Women's views of postnatal care in the context of the increasing pressure on postnatal beds in Australia

Background : Despite limited evidence evaluating early postnatal discharge, length of hospital stay has declined dramatically in Australia since the 1980s. The recent rising birth rate in Victoria, Australia has increased pressure on hospital beds, and many services have responded by discharging women earlier than planned, often with little preparation during pregnancy. We aimed to explore the views of women and their partners regarding a number of theoretical postnatal care ‘packages’ that could provide an alternative approach to early postnatal care.

Methods : Eight focus groups and four interviews were held in rural and metropolitan Victoria in 2006 with participants who had experienced a mix of public and private maternity care. These included 8 pregnant women, 42 recent mothers and 2 male partners. All were fluent in English. Focus groups explored participants’ experiences and/or expectations of early postnatal care in hospital and at home and their views of alternative packages of postnatal care where location of care shifted from hospital to home and/or hotel. This paper describes the packages and explores and describes what ‘value’ women placed on the various components of care.

Findings : Overall, women expressed a preference for what they had experienced or expected, which may be explained by the ‘what is must be best’ phenomenon where women place value on the status quo. They generally did not respond favourably towards the alternative postnatal care packages, with concerns about any shorter length of hospital stay, especially for first time mothers. Women were concerned about the safety and wellbeing of their new baby and reported that they lacked confidence in their ability to care for their baby. The physical presence and availability of professional support was seen to alleviate these concerns, especially for first time mothers. Participants did not believe that increased domiciliary visits compensated for forgoing the perceived security and value of staying in hospital. Women generally valued staying in hospital for the length of time they felt they needed above all other factors.

Key conclusions and implications for practice : Women were concerned about shortened postnatal length of hospital stay and these concerns must be considered when changes are planned in maternity service provision. Any moves towards shorter postnatal length of stay must be comprehensively evaluated with consideration given to exploring consumer views and satisfaction. There is also a need for flexibility in postnatal care that acknowledges women's individual needs.

The sex factor : media representations of women and men in Australia

Guest edited and with an introduction by Janine Little, this collection of five scholarly articles deals with the Australian media's representation of women in coverage of some of the most controversial issues in contemporary society. The authors are from the disciplines of sociology, journalism and literary studies, with four from Deakin University and one from Flinders University, Adelaide. This enables the monograph to consider a range of phenomena arising from the way that Australia situates women and men as media subjects

The legacy of Australia's treatment of onshore asylum seekers

The Australian government's response to the 'unlawful' arrival of asylum seekers has been characterised by a host of draconian measures - most notably mandatory detention and a punitive 'temporary protection visa' with severely limited access to settlement services. This hard stance was seen as important in stemming the tide of 'illegal' asylum seekers - most of whom seek protection in Australia from their war-torn countries in the Middle East. However, the government's own statistics suggest that this strategy is not working, as the number of asylum seekers has not decreased since these tough measures were adopted in October 1999. Moreover, as this study [2] argues, the restricted access to social services and income support imposed on TPV holders is causing significant economic hardships and unnecessarily traumatic settlement experiences. Many non-government agencies (most notably community organizations and ethnic associations) are left with the daunting challenge of meeting both practical and special needs of traumatized refugees.

Australian women`s experiences of living with hepatitis C virus: results from a cross-sectional survey

Background: Of the estimated 160 000 Australians currently infected with the hepatitis C virus (HCV), over one-third are women and very few have received clinical treatment, with most managing their illness in non-specialist settings. Little is known about the experiences of women living with HCV in the general community. The present study provides the results from the first comprehensive social survey of Australian women's experiences of living with HCV.

Methods: In 2000, a questionnaire was administered to a largely non-clinical sample of women with HCV (n = 462) living in the state of Victoria and the Australian Capital Territory, Australia. The questionnaire was self-administered with a return rate of 75%. The mean age was 35 years and 83% were 'current' or 'past' injecting drug users. The mean time since diagnosis was 4.6 years (SD = 4.0) and the mean time since infection was 10.5 years (SD = 8.2).

Results: Fifty-eight percent of women reported experiencing symptoms related to their HCV, the most common being tiredness (78%) and nausea (44%). Of the sample, 56% currently saw a doctor for their HCV, and while 52% had ever been referred to a specialist, only 17% of the total sample had ever begun interferon-based combination or monotherapy. Forty-eight percent of women reported experiencing less favorable treatment by a health professional because of their HCV. Age-related self-assessed health status was significantly lower than Australian norms, as were SF-12 physical and mental health scores. The SF-12 physical and mental health scores were highly correlated, indicating a significant physical and mental health burden associated with HCV.

Conclusion: The social, physical and mental health needs of women living with HCV are considerable. Most women had not accessed specialist treatment and the response of the primary health care system to HCV-related women's health issues requires improvement.

Real or imagined women? Staff representations of international women postgraduate students

In Australia's globalising universities many support staff and teaching staff now work with international women postgraduate students. But are they aware of the issues facing these women, and is their understanding of them adequate? Indeed, how do they represent them? In this paper we draw on a small-scale pilot study involving key university personnel. We argue that the ways in which such staff represent this group of students is problematic. Focusing primarily on academic issues and on the literature on learning styles, we analyse these staff members' representations of international women postgraduate students from a postcolonial perspective. We explore the extent to which such representations, and the learning styles literature that reflects and informs them, are what Edward Said calls 'Orientalist'. In so doing, we point to both the constitution of the international woman student as postcolonial female subject and show how this situates her in relation to the prevalent learning styles discourse. Further we argue that such representations of the students differ in crucial ways from the students' self-representations, suggesting that in certain subtle ways such staff members are engaging with 'imagined' rather than 'real' women.

Promoting transportation cycling for women : the role of bicycle infrastructure

Objective.
Females are substantially less likely than males to cycle for transport in countries with low bicycle transport mode share. We investigated whether female commuter cyclists were more likely to use bicycle routes that provide separation from motor vehicle traffic.
Methods.
Census of cyclists observed at 15 locations (including off-road bicycle paths, on-road lanes and roads with no bicycle facilities) within a 7.4 km radius of the central business district (CBD) of Melbourne, Australia, during peak commuting times in February 2004.
Results.
6589 cyclists were observed, comprising 5229 males (79.4%) and 1360 females (20.6%). After adjustment for distance of the bicycle facility from the CBD, females showed a preference for using off-road paths rather than roads with no bicycle facilities (odds ratio [OR] = 1.43, 95% confidence interval [CI]: 1.12, 1.83), or roads with on-road bicycle lanes (OR = 1.34, 95% CI: 1.03, 1.75).
Conclusions.
Consistent with gender differences in risk aversion, female commuter cyclists preferred to use routes with maximum separation from motorized traffic. Improved cycling infrastructure in the form of bicycle paths and lanes that provide a high degree of separation from motor traffic is likely to be important for increasing transportation cycling amongst under-represented population groups such as women.

Calcium and bone health : position statement for the Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia and the Endocrine Society of Australia

This position statement was prepared by the Working Group of the Australian and New Zealand Bone and Mineral Society and Osteoporosis Australia. The final statement was endorsed by the Endocrine Society of Australia.

Currently, the balance of evidence remains in favour of fracture prevention from combined calcium and vitamin D supplementation in elderly men and women.

Adequate vitamin D status is essential for active calcium absorption in the gut and for bone development and remodelling.

In adults with a baseline calcium intake of 500–900 mg/day, increasing or supplementing this intake by a further 500–1000 mg/day has a beneficial effect on bone mineral density.

Calcium intake significantly above the recommended level is unlikely to achieve additional benefit for bone health.

Lactation in Australian women : the effect of oral contraceptives on the vitamin and trace element content of breast milk

The aim of this project was to investigate the effects of oral contraceptives on the nutrient composition of breast milk. The design of the study also allowed the effects of stage of lactation and maternal diet on milk composition to be observed. A prospective study was designed to measure maternal dietary intake and vitamin and trace element concentration in milk and plasma. Vitamin A, ascorbic acid and iron, copper, zinc, manganese, selenium, cobalt, chromium, rubidium and caesium were measured. Two groups of women participated, oral contraceptive users and controls. Fasting milk and blood samples and 24-hour food records were collected from the women once a week for 20 weeks commencing 3-8 weeks post-partum, and 1-2 weeks before they began to take oral contraceptives. Fifteen women participated in the study; 5 took progestogen-only oral contraceptives, 1 took an oestrogen-progestogen oral contraceptive and 9 acted as controls. Progestogen-only oral contraceptives did not affect the milk or plasma concentration of the vitamins and trace elements measured. As only 1 subject took an oestrogen-progestogen preparation no conclusion could be drawn as to its effect. The mean milk and plasma concentration of all nutrients studied did not change significantly with the progression of lactation, with the exception of iron and zinc. The mean milk iron concentration was significantly higher at 16 weeks post-partum than at 8 and 23 weeks post-partum. The mean milk zinc concentration was significantly lower at 23 weeks post-partum than at 8 and 16 weeks post-partum. The infants1 mean estimated daily intakes of ascorbic acid and vitamin A from breast milk were above the U.S. and British Recommended Dietary Allowance for those vitamins. However, their mean estimated intakes of iron, zinc, copper, manganese and selenium were well below the U.S. recommendations. Effects of the maternal dietary intake on milk and plasma composition were variable. Implications of these findings have been discussed.

(Re)producing power-knowledge-desire : young women and discourses of identity

This study focuses on three young women in their final year of school using data gathered during a year-long process of individual conversational interviews, the contents of which were largely determined by their interests. Three themes arise from critical incidents during this year - the debutante ball, teenage pregnancy and dieting. These themes are used to focus wide ranging explorations of what it is to be a young woman at this particular time. The broader cultural production of discursive positions available to, and developed by, these young women as part of their identity formation is discussed. Methodological issues concerning power relationships between research participants are also the focus of critical attention. It is considered that young women's bodies and bodily practices are central to understanding the processes involved in their identity formation. It is in this context that the focus turns to bodies that matter. In contemporary Western cultures 'adolescent bodies' could be said to matter 'too much' in the sense that they are increasingly the focus for disciplinary practices in institutions such as schooling, the church, the family, health care, health promotion and the media. This disciplining is legitimised because adolescence is socially constructed as a 'becoming'. In this case it is a matter of 'becoming woman'; a sort of apprenticeship which allows for knowledgeable others to provide not only guidance and nurturance, but discipline. Using insights gained from feminist poststructuralist theory and cultural feminism this thesis argues that the discourses and practices generated within and across institutions, which are normalised by their institutional base, are gender differentiated. The focus is on young women's embodied subjectivity and how the discourses and practices they engage with and in work to construct an ideal feminine body-subject. The discursive production of a gendered identity has a considerable impact on young women's health and their health-related behaviours. This is explored specifically in the thesis in relation to sexuality and the cultural production of the 'ideal' female body. It is argued that health education and health promotion strategies which are designed to influence young women's health related behaviours, need to consider the forms of power, knowledge and desire produced through young women's active engagement with institutionalised discourses of identity if they are to have an ongoing impact

A status report on women academic accountants in Australia

This paper reports the findings of a survey of the attributes, career satisfactions and aspirations of Australian Academic Women Accountants (AAWA). The survey sought information about personal characteristics, institutional role expectations and perceptions of gender-related issues involving recruitment, promotion and retention of AAWAs. The data provide not only an interesting insight into respondents' perceptions of a career in academic accounting, but also a comparative measure against which future progress of AAWAs can be evaluated. The paper makes suggestions for facilitating the career paths of AAWAs at both institutional and individual levels.

Aboriginal women and reconciliation in Australia : communication strategies and symbolism

This thesis explores the voices of Aboriginal women in the Reconciliation movement from 1991to 2001. It charts their success and failure, the power of the media and Reconciliation symbolism. Some of these women leaders retain a passionate commitment to Reconciliation while others have totally withdrawn from the process.