A Prospective Study Of Psychosocial Predictors Of Reproductive Outcome In Younger And Older Pregnant Women

The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.

This book provides a collective examination of the theoretical, empirical, and clinical perspectives of pregnancy-related anxiety. Pregnancy-related anxiety is a distinct form of anxiety that is experienced by pregnant women and is characterized by pregnancy-specific fears and worries. This form of anxiety has been associated with a range of negative obstetric, neonatal, and maternal outcomes. There has been increased research interest in this form of anxiety, particularly over the last 15 years. The content is organized in three sections. The first section provides a thorough understanding of pregnancy-related anxiety, ranging from its historical development, evidence of its distinctiveness to the antecedents and outcomes of this anxiety for the mother and child. The second section examines key clinical issues around diagnosis and treatment specifically, current diagnosis/screening for this anxiety and approaches for intervention and treatment. The final section considers emerging areas of research such as pertinent issues around culture and acculturation which are key issues in an increasingly multicultural world. Moreover, the effects of pregnancy-related anxiety on the woman’s broader psychosocial functioning are considered with specific chapters on body image and sexual abuse, two key areas of concern. A seminal resource, this book provides a broad examination of the topic from multiple frameworks and perspectives which sets this book apart from other books in print. This book intends to inform and stimulate future research studies, as well as increase awareness and understanding of pregnancy-related anxiety. It is a must-read for researchers, educators, clinicians, and higher education students who care about delivering better support and services to pregnant women, particularly those who are vulnerable and distressed.

Experts estimate that nearly 60 percent of all U.S. pregnanciesâ€"and 81 percent of pregnancies among adolescentsâ€"are unintended. Yet the topic of preventing these unintended pregnancies has long been treated gingerly because of personal sensitivities and public controversies, especially the angry debate over abortion. Additionally, child welfare advocates long have overlooked the connection between pregnancy planning and the improved well-being of families and communities that results when children are wanted. Now, current issuesâ€"health care and welfare reform, and the new international focus on populationâ€"are drawing attention to the consequences of unintended pregnancy. In this climate The Best Intentions offers a timely exploration of family planning issues from a distinguished panel of experts. This committee sheds much-needed light on the questions and controversies surrounding unintended pregnancy. The book offers specific recommendations to put the United States on par with other developed nations in terms of contraceptive attitudes and policies, and it considers the effectiveness of over 20 pregnancy prevention programs. The Best Intentions explores problematic definitionsâ€""unintended" versus "unwanted" versus "mistimed"â€"and presents data on pregnancy rates and trends. The book also summarizes the health and social consequences of unintended pregnancies, for both men and women, and for the children they bear. Why does unintended pregnancy occur? In discussions of "reasons behind the rates," the book examines Americans' ambivalence about sexuality and the many other social, cultural, religious, and economic factors that affect our approach to contraception. The committee explores the complicated web of peer pressure, life aspirations, and notions of romance that shape an individual's decisions about sex, contraception, and pregnancy. And the book looks at such practical issues as the attitudes of doctors toward birth control and the place of contraception in both health insurance and "managed care." The Best Intentions offers frank discussion, synthesis of data, and policy recommendations on one of today's most sensitive social topics. This book will be important to policymakers, health and social service personnel, foundation executives, opinion leaders, researchers, and concerned individuals.

Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration. A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families. The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public.

presented in the Introduction (Chapter 1). The focus of Chapter 1 is twofold: (1) to present the research foundations for the psychophysiological correlates of prenatal psychosocial adaptation and the seven prenatal personality dimensions with progress in labor and birth outcomes, and particularly (2) to present the theory underlying the seven dimensions of prenatal psychosocial adaptation, which are further analyzed in the following seven chapters. Chapters 2–8 present a content analysis of the interview responses to the seven significant prenatal personality dimensions that are predictive of pregnancy adap- tion, progress in labor, birth outcomes, and postpartum maternal psychosocial adaptation, and they include: (1) Acceptance of Pregnancy, (2) Identification with a Motherhood Role, (3) Relationship with Mother, (4) Relationship with Husband, (5) Preparation for Labor, (6) (Prenatal) Fear of Pain, Helplessness, and Loss of Control in Labor, and (7) (Prenatal) Fear of Loss of Self-Esteem in Labor. There is no other comparable comprehensive, in-depth, prenatal personality research or empirical and content analysis of pregnancy-specific dimensions of maternal psychosocial adaptation to pregnancy.

The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.

Encyclopedia of Mental Health, Second Edition, tackles the subject of mental health, arguably one of the biggest issues facing modern society. The book presents a comprehensive overview of the many genetic, neurological, social, and psychological factors that affect mental health, also describing the impact of mental health on the individual and society, and illustrating the factors that aid positive mental health. The book contains 245 peer-reviewed articles written by more than 250 expert authors and provides essential material on assessment, theories of personality, specific disorders, therapies, forensic issues, ethics, and cross-cultural and sociological aspects. Both professionals and libraries will find this timely work indispensable. Provides fully up-to-date descriptions of the neurological, social, genetic, and psychological factors that affect the individual and society Contains more than 240 articles written by domain experts in the field Written in an accessible style using terms that an educated layperson can understand Of interest to public as well as research libraries with coverage of many important topics, including marital health, divorce, couples therapy, fathers, child custody, day care and day care providers, extended families, and family therapy