#6: no separation of mother and baby with unlimited opportunity for breastfeeding

In this position paper-one of six care practice papers published by Lamaze International and reprinted here with permission-the value of keeping mothers and their babies together from the moment of birth is discussed and presented as an evidenced-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. Babies held skin-to-skin with their mothers cry less often, breathe easier, and stay warmer than babies who are separated from their mothers. They also instinctively attach to the breast and begin breastfeeding, usually within one hour of birth. The advantages of rooming-in for mother and baby are also discussed. The accompanying commentary-written by two leading professionals in the field of maternity care and pediatrics-provides further evidence to support the practice of keeping mothers and their babies together after birth. Lamaze International encourages women to give birth in settings that do not separate mothers and babies after birth.     

Some factors affecting mother-child relationships following low birthweight delivery in a Nigerian sociocultural environment

Twenty mothers with low birthweight babies, cared for in a neonatal unit and kept in incubators (as index group) and 20 mothers with full-term babies (as control group) were studied to determine the extent of maternal separation and deprivation following delivery and the effects of these on mother-child relationships. The population was prospectively sampled and an interview method using a structured questionnaire, was adopted to obtain the information for the study. The result showed a delayed post-partum contact, negative reactions and some delays in maternal attachment in mothers of premature infants. Nevertheless, some degree of adjustment in the mother-child relationship, as shown by some positive perceptions of the infants, took place 6 months after leaving hospital. Other social and cultural factors that may contribute to the negative reactions of the mothers to premature delivery are highlighted.     

Outcome of abuse during childhood among pregnant low income women

The outcome of experiencing abuse as a child was studied by comparing pregnant women who did recall versus those who did not recall this type of maltreatment. Fourteen hundred low income women were interviewed in prenatal clinic; those who said they were both punished by abuse and beaten by caretakers as children were considered abused. Abuse was recalled by more white than black women but families were followed after delivery and protective service reports of abuse for their offspring were equal. Because of low numbers, black subjects were dropped and the 95 white women who recalled abuse during childhood were compared to the remaining 832 white subjects. The groups did not differ in attitude about current pregnancy, age or marital status, and no differences were found for their children at birth. Abused mothers were more likely to have felt unwanted and unloved as children and to have lower self-images and more isolation than controls. Abused mothers had greater stress, and many of their stresses reflected disturbances in interpersonal relationships. Thus, women abused as children had some characteristics similar to those of known child abusers. Although abused women had more aggressive tendencies, their children were reported to protective services for abuse at the same frequency as control children. Intergenerational transmission of abuse was therefore not demonstrated prospectively. Classic theories of child abuse suggest a special child, special parent and stress act as independent agents to cause abuse. The above data suggest, alternatively, that abuse during childhood may lead to other risk characteristics and to greater stress. These may act together to increase risk for abuse. The special child may have an independent influence on abuse.     

Effects of a prenatal care intervention for adolescent mothers on birth weight, repeat pregnancy, and educational outcomes at one year postpartum

About one-third of adolescent mothers receive inadequate prenatal care, and babies born to young mothers are more likely to be of low birth weight. The objective of this study is to evaluate a peer-centered prenatal care program for adolescent mothers. Pregnant adolescents were randomly assigned to an experimental or control group in a mastery modeling peer-support intervention designed to improve long- and short-term perinatal outcomes. A sample of 282 urban pregnant adolescents (94% African American, 4% Caucasian, 2% other) participated in the study. Participants were recruited from five clinics located mainly in Detroit, Michigan. Participants in the experimental group received care in a small group setting and learned to perform critical measurements with a peer partner during prenatal visits. Participants in the control group received individual prenatal care in the same clinics. Outcome measures included birth weight, years of schooling completed at one year postpartum, planned and unplanned pregnancy at one year postpartum, and employment and school attendance at one year postpartum. Mothers in the experimental group had a lower rate of low birth weight (6.6% vs. 12.5%, p=0.08). The rate of unplanned pregnancy was also lower for adolescents in the experimental group (13.4% vs. 15.9%), although this difference was not statistically significant. Adolescents who participated in the intervention were more likely to have continued their education during the pregnancy and the postpartum year. The mastery modeling, peer-centered, prenatal care program produced some positive pregnancy outcomes for adolescent mothers.     

Effects of formal support on mothers' adaptation to the hospital-to-home transition of high-risk infants: the benefits and costs of helping

94 mothers were randomly assigned to a control group or to a group who received a formal support program designed to aid their adaptation to the transition from hospital to home care of high-risk infants. Mothers' predischarge need for support and the severity of infants' predischarge medical problems moderated program effects assessed 6 months after NICU discharge. Positive effects of the program on mothers' sense of competence, perceived control, and responsiveness were evident for mothers who had needed the most support. But at low levels of need for support, participation in the program had negative effects on these outcomes. A similar pattern was found for the effects of the program on mothers' positive mood as a function of the severity of infants' medical problems. Secondary findings suggest why some mothers may benefit from formal support after NICU discharge and others may experience at least temporary disruptions in their adaptation from such support.     

A study of migrant mothers: Return home and role change

For migrant groups moving from one place to another usually means dealing with contradictions between home and host countries and with different cultural norms. Taking into consideration migrant women's previous status in the village and their new one in the host country, it can be said that migration is a turning point in women's lives. Research findings show that increased employability of women in the host country increases their independence and leads to sex role changes and changes within the family.Return migration is the last stage in the migration cycle and it is a rather neglected and little researched topic as yet. The purpose of this paper is to report on research on role changes within the family.Three groups of migrant mothers (two groups living in West Germany and one group repatriated) were compared with a control group in the District of Drama, Macedonia, on work employment and types of responsibilities concerning their children's upbringing.Results showed that mothers who live in West Germany are equally responsible with fathers for the child's social behavior, school performance and expenses and were significantly different from the control group. Return mothers were as much as fathers responsible for the child's school performance in contrast to the control group. More mothers than fathers, however, were responsible for the child's relationships and fewer mothers than fathers were responsible for the child's expenses; in this respect both parents resembled those of the control group. It seems therefore, that migrant mothers take over different roles in the host country than those of the controls, whereas return mothers adopt to a large extent the stereotyped role of control mothers.     

Maternal perinatal risk factors and child abuse

A retrospective matched pair study was designed to compare maternal perinatal factors such as abnormal pregnancy history and labor and delivery experience in families who subsequently were reported as physically abusive to one or more of their children as compared to non-abusive families. The study population consisted of the mothers of 532 children reported to the Baltimore (Maryland) Department of Social Services as physically abused during the years 1975-77. The comparison group was handmatched to the study group from State of Maryland birth certificates on the basis of the abused child's birth year and sex, maternal race, education and hospital of delivery. The study population was 67% black with a mean maternal education of 10.5 completed years. The abused children were 59% male with 48% less than 2 years of age. Results indicated that selected medical definitions of abnormal pregnancy, labor and delivery did not identify families at differential risk of maltreatment. However, mothers in maltreating families were younger, had shorter birth intervals, less prenatal care and were significantly more likely to have had a stillbirth or reported abortion or a prior child death. Study limitations are addressed as are suggestions for future research.     

Prior incest in mothers of abused children

Previous studies have shown that most abusing parents have a history of physical abuse or neglect in their own childhoods. There is little data on the frequency of prior sexual abuse among parents who physically or sexually abuse their children. Many case reports describe the uncovering of a prior incest experience in a parent during the investigation of the child's current incest accusation, but it is unclear how frequently this occurs. One hundred mothers of abused children were asked about sexual incidents that occurred before age 18; the control group consisted of 500 normal women from the same community who were surveyed during meetings of various voluntary organizations. Age and ethnicity did not differ in the two groups. Of the mothers of abused children, 24% reported a prior incest experience, whereas only 3% of the control women reported prior incest. This eightfold difference was highly significant. The 34 mothers from families where sexual abuse was occurring were no more likely to report prior incest than were the 66 mothers from families where physical abuse occurred. The one case of genital mutilation of a child occurred in a family where both parents had been incest victims. Case studies indicate that the parent who has been an incest victim has inhibitions and fears about tenderness, traceable to the childhood incest experience, which are important in the development of either physical abuse or sexual abuse in the family.     

Professionally mediated peer support and early breastfeeding success

Social support interventions that incorporate professionally mediated peer support (PMPS) for improved breastfeeding outcomes were compared with no special breastfeeding support. Fifty-five breastfeeding mothers participated. The breastfeeding outcomes of duration, completeness, satisfaction, and exclusive breastfeeding were compared at 6 weeks postpartum among an experimental group that received PMPS, and among younger community (YC) and older community (OC) groups that received no special breastfeeding support. The PMPS group exclusively breastfed for a significantly longer duration than the YC group. At 6 weeks, mothers in both community groups who had weaned were significantly less satisfied with their breastfeeding experiences than the mothers who were still nursing their babies. Professionally mediated peer support can improve the early breastfeeding outcomes of duration of exclusive breastfeeding and satisfaction with breastfeeding.     

Incest survivors: the relation of their perceptions of their parents and their own parenting attitudes

The present study examined the child-rearing attitudes of incest and nonincest child sexual abuse survivors and their perceptions of their own parents' behavior. From a sample of women with a history of child sexual abuse, 40 women with children completed questionnaires designed to assess their own and their parents' child-rearing behavior in terms of the dimensions of parental acceptance and control. The data indicated that women from incestuous backgrounds had more negative perceptions of their fathers and mothers in terms of acceptance and control than women abused by men who were not related to them. Moreover, incest victims who perceived their mothers negatively endorsed autonomy promotion in their own attitudes toward child rearing. The findings are discussed in terms of (1) the lack of positive parenting models when relations with both parents are experienced as negative, (2) incest survivors' conflicts about their own early maturity, and (3) the relation of these findings to the tendency for intergenerational repetition of father-daughter incest.     

Lifelong learning and becoming a mother: evaluation of the Young Parents Program

The purpose of this research was to identify how lifelong learning has the potential to accommodate the changed circumstances and future needs of women who become mothers as teenagers. The research drew on the previously separate theories of lifelong learning and becoming a mother to frame this initial study. A qualitative case study was used to evaluate the Young Parents Program, which was devised to meet the informal learning needs of young mothers aged between 15 and 25 years. A total of eight mothers completed a survey and four of them also participated in a focus group interview to provide more in depth responses. The results indicate that the content of the programme provided relevant information that met the informal learning needs of the participants. The delivery of the programme helped participants to make connections with other young mothers in similar circumstances. The findings imply that informal learning programmes that respond well to the immediate needs of young mothers have the potential to prevent young mothers from becoming socially isolated. Young mothers who become engrossed in their own problems without access to relevant informal learning may fail to undertake formal learning opportunities that might be available in the future.     

Correlates of mastery-related behavior: a short-term longitudinal study of infants in their second year

The present study examined correlates of mastery-related behavior across the infant's second year of life. Maternal control style was quantified on a control to support-of-autonomy continuum, infant-mother attachment was assessed in the Strange Situation, and mastery-related behavior was observed in a toy play session at 12 and 20 months. Infants whose mothers were supportive of their autonomy displayed greater task-oriented persistence and competence during play than did infants of more controlling mothers; securely attached and avoidant infants tended to exhibit greater persistence at tasks than anxious-ambivalent babies, and ambivalent babies were the most negative in affect.     

Effects of family support intervention: a ten-year follow-up

The delivery to impoverished mothers of a coordinated set of medical and social services, including day-care for their children, had effects that were evident a decade after the intervention ended. Intervention mothers were more likely to be self-supporting, and they had higher educational attainment and smaller family sizes than did control mothers. Intervention children had better school attendance, and boys were less likely to require costly special school services than were corresponding control children. The financial implications of these results were considerable, totaling about $40,000 in extra estimated welfare costs and documented school service costs needed by the 15 control families in the single year in which these follow-up data were gathered. There were no indications that the intervention had lasting effects on the children's IQ scores. The results suggest that family support procedures, including quality day-care, have considerable promise as a general model for intervention programs.     

Unwanted by whom?

Unwanted pregnancies bother various groups in the US. Many pregnant teenagers want to be pregnant, even though the pregnancies are often not planned. A childbirth educator in Boston, Massachusetts, wonders who considers adolescent pregnancies as unwanted, the young mothers or the middle class, white, well-educated, and well-meaning adults. Adolescents want babies for the same reasons adults want babies. The difference is that adolescents do not have the same personal, financial, and community resources as adults. A child cannot rob teenagers of a future they do not have; a child provides some joy and hope. These teenagers tend not to see a better life in their future. Education can generate a vision of the future and provide a path out of poverty. Yet, educational opportunities are not always available or inviting. Teenagers need childcare, financial support, and supportive role models or mentors. Many people erroneously believe that poor women have children to be on welfare or to receive subsidized food. Yet, public assistance does no hand out enough money to sustain a family. Besides, it is unpleasant. Some states are starting to deal with the broader problems linked to poverty and lack of education. For example, the welfare system in Florida requires young women to be in high school, to prepare for the GED, or to undergo technical training. If they fail to comply, they lose benefits. Role models and financial, practical, and emotional support allow teen fathers to stay close to their children, to earn a living, and to be responsible. Poverty, immigration, transience, substance abuse, and distance from family result in insufficient support and poor parenting models for teenage mothers. They still are developing physically and emotionally. Teenage mothers need the same support, encouragement, and assistance that adult mothers need. Freedom of choice, education, and responsibility will result in healthier teen mothers and children.     

The impact of childhood foster care and other out-of-home placement on homeless women and their children

OBJECTIVE: This study compares homeless women who had childhood histories of foster care or other out-of-home placement to those who have not. METHOD: A countywide probability sample of homeless women (n = 179) received structured interviews. RESULTS: One-third of homeless women reported being raised apart from their parents. Among women with children under age 18, most (61.5%) had children who had lived in foster care or other out-of-home placements. Variables associated with homeless mothers' children living in foster care or other out-of-home placements were: Child was school-age, mother was age 35 or older, mother had a current alcohol or drug use disorder, mother experienced childhood sexual abuse, and mother ran away from home (when under age 18). CONCLUSIONS: Parenting is difficult for homeless mothers who may need to place their children with others to facilitate school attendance. Parent-child interaction may be problematic in family shelters where privacy is rare. Thus, programs promoting family preservation for homeless mothers should provide parenting support as well as permanent housing.     

Differential responsiveness to a parenting intervention for mothers in substance abuse treatment

This study examines the relationship between levels of psychological distress in substance-dependent mothers and their differential response to a dyadic parent–child intervention. A sample of 66 mothers who were receiving treatment for substance abuse, as well as a simultaneous parenting intervention, were interviewed pre and post-treatment on measures of psychological distress, adult and child trauma history, parental reflective functioning, and child social–emotional development. Additionally, clinicians provided assessments of the parent–child relationships. As anticipated, trauma histories for mothers and children, children's social emotional development, and parental reflective functioning were associated with aspects of maternal psychological distress. Kruskal–Wallis and subsequent Wilcoxson signed rank tests revealed that women with highest levels of baseline psychological distress showed significant improvements in psychological functioning post-treatment while women with moderately elevated levels of psychological distress did not. Women who were most distressed at baseline showed increased levels of parental reflective functioning post-treatment while women with moderate and lower levels of baseline psychological distress showed improvements on clinician-rated assessments of parent–child relationships. Chi Square analyses showed that parents who endorsed the highest levels of distress at baseline reported that their children's risk status regarding social–emotional development decreased post-treatment. Despite similarities in substance dependence, mothers in this sample had different needs and outcomes in the context of this parenting intervention due to variation in mental health. Given this variation, parenting interventions for substance-dependent mothers need to account for the individual differences in levels of psychological distress.     

Social support, locus of control, and parenting in three low-income groups of mothers: black teenagers, black adults, and white adults

Mother's social support, their instrumental use of extended family members and of professionals for help, and their sense of personal control were examined as predictors of parenting skill in 3 groups of low-income women. Separate regression models were generated for black adult mothers, white adult mothers, and black teen mothers, all of whom had at least 1 infant. Black teen and white adult mothers who sought help with child-rearing problems from extended family members were more skillful parents. Among white mothers, use of professionals for help with child-rearing problems and mothers' sense of internal control were also significant predictors. Black adult mothers' parenting skill was predicted only by locus of control. These prediction models suggest that in 2 of the groups, social ties to significant others were the linkages through which child-rearing information flowed to affect parenting behavior.     

'Having It All' and the Discourse of Equal Opportunity: Reflections on choices and changing perceptions

Schooling has come to be viewed as an important site for the reproduction of gender relations and as a site for intervention and change. This article reports on a longitudinal study that explores the ways in which a group of young women--who had gone to school during an era of 'equal opportunity'--made decisions about their future careers and the ways in which they thought their life-paths would unfold. More than a decade later, the problem of 'having it all' had begun to surface for some of them. Those women who had already become mothers increasingly found that instead of effortlessly being able to combine the demands of small children with the pressures of a challenging job, a more workable option was to put their careers 'on hold'. While these women have demonstrated that they can succeed on male terms, a number of competing discourses, coupled with a workplace culture that enshrined male patterns of participation as the norm, ensured that their work patterns essentially replicated the employment patterns of women of an earlier generation. Certainly, this group of young women are reconciling the expectations of 'equal opportunity' with a quite different reality.     

Will the ‘good’ [working] mother please stand up? Professional and maternal concerns about education,care and love

The purposes of this article are to understand the factors that women are likely to take into consideration when making employment decisions and childcare choices while their babies are young, and to identify their choices, beliefs and dilemmas: the focus is on the experiences of working mothers in England. These choices are problematised in the context of mothers placing their babies with carers in day care settings who ‘love’ their children. Drawing from a larger study, the focus is on the narrative and experience of Ayesha in order to illuminate the tensions of being a mother responsible for, and making decisions about her child's care and education, coupled with her working role as an early years education advisor. Issues about gender and education are enmeshed in Ayesha's narrative through these two roles and the subject positions which they created. Ayesha's narrative illustrates the ways in which such decisions can be fuelled by contradictory political messages which are sensationalised by the media in relation to the role of a ‘good’ mother. The findings suggest there is a need to discuss the impact of media sensualisation on mothers' decision-making and to highlight the importance mothers place on close, loving relationships between the carer and the baby.