validity was assessed using a modified version of the Client Satisfaction Questionnaire.

Findings

Nine theoretically informed, reliable and valid stand-alone scales measuring the achievement of different dimensions of women’s expectancies of public maternity care were developed. The study scales are intended for use in identifying some potential areas of focus for quality improvement in the delivery of maternity care.

Research limitations/implications

Reliable and valid tools for monitoring the extent to which services respond to women’s expectations of their entire maternity care form part of the broader toolkit required to adequately manage health-care quality. This study offers guidance on the make-up of such tools.

Originality/value

The scales produced from this research offer a means to assess maternity care across the full continuum of care and are brief and easy to use.

Details

International Journal of Health Care Quality Assurance, vol. 29 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

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