Making peace in gestational conflicts

Mary Anne Warren's claim that there is room for only one person with full and equal rights inside a single human skin ([1], p. 63) calls attention to the vast range of moral conflict engendered by assigning full basic moral rights to fetuses. Thereby, it serves as a goad to thinking about conflicts between pregnant women and their fetuses in a way that emphasizes relationships rather than rights. I sketch out what a care orientation might suggest about resolving gestational conflicts. I also argue that the care orientation, with its commitment to the significance of the partial and the particular, cannot be absorbed within standard, impartialist moral theory.     

Envisioning motherhood: Mental-state language in caregiving narratives across the perinatal period

Nancy Suchman's work highlighted the fundamental role of maternal mentalization in maternal addiction, mental health, and caregiving challenges. In this study, we aimed to examine the role of mental-state language (MSL) as a measure of mentalization in prenatal and postnatal narratives and their sentiment in a sample of 91 primarily White mothers from the western United States, followed from the second trimester of pregnancy, through the third trimester, to 4 months postpartum. Specifically, we investigated the use of affective and cognitive MSL in prenatal narratives when mothers visualized caring for their baby and postnatal narratives when mothers compared their prenatal visualization to the current caregiving reality. Results indicated moderate consistency in MSL between the second and third trimesters, but prenatal and postnatal MSL was not significantly correlated. Across all time points, higher use of MSL was related to more positive sentiment, indicating an association between mentalization and positive caregiving representations across the perinatal period. Women used more affective than cognitive MSL in prenatal imagination of caregiving, but this pattern was reversed in their postpartum reflection. Implications on assessing parental mentalization prenatally and considering the relative dominance of affective and cognitive mentalizing are discussed while considering study limitations.     

Coping, competence, and aggression prevention: Part 2. Universal school-based prevention

Coping—competence theory yields a structural model of the development of persistent aggression in which current challenge encounters determine future life outcomes and competence. Driven by this model, universal, school-based prevention programs would aim in multiple ways to promote prosocial coping among high-risk, resilient, and advantaged youth from kindergarten through high school. Expected benefits of prosocial coping would include: less aggressive behavior, fewer adverse life outcomes (e.g., school dropout, police arrest, teen pregnancy, conduct, mood, and substance-use disorders), and a more competent self-definition and social reputation. Five stages are described that may prove useful in creating prosocial schools and neighborhoods supportive of youth in transition away from antisocial coping and deviant peers.     

Genetic counseling for pregnant adolescents

The genetic counseling literature has a paucity of information on how to provide genetic counseling services to adolescents, especially those who are pregnant. The adolescent population should be viewed as a separate culture, complete with their own beliefs and viewpoints, which are dependent upon the developmental growth tasks of puberty. The completion of these tasks is complicated by pregnancy, which has its own set of developmental goals. The adolescent struggle with developmental goals interferes with the ability to identify consequences, predict future outcomes, and communicate self-revealing statements or decisions effectively. Instead, the adolescent has an egocentric frame of reference and seeks peer approval. The genetic counseling dilemmas presented by pregnant adolescents are illustrated through two case reports. A model based on our own experience and a literature review for successful counseling of adolescents is presented, and utilizes the foundation of trust, patience, and nonjudgmental behavior. Techniques that address the adolescent's concern for autonomy and peer approval are important, and can be achieved through nonthreatening, open-ended questions that promote self-expression. Incorporation of these techniques in genetic counseling and in graduate training will enhance genetic counseling services to the adolescent population.     

Plenary address – A year of living ‘dangerously’: Reflections on risk,trust, trauma and change

This paper examines the role of emotions in the construction and performance of mis/trustful relations; with medical professionals, their technologies, and ultimately, with oneself. Using personal experience of two common conditions as illustrative examples, it questions what it means and feels like to trust, and how, where and by whom such feelings can be enhanced or undermined. It explores some of the ways in which discourses of risk are mobilized and embodied to create a crisis of trust, asking; what kind of selves and emotionalities surface, and what are the health outcomes, when bodies are viewed as ‘at risk’? Visualizing technologies that probe the interior for data play an increasingly prominent role in healthcare, and are typically considered more trustworthy sources of knowledge about the body than anything that might be produced by the tech-free sensing self. However, not all (even ‘physical’) trauma can be seen or quantified, and not all information is equal. The paper reflects on the emotional dissonance that ensues when one's own perceptions and representations are at odds with those of medical experts for whom one is supposed to perform trust. It examines the feeling rules that are broken when we fail to appreciate our treatment at their hands, and asks: What happens when we resist expert author-ity by telling different stories about our embodied selves, ones that make space for emotions in contexts where they are rarely seen to count, and where only what can be measured matters?     

Comparison of Maternal Perceptions of Preterm and Fullterm Infants

We compared maternal attitudes and feelings in two groups of mother–infant dyads: 25 mothers with preterm newborns (M=30.9 weeks of gestational age) and 25 mothers with fullterm newborns (M=39.7 weeks of gestational age). Both groups were matched for infant sex, age (corrected in preterms) and birth order as well as for maternal age and education. Semi-structured interviews were used to collect data on maternal attitudes and feelings about pregnancy and the first contacts with the newborn. Mothers completed rating scales to indicate the specific behavioural problems they perceived in their infants at 6 weeks and 3 months of (corrected) age. Observations of infant responses to visual and/or auditory stimuli were made at 6 weeks and 3 months in a laboratory setting. At 3 months, each infant was administered the Bayley Scale of Mental Development. There were no differences in maternal attitudes and feelings between the two groups of mothers prior to the birth. However, significant differences appeared after birth and indicated increased anxiety in mothers of preterm infants. Significantly more 6-week-old preterm infants were perceived by their mothers as irritable and to cry more than fullterm infants. At the age of 3 months, both groups of infants differed only in terms of irritability. Differences between the two groups of mother–infant dyads, age-related changes in these differences and relationships between maternal evaluations and the laboratory-based assessments are discussed in the context of contrasts in the stability of behavioural regulation in preterm and fullterm infants.     

Intruders of differing reproductive status alter aggression differentially in early and late pregnant mice

Independent groups of early and late pregnant mice, housed individually, were observed with an intruder in their home cage. The intruders were either males, virgin, early, or late pregnant females. Male intruders were sniffed less, but more frequently and more severely attacked, than any type of female intruder, both by early and by late pregnant residents. While early pregnant females behaved similarly with the three types of female intruders, late pregnant animals treated them differently: they showed practically no aggression to late pregnant intruders, more to early pregnant ones and were most aggressive towards virgin female intruders. The possible relation of these findings to reproductive behaviour is discussed.     

妊娠晚期亚临床甲状腺功能减退症对母婴合并症的影响

本研究旨在观察妊娠晚期亚临床甲状腺功能减退症对母婴合并症的影响。最终选择2010年1月～2010年11月期间共325例妊娠晚期孕妇分为病例组（A组,n＝65）和正常对照组（B组,n＝260）,观察两组之间母婴合并症的变化。结果显示,两组之间在年龄、住院日、血压、体质量指数（BM I）、心率、分娩时孕周、血糖以及血脂方面差异均无统计学意义（P＞0．05）。但与B组相比较,A组发生母亲合并症及胎儿合并症的发生率明显增加,差异有统计学意义（P＜0．05）。此研究提示妊娠晚期亚临床甲状腺功能减退症增加母婴合并症的风险。     

孕期生活事件与妊娠压力：心理健康的中介效应和丈夫支持的调节作用

用问卷调查法对上海市403名单胎、孕周在24～33周的孕妇进行研究,探讨怀孕过程中孕妇经历的生活事件和妊娠压力的关系,以及孕妇的心理健康状况和丈夫支持在其中所起的作用。结果表明：（1）怀孕计划的主效应显著,孕龄的主效应不显著,怀孕计划和孕龄的交互作用显著;妊娠压力在怀孕计划上的主效应显著,意外怀孕的孕妇的妊娠压力显著高于计划怀孕的孕妇的妊娠压力;（2）怀孕过程中孕妇经历的生活事件与妊娠压力呈显著正相关,与孕妇的心理健康呈显著负相关;（3）孕妇的心理健康状况在生活事件和妊娠压力的关系中起部分中介效应,即生活事件部分通过孕妇的心理健康状况影响孕妇的妊娠压力;而丈夫支持则对孕妇心理健康的中介效应起调节作用,当丈夫支持高时,心理健康状况越好的孕妇,其妊娠压力越低,心理健康状况对孕妇妊娠压力预测显著;当丈夫支持低时,心理健康状况对妊娠压力的预测不显著。     

Does Smoking by Pregnant Women Influence IQ, Birth Weight, and Developmental Disabilities in Their Infants? A Methodological Review and Multivariate Analysis

Neuropsychologists are asked frequently to address the issue of the cause of a variety of central nervous system problems that may affect higher cortical function. One such issue is the relationship of maternal smoking to adverse reproductive outcomes involving neocortical insult including mental retardation, learning disabilities, attention-deficit hyperactivity disorder, and other insults that may be related to prolonged hypoxic states in utero. The instant paper develops the issue of causation as a scientific inquiry, reviews several traditional, applicable models, and critiques these models. An additional model of motility is proposed and discussed. The issue of the relationship of maternal smoking to adverse reproductive outcomes is then addressed from a review perspective along with new empirical analyses, the latter demonstrating that researchers tend to draw causal conclusions independent of whether the respective design of their studies would support conclusions about the causation of an event. Causal conclusions in the absence of causal designs have often lead to incomplete and incorrect conclusions. It is necessary to match conclusions not only to the outcomes of a research project but also to its design and accompanying limitations.