She Said, She Said: Interruptive Narratives of Pregnancy and Childbirth

In diesem Beitrag zeigen wir die Nutzung von Narrationsanalysen für teilstrukturierte Interviews, die wir mit insgesamt sechs Frauen geführt haben, die in Großstädten im Süden der USA leben und sich für eine "natürliche" Geburt ihres ersten Kindes entschieden hatten. Mittels der Creative Analytic Practice präsentieren wir die Erfahrungen der Frauen in Gedichtform, um die Spannung nachvollziehbar zu machen zwischen den Wünschen der Frauen einerseits und ihren tatsächlichen Schwangerschafts- und Geburtserfahrungen andererseits. Das Gedicht verdeutlicht Behördenpolitiken, Wege, wie Konsens in einigen amerikanischen Gesundheitsinstitutionen umgelenkt oder konstruiert wird und auch die Resilienz der befragten Frauen.URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs170290In this article, we explore narrative inquiry data we collected with women who attempted to have a natural, drug-free childbirth for the birth of their first child. The data presented come from semi-structured life story interviews with six women who live in a metropolitan city in the mid-southern United States. Using creative analytic practice (CAP), the women's experiences are presented as a composite poem. The (re)presentation of the women's narratives in the poem emphasizes the tensions between what women desired and planned for in contrast to what they actually experienced during pregnancy and birth. The poem illustrates the politics of agency, the ways in which consent is bypassed or assumed in some medical institutions in the United States, and the resilience of the women.URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs17029

Women’s experiences of decision-making and informed choice about pregnancy and birth care: a systematic review and meta-synthesis of qualitative research

Background The purpose of this systematic review (PROSPERO Ref: CRD42017053264) was to describe and interpret the qualitative research on parent’s decision-making and informed choice about their pregnancy and birth care. Given the growing evidence on the benefits of different models of maternity care and the prominence of informed choice in health policy, the review aimed to shed light on the research to date and what the findings indicate. Methods a systematic search and screening of qualitative research concerning parents’ decision-making and informed choice experiences about pregnancy and birth care was conducted using PRISMA guidelines. A meta-synthesis approach was taken for the extraction and analysis of data and generation of the findings. Studies from 1990s onwards were included to reflect an era of policies promoting choice in maternity care in high-income countries. Results Thirty-seven original studies were included in the review. A multi-dimensional conceptual framework was developed, consisting of three analytical themes (‘Uncertainty’, ‘Bodily autonomy and integrity’ and ‘Performing good motherhood’) and three inter-linking actions (‘Information gathering,’ ‘Aligning with a birth philosophy,’ and ‘Balancing aspects of a choice’). Conclusions Despite the increasing research on decision-making, informed choice is not often a primary research aim, and its development in literature published since the 1990s was difficult to ascertain. The meta-synthesis suggests that decision-making is a dynamic and temporal process, in that it is made within a defined period and invokes both the past, whether this is personal, familial, social or historical, and the future. Our findings also highlighted the importance of embodiment in maternal health experiences, particularly when it comes to decision-making about care. Policymakers and practitioners alike should examine critically current choice frameworks to ascertain whether they truly allow for flexibility in decision-making. Health systems should embrace more fluid, personalised models of care to augment service users’ decision-making agency

Veiled aggression: Saudi women international students’ experiences of microcolonization in the United States

The 2016 presidential election in the United States entailed presidential candidates warning of ‘radical Islam,’ ‘Jihadist violence,’ and ‘refugee terrorism.’ At the same time, random and targeted violence against Arab Muslims has soared since the election. In everyday encounters at school, work, or in casual conversations, Islamophobia is enacted through microaggressions. This narrative inquiry study examined the ways in which Saudi women graduate students studying in the US experienced and negotiated instances of microaggression at the intersection of ethnicity, religion, and gender. Data was collected through unstructured in-depth life-story interviews and transcripts were analyzed using narrative analysis, with specific readings for moments of microaggression. Findings yielded that participants encountered various forms of microaggressions on a daily basis from faculty, classmates, and strangers. We propose microcolonization as a subcategory that addresses the women’s specific lived experiences within the niches of larger neo-imperialist contexts

At pains to consent: A narrative inquiry into women\u27s attempts of natural childbirth

Background With only 1.2% of all annual U.S. births registered as out-of-hospital births, national trends show an increase in medicalised hospital births. Caesarean sections have become the most common surgical procedure in the U.S.; Caesarean section rates have increased from 20.6% in 1997 to 31.5% in 2009. Furthermore, in 2009, 67% of hospital births utilised epidural analgesia and 26% used oxytocin augmentation. In response to the increased medicalisation of childbirth within the U.S., some women resist standardised medical procedures and instead choose to labour and birth without medical intervention. Aim The purpose of this study was to understand and contextualise the childbirth experiences of first-time mothers who planned to have a natural childbirth (without medical intervention) in the Midsouthern United States. Methods Using narrative inquiry, we collected data from six participants through semi-structured life-story interviews. Findings Utilising thematic analysis, four recurring themes emerged: (1) benefits and limitations of pre-labour self-education; (2) labouring women\u27s experiences of relationality; (3) the importance of birth stories and expectations; and (4) the creation of false dilemmas and complexities of “informed choice.” Discussion and conclusion The women\u27s stories suggest that U.S. medical establishments, the media, and society need to empower pregnant and birthing women by creating new narratives of labour and positive spaces of relationality. Furthermore, health care professionals need to critically examine their usage of the medical model of care while respecting women\u27s choices and agency

Epistles of dyspareunia: storying Christian women’s experiences of painful sex

Dyspareunia is painful attempted or completed vaginal-penile intercourse, and vaginal pain from other forms of touch. Because there is a persistent underlying message of shame and taboo surrounding female sexual pleasure in some Christian-informed cultural contexts, we sought to examine how self-identified Christian women in the Midsouthern USA conceptualise and experience dyspareunia. Data were collected through initial surveys and semi-structured interviews and analysed using incident-to-incident and in-vivo coding. Creative Analytic Practice was used to create composite character narratives from the data, storying five aspects of participants’ experiences: (1) ignorance and abstinence at home, church, and school; (2) socially-informed expectations of sex and painful realities; (3) making sense of, coping with, and seeking help for painful sex; (4) validation, diagnosis, and treatment; and (5) sex mis-education and desire for a different future. Findings suggest that participants’ understandings of and coping with their sexuality and the accompanying painful sex are shaped by implicit and explicit religious messages they encountered in their family upbringing, schooling, social and religious circles, and interactions with healthcare providers. Health professionals are urged to pre-screen women for symptoms of dyspareunia and include sexual wellness checks as routine procedure, and subsequently refer patients to pelvic health physical therapy when appropriate

Exploring Relationships Between Genito-Pelvic Pain/Penetration Disorder, Sex Guilt, and Religiosity Among College Women in the U.S.

Introduction: Despite a growing body of research on psychosocial factors in Genito-Pelvic Pain/Penetration Disorder (GPPPD) during sexual intercourse, there are few studies examining adolescent and young adult women\u27s experiences with painful sex and the effects of religiosity, sexual education, and sex guilt. Aim: The purpose of the study was to examine the occurrence of GPPPD among sexually active female college students, including psychosocial factors of religiosity and religious practice, sexual education, sex guilt, and sexual distress. Methods: Data were collected from 974 college women from a university in the Northeastern U.S. We limited our sample to sexually active women (n = 593, 60.9%; mean age: 18.96) who responded to the questionnaire item, “In general, do you feel pain with sexual intercourse?” Participants completed the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), Revised Mosher Sex Guilt Scale, Abbreviated Santa Clara Strength of Religious Faith Questionnaire, 10-item Gender Role Beliefs Scale, and measures on sexual wellness and practice and sexual education experiences. Data were analyzed using standard bivariate and regression analyses as well as path analysis. Main Outcome Measures: Women were asked, “In general, do you feel pain with sexual intercourse?” and categorized into one of three pain groups: occasional (10%–25% of the time), frequent (50% or more), and no pain (less than 10%). Results: GPPPD with sex was prevalent among young college women, with 113 (19.1%) reporting frequent pain and 143 (24.1%) occasional pain (control n = 337, 56.8%). Numerous statistically significant factors were identified, including frequency of sex, ability to orgasm, sensations during intercourse, presence of a steady sexual partner, expectations of painful sex, sex guilt, and sexual distress. Sex guilt acted as full mediator between religiosity and painful sex. Implications: Healthcare providers should proactively initiate conversations with young female patients about painful intercourse to identify issues and normalize language on pain with sex. Educators are urged to teach evidence-based information on pain-free and guilt-free sexual experiences inside and outside religious contexts. Conclusion: Painful sex affects adolescent and young adult women at a similar rate as non-college adult women and while religiosity does not directly impact young women\u27s GPPPD, religiosity does lead to painful sex if it causes sex guilt. Further research is needed into the mechanisms of religion-based sexual shaming and among religiously conservative women who practice abstinence until marriage. Azim KA, Happel-Parkins A, Moses A, et al. Exploring Relationships Between Genito-Pelvic Pain/Penetration Disorder, Sex Guilt, and Religiosity Among College Women in the U.S. J Sex Med 2021;18:770–782