Shorter ultrasonic femur lengths in Hmong fetuses.
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Asia, Southeastern↗
Biomedical subjects
D K Gjerdingen
Publications and source records attributed to D K Gjerdingen.
Growth of Hmong children.
OBJECTIVE: To investigate the growth of a group of young Hmong children. DESIGN: In this descriptive, comparative study, length and weight measures of Hmong children were abstracted from medical charts for each previous clinic visit (newborn to most recent visit) where both measures had been recorded, and measures were compared with National Center for Health Statistics (NCHS) standard percentiles. Visits occurred from 1988 to 1994. PARTICIPANTS AND SETTING: Participants were 579 Hmong children, ages 0 to 5 years, who were active patients at a family practice residency clinic. MAIN OUTCOME MEASURES: Length and weight. RESULTS: This group of Hmong children showed lengths similar to those of the NCHS reference population for the first 6 to 12 months of life, after which they lagged behind reference lengths. By the 24th month, median length for Hmong girls and boys was less than the NCHS 25th percentile. The Hmong children's average weight was slightly higher than the NCHS median until about 8 months of age, after which the distributions were similar. CONCLUSIONS: Compared with children who comprise the NCHS reference population, the Hmong children in this study were slightly heavier in the first several months of life, and shorter thereafter. Therefore, in general, the Hmong children were proportionately heavier than other children of similar height.
Anthropometry↗
Family practice residents' maternity leave experiences and benefits.
BACKGROUND: A growing number of residents are having babies during residency training. While many businesses are working to improve maternity conditions and benefits for their employees, residency programs are often not prepared to accommodate pregnant residents. This study was conducted to examine the maternity leave experiences of women who delivered infants during their family practice residency training. METHODS: Program directors from each of the 394 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs were asked to distribute surveys to female residents who gave birth during their residency training and had returned to work by the time of the study. RESULTS: Of 199 known eligible residents, 171 (86%) completed surveys; these women represented 127 programs located in 36 states and Puerto Rico. Only 56.8% of women were aware of their program having a written maternity leave policy. The average length of maternity leave was 8 weeks; 76% had leaves of 10 weeks or less. For many, the maternity leave was derived from more than one source, including vacation, sick time, or a mother-child elective. Nearly all (88.3%) the women breast-fed, and the mean duration of breast-feeding was more than 19 weeks. In general, participants believed that having a baby during residency was somewhat difficult. Problems frequently encountered by women after their return to work included sleep deprivation and tiredness, difficulty arranging for child care, guilt about child care, and breast-feeding. Factors that detracted most from the childbirth experience were too little sleep, problems arranging for child care, and lack of support from the partner, residency faculty, and other residents. CONCLUSIONS: Having a baby during residency is somewhat difficult for the average female resident. Factors that may ease this difficulty include getting adequate sleep and receiving support from one's partner, faculty, and other residents.
Adult↗
Women's postpartum maternity benefits and work experience.
BACKGROUND: This study was conducted to describe women's perceptions of their maternity leave policy and its implementation, maternity leave benefits, postpartum work experience, and factors that relate to returning to work. METHODS: Surveys were mailed to 436 married, recently employed, first-time mothers at 1, 3, 6, 9 and 12 months postpartum. RESULTS: Most respondents said they had written maternity leave policies they could understand, but they were not completely satisfied with their policies. The average 11.1-week maternity leave was considerably shorter than their 8-month ideal, and only 25.5% had the option of working part-time. A minority (35.8%) were allowed to use personal days to care for a sick infant. Most women were distressed about making child care arrangements. Compared with women who remained at home, those who returned to work complained of more respiratory, gynecologic, and breast symptoms. CONCLUSIONS: Relatively little is known about women's postpartum work experience. In this study, return to work after delivery was related to several demographic, occupational, and social factors and was associated with health problems and concerns about child care. With a majority of new mothers now returning to work, attention has recently been directed to factors that facilitate the merger of work and parenting roles. One such important factor is women's parental or maternity leave benefits, the focus of this study.
Adult↗
Mothers' experience with household roles and social support during the first postpartum year.
This prospective, longitudinal study was conducted to investigate the changes in the division of household labor, and in the emotional and practical support received by new mothers during the first postpartum year. Questionnaires were completed by 436 married, recently employed mothers at 1, 3, 6, 9, and 12 months after they had delivered their first child. Results showed that women assumed primary responsibility for the majority of household tasks studied, and that they perceived declines over time in their husbands' participation in household chores, their husbands' and others' expressions of caring, and in the frequency with which friends and relatives "helped out" during the year. Women who had had cesarean sections (versus those with vaginal deliveries) and who returned to work (versus those who stayed home) believed their husbands participated more in traditionally feminine household chores. Women's satisfaction with their husbands' contribution to household activities was significantly related to their own mental health, delivery type (cesarean section), job status (being at home vs. back at work), and family income; and to their husbands' occupation, expressions of caring, and participation in child care and certain household chores (house cleaning, grocery shopping, cooking, washing clothes and dishes, household repairs, car maintenance, and garbage removal). Overall, these findings showed diminishing levels of emotional and practical support for women at a time when the need for support was likely greater: following the birth of their first child.
Adult↗
The relationship of women's postpartum mental health to employment, childbirth, and social support.
BACKGROUND: This study was conducted to examine changes in women's mental health over the first postpartum year and factors that are associated with mental health. METHODS: Participants included women who were married, employed, English-speaking, and giving birth to their first child at one of two hospitals in St Paul, Minnesota. Women who were eligible and willing to participate were mailed questionnaires at 1, 3, 6, 9, and 12 months postpartum. RESULTS: There were significant changes in mothers' general mental health, depression, and anxiety over the first postpartum year (P < or = .01), with least favorable outcomes at 1 month and most favorable outcomes at 12 months postpartum. Poor mental health was related to work factors, such as longer work hours and maternity leave of less than 24 weeks, and to variables often associated with recent childbirth, such as maternal fatigue, loss of sleep, concerns about appearance, and infant illnesses. In addition, postpartum symptoms were predicted by physical illness, previous mental problems, poor general health, poor social support, fewer recreational activities, young age, and low income (R2 = 37% to 57%). CONCLUSIONS: In this select group of women, postpartum mental health was found to be least favorable 1 month after delivery and related to factors associated with employment, recent delivery, and level of social support.
Adult↗
Changes in women's physical health during the first postpartum year.
OBJECTIVE: To examine changes in women's physical health during the first postpartum year. DESIGN: Participants completed surveys at 1, 3, 6, 9, and 12 months post partum. PARTICIPANTS AND SETTING: Four hundred thirty-six first-time mothers who gave birth at one of two St Paul, Minn, hospitals during a 12-month period and who met the criteria for the study. MAIN OUTCOME MEASURES: Physical symptoms and number of illness days experienced within the previous 2 weeks. RESULTS: Physical problems seen at a higher prevalence at 1 month post partum included breast symptoms, vaginal discomfort, fatigue, hemorrhoids, poor appetite, constipation, increased sweating, acne, hand numbness or tingling, dizziness, hot flashes, and illness days. Several of these disorders--hemorrhoids, dizziness, fatigue, and constipation--persisted beyond 1 month and were joined by other "late" problems, including respiratory symptoms, sexual concerns, and hair loss. Women who returned to the work force noted more symptoms of respiratory infections, and women with vaginal deliveries had a higher prevalence of hemorrhoids, vaginal discomfort, pain with intercourse, difficulty reaching orgasm, sinus problems, and acne. CONCLUSIONS: Recovery from childbirth often requires more than the 6 weeks traditionally allotted, and postpartum health appears to be affected by delivery type and work status.
Adult↗
Follow-up of abnormal Papanicolaou smears among women of different races.
BACKGROUND: Current information about racial differences in the rate of cervical abnormalities is incomplete, and there are few data about racial differences in compliance with follow-up and treatment. The purpose of this study was to investigate the frequency and follow-up of abnormal Pap smear findings in white, black, and Southeast Asian women. METHODS: The charts of women who attended a St Paul family practice residency clinic and who had abnormal Papanicolaou (Pap) smear results between January 1, 1989, and September 1, 1992, were reviewed, and information about age, race, insurance, Pap smear findings, diagnostic studies, and treatment procedures was recorded. RESULTS: Of 1794 women who had Pap smears during this period, 190 (10.6%) had abnormal results, with a diagnosis of atypia, dysplasia, or carcinoma. The rate of abnormality was greater for black women (16.4%) than for Southeast Asian (6.1%) and white women (11.6%); however, the proportion of abnormal Pap smears that showed moderately severe or worse changes was greater for Southeast Asians than for whites (30.6% vs 14.3%, P < .05). Southeast Asian women with abnormal Pap smears were also less likely than whites and blacks to follow through with recommended diagnostic and treatment procedures. CONCLUSIONS: Southeast Asian women in this study were less likely than white and black women to comply with recommended follow-up diagnostic and treatment procedures for cervical disease.
Asian People↗
The parental leave debate: implications for policy relevant research.
Legislative activity regarding parental and family medical leave has been intense, with heated debate, in both national and state political arenas. Proponents of legislation report that policy is needed because of women's increasing rate of labor force participation and the concomitant shortage of substitute infant care. Benefits of policy are presumed to include women's health and parent-child bonding. However, no direct empirical evidence exists to support these assumptions. Opponents of legislation say that the cost of policy is burdensome to employers. However, the General Accounting Office reports that the only measurable net costs to employers associated with the federal bill will be to cover the leave takers' health insurance premiums. This literature review examines the above issues and identifies a policy relevant research agenda, crucial to the development of rational and humane policy.
Child Day Care Centers↗
Predictors of health in new mothers.
This survey study was conducted to determine the variables that predict mothers' mental health, work readiness, and use of health services several weeks after they give birth to, or adopt a baby. Regression analyses on 313 married women (108 first-time adoptive mothers, 72 first-time biological mothers, and 133 controls) showed a strong link between biological mothers' postpartum health and their infants' health; this relationship was not observed for adoptive mothers and their infants. Biological mothers' postpartum health problems were also related to their smoking, fatigue, and current work at a job; further, their readiness to work at a job two months postpartum was greater if they were in good general health, had not had a cesarean section, and were not currently breastfeeding. The results suggest that many mothers continue to have unique health needs several weeks after delivery and, if substantiated by future studies, these findings may have implications for postpartum health care practices and for maternity leave policy.
Adoption↗
The measure of health in new mothers: a factor analysis of physical and mental health variables.
This factor analysis study was conducted to determine the components of health in new mothers. The 286 participants included three groups of married women: 63 first-time biological mothers, 104 first-time adoptive mothers, and 119 controls (women without children). Results for the entire participant group showed four health status factors--mental health, use of health services, work readiness, and activity--and these four factors yielded a cumulative variance of 62.8%. While three of the factors--mental health, use of health services, and work readiness--were represented in the factor structures of each of the three groups, there were noteworthy differences in the constituents of factors between groups. The current change in roles and responsibilities of new mothers calls for a careful look at the health of this group of women; the health factors identified in this study may provide useful tools for further research involving these important members of our society.
Adoption↗
The effects of social support on women's health during pregnancy, labor and delivery, and the postpartum period.
This review of the literature on social support and its relationship to maternal health indicates that emotional, tangible, and informational support are positively related to mothers' mental and physical health around the time of childbirth. The importance of various types of support changes with the changing needs of women as they move from pregnancy to labor and delivery, and then to the postpartum period. During pregnancy, emotional and tangible support provided by the spouse and others is related to the expectant mother's mental well-being. In addition, informational support in the form of prenatal classes is related to decreased maternal physical complications during labor and delivery, and to improved physical and mental health postpartum. Mothers who have the support of a companion during labor and delivery experience fewer childbirth complications and less postpartum depression. Mothers' postpartum mental health is related to both the emotional support and practical help (eg, housework and child care activities) provided by the husband and others. Health care providers are in a unique position to educate prospective parents about the importance of social support around the time of childbirth and may play a critical role in mobilizing support systems for new mothers.
Delivery, Obstetric↗
Changes in women's mental and physical health from pregnancy through six months postpartum.
A longitudinal study was conducted to investigate changes in women's mental and physical health around the time of childbirth, and to determine whether health was related to length of maternity leave. Thirty-seven married, employed first-time mothers completed questionnaires during pregnancy, and again at 6 weeks, 3 months, and 6 months postpartum. Results showed that, from pregnancy to the 6th postpartum month, the number of days that mothers were ill because of infections steadily increased. In addition, depressive symptoms for new mothers rose from pregnancy to the 6th week postpartum, and declined thereafter. For women who did not return to work during the period of the study, a significant decline in depressive symptoms was observed from the prenatal period through the 6th postpartum month. These findings demonstrate significant changes in mental and physical health for this group of first-time mothers.
Adult↗
The fourth stage of labor: the health of birth mothers and adoptive mothers at six-weeks postpartum.
This study was conducted to determine the frequency of various health problems in new adoptive and biological mothers six weeks after they adopted or delivered their infants. Participants included 108 married first-time adoptive mothers, 72 married first-time biological mothers, and 133 controls (married women without children), each of whom completed a mailed questionnaire. Compared to controls, adoptive and biological mothers reported more fatigue, less readiness to work at a job, and less activity with household chores and recreational or social functions. In addition, biological mothers complained of more breast and genitourinary problems than did adoptive mothers or controls. Apart from their fatigue and hesitation to work at a job, adoptive mothers reported relatively good health, with the best mental health outcomes and the fewest acute physical problems of the three groups. These findings suggest that, for both adoptive and birth mothers, some aspects of postpartum recovery may continue up to and beyond the sixth postpartum week.
Adoption↗
A causal model describing the relationship of women's postpartum health to social support, length of leave, and complications of childbirth.
Recovery from childbirth is a complex process that may involve not only the gynecological organs, but also the cardiovascular, respiratory, musculo-skeletal, urologic, gastrointestinal, endocrine, and nervous systems. The process of postpartum recovery may span several months and is related to a variety of personal, family, and social variables. This paper presents a model that describes changes in women's health over the first postpartum year and the relationship between health changes and other variables. The model's dependent variables--mothers' mental and physical health--have a reciprocal effect on one another. The independent variables within the model include length of maternity leave, social support, complications of childbirth, baby's health, mother's use of cigarettes and alcohol, and demographic characteristics. This model is proposed as a research tool for future investigations in postpartum health, and as a conceptual framework to enhance our understanding of the relationship between postpartum health and other important variables.
Adult↗
The physician's appearance and professionalism.
The attire of 101 physicians in 24 Minnesota clinics was observed, and the relationships between appearance and 1) gender, 2) role, and 3) location were analyzed. Comparisons between resident and staff physicians revealed several significant differences. The results suggest that the physician's appearance affects how others view the physician as a professional.
Clothing↗
Patients' responses to short obstetrical hospital stays during a nurses' strike.
A 1984 St. Paul nurses' strike led to a reduction in the length of obstetrical hospital stays, and this effect persisted after the strike. The mean length of hospitalization for vaginal deliveries was 2.7 days before the strike, 1.6 days during the strike, and 2.4 days after the strike. Forty-nine women who delivered during the strike completed questionnaires investigating their attitudes about their length of hospital stay. Although the mean patient response to length of stay was slightly positive, several patients were dissatisfied with their short hospital stays. Patients who stayed for two days or longer were more positive about their length of stay than those who stayed for shorter periods of time. It was planned that most women with vaginal deliveries would be discharged within 24 hours; however, 11 of the 36 women with vaginal deliveries stayed two days or more. This study demonstrates the need to individualize discharge plans. Not all women with vaginal deliveries can be discharged within 24 hours, and one may expect some patient dissatisfaction when early discharge is mandated.
Adolescent↗
Patients' and physicians' attitudes regarding the physician's professional appearance.
Although physician appearance has been a topic of interest to medical historians for more than two centuries, little objective investigation has been made into patients' and physicians' attitudes toward the physician's appearance. This study analyzed responses from 404 patients, residents, and staff physicians regarding their attitudes toward various aspects of the male and female physician's professional appearance. Positive responses from all participants were associated with traditional items of dress such as the dress, shirt and tie, dress shoes, and nylons, and for physician-identifying items such as a white coat and a name tag. Negative responses were associated with casual items such as blue jeans, scrub suits, athletic shoes, clogs, and sport socks. Negative ratings were also associated with overly feminine items such as prominent ruffles and female dangling earrings and such temporarily fashionable items as long hair on men, male earrings, and patterned hose on women. Overall, patients were less discriminating in their attitude toward physician appearance than physicians. Patients rated traditional items less positively and casual items less negatively. This study confirms the importance of the physician's appearance in physician-patient communication.
Adult↗