Metropolitan Women Research Articles

'We country women need advocacy': Birthing narratives from the Western Australian Wheatbelt region.

This study describes the experiences of eight mothers from the Wheatbelt region of Western Australia who shared their stories of travelling and/or temporarily relocating for birth. The aim of this study was to describe rural and remote Western Australian mothers' experiences of travelling long distances and/or relocating to give birth. This study was based on Crotty's four elements of qualitative research. This study was underpinned by a constructivist epistemology, a feminist theoretical lens and a narrative approach using semistructured, story-based interviews. Participants narrated their stories of birthing away from home by telephone interview. Five major themes were identified utilising thematic analysis. These were (1) feeling forgotten in the system, (2) accessibility and choice, (3) compounded social isolation, (4) doing it hard: financial and logistical challenges and (5) building strength: advocating for myself and baby. Mothers' stories were reflective of current and historical failures of rural maternal health policy, including widespread closures of rural birthing hospitals. Mothers described the logistical barriers they faced with little support and suggested multiple solutions that would improve their experiences. Mothers faced significant obstacles which impeded their access to equitable maternal healthcare. This study highlights the complexities of birthing as a rural mother and the need to address maternal health inequities between rural and metropolitan women.

Rurality as a predictor of perinatal mental health and well-being in an Australian cohort.

Perinatal emotional well-being is more than the presence or absence of depressive and anxiety disorders; it encompasses a wide range of factors that contribute to emotional well-being. This study compares perinatal well-being between women living in metropolitan and rural regions. Prospective, longitudinal cohort. Eight hundred and six women from Victoria and Western Australia recruited before 20 weeks of pregnancy and followed up to 12 months postpartum. Rurality was assessed using the Modified Monash Model (MM Model) with 578 in metropolitan cities MM1, 185 in regional and large rural towns MM2-MM3 and 43 in rural to remote MM4-MM7. The Structured Clinical Interview for DSM-IV (SCID-IV) was administered at recruitment to assess depression, and symptoms of depression and anxiety were measured using the Edinburgh Post-natal Depression Scale and the State and Trait Anxiety Scale, respectively. Other measures included stressful events, diet, exercise, partner support, parenting and sleep. The prevalence of depressive disorders did not differ across rurality. There was also no difference in breastfeeding cessation, exercise, sleep or partner support. Women living in rural communities and who also had depression reported significantly higher parenting stress than metropolitan women and lower access to parenting activities. Our study suggests while many of the challenges of the perinatal period were shared between women in all areas, there were important differences in parenting stress and access to activities. Furthermore, these findings suggest that guidelines and interventions designed for perinatal mental health should consider rurality.

Stressful life events and depression in late pregnancy: Comparison between rural and metropolitan women using data from an Australian cohort study.

To identify whether a diagnosis of depression combined with rurality, compared with either depression or living in metropolitan areas alone, is associated with experiencing more stressful life events in pregnancy. This study uses data from 402 pregnant women (206 metropolitan and 196 rural), enrolled in the Western Australian arm of the Mercy Pregnancy and Emotional Wellbeing Study. Mercy Pregnancy and Emotional Wellbeing Study is a prospective, longitudinal cohort with women recruited during early pregnancy (<20weeks) across 3 groups: those with diagnosed depression, those taking antidepressant medication and control. Women were recruited from 3 metropolitan and 3 rural hospitals in Western Australia from 2017 to 2018 and 2018 to 2020, respectively. This study uses antenatal data collected at recruitment and during third trimester (weeks 32-34). The Stressful Life Events Scale was used to measure the number of self-reported stressful events. The degree of perceived stress due to the stressful event was also reported. Compared to pregnant metropolitan women diagnosed with depression, pregnant rural women with depression were more likely to report experiencing at least 1 stressful life event. Despite this, pregnant women with depression in both regions reported similar numbers of stressful life events. This study highlights women in rural Western Australia diagnosed with depression might be more vulnerable to experiencing stressful life events than rural women without depression and their metropolitan counterparts. Due to known adverse effects of antenatal depression and stress on maternal well-being and child outcomes, there is a clear need for targeted, preventative interventions for Australian rural women during this period.

Moral Value and Image of Women in The Novel of The Single Parasite Ayu Utami's Work

The purpose of this research is to describe the moral values ??and images of women contained in the novel The single parasite by Ayu Utami. This research uses a descriptive qualitative approach. The object and subject of this research study is Ayu Utami's novel Si ParasitLajang, published in 2013. The data of this study are the moral values ??and images of women contained in the novel The single parasite by Ayu Utami. The data source of this research is Ayu Utami's novel Si ParasitLajang. The data collection technique is done by reading the object of study in depth accompanied by an understanding of the moral values ??and images of women in the novel. This qualitative research data analysis technique is inductive in nature, namely an analysis based on the data obtained first by classifying the data that has been recorded in the data recording list for existing categories or classifications, the second data that has been classified is further analyzed to be used as a basis for interpretation all data and the third then concludes the research results. The results of the research on the moral values ??and images of women in the novel The single parasite by Ayu Utami are (1) the moral values ??in the novel The single parasite by Ayu Utami, namely: being responsible for the family, loyal, and care. (2) the image of women in the novel The single parasite by Ayu Utami is an educated woman, a woman who isindependent, women who have a high social life, beautiful women, ugly women, married women, single women, metropolitan women, brave women, and critical thinking women.

What factors influence the treatment decisions of women with breast cancer? Does residential location play a role?

Inequalities in cancer outcomes continue to exist throughout the world. In Australia, rural women diagnosed with breast cancer have significantly poorer 5-year survival, with variations in clinical management additionally observed. While factors impacting clinical management have been identified, there is little understanding about the factors that influence treatment decisions of women diagnosed with breast cancer. A mixed-methods study was conducted with women diagnosed with either pre-invasive or invasive breast cancer in Australia. The study included qualitative interviews and an online survey utilising Breast Cancer Network Australia's membership. Semi-structured interviews were conducted with rural women focusing on topics such as decision-making and factors influencing this. The online survey amongst metropolitan and rural (including regional, remote, very remote) women examined involvement in, and preference for, decision-making, and to what degree certain factors influenced treatment decisions. Sociodemographics included age, residential location, education and household income. Qualitative interviews were analysed using NVivo, and descriptive analyses were used to examine differences in frequency distributions across survey questions by residential location and age group for the online survey. Multivariable logistic regression analysis was conducted to examine factors associated with treatment decision-making. Nine women participated in the qualitative interviews and 815 (365 metropolitan and 450 rural) completed the online survey. Interviews found most women concurred with the recommendations of their doctor(s) and did not see this experience as 'making a decision'. In the online survey, 83.2% of women indicated at least some involvement in the decision-making with this being similar between rural and metropolitan women. Compared to women educated at an under- or postgraduate level, those educated at high school or less were about 50% less likely to be involved in treatment decision(s) (OR=0.51, 95% confidence interval=0.30-0.86). In both interviews and the online survey, factors having the strongest influence on treatment decisions centred around survival and reducing risk of progression or recurrence. Significantly more rural compared to metropolitan women indicated their decision was strongly influenced by treatment service location (42.8% and 28.1%, respectively, p<0.001). Rural women more frequently cited financial costs of treatment influenced their decision compared to metropolitan women (30.4% and 21.3%, respectively, p=0.04). Significantly fewer rural, (16.2%) compared to metropolitan (23.6%) women, had breast reconstruction (p=0.009). The option of having reconstructive surgery was less frequently cited as influencing treatment decisions for rural compared to metropolitan women (27.7% v 44.1% respectively, p<0.001). The treatment decisions of the majority of women were strongly influenced by the need to do everything possible to get better; however, rural women additionally indicated their decisions were also influenced by factors such as access to treatment services and the financial costs of treatment. Addressing travel and costs issues for rural women with breast cancer should be prioritised. Additionally, the finding that women with lower levels of education were significantly less likely to be involved in the decision-making process highlights the need to develop new or tailor existing resources. Further work could also examine the reasons why rural women are less likely to consider breast reconstruction important in decision-making.

대도시 여성의 세대 별 자녀가치 인식에 대한 질적연구

대도시 여성의 세대 별 자녀가치 인식에 대한 질적연구

Variations in outcomes by residential location for women with breast cancer: a systematic review

ObjectivesTo systematically assess the evidence for variations in outcomes at each step along the breast cancer continuum of care for Australian women by residential location.DesignSystematic review.MethodsSystematic searches of peer-reviewed articles...

Nausea and vomiting of pregnancy: Effects on quality of life and day-to-day function.

To investigate the effect of nausea and vomiting of pregnancy (NVP) on quality of life (QoL) and activities of daily living/socioeconomic function in a contemporary Australian setting. Observational, single centre prospective cohort study using validated survey instruments in pregnant women at 9-16weeks gestation at a tertiary metropolitan women's hospital in Sydney, Australia. QoL measured by the Short-Form Health Survey (SF-12) was compared between those with and without NVP. NVP severity scores were correlated with QoL scores, work patterns and medication use. Of 116 participants, 72% had NVP, with no baseline (including mental health) differences between women with or without NVP. As classified by modified Pregnancy-Unique-Quantified-Emesis (PUQE) survey, 42% had mild symptoms, 55% moderate and 1% severe. SF-12 Physical Component Summary (PCS) scores were significantly lower for those with NVP (P<0.001), but not Mental Component Summary (MCS) scores (P=0.11). Decreasing QoL was associated with increasing NVP severity (P<0.001), most markedly in the physical domain (P<0.001). Only 39% of women used any NVP treatment and 15% pharmacotherapy. Most used treatments were vitamin B6 , ginger, metoclopramide and natural remedies. Significantly more women with NVP required time off work (45% vs 16%, P=0.003). NVP is a physically morbid disease, affecting most pregnancies. NVP has a significant detrimental impact on QoL, especially physical QoL and work function. Despite this, we found low treatment utilisation, even in those with moderate/severe symptoms. Women should be encouraged to seek assistance for NVP and further education is required to improve practitioner awareness and management.

Risk Factors Discriminating Online Metropolitan Women Shoppers

Online shopping has been really male - oriented as the product categories were limited to software, computers, music and computer accessories. As the product category expanded to clothing, food, home care and toys, women started to adopt online shopping. Nowadays there is a massive surge in online shopping particularly among metropolitan women, as they tend to purchase both necessary and discretionary products. According to the report by Associate Chamber of Trade and Industry of India (ASSOCHAM), over 80% of the online shopping is done by metropolitan women shoppers.The present study investigates the prominent perceived risks of employed women in online shopping through a consumer survey and by applying multiple discriminant analysis .The results of the empirical analysis demonstrated that perceived physical risk and product risk were found vital in discriminating the respondents as intermediate or experts in online shopping .Whereas perceived psychological risk, quality risk, Information Security Risk, Time Risk, Delivery Risk, Social Risk, Source Risk and financial risk perception during online purchase adoption contributes comparatively lesser for discrimination. The findings elucidate how marketers can formulate and implement risk-reducing strategies during online purchasing.

Role Of Women In Development Of Pakistan: A Case Study of Women Participation in Labour Force in Pakistan

This paper highlights the “role of women in development of Pakistan”. Women participation is very vital for the prosperity of economy of Pakistan. Pakistan is a male dominated society despite the fact that its major population consists of women. In Pakistan the women face lots of obstacles when they want to utilize their skills for the growth and development of the country such as religious, political, social and environmental, although education, health and nutrition are the main issues on the top of list of severe problems. The Pakistani women are neglected and targeted by the customs and values of their families and relationships. The drastic fact is that majority of women of Pakistan live in rural areas as compared to the urban areas where they are treated as animals. However, it is also a fact that currently lots of metropolitan women in all provinces perform marvelous activities for the progress of Pakistan. The study reveals women play dynamic role in boosting economy. We cannot ignore the astonishing performance of women in building developed countries.

Knowledge, Attitudes and Behavior of Bangkok Metropolitan Women Regarding Cervical Cancer Screening.

To assess knowledge, attitudes and cervical cancer screening behavior of Bangkok Metropolitan women. Thai women, aged 25-to-65 years old, having lived in Bangkok for 5 years or more were invited to participate in the study. After signing informed consent, all women were asked to complete a self-questionnaire (Thai language) with literate assistance if needed. The questionnaire was divided into 3 parts: (I) demographic data; (II) knowledge about cervical cancer screening; and (III) behavior and attitudes, towards cervical cancer screening. Adequate screening was defined as women who had ≥two cervical cancer screening tests except women aged 25-30 years who may have only one screening, and the last screen was within 5 year or had had regular screening. Of 4,339 women, there were 1,857 (42.8%) with adequate screening and 2,482 (57.2%) with inadequate screening. Significant factors associated with inadequate screening included age < 45 years, pre-menopausal status, family monthly income <625 USD, no reported sexual intercourse, nulliparous, no knowledge, lack of awareness and poor attitudes. Three major reasons provided by women for inadequate screening were no symptoms (54.4%), fear of pain (33.2%), and embarrassment (34.6%). Personal features, knowledge, and attitudes influence screening behavior of Bangkok Metropolitan women. The three most common reasons of women for not undergoinging screening are no symptoms, fear of pain, and embarrassment. These factors should be the focus of attention to improve coverage of cervical cancer screening in Bangkok.

Are women birthing in New South Wales hospitals satisfied with their care?

BackgroundSurveys of satisfaction with maternity care have been conducted using overnight inpatient surveys and dedicated maternity surveys in a number of Australian settings, however none have been used to report on satisfaction with maternity care among women in New South Wales. The aims of this study were to investigate the association between: 1) parity (first and subsequent births) and patient experience of hospital care at birth, and 2) other patient, birth and hospital characteristics and experience of hospital care at birth.MethodsData were from the New South Wales (NSW) Ministry of Health surveys of overnight hospital inpatients, including maternity patients, between 2007 and 2011. Questionnaires were mailed to a sample of patients three months after receiving inpatient services involving at least 1 night in a public hospital. Experience of care included 12 items grouped into: satisfaction with care, staff and information. Results were weighted to overall hospital facility populations and age-standardised. Frequencies and chi-square tests were used.ResultsAnalysis of responses from 5,367 obstetric patients revealed three quarters of women were satisfied with care provided in hospital. Compared with women who had previously given birth, first-time mothers were more likely to recommend their birth hospital to friends and family (60.5% versus 56.4%; P < 0.05), less likely to have experienced differing messages from staff (44.8% vs 59.4%; P < 0.001), and less likely to feel they had received sufficient information about feeding (58.8% vs 65.0%; P < 0.001) and caring for their babies (52.4% vs 65.2%; P < 0.001). While metropolitan women were more likely to rate their birth hospital positively (76.0% vs. 71.3%; P < 0.05) than their rural counterparts, rural women tended to rate the care they received (68.1% vs. 63.4%; P < 0.05), and doctors (70.7% vs 61.1%; P < 0.05) and nurses (73.5% vs. 66.9%; P < 0.001) more highly than metropolitan women.ConclusionsThe overall picture of maternity care satisfaction in New South Wales is a positive one, with three quarters of women satisfied with care. Further resources could be dedicated to ensuring consistency and amount of information provided, particularly to first-time mothers.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1067-2) contains supplementary material, which is available to authorized users.

Is Step Down Assessment of screen‐detected lesions as safe as workup at a Metropolitan Assessment Centre?

Objective:BreastScreen WA offers population mammographic screening via fixed clinics in the metropolitan area and mobile clinics that visit country areas every two years. If an abnormality is suspected following mobile clinic screening, women undergo Step Down Assessment; diagnostic further views are performed at the mobile clinic and if a possibly significant abnormality persists, country women are referred to a Perth Metropolitan Breast Assessment Centre. The purpose of this retrospective cohort study was to determine if Step Down Assessment in country Western Australia offered the same diagnostic effectiveness as screening and assessment in the metropolitan area. Methods:The study included all screening episodes at BreastScreen WA between 1999 and 2008. Screening episodes from metropolitan and mobile clinics were compared according to the primary outcomes of cancer detection rates, recall and further investigations, cancer size, return to screen rates and interval cancers. Results:Cancer detection rate per 1,000 screening episodes was lower for the country program than the metropolitan program (3.07 (2.84–3.31) versus 7.04 (6.82–7.27)). The false negative (interval cancer) rate was lower for Step Down Assessment than for the metropolitan program. The size of cancers detected was similar for both screening services. Return to screen rates were comparable between both groups. Conclusion:The results indicate that the current service model is providing appropriate diagnostic effectiveness, as well as comparable client satisfaction, for country and metropolitan women.

Exploring the spatial wage penalty for women: Does it matter where you live?

Inequality between men and women has decreased over the past four decades in the US, but wage inequality among groups of women has increased. As metropolitan women’s earnings grew by 25% over the past four decades, nonmetropolitan women’s earnings only grew by 15%. In the current study we draw on data from the Current Population Survey to analyze the spatial wage gap among women. We explore differences in the spatial wage gap by education, occupation, and industry. Regression models that control for marriage, motherhood, race, education, region, age, and work hours indicate that metropolitan women earn 17% more per hour than nonmetropolitan women. Nonmetropolitan women earn less than metropolitan women who live in central cities and outside central cities. The gap in metropolitan-nonmetropolitan wages is higher for more educated women than for less educated women. The wage gap is only 5% for women without a high school degree, but it is 15% for women with a college degree and 26% for women with an advanced degree. Nonmetropolitan college graduates are overrepresented in lower-paying occupations and industries. Metropolitan college graduates, however, are overrepresented in higher-paying occupations and industries, such as professional services and finance.

Regardless of where they give birth, women living in non-metropolitan areas are less likely to have an epidural than their metropolitan counterparts

Can differences in Australian birth intervention rates be explained by women's residence at the time of childbearing?. Data were collected prospectively via surveys in 1996, 2000, 2003, 2006 and 2009 from women, born between 1973 and 1978, of the Australian Longitudinal Study on Women's Health. Analysis included data from 5886 women who had given birth to their first child between 1994 and 2009. Outcome measures were self-report of birth interventions: pharmacological pain relief (epidural and spinal block analgesia, inhalational analgesia and intramuscular injections), surgical births (an elective or emergency caesarean section) and instrumental births (forceps and ventouse). Primiparous women residing in non-metropolitan areas of Australia experienced fewer birth interventions than women residing in metropolitan areas: 43% versus 56% received epidural analgesia; 8% versus 11% had elective caesarean sections; and 16% versus 18% had emergency caesarean sections. Differences in maternal age and private health insurance status at first birth accounted for differences in surgical birth rates but did not fully explain differences in epidural analgesia. Non-metropolitan women had fewer birth interventions, particularly epidural analgesia, than metropolitan women. Differences in maternal age and private health insurance do not fully explain the differences in epidural analgesia rates, suggesting care provided to labouring women may differ by area of residence. The difference in epidural analgesia rates may be due to lack of choice in maternity services, however it could also be due to differing expectations leading to differences in birth interventions for primiparous women living in metropolitan and non-metropolitan areas.

Drugs and having babies: An exploration of how a specialist clinic meets the needs of chemically dependent pregnant women

Objectivesto explore the extent to which a specialist clinic meets the needs of chemically dependent women. Designa critical ethnography informed by theorists such as Habermas and feminists' interpretation of Foucault. Settinga specialist antenatal clinic for chemically dependent pregnant women at a major metropolitan women's hospital in Melbourne, Australia. Participantsa purposive sample of twenty (20) chemically dependent pregnant women who attended the clinic.Data collection and analysis included three taped interviews (two preceding the birth and one post birth), observation of the interactions between the women and the clinic staff over a 25-month period and chart audits. Findingssimilar to other studies there were multiple factors influencing development and maintenance of chemical dependency in this group of women, including family instability, family history of drug and alcohol abuse, childhood sexual abuse, having a chemically dependent partner and having a dual diagnosis of both drug addiction and mental illness. Initially there was considerable variation between the women and the clinic staff's expectations with regard to attending for antenatal care and conforming to a set regime as the women struggled with the contradictions inherent in their lifestyle and that of the ‘normal’ expectant mother. Aspects of that struggle included their belief that their opinions and knowledge of their lives was largely ignored, leading to episodes of resistance. Several women alleged the clinics staff's relationship with them was influenced by a belief that the women were ‘hopeless addicts in need of expert medical and midwifery care' and that the clinic staff exercised control in an authoritarian manner. However, as they explored possibilities for collaboration, they realised they could exercise power and work towards a more equal relationship with staff. The quality of relationships in most instances improved over time, and if not always strictly collaborative, was situated at various points along a continuum from minimal to full co-operation, with concomitant varying levels of success in terms of outcomes. It was often the attitude of individual staff members, particularly midwives, that was the key to the way in which the women responded to care. Key conclusions and implications for practicecomprehensive history-taking and engaging women as early as possible in pregnancy; providing continuity of care – particularly midwife care – to assist in developing a collaborative approach to care; provision of an extended period of postnatal support to at least six months for those women able to parent their children was a key recommendation.

Women and Violent Crime in Enlightenment Scotland. By Anne-Marie Kilday and Victims and Viragos: Metropolitan Women, Crime and the Eighteenth-Century Justice System. By Gregory Durston

Women and Violent Crime in Enlightenment Scotland. By Anne-Marie Kilday and Victims and Viragos: Metropolitan Women, Crime and the Eighteenth-Century Justice System. By Gregory Durston

Continuation rates and reasons for removal among Implanon® users accessing two family planning clinics in Queensland, Australia

Background This study examined demographic profile, continuation rates and reasons for removal among Implanon® users accessing two family planning clinics in Queensland, Australia. Study Design A retrospective chart audit of 976 women who attended for implant insertion over a 3-year period between May 2001 and May 2004. Results Continuation rates showed that at 6 months after insertion, 94% of women continued, 74% continued at 1 year and 50% continued at 2 years. Metropolitan women were more likely than rural women to discontinue use because of dissatisfaction with bleeding patterns. Cox regression analysis showed that those attending the regional clinic experienced significantly shorter time to removal. Conclusions Implanon® continuation rates and reasons for removal differ between clinics in metropolitan and rural locations. A cooling-off period did not affect the likelihood of continuation with Implanon®. Preinsertion counselling should emphasize potential changes in bleeding patterns.

Magic Moments of Struggle

This paper focuses on women's memories of participation in the Naxalbari movement in West Bengal. These memories, sourced from women's oral histories and published memoirs, capture not only women's visions of emancipation and camaraderie but their everyday struggles, experiences of fear and violence and patriarchal domination within the movement as well. As these memories are refracted by the women's diverse socio-economic and cultural locations, the paper makes an effort to distinguish the multiple meanings of the ‘magic moments of struggle’ in the lives of peasant/working-class women, from those of middle-class women from smaller towns and upper middle-class metropolitan women.

Survival and degree of spread for female breast cancers in New South Wales from 1980 to 2003: implications for cancer control

This study investigated associations of degree of spread at diagnosis of breast cancer and socio-demographic factors with the risk of death among NSW females diagnosed in 1980-2003. Trends by diagnostic period, socio-demographic differences, and the implications for cancer control were considered. NSW Central Cancer Registry data were analyzed using regression and rank-order tests to show predictors of death from breast cancer and trends in degree of spread. Compared with localized disease, case fatality was thrice and 14 times higher for cancers with regional spread and distant metastases, respectively. After adjusting for degree of spread and socio-demographic differences, the relative risk of death from breast cancer has declined in recent diagnostic periods compared with the 1980-1983 baseline, reaching a low of 0.38 (0.35, 0.40) for 1999-2003. Age-specific analyses indicated that relative risks were lower in 1999-2003 for 50-69 year olds (RR = 0.31) than younger (RR = 0.40), or older (RR = 0.46) females. Regional or distant disease at diagnosis was lowest in the older age groups, the highest socio-economic stratum and in more recent periods. Females born in non-English speaking countries presented with more advanced disease, as did metropolitan women with the highest access to health services. Degree of spread of cancer at diagnosis is a powerful predictor of case fatality. Case fatalities from breast cancer have declined by diagnostic period, after adjusting for degree of spread, which may reflect treatment and screening advances. Attention should be directed at reducing disparities by socio-economic status and encouraging migrant women to present earlier.