116 research outputs found

    Multiple Motherhoods: The Effect of the Internalization of Motherhood Ideals on Life Satisfaction

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    Purpose – This study examined whether life satisfaction varied among women who occupy different motherhood statuses, and if these variations were influenced by differences in women’s internalization of cultural motherhood norms. We distinguished among women as biological mothers, stepmothers, and “double mothers,” who were both biological and stepmothers. We also included two groups of women without children: voluntary childfree and involuntary childless women. Design/methodology/approach – Data were drawn from the National Study of Fertility Barriers and analyzed using OLS regression. Findings – Biological mothers reported greater life satisfaction than women in other motherhood statuses. Accounting for the internalization of motherhood norms, double mothers had significantly lower life satisfaction compared to biological mothers, but voluntary childfree women had significantly greater life satisfaction. More detailed analyses indicated that internalization of cultural norms only appears to influence the life satisfaction of women with biological children. Research limitations/implications – The results suggest that it may not simply be motherhood that affects women’s well-being, but rather that women’s internalization of motherhood ideals, particularly when it corresponds with their motherhood status, significantly impacts well-being. Limitations of this study include small cell sizes for some categories of women where additional distinctions may have been useful, such as lesbian or adoptive mothers. Future work should incorporate diverse family forms and expand on the newly named category “double mothers.” Originality/value – By providing a more nuanced approach to categorizing motherhood status, including identifying double mothers, stepmothers-only, and two groups of childless women, the study added detail that has been overlooked in previous work on well-being

    Complications of childbirth and maternal deaths in Kinshasa hospitals: testimonies from women and their families

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    <p>Abstract</p> <p>Background</p> <p>Maternal mortality in Kinshasa is high despite near universal availability of antenatal care and hospital delivery. Possible explanations are poor-quality care and by delays in the uptake of care. There is, however, little information on the circumstances surrounding maternal deaths. This study describes and compares the circumstances of survivors and non survivors of severe obstetric complications.</p> <p>Method</p> <p>Semi structured interviews with 208 women who survived their obstetric complication and with the families of 110 women who died were conducted at home by three experienced nurses under the supervision of EK. All the cases were identified from twelve referral hospitals in Kinshasa after admission for a serious acute obstetric complication. Transcriptions of interviews were analysed with N-Vivo 2.0 and some categories were exported to SPSS 14.0 for further quantitative analysis.</p> <p>Results</p> <p>Testimonies showed that despite attendance at antenatal care, some women were not aware of or minimized danger signs and did not seek appropriate care. Cost was a problem; 5 deceased and 4 surviving women tried to avoid an expensive caesarean section by delivering in a health centre, although they knew the risk. The majority of surviving mothers (for whom the length of stay was known) had the caesarean section on the day of admission while only about a third of those who died did so. Ten women died before the required caesarean section or blood transfusion could take place because they did not bring the money in time. Negligence and lack of staff competence contributed to the poor quality of care. Interviews revealed that patients and their families were aware of the problem, but often powerless to do anything about it.</p> <p>Conclusion</p> <p>Our findings suggest that women with serious obstetric complications have a greater chance of survival in Kinshasa if they have cash, go directly to a functioning referral hospital and have some leverage when dealing with health care staff</p

    Modeling causes of death: an integrated approach using CODEm

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    Background: Data on causes of death by age and sex are a critical input into health decision-making. Priority setting in public health should be informed not only by the current magnitude of health problems but by trends in them. However, cause of death data are often not available or are subject to substantial problems of comparability. We propose five general principles for cause of death model development, validation, and reporting.Methods: We detail a specific implementation of these principles that is embodied in an analytical tool - the Cause of Death Ensemble model (CODEm) - which explores a large variety of possible models to estimate trends in causes of death. Possible models are identified using a covariate selection algorithm that yields many plausible combinations of covariates, which are then run through four model classes. The model classes include mixed effects linear models and spatial-temporal Gaussian Process Regression models for cause fractions and death rates. All models for each cause of death are then assessed using out-of-sample predictive validity and combined into an ensemble with optimal out-of-sample predictive performance.Results: Ensemble models for cause of death estimation outperform any single component model in tests of root mean square error, frequency of predicting correct temporal trends, and achieving 95% coverage of the prediction interval. We present detailed results for CODEm applied to maternal mortality and summary results for several other causes of death, including cardiovascular disease and several cancers.Conclusions: CODEm produces better estimates of cause of death trends than previous methods and is less susceptible to bias in model specification. We demonstrate the utility of CODEm for the estimation of several major causes of death

    The causes of stalling fertility transitions

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    An examination of fertility trends in countries with multiple DHS surveys found that in the 1990s fertility stalled in mid-transition in seven countries: Bangladesh, Colombia, Dominican Republic, Ghana, Kenya, Peru, and Turkey. An analysis of trends in the determinants of fertility revealed a systematic pattern of leveling off or near leveling in a number of determinants, including contraceptive use, the demand for contraception, and wanted fertility. Findings suggest no major deterioration in contraceptive access during the stall, but levels of unmet need and unwanted fertility are relatively high and improvements in access to family planning methods would therefore be desirable. No significant link was found between the presence of a stall and trends in socioeconomic development, but at the onset of the stall the level of fertility was low relative to the level of development in all but one of the stalling countries
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