Fathers' functional status during pregnancy and the early postnatal period

Objective

to determine the functional status of fathers whose wives were pregnant or in the early postnatal period.

Sample and setting

the research population comprised 3750 fathers whose wives were pregnant or in the early postnatal period, and who were registered at a primary health clinic in the province centre. The research sample comprised 275 husbands of women who were registered at these clinics and who were in at least their 28th week of a normal (not at-risk) pregnancy with a single fetus, or who were in the early postnatal period (6–8 weeks postnatal) following birth of a single baby between the 38th and 42nd week without complications. Due to fathers declining to participate in the study or unable to participate because of busy work schedules, the research was completed with 155 fathers-to-be and 93 fathers; in total, 90% of the target sample was reached. A sociodemographic survey and the Inventory of Functional Status—Fathers were used for data collection and to describe the functional abilities of fathers-to-be and fathers.

Findings

no statistically significant differences were found in functional status between the husbands of pregnant women and the husbands of women in the early postnatal period. Number of pregnancies was not significantly related to any of the seven subscales of fathers’ functional status; age of husband, length of marriage and occupation of wife were significantly related to one subscale; occupation of husband and health insurance were significantly related to two subscales; income status of husband and educational level of wife were significantly related to three subscales; and educational level of husband was significantly related to four subscales.

Conclusion

although there was no significant difference in functional status for the husbands of pregnant women and the husbands of postnatal women, sociodemographic factors were found to have an effect.     

Mixed lymphocyte culture responses in infertile couples.

Twenty couples suffering from unexplained infertility have been tested in mixed leucocyte culture to determine if the wives were preimmunized against their husbands. The wives were tested against their husbands and four unrelated persons, and thymidine incorporation was measured on the third and fifth days of culture. No evidence was found that would indicate a preimmunization of the wife against her husband as an explanation for their infertility. A slight MLC stimulatory capacity was found in sera from infertile women.     

Antenatal blood donation for pregnant Nigerian mothers: the husbands' perspective.

This cross-sectional study was designed to evaluate the knowledge, attitude and motivation of husbands of pregnant mothers towards antenatal blood donation. A total of 700 husbands of pregnant mothers in Abakaliki, south-east Nigeria were interviewed over a 1-year period using a questionnaire. A total of 640 respondents completed the questionnaires giving a response rate of 91%. They had a mean age of 26.2 +/- 4 years with a range of 21 - 50 years. All the respondents had heard about blood donation but only 39% were well informed about it. One-third (33.1%) of respondents were willing to donate blood and the main motivating factor was their wives' previous experience with bleeding during pregnancy/delivery. Other motivating factors to blood donation included previous donation, information on blood donation and husband participation in antenatal programme. Two-thirds of respondents were unwilling to donate because of fear, misconception and availability of paid blood donors. Higher educational status was significantly associated with willingness to donate blood (p < 0.05). The willing blood donors showed a more positive attitude towards blood donation and were of the view that the donated blood if not used for their wives would benefit others. The non-donors on the other hand had a selfish attitude and would prefer to procure blood only when their wives needed blood transfusion. An intensive donor recruitment campaign, including mobilising husbands of pregnant mothers and providing information and education on all aspects of blood donation, will help correct some of the misconceptions about blood donation. This will increase the number of voluntary blood donors and thus increase available banked blood for pregnant women.     

Disclosure of HIV status and human rights: The duties and responsibilities of couples, medical professionals, family members and the state

This case history is about a young husband in India who became HIV positive and did not inform his wife. This man was working for a company in the city of Mumbai when he became ill with tuberculosis and was diagnosed with AIDS. This information was not disclosed to his 21-year-old wife, who was living with her parents-in-law in a rural area of South Kerala. He came home to recover and, supported by his parents' wishes, wanted his wife to become pregnant, even though she had asked that they wait until he had recovered. She came to know that her husband had AIDS and the dangers it posed only when she was eight months pregnant and he was seriously ill. Her husband died some three months after the baby was born and she went back to her parents' house, where she and the baby were living at the mercy of others. The contributors to this multi-authored Roundtable discuss the various human rights issues and the duties and responsibilities involved -not only of spouses and partners to each other but also of medical professionals, family members and the state-which arise from such a case.     

Exploring couple attributes and attitudes and marital violence in Vietnam

Using a couple-centered approach, this study focuses on the relative attributes and attitudes of spouses as predictors of marital violence. Analysis of data from Vietnam showed that 37% of married women have ever been hit by their husbands. Regression results found that husbands with lower resources or status than their wives were more likely to have abused. Results also found that the association between husbands' gender attitudes and marital violence depends on the level of equity of wives'attitudes. The decline in violence among couples in which husbands expressed gender equitable attitudes was greater when wives also expressed equitable attitudes.     

Sexual transmission and reinfection of group B streptococci between spouses.

OBJECTIVE: To study how GBS infection takes place between pregnant GBS-carriers and their husbands. METHODS: Pregnant women in whom GBS infections could be detected during 26 to 30 weeks of pregnancy and their husbands were studied during the two periods of August 1994 through May 1995 (Period A, 243 couples) and June through September 1997 (Period B, 141 couples). A urine sample was collected from a husband in the same morning when the vagina of his wife was tested for GBS. GBS were also classified according to their serotypes in 34 couples during Period A and B. RESULTS: In the two periods, GBS was detected in 18.1 and 19.3% of the wive's vaginal cultures, and in 19.1 and 17.0% of husbands' urinary cultures, respectively. There were no significant differences of the rate of GBS detection between the spouses, and also between the two trials. A high possibility of GBS infection was found in a couple when either of the spouses was possible to GBS. The serotypes of 31 of the 34 couples (91.2%) were identical. CONCLUSION: It is suggested that GBS can be sexually transmitted, and cause reinfection between spouses in spite of antepartum medication.     

The Significance of the Female Orgasm: A Nationally Representative,Dyadic Study of Newlyweds' Orgasm Experience

Background

Self-reported orgasm, perception of partner's orgasm, and misperception of partner's orgasm have each been correlated with individual sexual and relationship satisfaction, but these associations have rarely included dyadic data, have not fully accounted for potentially confounding variables such as sexual communication, and have never been simultaneously studied with a nationally representative sample.

Psychological reactions of couples to artificial insemination with donor sperm.

The case histories of 62 couples successfully treated by AID were established through nondirective interviews, and were surprisingly similar in all cases. Several distinct stages were regularly observed: the awareness of wanting a child while the woman cannot become pregnant; the investigation of the couple's sterility with as a result, the announcement that the husband is sterile; a period in which the couple adapt to this situation; the disappearance of the feeling of guilt both of the husband, wounded in his "virility," and of the wife, ashamed of her desire for a child; acceptance of the idea of AID; request for AID; conflict with the medical profession; the disturbing seances of AID, usually in the presence of the husband; uneasiness at the beginning of pregnancy; euphoric continuation of pregnancy; uncomplicated delivery of a child whose father is very involved in its upbringing, and then request for a second child by AID.     

不同人群体内抗精子抗体的初步观察

目的 :进一步探索 As Ab与生殖的关系。方法 :本文应用 EL ISA间接法对 1 4 0对不育夫妇的血清、2 9例初孕妇、6 5例未婚青年、2 57例 2 5岁～ 72岁已育者的血清作了抗精子抗体( As Ab)的检测 ,并用同法对 1 4 0例不育丈夫的精浆也作了 As Ab检测。结果 :不育夫妇血清As Ab阳性率男方为 3 0 %、女方为 2 2 .8%、精浆 As Ab阳性率为 1 3 .6 %。其血清 As Ab与未婚青年和初孕妇相比均有显著差异 ,与同龄生育者相比男性有显著差异 ,女性无显著差异。生育者血清 As Ab阳性率男性随年龄增长呈上升趋势 ,女性则无明显差异。结论 :人体内 As Ab与不育有一定关系 ,老年男性 As Ab可能作为一种自身抗体与机体免疫调节功能有关。     

Body image during pregnancy: an evaluation of the suitability of the body attitudes questionnaire

ABSTRACT: BACKGROUND: Available data suggest that body dissatisfaction is common during pregnancy and may even be a precursor to post-natal depression. However, in order to accurately identify at-risk women, it is essential to first establish that body image measures function appropriately in pregnant populations. Our study examines the suitability of the Body Attitudes Questionnaire (BAQ) for measuring body dissatisfaction among pregnant women by comparing the psychometric functioning of the BAQ: (1) across key phases of pregnancy, and (2) between pregnant and non-pregnant women. METHODS: A total of 176 pregnant women from Melbourne, Victoria filled out a questionnaire battery containing demographic questions and the Body Attitudes Questionnaire at 16, 24, and 32 weeks during pregnancy. A comparison group of 148 non-pregnant women also completed the questionnaire battery at Time 1. Evaluations of the psychometric properties of the BAQ consisted of a series of measurement invariance tests conducted within a structural equation modelling framework. RESULTS: Although the internal consistency and factorial validity of the subscales of the BAQ were established across time and also in comparisons between pregnant and non-pregnant women, measurement invariance tests showed non-invariant item intercepts across pregnancy and also in comparison with the non-pregnant subgroup. Inspection of modification indices revealed a complex, non-uniform pattern of differences in item intercepts across groups. CONCLUSIONS: Collectively, our findings suggest that comparisons of body dissatisfaction between pregnant and non-pregnant women (at least based on the BAQ) are likely to be conflated by differential measurement biases that serve to undermine attempts to accurately assess level of body dissatisfaction. Researchers should be cautious in assessments of body dissatisfaction among pregnant women until a suitable measure has been established for use in this population. Given the fact that body dissatisfaction is often associated with maladaptive behaviours, such as unhealthy eating and extreme weight loss behaviours, and with ante-and post-natal depression, that have serious negative implications for women's health and well-being, and potentially also for the unborn foetus during pregnancy, developing a suitable body image screening tool, specific to the perinatal period is clearly warranted.     

Tubal sterilization or vasectomy: how do married couples make the choice?

OBJECTIVE: To examine the relative importance of husband, wife, and couple factors as determinants of sterilization method choice. DESIGN: Married couples seeking sterilization interviewed before surgery and again 1 year later. SETTING: Kaiser Permanente Medical Care Program subscribers seeking care at the Kaiser Foundation Hospital, Santa Clara, California. PARTICIPANTS: Two hundred married women seeking a tubal sterilization and their husbands and 200 married men seeking a vasectomy and their wives. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Sterilization method chosen. RESULTS: In a logistic regression model, nine predictor variables correctly classified 94.9% of 395 couples (P less than 0.000). CONCLUSIONS: The choice of a sterilization method is achieved primarily through processes that involve both spouses. The motivations of both husband and wife, their mutual influence and communication, their present pattern of contraceptive use, and what they know about the satisfactions or dissatisfactions of other people who have had sterilizations are all factors that should be taken into account when the clinician helps a patient make the method-choice decision.     

Short Communication: Successful Pregnancy and Delivery Following Combined Treatment of In Vitro Maturation (IVM) and Testicular Sperm Extraction (TESE): A Case Report

PURPOSE: To report the efficacy of the combined treatment of in vitro maturation (IVM) and testicular sperm extraction (TESE). METHODS: A couple in which the wife had polycystic ovarian syndrome and the husband had severe oligozoospermia. Oocytes were cultured in vitro for maturation followed by oocytes pickup with natural cycle, and TESE was undergone for husband. Matured oocytes were fertilized by intracytoplasmic sperm injection, and two embryos were transferred to wife's uterine. RESULTS: This case was achieved during pregnancy and delivery of a healthy female infant. CONCLUSIONS: The combined treatment of IVM and TESE was effective for this couple's specific infertility factors.     

Therapeutic Uses of Human Figure Drawings by the Pregnant Couple

The woman's experience of her body during pregnancy is an important aspect of her psychological state and may be related to physiological functioning. How her husband perceives her pregnant body is important in terms of their marital relationship, Human figure drawings were collected from 39 couples during their third trimester of pregnancy Clinical observations are made on selected figure drawings demonstrating how they reflect the subjects' feelings regarding the pregnancy, the child, and their marriage. Human figure drawings can be used as a diagnostic instrument as well as a method for therapeutic intervention, e.g., as a catalyst for group discussions.     

Impact on perceived postnatal support,maternal anxiety and symptoms of depression in new mothers in Nepal when their husbands provide continuous support during labour

Background

when a husband provides continuous support during his wife's labour, his presence is considered effective in reducing her dissatisfaction with the childbirth process. The impact of this on the postnatal well-being of a new mother, however, is not clear.

Objective

to examine the impact on postnatal support, maternal anxiety and symptoms of depression experienced by new mothers in Nepal when their husband supported them continuously during labour.

Method

the study involved 231 Nepali women, of whom 77 were supported continuously by their husbands, 75 by female friends, and 79 were not supported by any companion during childbirth. They were contacted at six to eight weeks post partum, when postpartum support questionnaires, a state-trait anxiety inventory and the Edinburgh postnatal depression scale were administered. Structural equation modelling was conducted.

Findings

observations showed that continuous support from a husband during his wife's labour was related to a greater degree of postnatal support than those who were not supported by their husband during labour (β=0.23, p<0.001). Similarly, the more the women considered they were being supported, the less likely they were to experience maternal anxiety (β=−0.52, p<0.001), which in turn was associated with a lower level of depression (β=0.43, p<0.001). These findings were consistent, even after adjustments for the effect of female support during the postnatal period.

Conclusion

the study suggests that continuous support from husbands during labour has a direct impact on the perceived postnatal support, and an indirect impact on anxiety and depression in new mothers in Nepal.     

Condom use among married women at risk for sexually transmitted infections and HIV in rural China

Objective

To assess factors associated with condom use among married women in rural China, and provide evidence for implementing education strategies to prevent sexually transmitted infections and HIV.

Methods

A total of 737 sexually active married rural women who were aged between 18 and 49 years and had heard of AIDS were selected by cluster sampling and interviewed in 8 villages of Anhui province, China.

Results

The rate of condom use was only 5.4%.There were no significant differences in sexual behavior and condom use between married women whose husbands were away as migrant workers and the wives of nonmigrant men, except in knowledge of free condom sources. Significant factors associated with condom use included age, level of education, knowledge about condoms, training about condoms, sources of condoms, and husbands' attitude toward condoms.

Conclusions

More educational interventions are needed to increase condom knowledge and promotion, especially among less educated women and married women left behind by migrant husbands.     

Is fertility-problem stress different? The dynamics of stress in fertile and infertile couples.

OBJECTIVE: To compare the dynamics of fertility-problem stress experienced by wives and husbands in infertile couples with the dynamics of stress from other sources experienced by members of couples presumed to be fertile. DESIGN: Relationships of stress to four marriage factors and four aspects of life quality (subjective well-being) are examined within a causal modeling framework using data from structured interviews. SETTING: Face-to-face interviews were conducted in study participants' homes. PARTICIPANTS: Wives and husbands from 157 couples with primary infertility and from 82 presumed-fertile couples were studied. MAIN OUTCOME MEASURES: Final outcome measures were four multi-item scales assessing life quality with regard to the marriage, own self-efficacy, own health and appearance, and life as a whole. Intervening outcome scales measured four marriage factors: marital conflict, sexual self-esteem, sexual dissatisfaction, and frequency of intercourse. RESULTS AND CONCLUSIONS: Higher levels of stress, regardless of whether that stress was from attempting to solve a fertility problem or another problem, were related to reduced marital functioning and decreased life quality. For husbands, the strengths of the linkages did not depend on the source of the stress. For wives, however, the causal model suggested that fertility-problem stress had stronger negative impacts on sense of sexual identity and self-efficacy than did stress from other problems (P less than 0.05). Stress from any source had more impact on the lives of wives than of husbands, more impact on satisfaction with self and general well-being than on satisfaction with the marriage or health, and affected life quality mostly indirectly through its impacts on the marriage factors.     

An unaddressed issue: domestic violence and unplanned pregnancies among pregnant women in Turkey.

OBJECTIVE: The aim of this study was to estimate the prevalence and type of domestic violence during pregnancy in Turkey and to compare socioeconomic background factors. METHODS: A survey was carried out among a representative sample of 475 pregnant women. Data were collected on the incidence and the nature of domestic violence perpetrated by the woman's spouse or other family members during her current pregnancy and before. Sociodemographic characteristics such as age, duration of marriage, number of children, monthly income, education, occupation of the husband, domestic violence towards children, contribution to family decisions, smoking habits, sexual relations and whether the pregnancy was planned or not, were also recorded. RESULTS: Of the 475 women screened for domestic violence during pregnancy, 158 (33.3%) reported physical or sexual abuse since they had become pregnant. The source of the domestic violence was mainly the husband in 105 (66.5%) women. Types of abuse were psychological in 71 (44.9%) and physical in 87 (55.1%) women. The rate of women's satisfaction with their sexual life among abused women was 43.67% compared to 61.2% among non-abused women. Abused pregnant women were less educated, had lower income, had more children, had a longer duration of marriage, were applying violence towards their children, were not contributing to family decisions, were less satisfied with their sexual life and were more likely to have unplanned pregnancies when compared to non-abused women. CONCLUSION: Antenatal care protocols should be modified to address domestic violence and contributing factors during pregnancy so that identified women can be counseled appropriately and attempts can be made to intervene to prevent further episodes of domestic violence in primary care settings.     

Correspondence

The couvade syndrome can be considered to be the psychosomatic equivalent of primitive rituals of initiation into paternity. Various symptoms have been described in the husbands of pregnant women with an incidence from 11% to 65%. The most common of these are: variations in appetite, nausea, insomnia and weight gain. Seventy-three couples with the women in the last month of pregnancy were given a questionnaire; as a reference group, 73 men without pregnant wives or children under 1 year of age were taken. An emotional involvement connected with pregnancy was reported in 91.78% of the men. This involvement was expressed as changes in sexual habits in 87.67% of cases, fear and anxiety in 36.98% and curiosity in 47.94%. With the exception of nausea, physical symptoms were less frequent in the men with pregnant wives than in those without pregnant wives. These data cannot confirm the existence of the couvade syndrome with its own physical symptoms but we think that some male experiences, which constitute a peculiar imaginary and behavioral reality of the father-to-be, do exist.