Violence against women in Mexico: a study of abuse before and during pregnancy.
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OBJECTIVE: We identified the prevalence and types of violence experienced by pregnant women, the ways victimization changed during pregnancy from the year prior to pregnancy, and factors associated with violence during pregnancy. METHODS: We interviewed 914 pregnant women treated in health clinics in Mexico about violence during and prior to pregnancy, violence during childhood and against their own children, and other socioeconomic indicators. RESULTS: Approximately one quarter of the women experienced violence during pregnancy. The severity of emotional violence increased during pregnancy, whereas physical and sexual violence decreased. The strongest predictors of abuse were violence prior to pregnancy, low socioeconomic status, parental violence witnessed by women in childhood, and violence in the abusive partner's childhood. The probability of violence during pregnancy for women experiencing all of these factors was 61%. CONCLUSIONS: Violence is common among pregnant women, but pregnancy does not appear to be an initiating factor. Intergenerational violence is highly predictive of violence during pregnancy. (+info)
Social class, ethnicity and attendance for antenatal care in the United Kingdom: a systematic review.
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BACKGROUND: Evidence from outside the United Kingdom points to several socio-demographic factors associated with late initiation of antenatal care or fewer antenatal visits, but it is not clear how generalizable these studies are to the UK context. This systematic review addresses the question of whether there are social or ethnic inequalities in attendance for antenatal care in the United Kingdom. METHODS: We identified and reviewed UK studies assessing attendance for antenatal care according to any measure of social class, social deprivation or ethnicity. A wide range of electronic databases was searched for published and unpublished studies. Further studies were identified from reference lists, citation searches and key organizations. RESULTS: From over 1300 identified papers, 20 were potentially relevant. Nine were included in the review. Most studies were of poor quality, with only one study controlling for the effect of potential confounders such as age, parity and clinical risk factors. All but one were based on data collected around 20 years ago. Three of the five studies looking at antenatal attendance and social class found that women from manual classes were more likely to book late for antenatal care and/or make fewer antenatal visits than other women. All four studies reporting on antenatal attendance and ethnicity found that women of Asian origin were more likely to book late for antenatal care than white British women. CONCLUSIONS: There is little good quality evidence on social and ethnic inequalities in attendance for antenatal care in the United Kingdom. Recommendations for further research are suggested. (+info)
Maternal psychosocial well-being in Eritrea: application of participatory methods and tools of investigation and analysis in complex emergency settings.
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OBJECTIVE: To establish the context in which maternal psychosocial well-being is understood in war-affected settings in Eritrea. METHOD: Pretested and validated participatory methods and tools of investigation and analysis were employed to allow participants to engage in processes of qualitative data collection, on-site analysis, and interpretation. FINDINGS: Maternal psychosocial well-being in Eritrea is maintained primarily by traditional systems of social support that are mostly outside the domain of statutory primary care. Traditional birth attendants provide a vital link between the two. Formal training and regular supplies of sterile delivery kits appear to be worthwhile options for health policy and practice in the face of the post-conflict challenges of ruined infrastructure and an overstretched and/or ill-mannered workforce in the maternity health service. CONCLUSION: Methodological advances in health research and the dearth of data on maternal psychosocial well-being in complex emergency settings call for scholars and practitioners to collaborate in creative searches for sound evidence on which to base maternity, mental health and social care policy and practice. Participatory methods facilitate the meaningful engagement of key stakeholders and enhance data quality, reliability and usability. (+info)
Preventing the birth of infants with Down's syndrome: a cost-benefit analysis.
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The costs and economical benefits of providing routine prenatal diagnosis of Down's syndrome with termination of affected pregnancies in older pregnant women in the west of Scotland were examined. The potential economic benefits would be greater than the costs for women aged 40 and over, probably about equal to costs for those aged 35 and over, but less than costs if the service were extended to women under 35. (+info)
Commentary: the public health consequences of restricted induced abortion--lessons from Romania.
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The question of whether abortion should be legal is currently being decided in many countries. Although much of the discussion has focused on ethical issues, the public health consequences should not be overlooked and should be addressed realistically and responsibly. Nowhere are the public health manifestations of restricted abortion more apparent than in Romania. The pronatalist policies of the Ceaucescu regime resulted in the highest maternal mortality rate in Europe (approximately 150 maternal deaths per 100,000 live births) and in thousands of unwanted children in institutions. (+info)
The search for meaning: RU 486 and the law of abortion.
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The advent of RU 486 (mifepristone), a steroid analogue capable of inducing menses within 8 to 10 weeks of a missed menstrual period, has provoked a firestorm of concern and controversy. When used in conjunction with prostaglandin (RU 486/PG), it is at least 95% effective. Used in France principally to terminate confirmed pregnancies very early in the process of gestation, RU 486 raises many interesting legal questions. This article focuses on whether and how RU 486/PG can be accommodated within the framework of the world's current abortion laws. Four avenues are explored and conclusions drawn. First, it is clear that RU 486/PG can be used readily, if approved, within the regimens established by liberal abortion laws, as has been the experience in France, the United Kingdom, and even China. Second, although unlikely, the introduction of this new technology may inspire a reexamination of restrictive abortion statutes themselves. Third, some of the presently restrictive laws may be interpreted to permit RU 486/PG use as a legal procedure, for a very narrow range of reasons. Finally, in some settings the early use of RU 486/PG (before pregnancy can be confirmed) may fall outside the reach of abortion legislation and hence be acceptable from a legal point of view. (+info)
The Supreme Court, abortion, and the jurisprudence of class.
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The US Supreme Court's decision in Planned Parenthood of Southeastern Pennsylvania v Casey both protects a woman's liberty to choose to terminate her pregnancy and permits the state to make it more difficult for her to exercise her choice. In their opinion on the case, Justices O'Connor, Kennedy, and Souter eloquently defend constitutional protection of the right to make intimate decisions like continuing or ending a pregnancy. At the same time, they permit the state to try to persuade pregnant women not to have abortions and to make abortion harder to obtain and more costly, as long as the state's methods do not create an "undue burden" on the decision. Any restriction on abortion is a burden; whether it is "undue" (and therefore unconstitutional) depends on one's circumstances. The Court appears to view the difference between an undue burden and mere inconvenience from the perspective of privilege. The restrictions that were upheld may not significantly affect middle-class access to abortion, but they could prove insurmountable for many less privileged women. (+info)
Demographic and psychosocial profile of smoking among pregnant women in Lebanon: public health implications.
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OBJECTIVES: To assess the prevalence and determinants of smoking prior to and during pregnancy in Lebanon. METHODS: A cross-sectional study using two structured instruments. One instrument included information on demographic characteristics, smoking patterns in the index pregnancy and previous pregnancies, use of prenatal health services, stressful life events, and social support during pregnancy. The second was the Arabic General Health Questionnaire (GHQ-12). Women who delivered in 11 randomly selected hospitals in Beirut and its suburbs within 24 hours were asked to consent to participate in the study. The total sample interviewed was 576 women. RESULTS: The prevalence of pre-pregnancy smoking was 32% and 20% for smoking in pregnancy. Considering argileh smoking, the prevalence of tobacco use in pregnancy increased to 27% in Beirut and 25% in the suburbs. Pre-pregnancy smoking was associated with older maternal age [OR = 1.08, 95% CI (1.03, 1.14)], low and medium education [OR = 2.22, 95% CI (1.22,4.04)], increased psychiatric distress [OR = 3.11, 95% CI (1.77,5.46)], and a husband who smoked [OR = 5.00, 95% CI (2.98,8.39)]. Continued smoking during pregnancy was associated with low and medium education [OR = 3.77, 95% CI (1.31, 10.8)], younger age [OR = 1.11, 95% CI (1.02-1.20)], and a heavy pre-pregnancy smoking pattern [OR = 13.9, 95% CI (1.40,137.4)]. CONCLUSION: Policies and programs to eliminate or reduce smoking during pregnancy should be targeted toward young and less educated females and involving the spouse. Obstetricians should promote smoking cessation during pregnancy using evidence-based methods. (+info)