Deborah Payne

Managing breastfeeding and work: a Foucauldian secondary analysis

AIM This paper is a report of a secondary analysis of the experiences of employed breastfeeding mothers. BACKGROUND Health promotion policies exhort mothers to feed their infants breastmilk exclusively for the first 6 months and partially until the age of 2 years. More mothers are returning to paid employment less than a year after having a baby. Combining breastfeeding and paid work is an issue for nursing and midwifery as predominantly female professions caring for women and their children. METHOD Foucauldian discourse analysis was used for a secondary analysis of interviews performed in 2005 with 20 women who continued to breastfeed on their return to work. The discursive positions and disciplinary practices were identified and analysed. FINDINGS Combining breastfeeding and paid work required negotiating the positions of good mother and good worker. Being a good mother conferred health benefits on infants. Being a good worker required the mothers to constrain their breastfeeding practices. The practices performed by the mothers involved stockpiling breastmilk, maintaining milk supply, preparing the baby ready for absence, making sacrifices and remaining silent and invisible as a breastfeeding worker. CONCLUSION Breastfeeding workers have the potential to threaten the focus of the workplace. They discipline themselves to minimize their disruptive potential. Such strategies serve to maintain the marginalization of breastfeeding in the workplace and to keep womens efforts to continue breastfeeding invisible. The work of breastfeeding workers needs to be better recognized and supported.

Becoming mothers. Multiple sclerosis and motherhood: A qualitative study

Purpose. This study aimed to provide a better understanding of the experiences of women with multiple sclerosis (MS) in becoming or being a mother. The research also focused on eliciting their perspectives of strategies that helped them and their families manage mothering young children whilst living with MS. Method. A qualitative, interpretive, descriptive approach using individual interviews to elicit and analyze womens experiences of MS and pregnancy, birth, and mothering young children. Results. Analysis of interviews with nine women produced six key themes: becoming a mother as a public private experience, keeping the baby safe; support; conserving energy; being the ideal mother; and backgrounding of their MS. Having MS required the women to set in place specific strategies for managing pregnancy and motherhood associated with a number of these issues such as gathering information and identifying sources of physical and social support. Conclusion. This study highlights how pregnancy and motherhood are valued, but challenging times, for women with MS. Recommendations about how services might respond to the specific challenges for women with MS considering or becoming mothers are proposed.

Embryo donation in New Zealand: a pilot study

BACKGROUND In New Zealand, embryo donation to others was approved in late 2005 and follows strict guidelines. To date, few donations have proceeded. Given the novelty of embryo donation and New Zealands guidelines around donation, this study explores how potential recipients in New Zealand made meaning of embryo donation. METHODS Thirteen potential recipients were interviewed regarding decision-making around embryo donation. Data were analysed thematically, identifying the major concerns that shaped their perspectives and decision-making regarding embryo donation. RESULTS The concept of genetic lineage emerged as the most important consideration. Participants viewed the embryo as a direct and permanent link between the genetic parents and the child resulting from donation. The genetic link implied ongoing responsibility, interest, care and even ownership. Participants were particularly cognizant of the need for children born from embryo donation to have access to information regarding their heritage. Wider concerns around the quality of the embryos genetic material were expressed. Neither discarding surplus embryos nor embryo donation was seen as easy options. Participants found embryo donation to be a psychologically and morally complex issue and expressed some caution about pursuing this option. CONCLUSIONS The emphasis on genetic lineage as a priority in decision-making needs to be recognized especially within contexts where guidelines emphasize donor registration and cultures are shaped by open-adoption practices and the importance of knowing ones lineage.

The shaping of organisational routines and the distal patient in assisted reproductive technologies.

In this paper we comment on the changes in the provision of fertility care in Australia, New Zealand and the UK to illustrate how different funding arrangements of assisted reproductive technologies (ART) shape the delivery of patient care and the position of fertility nursing. We suggest that the routinisation of in vitro fertilisation technology has introduced a new way of managing the fertility patient at a distance, the distal fertility patient. This has resulted in new forms of organisational routines in ART which challenge both traditional forms of nursing and advanced nursing roles. We discuss the consequences of this increasingly globalised approach to infertility through the lens of three national contexts, Australia, New Zealand and the UK to unpack the position of nursing within the new forms of organisational routines.

‘It just makes you feel invincible’: a Foucauldian analysis of children's experiences of organised team sports

The childhood years are highlighted as a crucial time when ongoing participation in physical activity can be nurtured and maintained. The nurturing of a childs proclivity to participate in organised sport normally falls into the domain of adults. While both parents and coaches have been identified as key influences on childrens enjoyment of sport, some negative perceptions exist about their roles. Although childrens perspectives are increasingly being acknowledged as valuable, it would appear that young children are still marginalised as active participants in areas of health-related research. The primary objective of this study was to give space to childrens views of organised sport and to examine how adult behaviours affected these childrens enjoyment of sport. This qualitative study utilised eight focus group interviews with a total of 30 children (aged 6–11 years) in the Greater Auckland area of New Zealand. This paper presents a Foucauldian discourse analysis of childrens views relating to their sporting experiences. Children articulated three discursive constructions of sport: sport as competition, sport as fun and sport as fair play. The dominance of sport as competition would appear to serve the needs of coaches and parents more than those of children. Coaches who appear to be firmly positioned within a competitive discourse of sport use their power to support coaching practices that clash with the guidelines provided for them by their sporting bodies. Our analysis shows that many children may be exposed to discursive practices that are not conducive to a child-centred sporting environment. Through the exercise of disciplinary measures, there is pressure on children to conform to the normative behaviours associated with a dominant competitive sport discourse.

Childhood Constructions of Contemporary Technology: Using Discourse Analysis to Understand the Creation of Occupational Possibilities

Ten children aged 10-12 years were audio recorded discussing and demonstrating the types of technology they regularly used at home. A critical discourse analysis of the transcriptions was completed to identify dominant discourses the children deployed. Philosopher Michel Foucaults theories on the history of existence, power relations, the subject, and ethics of the self informed the analysis. Three discourses were identified: virtual reality as a new dimension, panoptic play, and technological play as risky. The children appeared to assume subject positions within their play that have been created by and through their technology use. These subject positions were created by the unique historical context of the present era and have allowed new relations of power to develop for children. The discourses and associated discursive constructions appear to have an effect on the occupational possibilities available to children at this life course stage, indicating the emergence of norms of behaviour and relations of power unique to technological play.

It's all about winning, isn't it? Competing discourses in children's sport in New Zealand

Abstract Children participating in organized team sports are both the objects and subjects of competing discourses, which can create contradictory and sometimes confusing experiences for those involved. Influenced by Foucault’s concept of discourse and drawing upon the experiences related by a focus group of sports administrators, this article argues that the construction of children’s sport is heavily influenced by the collision between three dominant discourses each of which constructs sport in a particular way: one of sport as a long term development of sport specific skills (progressive-developmental discourse); another of sport with a pre-occupation with winning (competitive discourse); and another of sport that is more child-centred (fun discourse). This analysis increases our understanding of the complexities and tensions that shape a child’s sporting experience.

Revealing Tact Within Postnatal Care

In this article, we explore the nature of good postnatal care through a hermeneutic unpacking of the notion of tact, drawing on the philosophical writings of Heidegger, Gadamer, and van Manen. The tactful encounters considered were from a hermeneutic research study within a small, rural birthing center in New Zealand. Insights drawn from the analysis were as follows: the openness of listening, watching and being attuned that builds a positive mode of engagement, recognizing that the distance the woman needs from her nurse/midwife is a call of tact, that tact is underpinned by a spirit of care, within tact there are moods and tact might require firmness, and that all of these factors come together to build trust. We conclude that the attunement of tact requires that the staff member has time to spend with a woman, enough energy to engage, and a spirit of care. Women know that tactful practice builds their confidence and affects their mothering experience. Tact cannot be assumed; it needs to be nurtured and sheltered.

Taking It Into Account: Caring for Disabled Mothers During Pregnancy and Birth

BACKGROUND: Although more disabled women are pursuing motherhood over time, little is known about their needs and experiences in achieving this goal. METHODS: A 3-phase study was designed with the aim of identifying ways for services to be more responsive for women living with physical or sensory impairment during and after pregnancy. This article draws on the qualitative phases of a 3-part mixed method study, which involved individual and focus group interviews with the women and maternity and child health practitioners. RESULTS: Sixty-two mothers with either a physical or a sensory impairment and 28 health practitioners participated in the study. Three themes were identified in relation to the current approaches to service provision: that the women were often responsible for educating the practitioners about their impairment, that they often encountered disabling environments, and that it was not uncommon for them to also encounter disabling attitudes from others. Strategies suggested by our participants to improve the provision of maternity services were for women’s impairments to be taken into account in the structure and process of service provision and for practitioners to problem solve and think ahead of how to meet the needs of disabled mothers. CONCLUSION: The need to take the woman’s impairment into account was an overarching issue and strategy identified by both women and practitioners. This consideration has relevance not only at the practitioner–women interaction level but also for educational, structural service provision and policy levels.

Physically disabled women and sexual identity: a PhotoVoice study

Abstract The issue of sexuality for young disabled women is not often talked about in society. Our study aimed to explore four young physically disabled women’s experiences and perspectives regarding sexuality and disability. We used PhotoVoice, a participatory action research method which uses photographs, to capture and convey our participants’ concerns. Through their photographs they showed that everyday interactions with others, particularly strangers or meeting people for the first time, were made difficult by how they were always seen as having a disability. Other parts of their identity were not recognised. The change the young women wanted was for people to see them as young women and not just as disabled.