Gender, occupation and first birth:Do 'career men' delay first birth too?

In the period following the turn of the Century European total fertility rates (TFR) dropped to well below replacement. Work examining this highlights that cohort postponement in births contributes to low TFRs. It is generally recognised that women in more advantaged occupations often postpone childbearing in contrast to those in less advantaged occupational groups. However, relatively little research has been conducted on men in similar terms. This paper contrasts the timing of first birth by occupational class between men and women using individual level data in a case study of Scotland. The data are an extract from the Scottish Longitudinal Study (SLS). This provides a 5.3% sample of the population of Scotland from the 1991 Census. The research applies the Cox proportional hazard model to estimate the speed to first birth during a period of observation between 1991 and 2006. Class is measured using NS-SEC 8 class analytic version. The model controls marital status, educational attainment, raised religion and urban-rural geography. It is found that 'career men' who occupy more advantaged occupational positions do not delay first birth in contrast to men in other occupational categories. This is in contrast to the well-known phenomenon of career women who have later childbearing. Our analysis shows that gender inequalities in how the social structure influences childbearing offer an avenue of explanation for wider patterns of social inequality

Teratogenic risk and contraceptive counselling in psychiatric practice: analysis of anticonvulsant therapy

<p>Background: Anticonvulsants have been used to manage psychiatric conditions for over 50 years. It is recognised that some, particularly valproate, carbamazepine and lamotrigine, are human teratogens, while others including topiramate require further investigation. We aimed to appraise the documentation of this risk by psychiatrists and review discussion around contraceptive issues.</p> <p>Methods: A retrospective review of prescribing patterns of four anticonvulsants (valproate, carbamazepine, lamotrigine and topiramate) in women of child bearing age was undertaken. Documented evidence of discussion surrounding teratogenicity and contraceptive issues was sought.</p> <p>Results: Valproate was most commonly prescribed (n=67). Evidence of teratogenic risk counselling at medication initiation was sub-optimal – 40% of individuals prescribed carbamazepine and 22% of valproate. Documentation surrounding contraceptive issues was also low- 17% of individuals prescribed carbamazepine and 13% of valproate.</p> <p>Conclusion: We found both low rates of teratogenic risk counselling and low rates of contraception advice in our cohort. Given the high rates of unplanned pregnancies combined with the relatively high risk of major congenital malformations, it is essential that a detailed appraisal of the risks and benefits associated with anticonvulsant medication occurs and is documented within patients’ psychiatric notes.</p&gt