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Unmarried motherhood: childhood experiences described by 22 adults whose mother was unmarried when they were born.

Content analysis was used to examine the childhood experiences of 22 autobiographers whose mother was unmarried when they were born. Their childhoods varied considerably. For significant periods of time, 12 lived with their mother alone or with her and their own father or a stepfather, 5 lived with their mother and her parents, 2 lived with unmarried aunts, and 7 lived in foster homes. Three mothers died, one was institutionalized and one abandoned her child without making alternative arrangements. Seven autobiographers were never told the identity of their father, and another 5 had to wait many years before they were told. This created an unhappiness in these individuals when they were teenagers that only increased with age. These findings cannot be assumed to apply to unmarried mothers and their children today; however, they raise some important issues for health care professionals and highlight the need for more research on contemporary unmarried motherhood.

Adult↗

Do microbiological factors account for poor pregnancy outcome among unmarried pregnant women in Poland?

OBJECTIVE: Being unmarried is a well-known risk factor for poor pregnancy outcome such as preterm delivery and intrauterine growth restriction. The aim of this prospective study was to assess the prevalence and risk of bacterial vaginosis (BV) and selected bacteria isolated from the lower genital tract and to determine the socioeconomic and microbiological characteristics that might be responsible for poor pregnancy outcome observed among unmarried pregnant women. METHODS: The study population comprised 196 pregnant women attending 10 randomly selected outpatient maternity units in the Lodz region, central Poland. Cervicovaginal samples were obtained between 8 and 16 weeks of gestation. Based on Spiegel's criteria, gram-stained vaginal smears were examined for BV and the BV-associated flora was sought by culture. To evaluate the risk factors, relative risk ratios were calculated using EPI INFO software. RESULTS: Among 196 pregnant women, 40 (20.4%) were unmarried. BV was diagnosed among 55 (28.1%) women studied. In the univariate analysis, unmarried pregnant women were characterized by younger age, primary educational level, poor economic situation and excessive smoking during pregnancy, as compared to married women. The unmarried status was a borderline risk factor for BV (OR = 1.83, 95% CI 0.94-4.9) after adjustment for age, smoking and education. An analysis of the microbiological culture from the lower genital tract revealed that unmarried pregnant women had a higher risk for several types of pathological microflora, as compared to married women. However, this finding was significant only for Mycoplasma hominis. The independent risk factors of M. hominis were the young age of the subject and a low concentration of Lactobacillus spp. CONCLUSIONS: The observed socioeconomic, demographic and microbiological differences between unmarried and married women could be responsible for the poor pregnancy outcome among unmarried pregnant women in Poland. Unmarried pregnant women should be covered by comprehensive medical care even before pregnancy. Further studies taking into account the role of psychological stress, patterns of sexual behavior and substance abuse during pregnancy could help identify the factors responsible for adverse pregnancy outcome among unmarried pregnant women.

Adult↗

Perinatal risk for infants of unmarried mothers over a period of 20 years.

The perinatal events of the infants of 444 unmarried mothers, 3.7% of the total Northern Finland birth cohort from 1966, were compared with those of infants of 11,525 married mothers (95.5%), and a similar comparison was made between 395 (4.2%) unmarried mothers and 7516 (80.3%) married mothers in a second Northern Finland birth cohort in 1985-86. 1336 mothers, 14.3% of the mothers in this later cohort, were cohabiting. Divorced and widowed mothers were excluded from both cohorts. The infants of the unmarried mothers had a significantly lower mean birth weight, were more likely to be small for their gestational age (SGA), of low birth weight (LBW) (below 2500 g) and had a higher incidence of pre-term births than those of the married mothers in both cohorts. Perinatal mortality was significantly higher among the unmarried mothers only in the former cohort. These differences in perinatal events diminished markedly after adjustment for maternal age, parity, height, years of schooling and smoking habits, but did not totally disappear. The difference in the incidence of pre-term births diminished, but remained significant in both cohorts. The difference in mean birth weight, in the incidence of LBW infants and in perinatal mortality remained significantly less favourable to the unmarried mothers only in the 1966 cohort. It seems that the gap between the married and unmarried mothers had diminished. The incidence of SGA infants did not differ significantly between the married and unmarried mothers in either cohort after adjustment for the background variables. The cohabiting mothers formed an intermediate group between the married and single unmarried mothers in respect of perinatal events, but were close to the married mothers. In raw figures, the mean birth weight in this group was significantly lower and the incidence of SGA infants higher than among the married mothers, but these differences also disappeared after adjustment of the background variables.

Body Height↗

Do family-planning workers in China support provision of sexual and reproductive health services to unmarried young people?

OBJECTIVE: To ascertain the perspectives of family-planning service providers in eight sites in China on the provision of sexual and reproductive health services to unmarried young people. METHODS: Data were drawn from a survey of 1927 family-planning workers and 16 focus group discussions conducted in eight sites in China in 1998-99. FINDINGS: Family-planning workers recognized the need to protect the sexual health of unmarried young people and were unambiguous about the need for government agencies to provide information and education on sexual and reproductive health to unmarried young people; however, perceptions about the appropriate age for and content of such education remained conservative. While about 70% of family-planning workers were willing to provide contraceptives to unmarried young people, and about 60% approved government provision of contraceptive services to unmarried young people, only one quarter agreed that the services could be extended to senior high schools. CONCLUSION: Family-planning workers in China are ambivalent about the provision of sexual and reproductive health services to unmarried young people, which potentially poses a significant obstacle to the adoption of safe sex behaviours by young people, as well as to the provision of sexual and reproductive health information and services to young unmarried people in China. Training programmes for family-planning workers are urgently needed to address this issue.

Adolescent↗

Meeting the contraceptive needs of unmarried young people: attitudes of formal and informal sector providers in Vientiane Municipality, Lao PDR.

In Lao PDR, evidence is emerging of considerable sexual activity among unmarried youth, but contraceptive services remain inadequate to meet their needs. This study explored the attitudes of formal and informal sector providers in serving the contraceptive needs of unmarried youth in Vientiane Municipality, their perceptions of quality of care, confidentiality and privacy, level of comfort in discussing sexual matters, and any differences between providers in the two sectors. In-depth interviews were carried out with 56 key informants, followed by a quantitative survey of 150 formal sector and 100 informal sector providers. We found ambivalence and discomfort among providers in communicating with unmarried youth and providing contraceptives to them, and low priority placed on their right to privacy and confidentiality. Providers tended to attribute difficulties almost entirely to young people's inhibitions and unwillingness to listen. Less than 60% of formal sector providers would supply contraceptives to unmarried youth, compared to 80% of informal providers, but the latter were more likely to charge a fee for supplies. Both formal and informal sector providers need training in communication and counselling skills for serving unmarried youth. Programmes must ensure that unmarried youth have access to good quality contraceptive services and supplies.

Adolescent↗

Geographical mapping of unmarried teen births and selected sociodemographic variables.

Texas is one of five states in the United States in which teen pregnancies exceed 70 per 1,000 females aged 15 to 17 years. The purpose of this retrospective exploratory study was to analyze and map sociodemographic variables associated with unmarried teen childbirth. It was hypothesized that selected sociodemographic variables would be related to the unmarried teen birthrates. Correlational analysis was employed to ascertain the relationship between the sociodemographic variables and the unmarried teen birthrates for 81 zip codes in Dallas County, Texas. The births occurred between January 1, 1995 and December 31, 1996. Geographic Information System (GIS) software illustrated the spatial distribution of the unmarried teen birthrates in conjunction with sociodemographic variables extracted from the 1990 U.S. Census Bureau. The results indicate that unmarried teen births are positively related to low socioeconomic status, single-parent family households, and minority populations. Mapping supports the quantitative relationships between the variables. Maps can be used to identify communities where teens most vulnerable to unmarried pregnancy and childbirth reside and provide policy makers with explicit information about their constituents so that they can develop and implement population-specific interventions.

Adolescent↗

Magnitude and causes of mortality differences between married and unmarried men.

STUDY OBJECTIVE: To determine the effect of marital status on mortality for men. In particular, to examine whether subgroups of unmarried men (widowed, single, and divorced/separated men) have a similar mortality to married men. DESIGN: Cohort study. SETTING: Whitehall civil service, London, between 1967 and 1969. PARTICIPANTS: A total of 18,403 men aged 40-64 years with 18 years' follow up. MEASUREMENTS AND MAIN RESULTS: Cause-specific mortality rates and risk factors at baseline were determined. Overall mortality was greater for all groups of unmarried men. Patterns of mortality were different in the subgroups of unmarried men. Widowed men had a significantly greater risk of dying from ischaemic heart disease (relative risk (RR) 1.46, 95% confidence interval (CI) 1.08, 1.97) which persisted after exclusion of deaths that occurred in the first two years. Divorced men had greater cancer mortality (RR 1.49; 95% CI 1.06, 2.10) that could not be explained simply by their greater consumption of cigarettes. The initial increased mortality for single men was no longer evident after adjustment for other risk factors, suggesting that single status in itself may not increase the risk. The risk for single men may have been underestimated, however, by over adjustment for possible intermediary factors. CONCLUSIONS: Previous studies, which have examined total mortality only or have grouped all unmarried men, have masked interesting differences in the cause of death between subgroups of unmarried men. The extent to which the findings are explicable by psychosocial factors or the role of other environmental factors, which may also differ in relation to marital status, is unclear. Future work should not assume that all unmarried men have similar mortality risks and must examine the life course of each subgroup to advance our understanding of the possible causal role of marital status in disease aetiology.

Adult↗

[[Attitudes toward marriage and their effect on expected life course patterns of unmarried Japanese women]].

"The aim of this paper is to study the perspectives unmarried women [in Japan] hold towards marriage, and towards their life course. This paper will also attempt to determine how changing life course perspectives among unmarried women are influencing the trend towards later marrying ages. [Data are from a] sample of 2,605 unmarried women aged 18-34 derived from the 9th National Fertility Survey conducted...in 1987....[The author finds that] while still planning to marry eventually, more women are putting off marriage. In conclusion, the increase in the proportion of unmarried women...is not so much because they have chosen the unmarried life course in order to pursue their careers, but rather merely because they are putting off marriage until later." (SUMMARY IN ENG)

Asia↗

The medical abortion experiences of married and unmarried women in Tunis, Tunisia.

CONTEXT: The study explores the social dimensions of abortion in Tunisia and offers evidence supporting the provision of medical abortion to special populations, such as young and unmarried women. METHODS: For this study we recruited 222 women (unmarried: n = 101, married: n = 121) at three clinics in Tunis, Tunisia, from April 1999 to March 2001. All eligible women who consented to participate were administered a simplified regimen of medical abortion consisting of 200 mg oral mifepristone + 400 microg oral misoprostol 2 days later either at home or in the clinic. RESULTS: Our results demonstrate that unmarried women (94.8%) are as likely as married women (94.1%) to have a successful abortion using this regimen. We noted a strong initial preference for home administration of misoprostol among both groups (unmarried: 73.3%, married: 80.2%), which grew even stronger after the procedure. Women indicated that home administration is desirable because transportation to the clinic is expensive (32.7%), home administration is more confidential (26.3%), easier and more convenient (12.8%). Both groups expressed a high degree of satisfaction with the method. CONCLUSIONS: Medical abortion with the option of home administration of misoprostol is safe and feasible for special populations; such as unmarried women in Tunisia.

Abortifacient Agents↗

Assortative mating: sex differences in mate selection for married and unmarried couples.

We studied assortative mating for age, nationality, educational level, and occupational level in married and unmarried parents to test evolutionary models explaining mate selection among humans. We used the marriage and birth registers of the Venezuelan population to compare recently married, fertile married, and fertile unmarried couples. The results show significant assortative mating for all variables, but the results are strongest for age and education. These data suggest that (1) selection criteria based on age vary along the life cycle and differ between married and unmarried couples; (2) male's socioeconomic status is more related to the availability of younger females among unmarried couples compared with married couples, except for young couples; and (3) female selection for better (more educated and/or better employed) mates is stronger among married couples, whereas male selection for younger females or those showing actual reproductive potential is stronger among unmarried couples.

Adolescent↗

[A preliminary analysis of unmarried mothers who were heads of households in Brazil during 1970 and 1980].

"This paper reports on an attempt to use census data from Brazil in 1970 and 1980 to investigate a rise in household headship by unmarried mothers 15-49.... Demographic analysis can be useful in decomposing the change into that due to a changed propensity of women 15-49 years of age to be unmarried, to have children if unmarried, and to head their own household if an unmarried mother. This was further analyzed in terms of age, marital status (whether single, divorced/separated or widowed), region of residence, and urban-rural status....However, the research encountered data problems that make firm conclusions impossible...." This is a translation of a paper originally presented at the 1992 Annual Meeting of the Population Association of America. (SUMMARY IN ENG)

Age Factors↗

Nursing students' stereotypes of married and unmarried pregnant clients.

The purpose of this study was to investigate the effects of information about a pregnant client's marital status on nursing students' initial perceptions of the client, attributions of group stereotypes to the client, predictions of client behavior, data sought, and verbal responses toward the client. Forty-three undergraduate nursing students from a large Midwestern university volunteered to participate. Subjects were randomly assigned to one of two experimental groups, the "married client" or "unmarried client." Subjects viewed a videotape of a nurse interviewing a pregnant client and were administered a series of questionnaires. Following this, they were asked to respond in writing to five statements made by the videotaped client. Videotapes were identical except that one group was told they were viewing an unmarried woman and the other group was told the client was married. Results indicated that students evaluated the married client more positively than the unmarried client. Students' perceptions were consistent with several cultural stereotypes. In addition, students predicted that, if hospitalized, the unmarried client would have greater difficulty than the married client. There were no differences between groups in the information they would seek from the client or in responses towards the client.

Adult↗

Unmarried mothers as a high-risk group for adverse pregnancy outcomes.

A total of 36,608 singleton births occurring to Black mothers in the District of Columbia in 1980-84 were examined. Infants of unmarried mothers had a 34 percent higher incidence of low birthweight and a 35 percent higher neonatal mortality rate than infants born to married mothers. To delineate the independent effect of marital status, a logit model was fit to 23,461 births occurring to mothers over 19 years of age. Despite controlling on maternal age, educational attainment and adequacy of prenatal care, the odds ratio for low birthweight was 1.18 for the infants of unmarried mothers. Supplemental analyses showed that if mothers were drug addicted or had their first delivery before age 18, the marital status differentials in the birthweights of their infants were no longer significant. These results indicate the importance of unmarried status as a demographic risk factor, and the need for discerning specific high-risk behaviors associated with life styles of unmarried mothers.

Adolescent↗

Effects of a community-based sex education and reproductive health service program on contraceptive use of unmarried youths in Shanghai.

PURPOSE: To evaluate the effectiveness of a youth-friendly intervention in promoting one safe sex behavior-contraception and condom use among unmarried young people aged 15-24 years in Shanghai, China. METHODS: The study was conducted in two towns of a suburban area of Shanghai (one as the intervention and the other as the control), with comparable socio-cultural-economic and demographic characteristics. The intervention intended to build awareness and offer counseling and services related to sexuality and reproduction among unmarried youths, in addition to the routine program activities, which were exclusively provided in the control site. Baseline surveys were conducted in both sites before the implementation of the intervention, and similar surveys were conducted in both sites 20 months after the intervention had been initiated to test the feasibility and effectiveness of the intervention. In total, 1220 unmarried young people from the intervention site and 1007 from the control site, including 1304 out-of-school youths and 923 high school students, were recruited, and about 92% of them were successfully followed up. Four main measures were examined (i.e., ever contraceptive use, current regular contraceptive use, ever condom use, and contraceptive use at onset of sexual intercourse-if it occurred during the course of the intervention). The reasons for nonuse of contraceptives, the status of joint decision on contraception and the first method used were also assessed. Data were analyzed using Logistic regression models with dichotomous measures of contraceptive use and Generalized Estimating Equations (GEEs) with repeated measures. RESULTS: At baseline, there was no statistical difference in contraceptive use between the intervention and control groups. After intervention, the proportions reporting regular contraceptive use and condom use in the intervention group were much higher than that in the control group (p <.001). A group x time interaction effect (p <.0001) was found for regular contraceptive use and ever condom use. Logistic regression analysis with dichotomous measures of contraceptive use and GEEs with repeated measures showed similar results. The regular contraceptive use and ever condom use were correlated with subject's occupation and family economic status, respectively. After adjusting for demographic factors, the subjects from the intervention group were 14.58 (OR) times as likely to use contraceptives at onset of intercourse as those from the control group (95%CI: 8.55-24.87, p <.0001). Similar results were found for both females and males. CONCLUSIONS: A multifaceted intervention program that provided information and skills, as well as counseling and services, appears to have positive influences on contraceptive practice and condom use among unmarried young females and males in suburban Shanghai.

Adolescent↗

Views of Chinese parents on the provision of contraception to unmarried youth.

This study sought the views of Chinese parents on sex education and contraception for unmarried youth. Data were drawn from 16 focus group discussions conducted in eight sites in China in 1998-1999 with parents of unmarried children aged 18-24. While parents tended to recognise the reality of changing sexual norms, they were ambivalent with regard to sexual activity among young people and the provision of services to them. To prevent this ambivalence from posing a significant obstacle to the adoption of safe sex behaviours by young people, the dilemmas faced by parents need to be addressed through programmes for parents. Parents were clearly concerned for the well-being of their unmarried children, and keen to see their children protected from unwanted pregnancy and disease; they supported the provision of life skills education and the development of negotiation skills, self-esteem and the ability to exercise informed choice. Parents appeared willing for government to establish educational and service delivery programmes for the unmarried; it is important that government acts upon this.

Abortion, Induced↗

A limited population of unmarried adolescent fathers: a preliminary report of their views on fatherhood and the relationship with the mothers of their children.

Although much has been documented regarding adolescent childbearing (Juhasz, 1974; Furstenburg, 1976; Card & Wise, 1978; Russ-eft, 1979; Chilman, 1980; Earl & Siegel, 1980), little is known about the attitudes of unmarried adolescent fathers toward fatherhood and their relationship with the mothers of their children. Most of what is known about this relationship has been learned from the young mothers (Sauber, 1966; Bernstein, 1971; Pope, 1971; bemis, 1976; Lorenzi, 1977; Clapp & Raab, 1978). With the exception of a few investigators (Pannor et al., 1968; Pannor, 1971, Hendricks, 1981), virtually no accounts can be found in the literature documenting unmarried adolescent fathers' perceptions of fatherhood and their relationship with the mothers of their children. This paper attempts to bridge this gap in the literature by reporting on how two select populations of black unmarried adolescent fathers view fatherhood and their relationship with the mothers of their children.

Adolescent↗