The effects of childbirth-related post-traumatic stress disorder on women and their relationships: a qualitative study

There is converging evidence that 1%-2% of women develop post-traumatic stress disorder (PTSD) as a result of childbirth. The current study aimed to explore the long-term effects of childbirth-related PTSD on women, their relationship with their partner and their relationship with their child. Semi-structured interviews were carried out with six women who reported clinically significant PTSD after birth, ranging from 7 months to 18 years beforehand. Interviews were transcribed and analysed using thematic analysis. Childbirth-related PTSD was found to have wide-ranging effects on women and their relationships. Women reported changes in physical well-being, mood and behaviour, social interaction, and fear of childbirth. Women reported negative effects on their relationship with their partner, including sexual dysfunction, disagreements and blame for events of birth. The mother-baby bond was also seriously affected. Nearly all women reported initial feelings of rejection towards the baby but this changed over time. Long-term, women seemed to have either avoidant or anxious attachments with their child. It is concluded that childbirth-related PTSD can have severe and lasting effects on women and their relationships with their partner and children. Further research is needed to compare this to normal difficulties experienced by women after having children.     

Factors Affecting HIV Contraceptive Decision-Making Among Women

We examined contraceptive decision-making among African American, Latina, and European American women ages 18–50 years. Logistic regressions examined relationships between demographic and religious factors, unintended pregnancies, sexually transmitted diseases (STDs), reasons for sex, and contraceptive decision-making. Women who were older, single, African American, used pregnancy prevention, and had histories of STDs and unintended pregnancies made contraceptive decisions alone. Older and African American women were more likely to choose no contraception. Among contraceptive users, African Americans used effective methods of pregnancy, but not disease, prevention. Women with STD histories, and younger, more educated women were more likely to use methods that prevent against both pregnancy and disease. Theoretical implications about contraceptive choices among ethnically diverse women are discussed.     

Returning to Work Following Childbirth: The Relationship Between Intentions and Behavior

College women's intentions to return to work following childbirth were compared to behavior 10 years later. Using an Ajzen-Fishbein model, college intentions were significantly related to how soon a mother returned to work after the birth of her first child. The amount of variance explained was significant for intentions and behavior. College intentions were influenced by perceived consequences, approval of significant referents, and personal control. Return to work was predicted by intention to do so, even though the behavior occurred an average of seven years after the intention was declared. This behavior was more likely to occur among those who had a sense of personal control.     

Sex education attitudes and outcomes among North American women

Attitudes and outcomes of sex education received by North American women are examined via an Internet survey (N = 1,400). Mean age was 19.5, with 24% reporting one or more unplanned pregnancies. Women were more satisfied with sex education from informal sources than from parents, schools, and physicians. Those receiving sex education from parents or schools reported fewer pregnancies and abortions. In school, women receiving a combination of contraceptive and abstinence education and those receiving primarily abstinence education were least likely to experience unplanned pregnancy. Religious identification was significantly related to unplanned pregnancy and type of sex education received from parents. These factors seem to play a significant role in reducing unplanned pregnancy and abortion.     

Obstetric Autonomy and Informed Consent

I argue that public officials and health workers ought to respect and protect women’s rights to make risky choices during childbirth. Women’s rights to make treatment decisions ought to be respected even if their decisions expose their unborn children to unnecessary risks, and even if it is wrong to put unborn children at risk. I first defend a presumption of medical autonomy in the context of childbirth. I then draw on women’s birth stories to show that women’s medical autonomy is often ignored during labor. Medical interventions are performed during childbirth without women’s consent. Childbirth is risky and some coercive medical interventions may be understood as attempts to protect children and to prevent mothers from acting impermissibly. However, even if it is wrong to make risky choices during childbirth, women have rights to do wrong in these cases. Therefore, coercive medical interventions are impermissible during childbirth and institutions should adopt specific protections for obstetric autonomy.     

Work, Family, and Religious Involvement for Men and Women

Do family formation and social establishment affect religious involvement in the same way for men and women, given increasing individualism and rapid changes in work and family roles? Using a random sample of adults from upstate New York (N = 1,006), our research builds on previous work in this area by using multiple measures of religious involvement, using multiple measures of individualism and beliefs about work and family roles, placing men and women in their work context, and looking at the relationships separately by gender. Men’s religious involvement is associated with marriage, children, and full‐time employment, signaling social establishment and maturity. Women’s involvement is higher when there are school‐aged children in the home, but it is also more intertwined with the salience of religion and with an assessment that religious institutions are a good fit with their values and lifestyles, including egalitarian views of gender. For men and women, views of religious authority and the role of religious institutions in the socialization of children are associated differently with religious involvement at different life stages. We call for further research to understand the gendered nature of religious involvement and the role of beliefs about work, family, and religion in explaining why individuals choose to be involved in religious institutions.     

Work Family Conflict Among Parents of Atypically Developing Children: Exploring the Impact of Worker,Work, and Child Factors

The purpose of this research was to examine the impact of worker characteristics (e.g., time spent caring for others), workplace support, and child characteristics on work family conflict among parents of atypically developing children. Participants (N = 51) were employed parents of atypically developing children who completed measures of work family conflict, workplace supports (i.e., supervisory support and organizationally supportive cultures), the availability and use of family supportive workplace programs, child characteristics, and worker characteristics. Hierarchical multiple regression analyses indicated that worker and child characteristics significantly predicted work family conflict, work in family interference, and family in work interference. In addition, workplace supports significantly predicted work family conflict and family in work interference. Implications of the results for managing the work family life interface are discussed.     

Occupational Turnover Intent Among Assistant Coaches of Women's Teams: The Role of Organizational Work Experiences

The purpose of this study was to examine the extent to which organizational work experiences could be used to understand when coaches planned to leave the profession. NCAA Division I assistant coaches (N = 188) were surveyed concerning (a) the age at which they anticipated leaving the coaching profession and (b) the extent to which the 3 work experiences described by S. Inglis, K. E. Danylchuk, and D. Pastore (1996)—Recognition and Collegial Support, Work Balance and Conditions, and Inclusivity—were fulfilled. Chi-square analyses revealed that women intended to leave the profession at an earlier age than did men. A multivariate analysis of covariance indicated that persons who intended to remain in the coaching profession after they turned 55 worked in organizational environments that emphasized Inclusivity. These results are particularly important for female coaches, as women consider an inclusive work environment to be more important than do men (D. L. Pastore, S. Inglish, & K. E. Danylchuck, 1996).     

Perceived social support, self-efficacy, and adjustment to abortion

Prior to their having a 1st trimester abortion, women's perceptions of social support from their partner, family, and friends and self-efficacy for coping were assessed. Depression, mood, physical complaints, and anticipation of negative consequences were measured after the 30-min recovery period. As predicted, perceived social support enhanced adjustment indirectly through its effects on self-efficacy. Women who perceived high support from their family, friends, and partners had higher self-efficacy for coping. Higher self-efficacy, in turn, predicted better adjustment on the psychological measures but not on the physical complaint measure. No direct path between social support and adjustment was observed. In addition, women who told close others of their abortion but perceived them as less than completely supportive had poorer postabortion psychological adjustment than either women who did not tell or women who told and perceived complete support.     

Pre- and Postpartum Fear of Childbirth in Nulliparous and Parous Women

The link between fear of childbirth and theories of anxiety in general is discussed. A possible expression of trait (T-fear) and state (S-fear) aspects of fear of childbirth was investigated in 77 nulliparous and 85 parous women based on data from gestational week 32, at 2 hours and at 5 weeks after childbirth. Data are based on the State Trait Anxiety Inventory and the Wijma Delivery Expectancy/Experience Questionnaire. According to their scores on the Wijma Delivery Expectancy/Experience Questionnaire during late pregnancy, women were divided into 3 groups: high, moderate and low levels of fear of childbirth. In gestational week 32, women in the low level of fear of childbirth group had lower trait anxiety than those in the moderate level of fear of childbirth group, who had lower trait anxiety than the women in the high level of fear of childbirth group. Nulliparous women had a higher level of fear of childbirth but a lower level of trait anxiety than did parous women. There was a significant decreasing trend in fear of childbirth from 2 hours to 5 weeks after delivery, in a parallel way for all 3 groups. Differences in fear of childbirth between nulliparous and parous women disappeared after delivery. These findings suggest that fear of childbirth comprises a considerable part of T-fear, with the risk of a vicious cycle, i.e. that during labour women experience what they are afraid of, which also influences the women's postpartum cognitive appraisal of the delivery.     

Childbearing depressive symptomatology in high–risk pregnancies: The roles of working models and social support

Guided by both attachment and social support theories, the authors conducted a longitudinal investigation exploring the concomitant effects of perceptions of spouse support (anticipated and received spouse support) and internal working models of attachment (positive–self and positive–other), on childbearing depressive symptomatology. Distinct main and interaction effects for attachment dimensions and perceived support variables were hypothesized for high– and low–risk pregnancies. Participants in the final sample were 200 pregnant women who completed the self–report between the 25th and the 29th weeks of pregnancy, and 8 weeks after childbirth. Controlling for initial levels of depressive symptoms and health conditions, results demonstrated the protective role of high levels of received support and of positive–other models on childbirth depressive symptoms. Moreover, received support and models of positive–other were found to interact with health conditions, producing distinct moderation effects: Received support was found to be a significantly stronger protective factor for childbearing depression among women with low–risk pregnancies; positive–other models were found to be a significantly stronger protective factor among women with high–risk pregnancies. The implications of these findings for the understanding of intrapersonal and interpersonal factors in successful coping with a health risk situation are discussed.     

Career or marriage?: Aspirations and achievements of able young women

Women who won National Merit Scholarships during the years 1956–1960 were followed up in 1965 to determine their marriage and/or career plans. Each of the 883 women was classified into one of five groups: marriage only, marriage with deferred career, marriage with immediate career, career only, or uncertain. Altogether, 85% of them said that they definitely planned on having a career. The educational and career field aspirations of these groups differed considerably, however, and those seeking an immediate career scored higher on scholastic ability tests than those who either planned no career or who planned to delay entering them. The groups also differed in their expression of problems encountered in making and implementing their plans as well as problems experienced because of being a woman.     

Work, Leisure, and Support Groups: An Examination of the Ways Women with Infertility Respond to Pronatalist Ideology

Pronatalism embodies the belief that a woman's social value is linked to her production of biological children (C. Morell, 2000). Conceiving and bearing children is literally impossible, however, for some of the 5 million women in the United States who struggle with infertility. Women negotiate their experiences with infertility within a pronatalist society, yet their experiences therein have been given little attention. Thus, the purpose of this research was to explore women's lived experiences with infertility in a pronatalist ideology. Active interviews with 32 participants who had experienced infertility revealed that the women were aware of a pronatalist ideology, which was manifested through insensitive comments or questions and unsolicited advice. The women responded by immersing themselves in their work, leisure activities/experiences, or support groups. The findings illustrate how pronatalist ideology is manifest in social interactions, but they also suggest how it may be resisted.     

Work Attitudes and Values of College Women

Despite woman's fast emergence into the working world, few studies have focused on individual changing attitudes and values that become initially responsible for setting future employment trends in our society. Following a historical perspective, a survey is presented that samples the inner feelings of young college women and their personal stand on the world of work. The results indicate a general rejection of much of the traditional work ethic. Although the attitudes expressed in this survey are simply contemporary, their hidden strength hints to the shape of a future American society that will potentially change the life-style of every individual.     

Sex differences in same- and cross-sex supportive relationships

The current study focused on sex differences in same- and cross-sex supportive relationships. Subjects, 249 female and 103 male volunteers, completed a questionnaire designed to assess the nature and quality of supportive relationships. Four dimensions of relationships were examined: the relative frequency and patterning of interactions, closeness, diversity of interactions, and interpersonal perception. A 2×2 multivariate analysis of variance (MANOVA) was conducted with sex of subject as a randomized factor and sex of supporter as a repeated factor. Sixteen dependent variables measured the relationship dimensions. Results of the MANOVA suggested that there are differences between women and men in the qualities of their same- and cross-sex supportive relationships. In same-sex relationships, women have more contact when under stress; are closer; more satisfied with initiation, balance, and closeness; and perceive themselves as knowing the other and being known by the other more than do men. Women initiate more in cross-sex relationships, and want to give more than men do. Men describe cross-sex relationships as closer than women do. Both women and men want more frequent contact, closer relationships, and want to give more in cross-sex relationships than in same-sex ones. These and further results, and implications of the findings are discussed.Portions of this paper were presented at the annual meeting of the American Psychological Association, Washington, D.C., August 1986.     

Unplanned pregnancy and risk of maternal depression: secondary data analysis from a prospective pregnancy cohort

Purpose: to evaluate the relationship between unplanned pregnancy (UP), a common problem in high and low income countries and maternal depression (MD). Methods: Secondary analysis of data from a prospective cohort study with pregnant women recruited from 10 primary care clinics of the public sector in São Paulo, Brazil. Participants were questioned about pregnancy intention at 20–30 weeks of gestation. The Self Report Questionnaire score >7 was used to evaluated the presence of depression during pregnancy and 11 months after childbirth. Four groups of MD were defined: never; antenatal only; postnatal only; persistent (both antenatal/postnatal). Multinomial logistic regression was used to assess the relationship between UP and MD, controlling for confounding. Results: Data were analysed for 701 at the postpartum period. Five hundred and sixty-two (67.8%) women did not plan the pregnancy. Women with UP had 2.5 more risk of being depressed during both assessments (during pregnancy and postpartum) when compared to women with a planned pregnancy (RR: 2.5; 95% CI: 1.47:4.30). In the adjusted models, women with UP were significantly more likely to have persistent depression (RR: 2.3; 95% CI: 1.2:4.3). Conclusion: UP is an independent risk factor for persistent depression, but not for postpartum depression     

Work,marriage, and health behaviors of African American working couples

Using a sample of 379 African American working husbands and wives, this study examined a unique link between work and marital experiences on health‐promoting behaviors. Results of the dyadic model show that husbands' and wives' control over work are directly associated with husbands' and wives' health‐promoting behaviors, respectively, after taking into account the dependencies between husbands and wives. The results of the dyadic model also show that husbands' and wives' control over work are indirectly associated with husbands' and wives' health behaviors through their perceived marital integrations. By understanding how work control and marital integration combine to influence both husbands' and wives' health behaviors, programs that promote healthy behaviors can be better designed and more effectively implemented.     

The Relationship between Characteristics of the Victim,Persuasive Techniques of the Batterer,and Returning to a Battering Relationship

Abstract

In two studies, we examined factors involved in the returning of American women to a battering relationship. In Study 1, several self-reported characteristics of 117 women in a shelter for battered women were found to predict intentions to return to the batterer or number of subsequent admissions to the shelter. In Study 2, 24 battered women identified on questionnaires several techniques commonly used by their batterers to persuade them to stay with or return to them.     

MEASURING PERCEPTIONS OF THE WORKING ENVIRONMENT FOR WOMEN IN CORPORATE SETTINGS

This study developed a scale to measure individual perceptions of dimensions of the work organization that contribute to a supportive or hostile environment for women. Based on analysis of survey data from 398 respondents working in corporate settings, a scale was developed to measure five dimensions: Dual Standards & Opportunities; Sexist Attitudes & Comments; Informal Socializing; Balancing Work & Personal Obligations; and Remediation Policies & Practices. Women perceived their work environments as significantly more hostile on all five dimensions than did men. Scores on the scale were related to intent to stay with the organization: For both men and women, the friendlier they perceived the work environment for women to be, the longer individuals intended to stay at the company.