Among young adults at risk for unintended pregnancies, preconception health and prenatal care programs aimed at positive birth outcomes remain unaddressed. The purpose of this phenomenological study was to explore the lived experiences of young adults in terms of their willingness to use preconception health and prenatal care as a means for increasing both positive birth outcomes and overall health. All study participants met the following criteria: (a) young adult man or woman, (b) age 18 to 25, (c) at risk for unintended pregnancies, (d) sexually active, (e) single or in cohabiting partnerships, and (f) living in the greater Los Angeles, Calif., area. The researcher conducted individual, semi structured interviews with study participants, and analyzed the resulting transcripts using a modified van Kaam analysis. Data analysis yielded 3 major themes to address the study's 3 research questions. First, participants believed that parenthood is largely learned through witnessing the practices of their parents, family members, and friends. Second, participants believed in the necessity of healthy lifestyle choices for healthy preconception and optimal prenatal care. Third, the key obstacle to perinatal care was the lack of awareness of pregnancy and available health care resources. These findings may provide a guideline for improving preconception health and prenatal care programs for young adults who are at risk of unintended pregnancies.

Low-income women in an Oregon city of approximately 35,000 inhabitants have limited access to prenatal care services during their pregnancies. The purpose of this study was to uncover the impacts of several factors on the experiences of twenty-seven health department clients with public health department prenatal care practitioners and with local private obstetricians. Ethnographic interviews were conducted with the clients, two health department practitioners, two local obstetricians, and one local direct-entry midwife. The focal finding that emerged from the research was that the clients preferred the care of the health department practitioners to that of obstetricians, even though the health department providers could not deliver the women's babies. The major impacts on the clients' experiences included fragmented service delivery and availability, economic and social restrictions on prenatal care options, biomedical constructs of a healthy pregnancy, and provider role constructions and attitudes towards Medicaid recipients and uninsured pregnant women. Local physicians' mechanistic philosophy, professional dominance and profit orientation afforded them a narrow understanding of the needs and identities of low-income women. Local public health workers are less professionally autonomous than medical doctors but their service orientation allowed them the potential to better serve low-income clients. Based on the twenty-seven clients' perceptions of their care providers and the services available to them, recommendations are made for more empowering, comprehensive prenatal care services in this county. Recommended changes to the public health system entail expanded funding for more appropriate programs and to establish continuity of care for health department clients from pregnancy through the postpartum period. The incorporation of direct-entry midwives into the prenatal and birthing care options open to low-income women is also recommended. Senate Bill 1063, which creates a process for direct-entry midwives to become state-licensed in order to be reimbursed by the Office of Medical Assistance Programs for perinatal services, is considered in terms of its implications for low-income women, the Oregon community of direct-entry midwives, and the texture of Oregon reproductive health care. / Graduation date: 1994

Thesis--American University. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

The aim of this phenomenological study was to explore women’s experiences of an Elective Caesarean Section (ECS) following a previous Traumatic Birth (TB). Thirteen women who had undergone an ECS following a TB were either interviewed or provided written accounts of their experiences. Data from these sources were analysed using Interpretative Phenomenological Analysis (IPA) (Smith, Flowers and Larkin, 2009). Five main themes were identified: ‘cautiously moving forward into the unknown: the drive to reproduce’, ‘attempting to make the unknown known’, ‘the longed for, positive birthing experience’ , ‘a different post-natal experience’ and ‘the interaction of the two experiences’. These findings were considered in relation to previous research; relevant theoretical perspectives were considered including those attached to Post-Traumatic Stress Disorder (PTSD). Post-traumatic stress reactions may increase during subsequent pregnancy impeding on women’s ability to consider facing another ‘unknown’ natural birth and domineering their decision to elect for a CS. An ECS following a TB may provide women with the controlled experience and high levels of care they long for. Such experiences could be redemptive and have positive outcomes for women’s relationships and wellbeing. These results highlight the importance of providing women in this position with information and choice regarding a subsequent birth. They also stress that prevention of women carrying Post Traumatic Stress (PTS) reactions into their subsequent pregnancies is imperative. Future research would benefit from focussing on the development and trialling of effective screening tools for PTS reactions following birth.

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The present study investigated the use of the Maternal Perinatal Scale (MPS) as an instrument for predicting group membership among normal versus emotionally handicapped children. An examination of neurological symptoms as they relate to specific behavioral factors within the Child Behavior Checklist (CBCL) was conducted, as well as an investigation of the relationship between factors within the MPS as predictors of specific behaviors within the CBCL. Subjects included 119 EH students and 211 normal subjects with a mean age of 10 years, 3 months. Samples were collected from a suburban midwestern area of approximately 800,000 population.Results of discriminant analyses indicated that the MPS items were able to predict group membership with 85.5% accuracy when the mother's history was included and 88.2% when the Childhood Checklist was added as additional data. Out of 66 possible factors, 22 yielded correlations which were significant at the .01 level.A significant relationship between the total number of neurological symptoms observed in a child and the degree of behavioral deviance as reported with the CBCL was an outstanding feature of this study. Nine of ten factors on the CBCL were correlated with the total NSI score at the .01 level of significance, with Attention Problems demonstrating the greatest degree of relationship. Canonical analysis of the MPS factors as predictors of specific CBCL subscales yielded vague results. Although several correlations were significant, the pattern of variance provided a minimal degree of interpretive utility.Future research stemming from these results would include further examination of the nature of relationships between perinatal factors and mother's history, as well as the incorporation of strategies to provide early intervention to infants and children at risk for future placement in the EH category. The MPS appears to offer promise as a tool for bringing consistency and replicability into the area of perinatal research, as well as serving to assist in the early identification of at-risk children. The prospect of predicting specific behavioral factors from perinatal variables continues to be a viable direction for future study. / Department of Educational Psychology

Diss. (sammanfattning) Stockholm : Karolinska instttutet, 2005. / Härtill 4 uppsatser.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2005. / Härtill 5 uppsatser.

Thesis (M.A. (Population and Reproductive Health Research))--Mahidol University, 2006. / LICL has E-Thesis 0016 ; please contact computer services.

Thesis--American University. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.