This dissertation seeks to rhetorically examine how women who have had abortions construct their abortion experience, with particular attention given to the role of various identity factors (such as race, nationality, class, spirituality, and geographic location) in the construction of their experiences. By giving voice to women's experiences and placing this voice in a historical context of differential racialization, as well as within both Critical Race Feminism (CRF) and Reproductive Justice (RJ) frameworks, this dissertation asks: How does the narrator construct the importance of her identity in her abortion and reproductive health services experiences?; Does the narrator link previous reproductive health services issues, such as sex education or cost of birth control, to her abortion experiences?; Does the narrator link her abortion experience to larger social structures and power issues?; How does the narrator construct her experience of abortion? What emotional elements does she present in her construction of the narrative?; How does the narrator construct her experience of deciding to have an abortion?; How does the narrator construct the role of her social support system in her abortion experience?; and How does the narrator reflect on her abortion experience? This dissertation argues that while women experience and construct abortion in very different ways, common experiential themes emerge. While women do not all construct or reflect upon their abortion experiences in the same way, narrative themes emerge that fade in and out of focus based on a woman's standpoint and the various aspects and intersections of her identity. In light of the emergent themes, this dissertation suggests enhanced opportunities for the sharing of women's abortion experiences, as well as more academic and activist work to examine and raise public awareness about issues of power and privilege in the abortion process.

The purpose of this thesis is to investigate how a public health crisis affects the pregnancy decisions and experiences of Canadians, how pregnancy history impacts these experiences, and whether the delivery of pregnancy care has been impacted or changed by the COVID-19 pandemic. This thesis surveyed women from across the country about their experiences during pregnancy with prenatal care and social support, as well as their birth experiences and perceptions of new motherhood during the pandemic. Interviews were conducted with perinatal care providers from Ontario about their personal experiences providing perinatal healthcare services, as well as their perceptions of their patients’ experiences. This thesis aims to identify prenatal, birth and postpartum experiences described by Canadians, and quality of perinatal health services during the COVID-19 pandemic.

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Background: Pregnant individuals who participate in physical activity throughout gestation have been shown to experience a wide spectrum of health benefits, along with the fetus. In nonpregnant populations, PA influences the polarization state of tissue resident macrophages, resulting in increased regulatory and decreased inflammatory profiles. The effects of PA on placenta-resident macrophages, or Hofbauer cells (HBCs), remains unknown. My thesis aimed to explore this novel area. Methods: The first objective of my thesis was to identify any associations between gestational PA and HBC polarization. PA was objectively measured in both mid (24-28 weeks) and late (34-38 weeks) pregnancy using accelerometry. Immunofluorescent localization of the panmacrophage marker CD68 and the anti-inflammatory macrophage marker CD206 was used to assess polarization states. Protein and gene expression of CD68 and CD206 were assessed using Western blot and qPCR, respectively. The second objective was to explore the relationships between gestational PA, HBC polarization, and angiogenic factors in the placenta. Western blot measured the relative protein expression of FGF2 and SPRY2, and the localization of FGF2, SPRY2, and VEGF within HBCs was explored using immunofluorescent colocalization in term placenta tissue and primary HBC cultures. Results: While there were no differences in the absolute numbers of total or CD206+ HBCs, the proportion of CD206+ HBCs was elevated in active individuals. There were no significant differences in the gene expression of CD68 or CD206, nor in the gene expression of CD206; however, CD206 protein expression was observed to be lower in active participants. Both CD206+ and CD206- HBCs expressed VEGF. Active individuals had significantly higher low molecular weight-FGF2. There were no differences in the protein expression of SPRY2, total FGF2, or high molecular weight FGF2 based on PA. HBCs both in vitro and in vivo of all polarizations expressed VEGF, SPRY2, and FGF2, and were observed to create intracellular junctions and multi-nucleated giant cells. Conclusions: In conclusion, PA was associated with a higher proportion of CD206+ HBCs and reduced levels of CD206 protein. In combination with the lack of significant difference in CD206 mRNA based on PA levels, this suggests a potential effect mediated by PA on the transcriptional regulation of CD206. HBCs were seen to express SPRY2, VEGF, and FGF2, identifying them as potential players in angiogenesis regulation in the placenta. The elevated levels of low molecular weight FGF2 in active individuals suggests the PA may play a role in the modulation of placental angiogenesis. Future research should continue to explore the relationships between PA, HBC polarization, and angiogenesis.

京都大学 / 新制・課程博士 / 博士(理学) / 甲第24457号 / 理博第4956号 / 新制||理||1707(附属図書館) / 京都大学大学院理学研究科生物科学専攻 / (主査)准教授 中野 隆文, 教授 本川 雅治, 教授 森 哲 / 学位規則第4条第1項該当 / Doctor of Science / Kyoto University / DGAM

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A central question in life history theory is, what combination of traits and behaviors will lead to the highest reproductive success throughout a lifetime. The trade-off between current and future reproduction is central to the lifetime reproductive success of an organism. If there is a cost to reproduction, then allocation of energy to current reproduction will come at a cost to future reproduction. We expect young individuals to favor future reproduction over current reproduction and that balance shifts to current reproduction as they age (i.e. terminal investment hypothesis). However, how this transition from an emphasis on future reproduction to emphasis on current reproduction changes throughout a lifetime should depend on environmental factors like mortality and resource availability. We test for the generality of terminal investment across three species of poecilliid fishes in a range of environments. We found evidence of terminal investment in all three species in both high and low mortality environments and high and low resource availability environments. In general, high mortality or high resource availability tended to result in a decreased slope of the relationship between reproductive allocation and body size. Terminal investment appears to be general, even though there was an effect of high mortality and resource availability, it was not sufficient to completely preclude terminal investment.

INTRODUCTION) Modern contraception is a safe and effective clinical service for reducing unintended pregnancy and improving birth spacing for women. Provider counseling is an important factor that may influence women’s decision making, satisfaction, and self-efficacy with contraception use. This study measures women’s perceptions of recent provider interactions and examines the extent to which these perceptions are associated with method satisfaction and confidence in use. We hypothesize that women who perceive more positive interactions are ultimately more satisfied and confident with their contraceptive method choice. METHODS) A cross-sectional survey of adult reproductive-aged women in two southern states (aged 18 to 44 years old) was used for the analysis. The Statewide Survey of Women was conducted in 2017 by NORC at the University of Chicago. Women were asked to rate providers across a series of statements reflecting aspects of patient-centered contraceptive counseling using a 5-point Likert scale. Responses were dichotomized to reflect those with very good/excellent experiences compared to those with less favorable experiences (Poor, Fair, Good). Women were subsequently asked about their level of satisfaction with current contraceptive methods and confidence in use, also using a 5-point Likert scale. These measures were also dichotomized. A chi-squared test for independence and unadjusted logistic regression models were used to examine associations between patient-provider interactions, satisfaction and confidence in contraceptive use. FINDINGS) The survey included 4,281 respondents. The majority of women reported being satisfied with their current contraceptive method (92.6%) and confident in its use (94.9%). Approximately 93% of women who felt respected as a person by their provider also reported being satisfied with their current birth control method, compared to 73% among women who did not feel respected as a person (p<0.001). Among women who felt their provider allowed them to say what mattered to them about their birth control method, 93.5% were satisfied with their current method, compared to 75% among those who did not feel allowed to say what mattered (p<0.001). Women who felt like their provider took their preferences for birth control into consideration were also more satisfied with their current birth control method compared to those who did not feel the same way (93.7% versus 73.5%; p<0.001). Women who felt their provider allowed them to say what mattered and those who felt their provider took their preferences into consideration were also associated with higher rates of confidence in correct use. Women reporting that their provider gave them enough information to make the best decision about their birth control method was also associated with greater confidence in correct use (95.6% versus 87.5%; p=0.007). CONCLUSION) Findings suggest that positive patient-provider interactions are associated with increased satisfaction in current contraceptive method use. Interestingly, women reporting that providers did not give them enough information to make the best decision about birth control methods also reported being less confident in using their current method. Collectively, these findings support existing evidence suggesting that patient-provider interactions are important for patient-centered care and can be used to inform future clinical practice guidelines around contraceptive counseling.

State regulation of assisted reproductive technology (ART) has been occurring since the inception of earlier technological advances such as artificial insemination to aid human reproduction. I provide a brief overview of the current regulation of ART in the U.S. and the literature on state regulation. Unlike previous studies of ART regulation which use content analysis or case studies of individual state laws I estimate ART regulation for the entire U.S. by using a series of random effects logistic regression models for the time period 1995-2006. To my knowledge this is the first quantitative analysis of ART regulation. I test the hypothesis that the demand for ART is an important predictor of ART legislation in the U.S. Other hypotheses derived from the ART literature were also tested in the analysis. Results indicate that demand for ART is the most influential factor in predicting ART legislation from 1995-2006. Additionally, educational attainment of a state's population and the percentage of married couple households with children in each state may have a direct effect on the demand for ART and an indirect effect on ART regulation.