A Birth Education Program for Expectant Fathers in Taiwan: Effects on Their Anxiety

Background: A father who does not know how to assist the mother in relieving labor pains may experience a sense of powerlessness and anxiety. The objective of this study was to evaluate how an education program for expectant fathers who attended their partners' labor and birth affected their anxiety. Methods: In a randomized controlled trial, 87 expectant fathers who attended their pregnant partners through labor and birth at a hospital in central Taiwan were allocated by block randomization to an experimental (n = 45) and a control (n = 42) group. The men completed their basic personal information, a childbirth expectations questionnaire, and a Trait Anxiety Inventory when they were recruited. Two hours after birth of their child, all the expectant fathers completed a State of Anxiety Inventory. Results: Our results showed no statistically significant differences between the experimental and control groups of fathers in trait anxiety and their prenatal childbirth expectations. After analysis of covariance (ANCOVA) was applied to correct for education level, sources of childbirth information, attendance at Lamaze childbirth classes, and childbirth expectations at baseline, the effect of the childbirth program was significant for the postnatal level of anxiety (F = 3.38, p = 0.001). Conclusions: The study findings justify the clinical implementation of a birth education program based on the self‐efficacy theory as an effective means of reducing anxiety among expectant fathers.     

Pregnancy Intentions among Expectant Adolescent Couples

Study ObjectiveTo examine the self-reported pregnancy intentions of the male partners of expectant adolescent mothers, the accuracy of adolescent mothers' perceptions of their partner's pregnancy intentions, and the concordance between young mothers' and fathers' pregnancy intentions.DesignThis cross-sectional pilot study collected interview data from expectant adolescent mothers and their male partners.SettingData were collected in participants' homes.Participants35 expectant couples were interviewed separately. Most participants were African American (89% of mothers, 74% of fathers). 69% of mothers were 17-18 years old, and half of the fathers were ≥19.Main Outcome MeasuresParents responded to survey questions adapted from the Center for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System Questionnaire.Results44% of fathers reported wanting their partner to get pregnant. Another 15% were ambivalent. A kappa statistic of 0.12 (P = .33) indicated very little “accuracy” of mothers' perceptions of their partners' pregnancy intentions. Further, there was low concordance between the pregnancy intentions of mothers and fathers. Young fathers who wanted or were ambivalent about pregnancy were significantly more likely to use no contraception or withdrawal.ConclusionFor a notable number of minority couples, adolescent mothers do not have an accurate perception of their partners' pregnancy intentions and use contraceptive methods that are not within their control. These findings indicate that teen pregnancy prevention interventions must target young males in addition to females and sexually active adolescents should be encouraged to discuss pregnancy intentions with each other.     

The impact of maternal nausea and vomiting in pregnancy on expectant fathers: findings from the Australian Fathers’ Study

Introduction: Nausea and vomiting in pregnancy (NVP) are common. Whilst the impact on pregnant women has been well documented, there is less data on the impact on partners. This study evaluated awareness and impact of maternal NVP on expectant fathers.

Methods: Observational study of 300 expectant fathers. Institutional ethics approval and consent were obtained. Fathers were recruited from antenatal clinics and community settings. Researchers administered demographic, attitudinal and the Hospital Anxiety and Depression scale questionnaires during the third trimester. Expectant fathers were asked if their partner experienced NVP. If aware, they were asked to comment upon the impact on their lives.

Results: Participants were similar in demographics to those of the wider Australian community of expectant fathers. Most fathers were aware whether their partner experienced NVP (82%). Of these fathers, 20% reported no NVP, and 30%, 37% and 13% men reported maternal NVP was mild, moderate and severe, respectively. There was no correlation between paternal depression and maternal NVP, but a significant association was found between moderate and severe maternal NVP and paternal anxiety. In qualitative comments, five themes emerged: disruption on work, feelings of frustration and helplessness, concern over depression in their partner, concern for the developing baby and a sense of being manipulated in the third trimester of pregnancy.

Discussion: Most expectant fathers are aware of NVP in their partner. Moderate and severe maternal NVP are associated with significantly higher symptoms of paternal anxiety.     

The pregnant male: a metasynthesis of first-time fathers’ experiences of pregnancy

Objective: To synthesise qualitative study findings in order to gain an understanding of fathers’ experiences of pregnancy. Background: As the transition to fatherhood can be challenging, awareness of the factors facilitating or hindering expectant fathers’ adjustment is important. Our aim was to better understand the experiences of men during this significant life cycle phase, and to use this knowledge to advise health care professionals on how best to support men during this transition. Methods: We used Noblit and Hare’s metasynthesis approach to review and synthesise 13 qualitative studies relating to expectant fathers’ experiences of pregnancy. Results: The synthesis revealed five super-ordinate themes, which captured the emotional, psychological and physiological experiences of the expectant fathers during pregnancy: (1) Reacting to early pregnancy; (2) On the outside looking in; (3) The pregnant male; (4) A journey of acceptance; and (5) Redefining self as a father. Conclusion: Possible clinical implications and limitations of the metasynthesis approach are discussed. Relevant recommendations on how health professionals and services can be more effectively supportive of men during this period are outlined.     

Playing Second Fiddle Is Okay–Swedish Fathers' Experiences of Prenatal Care

Introduction: In Sweden, prospective fathers are encouraged and welcome to attend prenatal visits, and pregnant women assess their partners' involvement in prenatal care as very important. The aim of this study was to describe expectant fathers' experiences of and involvement in prenatal care in Sweden. Methods: Data were drawn from a 1‐year cohort study of 827 Swedish‐speaking fathers recruited during their partners' midpregnancy and followed up 2 months after childbirth. Results: The participants reported that the most important issues in prenatal care were the woman's physical and emotional well‐being and the support she received from her midwife. However, care was identified as deficient in nearly all aspects of information, medical care, and fathers' involvement. “Excessive” care was also reported and related to how the father was treated by the midwife, mainly in terms of attention to his emotional well‐being. Discussion: Although fathers prioritize the needs of their pregnant partners, it is important for caregivers to assess fathers' needs and incorporate a family‐oriented approach to prenatal care.     

Alcohol consumption during pregnancy: Cross-sectional survey

Objectiveto assess the prevalence and pattern of alcohol consumption pre-conception and/or during the first trimester using the Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) and T-ACE (Tolerance, Annoyance, Cut Down and Eye-Opener) alcohol screening questionnaires, and determine the socio-demographic predictors of drinking in this time period.Designcross sectional survey of a consecutive sample of 500 pregnant women attending their first antenatal appointment at approximately 10–11 weeks gestation.Settingtwo antenatal clinics in the South West of England.Findingsof the 409 women respondents, we found a quarter of women reported drinking alcohol despite being aware they are pregnant. Between two to three in every 100 women reported drinking six or more units on a single occasion (heavy episodic or ‘binge’ drinking) at least monthly or weekly in the past three months. A similar proportion reported exceeding the recommended drinking limits of one to two units, once or twice a week. The majority of heavy episodic drinkers were otherwise low risk drinkers. 5.4% of respondents had an AUDIT-C score of 3 or more, and 22.2% a T-ACE score of 2 or more, indicating risk drinking in the peri-conception period. Drinking pre-conception and/or during the first trimester was more likely if women were multiparous and of white ethnicity.Key conclusionsin this study pregnant women attending an antenatal appointment were willing to complete brief alcohol screening questionnaires. A minority of women reported drinking pre-conception and/or during the first trimester with a small percentage drinking at levels potentially harmful to the fetus.Implications for practiceuse of these questionnaires would help midwives gather information about alcohol use to help identify women drinking at levels in excess of recommended limits in order that appropriate advice and support be offered.     

Human papillomavirus genotypes in male genitalia and their concordance among pregnant spouses participating in the Finnish Family HPV study

IntroductionGenotype‐specific concordance among human papillomavirus (HPV)‐infected spouses is incompletely assessed. HPV concordance is of importance in counselling HPV‐infected subjects and their partners.AimTo determine HPV‐genotype distribution and prevalence in semen and urethral samples of young fathers and their concordance with HPV‐genotypes in cervical and oral mucosal samples of their spouses.MethodsIn the Finnish Family HPV study, urethral and semen samples were collected from 131 fathers‐to‐be for HPV genotyping with Multimetrix assay. HPV‐genotyping data were correlated with the data of the cervical and oral mucosal samples of the spouses collected at third trimester pregnancy at baseline.Main Outcome MeasureConcordance of HPV‐genotypes between the spouses.ResultsUrethral and/or semen samples tested HPV positive in 47/131 (35.9%) of the fathers‐to‐be, more frequently in semen (28/90; 31%) than in urethral (29/128; 23%) samples. In women, 18.8% of their cervical and 17.2% of the oral samples tested HPV‐positive. Of the HPV‐positive samples, HPV16 was the most frequent genotype, present in 39.3% of semen, 77.3% of mothers' oral, and 29.2% of cervical samples. Multiple‐type infections were found in 24.1% of HPV‐positive urethral and 21.6% of semen samples. In mothers, half of their cervical and 4.5% of oral HPV were multiple‐type infections. The HPV‐genotype‐specific concordance among spouses ranged from 0% to 9.5%, according to the sampling sites. Altogether, eight couples disclosing such a concordance were analyzed separately for a risk‐profile. Mothers of the HPV‐concordant couples reported significantly higher number (>6) of life‐time sexual partners than did the discordant mothers (P = 0.030).ConclusionsAsymptomatic HPV infections were common in both parents, while the genotype‐specific concordance among spouses was low. In both partners, HPV16 is the dominant genotype. HPV6 was a prevalent HPV genotype in male genitalia. Female risk profile might enhance the transmission of HPV infection to her male partner and increase the genotype‐specific HPV concordance between the spouses. Kero K, Rautava J, Syrjänen K, Grenman S, and Syrjänen S. Human papillomavirus genotypes in male genitalia and their concordance among pregnant spouses participating in the Finnish family HPV study. J Sex Med 2011;8:2522–2531.     

Approaches to assessment of alcohol intake during pregnancy in Swedish maternity care—a national-based investigation into midwives’ alcohol-related education,knowledge and practice

Objective

to evaluate how much education midwives in Sweden have undertaken to help them assess alcohol intake during pregnancy, and what tools they use to identify women who may be at risk of drinking during pregnancy.

Design

a national survey was conducted in March 2006, using a questionnaire constructed by a Swedish team of researchers and clinicians.

Setting

maternity health-care centres in Sweden.

Participant

2106 midwives.

Findings

nearly all midwives stated that they had excellent or good knowledge concerning the risks associated with drinking during pregnancy. They considered themselves less knowledgeable about detecting pregnant women with risky alcohol consumption before pregnancy. The majority of the midwives had participated in some education in handling risky drinking. Almost half of the midwives assessed women's alcohol intake before pregnancy. Important facilitators for increased activity concerned recommendations and decisions at different levels (national, local and management) on how to address alcohol with expectant parents and work with risky drinkers.

Key conclusions

more education was associated with more common use of a questionnaire for assessment of women's alcohol intake before pregnancy, and more frequent counselling when identifying a pregnant woman whose pre-pregnancy consumption was risky.     

Surface Expression of Neutrophil Adhesion Molecules in Pregnant Women at Risk for Hypertensive Complications

Objective: To determine if neutrophil activation is a pathogenetic factor in hypertensive disorders in pregnancy, the neutrophil expression of adhesion molecules was prospectively investigated in pregnant women at risk, prior to the development of hypertensive complications. Methods: Two neutrophil activation parameters, β₂‐integrin (CD11b) and l‐selectin (CD62L), were assessed at admission between 14 and 24 weeks of gestation in 82 pregnant women at risk of preeclampsia and other hypertensive complications. Results were compared to those in 20 healthy normotensive women. Results: Of the 82 women at risk, 23 (28%) developed hypertensive complications: 9 (11%) preeclampsia and 14 (17%) others, such as intrauterine growth restriction (n = 6), fetal or neonatal loss (n = 8), and preterm delivery (≤ 30 weeks of gestation) (n = 8). All pregnancy outcome measures were significantly worse in the patients with complications than in those at risk but without complications or the healthy controls. Expression of β₂‐integrin was significantly higher in early stages of pregnancy in the women who eventually developed complications than the women who did not, P = .019, or the healthy controls, P = .049. Conclusions: Surface expression of β₂‐integrin is increased in pregnant women at risk for hypertensive complications before the clinical manifestations of the disorder.     

Men and Infant Feeding: Perceptions of Embarrassment,Sexuality, and Social Conduct in White Low‐Income British Men

Background: The views of fathers have been shown to be important determinants of infant feeding decisions, but men’s perceptions of breastfeeding and formula feeding are rarely explored. Our objectives were to address this gap and examine cultural associations and beliefs concerning infant feeding practices among men. Methods: Five focus groups were conducted with low‐income men (n = 28) living in areas of social deprivation in Leeds, northeast of England, and low‐income areas of Glasgow, west of Scotland. Participants were white British men, aged between 16 and 45 years, and included fathers, expectant fathers, and potential fathers. Results: Overarching themes concerning sexuality, embarrassment, and social conduct were identified across all groups. Participants perceived breastfeeding as “natural” but problematic, whereas formula feeding was mainly considered as convenient and safe. Participants without direct experience of breastfeeding assumed that it involved excessive public exposure and attracted unwanted male attention. Underpinning these fears were strong cultural associations between breasts and sexuality and anxieties concerning appropriate gender roles. Conclusions: In some communities few opportunities may occur to witness breastfeeding, and thus existing fears concerning the activity as attracting predatory male attention remain unchallenged. Perceptions of breastfeeding as a sexual activity and the dominant mass media emphasis on breasts as a sexual site may present additional obstacles to breastfeeding. Antenatal or perinatal education with men should address not only practical issues but also provide advice on tackling problems generated by wider sociocultural issues of sexuality and masculinity. (BIRTH 38:1 March 2011)     

Alcohol Use and Pregnancy: Improving Identification

Objective: To test the effectiveness of a four-item prenatal-alcohol-use, self-administered screening questionnaire that asks about tolerance to alcohol, being annoyed by other’s comments about drinking, attempts to cut down, and having a drink first thing in the morning (“eye-opener”) (T-ACE) in an ethnically and socioeconomically diverse sample.Methods: Two hundred fifty T-ACE–positive and 100 T-ACE–negative women completed a comprehensive assessment of their alcohol use after initiating prenatal care at the Brigham and Women’s Hospital in Boston, Massachusetts. This comprehensive assessment, which included the Alcohol Use Disorders Identification Test and the Short Michigan Alcoholism Screening Test as comparisons to the T-ACE, generated three criterion standards: Diagnostic and Statistical Manual of Mental Disorders, Third Ed., Revised (DSM-III-R), lifetime alcohol diagnoses, risk drinking (regularly having more than one fluid ounce of alcohol per drinking day before pregnancy), and current drinking.Results: T-ACE–positive pregnant women were more likely than T-ACE–negative women to satisfy DSM-III-R criteria for lifetime alcohol diagnoses (40% versus 14%, P < .001) and risk drinking (39% versus 8%, P < .001) and to have current alcohol consumption (43% versus 13%, P < .001). In contrast, obstetric staff members documented only 33 (9%) women as using alcohol at any time, even though nearly all subjects (96%) were asked about drinking upon initiation of prenatal care.Conclusion: The T-ACE was the most sensitive screen for lifetime alcohol diagnoses, risk drinking, and current alcohol consumption. It outperformed obstetric staff assessment of any alcohol use by pregnant women enrolled in the study.     

Maternal and paternal alcohol consumption and miscarriage

Summary. To explore the role of parental alcohol consumption in miscarriage we interviewed 80 women who miscarried about their own and their partners' drinking habits. A control group of 81 gestational-age-matched women whose pregnancy ended in the delivery of a healthy infant at term were similarly questioned. The use of alcohol by women and men was equally frequent in both groups. Before pregnancy, the mean alcohol consumption per week had been about 1–2 drinks for the women and 4–5 drinks for the men. During the presumed day of conception, 13% of the women who miscarried and 11% of the women in the control group had drunk on average 3–4 drinks; the other women had been abstinent at this time. Of the partners, 13% and 15%, respectively, had taken a mean of 4–5 drinks. In both groups 58% of the subjects continued to consume alcohol during pregnancy. The mean consumption was about one drink a week by the women who miscarried and half a drink a week in the control group. Of women who miscarried, 36 had a blighted ovum and in this subgroup alcohol consumption in both women and men was similar to that in the other women who miscarried and their partners, suggesting that alcohol is not causally related to the development of a blighted ovum. These results suggest that moderate maternal or paternal alcohol consumption does not increase the risk of miscarriage.     

Heavy prenatal alcohol exposure and risk of stillbirth and preterm delivery

We prospectively identified 96 women consuming at least 4 drinks/day during pregnancy by screening 9628 pregnant women. In these women with heavy prenatal alcohol use, there were three stillbirths and one preterm delivery; 98 matched nondrinking women had no stillbirths and two preterm births. Preterm rates did not differ significantly. The stillbirth rate was higher in the exposed group (p?=?0.06). Additional investigation showed the stillbirth rate in the exposed population (3.1%) was significantly higher (p?=?0.019) than the reported Chilean population rate (0.45%). Our data suggest that heavy alcohol consumption may increase the risk for stillbirth but not preterm delivery.     

Men’s and Women’s Patterns of Substance Use Around Pregnancy

ABSTRACT: Background: Little is known about men’s patterns of substance use around their partner’s pregnancy, despite evidence from studies of pregnant women that men’s substance use may reduce women’s ability to desist from substance use during pregnancy, increase the probability that women will return to use postpartum, and increase the risk of adverse child outcomes. The purpose of this study was to describe the association between pregnancy or partner’s pregnancy and month‐by‐month patterns of binge drinking, daily smoking, and marijuana use among young men and women. Methods: Data were drawn from the Seattle Social Development Project, which included 412 men and 396 women (age 24 yr) from a community sample of individuals who attended elementary school in the northwestern United States. Event history calendars were used to measure month‐by‐month patterns of binge drinking, daily smoking, marijuana use, and childbirth over a 3‐year period from 1996 to 1999. Results: Births during the calendar period were reported by 131 women and 77 men. Hierarchical generalized linear modeling analyses showed that men’s rates of binge drinking and marijuana use were unaffected by their partner’s pregnancy. Pregnancy decreased the probability of substance use among women, but use returned to prepregnancy levels within 2 years postpartum. Conclusions: Men’s substance use was not affected by their partner’s pregnancy. Pregnancy decreased the probability of substance use among women, but substantial proportions of women users of cigarettes and marijuana used these substances during pregnancy. Many of the women who desisted from substance use while pregnant returned to use after their child was born. (BIRTH 35:1 March 2008)     

Mean cell volume and gamma-glutamyl transferase are superior to carbohydrate-deficient transferrin and hemoglobin-acetaldehyde adducts in the follow-up of pregnant women with alcohol abuse

BACKGROUND AND OBJECTIVE: To compare the usefulness of carbohydrate-deficient transferrin (CDT), the ratio of CDT to total transferrin, and hemoglobin-acetaldehyde adducts with mean cell volume (MCV) and gamma-glutamyl transferase (GGT) in the follow-up of alcohol abuse during pregnancy. METHODS: Forty-four pregnant drug and alcohol abusing female patients attending a special outpatient clinic were followed from the 8th to 24th gestational week onwards. A population of sixty-two healthy pregnant women was recruited to assess the effect of gestation on the markers. RESULTS: Eight of thirteen heavy drinking (> or =8 drinks/week) patients delivered infants with fetal alcohol effects (FAE). MCV and GGT were higher among heavy drinking patients than in moderately drinking (<8 drinks/week) patients (92+/-4 vs 90+/-3 fl and 31+/-34 vs 16+/-10 U/ L, respectively), and in patients delivering infants with FAE compared with patients delivering healthy infants (95+/-3 vs 90+/-3 fl and 34+/-26 vs 15+/-10 U/L, respectively). Hemoglobin-acetaldehyde adducts, CDT, and the ratio of CDT to total transferrin were neither associated with the reported level of alcohol consumption nor with the occurrence of FAE. In the receiver operating characteristics analysis MCV was found to be superior to CDT and the adducts, and GGT superior to the adducts, in identifying heavy drinking and in predicting FAE. In the control population, both CDT and total transferrin were found to rise during pregnancy, whereas the ratio of CDT to total transferrin was found to decline. The upper reference range of 33 U/L for CDT was considerably higher than that of non-pregnant women (26 U/L). CONCLUSION: MCV and GGT appear to be the most efficient laboratory markers for detecting excessive alcohol consumption and the adverse effects of alcohol on the fetus.     

ORIGINAL RESEARCH–ERECTILE DYSFUNCTION: Alcohol Consumption and Male Erectile Dysfunction: An Unfounded Reputation for Risk?

IntroductionAlcohol consumption is a contentious social topic and is often assumed to have deleterious effects on sexual performance. There is a lack of consensus on whether alcohol consumption may in fact be beneficial to erectile function.AimWe examined the data from a population-based cross-sectional study of men's health to assess the association between usual alcohol consumption and erectile dysfunction (ED).MethodReply-paid questionnaires were posted to a randomly selected age-stratified male population sample obtained from the Western Australian (WA) Electoral Roll.Main Outcome MeasuresThe survey questionnaire included sociodemographic details, self-reported clinical information, and drinking habits. The 5-item International Index of Erectile Function (IIEF-5) was used to assess erectile function.ResultsMost (87%) participants were current alcohol drinkers, with binge drinking, as defined by the Australian National Health and Medical Research Council (NHMRC), reported by 20% of drinkers. Compared with never-drinkers, the age-adjusted odds of ED were lower among current, weekend, and binge drinkers and higher among ex-drinkers. Among current drinkers, the odds were lowest for consumption within the NHMRC guidelines of between 1 and 20 standard drinks a week. On further adjustment for cardiovascular disease (CVD) or for cigarette smoking, age-adjusted odds of ED were reduced by 25–30% among alcohol drinkers.ConclusionsOur findings suggest a modest negative association between alcohol consumption and ED and confounding of the association by CVD and cigarette smoking. The Western Australia Men's Health Study certainly provides no justification for advising men with ED whose drinking habits are consistent with NHMRC guidelines that they should cease or reduce their consumption of alcohol. Chew K-K, Bremner A, Stuckey B, Earle C, and Jamrozik K. Alcohol consumption and male erectile dysfunction: An unfounded reputation for risk? J Sex Med 2009;6:1386–1394.     

Maternal and paternal moderate daily alcohol consumption and unexplained miscarriages

The relation between parental moderate alcohol consumption and the risk of miscarriage was analysed using data from a case-control study in Milan between January 1987 and June 1988. Cases were 94 women who had two or more 'unexplained' miscarriages (after exclusion of genetic, endocrine and Müllerian factors) and without full-term pregnancies, admitted or referred to the First Obstetric and Gynecologic Clinic of the University of Milan. A total of 176 women admitted for normal delivery on selected days to the same university clinic and without previous miscarriages were chosen as controls. Compared with non-drinkers the risk of recurrent miscarriage was 0.9 for regular drinkers. The point estimates were 0.9 for women reporting one drink per day and 0.8 for those reporting two or more. Compared with non-drinkers, the relative risk estimates for drinking by fathers were slightly above unity, being 1.7 for less than three drinks and 1.4 for three or more drinks per day, but the trend in risk was not statistically significant.     

Impact of Maternal Activity Restriction for Preterm Labour on the Expectant Father

Objective: To describe the impact on expectant fathers of their partners' activity restricted pregnancies.
Design: Qualitative.
Setting: Private physician practices and two teaching hospitals in a large southern city.
Participants: Self-selected sample of 15 fathers recruited within 2 weeks of initiation of their partners' activity restriction for high-risk pregnancy (phase I) and 15 fathers recruited 1–2 years after a previous experience with their partners' activity-restricted pregnancies (phase 2).
Data Collection: In phase 1, two semistructured interviews during the period of activity restriction and one interview after the birth. In phase 2, one semistructured, focus group interview.
Results: Fathers reported high levels of worrying immediately after diagnosis of their partners' preterm labor and initiation of activity restriction. Later, fathers also reported distress related to responsibility for child care, household management, and maintaining a supportive environment for their partners. Fathers reported few sources of personal support and little or no contact with health professionals during their partners' activity restriction.
Conclusions: Activity restriction during pregnancy may have a significant psychological impact on expectant fathers. High levels of emotional distress may result in family disruption. Systematic nursing assessment and intervention may prevent or ameliorate distress.     

Foetal and neonatal outcomes in women reporting ingestion of low or very low alcohol intake during pregnancy

Objective: This study aimed to assess the pregnancy outcomes of women who reported social intake of low or very low alcohol levels during pregnancy. Methods: Obstetric and foetal outcomes were assessed in a prospective cohort of 1667 pregnant women who reported low or very low alcohol consumption during pregnancy (cases) and 1840 alcohol-abstainer women (controls). Results: Among cases, alcohol consumption occurred during the first 4.4 (median) weeks of pregnancy, with a median ingestion of 1.0 (0.01–6.0) drinks/week, equivalent to 7.6 (0.09–47.5) g/week. Cigarette smoking was reported approximately four times more often in the exposed group than in the controls (p < 0.001). Pregnancy outcomes were similar between groups. There were 37 (2.4%) babies born with malformations in the exposed group and 41 (2.4%) in the control group (p = 0.9). Conclusions: Low-to-very low levels of alcohol ingestion during pregnancy do not appear to be associated with adverse maternal or foetal outcomes.     

Reclaiming a moral identity: stillbirth, stigma and 'moral mothers'

Objectives

to understand the effect of expectant motherhood discourses on parents who suffer a stillbirth.

Design

a qualitative, exploratory study using in-depth interviews to understand parental experience of stillbirth.

Setting

interviews took place in the homes of bereaved parents across several English health authorities.

Participants

10 couples and 12 mothers who had experienced a stillbirth.

Findings

mothers were keen to distance themselves from behaviour that might be seen as stigmatising, that is, smoking, drinking, etc., while pregnant. Fathers, while keen to stress that their partners had behaved well in pregnancy, made no such claims.

Key conclusions

stillbirth constitutes a threat to a maternal ‘moral’ identity, which results in a differential experience of loss for mothers than for fathers.

Implications for practise

comprehending that the experience of stillbirth might lead the mother to feel that her identity as a ‘moral mother’ is under threat is essential in understanding the maternal experience of stillbirth.