Perceptions of family planning among low-income men in Western Kenya.

BACKGROUND: Men have rarely been involved in either receiving or providing information on sexuality, reproductive health or birth spacing. They have also been ignored or excluded in one way or the other from participating in many family planning programmes as family planning is viewed as a woman's affair. AIM: To describe the perceptions of family planning among low-income men in Western Kenya. METHODS: A qualitative study using focus group interviews and content analysis was conducted, with 64 men aged 15-54 years participating actively. FINDINGS: Perceptions of family planning were manifold. For example, some perceived it as meaning having the number of children one is able to provide for. Most men knew about traditional and modern methods of birth control, although their knowledge was poor and misconceived. Modern methods were thought to give side effects, discouraging family planning. Low instances of family planning were also because of the fact that culturally, children are considered wealth. A law advocating family size limitation was regarded as necessary for the future. CONCLUSION: Men's perceptions of family planning are manifold. Their knowledge about contraception is poor and sometimes misconceived. Preferences regarding a child's gender are strong, thus attitudes and cultural beliefs that might hinder family planning have to be considered. A policy on male contraception and contraceptive services is seen as necessary.

Development of the Delivery Fear Scale.

This article reviews the development of the Delivery Fear Scale (DFS) to measure fear during labor and delivery. In an initial study, 92 women in labor answered a list of 60 items, expressing fear-related appraisals and their contrasts that were characteristic of women in labor. The items were then selected by means of an item-total analysis. In a second study, the final list of ten items was tested psychometrically, and a semi-structured interview was performed on 45 women in labor, to explore the women's descriptions of the content of each of the ten items. According to the content analysis of the interviews, the dominating connotation of the ten items is fear based on the appraisal of being captured. The studies show that the DFS is a questionnaire that almost effortlessly can be completed within 60-90 seconds during any moment of labor and delivery. The scale has a good reliability: Cronbach's alpha was 0.88 in both studies.

Fear during labor.

BACKGROUND: The aims of the present study were to compare primiparous and multiparous women's experiences of fear of delivery during an early stage of active labor (cervix dilatation 3-5 centimeters) and to study whether fear of delivery, measured during the early stage of active labor, was a predictor of the amount of pain relief received during the remaining part of labor (cervix dilatation 5 cm - partus), of the duration of the remaining part of labor, and of the occurrence of instrumental vaginal delivery and emergency cesarean section. METHOD: Thirty-five primiparous and 39 multiparous women answered the Delivery Fear Scale (DFS) once during the early stage of labor and before they had received any pain relief. RESULTS: Primiparous women reported higher levels of fear than multiparous women did. Fear during the first phase of labor predicted only the total amount of pain relief received during labor. CONCLUSION: The clinical implications of the study are that the delivery staff should consider women's fear during labor and pay attention especially to primiparous women's increased risk of higher levels of fear during an early stage of active labor, as compared with multiparous women's. The challenge for staff of a delivery ward is to support the woman in labor in a way that decreases fear, which in turn might reduce the woman's need of pain relief.

Can women's cognitive appraisals be registered throughout childbirth?

The aims of the present study were: (a) to examine whether it was possible to measure women's cognitive appraisals hourly during the whole process of labor and delivery, and (b) to explore how the appraisals varied during labor. Measurements from 12 nulliparous women are presented. The findings indicate that it is possible to study psychological appraisals directly, in detail and continuously during the process of labor and delivery. The women's cognitive appraisals varied throughout labor both per individual woman and between the participating women.