African Mothers Research Articles

Disparities in Child Development by Maternal Birthplace and Child Sex among Kindergarten Children in Manitoba, Canada: A Population-Based Data Linkage Study.

Little is known about differences in child developmental vulnerability before school entry according to maternal birthplace and sex. Official immigration records were linked with the Early Development Instrument assessments among children in kindergarten in the province of Manitoba, Canada (2005-2017). Logistic regression was used to estimate odds ratios of vulnerability in five developmental domains associated with maternal birthplace and child sex. Children of immigrant mothers from most birthplaces had higher adjusted odds of developmental vulnerability than non-immigrants in domains related to language and communication skills, except those of the rest of North America & Oceania. Children of Sub-Saharan African mothers were more vulnerable in four domains. Boys were consistently more vulnerable than girls across domains and maternal birthplaces. Children of immigrant mothers exhibited higher developmental vulnerability than non-immigrants in domains related to language and communication skills, potentially reflecting exposure to English and French as second languages.

Knowledge, attitudes and support practices related to breastfeeding promotion of doctors and nurses in Motheo district, Free State province, South Africa

Background: Breastfeeding is widely acknowledged as the optimal method of infant feeding. However, the percentage of South African mothers who exclusively breastfeed remains alarmingly low. Healthcare workers (HCWs) are pivotal in promoting breastfeeding; however, a deficiency in their knowledge, negative attitudes, and unfavourable practices can impede the promotion and support of breastfeeding. Aim: To assess the knowledge, attitudes, and support practices related to breastfeeding promotion of HCWs in the Motheo district, Free State province, compared with the 2016 WHO Guideline updates on HIV and infant feeding and 2018 Mother-Baby Friendly initiative guidelines. Methods: A quantitative analytical cross-sectional study involving paediatricians, obstetricians, general practitioners (GPs), and midwives was conducted using a self-administered questionnaire. Results: Over half of the HCWs (59%) were able to define exclusive breastfeeding (EBF), with a significant majority of GPs (76.1%) and midwives (78.6%) recommending EBF up to six months, compared with only 10% of paediatricians and 25% of obstetricians (p < 0.001). Some 11.1% of the total group of HCWs reported that breastfeeding is contraindicated for HIV-infected mothers, while 15.4% were unsure of the recommendation for breastfeeding among HIV-infected mothers. A higher proportion of midwives, compared with other HCWs, felt highly confident in providing breastfeeding advice (p < 0.001). Additionally, more than half (56%) of HCWs had not completed the 20-hour WHO Lactation Management Training, and 55% believed their prior breastfeeding training was not sufficient to support and educate breastfeeding mothers. Conclusion: Regular breastfeeding training of HCWs on the latest breastfeeding guidelines is necessary to equip HCWs with the knowledge and competence to successfully promote, protect, and support breastfeeding.

Intimate Partner Violence Among Adolescent Mothers Living With and Without HIV: A Pre- and During–COVID-19 South African Cohort Analysis

PurposeAdolescent mothers face heightened economic and social vulnerabilities, which can place them at increased risk of intimate partner violence (IPV), prepandemic, and during COVID-19. However, few studies examine this population, and even less disaggregate findings by HIV status. MethodsWe analyzed data from 834 South African adolescent mothers, 35% living with HIV (LHIV), who reported on physical, psychological, and sexual IPV exposure at two interviews: 2018-2019 (prepandemic) and 2021-2022 (during COVID-19). We estimated lifetime prevalence of IPV, disaggregating by HIV status. We used inverse weighted probability multivariate mixed-effects logistic regression to examine changes in IPV between the two periods and if changes in IPV differed by HIV status. ResultsA quarter of adolescent mothers had experienced any IPV during COVID-19, quadruple prepandemic levels (24.7% vs. 6.0%). The increase was driven by surges in physical (+15.7%) and psychological (+11.2%) IPV. In both periods, psychosocial and physical IPV were the most prevalent forms and the most common combination among those who had experienced multiple forms of IPV. Exposure to any IPV was significantly more prevalent among those LHIV compared to those without HIV, prepandemic (9.5% vs. 4.1%, p = .026) and during COVID-19 (31.8% vs. 20.6%, p < .001). Adjusted models revealed an 18.2% significant increase in the average predicted probability of reporting IPV during COVID-19 compared to prepandemic, with no differential effect by HIV status. DiscussionAdolescent mothers experienced a significantly higher burden of IPV during COVID-19 than prepandemic, with those LHIV experiencing the highest level. Initiatives to reduce IPV need to reach adolescent mothers, particularly those living with HIV.

Characterizing medical decision-making in sickle cell disease during childhood: Qualitative perspectives of caregivers.

Sickle cell disease (SCD) is the most common genetic disorder among children. As the most common type of SCD, sickle cell anemia (SCA) is associated with severe complications across the lifespan. As parents/caregivers hold primary disease management responsibility during childhood, their involvement in disease management activities, including medical decision-making, is critical to successful and timely management of pediatric SCD. However, the processes through which caregivers make SCD-related decisions remain unknown. The current paper examined caregivers' decision-making processes and priorities when managing their child's SCD. Parents and primary caregivers (N=27) of children with SCA (ages 0-12) completed individual semi-structured qualitative interviews exploring links between caregivers' decision-making and both daily and ongoing SCA management practices. Data were transcribed verbatim, cleaned, systematically coded, and analyzed using applied thematic analysis. Participating caregivers were primarily Black or African American (88.9%), mothers (81.5%), publicly insured (55.6%), and single (51.9%). Caregivers described medical decision-making across acute symptom response, preventive disease management, and treatment initiation and/or discontinuation. Across these contexts of disease management, caregivers overarchingly prioritized protecting and improving their child's quality of life. Caregivers' medical decision-making processes were influenced by their SCA management experience, acquisition of SCA knowledge, and trust in medical providers. The extent to which these influences impacted caregivers' decision-making varied based on disease severity, disease management experience, and time since diagnosis. Findings highlight how processes underlying caregivers' decision-making are directly influenced and informed by caregivers' lived experiences. Future work should develop provider-initiated collaborative interventions to support medical decision-making.

The role of maternal postmigration living difficulties in intergenerational trauma transmission among asylum-seeker mother-child dyads: Exploring complex posttraumatic stress disorder as a mechanism.

Among forcibly displaced people, maternal trauma and stress have been implicated in poor child socioemotional outcomes via intergenerational trauma transmission. This study explored the role of maternal postmigration living difficulties (PMLD) in the pathway linking maternal trauma, trauma-related psychopathology, and child socioemotional outcomes among mother-child dyads seeking asylum in a high-risk urban setting. Participants were East African (Eritrean) mothers (N = 127) of preschool-aged children seeking asylum in Israel. Using moderated mediation analysis, we tested whether and how PMLD may moderate the mediating role of current maternal International Classification of Diseases, 11th revision (ICD-11) posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder disturbances in self-organization (DSO) symptoms between past maternal trauma exposure and current postdisplacement child internalizing and externalizing difficulties. Children's direct exposure to adverse life experiences was controlled for. Maternal PTSD symptoms mediated the association between past maternal trauma exposure and child internalizing difficulties, but not externalizing difficulties, across all levels of current maternal PMLD. However, maternal DSO symptoms mediated internalizing and externalizing child outcomes, but only among mothers reporting high levels of current PMLD. This study provides novel evidence that PMLD may amplify the toxicity of past maternal trauma exposure for poor child socioemotional outcomes via ICD-11 DSO symptoms. The intergenerational transmission pathway via the narrower fear-based ICD-11 PTSD, however, is independent of the degree of maternal PMLD. Findings suggest that policies designed to buffer intergenerational trauma transmission among forcibly displaced people may need to consider the toxicity of PMLD as well as enable mothers to heal from PTSD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

African Mother Scholar

African Mother Scholar is a poem born out of my disillusionment with life, love, and womanhood. As an African woman, immigrant, mother, and scholar, I am forced to come to terms with conflicting identities, a colonial past, and present patriarchal structures. In search of both who I am and who I want to become, I find myself questioning long held cultural beliefs on my role as a wife and mother and how these beliefs align with my desire for intellectual growth. It is in this state of ontological flux that I find a newfound sense of freedom, power, and control. My search for knowledge–for truth, healing, and identity–both unravels and remakes me. In these halls of knowledge, I experience never ending conversations, community, and laughter, as if returning from a distant homeland. I find myself dreaming of the impossible. I am finally the author of my own story.

Concordant fatal congenital anomaly in twin pregnancy: a case report and review of the literature

BackgroundWhen a pregnant mother finds out she has a fetus with a congenital defect, the parents feel profound worry, anxiety, and melancholy. Anomalies can happen in singleton or twin pregnancies, though they are more common in twin pregnancies. In twins, several congenital defects are typically discordant.Case summaryWe present a rare case of concordant fatal anomaly in twin pregnancy in a 22-year-old African patient primigravida mother from Western Ethiopia who presented for routine antenatal care. An obstetric ultrasound scan showed anencephaly, meningomyelocele, and severe ventriculomegaly. After receiving the counseling, the patient was admitted to the ward, and the pregnancy was terminated with the medical option. Following a successful in-patient stay, she was given folic acid supplements and instructed to get preconception counseling before getting pregnant again.ConclusionThe case demonstrates the importance of early obstetric ultrasound examination and detailed anatomic scanning, in twin pregnancies in particular. This case also calls for routine preconceptional care.

Levels and Determinants of Bisphenol Concentrations in Breast Milk Samples Collected from South African Mothers and Associations with Infant Growth

Levels and Determinants of Bisphenol Concentrations in Breast Milk Samples Collected from South African Mothers and Associations with Infant Growth

Judging Gender: The Sentencing of South African Mothers Who Murder Their Children

Judging Gender: The Sentencing of South African Mothers Who Murder Their Children

“I wonder if you will be sad?”: Employing the concept of mentalization psychosocially with low-income mothers

We demonstrate the value of a rapprochement between psychoanalytic work aimed at supporting marginalized mothers and discursive accounts of low-income mothers, providing a psychosocial analysis of data from an interview study with six low-income South African mothers. Employing discourse analysis, we show how instrumental mothering is a dominant and precarious construction in these mothers’ talk. We use the concept of mentalization to track the affective work that accompanies the interactional emergence of this instrumental mothering discourse in a particular interview encounter. The implications of the research are discussed in the light of increasing demands for sociocultural responsive research and clinical practice.

A randomised trial comparing preoperative administration of single-dose kefazolin to kefazolin plus metronidazole as prophylactic antibiotics at caesarean section.

Caesarean section is a life-saving procedure which is associated with high rates of maternal and neonatal complications. It has been estimated that globally, 29.7 million births occur by caesarean section annually. The risk of postpartum infection is estimated to be five to ten times higher compared with normal vaginal delivery. Pregnancy-related sepsis was listed as a top-six cause of maternal mortality in the South African Saving Mothers report between 2017 and 2019. Multiple trials have been conducted in an attempt to optimise administration of prophylactic antibiotics in an effort to reduce postpartum infection and maternal sepsis, and current practice guidelines suggest that there is sufficient evidence that extended-spectrum antibiotics, in combination with kefazolin, result in reduction of postpartum infections. To investigate the effect of perioperative administration of kefazolin alone compared with kefazolin plus metronidazole on postpartum infection in women undergoing caesarean section at Kalafong Provincial Tertiary Hospital, Pretoria, South Africa. All patients undergoing emergency or elective caesarean section were randomised and then sequentially numbered in opaque sealed envelopes, which were placed in the caesarean section operating theatre. The intervention group received kefazolin and a sealed envelope with metronidazole. The control group received kefazolin and a sealed envelope with normal saline. A total of 57/1 010 patients (5.64%) had surgical site infections, of which 27 (5.33%) were in the control group, and 30 (5.96%) were in the intervention group (p=0.66). Two patients in each arm (0.40% in the intervention arm and 0.39% in the control arm) underwent laparotomy procedures, while three women (0.60%) in the intervention arm and four women (0.79%) in the control arm underwent hysterectomy procedures. There were no statistically significant differences in all the measured secondary outcomes between the two groups. The overall sepsis rate in this study was 5.64%. Postpartum infection is multifactorial and there are multiple factors that can be addressed in strengthening the sepsis care bundle. We do not recommend the addition of metronidazole to kefazolin as prophylaxis at caesarean section.

Early online.

Caesarean section is a life-saving procedure which is associated with high rates of maternal and neonatal complications. It has been estimated that globally, 29.7 million births occur by caesarean section annually. The risk of postpartum infection is estimated to be five to ten times higher compared to normal vaginal delivery. Pregnancy-related sepsis was listed as a top six cause of maternal mortality in the South African Saving Mothers report between 2017 and 2019. Multiple trials have been conducted in an attempt to optimise administration of prophylactic antibiotics in an effort to reduce postpartum infection and maternal sepsis, and current practice guidelines suggest that there is sufficient evidence that extended spectrum antibiotics, in combination with kefazolin, result in reduction of postpartum infections Objectives. To investigate the effect of perioperative administration of kefazolin alone compared to kefazolin plus metronidazole on postpartum infection in women undergoing caesarean section at Kalafong Provincial Tertiary Hospital. All patients undergoing emergency or elective caesarean section were randomised and then sequentially numbered in opaque sealed envelopes, which were placed in the caesarean section operating theatre. The intervention group received kefazolin and a sealed envelope with metronidazole. The control group received kefazolin and a sealed envelope with normal saline. A total of 57/1 010 patients (5.64%) had surgical site infections, of which 27 (5.33%) were in the control group, and 30 (5.96%) were in the intervention group (p=0.66). Two patients in each arm (0.40% in the intervention arm and 0.39% in the control arm) underwent laparotomy procedures, while three women (0.60%) in the intervention arm and four women (0.79%) in the control arm underwent hysterectomy procedures. There were no statistically significant differences in all the measured secondary outcomes between the two groups. The overall sepsis rate in this study was 5.64%. Postpartum infection is multifactorial and there are multiple factors that can be addressed in strengthening the sepsis care bundle. We do not recommend the addition of metronidazole to kefazolin as prophylaxis at caesarean section.

The pandemic and working mothers: perspectives from American and South African working mothers

The purpose of the current study was to examine the effects of the COVID-19 pandemic on working mothers from the United States and South Africa. This study sought to highlight both cross-cultural similarities and differences. American and South African working mothers took part in online interviews. Eighteen participants were included in the sample, ten participants lived in the United States, while eight participants currently resided in South Africa. The age range of the participants’ children was from 0 to 21 years old. Each participant met individually with the researcher and answered a series of open-ended questions regarding their experiences of being a working mother during the COVID-19 pandemic. Researchers analyzed interviews using thematic analysis. Common themes emerged in the interviews with both American and South African working mothers. Mothers in the United States and South Africa both noted the need for flexible work schedules as well as expressed difficulty balancing roles as mothers and professionals during the pandemic. Increased motivation and resiliency as well as lack of representation of women leaders were themes specific to South African mothers in this study. Conversely, feelings of decreased interest in pursuing leadership opportunities was a theme specific to American mothers in this study. The current study adds to the growing body of literature documenting the effect of the pandemic on working mothers, and builds on this research by including a qualitative component to gain knowledge from working mothers themselves. The narratives collected in the current study highlight commonalities as well as differences in the experiences of working mothers in the United States and South Africa, which holds important implications for how workplaces and the broader community can best attend to the unique needs of working mothers.

Sociocultural context of exclusive breastfeeding in Africa: A narrative review.

Although exclusive breastfeeding (EBF) has many benefits, it is not commonly practiced in several countries as a result of context-specific challenges. EBF practice is thus a global health discourse because over 200 million children suffer from malnutrition despite the abundance of human milk. The risk of starvation remains very high among African children with less than 40% of them exclusively breastfed. In Africa, the adoption or nonadherence to EBF is a sociocultural issue. Hence, this narrative review examined the sociocultural context of EBF in the region. PubMed, Google Scholar, and Scopus were searched using keywords related to EBF and Africa. Relevant data from selected studies were synthesized narratively and reported using a structured narrative format. EBF is strongly rooted in every culture and is a culturally determined behavior. Some believe that colostrum is dirty and harmful to newborns and, thus, needs to be purified. Despite the belief that human milk is the best food for babies, mothers often complement human milk with other foods right from birth because of perceived lactation inadequacy. Most African mothers believe in prelacteal feeding to help cleanse the infant's gastrointestinal tract for digestion, quench thirst, flush the bladder and help the mother to rest after childbirth before breastfeeding (BF) is initiated. The role of significant others was equally found important in the decision and duration of BF. The availability of family support (especially from grandmothers and husbands) reportedly encouraged EBF in Africa. The duration and exclusivity of BF in Africa are negatively associated with demographic variables like young age, low level of education, being unmarried, low income, out of employment, and parity (first-time mother). While there have been some efforts and policies to improve EBF, it is important to consider context-specific challenges and sociocultural factors. There is a need for more deliberate efforts to encourage mothers through the implementation of effective best practices concerning EBF in Africa.

Expression of Concern: 'Lactomassilus timonensis,’ a new anaerobic bacterial species isolated from the milk of a healthy African mother

Expression of Concern: 'Lactomassilus timonensis,’ a new anaerobic bacterial species isolated from the milk of a healthy African mother

Unsung Heroes of Mission Bible Translation in Colonial West Africa: Ludwig Adzaklo of the Bremen Mission in German Togoland

The Africanisation of Christianity in Africa is closely linked to the availability of the Bible in African mother tongues. However, mission-led Bible translation in Africa in the nineteenth and early twentieth centuries was not solely the work of European missionary linguists. Africans, such as Ludwig Adzaklo of the Bremen Mission, played essential roles in this process. Nevertheless, African translators like him were considered as mere Sprachgehilfe (language assistants) to the missionaries and not as co-translators. After a postcolonial analysis of archival data on the translation of the Old Testament into Ewe by Ludwig Adzaklo and Jakob Spieth, this study argues that Adzaklo was not just Spieth’s Sprachgehilfe but a co-translator on the project. Being referred to as Spieth’s Sprachgehilfe was a colonial-missionary label that denied Adzaklo’s agency in mission-led Bible translation in Africa. Therefore, the study suggests that Adzaklo should be viewed as an early Ewe mother-tongue Bible translator in the history of West African Christianity.

Motherhood, role conflict, and identity: South African mothers’ experiences amid a pandemic

ABSTRACT This qualitative study aimed to explore and describe the role conflict that working South African mothers experienced during the COVID-19 pandemic in relation to their maternal and work roles and examine the mothers’ descriptions and experiences of their individual and maternal identities. The phenomenon of work-life conflict is not new; however, the COVID-19 pandemic provided new research opportunities since the lockdown restrictions created unprecedented working and living circumstances within the home environment. Work-life conflict was explored within the context of motherhood and its subsequent role fulfilment, gaining a deeper understanding of the experience and integration of maternal and individual identities. Semi-structured interviews with nine mothers were analysed using reflexive thematic analysis. The analyses revealed that mothers experienced increased role conflict during the COVID-19 pandemic. Participants emphasized that they experienced particular challenges, including social isolation, limited time for self-care, re-evaluations of work and maternal roles, and subsequent influences on their personal and maternal identities. This study provides insight into the complexities and nuanced experiences of mothers’ work and family conflict within the unknowns and uncertainty of an overwhelming pandemic.

THE LIVED EXPERIENCES OF DISPLACED AFRICAN SINGLE MOTHERS IN THE AFTERMATH OF FLOODS IN KWAZULU-NATAL

In April 2022, heavy rainfall and flooding took place in most areas of KwaZulu-Natal, South Africa. The floods left a trail of destruction, grief and displacement for the most vulnerable social groups. The condition of African single mothers was of particular concern because of the multiple disadvantages they already face. Based on a qualitative study conducted with 30 displaced single mothers who were purposively selected, the article explores the lived experiences of displaced African single mothers in the aftermath of the KwaZulu-Natal floods. The findings revealed that although temporary shelters were provided for their safety, African single mothers were subjected to various forms of secondary trauma, which aggravated their vulnerability. This suggested a need for psychosocial interventions and a comprehensive emergency plan for single mothers during natural disasters. Based on the strengths perspective, the article recommends intensive social work interventions and strategic resource management amongst community stakeholders and political leaders to ensure the effectiveness and sustainability of support. Keywords: displaced, floods, KwaZulu-Natal, natural disasters, single mothers, social work practice

Lipid profile in women of different ethnicity with gestational diabetes: Relationship with fetal growth.

Pregnancy complicated by gestational diabetes mellitus (GDM) is characterized by excessive insulin resistance that impairs the metabolism of glucose and lipids. the aim of the study was to examine lipid profiles during pregnancy of women with GDM, and its impact on fetal growth in a multiethnic population. The study included 322 pregnant women of different ethnicity with GDM attending a clinical unit specializing in metabolic diseases. The area under the curve for the 75-g oral glucose tolerance test and glycated hemoglobin were significantly different among all groups. At the time of being diagnosed with GDM, Asian and African mothers had significantly lower levels of total and low-density liprotein cholesterol than European mothers (P < 0.001). The trend for high-density liprotein cholesterol was similar. Triglycerides levels in the Asian group (193.6 ± 65.5 mg/dL) were higher than in the African group (133.2 ± 49.6 mg/dL, P < 0.001), whereas the European group presented intermediate values (175.8 ± 58.8 mg/dL), which differed significantly only versus the African group (P < 0.001). Pre-partum lipid profiles showed a trend quite similar to that observed at diagnosis. The newborn's birthweight was significantly different, with that of African women (3,437 ± 503 g) being the highest, followed by that of European women (3,294 ± 455 g) and of Asian women (3,006 ± 513 g). The rates of macrosomia showed a trend with higher values in the African group (13.5%), followed by the European group (5.7%, P = 0.1162), whereas that of the Asian group was zero (P = 0.0023 vs African). Our data show that lipid profiles in women with GDM differ by ethnicity. The impact of lipid profile on fetal growth is limited and uninfluenced by ethnicity.

Birth stories of South African mothers of children with albinism: A critical human rights analysis

BackgroundThe genetic condition of oculocutaneous albinism is disproportionately present in Africa. Little research has addressed the experiences of mothers impacted by albinism, even though they are more likely to be impacted by human rights violations. MethodsA qualitative study was designed to examine the resilience of mothers affected by albinism in South Africa. Virtual and in-person fieldwork was conducted with the facilitation of community-based researchers and local cultural liaisons. FindingsGiving birth to a child with albinism in South Africa, as in many parts of sub-Saharan Africa, was a life-defining moment for mothers and their families, setting them on a trajectory of health-related stigma, gender inequalities, reduced access to social determinants of health, and other human rights violations. Mothers engaged in sense-making processes shaped by the responses of birth attendants and families, and that reflected social discourses. Their resilience was impacted by access to health teaching, genetic counselling, and health and social services, which were often incomplete or absent all together. Civil society organizations, peer groups, and faith communities were vital in filling these gaps. ConclusionsThe experience giving birth to a child with albinism was both the same and different compared to mothers forty years earlier. What varied was the digital availability of health information; progressive health and social policies and resourcing; and human rights instruments. These transformations point to best practices to support mothers’ resilience.