Life with a new baby: How do immigrant and Australian‐born women's experiences compare?

Objective: Little is known about immigrant mothers’ experiences of life with a new baby, apart from studies on maternal depression. Our objective was to compare the post‐childbirth experiences of Australian‐born and immigrant mothers from non‐English speaking countries. Methods: A postal survey of recent mothers at six months postpartum in Victoria (August 2000 to February 2002), enabled comparison of experiences of life with a new baby for two groups of immigrant women: those born overseas in non‐English‐speaking countries who reported speaking English very well (n=460); and those born overseas in non‐English‐speaking countries who reported speaking English less than very well (n=184) and Australian‐born women (n=9,796). Results: Immigrant women were more likely than Australian‐born women to be breastfeeding at six months and were equally confident in caring for their baby and talking to health providers. No differences were found in anxiety or relationship problems with partners. However, compared with Australian‐born women, immigrant mothers less proficient in English did have a higher prevalence of depression (28.8% vs 15%) and were more likely to report wanting more practical (65.2% vs 55.4%) and emotional (65.2% vs 44.1%) support. They were more likely to have no ‘time out’ from baby care (47% vs 28%) and to report feeling lonely and isolated (39% vs 17%). Conclusion and implications: Immigrant mothers less proficient in English appear to face significant additional challenges post‐childbirth. Greater awareness of these challenges may help to improve the responsiveness of health and support services for women after birth.     

Adolescent Mothers’ Perceptions of Fathers’ Parental Involvement: Satisfaction and Desire for Involvement*

Abstract: Grounded in family systems and ecological theories, this study examined teenage mothers’ perceptions of fathers’ parental involvement and the role of teenage mothers’ gatekeeping beliefs. Fathers’ involvement was perceived to be greater when teenage parents were romantically involved (n = 55). When they no longer shared a romantic relationship (n = 59), mothers’ satisfaction with and desire for fathers’ involvement (i.e., gatekeeping beliefs) mediated the association between mothers’ perceptions of developmental and contextual factors and their perceptions of fathers’ involvement. Overall, the proposed developmental‐contextual model was not significant for romantically involved teenage parents. Findings underscore the need to account for and incorporate issues related to relationship status, grandparent support, historical support, and maternal gatekeeping beliefs when developing programs for adolescent parents.     

Sociocultural and Environmental Influences on Brazilian Immigrant Mothers’ Beliefs and Practices Related to Child Feeding and Weight Status

Background Length of residence in the United States (US), changes in dietary and physical activity behaviors, and economic and social barriers contribute to high childhood obesity rates among children from immigrant families in the US. Brazilians comprise a fast-growing immigrant population group in the US, yet little research has focused on health issues affecting Brazilian children in immigrant families. Understanding sociocultural and environmental influences on parents’ beliefs and practices related to child feeding and weight status is essential to altering obesity trends in this group. Methods Qualitative study consisting of five focus groups with a convenience sample of 29 Brazilian immigrant mothers. Results Analyses revealed that the sociocultural and environment transitions faced by Brazilian immigrant mothers’ influence their beliefs and practices related to child feeding and weight status. Additionally, acculturation emerged as a factor affecting mothers’ feeding practices and their children’s eating habits, with mothers preferring Brazilian food environments and that their children preferring American food environments. Mothers viewed themselves as being responsible for promoting and maintaining their children’s healthy eating and feeding behaviors, but changes in their social and cultural environments due to immigration and the pressures and demands of raising a family in a new country make this difficult. Conclusions Health promotion interventions to improve healthful eating and feeding practices of Brazilian children in immigrant families must account for social and cultural changes and daily life demands due to immigration as well as potential variation in the levels of acculturation between mothers and their children.     

Reproductive health rights and survival: The voices of mothers experiencing homelessness

ABSTRACT

Women experiencing homelessness report higher rates of reproductive health-related traumas, including unplanned pregnancy, miscarriage, and abortion than their non-homeless peers. Using phenomenological hermeneutic methods, we sought to understand the reproductive health histories of women currently experiencing homelessness (N = 20, 25–61 years old, Mage = 38.33, SDage = 9.33) analyzing data collected between June 2014 and July 2015 in north central Texas. Three key themes highlight the essence of the women’s experiences: (1) unexpected pregnancy—pregnancy just happened, (2) loss of reproductive health rights—I was broken, and (3) resilience—giving back and looking forward to good things. Many of the women became mothers through unexpected pregnancies, and overnight found that their lives were transformed irrevocably. Often unexpected pregnancy was the result or cause of a lack of ownership over their reproductive health and led to prolonged health-related traumas. Over time, though, many of the women whom we interviewed re-expressed resilience through social support, housing assistance, and a sense of giving back to society. Results indicate that reproductive health care providers require training to identify the relationship among unexpected pregnancy, reproductive health-related traumas, and housing insecurity. Providers can help preserve women’s reproductive health rights through education and empowerment.     

A corazón abierto: vivencias de madres y padres de menores con anomalías congénitas cardiacas

ObjectiveTo explore, from a gender perspective, the experiences of mothers and fathers of children with congenital heart disease at the time of diagnosis, including the opinions of medical staff taking care of these children and their families.MethodsQualitative research. Four individual interviews with medical staff and four focus groups with mothers and fathers living in Valencia Region (Spain) were carried out. Participants were selected by purposive sampling. The discourse analysis was triangulated between techniques and researchers and the results were verified with mothers, fathers and medical staff.ResultsMothers and fathers differed in the way they expressed their emotions and in how they accepted the diagnosis of a serious illness in their child. However, both parents expressed the need for psychological support and highly appreciated the informal support from other parents with similar experiences.ConclusionsThe experience of the disease in a child is experienced differently by mothers and fathers. Health servies should pay attention to the psychological well-being of families, by including peer support groups and patient associations, which can play an important role as health assets.     

"He told me it would be extremely selfish of me to even consider [having kids]": The importance of reproductive health to women with spina bifida and the lack of support from their providers

BackgroundAs more women with spina bifida (SB) enter their reproductive years, the number having children is significantly increasing. However, little is known about their understanding of their ability to get pregnant or their experiences in considering, planning, or interacting with providers during a pregnancy.ObjectiveWe sought to determine what women have been told and understand about their reproductive health, their attitudes towards having children, and their experiences interacting with providers when seeking reproductive health care.MethodsIn this exploratory study employing qualitative research methods and following Grounded Theory, interviews with women with SB 16 years or older were transcribed verbatim and analyzed by three coders.ResultsInterviews of 25 women with SB ages 16–52 (median 26) revealed the following themes about their reproductive health perceptions and experiences: 1) poor understanding of reproductive health and potential, 2) interest in having a family, 3) facing provider's opposition to their reproductive goals, 4) going into pregnancy and delivery unprepared, 5) the importance of provider support for reproductive goals. Five women experienced an unintended pregnancy.ConclusionsAlthough having children is important to most women with SB in this study, they report a poor understanding of their reproductive potential with several noting unintended pregnancies. They feel uninformed and unprepared during pregnancy and face discouragement from providers. Those experiencing supportive providers report a more positive experience. This demonstrates the urgent need to educate women with SB about their reproductive health and the providers who care for them how to support and counsel these women.     

Hispanic Immigrant Father Involvement with Young Children in the United States: A Comparison with US-Born Hispanic and White non-Hispanic Fathers

Objectives Fathering is known to foster child development and health, yet evidence on Hispanic immigrant fathers’ involvement with their young children is sparse. This study assessed disparities in pregnancy intendedness and father involvement with children ages 0–4 among Hispanic immigrant co-resident fathers versus two reference groups: US-born Hispanic and US-born White fathers. We hypothesized that differentials in involvement were associated with socioeconomic and cultural factors. Methods Using 2011–2013 data from the National Survey of Family Growth (N?=?598), we performed bivariate, logistic and linear regression analyses to assess disparities in pregnancy intendedness and five father involvement outcomes (physical care, warmth, outings, reading and discipline). The models controlled for socio-economic, structural, health and cultural covariates. Results Pregnancy intendedness did not differ significantly between Hispanic immigrant fathers and the two reference groups. Compared with US-born Hispanics, unadjusted models showed that immigrant fathers were less likely to engage in physical care, warmth and reading, (p?≤?0.05) though the differences were attenuated when controlling for covariates. Hispanic immigrant fathers were less likely than US-born White fathers to engage in each of the father involvement outcomes (p?≤?0.05), with the disparity in reading to their child persisting even after controlling for all covariates. Conclusions for Practice We found marked socio-economic and cultural differences between Hispanic immigrant and US-born Hispanic and White fathers which contribute to disparities in father involvement with their young children. Hispanic immigrant status is an important determinant of involved fathering and should be taken into account when planning public health policies and programs.     

“We need good nutrition but we have no money to buy food”: sociocultural context,care experiences,and newborn health in two UNHCR-supported camps in South Sudan

Background

Determinants of newborn health and survival exist across the reproductive life cycle, with many sociocultural and contextual factors influencing outcomes beyond the availability of, and access to, quality health services. In order to better understand key needs and opportunities to improve newborn health in refugee camp settings, we conducted a multi-methods qualitative study of the status of maternal and newborn health in refugee camps in Upper Nile state, South Sudan.

Methods

In 2016, we conducted 18 key informant interviews with health service managers and front-line providers and 13 focus group discussions in two Sudanese refugee camps in Maban County, South Sudan. Our focus group discussions comprised 147 refugee participants including groups of mothers, fathers, grandmothers, traditional birth attendants, community health workers, and midwives. We analysed our data for content and themes using inductive and deductive techniques.

Results

We found both positive practices and barriers to newborn health in the camps throughout the reproductive lifecycle. Environmental and contextual factors such as poor nutrition, lack of livelihood opportunities, and insecurity presented barriers to both general health and self-care during pregnancy. We found that the receipt of material incentives is one of the leading drivers of utilization of antenatal care and facility-based childbirth services. Barriers to facility-based childbirth included poor transportation specifically during the night; insecurity; being accustomed to home delivery; and fears of an unfamiliar birth environment, caesarean section, and encountering male health care providers during childbirth. Use of potentially harmful traditional practices with the newborn are commonplace including mixed feeding, use of herbal infusions to treat newborn illnesses, and the application of ash and oil to the newborn’s umbilicus.

Conclusions

Numerous sociocultural and contextual factors impact newborn health in this setting. Improving nutritional support during pregnancy, strengthening community-based transportation for women in labour, allowing a birth companion to be present during delivery, addressing harmful home-based newborn care practices such as mixed feeding and application of foreign substances to the umbilicus, and optimizing the networks of community health workers and traditional birth attendants are potential ways to improve newborn health outcomes.

     

Navigating disability and related services: stories of immigrant families

Cultural beliefs, values, language differences, and unfamiliar educational infrastructures and practices can impact immigrant parents’ capacity to support their children with disabilities in their new country. This study presents perspectives of disability and experiences with special education services based on interviews with eight immigrant parents of children with disabilities from four countries. Results indicate that the process for accepting, or not accepting, that their child has a disability differed across cultural contexts. Additionally, immigrant parents encounter diverse labelling practices and have varying levels of participation in special education services. Moreover, immigrant families who are refugees have differential access to services and a more limited cultural perspective of their heritage country than families who came to the USA directly from their heritage country. These results can assist professionals in rethinking policies and practices to more effectively establish partnerships with culturally and linguistically diverse families.     

Undoing female genital cutting: perceptions and experiences of infibulation,defibulation and virginity among Somali and Sudanese migrants in Norway

Abstract

This paper explores the dynamics of change in meaning-making about female genital cutting among migrants from Somalia and Sudan residing in Norway. In both countries, female genital cutting is almost universal, and most women are subjected to the most extensive form – infibulation – which entails the physical closure of the vulva. This closure must later be re-opened, or defibulated, to enable sexual intercourse and childbirth. Defibulation can also ease other negative health consequences of the practice. In Norway, surgical defibulation is provided on demand by the public health services, also beyond the traditional contexts of marriage and childbirth. This study explores experiences and perceptions of premarital defibulation. It explores whether Somali and Sudanese men and women understand defibulation as a purely medical issue or whether their use of the services is also affected by the cultural meaning of infibulation. This study analyses data from in-depth interviews with 36 women and men of Somali and Sudanese origin as well as participant observation conducted in various settings during 2014–2015. It reports that although all of the informants displayed negative attitudes towards infibulation, cultural meanings associated with virginity and virtue constitute a significant barrier to the uptake of premarital defibulation.     

The Link Between Couples’ Pregnancy Intentions And Behavior: Does It Matter Who Is Asked?

CONTEXT: Previous studies have linked pregnancy intentions with some pregnancy‐related behaviors and infant health outcomes. However, most have used only women’s reports of intentions and examined only maternal behaviors. METHODS: Baseline data from the Fragile Families and Child Wellbeing Study (1998–2000) are used to examine whether parents of newborns considered abortion upon learning of the pregnancy and whether this measure of pregnancy intention is associated with their behaviors during pregnancy or with infant birth weight. Associations between outcomes and each parent’s pregnancy intention are explored with multivariate probit regressions or least squares regressions for 737 married and 2,366 unmarried couples. RESULTS: If at least one parent considered abortion, unmarried mothers had a significantly reduced probability of initiating early prenatal care, and unmarried fathers had a significantly reduced probability of providing cash or in‐kind support during the pregnancy. The proportion of mothers receiving care in the first trimester was 12 percentage points lower when the mother only or both parents considered abortion than when neither parent did; depending on which parent reported on fathers’ support during pregnancy, the proportion of fathers who provided cash or in‐kind assistance was 6–10 percentage points lower when the father only considered abortion and 6–14 points lower when both parents considered abortion than when neither did. CONCLUSIONS: Future research on pregnancy intentions should incorporate both men and women. Understanding men’s pregnancy intentions and their associations with early support of mothers may inform discussions of how to encourage men’s involvement in family planning, prenatal health care and parenting.     

Immigrant parent involvement in government funded early childhood education programming: an examination of FACES

ABSTRACT

Head Start is a federally funded early childhood education programme that takes a unique 2-generation approach to working with families. Family engagement in early education like Head Start has been shown to improve academic and behavioural outcomes in children, with particular beneficial effects in the children of immigrant parents. This study seeks to explore predictors of involvement in Head Start services among immigrant families. Through an examination of Family and Child Experiences Survey (FACES) 2009 data, this study uses bivariate and multivariate regression, and Karlson/Holm/Breen (KHB) analyses to determine variables associated with involvement in Head Start services. Results indicate that immigrant and U.S.-born parents do not differ in their levels of involvement in Head Start services. Rather, for both groups of parents, parental education attainment and satisfaction in services predicted levels of involvement. Furthermore, for mothers, the relationship between levels of educational attainment and involvement was fully mediated by mothers’ levels of employment.     

Mental health outcomes among parents of a child who has a developmental disability: Comparing different types of developmental disability

BackgroundThere is very little information on the effects of different types of developmental disability on the mental health of parents of children who have a DD.ObjectiveThis paper compared the mental health of parents of children with Autism Spectrum Disorder (ASD), Down syndrome, Fetal Alcohol Syndrome (FAS) and other types of DD.MethodsA cross-sectional design was used to examine population-level administrative health data for mental health outcomes in cohorts of fathers and mothers of children with four different types of a DD. As well as type of DD, additional variables were examined, these included: sex of the parent, age of the parent at birth of the child with the DD, income, sex of the child with the DD, number of children in the family and place of residence.ResultsFor both fathers and mothers odds of a diagnosis of depression or another mental health problem were associated with type of DD. Parents of children with FAS experienced the greatest odds of a depression or other mental health diagnosis. Odds of a diagnosis for fathers were associated with low income. Odds of a diagnosis for mothers were associated with the sex of the child with the DD.ConclusionsThese findings are important for understanding families which include a child with a DD, as a guide for future research, and for developing effective programs and services for these parents.     

Fathers' participation in childbirth at a public hospital: institutional difficulties and motivations of couples

Participation by fathers in the process of childbirth, an aspect of the humanization of obstetric care, helps foster the fathers' involvement in raising their children. This participation provides psychosocial support for pregnant women during labor and delivery, sharing of the experience by the couple, and father-child bonding. The focus of this ethnographic research was the impact of this process on fathers participating in childbirth at a State hospital in Rio de Janeiro, with two stages: participant observation of labor and delivery and eleven interviews with fathers who had been present at delivery. Fathers' participation was influenced by: the motivation of mothers and fathers; social representations of delivery and fatherhood; and exclusion of fathers from reproductive health and pediatrics services. The father's participation was not valued by the attending staff as either a source of emotional support for the mother or as part of fatherhood. The following are necessary: inclusion of fathers in prenatal care, delivery, and pediatrics services; the training of staff to work with the families; social discussion of fatherhood and health services policies to ensure the presence of fathers during labor and childbirth.     

Connecting Knowledge about Abortion and Sexual and Reproductive Health to Belief about Abortion Restrictions: Findings from an Online Survey

BackgroundThe objective of this research was to examine individuals' knowledge about abortion in the context of their knowledge about other sexual and reproductive health (SRH) issues, including contraception, abortion, pregnancy, and birth.MethodsDuring August 2012, we administered an online questionnaire to a randomly selected sample of 639 men and women of reproductive age (18–44 years) in the United States.FindingsRespondents reported the highest levels of perceived knowledge about SRH in general (81%), followed by pregnancy and birth (53%), contraception (48%), and abortion (35%); knowledge of specific items within each of these areas paralleled this pattern. Respondents who believe that abortion should be allowed in at least some circumstances were more likely to be correct regarding the safety and consequences of contraception and abortion. Characteristics associated with higher levels of knowledge regarding abortion-related issues included having higher levels of knowledge about non–abortion-related SRH issues and having less restrictive abortion beliefs.ConclusionsWomen and men are not well-informed about the relative safety and consequences of SRH-related experiences. Many overestimate their knowledge, and personal beliefs about abortion restrictions may influence their knowledge about the safety and consequences of abortion and contraception. Providers of SRH services should provide comprehensive evidence-based information about the risks and consequences of SRH matters during consultations, particularly in the case of abortion providers serving women who hold more restrictive abortion beliefs.     

Intergenerational relations,circumstances, and changes in mothers’ marital quality during two years following childbirth

Abstract

In this study, the researchers examined, from an attachment theory perspective, changes in mothers’ (n?=?707) perception of the marital relationship over the course of the two years following childbirth. We found a decline in perceived quality of mothers’ marital relationship over time, as well as several significant associations between birth circumstances (assisted reproductive technology, first/non-first baby), insecure attachment, and certain forms of support from the grandmothers on the one hand, and marital quality immediately after childbirth and over time on the other. Some forms of support served as partial mediators between attachment orientation and marital quality. We believe that the current findings can assist in designing interventions aimed at improving the spousal relationship after childbirth and decreasing potential stressors for both parents and newborns.     

Estado de salud y frecuentación de los servicios sanitarios de los menores hijos de inmigrantes

ObjectiveTo provide empirical evidence to assess whether having immigrant parents is a source of variation in health status and in health services’ utilization among children.MethodThe analysis was based on the sample of children from the Catalan Health Survey, 2006. Modelling of health status and use of health services was developed from the specification of distinct probabilistic models.ResultsThe results indicate that the children of immigrants had a significantly fewer chronic diseases, while perceived health status, according to the self-evaluation of the parents or responsible person, was worse if both parents belonged to this group. Significant differences were found in the utilization of distinct health services.ConclusionsThe analyses developed suggest that parental origin leads to differences in the utilization of the various levels of the Spanish health system. While no widespread pattern of increased or decreased utilization of the whole system was identified, differences were found in the number of specialist visits and admissions. Statements of the child's perceived health status were influenced by immigrant families’ socioeconomic conditions, which probably affected outcomes.     

Randomized Study of a Prebirth Coparenting Intervention With Adolescent and Young Fathers*

Abstract: This randomized study tested the effects of 2 prebirth interventions, Minnesota Early Learning Design coparenting and childbirth curricula, on young African American and Hispanic fathers and their adolescent partners (N = 154). The coparenting intervention (n = 44) was associated with changing fathers’ perceptions of their coparenting behavior rather than mothers’ perceptions of the fathers’ behavior compared with the childbirth program (n = 46). Fathers and mothers consistently reported fathers’ improved coparenting behavior when the coparenting intervention was compared with a no‐intervention control group (n = 64). Fathers (regardless of residence) and mothers residing with the father reported higher levels of fathers’ engagement with the infant when the father participated in the coparenting intervention compared with fathers who participated in the childbirth intervention.