Congratulations to FHSS authors on the publication of their paper “A Priori and a Posteriori Dietary Patterns in Women of Childbearing Age in the UK” which has been published in the scientific journal Nutrients. The authors highlight that a poor diet quality is a major cause of maternal obesity. They investigated investigate a priori and a-posteriori derived dietary patterns in childbearing-aged women in the United Kingdom. An online survey assessed food intake, physical activity (PA), anthropometry and socio-demographics. A poor diet quality was found among childbearing-aged women; notably in the younger age category, those of white ethnicity, that were more physically inactive and with a lower socioeconomic background.
The article is Open Access and freely available (click here!).
Khaled, K.; Hundley, V.; Almilaji, O.; Koeppen, M.; Tsofliou, F. (2020) A Priori and a Posteriori Dietary Patterns in Women of Childbearing Age in the UK. Nutrients2020, 12, 2921.
Huge numbers of pregnant women and new mothers are taking their own lives in Nepal as they deal with extreme poverty, natural disasters, domestic violence and oppression. Research shows suicide represents 16% of all deaths in women of reproductive age. The rate is higher than previously recorded and there has been a considerable increase over the past few years. But a new project which trained midwives about mental health issues might hold the key to turning this around.
Suicide is primarily associated with unwanted pregnancy or the feeling of being trapped in poverty or situations of sexual and physical abuse. A study of 202 pregnant women (carried out between September and December 2014) found that 91% of them experienced some kind of physical, emotional or sexual abuse – mostly at the hands of their husbands and/or mother-in-laws.
Pregnancy is a known trigger for mental health problems. But gender discrimination and domestic violence are making matters worse. In addition to these issues, natural disasters are also a huge contributing factor to the spiralling mental health problems of young mothers.
Lack of control
In Nepal, making decisions about seeking maternity care is not in the hands of the pregnant woman but usually lies with her mother-in-law or husband. When young women marry they move in with their husbands’ family and their lives are ruled by their in-laws. These women often have little say in seeking health care during pregnancy, childbirth and the postnatal period.
In many poor families, husbands migrate for work leaving their young wives with family. Nepal has a real migrant workers economy with close to 50% of Nepalis relying on financial help from relatives abroad. Mental health problems can worsen for women who have been taken away from their own families. In other cases, young women face domestic violence due to their husbands’ drinking leading to mental health issues and suicide.
There is also a lack of understanding of pregnancy and childbirth-related mental health issues and husbands and mothers-in-law often fail to support these vulnerable young women. They in turn are reluctant to seek help due to the stigma associated with mental illness.
Cultural and social norms
Cultural practices and social norms, like gender inequalities and early marriage, hinder women who have a lack of choice when it comes to their role as mothers. There is also a preference for sons rather than daughters, who are seen as an “economic burden” in many families. If a woman is expecting a daughter, especially for the second or third time, this can also trigger mental health issues.
Depression and anxiety are common and affect ten to 15 out of every 100 pregnant women in the country. Postnatal depression is often reported, but less attention is given to more common and less obvious mental health issues.
Natural disasters and midwives
Recurrent earthquakes and floods exacerbate issues of depression and helplessness as women are forced to live in temporary shelters and have the burden of increased poverty.
For many rural Nepali women, the most qualified birth attendant they can expect to look after them is the Nepali Auxiliary Nurse Midwives (ANMs). But a study found that they received little or no formal training on perinatal mental health issues. Although there have been gradual improvements in health care for women during pregnancy, mental health support is leaving many women feeling that suicide is their only option.
As part of a Tropical Health and Education Trust project, funded by DFID, around 80 ANMs were trained on perinatal mental health issues. The project used UK-based volunteers in Nepal over two years.
The training helped raise awareness of mental health well-being and improved access to mental health care for pregnant women and new mothers. This is a vital first step towards improving community-based services for pregnant women in rural Nepal. But to offer hope to more young women there needs to be a significant increase in this type of training and awareness raising.
We are preparing a lively debate on the motion: “Advising pregnant women to avoid drinking alcohol during pregnancy is symptom of the Nanny State and another step towards the medicalisation of childbirth”. The venue for this event is the Executive Business School on 89, Holdenhurst Road. Members of the public, staff and students are invited to come along on Tuesday 28th June 13.30-14.30!
The UK Government state there is no known safe level for drinking alcohol in pregnancy. Therefore, it recently changed the official recommendation to pregnant women avoid drinking any alcohol as a precaution. In doing so the UK follows countries like Canada, where a similar recommendation has been in place for over a decade. At the same time one can ask whether such approach undermines a woman’s right to make an informed choice regarding the health of her unborn child. Some would argue that is represents yet another step towards the medicalisation of childbirth.
Faculty of Health & Social Sciences’ staff Liz Norton and Edwin van Teijlingen affiliated with the Centre for Midwifery, Maternal & Perinatal Health and will argue in favour of the motion. Donna Wixted, Joint Bournemouth University (BU)-Portsmouth Hospitals NHS Trust, doctoral student and Greta Westwood of Portsmouth Hospitals NHS Trust & the University of Southampton will argue against the motion.
The audience will be asked to vote for or against the motion, both before and after the debate, to see if the debate has helped anybody in making up their mind. Our debate will be chaired by Prof. Vanora Hundley from the Faculty of Health & Social Sciences. In previous Festival of Learning events she has been involved in various debates around childbirth, such as The media is responsible for creating fear in childbirth and the year before that on Caesarean Section on demand under the title Intervention in childbirth: What’s wrong with letting women choose?
The debate is part of BU’s annual Festival of Learning which this year for the first time has satellite events in China and Malaysia.
If you are interested to come along please book your free ticket here! The Executive Business School is easy to find on 89, Holdenhurst Road near Bournemouth Railway Station.
Donna Wixted, Liz Norton, Greta Westwood, Vanora Hundley & Edwin van Teijlingen
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