The primary aim of the present study was to compare mothers' reactions to obstetrical interventions and procedures and obstetricians' perceptions of these. The sample population consisted of one hundred and forty seven white, married, English-speaking mothers and a group of fifty three obstetricians practising in trie Johannesburg area. Questionnaires, developed for both groups, were administered postally to obstetricians and in hospital within the first post-partum week to mothers. Perceptions of interventions occurring in the ante-natal period and during the three stages of labour were explored. Reactions to psycho-social and hospital procedures were also obtained. Median and modal ratings of these events were calculated for both samples. The data were analysed using the Median test to compare the groups and Fisher's exact probability test to determine significant differences. Using a significance level of one per cent, several significant findings emerged. Results suggested that, in general, obstetricians rated mothers' experiences more negatively than did the mothers themselves, These findings were discussed in the light of available research and literature in the area

分娩痛是一種生理性的疼痛，分娩過程中劇烈疼痛痛苦難以忍受，同時使產婦焦慮、緊張和恐懼，致使產婦血中兒茶酚胺、腎上腺皮質激素增高，導致血壓升高，心臟負荷加重﹔產婦由於疼痛呼喊、過度換氣、耗氧量增加，可導致呼吸性堿中毒，從而影響胎盤血供，導致母兒出現低氧血症。隨著產程進展、疼痛加劇，產婦血壓升高、呼吸頻率增快，過度耗氧，引起胎兒宮內窘迫，種種危險和痛苦導致剖宮產率逐年上升，加之藥物麻醉對產婦和胎兒都可以產生一定的不良反應。因此，合理地運用適當的疼痛緩解措施，可以使疼痛應激反應減輕甚至消失，提 高圍產期品質，分娩鎮痛日益受到重視。 研究目的 研究希望通過對現有關於通過穴位進行分娩鎮痛的臨床研究類文獻搜集、整理、分析，從而對通過穴位分娩鎮痛的常用方法、常用穴位、有效率等等方面做一個較為全面的展示，並對當前通過穴位分娩鎮痛的臨床研究的現狀和可能存在的問題進行探討。 方法 以中國期刊全文資料庫進行標準檢索，檢索選項為“主題”，檢索詞為“針刺”or“穴位”並包含“分娩鎮痛”or“分娩痛”，時間年限設定為2004年－2014 年。按納入排除標準進一步篩選文獻。 小結 就通過穴位分婉鎮痛的常用方法、常用穴位、有效率、產程變化、產後出血量等等方面進行文獻研究總結後，發現近年來通過穴位分娩鎮痛的臨床實驗文獻逐漸增多，初步證明穴位分娩鎮痛安全有效，但目前可搜到的臨床文獻存在臨床研究方式較為單一、選穴單一、結論標準不統一、隨機對照試驗設計不嚴謹等等問題，提示我們進行進一步研究。 關鍵字：分娩鎮痛﹔針刺鎮痛﹔ 穴位鎮痛﹔ 分娩痛﹔

Thesis (M.Cur.) --University of Limpopo, 2011 / Introduction and aim: Globally it is of paramount importance that all pregnant women in labour are monitored by midwives utilizing a partograph so that a live baby is delivered. Midwives seemed not to utilize the partograph correctly when monitoring women in labour. The purpose of this study was to determine the utilization of the partograph by midwives in the labour wards of Lebowakgomo and Zebediela level 1 hospitals in the Capricorn District of the Limpopo Province, South Africa. The research question was, “What skills and knowledge do midwives have on the utilization of the partograph for monitoring pregnant women in labour”. The objectives of this study were to explore and describe the utilization of the partograph by midwives in Lebowakgomo and Zebediela level 1 hospitals in the Capricorn District of the Limpopo Province, and to develop guidelines that would assist midwives to effectively utilize the partograph hence provision of quality midwifery care. Research Design and method: The research design was qualitative, descriptive, explorative and contextual in nature. The population comprised all midwives registered with the South African Nursing Council and practicing as such in Lebowakgomo and Zebediela level 1 hospitals. A purposive sampling technique was used to select 15 participants. Data were collected using semi-structured in–depth interviews with a guide. The semi-structured in-depth interviews were conducted until data were saturated. Trustworthiness was ensured by credibility, dependability, transferability and confirmability. Ethical clearance to conduct the study was obtained from the University of Limpopo and from the Department Health and Social Development. The principles of informed consent, confidentiality and anonymity were observed during the study. Data were analyzed using the Tesch’s approach as described by Creswell (1994) cited in de Vos (2005:333). Conclusions: The following themes emerged during data analysis: monitoring of foetal status during intrapartum, monitoring of the progress of labour during intrapartum, monitoring of the maternal status during intrapartum, and shortage of staff in the labour wards. Guidelines which aimed at improving midwifery care were formulated.

Existing research suggests that childbirth may be a significant trigger of posttraumatic stress disorder (PTSD) in the postpartum period. While literature presents important results regarding the prevalence and risk factors of postpartum PTSD, several gaps remain. The current study examined the factor structure of perinatal PTSD by comparing two supported structures of PTSD. Additionally, structural equation modeling (SEM) was used to examine whether subjective birthing experiences and objective childbirth characteristics mediated the relationship between psychosocial variables (history of trauma, fear of childbirth, and social support) and postpartum PTSD. Women were recruited during pregnancy from the University of Iowa Hospitals and Clinics. Symptoms of PTSD, OCD, and depression, as well as risk factors for postpartum PTSD were measured at pregnancy, 4, 8, and 12 weeks postpartum. Additionally, structured clinical interviews were conducted to assess for depression, PTSD, OCD, and mania. Five factor structures were examined using confirmatory factor analysis, including two four factor models with correlated latent factors, two four factor hierarchical models, and a unidimensional model. All models resulted in adequate global fit and excellent component fit. The most parsimonious model, the unidimensional model was retained. The SEM showed that subjective perceptions of childbirth mediated the relationship between fear of childbirth and postpartum PTSD at 4 weeks postpartum. At 8 weeks postpartum, objective childbirth characteristics mediated the relationship between fear of childbirth and postpartum PTSD and there was a direct relationship between fear of childbirth and postpartum PTSD. The current study supports a hierarchical or unidimensional structure of PTSD in perinatal samples emphasizing the importance of a higher-order, shared dimension of PTSD symptoms. It further emphasizes the importance of fear of childbirth and both subjective and objective birthing experiences in predicting postpartum psychopathology. Future research should examine these symptoms and risk factors in a more diverse and at-risk sample. Additionally, accurate assessments, and influential interventions for postpartum PTSD should be further examined.

Attitudes of 74 first-time fathers were studied as they varied vi by childbirth preparation and participation. A 50-variable questionnaire was used to tap fathers' attitudes towards their marital relationship and partner, their infants, themselves as fathers, and the pregnancy/childbirth experience . Fathers agreed on being elated with fatherhood, wanting tactile, verbal, and extended home contact with their infants, planning on a partnership in parenting, and seeing their marriage at a high point. They saw pregnancy as a time of stress and adjustment and felt father participation was important. Their attitudes varied most on wife's performance and their own helpfulness through labor and delivery. The variance and the numerous relationships of the 50 variables were consolidated through factor analysis. 2 x 2 ANOVA on eight factors revealed the effects of preparation and participation. It was found that participation increases the father's respect for his wife, gives him more purpose in the childbirth, and increases his elation at becoming a father. The prepared and participating father realized the importance and responsibili ty of his ~articipation and perceived his infant as being perfect. A trend was seen between preparation and concerns with the infant time involvement, the pleasure with the news of pregnancy. and a desire to go through the childbirth experience again. Herit was also given to a lack of preparation and participation through the results of analysis on Factor II--The triad. The nonprepared nonparticipating fathers saw the marriage a t a high point, showed tactile and visual engrossment, and planned on a parenting partnership more than any other group of fathers in the sample.

A key midwifery activity is the support of a woman in labour. Pain in labour has been extensively researched from the woman's perspective, but less has been explored in relation to the midwife and her approach to pain. The way in which the midwife works with a woman and her pain in labour is the focus of this qualitative study, using Heideggerian hermeneutic phenomenology. This philosophical approach seeks to uncover or illuminate aspects of the midwife's practice which are frequently taken for granted in their everydayness. Seven midwives, including both independent practitioners and hospital-employed, were interviewed. Their narratives were analysed to uncover the meaning of the way in which midwives work with women and their pain in labour. The findings of this thesis suggest that midwives work by interpreting the woman's pain. Before the pain begins, they 'leap ahead' to help them anticipate the pain and how they will confront it. During labour, midwives give pain meaning by translating its purpose in that context. They 'leap in' when required, sometimes using 'self as an intervention. Midwives interpret women's pain through their understanding of lived time. They know how the perception of time passing changes depending on the setting for labour or the amount of anxiety and pain the woman is experiencing. Midwives use time in their work. They break it down to help a woman focus on a single contraction rather than looking too far ahead toward the unknown. Time can be a midwife's friend when the arrival of the baby replaces the urgent need for pain relief. It can also be her enemy if her interpretation of a woman's pain differs from the woman's perception. The memory of pain may persist for the woman, after labour has finished, with a backlash for the midwife. Some midwives believe in the process of birth and the woman's ability to labour with such conviction that they gain a woman's complete trust. At her most vulnerable time, they encourage the woman to call upon inner reserves and be truly empowered by her experience.

This dissertation explores the effect of teen childbearing on the adult mother’s employment, earnings and welfare participation. This study contributes to the literature on the consequence of teen childbearing by relying on original datasets and using an array of samples and econometric methods to test the robustness of the results. We use state administrative data from several sources including the Georgia subset of the Vital Statistics for the years 1994-2002, the Wage and Employer files for the years 1990-2003, and the Welfare dataset for the years 1990-2005. We select three samples. The first sample is constructed with sisters raised in families on welfare, where one sister is a teen mother and the other a non-teen mother. The second sample is composed of young mothers who were pregnant as teens and whose first pregnancy ended with either a birth (teen mothers) or a fetal death (non-teen mothers). A third sample is selected by the propensity score matching technique on a subset of the second sample. For the labor market outcomes, this study suggests that teen childbearing has a negative effect on the employment and earnings of Blacks in the miscarriage sample and in the propensity score sample. However, White teen mothers are more likely to be employed and to earn more than the White non-teen mothers in the miscarriage sample. In contrast, the sisters’ sample does not show any statistical significant effect of teen childbearing on employment or earnings. These mixed results are probably due to the different distribution of the mothers’ race and socioeconomic status before pregnancy. Concerning welfare receipt, very few mothers in the sisters’ sample and no mothers in the propensity score sample receive welfare during the years of study. For the miscarriage sample, White teen mothers are less likely than the White non-teen mothers to receive welfare at any time. Blacks become less likely to receive welfare as their child’s age increases. The effect on Blacks might be due to the welfare reform that tightened the rules for welfare eligibility. This research suggests that as far as employment and earnings are concerned, policy dollars aimed at preventing teenage childbearing would be more efficiently used for the Blacks and low-income populations. However, the small magnitude of the teen coefficients in the employment and earnings analyses suggests that teen pregnancy prevention only will not have a very dramatic influence on the adult mothers’ standards of living. Therefore, policy dollars should also be directed to issues correlated with teen childbearing such as poverty or low education attainment. As for welfare participation, teen mothers are no more likely to rely on public assistance than non-teen mothers so their welfare dependence should not be a concern.

Thesis (Ph. D.)--Rutgers University, 2009. / "Graduate Program in History." Includes bibliographical references (p. 192-201).

Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 313-320).

North American research on childbearing demonstrates that many first-time mothers rely on educational books for information and advice concerning pregnancy and childbirth. Popular literature on childbearing advises women on a variety of topics including choosing a caregiver, prenatal testing, safety and risk, natural vs. medicated labour, and place of birth. Such information may shape women’s expectations, choices, and belief systems regarding the body, obstetric technology, pregnancy and birth. These varied forces and belief systems coalesce to influence the ways in which women experience birth, thereby affecting post-natal mental, socioemotional, and physical health. Currently, however, research exploring the various messages disseminated by popular literature on pregnancy and birth is limited. In this study, the author examines four popular North American childbearing advice books for discourses related to biomedical and midwifery cultures, ways of knowing, power, and choice. Discourses are considered through a feminist intersectional framework, with particular attention paid to the ways in which childbearing ideologies are shaped by interactive biological, socio- cultural, economic, and political factors. The author explores how power matrices and the privileging of biomedical knowledge can shape conceptualizations of gender and sexuality, women’s bodies, maternity care, pregnancy, labour, and birth. In addition, peripheral discourses that provide possibilities for other, non-normative narratives of birth are highlighted. / Graduate