Much of the maternal health care literature on Aboriginal women is biomedical in its focus, covering topics such as gestational diabetes, abnormal birth weight, and infant morality. There has also been some exploration of First Nations womens relationships with health professionals. There is a dearth of literature that addresses First Nations womens choices, experiences, knowledges (traditional and medical), attitudes, beliefs and values surrounding their pregnancies and prenatal health care. This qualitative study conducted by a Mikmaw woman explores Mikmaw womens perceptions of their maternal health, the relationships that support or serve Mikmaw women during their pregnancy, birthing, and postpartum delivery in two First Nations communities in Nova Scotia. The stories of fourteen Mikmaw female participants, ranging from young women to Elders, were explored using a narrative inquiry approach that is consistent with First Nations oral traditions of storytelling. Stories were told in a focus group and individual interviews. Data collection, analysis, and interpretation was guided by an Indigenous framework of two superimposed medicine wheels: (1) holistic model of health (mental, physical, emotional and spiritual), and; (2) maternal health life cycle (becoming a woman, teachings during pregnancy, experiences during birth, motherhood and the fourth trimester: after birthing). This study found that the colonization of birthing has significantly impacted Mikmaw maternal health experiences, and is characterized by a tension between western medical knowledge and Mikmaq traditional knowledge systems that plays out very strongly during this critical period in the life of a woman and her child. In addition, recognition of the socio-cultural context of Mikmaq women is critical to understanding their decision making in regards to maternal health. The results suggest there is a need to create culturally sensitive models of maternal health that incorporate First Nations traditional knowledge of maternity and Western medical knowledge.

This dissertation focused on two classes of molecules implicated in processes of implantation and placentation in sheep and pigs. Study one examined the temporal/spatial distribution of several Small Integrin-Binding Ligand, N-Linked Glycoprotein (SIBLING) family members in cyclic and pregnant ovine uterus. Studies two and three evaluated the relationships between progesterone (P4) and estrogen (E2) and their receptors (PGR and ESR1, respectively) on FGF7 mRNA expression within the endometrium and placenta of pigs. Study one showed that dentin sialophosphoprotein (DSPP) was first detected in luminal epithelium (LE) of Day 15 cyclic and pregnant sheep. Stromal expression of DSPP was first detected on Day 20 of pregnancy in stratum compactum and remained prominent in stroma through Day 120. Stromal DSPP protein was positively influenced by the conceptus based upon analysis of a unilaterally pregnant ewe model system. Immunoreactive dentin matrix protein 1 (DMP1), matrix extracellular phospoglycoprotein (MEPE) were localized to the stroma of cyclic and pregnant sheep, however, these proteins appeared to be constitutively expressed. BSP was not detected in ovine endometrium. Study two determined the effects of E2, P4, P4+E2, P4+the PGR antagonist (ZK137, 316), and P4+E2+ZK on FGF7 mRNA expression in uterine LE of ovariectomized pigs. Results indicate that P4 is permissive to FGF7 mRNA expression by down-regulating PGR in LE; P4 stimulates PGR-positive uterine stromal cells to release an as yet unidentified progestamedin that induces FGF7 mRNA expression by LE; E2 and P4 can induce FGF7 mRNA in the absence of PGR rendered nonfunctional by ZK. Study three showed the expression of ESR1, PGR and FGF7 in the uterine and placental tissue of pregnant pigs from Day 20 through 85. Results reveal a positive correlation between stromal cell expression of PGR and FGF7 mRNA which suggests that P4 is permissive to FGF7 mRNA expression by down-regulating PGR in LE. FGF7 mRNA in later pregnancy is maintained by the release of progestamedin from PGR-positive stromal cells. A novel finding was the presence of ESR1 in porcine placenta on Days 20 through Day 85 of pregnancy suggesting that E2 may play important roles in the placental biology of the pig.

Maternal contributions from the uterine endometrial luminal (LE) and glandular (GE) epithelia are unequivocally required to support ruminant conceptus growth and development, elongation and implantation. Therefore, studies were conducted to examine expression of endometrial genes hypothesized to regulate conceptus development. The first study investigated two genes specifically expressed in the LE and superficial GE of the ovine uterus. Insulin-like growth factor binding protein (IGFBP1) and (IGFBP3) expression was coordinate with ovine conceptus elongation. Treatment with P4 induced and IFNT stimulated IGFBP1, but not IGFBP3; however, IFNT only moderately stimulated IGFBP1, indicating that another conceptus-derived factor stimulates endometrial IGFBP1 expression. IGFBP1 did not affect proliferation of ovine trophectoderm (oTr) cells in vitro, but stimulated their migration and attachment. Results indicated that IGFBP1, but not IGFBP3 is a marker of conceptus elongation in ruminants and stimulates cell migration and attachment. The second study evaluated the effects of pregnancy, P4 and IFNT on expression of hydroxysteroid (11-beta) dehydrogenases (HSD11B1 and HSD11B2), nuclear receptor subfamily 3, group C, member 1 (NR3C1), and prostaglandin-endoperoxide synthase 2 (PTGS2) in the ovine uterus. Expression of HSD11B1 mRNA and PTGS2 protein in endometrial LE and sGE were coordinate with conceptus elongation, while HSD11B2 mRNA was expressed primarily in the conceptus. Further, P4 induced, but IFNT only moderately stimulated HSD11B1. Thus, HSD11B1 expression may be regulated by prostaglandins (PGs) during early pregnancy. The presence of NR3C1 in the ovine uterus implicates cortisol, the main product of HSD11B1, in peri-implantation period events that include elongation of the ovine conceptus. The third study determined in vivo effects of PGs on ovine conceptus elongation and endometrial gene expression. Compared to control ewes, intrauterine infusions of a PTGS2 inhibitor, meloxicam, retarded elongation and decreased expression of elongation-related genes including IGFBP1, IGFBP3, HSD11B1, galectin 15 (LGALS15), solute carrier family 2, member 1 (SLC2A1), gastrin-releasing peptide (GRP), cystatin C (CST3), radical S-adenosyl methionine domain containing 2 (RSAD2), and ISG15 ubiquitin-like modifer (ISG15). Collectively, these studies assessed the effects of pregnancy, P4, IFNT, and PGs on endometrial genes implicated in conceptus growth. These results indicate that IGFBP1 is a marker of conceptus elongation in ruminants and provide novel roles for both cortisol and PGs in endometrial gene expression and conceptus elongation.

No description available.

Pregnancy diagnosis by transrectal ultrasonography (using a 5 MHZ linear probe) presented the maximum sensitivity and negative predictive values at day 26 and day 29 after estrus in heifers and cows, respectively. Palpation per rectum using the fetal membrane slip for pregnancy diagnosis did not increase embryo/fetus mortality when compared with a positive control group of non-palpated females. The use of a controlled randomized block design was a useful approach to study this problem. Blocking for category and number of embryos allowed us to remove these confounding factors. Factors that affected pregnancy loss during the first four months of pregnancy were: period of pregnancy, age of the animal, number of previous lactations and number of embryos. Pregnancy loss was higher during the embryonic than fetal periods. Spontaneous embryo/fetal mortality increased with the age of the animal and lactation number. The risk of spontaneous embryo/fetus mortality was higher in twin than in single pregnancies. Two types of embryo/fetus mortality were noted: Type I and Type II. Type I was characterized by presence of positive fetal membrane slip by palpation per rectum, signs of degeneration by transrectal ultrasonography and persistence of a functional corpus luteum. The uterus took approximately 3 weeks to be noted clean by transrectal ultrasonography and the animals showed estrus one month after the conceptus was diagnosed dead. Type II was characterized by absence of positive signs of pregnancy by palpation per rectum, absence of signs of degeneration by transrectal ultrasonography and absence of a functional corpus luteum. Pregnancy loss in nuclear transfer derived embryos was higher compared to in vivo derived embryos produced by artificial insemination. Pregnancy loss occurred mainly during the transition from the embryonic to the fetal period. Embryo/fetus mortality detected was Type I. Progesterone produced by the corpus luteum was noted at pregnancy levels for approximately two weeks after embryo/fetus death. Protein B, a hormonal placental marker, was maintained at pregnancy levels for approximately 3 weeks after embryo/fetus death. No differences in the levels of the two hormones were noted when comparing females with dead or live conceptuses.

Thesis (Ph.D.) in Nursing--University of Maine, 2009. / Includes vita. Includes bibliographical references (leaves 134-152).

Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 70-78).

Thesis (Ph.D.)--Ohio University, June, 2009. / Release of full electronic text on OhioLINK has been delayed until June 1, 2012. Includes bibliographical references (leaves 222-251)

Thesis (Ph.D.)--Ohio University, June, 2009. / Title from PDF t.p. Release of full electronic text on OhioLINK has been delayed until June 1, 2012. Includes bibliographical references (leaves 222-251)