ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00528.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT:This survey investigated the cesarean section rate in teaching hospitals in the United States and the factors that may influence it. A national survey was performed by mailing a questionnaire to 277 accredited residency programs in obstetrics and gynecology. The estimated cesarean rate in all hospitals, with residencies in obstetrics and gynecology in the United States in 1990 was 20.3 percent, compared with an overall national rate of 23.5 percent. Women delivering in teaching hospitals were less likely to have a cesarean section than those delivering in hospitals without residency programs (odds ratio = 0.77, 95% CI 0.77–0.78, p = 0.0001). As centers for training and research, teaching hospitals represent an appropriate setting to begin the process of lowering the United States cesarean section rat

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00529.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT:Since 1981, the cesarean birth rate of a joint practice has been consistently lower than that of physician‐only practices at a private community hospital in Yolo County, California. This study sought to determine whether differences in perinatal outcomes were influenced by women's use of a joint versus a physician‐only practice or were associated with parity, maternal age, or newborn birthweight. Data from the hospital's 1634 consecutive singleton births in 1990 were examined, using a prospective concurrent analytic cohort study design. Chi square statistics and stepwise logistic regressions were used for data analysis. The joint practice had a significantly lower rate of total cesarean births (9.3%) compared with the physician‐only practices (17.7%); the frequencies of severe lacerations were 1.0 percent and 6.4 percent, respectively. No significant differences were found in parity, birthweight, or newborn outcomes in the two types of practice. Type of practice was the major determinant of cesarean birth (p>0.0001). All variables studied, including type of practice, were significant determinants of primary cesarean birth. Parity and practice type were significant determinants of third‐ and fourth‐degree lacerations (p>0.0001). The type of practice from which women receive care is significantly associated with both method of birth and possibility of severe perine

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00530.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT:This prospective, longitudinal study was conducted to describe the experiences of 82 primiparas who breastfed longer than 12 months. They were compared with 541 primiparas who weaned their infants within the first year. Greater age, education, and weeks of exclusive breastfeeding were associated with longer duration of breastfeeding. More than two‐thirds (68%) of the women who breastfed longer than one year returned to employment before their infant was 1 year old. The most frequently chosen reason for long‐term breastfeeding was that breastfeeding was a special time for mother and baby that the mother was not ready to give up. Nearly half of the women reported breastfeeding their‐ babies on demand. At 12 to 15 months, 54 percent of the babies slept in a crib in a separate room, and 37 percent slept in the same bed with their mother all or part of the night. Most mothers (57%) considered their support group to be slightly or moderately important in influencing their decision to breastfeed beyond a year, and 10 percent considered it to be extremely important. The major themes that emerged from women's comments were the importance of being strong in the face of social unacceptability, development of n close mother‐child bond, and the naturalness of breastfeeding beyond 12 months. Health caregivers should recognize the emotional and interpersonal aspects of long‐term breastfeeding, support the breastfeeding relationship, and avoid contributing to the development of “closet nursers” so that women may feel free to discuss their concerns about their c

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00531.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT:This field study used the ethnographic method to describe and analyze the labor experiences of childhood sexual abuse survivors. The sample included seven sexual abuse survivors, five nurse‐midwives, and three labor and delivery nurses. Data collection included in‐depth interviews, participant observation in labor and delivery over a period of six years, and anecdotal material from the literature. Analysis followed Spradley's Developmental Research Sequence and included domain, taxonomic, componential and theme analysis. Women reported both forgetting and remembering abusive incidents, and described labor sensations reminiscent of sexual abuse. A heuristic for appraising labor styles suggestive of past sexual abuse includes fighting, taking control, surrendering, and retreating. These styles are considered extremes of women's reactions to labor and are directly linked to posttraumatic stress disorder. This study demonstrated that it is important for perinatal caregivers to understand the link between childhood sexual abuse and childbirth so that they can assist women to have a positive birth experi

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00532.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT:Over 80 million women in more than 30 countries have undergone female genital mutilation, also called female circumcision, according to World Health Organization estimates. Over the past decade 70,000 Somalians have become residents in Canada, 50,000 of whom live in Toronto, Ontario. Many of the women are of childbearing age, and 99.5 percent of women in Somalia are reported to have been genitally mutilated. Canadian medical organizations have published position statements prohibiting the practice. This case report describes the pregnancy and childbirth of a Somalian woman with the infibulation type of procedure. When perinatal health professionals are aware of and sensitive to the cultural and medical implications and sequelae of female genital mutilation, they will give better care to affected women.

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00533.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00534.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT:Ancient cultures have applied a variety of fascinating therapies to prevent the occurrence and reoccurrence of miscarriage. Ceremonies of ritual purification, special prayers, and a variety of medicinal therapies were employed throughout the ages to prevent this feared event. Rituals to memorialize and help mourn the lost pregnancy were developed in many cultures. These rituals reinforce how deeply men and women are affected by early pregnancy loss.

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00535.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00536.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00537.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY