In Deutschland ist eine zunehmende Kinderlosigkeit zu beklagen (Statistisches Bundesamt 2009). Die Ursachen hierfür werden primär vor dem Hintergrund der Unvereinbarkeit von Berufstätigkeit und Mutterschaft diskutiert (Schrupp 2008). Aus lerntheoretischer Perspektive wären subjektiv empfundene gesundheitliche Ein-schränkungen von Frauen nach der Geburt eines Kindes als weitere Ursache denkbar. Über die subjektiven Gesundheitseinschätzungen von Frauen im geburtshilflichen Kontext ist jedoch nur wenig bekannt. Vereinzelt finden sich Hinweise, dass Frauen ihre subjektive Gesundheit (SGH) nach der Geburt ihres Kindes trotz bestehender Morbidität sehr positiv bewerten (Bauer 2011, Schytt et al. 2005, Borrmann 2005). Ziel der Studie ist es die subjektive Morbidität, die SGH sowie die gesundheitsbezogenen Lebensqualität (GHLQ) gesunder Frauen acht Wochen und sechs Monate nach der Geburt eines Kindes zu erfassen und die Faktoren zu ermitteln, die sich beeinflussend auf SGH und GHLQ auswirken. Methode: Retrospektive, longitudinale Kohortenstudie. Basis der Sekundäranalyse bilden Daten von 1029 Erst- und Mehrgebärenden, die im Rahmen einer multizentrisch angelegten, prospektiven Interventionsstudie zum Versorgungskonzept Hebammenkreißsaal an der Hochschule Osnabrück unter Förderung des Bundesministeri-ums für Bildung und Forschung (FKZ 01 GT 0616) zum Zeitpunkt der Geburt (t0) sowie acht Wochen (t1) und sechs Monate (t2) nach der Geburt erhoben wurden. Zur Ermittlung der SGH wurde der SF-1 angewendet. Die Operationalisierung der GHLQ erfolgte über die standardisierte körperliche und die standardisierte psychische Summenskala des SF-36. Ergebnisse: Gut die Hälfte der Studienteilnehmerinnen bewertete ihre SGH zu t1 und t2 besser als gut, wobei Erstgebärende gegenüber Mehrgebärenden signifikant häufiger diese positive Einschätzung vornahmen (p<.007). Neben einer Reihe von Faktoren, die in keinem unmittelbaren Zusammenhang mit der Geburt stehen, zeigten sich geburtsspezifische Aspekte als signifikante Einflussgrößen. In der Gruppe der Erstgebärenden er-höhte sich bei Vorliegen geburtsverletzungsbedingter Beschwerden die Chance auf eine beeinträchtigte SGH zu t1 signifikant (OR 1.68, [95% KI 1.04-2.71]; p=.035). In der Gruppe der Mehrgebärenden erwies sich ein nega-tives Geburtserleben zu t2 als signifikante Einflussgröße für eine beeinträchtigte SGH (OR 7.66, [95% KI 2.17-26.99]; p=.002). Hinsichtlich der GHLQ konnten ebenfalls geburtsspezifische Aspekte als Einflussgrößen ermit-telt werden. Zu t1 erhöhten in der Gruppe der Erstgebärenden geburtsverletzungsbedingte Beschwerden die Chance auf eine verminderte GHLQ um fast das Dreifache (OR 2.83, [95% KI 1.63-4.93]; p<.001). Ein negati-ves Geburtserleben verdoppelte die Chance auf eine verminderte GHLQ in dieser Gruppe (OR 2.09, [95% KI 1.19-3.65]; p=.010). In der Gruppe der Mehrgebärenden zeigte sich das negative Geburtserleben ebenfalls als signifikante Einflussgröße (OR 3.93, [95% KI 1.14-13.53]; p=.030). Dies allerdings erst zu t2. Insgesamt konn-ten in einzelnen Subskalen des SF-36 signifikante Abweichungen zwischen der landes-, alters- und geschlechts-spezifischen Normstichprobe und dem Studiensample festgestellt werden. Schlussfolgerung: Geburtsverletzungsbedingte Beschwerden und ein negatives Geburtserleben beeinflussen die SGH und GHLQ nachhaltig. Mit dem Anspruch einer qualitativ hochwertigen geburtshilflichen Versorgung gilt es die subjektiven Gesundheitseinschätzungen von Frauen nach der Geburt eines Kindes standardisiert zu evalu-ieren. Um Ceiling-effekte zu vermeiden müssen die in anderen Bereichen bisher üblichen Erhebungsverfahren für den geburtshilflichen Kontext modifiziert werden

Quiet Little Animals is a novel set in early-1940s Spain. The story begins with a young couple, Carmen and Ernesto, who are expecting their first child. Carmen gives birth to their daughter Isadora in a Catholic hospital, but when she wakes up after the birth, she's told that the baby has died. However, the truth is that the baby was kidnapped by the nun Sor Eugenia, who decided that she would provide the baby with a better life by sending her away to be adopted by a more "proper" family - and a young religious woman named Ava finally gets the baby she's been trying for years to have, her little Maria. The story follows the four main point-of-view characters - Carmen, Ernesto, Sor Eugenia and Ava - as their lives move past that moment when Isadora/Maria was taken from one family and given to another. In addition to the four main points of view, there are also a number of chapters that are told in the form of fairy tales. The use of multiple points of view to tell one story allows each of the characters to have a known stake in the outcome of the narrative, and is a major stylistic interest of the piece. The central themes of the book are motherhood, grief, birth and death. It also asks questions about the creation of family, fate, and the aftermath of civil war.

La mortalité maternelle est considérée depuis quelques années comme un problème de santépublique au Sénégal ; ce qui a engendré pendant ces dernières décennies, un ensemble d’actionsparfois pertinentes, mais dont la mise en oeuvre est très souvent discutée, comme c’est le cas dansde nombreux pays africains.En 2010, le ratio de mortalité maternelle du pays est estimé à 392 décès maternels pour 100 000naissances vivantes selon le rapport de l’enquête démographique et de santé (EDS). Ce niveau resteélevé en dépit d’une hausse considérable du recours à l’assistance à l’accouchement.L’assistance médicale à l’accouchement qualifiée, définie comme « le processus par lequel unefemme reçoit des soins adéquats durant le travail, l’accouchement et le post-partum précoce », estapparue dans plusieurs études comme un déterminant-clé dans le processus de réduction de la mortalitématernelle.Deux conclusions principales sont obtenues à partir de nos analyses.D’une part, la très forte hausse du recours à l’assistance médicale à l’accouchement observée aucours de la première décennie des années 2000 a été sanctionnée par une baisse régulière, mais modérée,de la mortalité maternelle. D’autre part, cette faible baisse s’explique par une offred’assistance médicale à l’accouchement excessivement centrée sur des sages-femmes dont les qualificationssont hétérogènes et trop souvent limitées. Elle s’explique aussi par des infrastructures encoretrop peu adaptées à la gestion des urgences obstétricales.En effet, malgré tous les progrès accomplis dans ce domaine, il reste encore une marge importantepour poursuivre l’accès à un accouchement assisté. C’est en particulier le cas dans les campagnes,chez les femmes les plus jeunes, celles qui ont reçu une faible instruction et qui dépendent exagérémentde leurs conjoints. De ce fait, il serait intéressant de mener des politiques de sensibilisationdu côté des hommes.Au final, les enjeux futurs de l’assistance médicale à l’accouchement au Sénégal continuent à combinerdes problèmes d’offre et des problèmes de demande malgré les progrès accomplis dans cedomaine. / Maternal mortality is considered for several years as a public health problem in Senegal; which resultedin recent decades of a set of relevant actions sometimes, but the implementation is very oftendiscussed, as is the case in many African countries.In 2010, the maternal mortality ratio in the country is estimated at 392 maternal deaths per 100,000live births according to the report of the Demographic and Health Survey (DHS). This level remainshigh despite of a significant increase in the use of Delivery Assistance.The qualified medical assistance in childbirth, defined as "the process by which a woman receivesadequate medical care during labor, delivery and the early postpartum," has appeared in severalstudies as a key determinant in the maternal mortality reduction process.We can note two main conclusions from our analysis.First, the very strong increase in the use of medical assistance in delivery which has been observedin the first decade of the 2000s was sanctioned by a regular but moderate decline in maternal mortality.Then, this small decrease is due to a medical assistance in childbirth entirely performed bymidwives whose qualifications are heterogeneous and often limited. It is also explained by infrastructureswhich are not adapted to the management of obstetric emergencies.In fact, despite all the progress made in this field, there still are significant things to do before accessingto assisted delivery. This is particularly the case in rural areas, among younger women,those who received low education and who depend excessively on their husbands. Therefore, itwould be interesting to make aware of men on this issue.In the end, the future challenges of Assisted Reproduction Technology (ART) in Senegal continueto combine problems of supply and demand problems despite the progress made in this field.

En graviditet är en fysisk och psykisk utvecklingsperiod i livet. Det är individuellt hur graviditeten påverkar hälsan, men upplevelser av oro och bäckenrelaterad smärta är vanligt förekommande. Då det framkommit att yoga potentiellt genererat ökat välmående samt trygghet vid graviditet, var syftet att beskriva gravida personers upplevelse av gravidyoga med inriktning på dess hälsoeffekter och komponenter. En kvalitativ deskriptiv design tillämpades med induktiv ansats. Personer som utövade gravidyoga på ett privat center rekryterades för att medverka i individuella telefonintervjuer. Databearbetning utfördes med tematisk analys. De identifierade temana belyste en mångfacetterad upplevelse av gravidyogan. Det framgick att den praktiska och miljömässiga utformningen samt gruppsammanhanget hade betydelse för upplevelsen. Likaså beskrevs gravidyogan generera varierande fysiska och psykiska hälsoeffekter samt förberedning inför barnafödandet. Efter en avvägning av fynden relaterat till tidigare studier blev konklusionen att gravidyoga potentiellt skulle kunna tillämpas i större utsträckning inom barnmorskans förebyggande och hälsofrämjande arbete. Studien har bidragit till ett ökat kunskapsunderlag för gravidyoga och därmed till evidensen gällande traditionell och komplementär medicin. Dock behövs troligtvis mer forskning för en ökad implementering. / A pregnancy is a period of physical and mental development in life. It varies between individuals how pregnancy affects health, but experiences of anxiety and pelvic-related pain are common. Since it has emerged that yoga may generate increased wellbeing and security during pregnancy, the aim was to describe pregnant people's experience of pregnancy yoga with a focus on its health effects and components. A qualitative descriptive design was applied with an inductive approach. People who practiced pregnancy yoga at a private center were recruited to participate in individual telephone-interviews. Data analysis was performed with thematic analysis. The identified themes highlighted a multifaceted experience of pregnancy yoga. The practical and environmental design and the group context was shown to be important for the experience. Pregnancy yoga was also described as generating varying physical and mental health effects and preparation for childbirth. Considering the findings in relation to previous studies, it was concluded that pregnancy yoga could potentially be applied to a greater extent in the midwife's preventive and healthpromoting work. The study has contributed to an increased knowledge base for pregnancy yoga and to the evidence regarding traditional and complementary medicine. However, more research is probably needed for increased implementation.

Bakgrund: Majoriteten av tonårsgraviditeterna var oplanerade men tonårsmammorna ställde sig ofta positiva till sin graviditet.  Även fast graviditeten var oplanerad användes preventivmedel endast i liten utsträckning vid tiden för befruktningen. Tonårsmammans första kontakt med mödrahälsovården skedde någon gång mellan vecka 5–36. Barnmorskor i Sverige upplevde att bemötande av den gravida tonåringen var en svår balansgång. Tonårsmamman vill inte bli behandlad som en omogen person av barnmorskan utan vill ses och behandlas som den gravida kvinna hon är. Syfte: Syftet med denna studie var att beskriva tonåringars erfarenheter av vårdpersonalens bemötande i samband med graviditet och barnafödande. Metod: Studien genomfördes som en tvärsnittsstudie med en webbaserad enkät och med deskriptiv ansats. Resultat: Resultatet visade att den gravida tonåringen över lag var nöjd med vårdpersonalens bemötande under graviditet och barnafödande. Ungefär hälften uppgav att de blivit diskriminerade på grund av sin unga ålder. Ett tydligt samband sågs mellan en positiv förlossningsupplevelse och känslan av trygghet, stöttning, att bli lyssnad på och barnmorskans lyhördhet under förlossningen. Önskan fanns om riktade föräldragrupper till unga vuxna. Slutsats: Sammanfattningsvis visade studien att tonårsmammorna i stor utsträckning är nöjda med vården i samband med både graviditet och barnafödande. Det framkom önskemål om riktade föräldragrupper för unga vuxna. Det visade sig även finnas behov av förbättring kring vårdpersonalens kunskap om tonårsmammor, främst på BB. Mer forskning krävs för att ta reda på hur vården kan anpassas på bästa sätt för att ge bra vård till tonårsmammor. / Background: Most of teenage pregnancies were unplanned, but the teenage mothers were often positive about their pregnancy. Even though the pregnancy was unplanned, contraceptives were used only to a small extent at the time of conception. The teenage mother's first contact with maternal health care took place sometime between weeks 5–36. Midwives in Sweden experienced that treating the pregnant teenager was a difficult balancing act. The teenage mother does not want to be treated as an immature person by the midwife but wants to be seen and treated as the pregnant woman she is. Aim: The aim of this study was to describe teenagers' experiences of the care staff's care encounter in connection with pregnancy and childbirth. Method: The study was conducted as a cross-sectional study with a web-based questionnaire and with a descriptive approach. Results: The results showed that the pregnant teenager was generally satisfied with the care staff's care encounter during pregnancy and childbirth. About half stated that they had been discriminated due to their young age. A clear connection was seen between a positive birth experience and the feeling of security, support, being listened to and the midwife's sensitivity during the birth. There was a desire for targeted parent groups for young adults. Conclusion: In summary, the study showed that teenage mothers are mainly satisfied with the care in connection with both pregnancy and childbirth. There were requests for targeted parent groups for young adults. It also turned out that there was a need for improvement in the care staff's knowledge of teenage mothers, mainly at postpartum ward. More research is needed to find out how care can adapt in the best way to provide good care for teenage mothers.

The Crime of Murder of a Newborn Child by the Mother Abstract The topic of this diploma thesis is the crime of murder of a newborn child by the mother. In the first part of the thesis, the author deals with a historical excursion in the Czech lands from the 16th century until the end of the 20th century. The chapter maps the development of the regulation from early modern laws to the current Criminal Code and reflects the influence of previous regulations on the current form of this crime. The work also deals with criminological aspects of this issue in the 16th-19th century. The second chapter focuses on the individual elements of § 142 of the Criminal Code, ie. object, actus reus, subject and mens rea of this crime. The author discusses here, for example, the definition of the time when the crime of murdering a newborn child by a mother can be committed. It also addresses the issue of committing this crime in an omissive manner and the pitfalls associated with proving intent in such cases. The following chapter deals with the developmental stages of this crime and the author discusses mainly the attempt of this crime, with emphasis on the circumstances of the cessation of criminality of the attempt and the attempt on an unfit object of an attack. The fourth chapter of this work is devoted to prevention....

Thesis (MPH.) -- University of Limpopo, 2022 / The burden of labour and delivery-related complications are health problems that are life-threatening for the fetus and pregnant women. Mokopane hospital in Waterberg of Limpopo Province reports many maternal health complications. There has not been an investigation into the burden of delivery complications and therefore this study aims to investigate the burden of labour and delivery complication experienced by women giving birth at Mokopane hospital of Limpopo province. Purpose: of this study was to explore the burden of labour and delivery-related complications among pregnant women at Mokopane hospital of Limpopo province. Methods: A cross-sectional, retrospective descriptive study was conducted. The study followed a quantitative approach and the researcher completed a questionnaire using clinical records from all delivery files of mothers delivered at maternity between January 2017 to December 2019 Mokopane hospital. Findings: The major finding of this study was the majority of women were at a low risk of pregnancy (69%) followed by a high risk of pregnancy (24%). The study further revealed that (73.7%) of women at Mokopane hospital were delivered through the normal virginal procedure and (25.8%) delivered through Caesarean section. Moreover, about 86% of the mothers were normal after delivery whilst 14% were sick or had complications. Conclusion: This study, therefore, recommends that educational programs about labour and delivery-related complications and related programs should be prioritised for pregnant women. KEY CONCEPTS The burden: Is the intensity or severity of disease and its possible impact on daily life (Gidron 2013). In the context of this study, the burden will refer to the death and loss of health due to labour and delivery-related complications among pregnant women at Mokopane hospital of Limpopo Province. Labour: This is the process of rhythmic uterine contractions which results in cervical dilatation, a descent of the presenting part; and delivery of the fetus, placenta, and membrane. (Anthony & Van Der Spuy, 2002; Clark, Van de Velde, & Fernando, 2016). In the context of this study, labour will be defined as a physiologic process during which the fetus, membranes, umbilical cord, and placenta are expelled from the uterus. Delivery related complication: Is an acute condition arising from a direct cause of maternal death, such as antepartum or postpartum haemorrhage, obstructed labour, postpartum sepsis, a complication of abortion, pre-eclampsia or eclampsia, ectopic pregnancy and ruptured uterus, or indirect causes such as anaemia, malaria and tuberculosis. (WHO, 2018). In the context of this study, delivery related complications will include amongst others severe antenatal bleeding, Postpartum haemorrhage, nonconvulsive hypertensive disorder of pregnancy (pre-eclampsia), Eclampsia: preeclampsia plus convulsions, Convulsions, Prolonged labour, Premature rupture of the membranes, Retained placenta. Pregnant women: Is a woman who is in the period from conception to birth in which the egg is fertilised by a sperm and then implanted in the lining of the uterus then develops into the placenta and embryo, and later into a foetus (Martin, 2015). In the context of this study, a pregnant woman will be described as a woman who is carrying a developing embryo or fetus within her body.

The childbirth metaphor adopts imagery from female bodies carrying and delivering children to describe the effort and relationship of a poet to his/her poem. This was a commonly used trope in the renaissance, particularly by male authors. This thesis examines the way early modern woman poet, Aemilia Lanyer uses the childbirth metaphor in her poem, Salve Deus Rex Judaeorum. Lanyer ultimately considers not only the physical realities of childbirth in her use of the metaphor, but also the emotional, social, and theological consequences. By doing so, I argue that Lanyer reclaims the metaphor from her male contemporaries in order to justify women's participation in literature and theology. Lanyer adopts a position analogous to the Virgin Mary as she "births” her poem. As she situates all women as powerful procreators, she claims a poetic priesthood through motherhood.

This dissertation consists of three chapters exploring challenges that many developing countries face in augmenting state capacity and accumulating human capital. In particular, I focus on difficulties in developing state capacity and human capital induced by political violence, natural disasters, and over-reliance on income from foreign countries. The first chapter explores the effects of losing local politicians on the fiscal and personnel capacity of local governments using the outcome of the assassination attempts on mayors in Mexico. The second chapter investigates the effects of exposure to natural disasters on birth outcomes in Indonesia, using the Indian Ocean Tsunami as a natural experiment. In the final chapter, I use a cross-country analysis to study the link between reliance on remittances and the capacity of a country to collect taxes efficiently. The first chapter investigates the effects of losing mayors to successful assassinations on the capacity of local governments. By leveraging the randomness in the outcomes of assassination attempts against mayors in Mexico in 2002-21, I find that the loss of mayors negatively affects the fiscal and personnel capacities of the local governments. Municipal tax collection decreases by 29\%. The share of expenditure on primary services falls by 3 percentage points and is crowded out toward investment in construction. Municipal workers at productive stages in their careers leave the position. The back-of-the-envelope calculation shows that wages should increase by 13\% to retain them after assassinations. Organized criminal groups take advantage of the loss of mayors by increasing their presence in municipalities with successful assassinations. The results are not explained by non-political violence, levels of economic activities, or population changes. The results speak to the significance of leaders in maintaining fiscal capacity and retaining capable personnel in the workforce even in a violent environment. In the second chapter, co-authored with Elizabeth Kayoon Hur (Michigan State University), I evaluate the effect of in-utero exposure to the 2004 Indian Ocean Tsunami on short-term childbirth outcomes in Indonesia. Exploiting variation in the timing of exposure, I find that the probability of successful pregnancies drops by 5.9 percentage points (pp), while miscarriages increase by 5.5 pp for those exposed in the earliest stage of pregnancy. I find suggestive evidence that post-disaster health investments by households may have shielded later cohorts from harmful effects. The results suggest the importance of considering fetal loss in developing countries and highlight that facilitating household investment in health through various policies may mitigate negative birth effects in the aftermath of natural disasters. The third chapter investigates the relationship between a country's reliance on remittances from abroad and its ability to collect taxes from various domestic sources. Despite the increasing flow of remittances in volume and proportion, particularly among developing countries, their role in determining the state's capacity to collect taxes has received little attention. This chapter explores the link between remittances and various tax revenue categories using country-level data. Two-way panel regressions suggest that a 1 percentage point (pp) increase in the inflow of remittances explains a 0.12 pp rise in consumption tax revenues. The same estimate derived from IV methods proxying for migrant network strength and openness of borders increases to 0.9 pp. Decomposing this result reveals that the increase in household consumption expenditure explains all of the statistical association, not the efficient tax-collecting mechanisms such as VAT. Subsample regressions by income category suggest that the association between remittances and consumption tax revenue is stronger in countries with lower income.

This study was carried out as part of efforts to better understand the factors that impinge on childbirth service delivery and to develop guidelines to help improve the quality and safety of childbirth services in Ghana. The objectives were to: assess the factors that influence client-centredness; explore women’s and health professional’s views of and experiences with client-centred childbirth services; and develop guidelines to assist improve client-centred childbirth services in hospitals. The fixed mixed methods design comprising both quantitative and qualitative methods was employed. Structured questionnaire and exit interviews were used to gather data from 754 women who delivered in the hospitals. Furthermore, in-depth interviews were used to examine the experiences of women, doctors and midwives. STATA MP Version 13 was used to analyse the data by generating frequencies, chi-square and binary logistic regression results. Qualitative data analysis was analysed through data reduction, data display and generation of themes and categories. The process of developing the guidelines comprised: drafting based on the findings of the study and additional literature review, and a number of reviews by senior health professionls to build consesnsus on the content. With a response rate of 97.8%, the results indicated average performance. A number of the items examined under demographic characteristics, ante-natal, labour and postnatal care were significantly associated with the experience of excellent client-centred care. These included: number of weeks pregnant before delivery; health professional who assisted with delivery; mode of delivery; labour pain management; and length of stay after delivery. On the whole, the findings of the quantitative study were support by that of the structured interviews. Most of the themes from in-depth interviews with women were had to do with the relationship between health care provider and clients. Issues of support during childbirth; decision-making and informed choice; and continuity were raised. Themes deduced from the doctors’ and midwives’ interviews demonstrated a fair understanding of principles of client-centred care and delineated relational as well as client, health care worker and organisational factors that facilitate or limit effective implementation of client-centred care. The findings of the studies were used to develop guidelines to help improve services. It is recommended that the Ministry of Health, Ghana adopt the guidelines and provide the enabling environment for its effective implementation. / Health Studies / D. Litt. et Phil. (Health Studies)