Mothers' dating after divorce has been linked to health benefits for mothers (Amato, 2000). However, this association assumes that all repartnering relationships are beneficial for mothers (Symoens et al., 2014). According to the divorce-stress-adaptation perspective (Wang & Amato, 2000), mothers' dating after divorce may be a supportive factor for her adjustment if her relationship is high quality, which can assist mothers with post-divorce stress (Amato, 2000; Wang & Amato, 2000), or can contribute to post-divorce stress through low quality relationships (Hetherington, 2003; Montgomery et al., 1992). However, not all mothers date, and those that do, use different approaches to dating, such as dating only one partner versus multiple partners. Another deficit in the literature is the influence of selection processes during repartnering. As well as examining the impact of relationship quality on maternal well-being, the current study includes the influence of stable traits, such as age and length of marriage, in order to examine the threat of selection across different repartnering histories. The current study used four repartnering histories that mothers reported after divorce (no dating, dating monogamously, dating multiple partners serially, and dating multiple partners simultaneously) to examine consequences on maternal well-being (depressive symptoms, life satisfaction, drunkenness, and unprotected sex). Relationship quality is reported for each relationship. Using longitudinal monthly diary data collected over a two-year period beginning with filing for divorce and multi-level models, I examined changes in the intercept and slope of maternal well-being for each repartnering history, as well as the effect of breakup with a particular focus on the interaction of relationship quality. To test for the threat of selection, I used mothers' stable traits as level-2 predictors. Results for this study show that mothers who enter in a high quality relationship report slightly higher levels of maternal well-being. Mothers entering low quality relationships report slightly lower levels of maternal well-being compared to times when mothers are not dating. Maternal well-being was not consistently influenced by maternal breakup. Mothers also reported increases in unprotected sex throughout the study, which may be a better marker of trust than maternal well-being. Only support was found for selection effects. Implications for maternal well-being are discussed. / text

Book Summary: This volume offers an overview of the latest research on perinatal adaptation among women who have faced trauma, loss and/or adversity, both in childhood and/or as an adult, and describes the varied trajectories of adaptive and maladaptive coping that follow. The range of outcomes considered span from health-limiting (e.g. mental illness, substance use, unhealthy life style behaviours) to health-promoting (e.g. resilience and posttraumatic growth). These outcomes are examined both in relation to mothers’ experience of motherhood and parenting, and with regard to their children’s lives. Interpersonal trauma, experienced in childhood and/or or adulthood, can have a profound effect on how women experience the transition into motherhood – from pregnancy, to childbirth, and postpartum caregiving. Women across the globe are exposed to high rates of interpersonal violence, and face the physical and emotional consequences of such events. The shift into motherhood is an emotionally evocative period in a woman’s life, entailing not only challenges, but also the potential for healing and growth. Individual chapters will present state-of-the-art research, and will also highlight the voices of women who have personally experienced trauma, illustrating the effects on their experiences as mothers. Throughout the book, the consistent emphasis is on clinical implications and on ways that providers can create a context for healing and growth with the help of current evidence-based and promising treatment methods.

The transition to motherhood requires adjustments to new roles and growing demands on time and financial resources. Consequently, this transition can be a time of emotional upheaval and can often lead to increased levels of maternal stress. Research on parenting stress has identified social support as an important resource for coping with the demands of parenting, but, empirical studies also show that access to social support is likely to differ based on one’s socioeconomic status. Consequently, levels and effects of support may differ by maternal educational level. The primary purpose of the current study is to investigate the associations between four types of perceived support, maternal educational attainment and maternal parenting stress. The study sample is drawn from the first year follow-up wave of the Fragile Families and Child Well-being dataset (n=2412) and includes only mothers who were involved with the father of the child at the time of the child’s birth. Fragile Families is a nationally based, longitudinal birth cohort study of approximately 4,800 mothers and their children. Data were analyzed using multivariate regression modeling to investigate direct effects of perceived support and education on maternal stress as well as testing a moderating effect of education on the association between perceived support and maternal stress. The results showed that perceived support from one’s partner significantly lowers maternal stress regardless of the level or type of support (emotional, mothering or instrumental) that the partner provides. Expected support from kin or friends does not have an effect on maternal stress. The effect of perceived support differs by education level for two types of partner support: support of mothering practices and instrumental support. Increased symptoms of depression and fussy child temperament each increase maternal stress levels. Investigation of the direct effect of various types of perceived support on maternal stress indicate that partner support is critical during the first year of motherhood. Results reveal that not all types of perceived support affect maternal stress with the same magnitude. Thus, special attention should be given to the context within a mother is functioning. / text

This dissertation explores whether families of incarcerated fathers are more likely to experience food insecurity as a result of the conviction of the father. More specifically, I test whether food insecurity explains some of the devastating consequences of paternal incarceration on mothers and children. Because children of incarcerated fathers are at higher risk of following their fathers’ footsteps, this cycle of incarceration can be self-perpetuating. I try to determine how policy can be used to break this cycle. This dissertation examines the role of food insecurity in explaining the negative impact of paternal incarceration on the well-being of mothers and children. The United States has experienced a huge prison boom over the last 40 years. A growing proportion of the incarcerated population are parents. Children growing up with one or both parents missing tend to have long-lasting disadvantages. Previous studies have attempted to suggest a few mechanisms through which paternal incarceration has negative consequences for families but has not considered the role of food insecurity. I propose a theoretical framework to show that paternal incarceration negatively affects mothers and children through food insecurity. Using a longitudinal study of fragile families, I find that food insecurity explains some of the negative consequences of paternal incarceration on maternal depression. On the other hand, food insecurity plays no role in the effect of paternal incarceration on child behavior problems. The findings also cast doubt on whether paternal incarceration affects child well-being. The implications for policy are two-fold. First, reducing food insecurity would mitigate the negative effects of paternal incarceration on maternal depression. More research is needed in order to understand whether the negative effects of paternal incarceration on maternal well-being can be further mitigated. Second, prison reform would do little to reduce the behavior problems experienced by children of incarcerated fathers. Rather than incarceration, other factors contributing to social disadvantages could explain why children of incarcerated fathers have more behavior problems than other children.

This dissertation explores whether families of incarcerated fathers are more likely to experience food insecurity as a result of the conviction of the father. More specifically, I test whether food insecurity explains some of the devastating consequences of paternal incarceration on mothers and children. Because children of incarcerated fathers are at higher risk of following their fathers’ footsteps, this cycle of incarceration can be self-perpetuating. I try to determine how policy can be used to break this cycle. This dissertation examines the role of food insecurity in explaining the negative impact of paternal incarceration on the well-being of mothers and children. The United States has experienced a huge prison boom over the last 40 years. A growing proportion of the incarcerated population are parents. Children growing up with one or both parents missing tend to have long-lasting disadvantages. Previous studies have attempted to suggest a few mechanisms through which paternal incarceration has negative consequences for families but has not considered the role of food insecurity. I propose a theoretical framework to show that paternal incarceration negatively affects mothers and children through food insecurity. Using a longitudinal study of fragile families, I find that food insecurity explains some of the negative consequences of paternal incarceration on maternal depression. On the other hand, food insecurity plays no role in the effect of paternal incarceration on child behavior problems. The findings also cast doubt on whether paternal incarceration affects child well-being. The implications for policy are two-fold. First, reducing food insecurity would mitigate the negative effects of paternal incarceration on maternal depression. More research is needed in order to understand whether the negative effects of paternal incarceration on maternal well-being can be further mitigated. Second, prison reform would do little to reduce the behavior problems experienced by children of incarcerated fathers. Rather than incarceration, other factors contributing to social disadvantages could explain why children of incarcerated fathers have more behavior problems than other children.

Introduction: Prenatal care has high priority in public health policy in Brazil, due to it is strong influence on rates of maternal and infant morbidity and mortality. Evaluation processes of the quality of care for pregnant women are important tools for optimizing the impact of health services on maternal and fetal health. The goal of the study was to evaluate the quality of prenatal care offered to pregnant women in Fortaleza (CE), using parameters established by the Ministry of health, aiming to contribute to the improvement of care for women in pregnancy and childbirth. Methodology: The cross-sectional study was based on the V Study on Maternal and Child Health of Cearà(PESMIC), a population survey carried out in a sample of women of reproductive age living in Fortaleza. From the 2.553 surveyed women, 195 reported a birth in the previous 12 months, being the target of the analysis. The quality of care was a evaluated in three levels of complexity: Level 1, the onset and frequency of consultations; Level 2, Level 1 plus the completion of laboratory tests, and level 3, Levels 1 and 2, plus the achievement of clinical and obstetric procedures. The chi-square test was used to evaluate the statistical significance (ÃÂ=0,05) of associations between characteristics of pregnant women and prenatal care. Results: Pregnant adolescents were associated with fewer consultations (p=0,057) and HIV testing (p=0,014), as compared with adults. Pregnant women without a partner had a later start of the prenatal care (p=0,004) and fewer consultations (p=0,032), than those living with a partner. Pregnant women with years of schooling up to 8 years were associated with fewer visits (p=0,024) and lower guidance relating to breast feeding (p=0,001), compared to those with more than 8 years of schooling. Family income of up to 2 minimum wages were associated to a later beginning of the prenatal care (p=0,018) and lower referral to delivery care facilities (p=0,018), as compared to those with income above 2 minimum wages. Pregnant women who had the SUS as a health care provider, were associated with an late pre natal care (p=0,001), fewer consultations (p=0,002), less breastfeeding advice (p=0,029), and lower referral to delivery care facilities (p=0,017) as compared to those who had health insurance. The assessment of the quality of care found that only 63% of pregnant women started and managed to hold consultations at the appropriate time (Level 1). When this parameter was added to the performing of basic laboratory tests (Level 2), the percentage was only slightly reduced, to 55%. However, when these two levels were considered in conjunction with Level 3 (clinical and obstetric procedures performed by professionals) the percentage of adequacy has dropped dramatically, reaching only 3,6 %. Conclusion: Despite it is high coverage, prenatal care in Fortaleza should be reconsidered qualitatively. It is recommended a broad discussion of the results of this assessment with managers, health professionals and community, as well as the organization of a training program for improving the technical quality of the care provided by such professionals. ÃâÆ / IntroduÃÃoo: A atenÃÃo prÃ-natal destaca-se como prioridade em saÃde no Brasil, por ser um fator de marcada influÃncia sobre as taxas de morbimortalidade materna e infantil do PaÃ. Processos avaliativos da qualidade da atenÃÃo àgestante, por sua vez, sÃo importantes instrumentos para a otimizaÃÃo do impacto dos serviÃos de saÃde sobre a saÃde materno-fetal. O objetivo do estudo foi avaliar a qualidade da atenÃÃo prÃ-natal ofertada Ãs gestantes de Fortaleza-CE, tendo como parÃmetros os indicadores preconizados pelo MinistÃrio da SaÃde, visando a contribuir para a melhoria da assistÃncia à mulher no ciclo gravaÂdico-puerperal. Metodologia: O estudo transversal teve como base a V Pesquisa de SaÃde Materno-Infantil do Cearà (PESMIC), com uma amostra de 2.553 mulheres em idade reprodutiva residentes em Fortaleza, das quais 195 referiram gravidez nos pravios doze meses anteriores à entrevista, compreendendo os anos de 2007 e 2008. A qualidade da atenÃÃo foi avaliada em trÃss nÃÂveis de complexidade: no NÃÂvel 1, o inÃÂcio e frequencia das consultas; no NÃvel 2, o NÃÂvel 1 mais a realizaÃÃo dos exames laboratoriais; e no NÃÂvel 3, os NÃÂveis 1 e 2, mais a realizaÃÃo dos procedimentos clÃÂnico-obstÃtricos. O teste do Qui-quadrado foi utilizado para avaliar a significÃncia estatÃÂstica (ÃÂ=0,05) das associaÃÃes entre as caracterÃÂsticas das gestantes e as do prÃ-natal. Resultados: Gestantes adolescentes estiveram associadas a um menor nÃmero de consultas (p=0,057) e a uma menor realizaÃÃo do teste HIV (p=0,014), em comparaÃÃo a gestantes adultas. Gestantes sem companheiro estiveram associadas a um inÃÂcio de prÃÂ-natal tardio (p=0,004) e a um menor nÃmero de consultas (p=0,032) quando comparadas as que viviam com companheiro. Gestantes com nÃÂvel de escolaridade de atà oito anos de estudo estiveram associadas a um menor nÃmero de consultas (p=0,024) e menor orientaÃÃo referente ao aleitamento materno (p=0,001) em comparaÃÃo aquelas de mais de oito anos de estudo. Gestantes com renda familiar de atà dois salÃÂrios mÃnimos estiveram associadas a um inÃÂcio do prÃ-natal tardio (p=0,018) e a um menor encaminhamento ao parto (p=0,018) em comparaÃÃo as que referiram renda superior a dois salÃrios. Gestantes que tinham o SUS como provedor de saÃde estiveram associadas a um inÃÂcio de prÃ-natal tardio (p=0,001), a um menor nÃmero de consultas (p=0,002), a uma menor orientaÃÃo ao aleitamento (p=0,029) e menor encaminhamento ao parto (p=0,017) em comparaÃÃo as que possuÂam plano de saÃde. Na avaliaÃÃo da qualidade da atenÃÃo, observou-se que somente 63% das gestantes iniciaram e conseguiram realizar as consultas na Ãpoca adequada (NÃvel 1); quando esse parÃmetro foi acrescido da realizaÃÃo dos exames laboratoriais bÃsicos (NÃvel 2) , este percentual de adequaÃÃoo reduziu-se levemente para 55%. Entretanto quando estes dois nÃÂveis foram considerados em conjunto com o NÃÂvel 3 (procedimentos clÃÂnico-obstÃtricos realizados pelos profissionais), o percentual de adequaÃÃo caiu drasticamente, alcanÃando apenas 3,6%. ConclusÃo: Apesar da elevada cobertura, a atenÃÃo prÃ-natal no MunicÃpio de Fortaleza deve ser reconsiderada qualitativamente. Recomenda-se ampla discussÃo dos resultados desta avaliaÃÃo com gestores, profissionais de saÃde e comunidade, bem como a organizaÃÃo de um programa de sensibilizaÃÃo e capacitaÃÃo para a melhoria da qualidade tÃcnica da assistÃncia prestada por estes profissionais.

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