J. D. Keeping

The mental health of women 6 months after they give birth to an unwanted baby: A longitudinal study

This study reports a longitudinal prospective study of the impact of an unwanted pregnancy on the mental health of the mother. Data are derived from a Brisbane, Australian sample of 8556 mothers who were enrolled at their first clinic visit (mean gestation 18 weeks) and then interviewed again some 3-5 days after the birth and when the baby was 6 months of age. Standard scales of mental health were administered on each of these occasions and mothers whose babies were unwanted were compared with the rest of the sample. The results indicate that mothers of unwanted children have somewhat higher rates of anxiety and depression than the comparison group, but that the magnitude of the mental health differences between the two groups: (a) diminishes over the period of the follow-up, (b) may be partly attributable to the prior poor mental health of women giving birth to an unplanned and unwanted baby, (c) is such that relatively few women who give birth to an unwanted baby experience mental health problems. The paper considers the implications of these results for health planners, notes the absence of contrary data and the need to acknowledge that these results may reflect situational factors which are characteristic of but not necessarily limited to Brisbane.

Information control and the exercise of power in the obstetrical encounter

Interactions between doctor and patient involve participants with unequal power and possibly different interests. While a number of studies have focused upon the doctor/patient relationship, few have examined the utility of the concept of power and its capacity to help us understand the outcome of these interactions. The information sought by pregnant women from their obstetricians is used to provide a case study of one conceptualization and test of the utility of the concept of power. Pregnant women and their obstetricians are found to have different perceptions of the information that should be exchanged during their interactions. Women generally fail to obtain the information they want. Lower social class patients desire more and obtain less information than their higher status counterparts.

BIRTH WEIGHT: ANALYSIS OF VARIANCE AND THE LINEAR ADDITIVE MODEL

The normal distribution of birth weight in a Queensland population has been surveyed. A method of analysis is presented which allows for the influence of a number of factors that affect birth weight.

Religious values, practices and pregnancy outcomes: a comparison of the impact of sect and mainstream Christian affiliation.

In this report 6566 women enrolled in the Mater-University of Queensland Study of Pregnancy (MUSP) were separated into three groups; members of religious sects, Christians who attend church frequently and Christians who are infrequent attenders. These three groups, respectively labelled Christian sects, Christian attenders and lukewarm Christians were compared on a number of social background, lifestyle and pregnancy outcome variables. The sect members appeared to have the most favourable health, lifestyles and healthy babies at delivery, though this latter finding appears attributable to specific characteristics of the mother and her lifestyle. On most measures the children of lukewarm Christians appear to manifest the worst health while Christian attenders form a group whose childrens health is between that of sect members and lukewarm Christians.

Poor Antenatal Attendance and Obstetric Performan

Summary: A survey of attendance for antenatal care at a public hospital in Brisbane was carried out.“Poor attenders” were more likely to be young, unmarried, grande multiparous, or aboriginal, and to live in a poorer area of the City. This group comprised 6.5% of the total population, but accounted for 14.6% of all low Apgar scores, 23 % of all low birth weight babies, 23.1 % of all stillbirths, and 18.2% of all neonatal deaths.

The Employment of Mothers and the Outcomes of their Pregnancies: An Australian Study

One of the more dramatic structural changes in a number of western industrial societies has involved the increased participation of women in the paid labour force. Little is known about the health consequences of this change. This paper reports the findings of a prospective longitudinal study of 8,556 pregnant women who were interviewed on three occasions; early in their pregnancy, shortly after the birth of the baby and some six months later. Additional data were derived from the medical record of the delivery. The findings suggest that employed women and housewives differ in their health behaviour (e.g. number of missed appointments, attendance at antenatal classes, smoking) and emotional health in pregnancy, but that there are no significant differences between employed women and housewives in their physical health or pregnancy outcomes. Although none of the differences was statistically significant, virtually all of the indices of outcome were slightly more favourable for the housewives than for the employed women.

Perinatal Death: Audit and Classification

Summary: Two hundred and thirteen perinatal deaths occurred in a population of 10,539 deliveries over a 4‐year period. The associated obstetric complications and circumstances were analysed.

Birthweight Below the Tenth Percentile: The Relative and Attributable Risks of Maternal Tobacco Consumption and Other Factors

Analysis of 7776 singleton births defined a cohort of babies with birthweight below the 10th percentile after adjusting for gestational age and sex. The relative risk of a baby being small for gestational age in respect to a number of factors, such as parental anthropometry, demographic factors, behavior patterns (tobacco, cannabis, alcohol, and caffeine consumption), maternal pathology, and fetal abnormality, was calculated. The highest relative risks are associated with severe antepartum hemorrhage, severe pre-eclampsia, and severe fetal abnormality. As these are relatively rare events, a more accurate calculation of overall risk to the population as opposed to the individual can be obtained by studying the percent attributable risk of each of the factors. This demonstrates that maternal tobacco consumption is the major environmental risk factor in our population.

Understanding Preterm Labour: The Use Of Path Analysis

A retrospective study was performed on 465 spontaneous preterm and 13,949 term births, in order to analyze the sequence of events that culminate in preterm labour. Twenty‐one variables were investigated by the mathematical technique of Path Analysis. Nine direct and independent precursors of preterm labour were identified. These were antepartum haemorrhage, poor antenatal attendance, previous delivery of a small baby, multiple pregnancy, proteinuria, grand multiparity, cervical suture, low maternal weight, and a history of bleeding before 20 weeks.

Sterilization: a comparative review.

Summary: Publications relating to surgical procedures for sterilization have been reviewed, and the incidences of complications and subsequent pregnancies compared.