Midwives experiences of establishing partnerships: working with pregnant women who use illicit drugs

OBJECTIVE: To present the interpreted experiences of midwives who choose to work with pregnant women who also use illicit drugs. DESIGN: Twelve (n=12) Australian midwives were interviewed. Each interview was audio-taped, de-identified and transcribed. The interviews were analysed using a systematic, thematic analysis approach informed by Heideggarian hermeneutic phenomenology. FINDINGS: Three themes identified from the data that encapsulate the experience were establishing partnerships, making a difference, and letting go and redefining practice. The interpretations of establishing partnerships which includes engagement, genuine regard and compassion, with a subtheme courting the system are presented in this paper. The midwives' experiences were both positive and negative, as they were rewarded and challenged by the needs of women who use illicit drugs and the systems in which they worked. CONCLUSION: The midwives in this study found that establishing partnerships was essential to their work. They appraised their experience of working with pregnant women who used illicit drugs and found strategies that attempted to meet the needs of the women, the system and themselves. The participants revealed that to support women and families who use illicit drugs in their community, partnerships must be based on deep respect and trust. Significant components engagement, genuine regard and compassion that are central to midwifery partnerships require revisiting to address the needs of this vulnerable population of women.

Making a difference: the experiences of midwives working with women who use illicit drugs

AIM: This article describes the experiences of midwives who choose to work with pregnant womenwho use illicit drugs.BACKGROUND: Pregnant women who use illicit drugs present complex challenges for those whochoose to work with them. Society’s views on illicit drug use fluctuate from acceptance and harm minimizationto reprimand and retribution.METHOD: Qualitative interviews were conducted between June and August 2009 with 12 Australianmidwives. A thematic analysis method informed by hermeneutic phenomenology was applied to interpretthis data to explicate lived experiences and gain deeper understanding and meanings of this phenomenon.FINDINGS: Three major themes encapsulated the experience: making a difference, making partnerships,and learning to let go. The focus of this article, “making a difference,” included two subthemes of“working on the margins” and “transition and transformation.” The midwives were both rewarded andchallenged by the needs of women who use illicit drugs and by the systems in which they worked.CONCLUSIONS: The midwives acknowledged that their aspirations “to make a difference” was notalways sufficient when working with women who use illicit drugs. They also require the establishmentof maternity services that are compassionate and accessible, including woman–care provider partnershipsand continuity of the care environments.

Theoretical issues and political dilemmas in working with men

The aim of this chapter is to highlight some of the theoretical issues and political dilemmas involved in working with men in the human services. To develop a framework for practice with men, we have to adequately conceptualise the issues £1cing men. These are confusing and unsettling times for many men. To make sense of this confusion it is important to understand men's experiences within the context of the patriarchal structures in society and their relationship to class, race and gender regimes. Men and women who work with men in the human services should have an analysis of the social construction of masculinities and they need to understand how the forces that construct dominant masculinities embed men and women in relations of dominance and subordination that limit the potential for them to be in partnership with each other. To the extent that we ignore the social construction of masculinity,
it blocks insight into the real trouble in men's lives. Furthermore, if men do not grasp the basic notion of gender as a social construction, then feminist critiques of patriarchy, dominant masculinity and abusive male behaviours are going to be felt by men at a deeply personal level (Schwalbe 1996, pp. 187, 231).

How well do Australian women comply with dietary guidelines?

Objective: To investigate the proportion of middle-aged Australian women meeting national dietary recommendations and its variation according to selected sociodemographic and behavioural characteristics.

Design: This cross-sectional population-based study used a food-frequency questionnaire to investigate dietary patterns and compliance with 13 commonly promoted dietary guidelines among a cohort of middle-aged women participating in the Australian Longitudinal Study on Women's Health.

Setting: Nation-wide community-based survey.

Subjects: A total of 10 561 women aged 50–55 years at the time of the survey in 2001.

Results: Only about one-third of women complied with more than half of the guidelines, and only two women in the entire sample met all 13 guidelines examined. While guidelines for meat/fish/poultry/eggs/nuts/legumes and ‘extra’ foods (e.g. ice cream, chocolate, cakes, potatoes, pizza, hamburgers and wine) were met well, large percentages of women (68–88%) did not meet guidelines relating to the consumption of breads, cereal-based foods and dairy products, and intakes of total and saturated fat and iron. Women working in lower socio-economic status occupations, and women living alone or with people other than a partner and/or children, were at significantly increased risk of not meeting guidelines.

Conclusions: The present results indicate that a large proportion of middle-aged Australian women are not meeting dietary guidelines. Without substantial changes in their diets, and help in making these changes, current national guidelines appear unachievable for many women.

Changes in attitudes to mothers working: evidence from Australian surveys

The aim of this article is to contribute to the development of our  understanding of two aspects of attitude change in Australia. First, both cohort and individual explanations for attitude change are tested empirically. Second, empirical evidence is provided about the nature and scope of change in gender role attitudes amongst males and females, and of different birth cohorts in Australia, as reported in two survey periods: 1994 and 2002. In particular, the question of whether there is empirical evidence of cohort differences in attitudes to gender roles in Australia is investigated. TheThe aim of this article is to contribute to the development of our understanding of two aspects of attitude change in Australia. First, both cohort and individual explanations for attitude change are tested empirically. Second, empirical evidence is provided about the nature and scope of change in gender role attitudes amongst males and females, and of different birth cohorts in Australia, as reported in two survey periods: 1994 and 2002. In particular, the question of whether there is empirical evidence of cohort differences in attitudes to gender roles in Australia is investigated. The findings show that birth cohorts display progressively more modern attitudes, but people tend not to change their attitudes as they get older. In addition, men and women have different attitudes to gender roles, with men displaying more traditional beliefs than women. Having more than one child makes women less inclined to express the belief that women should work.

Managing the family`s health: preferences and experiences of women with different work and family arrangements.

Balancing the needs of work and family is a subject of much debate.The purpose of this research was to explore how families manage their children's health within the context of different work and family arrangements.In-depth interviews were conducted with women who were at home full time (8) or in paid work over 30 hours a week (7). Women had at least one child under the five years of age. Findings revealed there was no simple relationship between women's working arrangements and how they managed their children's health. All women, irrespective of their working arrangements, held similar preferences for managing their children's health.However, most women experienced either time or financial constraints that meant they had to compromise their original preferences. In some cases this meant children missed out on receiving health services. Workplace support, extended family support and general satisfaction with work and family arrangements appeared to be important factors for the small number of women who had no problems in managing their children's health. The implications of these findings are discussed.

Women in research? Investigating research opportunities for female academics in Australia

Women continue to be surprisingly under-represented in academia, given the increasing numbers of female postgraduate students and the flexible working conditions offered by most Australian Universities. To date, research has emphasised multiple causes for the 'gender gap' in academia, including the structural characteristics of the university system, cultural and societal barriers to the advancement of women, the influence of marital status on the productivity of women academics and the interaction of cultural, social and personality factors on women's professional careers. However, the implications of a 'gender gap' in academic rank reach beyond arguments of equality between sexes, to questions regarding consequences of a male-dominated professoriate to the nature and subjects of academic research in Australia. The aim of this paper is to investigate the factors that determine the rank of Australian academics and in part, to investigate whether there is a gender gap of rank or authority, through an analysis of data collected on all Australian academics by the Federal Department of Education, Science and Training. The implications of these findings on opportunities for female academic researchers and for research outcomes will be discussed.

Working mothers of children with chronic illness: narratives of working and caring

This paper reports the initial findings of an exploratory, qualitative study of the life and work of people who are working full-time and also caring for a child with chronic illness. The demands of such a lifestyle are significant. Respondents - all women - often reported 'doing-it-all' while constantly being frustrated and challenged in their mothering role.

Factors that influence women's disclosures of substance use during pregnancy : a qualitative study of ten midwives and ten pregnant women

The present study was designed to examine the factors that motivate or act as barriers to disclosure of substance use by pregnant women. Participants included 10 midwives and 10 pregnant women who attended two ante-natal clinics at an Australian maternity hospital. One clinic specialized in women who were substance users and one clinic was specifically for young women (under 19 years of age). Midwives and pregnant women were interviewed in-depth about disclosure of substance use. Interview transcripts were analyzed, and the results revealed six main themes: practice style, assessment of substance use, practice environment and privacy, child protection issues, health of the baby, and continuity of care. The findings are discussed in relation to recommendations for best practice in midwifery care when working with pregnant women who use substances.

Embodied women at work in neoliberal times and places

In this article five women explore (female) embodiment in academic work in current workplaces. In a week-long collective biography workshop they produced written memories of themselves in their various workplaces and memories of themselves as children and as students. These memories then became the texts out of which the analysis was generated. The authors examine the constitutive and seductive effects of neoliberal discourses and practices, and in particular, the assembling of academic bodies as particular kinds of working bodies. They use the concept of chiasma, or crossing over, to trouble some aspects of binary thinking about bodies and about the relations between bodies and discourses. They examine the way that we simultaneously resist and appropriate, and are seduced by and appropriated within, neoliberal discourses and practices.

Working parents of children with chronic illness/disability: narratives of concern

This paper reports some initial findings of an exploratory, qualitative study of the life and work of people who are, concurrently, parents of a child with chronic illness/disability and working full time. The respondents of this study happen to be all women. Two emerging themes of interest are explored here. The first is a revisit of traditional notions of the abusive workplace, which seems to be of special interest when considering the plight of these women. Secondly, the numerous work and home demands on the working mother, especially the working mother of a child with chronic illness or disability. [twas unsurprising that these women reported extensive and multiple physical and emotional demands while trying to manage full time work with significant home and caring responsibilities. What is surprising is that these narratives of concern have not previously been explored, and should be.

To stand by the women of the Orient : Australian women and China in the twentieth century

This paper will examine the history of Australian women living and working in China in the twentieth century. To do this I will compare the Australian experience with research on American, British and New Zealander women. The paper includes a study of two categories of Australian women in China: the expert observers, and the secular reformers. Using current theorising of post-colonialism, I will identify the specific contribution and dimensions of Australian women's experience in China.

Short-term changes in endogenous estrogen levels and consumption of soy isoflavones affect working and verbal memory in young adult females

Estrogen is known to modulate certain cognitive functions, most notably improving working memory and verbal memory. Soy foods contain isoflavones, phytoestrogens structurally similar to estrogen that weakly bind to estrogen receptors.We investigated the effects of natural variations in estrogen levels and short-term dietary supplementation with soy isoflavones on cognitive function in 28 young women. Performance was examined across a range of cognitive tasks on three occasions during separate menstrual cycles: during a menses phase (low estrogen), during a luteal phase (highest estrogen), and once during a menses phase after a 3-day phytoestrogen-rich dietary intervention. Soy supplementation during menses led to an improvement in working memory and verbal memory. The menstrual cycle effects were mixed, with high estrogen improving performance on a verbal memory task but not on working memory. Our results suggest that soy phytoestrogens may improve working memory through estrogen-independent mechanisms.