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No description available.

The association between pain and depression is well documented across various populations, but not in puerperal women. This study examined the association of childbirth pain with postpartum depression (PPD) in a nationally representative sample of Canadian women. Data from the Canadian Maternity Experiences Survey (n=6421) was used. Multivariate logistic regressions and partial proportional odds models were fitted and included socio-demographic, obstetric, health, psychological, and psychosocial factors. Chronic pain sufferers at mean 7.3 months postpartum had adjusted odds of PPD of 2.4 (95% CI: 1.6, 3.6) compared to women without pain. Adjusted odds of PPD increased with the number of areas of chronic pain, reaching 4.2 (95% C.I.: 0.7, 25.0) for 3 or more areas. Immigration, obesity, cesarean section and social support increased the strength of the association while smoking and the use of pain relief were protective effect modifiers. Persistent postpartum pain is a major risk factor for PPD.

The increasing rates of intervention in childbirth are an issue for women, their families, health professionals, and society across much of the Western World. This study is a response to these increasing rates of intervention, as reflected in the research question: 'What is shaping the practice of health professionals and the understanding of the public in relation to increasing intervention in childbirth?' The participants in the study were nine health professionals: midwives and obstetricians, who were interviewed individually, and thirty-three members of the public who took part in six focus groups. The research was carried out under the umbrella of critical hermeneutics, and the particular approach used was that of critical interpretation as formulated by Hans Kogler. This approach enabled a hermeneutical thematic analysis of that which is shaped (worldviews) and a critical structural analysis (discursive orders, social practices, relationships of power and structures of domination) of the shaping and shapers of practice and understanding. The research process facilitated by critical interpretation in identifying and describing the shaping and shapers of practice and understanding adds an important dimension to the statistical picture of increasing intervention that is of concern, both to health professionals and the public. The research revealed that the everyday world and its associated processes of socialisation in the 21st century - in particular pain, choice, and technology - shape the practice of health professionals and the understanding of the public in relation to increasing intervention. The study's findings were supported by the revelation that many of the social and cultural values, such as convenience, ease, and control, that underpin Western society in the 21st century, correlate with what intervention has to offer, which results in intervention being increasingly sought after and utilised. This milieu of intervention, which increasingly surrounds childbirth, is shown to be calling into question those things that have traditionally been at the heart of childbirth: the ability of the woman to birth and the clinical skills of the health professional. This research provides insight and awareness of those things that are shaping understanding and practice and birth itself and creating a milieu in which intervention is increasingly normalised.

In the past decade there has been growing recognition that a sexual abuse history may manifest during health care examinations. More recently, awareness has been raised about a possible link between a history of sexual abuse and traumatic labour and birth. It is theoretically likely that the intimacy of labour and birth for women with a history of sexual abuse may trigger post-traumatic stress symptomatology. In this cross sectional study, a survey method was used to establish prevalence of sexual abuse and to measure obstetric outcomes, birth experience and birth trauma in a cohort of women who have recently given birth and to test whether there are associations between sexual abuse and birth outcomes. Eighty-five women whose 3½ to 5 year old children attend kindergarten participated. Lifetime sexual abuse was found to be a common experience for study participants. One out of every three women disclosed an experience of sexual abuse in her lifetime. A history of sexual abuse was not associated with adverse labour and birth outcomes; however women with a positive sexual abuse history were more likely to report postnatal depression. A quarter of the women had PTSD symptoms but overall, women had positive birth experiences and felt well supported. Many women are able to overcome traumatic abuse experiences and successfully cope with birth, an event that may potentially replicate the dynamics of sexual abuse. Further research is needed to identify women who may be at high risk for traumatic birth experiences. Undertaking screening for sexual abuse in the antenatal period in a safe environment may provide reassurance for women and enable identification of those women at high risk for abuse related traumatic birth experiences.

This research analyses the first paternal experience of childbirth and its affects on how men experience themselves as fathers. The study adopts a moral and philosophical standpoint, to ensure that the experiences of other key stakeholders in the childbirth realm are considered. This recognises that childbirth is women�s business, and how, as a male researcher, I have the potential to impose my views from a position of social dominance. Qualitative data were collected from twenty four participants who described their experiences of childbirth, in five focus groups. Participants were men whose first experience of childbirth occurred from as recently as one month to five years ago. Twelve participants were then involved in individual interviews to discuss, in depth, their experiences of fathering. An interview was also conducted with a midwife to illuminate her experiences of men and childbirth. Using interpretive interactionism as the chosen method for data analysis, I have identified the first paternal experience of childbirth as an epiphany in its major form. Epiphanies of which there are four types; the major, the cumulative, the minor illuminative and the relived, are those experiences that have the potential to transform and even radically alter peoples lives, and how they define themselves and their relations with others (Denzin,1989b:15). Data were phenomenologically analysed and six primary childbirth and fathering themes have been identified. Men�s first experience of childbirth entails emotions that range from fear and anger to awe and amazement. The reason that this life experience constitutes an epiphany for men, is that it affects how they experience themselves as fathers. The memory of their partner�s labour and birth pain is significant in how men construct their paternal identity. Important to men is the ability to biologically sire a child, and in particular a son, the need to create the child in men�s own likeness and responsibility for financial provision and discipline of the child.

Thesis (Ph. D. in Religion)--Vanderbilt University, May 2008. / Title from title screen. Includes bibliographical references.

Thesis (J.C.L.)--Catholic University of America, 1989. / Includes bibliographical references (leaves 67-71).

Thesis (MHSc--Health Science) -- Auckland University of Technology, 2005. / Also held in print (xi, 149 leaves, 30 cm.) in Akoranga Theses Collection. (T 616.858369 FYF)

Thesis PlanB (M.S.)--University of Wisconsin--Stout, 2008. / Includes bibliographical references.