Canadian Mothers Research Articles

Family structure, social capital, and mental health disparities among Canadian mothers

ObjectivesTo examine the extent to which inequities in mental health between single and partnered mothers can be explained by social capital, independently and in concert with socio-economic circumstances. Study designCross-sectional study. MethodsThe sample consisted of 2920 mothers participating in Statistics Canada's 2010 General Social Survey. Chi-square and logistic regression analyses were used to investigate the extent to which family structure differences in self-rated mental health, if observed, were mediated by various dimensions of social capital. ResultsCompared with partnered mothers, fair/poor self-rated mental health was more common among previously married mothers (OR = 3.14; 95% CI 2.15–4.59) and never married mothers (OR = 3.01; 95% CI 1.95–4.65). After adjustment for socio-economic and social capital variables, the odds ratio between single mother family structure and fair/poor mental health decreased but remained significant (ORpreviously married = 1.90, 95% CI 1.22–2.98; ORnever married = 1.90, 95% CI 1.14–3.16). ConclusionSingle mothers' more limited access to economic and social capital resources partially explain their compromised self-rated mental health. Longitudinal research with multi-item measures of mental health is needed to corroborate these findings and extend their understanding of the relationship between family structure, social capital, and mothers' mental health.

O-038 Polyunsaturated Fatty Acid Composition Of Breast Milk From Eastern Canadian Mothers Of Preterm Infants

<h3>Background and aim</h3> Polyunsaturated fatty acids (PUFAs) are essential for early human neurodevelopment. Since breast milk represents the main dietary source of PUFAs for preterm infants, its fatty acid composition is of particular interest. Breast milk fatty acid composition fluctuates from one woman to another, by duration of gestation and stage of lactation, and among countries. As PUFA composition of breast milk from Western Canadian mothers of preterm infants has been previously described, the aim of this pilot study was to describe the compositional variations of PUFAs in breast milk of Eastern Canadian mothers of preterm infants over the first 6 weeks of lactation. <h3>Methods</h3> Samples of breast milk were collected on the 7th, 21st, and 42nd day of lactation from 40 Eastern Canadian mothers who had given birth to preterm infants of gestational age less than 30 weeks. Lipids were extracted using the Folch method (Folch <i><i>et al</i></i>., 1957). Thereafter, the method of direct transesterification was performed (Lepage and Roy, 1986) and PUFAs were quantified by gas chromatography. <h3>Results</h3> Throughout the study, fatty acids from the n-3 and n-6 families, linoleic acid (C18:2n-6), α-linolenic acid (C18:3n-3), and eicosapentaenoic acid (C20:5n-3) remained stable, whereas arachidonic acid (C20:4n-6) and docosahexaenoic acid (C22:6n-3) decreased significantly. <h3>Conclusion</h3> Results on the compositional variations of PUFAs in breast milk over the first weeks of lactation are somewhat similar to results of previous European studies. However, values of PUFAs in preterm breast milk of Eastern Canadian mothers are lower than those of Western Canadian mothers.

The motivational state and perceived benefits and barriers to physical activity participation in parents of preschool age children

Introduction Due to the decline in physical activity documented during the transition to adulthood, as well as the powerful modeling effect parents have on their young children, parents of preschool-age children are a valuable population sub-group to examine in physical activity research. Method In this investigation, 118 Canadian mothers and fathers of preschool-age children filled out three questionnaires: the Godin leisure-time physical activity participation [1] , Stage of motivational readiness to change [2] , and Exercise Benefits/Barriers Scale (EBBS) [3] . Results Consistent with previous research, the trans-theoretical model of behavior change was supported. That is, respondents classified in higher stages of motivational readiness to change reported higher levels of physical activity. This finding held for both exercising alone or with their children. Similarly, participants classified into higher stages of motivational readiness to change also reported greater perceived benefits and fewer perceived barriers to physical activity participation. Contrary to previous research, gender was not found to be a significant correlate of physical activity participation in this sample. Parental time demands emerged as a novel barrier to physical activity participation in the EBBS. Mothers in lower stages of motivational readiness to change were more likely to view parenting as a barrier to physical activity participation. Active parents, in higher stages of motivational readiness to change, were less likely to view parenting related time demands as barriers to physical activity participation and were more likely to engage in physical activity with their children. Conclusion The relationships between gender, parenting related time demands, physical activity participation and stage of motivational readiness to change are complex. However, since parenting has a unique effect on families’ daily physical activity engagement, a practical conclusion of the study is that healthy living interventions targeting families with young children need to incorporate the parental expectations and needs to perceived benefits and barriers.

Defining competencies for training in obstetric medicine.

The recognition of Obstetric Medicine as a subspecialty of Internal Medicine is being pursued in a number of countries. In Canada, this has involved moving from the standard concept of curricula-based learning to development of a competency-based approach. Competency-based models are being increasingly used in the corporate world.1 Competency-based models have replaced task-based model in job analysis and are thought to be able to distinguish top performers from average performers. Organizations view workers as a whole, with an emphasis on their observable behaviours and measurable capabilities as indicators of the individual’s potential. Conventional measures of intelligence and abilities are no longer thought to be able to predict job performance or success in life. The Royal College of Physicians and Surgeons of Canada has started a multi-year initiative to implement competency-based medical education. Several specialty training programs are currently revising the standardized training objectives into competencies. According to Allen et al.,2 a competency should include the following: Focus on the performance of the end product or goal of instruction. Reflect expectations that apply what is learned in the immediate instructional program. Be expressed in a measurable behaviour. Use a standard for judging competence that is not dependent on the performance of other learners. Inform learners, as well as other stakeholders, of what is expected of them. Competency-based learning is focused on the learner, who can acquire the individual skills they find challenging at a slower pace, and move to other skills that they are more able at, more rapidly. The instructor serves the role of the facilitator. Learners are evaluated on an individual competency and only once they have displayed the measurable behaviours or actions towards a specific outcome do they move on to a larger learning goal. This is in contrast to a didactic course or module where all learners in the course/module are expected to learn at the same speed. The emphasis in the competency-based learning is on performing rather than just knowing. The Canadian Working Group on Obstetric Medicine fellowship training was established in the fall of 2012. The aim of the Working Group is to obtain the Area of Focused Competence (AFC) or diploma recognition of Obstetric Medicine from the Royal College of Physicians and Surgeons of Canada (RCPSC). The AFC or diploma program was established by RCPSC in 2011. In order for the application to be successful, several key elements are required, including: defining the scope of practice of Obstetric Medicine (in terms of how it is different from General Internal Medicine (GIM) or Maternal Fetal Medicine), projecting workforce requirement of Obstetric Internists in Canada, obtaining application funding of $14,000, and writing the Obstetric Medicine training curriculum into competencies. The AFC or diploma training programs are generally one-year in duration; however, the application will likely be stronger in the current climate if defined by competency-, rather than time-based. The Working Group will adopt Cumyn’s Canadian curriculum in Obstetric Medicine (CanCOM).3 The CanCOM curriculum was created based on (a) document analysis of RV Lee’s textbook Medical Care of the Pregnant Patient, (b) review of available curricula including the Brown University and ISOM curricula and (c) triangulation with cases seen over a six-month period in a busy Canadian Mother–Child University Teaching Hospital. The 420 content items were then validated by Delphi survey methodology by 25 Canadian physicians who practice Obstetric Medicine. The curriculum which includes the seven CanMEDS domains, namely medical expert, communicator, collaborator, leader (formerly manager), health advocate, scholar and professional, will be written as competencies that are “active abilities required, rather than knowledge or comprehension of those abilities; thus, verbs such as “identify,” “analyze,” “engage in,” or “demonstrate” are preferred over “describe” or “explain”.”4 For instance, under Chronic Hypertension and Evaluation, the learner should: Identify baseline investigations to be done prior to or at the onset of pregnancy in a woman with hypertension. Perform work-up of secondary causes of hypertension, as it pertains to pregnancy. Analyze physiologic changes to blood pressure in pregnancy. Demonstrate the proper techniques of blood pressure measurement in pregnant women. Since several objectives in Obstetric Medicine are also present in the GIM subspecialty training objectives, the Obstetric Medicine Working Group will work with the Canadian GIM group in their pilot project to further clarify the scope of similar competencies. For instance, for the management of a hypertensive pregnant woman, how much is expected of a General Internist versus an Obstetric Internist. We are optimistic that competency-based training model in Obstetric Medicine will enhance our diploma application and that Obstetric Medicine can be formally recognized as a RCPSC AFC in Canada. We expect that this collective effort will serve as a model for programs worldwide who are also aiming to develop high-quality Obstetric Medicine Training.

The maternal adversity, vulnerability and neurodevelopment project: theory and methodology.

To describe the theory and methodology of the multi-wave, prospective Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN) study. The goal of MAVAN is to examine the pre- and postnatal influences, and their interaction, in determining individual differences in mental health. MAVAN is a community-based, birth cohort study of pregnant Canadian mothers and their offspring. Dyads are assessed longitudinally, with multiple assessments of both mother and child in home and laboratory across the child's development. Study measures, including assessments of cognitive and emotional function, are described. The study uses a candidate gene approach to examine gene-environment interdependence in specific developmental outcomes. Finally, the study includes measures of both brain-based phenotypes and metabolism to explore comorbidities associated with child obesity. One of the unique features of the MAVAN protocol is the extensive measures of the mother-child interaction. The relation between these measures will be discussed. Evidence from the MAVAN project shows interesting results about maternal care, families, and child outcomes. In our review, preliminary analyses showing the correlations between measures of maternal care are reported. As predicted, early evidence suggests that maternal care measures are positively correlated, over time. This review provides evidence for the feasibility and value of laboratory-based measures embedded within a longitudinal birth cohort study. Though retention of the samples has been a challenge of MAVAN, they are within a comparable range to other studies of this nature. Indeed, the trade-off of somewhat greater participant burden has allowed for a rich database. The results yielded from the MAVAN project will not only describe typical development but also possible targets for intervention. Understanding certain endophenotypes will shed light on the pathogenesis of various mental and physical disorders, as well as their interrelation.

Poster #T91 CHILDHOOD ABUSE AND BRIEF LIFE EVENTS IN POSTPARTUM PSYCHOSIS

Risk and protective factors for postpartum depression have been extensively studied, and in recent studies an association between breastfeeding and maternal mood has been reported. The present retrospective, cross-sectional study was conducted to evaluate the association between breastfeeding-related variables and postpartum depression (based on Edinburgh Postnatal Depression Scale threshold criteria) within the context of other known risk factors.Breastfeeding information, demographic information, and scores on the Edinburgh Postnatal Depression Scale were examined from the Canadian Maternity Experience Survey. This survey contains data collected from 6421 Canadian mothers between October 2006 and January 2007, and 2848 women between five and seven months postpartum were included in the current analyses.In contrast to previous research, logistic regression analyses revealed that when considered within the context of other risk factors, breastfeeding attempt and duration were not associated with postpartum depression at five to seven months postpartum. Although a relationship between the prenatal intention to combination feed and postpartum depression was observed, these variables were no longer related once other potential risk factors were controlled for. Factors that were associated with postpartum depression included lower income, higher perceived stress, lower perceived social support, no history of depression, or no recent history of abuse.A clinical diagnostic instrument was not used and variable selection was restricted to data collected as part of this survey.These findings suggest that the association between breastfeeding and postpartum depression reported by previous researchers may in fact be due to alternative risk factors.

Comparing plasma concentrations of persistent organic pollutants and metals in primiparous women from northern and southern Canada

The exposure of Aboriginal peoples in the Canadian Arctic to persistent organic pollutants (POPs) and metals through the consumption of traditional food items is well recognized; however, less information is available for Canadian immigrants. The direct comparison of blood chemical concentrations for expectant primiparous women sampled in the Inuvik and Baffin regions of the Canadian Arctic, as well as Canadian- and foreign-born women from five southern Canadian centers (Halifax, Vancouver, Hamilton, Ottawa, and Calgary), provides relative exposure information for samples of northern and southern mothers in Canada. Based on our analyses, Canadian mothers are exposed to a similar suite of contaminants; however, Inuit first birth mothers residing in the Canadian Arctic had higher age-adjusted geometric mean concentrations for several legacy POPs regulated under the Stockholm Convention, along with lead and total mercury. Significant differences in exposure were observed for Inuit mothers from Baffin who tended to demonstrate higher blood concentrations of POPs and total mercury compared with Inuit mothers from Inuvik. Conversely, northern mothers showed a significantly lower age-adjusted geometric mean concentration for a polybrominated diphenyl ether (PBDE-153) compared to southern mothers. Furthermore, southern Canadian mothers born outside of Canada showed the highest individual concentrations measured in the study: 1700μg/kg lipids for p,p′-dichlorodiphenyldichloroethylene (p,p′-DDE) and 990μg/kg lipids for β-hexachlorocyclohexane (β-HCH). Data from Cycle 1 (2007–2009) of the nationally-representative Canadian Health Measures Survey (CHMS) places these results in a national biomonitoring context and affirms that foreign-born women of child-bearing age experience higher exposures to many POPs and metals than their Canadian-born counterparts in the general population.

Effects of a Brief, Prevention-Focused Parenting Education Program for New Mothers

We evaluated the effects of a parenting program, Baby and You, on parenting knowledge, parenting morale, and social support using a single-group, pre-test, and post-test design with 159 Canadian mothers of infants aged 2 to 9 months old. Baby and You is a prevention-focused parenting program (PFPP) to improve maternal and infant health through education and social support. The 4-week curriculum focuses on infant development and safety, parent-child relationships, maternal self-care, and community resources. We computed repeated-measures ANOVAs separately for scores on Parenting Knowledge Scale, Parenting Moral Index, and Family Support Scale. We found a significant increase between pre-test and post-test on parenting knowledge, but not parenting morale or social support. Parenting morale may be a stable construct that shows little change over time. It may take more than 4 weeks of programming for mothers to identify and integrate new sources of social support.

Home in Time for Dinner by K. Ellis

Ellis, Kathryn. Home in Time for Dinner. Markham, ON: Red Deer Press, 2012. Print.From the author of the book Degrassi Junior High and scripts for the original Degrassi Junior High television show, comes a story about a thirteen-year-old boy who has grown up in Texas, not knowing that is father had abducted him from his Canadian mother in a nasty divorce and custody battle. Ellis is definitely in tune with teenage boys. She flawlessly takes the reader through Chris Ramsey’s discovery that he is one of the “missing children” profiled on television, his plan to escape and his flight to Canada. By presenting the story through Chris’s eyes, Ellis draws the reader into the world of a confused and distressed, but determined teenager.Ellis masterfully responds to all of the obvious objections to the events in the story. Why doesn’t Chris just go to the police? His father has taught him to fear and avoid the police. Chris makes terrible errors in judgement on his journey, but we know that his father has always controlled him, and not allowed him to make decisions, so he has little experience with it. Remarkably, his mother still lives in the same apartment in Kingston, but Ellis tells us that she’s been waiting for him to return. So while, objectively, the plot is too tidy, it doesn’t seem that way when you are reading the story. The one point that really stretches the suspension of disbelief is Chris’ being easily smuggled across the border. While the plot line is simple, Ellis has a knack for getting at the essence of a situation in just a few words. Whether the alcoholic former preacher who gives Chris a ride, the manipulative Moth who gives a him a place to sleep and then robs him or the moment when Chris’s mother recognizes her child who has been missing for years, Ellis creates unforgettable characters and scenes. This is one of the best young adult novels that I have read recently. It is not a high literary work, but it is a good read and would be a great addition to public and junior high school libraries. Highly recommended: 4 stars out of 4 Reviewer: Sandy CampbellSandy is a Health Sciences Librarian at the University of Alberta, who has written hundreds of book reviews across many disciplines. Sandy thinks that sharing books with children is one of the greatest gifts anyone can give.

Feeding the ‘organic child’: Mothering through ethical consumption

In this article, we examine the gendering of ethical food discourse by focusing on the ideal of the ‘organic child’. Drawing from qualitative focus groups and interviews with Canadian mothers of various class backgrounds, we find that the organic child reflects the intersecting ideals of motherhood and ethical food discourse, whereby ‘good’ mothers are those who preserve their children’s purity and protect the environment through conscientious food purchases. Women in our study express the desire to nurture the organic child, and feel responsible for protecting their children’s purity. At the same time the organic child represents a gendered burden for women, our participants negotiate the ideal in complex ways that involve managing emotions and balancing the normative expectations of motherhood with pragmatic demands. The idealized figure of the organic child not only works ideologically to reinforce gendered notions of care-work, but also works to set a classed standard for good mothering that demands significant investments of economic and cultural capital. We argue that the organic child ideal reflects neoliberal expectations about childhood and maternal social and environmental responsibility by emphasizing mothers’ individual responsibility for securing children’s futures.

Understanding Parental Support of Child Physical Activity Behavior

To examine parental support of child physical activity with an adapted theory of planned behavior model. A representative sample of Canadian mothers (N = 663) who completed measures of family priorities, social cognition, and child physical activity. An assessment of family priorities showed that mothers ranked physical activity almost as high as homework and far higher than other activities. Attitude about providing support for child physical activity predicted intention, yet only perceived control over support predicted behavior. Mothers perceive great import of physical activity for their children but they are inhibited by a low perception of control.

Predictors of exclusive breastfeeding: observations from the Alberta pregnancy outcomes and nutrition (APrON) study.

BackgroundDespite growing evidence that supports the importance of 6-month exclusive breastfeeding, few Canadian mothers adhere to this, and early weaning onto solids is a common practice. This study assessed infant feeding transitions during the first 6 months postpartum and factors that predicted exclusive breastfeeding to 3 and 6 months.MethodsThis prospective cohort study was part of the Alberta Pregnancy Outcomes and Nutrition study (APrON). From an initial sample of 600 pregnant women recruited from Edmonton and Calgary, 402 mothers provided complete details at 3 months postpartum; 300 stayed on to provide information at 6 months postpartum. During pregnancy and at 3 and 6 months postpartum, data on maternal and infant socio-demographic, behavior, and feeding were collected.ResultsEven though there was a high rate of “ever having breastfed” (98.6%), exclusive breastfeeding rates for 3 and 6 months were 54.0% and 15.3%, respectively. After controlling for potential confounders, the study showed that mothers who held post-graduate university degrees were 3.76 times more likely to breastfeed exclusively for 6 months than those without a university degree (95% CI: 1.30-10.92; p = 0.015). In addition, mother of previous children were more likely to breastfeed exclusively for 6 months (OR: 2.21, 95% CI: 1.08-4.52; p = 0.031). Mothers who were in the highest quartile of the Iowa Infant Feeding Attitude Score were 4.29 and 5.40 times more likely to breastfeed exclusively for 3 months (95% CI: 1.31-14.08; p-trend < 0.001) and 6 months (95% CI: 2.75-10.60; P-trend < 0.001), respectively.ConclusionsThe 6-month exclusive breastfeeding rate in Alberta is considerably below national and international breastfeeding recommendations. Professional advice that focuses on prenatal maternal knowledge, attitudes, and misperceptions may promote adherence to World Health Organization breastfeeding guidelines. Knowing that exclusive breastfeeding is less likely to take place among lower-educated, primiparous women may help health practitioners focus their support and education for this group.

Socioeconomic position and factors associated with use of a nonsupine infant sleep position: findings from the Canadian Maternity Experiences Survey.

With a focus on socioeconomic position, we examined the association between maternal education and nonsupine infant sleep position, and examined patterns of effect modification with additional sociodemographic, maternal, infant, and health services predictors. Data were from the Maternity Experiences Survey, a national population-based sample of 76 178 new Canadian mothers (unweighted n = 6421) aged 15 years or older interviewed in 2006-2007. Using logistic regression, we developed multivariate models for 3 maternal education strata. Level of maternal education was significantly and inversely related to nonsupine infant sleep position. Stratified analyses revealed different predictive factors for nonsupine infant sleep position across strata of maternal education. Postpartum home visits were not associated with use of this sleep position among new mothers with less than high school completion. Adequacy of postpartum information regarding sudden infant death syndrome was not associated with nonsupine infant sleep position in any of the educational strata. These findings suggest a need to revisit Back to Sleep health promotion strategies and to ensure that these interventions are tailored to match the information needs of all families, including mothers with lower levels of formal education.

Medicalized Mothering: Experiences with Breastfeeding in Canada and Norway

This paper explores infant feeding practices and experiences of mothers in Canada and Norway, two countries where breastfeeding rates are relatively high. Based on interviews with 33 Canadian mothers and 27 Norwegian mothers, we also examine how mothers feel, think and talk about their infant feeding decisions and experiences, and examine similarities and divergences across their stories. Our findings reveal that infant feeding is very much organized according to the logic of the broader medical discourse, a finding which lends support to arguments that contemporary parenthood is characterized by a process of increasing medicalization. Our findings also reveal the existence of a broader culture of pressure, competition, judgement and surveillance regarding breastfeeding, suggesting that the high breastfeeding rates in these two countries are not merely a result of favourable structural conditions, but also of strong cultural expectations towards breastfeeding. We discuss our findings in connection with the broader argument that medical discourses and health professionals are becoming the primary authorities and moral gatekeepers of contemporary parenthood.

Validation of Canadian mothers’ recall of events in labour and delivery with electronic health records

BackgroundMaternal report of events that occur during labour and delivery are used extensively in epidemiological research; however, the validity of these data are rarely confirmed. This study aimed to validate maternal self-report of events that occurred in labour and delivery with data found in electronic health records in a Canadian setting.MethodsData from the All Our Babies study, a prospective community-based cohort of women’s experiences during pregnancy, were linked to electronic health records to assess the validity of maternal recall at four months post-partum of events that occurred during labour and delivery. Sensitivity, specificity and kappa scores were calculated. Results were stratified by maternal age, gravidity and educational attainment.ResultsMaternal recall at four months post-partum was excellent for infant characteristics (gender, birth weight, gestational age, multiple births) and variables related to labour and delivery (mode of delivery, epidural, labour induction) (sensitivity and specificity >85%). Women who had completed a university degree had significantly better recall of labour induction and use of an epidural.ConclusionMaternal recall of infant characteristics and events that occurred during labour and delivery is excellent at four months post-partum and is a valid source of information for research purposes.

Is it all bad? Rewards and challenges of mothering children with hidden disabilities

Little is known about mothering children with hidden disabilities affecting behaviour, so social workers can underestimate their impact. As research emphasizes negative outcomes, this study examined mothering rewards and challenges, along with influence of caregiving, family, work, demographic factors, perceived demands and supports. Survey participants were 197 employed Canadian mothers of children with ADHD and related disabilities. Rewards came from children's special qualities, progress despite disability and mothers’ personal growth. Half the challenges arose from children's behaviour, others from school, organizational and family conflict problems. Higher rewards were predicted by mothers’ education, fewer children, support (overall, school professionals). Nearly half the variance in challenges was explained by 4 predictors: combined ADHD subtype, perceived family demands, overall and health professional support. Social workers can point out rewards, recognize difficulties, reframe perceived demands, advocate for increased formal support and acceptance. Further research is needed on family impact of disability.

Mattering Moderates the Link between Gender Ideology and Perceived Fairness of the Division of Household Labor

This study examines the moderational role played by the feeling of mattering to the partner in the relationship between gender ideology and perceived fairness using a sample of 141 Canadian mothers with at least one child between the ages of two to five years old. Results support the moderator model and suggest that the emotional rewards mothers receive from their romantic partner influence the way they use gender ideology to evaluate the fairness of the division of family labor in their household. The results show that egalitarian gender ideology is associated with a greater sense of unfairness only when women feel that their partner demonstrates a low level of appreciation toward them. The findings are discussed in terms of the distributive justice theory.

Canadian adolescent mothers' perceptions of influences on breastfeeding decisions: a qualitative descriptive study.

BackgroundThere is increased recognition of the importance of breastfeeding at a national level as evidenced by the increased number of Canadian mothers initiating breastfeeding. However, adolescent mothers (<19 years), compared to all other mothers, have lower rates of breastfeeding initiation and duration. The purpose of this study was to examine the facilitating influences and barriers to initiating, and continuing breastfeeding, as perceived by adolescent mothers in Durham Region, Ontario, Canada.MethodsThe principles of interpretive description guided this qualitative study. A purposeful, homogenous sample of 16 adolescent mothers (15–19 years) were recruited to complete individual, semi-structured, face-to-face interviews. Conventional content analysis was used to code data, identify concepts and synthesize them into overall themes.ResultsAdolescent mothers in this study expressed that the decision to breastfeed was made prenatally and while partner and family member opinions about breastfeeding initiation were influential, the decision was made independently. Mothers were primarily motivated to initiate breastfeeding due to the health benefits for the infant. Lower breastfeeding duration rates were found among mothers who decided to only “try” breastfeeding when compared to the mothers who committed to breastfeeding. Influences on continued breastfeeding included: 1) the impact of breastfeeding on social and intimate relationships; 2) the availability of social support; 3) the physical demands of breastfeeding; 4) mothers’ knowledge of breastfeeding practices and benefits; and 5) mothers’ perceived sense of comfort in breastfeeding.ConclusionsThe results of this study provide health care providers new conceptual insight and understanding of the factors that influence adolescents’ decisions to “try” breastfeeding and to continue providing breastmilk to their infants. Professional implications drawn from this study include active engagement of adolescents in the pre and postnatal periods, including early assessment of potential barriers surrounding breastfeeding decisions. This early professional interaction highlights the professional as a form of support, and allows for sharing of evidence-informed breastfeeding information and practical breastfeeding skills. Inclusion of adolescents’ positive social support networks should be emphasized in professional breastfeeding support. Motivational interviewing is a promising prenatal strategy to influence behavior change and reduce ambivalence in decision-making about breastfeeding, creating opportunities for health care providers to tailor interventions.

Prevalence of Abuse and Violence Before, During, and After Pregnancy in a National Sample of Canadian Women

We describe the prevalence of abuse before, during, and after pregnancy among a national population-based sample of Canadian new mothers. We estimated prevalence, frequency, and timing of physical and sexual abuse, identified category of perpetrator, and examined the distribution of abuse by social and demographic characteristics in a weighted sample of 76,500 (unweighted sample = 6421) Canadian mothers interviewed postpartum for the Maternity Experiences Survey (2006-2007). Prevalence of any abuse in the 2 years before the interviews was 10.9% (6% before pregnancy only, 1.4% during pregnancy only, 1% postpartum only, and 2.5% in any combination of these times). The prevalence of any abuse was higher among low-income mothers (21.2%), lone mothers (35.3%), and Aboriginal mothers (30.6%). In 52% of the cases, abuse was perpetrated by an intimate partner. Receiving information on what to do was reported by 61% of the abused mothers. Large population-based studies on abuse around pregnancy can facilitate the identification of patterns of abuse and women at high risk for abuse. Before and after pregnancy may be particularly important times to monitor risk of abuse.

The Discourse of Parent Involvement in Special Education

Parent involvement is acknowledged as a crucial aspect of the education of students with special needs. However, the discourse of parent involvement represents parent involvement in limited ways, thereby controlling how and the extent to which parents can be involved in the education of their children. In this article, critical discourse analysis (CDA) was used to examine the discourse of parent involvement in excerpts from policy documents and interviews from a larger study on immigrant Chinese Canadian mothers’ involvement in the education of their children with disabilities. Contrasting policy documents and interviews, the discourse of parent involvement positioned mothers as over- or underinvolved, subordinate, and inexpert.