Disabled women’s experiences of accessing and utilising maternity services when they are affected by domestic abuse: a critical incident technique study

Background: Women and their babies are entitled to equal access to high quality maternity care. However, when women fit into two or more categories of vulnerability they can face multiple, compound barriers to accessing and utilising services. Disabled women are up to three times more likely to experience domestic abuse than non-disabled women. Domestic abuse may compromise health service access and utilisation and disabled people in general have suboptimal access to healthcare services. Despite this, little is known about the compounding effects of disability and domestic abuse on women’s access to maternity care.

Methods: The aim of the study was to identify how women approach maternity care services, their expectations of services and whether they are able to get the type of care that they need and want. We conducted a qualitative, Critical Incident Technique study in Scotland. Theoretically we drew on Andersen’s model of healthcare use. The model was congruent with our interest in women’s intended/actual use of maternity services and the facilitators and barriers
impacting their access to care. Data were generated during 2013 using one-to-one interviews.

Results: Five women took part and collectively reported 45 critical incidents relating to accessing and utilising maternity services. Mapped to the underpinning theoretical framework, our findings show how the four domains of attitudes; knowledge; social norms; and perceived control are important factors shaping maternity care experiences.

Conclusions: Positive staff attitude and empowering women to have control over their own care is crucial in influencing women’s access to and utilisation of maternity healthcare services. Moreover these are cyclical, with the consequences and outcomes of healthcare use becoming part of the enabling or disabling factors affecting future healthcare decisions.Further consideration needs to be given to the development of strategies to access and recruit women in these circumstances. This will provide an opportunity for under-represented and silenced voices to be heard.

Men, Women and an Integrated History of the Russian Revolutionary Movement

Since its emergence as a discipline in the 1960s, women’s history has had a profound effect on the study of the past. Scholarship on women’s experiences of and contributions to the Russian revolutionary movement has increased exponentially since the publication of a number of biographies of Aleksandra Kollontai in the 1970s and 1980s and a comprehensive picture has emerged of women’s involvement in all the major revolutionary parties, as leading figures as well as rank and file activists. Despite this wealth of historical discovery, remarkably little has found its way into so-called ‘general’ histories of the revolution. An integrated history, which is the ultimate aim of women’s history, has yet to be produced for the Russian revolutionary movement, even though recent prosopographical studies of revolutionary women have made clear the numerous ways in which men and women cooperated and interacted on a daily basis in the underground. This article explores the nature of and reasons for this failure, makes a case for why incorporating women’s experiences into the grand narrative of the Russian revolution is important and discusses how this might be achieved.

Man-up Against Suicide

Male suicide rates are high in Western countries including the US and Canada. Underpinned by men’s resistance to health help-seeking and challenges diagnosing mental illness including male depression, suicide ends the lives of many men amid inflicting pain and grief on the family and friends who are left behind. Fuelled by the discordant relationship between men’s low rates of depression and high rates of suicide we embarked on a unique and novel photovoice study title Man-Up Against Suicide. Specifically, men who have contemplated suicide in the past, and individuals (men and women) who have lost a male partner, family member or friend to suicide were invited to take photographs representing their experiences with men’s suicide with the ultimate goal of messaging ‘at risk’ men that there are alternatives to taking one’s life. Participants subsequently completed semi-structured individual interviews narrating the photographs and providing captions to accompany their selected images. In this presentation we share the preliminary study findings along with some participant photographs and narratives as a means to discussing; 1) men’s experiences of suicidal behaviours and their management strategies; and, 2) how men’s and women’s experiences of losing a male to suicide can de-stigmatize men’s mental illness and raise public awareness about male suicide.

Women’s Perceptions and Experiences of Fetal Macrosomia

Objective
to explore women's perceptions and experiences of pregnancy and childbirth following birth of a macrosomic infant (birth weight ≥4000 g).

Methods
a qualitative design utilising interviews conducted 13–19 weeks post partum in women's homes. The study was conducted in one Health and Social Care Trust in Northern Ireland between January and September 2010. Participants were identified from a larger cohort of women recruited to a prospective study exploring the impact of physical activity and nutrition on macrosomia. Eleven women who delivered macrosomic infants participated in this phase of the study.

Findings
four overarching themes emerged: preparation for delivery; physical and emotional impact of macrosomia; professional relations and perceptions of macrosomia. Findings highlighted the importance of communication with health professionals in relation to both prediction of macrosomia and decision making about childbirth, and offers further understanding into the physical and emotional impact of having a macrosomic infant on women. Furthermore, there was evidence that beliefs and perceptions relating to macrosomia may influence birth experiences and uptake of health promotion messages.

Key conclusions and implications for practice
this study provides important insight into women's experiences of macrosomia throughout the perinatal period and how they were influenced by previous birth experiences, professional relations and personal perceptions and beliefs about macrosomia. Pregnant women at risk of having a macrosomic infant may require extra support throughout the antenatal period continuing into the postnatal period. Support needs to be tailored to the woman's information needs, with time allocated to explore previous birth experiences, beliefs about macrosomia and options for childbirth.

OLDER WOMEN’S LIFELONG EXPERIENCES OF DOMESTIC VIOLENCE IN NORTHERN IRELAND

Violence against women is a serious criminal and public health issue with devastating consequences for women, families and society. To date, little international research has been given to understanding the needs of older women, who are experiencing domestic violence; that is, physical, sexual, emotional or financial abuse carried out by a spouse or partner. This study fills a significant gap in the literature as the needs of older women who have experienced a lifetime of domestic violence in Northern Ireland are unknown. Health professionals, service providers and policy makers often assume that violence stops at age 55 and there is a noticeable lack of literature, research and guidelines on the issue. The greatest challenge for health visitors is that abuse remains hidden, with women remaining silent and finding it difficult to speak openly or seek help.

‘Hearing Voices': Punishing women’s mental ill-health in Northern Ireland’s jails

Informed by primary interviews and observational research conducted by the authors with women prisoners in Northern Ireland, this article focuses on prison as an institutional manifestation of women’s powerlessness and vulnerability, particularly those enduring mental ill-health. It contextualises their experiences within continua of violence and ‘unsafety’. It also considers official responses to critical inspection reports and those of the Northern Ireland Human Rights Commission based on the authors’ research findings. Finally, the primary research demonstrates that three decades on from publication the first critical analyses of women’s imprisonment, the conditions of gendered marginalisation, medicalisation and punishment remain. This is brought into stark relief in the punitive regimes imposed on those most vulnerable through mental ill-health.

Young Women’s Positive and Negative Perceptions of Self in Northern Ireland

This paper represents analysis of one aspect of a larger research project examining the everyday lives and experiences of young women in Northern Ireland. As an introductory exercise within focus groups, 48 young women considered and discussed the good and not so good things about being a young woman in Northern Ireland. Through these accounts many issues emerged, some in direct contrast and contradiction to one another. The area focused upon for the purpose of this paper is the body, particularly with regard to body image (self-expression versus pressure) and becoming a woman (growing up versus menarche). The aim is to illustrate that what young women cite as being potentially positive aspects of growing up or being a young woman often have negative experiences and implications attached to them. In light of the advancements made by young women in Northern Irish society, an opening of opportunities and their awareness of the persistence of gendered messages regarding their bodies, many young women are of the belief that such messages have less impact upon them today and that gender is a barrier that can be overcome. It is illustrated and argued here, however, that dominant cultural messages regarding women’s bodies are more subtle, confusing and perhaps pervasive than they ever have been. As a consequence, this has created more pressure and confusion for young women and tensions exist in terms of young women’s beliefs and their actions. In light of these research findings, this paper considers practice implications for those working with and for young women.

Degradation, Harm and Survival in a Women’s Prison:Special Issue on Gendered Violence

This article is derived in in-depth qualitative research in the women’s unit of a male prison in Northern Ireland. The researchers had unprecedented observational and interview access and moved freely within the unit including the punishment block. What follows focuses primarily on the experiences of women and girls, recording their accounts of the impact on their lives of a harsh and neglectful regime. It demonstrates how the institutionalisation of violation and neglect within women’s prisons is often gender specific. Finally, it considers the key research recommendations, noting official responses.

Design-Build Experiences and Student Safety

Design-build experiences (DBEs) are an essential element of any programme based on the CDIO methodology. They enable students to develop practical hands-on skills, they enable the learning of theory by stealth and they provide a forum for developing professional skills such as team working and project management. The hands-on aspect of certain DBEs has significant risk associated with it, which must be addressed through the formal evaluation of risks and the development of a methodology for controlling them. This paper considers the aspects of design-build experiences that may impact on student safety. In particular, it examines the risk associated with each of the four stages of CDIO and gives examples of risks which may commonly apply across engineering disciplines. A system for assessing and controlling the risks in any particular DBE is presented and the paper finishes by discussing the significance of health and safety in the educational environment.