Prenatal education: profile and expectations of the couples.

Characterize the profile and describe the expectations of a sample of couple's participants in prenatal education programs integrated into the 'Tender Adventure - Preparation for childbirth and parenting' ", an outreach project of Nursing School of Coimbra.

The “Iranian ART Revolution”: infertility, assisted reproductive technology, and third-party donation in the Islamic Republic of Iran

Infertility is a social onus for women in Iran, who are expected to produce children early within marriage. With its estimated 1.5 million infertile couples, Iran is the only Muslim country in which assisted reproductive technologies (ARTs) using donor gametes and embryos have been legitimized by religious authorities and passed into law. Th is has placed Iran, a Shia-dominant country, in a unique position vis-à-vis the Sunni Islamic world, where all forms of gamete donation are strictly prohibited. In this article, we first examine the “Iranian ART revolution” that has allowed donor technologies to be admitted as a form of assisted reproduction. Then we examine the response of Iranian women to their infertility and the profound social pressures they face. We argue that the experience of infertility and its treatment are mediated by women’s socioeconomic position within Iranian society. Many women lack economic access to in vitro fertilization (IVF) technologies and fear the moral consequences of gamete donation. Thus, the benefits of the Iranian ART revolution are mixed: although many Iranian women have been able to overcome their infertility through ARTs, not all women’s lives are improved by these technologies.

Suicide plays

Suicide is a uniquely human behaviour and has always elicited strong - usually negative - opinions. Thus I would like to state from the very outset that this morbid collection of writing (all separately published elsewhere previously) should not be seen as an attempt to glamorise the act of felo-de-se. Nevertheless, one needs to recognise the inherent theatricality of suicide: too often it is a petulant, peevish performance intended to convey a bitter message to the audience of those left behind. Unfortunately, it is also a performance that many similarly unhappy souls try to emulate, and this phenomenon, known as “The Werther Effect”, is the subject of the first paper, which serves as a most appropriate introduction to the four plays that follow it. The first play, entitled “Hamlet + Ophelia = ?”, is deliberately provocative, and may easily be misunderstood as a call to commit self-murder. It is hoped, however, that the protagonists of this angry little piece are seen to be impetuous and childish, rather than noble or deep. The second play, “Games for Married Couples”, is less about seppuku than it is about the despair of child-less marriage. It is not much happier than the first, but may nevertheless raise a smile or two. “His ... or Her ... Suicide”, on the other hand, is utterly frivolous. I am sure no reader will take it seriously. Finally, and circuitously, is the stage adaptation (and translation) of Goethe’s classic 1774 novella "Die Leiden des jungen Werthers". This piece was produced as part of my 2005 Master of Creative Arts at the University of Melbourne in Australia. Many thanks must go to my supervisor, Associate Professor Angela O’Brien, for prodding and poking me until the thesis was of an acceptable standard.

‘Live your liberation, don’t lobby for it’ : Australian queer student activists’ perspectives of same-sex marriage

One topic covered in Australian queer university student print media is the legalisation of same-sex marriage. The legalisation of same-sex marriage is currently generating much debate in Western queer communities. Same-sex marriage is legalised in some countries such as, Canada, Spain, the Netherlands and Belgium. It has been outlawed in Australia and most states in the US. Campaigns continue to reverse these restrictions. Other countries, such as the UK and New Zealand allow same-sex civil unions, providing couples with the rights afforded to married couples. There is a range of research documenting queer communities’ attitudes towards this issue (for example Lannutti 2005; Clarke, Burgoyne and Burns 2006; Yep, Lovaas and Elia 2003; Wolfson 1993; Egan and Sherrill 2005). These studies document broad community views as well as those of community sub-sections. For example, Yip (2004) looks at the views of gay and lesbian Christians on same-sex marriage and Lahey and Alderson (2004) document the experiences of same-sex couples who have gotten married or who are waiting to get married. Philosophical analyses consider the legalisation of same-sex marriage in relation to, for example, liberalism, equal rights, liberation, queer theory, citizenship, history, activism, religious discourse and feminism (Ferguson 2007; Jordan 2005; Josephson 2005; Lipton 2006; Sullivan and Chauncey 2005; Riggs 2007). This paper explores Australian queer university student activist media’s representation of same-sex marriage, and the debates surrounding its legalisation. It examines a selection of queer student media from four metropolitan Australian universities, and the 2003 and 2004 editions of national queer student publication, Querelle. This paper uses discourse analysis of queer student activists’ media representations of marriage to investigate this issue in one specific context – metropolitan Australian universities. This paper thus contributes to the history of queer activism, documenting what one group of young people say about the legalisation of same-sex marriage, and furthers research on queer perspectives of marriage and same-sex relationships.

Prevention of postnatal distress or depression : an evaluation of an intervention at preparation for parenthood classes.

Determined the effectiveness of a psychosocial intervention, provided to expectant couples in routine antenatal classes, on the postpartum psychosocial adjustment of women and men. Preparation for Parenthood programs were randomly allocated to one of three conditions: usual service ('control'), experimental ('empathy'), or non-specific control ('baby-play'). The latter condition controlled for the non-specific effects of the intervention, these being: the provision of an extra class; asking couples to consider the early postpartum weeks; and receiving booster information after the antenatal class, and again shortly after the birth. Women and men were categorised into three levels of self-esteem, as measured antenatally: low, medium and high. 268 participants were recruited antenatally. Interview data and self-report information was collected from 202 of these women at 6 weeks postpartum, and 180 women at 6 months postpartum. The intervention consisted of a session focusing on psychosocial issues related to becoming first-time parents. Participants discussed possible postpartum concerns in separate gender groups for part of the session, and then discussed these issues with their partners

Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners

BACKGROUND: The Edinburgh Postnatal Depression Scale (EPDS) has been validated and used extensively in screening for depression in new mothers, both in English speaking and non-English speaking communities. While some studies have reported the use of the EPDS with fathers, none have validated it for this group, and thus the appropriate cut-off score for screening for depression or anxiety caseness for this population is not known. METHODS: Couples were recruited antenatally and interviewed at six weeks postpartum. EPDS scores and distress caseness (depression or anxiety disorders) for 208 fathers and 230 mothers were determined using the Diagnostic Interview Schedule. RESULTS: Analyses of the EPDS for fathers using distress caseness (depression or anxiety disorders) as the criterion shows that a cut-off of 5/6 has optimum receiver operating characteristics. Furthermore acceptable reliability (split-half and internal consistency) and validity (concurrent) coefficients were obtained. For mothers the optimum cut-off screening value to detect distress caseness was 7/8. Item analysis revealed that fathers endorsed seven of the ten items at lower rates to mothers, with the most significant being that referring to crying. CONCLUSIONS: The EPDS is a reliable and valid measure of mood in fathers. Screening for depression or anxiety disorders in fathers requires a two point lower cut-off than screening for depression or anxiety in mothers, and we recommend this cut-off to be 5/6

Same-sex intimate partner violence : exploring the parameters

Intimate partner violence (IPV) is not only a problem for heterosexual couples. Although research in the area is beset by methodological and definitional problems, studies generally demonstrate that IPV also affects those who identify as non-heterosexual; that is, those sexualities that are typically categorized as lesbian, gay, bisexual, transgender, or intersex (LGBTI). IPV appears to be at least as prevalent in LGBTI relationships as it is in heterosexual couples, and follows similar patterns (e.g. Australian Research Centre on Sex, Health and Society 2006; Donovan et al. 2006; Chan 2005; Craft and Serovich 2005; Burke et al. 2002; Jeffries and Ball 2008; Kelly and Warshafsky 1987; Letellier 1994; Turrell 2000; Ristock 2003; Vickers 1996). There is, however, little in the way of specific community or social services support available to either victims or perpetrators of violence in same-sex relationships (see Vickers 1996). In addition, there are important differences in the experience of IPV between LGBTI and non-LGBTI victims, and even among LGBTI individuals; for example, among transgender populations (Chan 2005), and those who are HIV sero-positive (Craft and Serovich 2005). These different experiences of IPV include the use of HIV and the threat of “outing” a partner as tools of control, as just two examples (Jeffries and Ball 2008; Salyer 1999; WA Government 2008b). Such differences impact on how LGBTI victims respond to the violence, including whether or not and how they seek help, what services they are able to avail themselves of, and how likely they are to remain with, or return to, their violent partners (Burke et al. 2002). This chapter explores the prevalent heteronormative discourses that surround IPV, both within the academic literature, and in general social and government discourses. It seeks to understand how same-sex IPV remains largely invisible, and suggests that these dominant discourses play a major role in maintaining this invisibility. In many respects, it builds on work by a number of scholars who have begun to interrogate the criminal justice and social discourses surrounding violent crime, primarily sexual violence, and who problematize these discourses (see for example Carmody 2003; Carmody and Carrington 2000; Marcus 1992). It will begin by outlining these dominant discourses, and then problematize these by identifying some of the important differences between LGBTI IPV and IPV in heterosexual relationships. In doing so, this chapter will suggest some possible reasons for the silence regarding IPV in LGBTI relationships, and the effects that this can have on victims. Although an equally important area of research, and another point at which the limitations of dominant social discourses surrounding IPV can be brought to light, this chapter will not examine violence experienced by heterosexual men at the hands of their intimate female partners. Instead, it will restrict itself to IPV perpetrated within same-sex relationships.

Listening to late discovery adoption and donor offspring stories : adoption, ethics and implications for contemporary donor insemination practices

For most of the 20th Century a ‘closed’ system of adoption was practised throughout Australia and other modern Western societies. This ‘closed’ system was characterised by sealed records; amended birth certificates to conceal the adoption, and prohibited contact with all biological family. Despite claims that these measures protected these children from the taint of illegitimacy the central motivations were far more complex, involving a desire to protect couples from the stigma of infertility and to provide a socially acceptable family structure (Triseliotis, Feast, & Kyle, 2005; Marshall & McDonald, 2001). From the 1960s significant evidence began to emerge that many adopted children and adults were experiencing higher incidences of psychological difficulties, characterised by problems with psychological adjustment, building self-esteem and forming a secure personal identity. These difficulties became grouped under the term ‘genealogical bewilderment’. As a result, new policies and practices were introduced to try to place the best interests of the child at the forefront. These changes reflected new understandings of adoption; as not only an individual process but also as a social and relational process that continues throughout life. Secrecy and the withholding of birth information are now prohibited in the overwhelming majority of all domestic adoptions processed in Australia (Marshall & McDonald, 2001). One little known consequence of this ‘closed’ system of adoption was the significant number of children who were never told of their adoptive status. As a consequence, some have discovered or had this information disclosed to them, as adults. The first study that looked at the late discovery of genetic origins experiences was conducted by the Post Adoption Resource Centre in New South Wales in 1999. This report found that the participants in their study expressed feelings of disbelief, confusion, anger, sorrow and loss. Further, the majority of participants continued to struggle with issues arising from this intentional concealment of their genetic origins (Perl & Markham, 1999). A second and more recent study (Passmore, Feeney & Foulstone, 2007) looked at the issue of secrecy in adoptive families as part of a broader study of 144 adult adoptees. This study found that secrecy and/or lies or misinformation on the part of adoptive parents had negative effects on both personal identity and relationships with others. The authors noted that those adoptees who found out about their adoption as adults were ‘especially likely to feel a sense of betrayal’ (p.4). Over recent years, stories of secrecy and late discovery have also started to emerge from sperm donor conceived adults (Spencer, 2007; Turner & Coyle, 2000). Current research evidence shows that although a majority of couples during the donor assisted conception process indicate that they intend to tell the offspring about their origins, as many as two-thirds or more of couples continue to withhold this information from their children (Akker, 2006; Gottlieb, A. McWhinnie, 2001; Salter-Ling, Hunter, & Glover, 2001). Why do they keep this secret? Infertility involves a range of complex factors that are often left unresolved or poorly understood by those choosing insemination by donor as a form of family building (Schaffer, J. A., & Diamond, R., 1993). These factors may only impact after the child is born, when resemblance talk becomes most pronounced. Resemblance talk is an accepted form of public discourse and a social convention that legitimises the child as part of the family and is part of the process of constructing the child’s identity within the family. Couples tend to become focused on resemblance as this is where they feel most vulnerable, and the lack of resemblance to the parenting father may trigger his sense of loss (Becker, Butler, & Nachtigall, 2005).

Adoption Law and Practice [2nd ed.]

This book addresses the modern law relating to adoption. It comes at a time of fundamental change in adoption practice as, increasingly, Irish couples look outside the jurisdiction for the child that will make their family complete.---------- * Examines and explains the new regulatory framework and the law now governing domestic and intercountry adoption.---------- * Provides a guide to the changes outlined in the Adoption Bill 2008 which also consolidates the provisions of seven previous statutes and incorporates the Hague Convention into Irish statute law.---------- * Considers the responsibilities of the new Adoption Authority, and the roles of other administrative and legal bodies.---------- * Sets out the adoption process, explaining the complexities of intercountry adoption, giving consideration to the interface between adoption and children in care and dealing with the rights of the parties involved.

The Australian Grey Nomads : are they who we think they are? Enhancing formative research through the quantitative assessment of psychological constructs

Issue addressed: Measures of 'social identity' and 'psychological sense of community' were included within a broader formative research inquiry to gain insight into the identity characteristics and level of connectedness among older recreational road travellers (commonly known as Grey Nomads). The research sought to gain insights on how best to reach or speak to this growing driver cohort. ----- ----- Method: Participants included 631 older recreational road travellers ranging in age from 50 years to over 80 years. Data were obtained through three scales which were incorporated into a larger formative research survey; an identity hierarchy, the Three Factor Model of Social Identity and the Sense of Community Index. ----- ----- Results: Older recreational road travellers see themselves principally as couples, with social group identity being secondary. Although many identified to some degree with the Grey Nomad identity, when asked to self categorise as either members of the Broad Network of Recreational Vehicle Travellers or as Grey Nomads, the majority categorised themselves as the former. Those identifying as Grey Nomads, however, reported significantly higher levels of 'social identification' and 'sense of community'. ----- ----- Conclusion: The Grey Nomad identity may not be the best identity at which to target road safety messages for this cohort. Targeting travelling 'couples' may be more efficacious. Using the 'Grey Nomad' identity is likely to reap at least some success, however, given that many identified to some degree with this group identity. Those identifying as Grey Nomads may be more open to community participation or behaviour change given their significantly higher levels of 'social identity' and 'sense of community'.

Being Grateful : Does it Bring Us Closer? Gratitude, Attachment and Intimacy in Romantic Relationships

To date, little is known about the function of gratitude in romantic relationships. Being grateful has been demonstrated to provide a number of positive benefits for individuals; however, few studies have explored how grateful experiences may be beneficial in enhancing romantic relationships. This study explored the extent to which adult attachment moderates the relationship between dispositional gratitude and the experience of intimacy within romantic relationships. A greater disposition toward gratitude was expected to result in more frequent experiences of gratitude. It was also anticipated that experiences of gratitude would be associated with feelings of closeness. Participants (n = 156) were required to be currently in a relationship of at least six months duration and completed a series of questionnaires assessing dispositional gratitude, attachment and emotional intimacy. Moderation analysis revealed that although a positive, weak correlation existed between dispositional gratitude and intimacy, attachment did not moderate this association. It was concluded that further investigation of the experience of gratitude is necessary to understand the function of gratitude in romantic relationships. Methods focusing on specific experiences of gratitude in romantic relationships, and the associated feelings of closeness experienced by each partner, may yield more conclusive findings and may provide support for therapeutic approaches focused on enhancing closeness between couples by increasing experiences of gratitude.

Being grateful : does it bring us closer? Gratitude, attachment and intimacy in romantic relationships

This study proposed that levels of dispositional gratitude influence experiences of intimacy within romantic relationships and that this influence is moderated by relationship attachment. Gratitude, in this study, was described as feelings of appreciation associated with the perception that one had been the focus of another’s intentionally beneficial actions. A greater disposition toward gratitude was expected to result in more frequent experiences of gratitude. It was also anticipated that experiences of gratitude would be associated with feelings of closeness toward the one responsible for the beneficial act. Participants (n=156) ranged in age from 18 – 70 and, although required to be currently in a relationship of at least six months’ duration, each was studied as an individual. Participants included both males and females, in same-sex or other-sex relationships, and completed a series of questionnaires assessing dispositional gratitude, attachment and emotional intimacy. Moderation analysis was conducted using hierarchical regression and revealed that although a positive, weak correlation exists between gratitude and intimacy, attachment did not moderate that association. However, the measures used did not elicit sufficiently divergent responses. Thus neither complete exploration of the proposed association between gratitude and intimacy, nor of the moderation of that association by attachment were possible. In conclusion, further investigation of experiences of gratitude, particularly in relation to enhancing feelings of closeness, is necessary to understand the function of gratitude in romantic relationships. Methods focusing on specific experiences of gratitude in romantic relationships and the associated feelings of closeness experienced by each partner may yield more conclusive findings. In addition, such findings may provide support for therapeutic approaches focused on enhancing closeness between couples by increasing experiences of gratitude.

Tubal damage, infertility and tubal ectopic pregnancy : chlamydia trachomatis and other microbial aetiologies

Infertility is a worldwide health problem with one in six couples suffering from this condition and with a major economic burden on the global healthcare industry. Estimates of the current global infertility rate suggest that 15% of couples are infertile (Zegers-Hochschild et al 2009) defined as: (1) failure to conceive after 12 months of unprotected sexual intercourse (i.e. infertility); (2) repeated implantation failure following ART cycles; or (3) recurrent miscarriage without difficulty conceiving (natural conceptions). Tubal factor infertility is among the leading causes of female factor infertility accounting for 7-9.8% of all female factor infertilities. Tubal disease directly causes from 36% to 85% of all cases of female factor infertility in developed and developing nations respectively and is associated with polymicrobial aetiologies. One of the leading global causes of tubal factor infertility is thought to be symptomatic (and asymptomatic in up to 70% cases) infection of the female reproductive tract with the sexually transmitted pathogen, Chlamydia trachomatis. Infection-related damage to the Fallopian tubes caused by Chlamydia accounts for more than 70% of cases of infertility in women from developing nations such as sub-Saharan Africa (Sharma et al 2009). Bacterial vaginosis, a condition associated with increased transmission of sexually transmitted infections including those caused by Neisseria gonorrhoeae and Mycoplasma genitalium is present in two thirds of women with pelvic inflammatory disease (PID). This review will focus on (1) the polymicrobial aetiologies of tubal factor infertility and (2) studies involved in screening for, and treatment and control of, Chlamydial infection to prevent PID and the associated sequelae of Fallopian tube inflammation that may lead to infertility and ectopic pregnancy.

Surrogacy : is it harder to relinquish genes?

Surrogacy has produced some positive outcomes creating an opportunity for otherwise childless couples to live their dream of parenthood. However it has also been problematic, particularly where the surrogate mother fails to relinquish a child born as a result of the surrogacy arrangement. This article examines whether a surrogate mother, who is genetically related to the child she delivers, is less likely to relinquish the child than one who has no genetic ties. An examination of empirical evidence provides support for this argument. Legislation and case law in three jurisdictions, Australia, the United States and the United Kingdom, is examined to determine which, if any, of these jurisdictions take into account the existence, or otherwise, of a genetic link between the surrogate mother and the child she bears. The article concludes that surrogacy legislation should, subject to exceptional circumstances, encourage surrogacy arrangements where the child and the surrogate are not genetically related.