Master of Public Health - MPH / Access to appropriate health care service during childbirth is a great challenge to many women in Africa and Namibia is no exception. More than 70% of women in Otjozondjupa region experienced some form of delay during childbirth, and while maternal mortality continued to rise over the years in Namibia it is currently at about 265/100 000, which is too high for a middle-income country. Hence, this study aimed to get a deeper understanding of the perceptions of women who experienced any of the three delays in accessing appropriate health care during childbirth in Otjiwarongo hospital.

京都大学 / 0048 / 新制・課程博士 / 博士(地域研究) / 甲第22559号 / 地博第262号 / 新制||地||99(附属図書館) / 京都大学大学院アジア・アフリカ地域研究研究科東南アジア地域研究専攻 / (主査)教授 速水 洋子, 准教授 伊藤 正子, 准教授 小林 知, 教授 松岡 悦子 / 学位規則第4条第1項該当 / Doctor of Area Studies / Kyoto University / DGAM

Abstract BACKGROUND: The number of homeless pregnant women is continuing to increase around the world. Homeless women are experiencing difficulties with their pregnancy that others may not face, including birth abnormalities and not seeking appropriate care due to cost and stigmatization. Nurses need to educate homeless pregnant women on what is needed for a healthy pregnancy and childbirth. OBJECTIVE: This exploratory research describes the needs for advocacy in women who are experiencing homelessness while pregnant and how homelessness affects pregnancy, childbirth, and postpartum care. LITERATURE REVIEW: The search methods used was CINAHL and ETSU Library. Keywords: homelessness, childbirth, homeless women, nursing. There were ten studies established all together. FINDINGS: Homeless pregnant women are not educated on contraceptives and what they need to do to have a healthy pregnancy. For example, they don’t know that being homeless and absence of proper care results in abnormalities such as low birth weights, longer NICU stays, and premature childbirths. CONCLUSION: We conclude that homeless pregnant women should be advocated for in hopes they will feel comfortable and seek proper care for a safe pregnancy. Keywords: homelessness, childbirth, homeless women, nursing

Attitudes of primiparous women toward childbirth were studied longitudinally as they varied with the intervention of childbirth education classes before delivery; and as they varied with the experience of labor and deli very and having a baby in the home after delivery. An anxiety scale was used measuring anxiety toward labor, delivery, the parenthood role, and stress on the marriage relationship. Measurement on the anxiety scale was taken prior to childbirth education when primiparous mothers ranged from 4 months to 7-l/2 months gestation. Measurement II on the anxiety scale was taken after childbirth education, one month prior to delivery. Measurement III on the anxiety scale was taken one month following delivery . The sample consisted of primiparous women selected from two Childbirth Education Classes at the Logan L. D. S. Hospital, Logan, Utah, in September and October of 1974. The following numbers of women responded on each of the three questionnaires: Measurement I - 77 Measurement II - 69 Measurement III - 66 Total Matched sample including all three measurements - 56. H was found that anxiety toward delivery increased significantly alter childbirth education and as time for delivery drew nearer, while anxiety toward labor decreased slightly but not significantly. One month following delivery, however, anxiety decreased toward both labor and delivery, as was expected, but anxiety toward delivery dec rea ed to a lower level than did anxiety toward labor. H appears that these primiparous women experience more anxiety toward delivery prior to the experience, but after experiencing labor and delivct·y, some feel more anxious about labor than about delivery. No differctlCC was found between any of the three measures on anxiety toward the role of parent. The participation of husbands in labor and delivery was viewed by over !JO percent of these primiparous mothers as a positive factor, on all th rcc measurements. Earlier in pregnancy, prwr to childbirth education on Measurement 1, a strong positive correlation was found between physical symptoms of pregnancy and overall an.xiety level. However, this relationship seemed to disappear after childbirth education, one month prior to delivery on Measurement II. An analysis of variance showed significant variation in the anxiety or stress of the childbearing cycle on the marriage relationship with the highest stress being just prior to delivery.

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This project has researched why a welfare country like Sweden has a growing number of mothers with negative and traumatic childbirth experiences and aimed to propose a conceptual solution on how design could enhance factors contributing to a positive and empowering childbirth experience.  With close contact to both midwives and mothers the research brought light on the dissonance between the physiological mechanism behind birth and the existing user journey when giving birth at Maternity Wards at hospitals. A woman in labor is treated in a generalized pathologic medical system and will encounter several blockades, which risks to prevent her from experiencing a smooth birth on her own terms, this often causing unnecessary interventions and most importantly - a disbelief in her own ability to give birth and to be a woman.   The result of the project is a couple of guidelines and visual suggestions of how a Swedish Birth Center could be established, interacted with and how a birth space could look like, with focus on providing accessibility for a positive and empowering birth experience. Enabling a woman to find her full capability to give birth requires an undisturbed and respectful environment, protecting the powerful but sensitive hormones of birth.  The concept is called Mammisi, the ancient name for birth place; birth house, referring to the findings of ancient temple complexes which were dedicated to worshipping goddesses of motherhood, fertility, birth and rebirth and where birth and fertility rituals took place. make a big difference, both for maternal health, long term economical profits and how a Birth Center implementation can be done with a low carbon footprint. The concept is easily applicable in real time, and can be used as a guide for spaces wanting to create fundations for a positive and smooth birth experience or a relaxation space.

This research examines the structure of the NICU (neonatal intensive care unit), a venue that juxtaposes a highly technological and medical setting against the care and nurturing of child by her parents. In this site, parents must construct and refine their definition of what it means to be a good parent in the context of the environment, medical professionals' expertise, and their child's hospitalization. At the same time, the health professionals on the unit are also impacted by their own experiences, preconceptions, and faith in medicine. Particularly relevant actors are the registered nurses, who care for babies but interact with parents; how nurses conceive of the parenting role influences the nature of this interaction, and therefore the experience of the parents in the unit. Yet nurses' definition of good parenting in the NICU often contradicts that of parents, and those who fail to meet the nurses' definition may find themselves labeled bad parents. Data for this research was collected in two urban NICUs. Mixed qualitative methods were used in the form of participant observation and in-depth interviews with both parents and staff members at both institutions, to the end of uncovering themes regarding commonalities of characterizations of good and bad parenting. Findings demonstrate that in constructing a definition of good parenting, parents medicalized themselves in the context of the NICU. Many incorporated medicalization into the parental role by accepting the notion that they could help to heal their baby, not just through care work but by actively taking on responsibilities that they felt could be beneficial. Parents' definitions of good parenting also included relying on the opinions of medical experts, which demonstrated a faith in the professionalization of medicine and the medicalization of childbirth and child care. Nurses' conceptions of what made up a good parent included deference. Many believed that parents needed to do what was best for the baby, defining this in part by stating that it meant listening to the experts, including themselves. Taking a Foucauldian approach to examine the position of nurses in the hospital, this fulfilled a need many nurses had to be respected for their skills and feel powerful on the unit. Additionally, nurses would label those whom they did not feel were meeting their parameters for being a good parent as bad parents, which often involved judging parents on the basis of their actions before or during their pregnancy. Parents were also judged based on how they acted in the unit. The bad parent label was applied both to parents who had confidence in their own abilities to parent while in the NICU, and also to mothers with a history of drug abuse. In accordance with labeling theory, once this label was affixed, it impacted the way that nurses and other staff treated parents and viewed all of their activities. The recent nature of this work reflects the impact of the newest technological innovations on the parental experience. This includes the increasingly sophisticated medical equipment in the NICU, what this has meant in terms of pushing the limits of viability, and the ability of parents to access information via the Internet. It also demonstrates the gap in parents' and nurses' ideas in the NICU, validating the place of sociology in discussions of family-centered care. / Sociology

In recent years, there has been a surge of interest in fathers' involvement in childrearing and childbirth. The purpose of this study was to determine how the attitudinal and demographic characteristics of expectant fathers influence their decision about participation vs non-participation in childbirth. A questionnaire which measured sex role attitudes, marital satisfaction, authoritarian parenting attitudes and belief in reciprocity was distributed to 44 men whose wives were in their third trimester of pregnancy. Multivariate and univariate analyses were performed. The univariate analysis was deemed the more appropriate statistic based on unequal sample sizes of participants and non-participants. Differences between the two groups on demographic data were slight. Of all the criterion variables, only belief in reciprocity producted significant differences between groups, p < .05. Belief in reciprocity was the best predictor of fathers' involvement in childbirth. / M. S.

The purposes of this study were to explore the work of midwives and their experiences with the medical community, and to examine their goals and hopes for the profession of midwifery in Virginia. To facilitate this purpose, the guiding research questions included: What do midwives believe the role of a midwife is? What are their experiences with the medical community? What are their hopes and goals for the future of midwifery in Virginia? Through interviews, focus groups and participating as a researcher-observer, I found that both certified nurse-midwives and certified professional midwives believe the role of midwife is one of support. Furthermore, midwives' experiences with the medical community are both restrictive and supportive, and both groups are pursuing the advancement of midwifery acceptance and practice through building relationships and advocating for midwifery. The dominance of medical authoritative knowledge of childbirth in the United States creates struggles for midwives. Consequently networking and consumer advocacy are cited as vehicles for the growth of midwifery. / Master of Science

The purpose of this research was to investigate the effect of parent education on maternal confidence and predictions of pain medication use in labor. The variables in this study were maternal age, parity, self-efficacy, prediction of pain medication usage, and parent education attendance. A convenience sample of 100 pregnant women enrolled in parent education classes at a major metropolitan tertiary care system was used. Data were collected through surveys administered by parent educators prior to the first class in the series and at the end of the last class. Instruments included the Childbirth Self-Efficacy Inventory and a questionnaire regarding maternal preference for pain control during tabor. The findings indicated that the parent education classes had a positive effect on the women's childbirth self-efficacy and outcome expectancy. Additionally, at the end of the classes a significant number of women reported they were less certain that they would have an epidural or use narcotic pain medication during labor. The findings, however, demonstrated no significant difference among the CBSEI scores of women with different preferences for pain control during labor.