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Blacks are more likely than white, in the United States, to experience a stillbirth. In this study, I use a structural perspective of race to create a heuristic model that…
Abstract
Blacks are more likely than white, in the United States, to experience a stillbirth. In this study, I use a structural perspective of race to create a heuristic model that combines medical and social epidemiological explanations to understand the racial disparity in stillbirths. Using data from the National Maternal and Infant Health Survey 1988 (NMIHS), I examine whether racial disparities in stillbirths can be explained by medical and social epidemiological variables. My findings show that medical and social epidemiological explanations do little to reduce the racial disparity. However, many medical model variables were important predictors of stillbirths including multiple gestations, being overweight, obesity, vaginal bleeding, advanced maternal age, and parity.
Seamus Allison, M. Bilal Akbar, Claire Allison, Karla Padley and Stephen Wormall
This study aims to demonstrate the evaluation of an incentive scheme to encourage pregnant people to set a quit-smoking date.
Abstract
Purpose
This study aims to demonstrate the evaluation of an incentive scheme to encourage pregnant people to set a quit-smoking date.
Design/methodology/approach
The paper outlines a collaborative approach, working with pregnant people, clinicians, tobacco dependency practitioners and academics to gain insights into their perspectives and experiences. Quantitative and qualitative data were analysed.
Findings
The incentive scheme and appropriate support from clinicians have been shown to encourage pregnant people to set a quit date. The tobacco dependency practitioners helped remove barriers, such as the perception of the stigmatisation of smoking when pregnant. The practitioners also helped pregnant people make informed decisions to support successful behaviour change. The impact of the scheme resulted in improved infant health indicators. The scheme’s evaluation also supported establishing stakeholder knowledge exchange and learning processes.
Research limitations/implications
This is a single-site study among a relatively small group of people designed to achieve a specific evaluation objective. Caution in generalising to wider settings should be exercised.
Practical implications
This study highlights the efficacy of an incentive scheme, complemented with support from clinicians, and the significance of knowledge exchange and collaboration between stakeholders in health care with significance in similar settings.
Originality/value
The paper details the incentive scheme input, actions, output, outcomes and impact involving a wider range of stakeholders, including the emotional consequences for participants, clinicians and academics.
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Ron Gray, Debra Bick and Yan-Shing Chang
The purpose of this paper is to describe the major factors affecting health during pregnancy, birth and the postnatal period and outline the evidence for interventions to improve…
Abstract
Purpose
The purpose of this paper is to describe the major factors affecting health during pregnancy, birth and the postnatal period and outline the evidence for interventions to improve outcomes in women and their children.
Design/methodology/approach
Selective review of the literature. A number of electronic bibliographic databases were searched, including the Cochrane Database of Systematic Reviews, PubMed and PsycINFO, for relevant studies published since 1990. Papers were restricted to those published in English which presented data from studies conducted in high-income countries, with priority given to systematic reviews, randomised controlled trials and other quantitative studies which present a higher level of evidence.
Findings
Many factors may affect maternal and infant health during and after pregnancy. Potentially modifiable factors with an evidence base to support intervention include improving diet, and the avoidance of smoking, alcohol and illicit drugs. Good clinical management of underlying illness is also important, along with attempts to engage women in improving health prior to conception and postnatally rather than once pregnancy is established.
Research limitations/implications
The evidence base for interventions on some potentially modifiable risk factors is incomplete. There is good evidence of benefit from some health behaviours such as smoking cessation and uptake of breastfeeding and accumulating evidence of the benefit of some models of maternity care.
Practical implications
Good maternal health during and after pregnancy plays a key role in giving the child a better start in life. Improved health behaviours are vital but often these are heavily dependent on social context and hence working to tackle social inequality and provide maternity care tailored to individual need is likely to be just as important as trying to directly alter behaviour.
Originality/value
Pregnancy and the postnatal period present an opportunity to improve maternal health and have a positive effect on future child health. Greater investment is required in this antenatal period of life.
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Celine S.M. Cheng and Amanda P.Y. Lau
The purpose of this paper is to review cases about complaints of abortuses handling in Hong Kong, and to further propose policy recommendations to help comfort parents with…
Abstract
Purpose
The purpose of this paper is to review cases about complaints of abortuses handling in Hong Kong, and to further propose policy recommendations to help comfort parents with respect and dignity toward abortuses.
Design/methodology/approach
There is a systematic review of articles/newspapers related to the practice and regulation of abortuses handling in Hong Kong and overseas countries. Also, point of views among stakeholders are selected from: newspapers, patients’ groups, Hong Kong SAR Government’s websites, radio programmes’ interviews, related organizations’ websites, blogs from legislative councilors and lawyers.
Findings
Since parents suffered from miscarriage before 24 weeks’ pregnancy are increasingly willing to share their experiences and struggled for arranging a legal funeral for their children, Hong Kong SAR Government is able to understand these parents’ needs and hence set up more “Angel Garden” in both the public and the private cemeteries. Yet, the provision of funeral and cremation services are still not comprehensive. Existing measures from Mainland China and overseas countries to handle abortuses and to provide support for parents are analyzed. More critically, ethical concern on handling abortuses as one of the clinical wastes is further included in the discussion.
Originality/value
Although all less than 24 weeks’ fetuses cannot be given any Certificate of Stillbirth, respect and dignity can still be presented toward their parents by flexible regulation. After discussing the related measures on handling abortuses from other countries, some of their humane regulations are feasible to be applied to Hong Kong.
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Perinatal health is a good indicator of both maternal health status and the level of socioeconomic status attained in any community. This article presents part of the findings of…
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Perinatal health is a good indicator of both maternal health status and the level of socioeconomic status attained in any community. This article presents part of the findings of a research project conducted in 1997 by the author to look at the determinants of maternal and perinatal health in Kisumu district of Kenya. Data were collected from four health facilities within the district which were selected through purposive sampling to act as sentinel centres. In total, 1,455 obstetric cases were enumerated and those with perinatal complications were isolated. Perinatal health status was measured by the frequency of low birth weights, neonatal deaths, still‐births, and early neonatal morbidity. Cross‐tabulations and multivariate analysis have been used to identify the major risk factors of the perinatal health problems identified in the study area. Among other things, the study reveals that the risk of most perinatal complications is significantly increased by maternal and environmental factors. These include poor pregnancy care, malaria and anaemia during pregnancy, poor socioeconomic conditions of the mother and poor sanitary conditions in the household. Any policy measure aimed at promoting perinatal health should seek to address all these factors.
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Western countries have invested considerable resources in efforts aimed at reducing the amount of cigarette smoking in their countries, along with its accompanying hazards. Canada…
Abstract
Western countries have invested considerable resources in efforts aimed at reducing the amount of cigarette smoking in their countries, along with its accompanying hazards. Canada is no exception to this challenge and takes pride in its participation in the global quest:
The study of birth defects has increased in importance in recent years because the rate of infant mortality due to other causes (such as infection and nutritional disease) has…
Abstract
The study of birth defects has increased in importance in recent years because the rate of infant mortality due to other causes (such as infection and nutritional disease) has decreased more quickly than has the rate of deaths due to birth defects. Today, abnormalities are detected in approximately 3 percent of newborn humans, and twice as many prenatally acquired defects are found in children after infancy as are discovered at birth. In addition, many of the more than 500,000 miscarriages and stillbirths that occur each year in the United States are due to abnormal fetal development.
John M. Violanti and Michael E. Andrew
Policing requires atypical work hours. The present study examined associations between shiftwork and pregnancy loss among female police officers.
Abstract
Purpose
Policing requires atypical work hours. The present study examined associations between shiftwork and pregnancy loss among female police officers.
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
The present study is preliminary and cross-sectional.
Practical implications
With considerable further inquiry and findings into this topic, results may have an impact on police policy affecting shift work and pregnant police officers.
Social implications
Implication on the health and welfare of police officers.
Originality/value
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.
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