Trends and motivations for freebirth: A scoping review.

BACKGROUND: Even when maternity care facilities are available, some women will choose to give birth unassisted by a professional (freebirth). This became more apparent during the pandemic of coronavirus disease 2019 (COVID-19), as women were increasingly concerned they would contract the virus in health care facilities. Several studies have identified the factors that influence women to seek alternative places of birth to hospitals, but research focusing specifically on freebirth is limited. METHODS: Eight databases were searched from their respective inception dates to April 2022 for studies related to freebirth. Data from the studies were charted and a thematic analysis was subsequently conducted. RESULTS: Four themes were identified based on findings from the 25 included studies: (1) Geographical and socio-demographic determinants influencing freebirth, (2) Reasons for choosing freebirth, (3) Factors hindering freebirth, and (4) Preparation for and varied experiences of freebirth. DISCUSSION: More women chose to give birth unassisted in low- and middle-income countries (LMICs) compared with high-income countries (HICs). Overall, motivation for freebirth included previous negative birth experiences with health care professionals, a desire to adhere to their birth-related beliefs, and fear of contracting the COVID-19 virus. Included studies reported that study participants were often met with negative responses when they revealed that they were planning to freebirth. Most women in the included studies had positive freebirth experiences. Future research should explore the different motivators of freebirth present in LMICs or HICs to help inform effective policies that may improve birth experiences while maintaining safety.

Conceptual comparison of constructs as first step in data harmonization: Parental sensitivity, child temperament, and social support as illustrations.

This article presents a strategy for the initial step of data harmonization in Individual Participant Data syntheses, i.e., making decisions as to which measures operationalize the constructs of interest - and which do not. This step is vital in the process of data harmonization, because a study can only be as good as its measures. If the construct validity of the measures is in question, study results are questionable as well. Our proposed strategy for data harmonization consists of three steps. First, a unitary construct is defined based on the existing literature, preferably on the theoretical framework surrounding the construct. Second, the various instruments used to measure the construct are evaluated as operationalizations of this construct, and retained or excluded based on this evaluation. Third, the scores of the included measures are recoded on the same metric. We illustrate the use of this method with three example constructs focal to the Collaboration on Attachment Transmission Synthesis (CATS) study: parental sensitivity, child temperament, and social support. This process description may aid researchers in their data pooling studies, filling a gap in the literature on the first step of data harmonization.•Data harmonization in studies using combined datasets is of vital importance for the validity of the study results.•We have developed and illustrated a strategy on how to define a unitary construct and evaluate whether instruments are operationalizations of this construct as the initial step in the harmonization process.•This strategy is a transferable and reproducible method to apply to the data harmonization process.

Childlessness: Concept Analysis.

The purpose of this concept analysis is to explore childlessness and provide understanding to professionals involved in the field of infertility. Walker and Avant's method was used to identify descriptions, antecedents, consequences, and empirical referents of the concept. A model with related and contrary cases was developed. The analysis was based on the definition of the term in major dictionaries in the Greek, Lithuanian, Finnish, Maltese, and Turkish languages, while further literature searches utilized the Web of Science, PubMed, PsychInfo, Medline, Google Scholar, and National Thesis Databases. The literature search was limited to papers/books published in the authors' national languages and English. As a result, childlessness is defined as the absence of children in the life of an individual, and this can be voluntary or involuntary. However, the deeper analysis of the concept may be preceded and amplified through cultural, psychological, biological, philosophical, theological, sociological, anthropological, and linguistic aspects throughout history. These elements presented challenges for childless individuals, ultimately influencing their choices to resort to alternative ways of becoming parents, such as in vitro fertilization (IVF), surrogacy, adoption, or other forms of childbearing. Historically, childlessness has been viewed with negative connotations due to its potential impact on the survival of the human species. This negativity can be directed even to individuals who may decide to opt to voluntarily remain childfree. The long-term impact of the experience, both on an individual and collective level, continues to cause pain to those who are involuntarily childless. In conclusion, health professionals and other stakeholders who have a deep understanding of childlessness, including the antecedents and attributes, can minimize the potential negative consequences of those factors contributing to childlessness, whether voluntary or involuntary. In fact, they can capitalize on a powerful impact of change adaptation by providing support to those in their practice to recover the lost homeostasis.

Childbirth Experience Associated With Maternal and Paternal Stress During the First Year, but Not Child Attachment.

Women, as well as their partners, can experience childbirth in many different ways. A negative childbirth experience may have adverse effects on the entire family, resulting, for instance, in parental stress symptoms and a weakened parent-child relationship. Parental stress, without sufficient resources to compensate for it, may also in and of itself negatively influence the parent-child relationship. This study contributes to the current knowledge of the psychological effects of childbirth experience by using longitudinal data collected with both self-reports and observational measures, as well as multiple informants (i.e., mothers and partners). The aim of this study was to investigate whether 1) women's retrospective birth experiences were related to maternal and paternal parenting stress, 2) birth experience was indirectly associated with child attachment via maternal stress, and 3) birth experience was directly related to child attachment. Data were collected from a mixed sample of community and at-risk primipara women (N = 1,364), as well as from their partners and children. Retrospective childbirth experience was measured 3 months postpartum with a latent factor consisting of five items asking about the feelings that women have about their childbirth. Parental stress was measured at 3 months postpartum for partners and 3 and 12 months postpartum for mothers using the adult domain of the parental stress index (PSI). Finally, parent-child attachment is observed in a subsample of 223 women and children at 12 months postpartum with the Strange Situation Procedure (SSP). Results show that women's birth experience was significantly related to both mothers' and their partners' parenting stress. However, birth experience was not related to child attachment, neither directly nor indirectly via maternal stress. These findings emphasize the long-lasting impact that childbirth may have on both parents. Future research is still needed to further investigate which protective factors may weaken the association between birth experience and parental stress.

Does Theory of Mind Training Enhance Empathy in Autism?

Youth with ASD often show limited or atypical empathic responsiveness. The direct effects of social skills interventions on enhancing empathic responsiveness is unknown. Data from a randomized controlled trial were used to investigate whether a Theory of Mind training improves the empathic responsiveness, measured through structured observations. The current study included a large sample (n = 135) of 8-13-year-old children with ASD. When comparing the change scores of empathic responsiveness from baseline to post-test, the intervention group performed significantly better than the waitlist group. Thus, the current findings support the use of Theory of Mind training as intervention of ASD by showing its efficacy also in improving one's empathic responsiveness, in addition to previous knowledge regarding the improvements in empathic understanding.