Building Capacity of State Adolescent Pregnancy Prevention Coalitions to Implement Science-Based Approaches

A central question in adolescent reproductive health circles is how to effectively disseminate research to practitioners in a way that supports them in using the most scientifically sound and effective programming. In 2002, the Division of Reproductive Health at the Centers for Disease Control and Prevention (CDC) tackled this question by funding three national-level and five state-level organizations focused on adolescent pregnancy prevention to promote the use of science-based programs and approaches. Healthy Teen Network (HTN) and Education, Training and Research Associates (ETR), two national organizations, have partnered under this CDC funding to implement an effective model for capacity building. This paper provides an overview of the approaches used by HTN and ETR in capacity building using a seven-step process. We describe how we modified the Interactive Systems Framework for Dissemination and Implementation (ISF) for science-based innovations to apply to capacity-building for adolescent reproductive health (ARH) programs, and how we developed relevant, sustainable training and technical support. We conclude by reviewing some of the results of this training, and discuss the future work that will likely continue to advance the science behind effective dissemination of ARH research to practice.     

代孕技术的伦理与法律思考

简要介绍了代孕的概念,指出了在我国有条件开放代孕的合理性。从家庭关系、子宫工具化和婴儿商业化三个方面给出了代孕合理性的伦理依据。从合同法、身体权、生育权三个方面给出了法律的解读。从伦理与法律两方面对我国有条件的开放代孕加以论述,并提出相应对策及理论支持。     

‘You've got to grow up when you've got a kid’: Marginalized young women's accounts of motherhood

Teenage motherhood has been a source of considerable debate in policy and media circles in recent years. This paper explores the meanings of teenage motherhood for young women who were mothers before the age of 21, who were living in economically deprived areas of England and most of whom had been in residential or foster care. Qualitative interviews were carried out at several sites across England, with a total of 33 young women taking part in group interviews and one‐to‐one interviews. The accounts of the young women suggest that they talk about motherhood in three main ways: as ‘hardship and reward’, ‘growing up and responsibility’ and ‘doing things differently’. It is argued that these ways of talking about motherhood present a different picture of teenage motherhood from that of dominant discourses. Furthermore, the young women are active in negotiating and constructing their own identities as mothers, carers and women. Copyright © 2008 John Wiley & Sons, Ltd.     

Surrogacy and the Construction of the Maternal-Foetal Relationship: The Feminist Dilemma Examined

The feminist movement remains fundamentally divided over the issue of surrogacy. Within the confines of this article it is argued that the inadequacy of positions on both sides of the debate rests upon their common tendency to deal with the ethical consequences of surrogacy for isolated agents, without sufficient concern for the broader social implications for all pregnant women in society. In order to clarify the issues involved, feminist theorists must consider the implications of surrogacy in a broader social spectrum. Such an analysis will illustrate that the two-person dichotomous model of the maternal-foetal relationship proposed by the surrogacy arrangement has hugely prejudicial effects on the treatment received by non-contract mothers when they interact with agents of certain social institutions whose prior contact with surrogate mothers has made them more susceptible to conceiving the maternal-foetal relationship as fundamentally disconnected. In a climate of increased medical surveillance and intervention in the non-clinical context of pregnancy, the dangers of adopting this dichotomous model are palpable. Given the oppressive physical and psychological effect that this would have upon the liberty of the majority of pregnant women in society, this article argues that the feminist movement must abandon any promotion of the abstracted model of the mother-foetus relationship that is implicit in its arguments in favour of surrogacy.     

Psychological characteristics of infertile couples: can they predict pregnancy and treatment persistence?

The paper describes an exploratory study of the relative importance of different psychological variables for the prediction of (a) pregnancies and (b) treatment continuation in a sample of 140 couples seeking specialized infertility treatment one year after their first contact with an infertility clinic. The couples filled out questionnaires dealing with psychological and interpersonal functioning, marital and life satisfaction, child-related attitudes, causal attribution of infertility and general expectations towards the treatment. It could be shown that the psychological variables explain a relatively small amount of the variance of the pregnancy criterion. Nevertheless, there were some indications supporting the hypothesis that psychological complaints can be seen as a ‘risk factor’ associated with a lower pregnancy rate. Couples who had terminated treatment after one year indicated a higher amount of psychological and interpersonal complaints (females) as well as partner problems (males and females), and a dominance of internal attributions of the fertility problem. This result—which might help to develop strategies for counselling couples making use of the new reproductive technologies—highlights the importance of attribution and cognitive appraisal in coping with infertility. © 1998 John Wiley & Sons, Ltd.     

Cultural Dimensions of Early Pregnancy Loss: Spiritual and Religious Issues

Nearly one in five clinically confirmed pregnancies ends in a loss before 20 weeks (Bardos et al., 2015). Despite the prevalence of miscarriage, many women and partners experience a lack of acknowledgment and support while also encountering complicated concerns related to the intersection of perinatal loss, culture, religious and spiritual issues, medical treatment, their reproductive stories, and grief (Randolph et al., 2015). Counselors working with these clients must address complex cultural considerations. As such, we review key cultural and religious/spiritual issues related to early pregnancy loss and offer recommendations for practice based on the current literature in the context of the Association for Spiritual, Ethical, and Religious Values in Counseling (2009) counseling competencies.     

Randomised controlled pilot trial of mindfulness training for stress reduction during pregnancy

This randomised controlled pilot trial tested a six-week mindfulness-based intervention in a sample of pregnant women experiencing high levels of perceived stress and pregnancy anxiety. Forty-seven women enrolled between 10 and 25 weeks gestation were randomly assigned to either a series of weekly Mindful Awareness Practices classes (n = 24) with home practice or to a reading control condition (n = 23). Hierarchical linear models of between-group differences in change over time demonstrated that participants in the mindfulness intervention experienced larger decreases from pre-to post-intervention in pregnancy-specific anxiety and pregnancy-related anxiety (PRA) than participants in the reading control condition. However, these effects were not sustained through follow-up at six weeks post-intervention. Participants in both groups experienced increased mindfulness, as well as decreased perceived stress and state anxiety over the course of the intervention and follow-up periods. This study is one of the first randomised controlled pilot trials of a mindfulness meditation intervention during pregnancy and provides some evidence that mindfulness training during pregnancy may effectively reduce PRA and worry. We discuss some of the dilemmas in pursuing this translational strategy and offer suggestions for researchers interested in conducting mind-body interventions during pregnancy.     

Causal explanations for lack of pregnancy applying the common sense model of illness representation to the fertility context

Abstract

Objectives: The current study explored causal explanations for lack of pregnancy and association with help-seeking behaviour. Differences based on gender and country Human Development Index were examined.

Design: A mixed method design was used.

Main outcome measures: Data were drawn from the International Fertility Decision-Making Study, a cross-sectional study of 10,045 individuals (1690 men; 8355 women) from 79 countries. Respondents rated to what extent they believed their lack of pregnancy was due to something they or their partner had done/not done or other factors and described their reasons for making this rating.

Results: Respondents were aged 18–50 (M?=?31.83) years, partnered and had been trying to achieve a pregnancy/father a child for over six months (M?=?2.8 years). Men and women primarily believed their lack of pregnancy was due to medical problems or chance/bad luck. Thematic analysis of textual responses from 29.7% of the sample found that respondents focused on their personal experience or a salient life event when describing the cause of their lack of pregnancy. Women expressed more regret and helplessness about causes than men. Significant country differences were observed.

Conclusions: Individuals may develop inaccurate causal explanations based on their personal experiences. Access to accurate information is necessary to facilitate timely help-seeking.     

Career Intervention Considerations for Unwed Young Black Mothers in the United States

Teen pregnancy among unwed young Black mothers is still an issue of concern in the United States. Black teen mothers face educational, economic, and career/vocational challenges. This article discusses integrating Gottfredson's (1981) career theory and the Outline for Cultural Formulation ( American Psychiatric Association, 1994 ) in career development counseling with young Black mothers.