Expectant fathers' and mothers' perceptions of breastfeeding and formula feeding: a focus group study in three US cities.

The objective of the current study was to better understand how pregnant women and male partners conceptualize infant feeding and support for breastfeeding. Information was collected through 18 focus group interviews in 3 major US cities. There were 121 focus group participants of varying professions and income levels. Half were African American and half were Caucasian. Pregnant women and male partners had favorable attitudes toward breastfeeding, but did not articulate specific benefits to mothers or infants. Men expressed empathy for their partners' pregnancies and deferred to their partners' feeding decisions. Both groups disapproved of breastfeeding in public. Women voiced concerns about father-infant bonding more than men did. Both groups emphasized fathers' support of the infant, but not of the mother. Educators and practitioners may wish to consider expectant couples' perceptions of breastfeeding in public, knowledge of breastfeeding laws, and expectations of father-mother and father-infant relationships in their approach to breastfeeding promotion among expectant couples.

Confident commitment is a key factor for sustained breastfeeding.

BACKGROUND: The characteristics that distinguish women who breastfeed successfully from those who do not are just beginning to be identified in breastfeeding literature. The objective of this study was to identify the processes contributing to breastfeeding decisions among Caucasian and African American women. METHODS: Data were initially collected through 24 focus groups consisting of separate groups of African American and Caucasian pregnant women, and breastfeeding and formula-feeding mothers from three major United States cities. The focus group study was initiated by the U.S. Department of Health and Human Services to obtain data on salient messages that would inform a national campaign to promote breastfeeding. This study was a secondary analysis of those data using a modified grounded theory approach. RESULTS: The process that emerged associated with successful breastfeeding was labeled "confident commitment." This process included several components: a) confidence in the process of breastfeeding, b) confidence in their ability to breastfeed, and c) commitment to making breastfeeding work despite obstacles. CONCLUSIONS: Contrary to popular conceptions, breastfeeding appears to be a learned skill. If mothers achieved a level of "confident commitment" before the birth, they were able to withstand lack of support by significant others and common challenges that occurred as they initiated breastfeeding. Without the element of "confident commitment," a decision to breastfeed appeared to fall apart once challenged.

An exploration of the dimensions of pregnancy intentions among women choosing to terminate pregnancy or to initiate prenatal care in New Orleans, Louisiana.

OBJECTIVES: We examined pregnancy decisionmaking among women seeking abortion or prenatal care. METHODS: Conventional measures of pregnancy intentions were compared with newer measures in 1017 women seeking abortion. A reduced sample of abortion patients (142 African American women from New Orleans) was compared with 464 similar women entering prenatal care. RESULTS: Virtually all abortion patients reported the pregnancy as unintended; two thirds of prenatal patients reported the pregnancy as unintended. Reasons for seeking abortion related to life circumstances, including cost, readiness, not wanting any more children, marital status, relationship stability, and being too young. Abortion patients were more likely to report trying hard to avoid a pregnancy and not being in a relationship. They were less likely to report that their partner wanted a baby (odds ratio=0.10) or that they wanted a baby with their partner (odds ratio=0.13) than prenatal patients. CONCLUSIONS: Traditional measures of pregnancy intentions did not readily predict a woman's choice to continue or abort the pregnancy. Relationship with male partners, desire for a baby with the partner, and life circumstances were critical dimensions in pregnancy decisionmaking.

Understanding pregnancy in a population of inner-city women in New Orleans--results of qualitative research.

Unintended pregnancy has conventionally been defined as a pregnancy that is mistimed or unwanted, and this classification has been widely used in survey research. This study explores the utility of these constructs for women who visited a family planning clinic and a prenatal clinic in inner-city New Orleans, LA, and, by extension, for women of similar background and experience. We used semi-structured, open-ended research to explore sexual debut and history, contraceptive knowledge and use, pregnancy history, partner relations, and service use among 77 women (73 of whom were African-American). This study addresses the apparent paradox of high-risk sexual and contraceptive behavior in the presence of expressed preferences to postpone childbearing. It provides some insight into the cultural and social context in which these events and decisions take place and explores the multiple dimensions that shape women's sexual behaviors and their desires for pregnancy. The dimensions explored include perceptions of and experiences with sex/sexuality, values concerning childbearing/motherhood, relationships with partners, experiences with contraception, and attitudes toward abortion. The apparent ambivalence seen in reports of women asked whether a pregnancy was intended, such as statements that they did not want to get pregnant but were either not using contraception or using it irregularly, calls into question the idea that intendedness can be routinely and easily inferred from survey research. Correspondingly, it is not possible to simply assume that either intentionality or future intentions directly affect decisions to use contraception. The problem is that the many factors-structural and individual-affect women's preferences and ability to postpone a pregnancy or to use contraception.

Psychosocial assessment for victims of violence in Peru: the importance of local participation.

This paper describes a pilot study assessing the psychosocial impact of political violence in the Peruvian Andes, utilizing a collaborative approach with local professionals and communities. The study team prioritized dialogue and information exchange with the local professional community and villagers participating in the assessment in order to raise awareness of psychosocial issues and provide education and support. Participation in the pilot study had positive therapeutic effects for villagers, and inspired ongoing discussion groups to address psychosocial problems in communities. This paper also describes a psychosocial assessment strategy utilizing qualitative methods and an adaptation of the Harvard Trauma Questionnaire in collaboration with Andean villagers. Usefulness and limitations of the data will be reviewed, in terms of cultural and context relevance, usefulness for informing interventions, and comparisons with ethnographic methodologies and other survey instruments.