Sex talk? overcoming barriers about sex and contraception after childbirth

Anecdotal evidence tells professionals that childbirth is the best form of contraception. However, sexual health problems are the very common after childbirth with Barrett et al (2000) arguing that only 15% of women who have a postnatal sexual problem reported discussing it with a health professional. As health professionals with a predilection for the ‘clinical’ and the ‘prescriptive’ we organise antenatal classes to discuss bathing the baby and post partum reunions to recount birth stories, but often fail to address sexual health problems and contraception after birth.(Glazener 1997). Many women who have carefully used contraception for years prior to pregnancy are often not helped to re-engage with the issues following birth. This would seem to be a particular problem for the most vulnerable parents such as adolescent mothers and their partners (Social Exclusion Unit 1999, 2004) where some young women go on to have more than one baby in a short time period (Reeves 2003). The focus of this paper is to explore the apparent general failure of health professionals to discuss sex after childbirth and provide information regarding reliable contraception. Glazener (1997) tells us that health professionals are encouraged to educate and prepare patients antenatally, for example to be trained to identify problems and deal with them openly and sympathetically. What is brought into question is why this form of rigorous support is not extended to providing sexual health advice in the immediate and often vulnerable postnatal period and why this provision is not a priority for some groups. The paper will explore if this situation caused by a lack of training or is it a symptom of our culture and a British attitude towards sex and contraception.

The centrality of groups and classes

This paper extends the standard network centrality measures of degree, closeness and betweenness to apply to groups and classes as well as individuals. The group centrality measures will enable researchers to answer such questions as ‘how central is the engineering department in the informal influence network of this company?’ or ‘among middle managers in a given organization, which are more central, the men or the women?’ With these measures we can also solve the inverse problem: given the network of ties among organization members, how can we form a team that is maximally central? The measures are illustrated using two classic network data sets. We also formalize a measure of group centrality efficiency, which indicates the extent to which a group's centrality is principally due to a small subset of its members.