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From 2005-06 to 2015-16, proportion of cesarean deliveries in total deliveries has almost doubled in India. In this paper, we study changes in prevalence of cesarean deliveries across different social-economic groups and study factors affecting odds of undergoing cesarean delivery. The present paper was based on National Family Health Surveys and employs logistic regression. We find that rise in cesarean deliveries has been across social groups, religions, urban/rural India, wealth groups, though increase has not been uniform. Further, many economically affluent states have high proportion of cesarean deliveries. We find that women delivering at private hospitals had significantly higher odds of opting for cesarean delivery. Further, women belonging to rich households were more likely to go through surgery for birth. In case of earlier terminated pregnancies, odds were higher too. The higher odds of cesarean sections in the relatively affluent geographic regions, richer households and private institutions indicate that these procedures may be driven by non-medical reasons in many cases, pointing toward the use of surgical procedures for the convenience. [ABSTRACT FROM AUTHOR]

This paper presents the results of formative research conducted from January to June 2020 in the Department of Atlántico, Caribbean region of Colombia, whose findings were used as inputs to design the national strategy for comprehensive sexuality education (CSE) outside school – Tírala Plena – including its curriculum. This is within the framework of the multi-country project coordinated by UNFPA and WHO aimed at generating evidence on the role of facilitators in the delivery of CSE in non-school contexts. The research was carried out in four municipalities in northern Colombia, in rural and marginal urban contexts with conditions of vulnerability for the adolescent population, including a strong presence of migrant populations from Venezuela. A total of 150 male and female adolescents ages 10–17 participated in the formative research. Workshops such as patchwork quilt, body mapping and talking maps were used as methods to gather information. The groups were divided by sex and age (10–13 years old and 14–17 years old). Knowledge, attitudes and social norms regarding adolescent pregnancy, sexually transmitted infections, including human immunodeficiency virus, and gender-based violence, were identified in adolescents (schooled and not schooled, but with minimal or no access to CSE). All of the above enabled us to establish a set of recommendations for the strengthening of the CSE strategy Tírala plena. [ABSTRACT FROM AUTHOR]

Purpose: Women's experiences of pregnancy, labour and birth are for some pregnant women negative and they develop a fear of childbirth, which can have consequences for their wellbeing and health. The aim was to synthesize qualitative literature to deepen the understanding of women's experiences of fear of childbirth. Methods: A systematic literature search and a meta-synthesis that included 14 qualitative papers. Results: The main results demonstrate a deepened understanding of women's experiences of fear of childbirth interpreted through the metaphor "being at a point of no return". Being at this point meant that the women thought there was no turning back from their situation, further described in the three themes: To suffer consequences from traumatic births, To lack warranty and understanding, and To face the fear. Conclusions: Women with fear of childbirth are need of support that can meet their existential issues about being at this point of no return, allowing them to express and integrate their feelings, experiences and expectations during pregnancy, childbirth and after birth. Women with fear after birth, i.e., after an earlier negative birth experience, need support that enables them to regain trust in maternity care professionals and their willingness to provide them with good care that offers the support that individual women require. Women pregnant for the first time require similar support to reassure them that other's experiences will not happen to them. [ABSTRACT FROM AUTHOR]

Background: Pregnancy amongst adolescent girls is common in many parts of the world. The dominant discourse in public health unquestioningly paints this as a problem; it does not pay sufficient attention to girls' views. Objectives: This paper presents a critical account of adolescent South Sudanese girls' reasons for and explanations of childbearing. It discusses their experiences and views on childbearing and attempts to explain their reproductive choices and actions, in context. Methods: The study draws upon 24 interviews with adolescent boys, girls and parents from Wau, South Sudan. Data was analysed using the framework analysis approach. Results: Three interacting themes within which adolescent girls framed their views and decisions about childbearing are identified. The local society places high value on motherhood – adolescent girls' desires to become mothers is a reproduction of this social norm. Girls linked having a child to the possibility of making one's 'own home'; in the difficult and uncertain context they lived in, for many girls, having a child (and making a home) appeared as one of the few means to be happy. In making the decision to bear a child, the girls navigated multiple dilemmas and trade-offs between an unpromising present and an uncertain future. Bearing a child and making one's 'own home' was seen as a way to exit into the world of adults, and as a strategy towards achieving security and stability. Conclusions: Instead of simplistically problematizing adolescent pregnancy in South Sudan, it is important to take into account the experiences and standpoints of adolescent girls, and to recognize that in choosing to become mothers, they are in many ways exercising agency despite being severely constrained by complex, insecure and unfair social circumstances. We argue that such an approach will allow the development of more appropriate, realistic and inclusive health and social policies and programs. [ABSTRACT FROM AUTHOR]

Internally displaced women are underserved by health schemes and policies, even as they may face greater risk of violence and unplanned pregnancies, among other burdens. There are an estimated 450,000 internally displaced persons in India, but they are not formally recognised as a group. Displacement has been a common feature in India's northeast region. This paper examines reproductive and maternal health (RMH) care-seeking among Bru displaced women in India. The study employed qualitative methodology: four focus group discussions (FGDs) were held with 49 displaced Bru women aged 18–45 between June and July 2018; three follow-up interviews with FGD participants and five in-depth interviews with community health workers (Accredited Social Health Activists – ASHAs) in camps for Bru displaced people in the Indian state of Tripura. All interviewees gave written or verbal informed consent; discussions were conducted in the local dialect, recorded, and transcribed. Data were indexed deductively from a dataset coded using grounded approaches. Most women were unaware of many of the RMH services provided by health facilities; very few accessed such care. ASHAs had helped increase institutional deliveries over the years. Women were aware of temporary contraceptive methods as well as medical abortion, but lacked awareness of the full range of contraceptive options. Challenges in accessing RMH services included distance of facilities from camps, and multiple costs (for transport, medicines, and informal payments to facility staff). The study highlighted a need for comprehensive intervention to improve RMH knowledge, attitudes, and practices among displaced women and to reduce access barriers. [ABSTRACT FROM AUTHOR]

To explore the pregnancy and childbearing experiences of women-survivors of childhood sexual abuse [CSA]. We aimed to generate a theory explaining those experiences for this population (women), this phenomenon (pregnancy and childbirth), and this context (those who have survived CSA). Participants (N=6) were recruited to semi-structured interviews about their experiences of CSA and subsequent pregnancy and childbirth. Data saturated early, and were analysed using Grounded Theory (appropriate to cross-disciplinary health research). Coding was inductive and iterative, to ensure rigour and achieve thematic saturation. Open and focused coding led to the generation of super-categories, which in-turn were collapsed into three distinct, but related themes. These themes were: Chronicity of Childhood (Sexual) Abuse; Pregnancy and Childbirth as Paradoxically (Un)safe Experiences; Enduring Nature of Survival Strategies. The relationship between these themes was explained as the theory of: (Re)activation of Survival Strategies during Pregnancy and Childbirth following Experiences of Childhood Sexual Abuse. Pregnancy and childbirth can be triggering for women-survivors of CSA. Survival strategies learnt during experiences of CSA can be (re)activated as a way of not only coping, but surviving (the sometimes unconsented) procedures, such as monitoring and physical examinations, as well as the feelings of lack of control and bodily agency. [ABSTRACT FROM AUTHOR]

Better understanding attitudes toward pregnancy – a potent predictor of adolescent pregnancy – could help explain the high adolescent pregnancy rate in Nunavik, Canada. The objective of this study was to assess the distribution of different attitudes toward pregnancy and the factors associated with high pregnancy likelihood attitudes (HPLA; favourable, indifferent, and ambivalent), focusing on the perceived benefits of childbearing (BOC). T-tests, chi-square tests, and logistics regressions were performed based the answers of 159 Inuit women aged 16 to 20 years from the Qanuilirpitaa? survey. About 43% were ambivalent, 16% favourable, 5% indifferent, and 35% unfavourable toward pregnancy. Bivariate analysis indicate that the HPLA group was more likely to work, to report less frequent positive interactions, and to show a higher BOC score compared to others. Multivariate analysis show that an increased BOC score was associated with HPLA (OR = 1.09, 95% CI = 1.01 − 1.18). Perceiving that a baby would strengthen the relationship with the other parent (OR = 1.65, 95% CI = 1.15 − 2.37) and that it would help to access housing were individually associated with HPLA (OR = 1.45, 95% CI = 1.02 − 2.10). Findings provide evidence to support Inuit adolescents’ reproductive choices. [ABSTRACT FROM AUTHOR]

This study explored women's lived experience of making fertility decisions six years after attending the Fertility Assessment and Counselling (FAC) clinic in Copenhagen, Denmark, which is a personalised fertility awareness intervention. We conducted a qualitative interview study with 24 women who attended the FAC clinic 6 years earlier. Interviews were semi-structured and broadly examined the women's perceptions and experience of the intervention during follow-up. Data was analysed using a phenomenological framework and themes were identified related to women's experience of making fertility decisions after attending the FAC clinic. The overarching theme regarding the women's lived experience of making fertility decisions after attending the FAC clinic was: Fertility decisions were guided by the 'family clock'. There were four themes: (i) Deciding to 'get started' by attending the FAC clinic; (ii) Sense of making informed and empowered decisions; (iii) Influence of partner status on fertility decisions; and (iv) Decisions dictated by circumstance over preference and knowledge. At follow-up, the majority (21 women, 88%) had become parents. More than half of the women said that they had not achieved their desired family size. Consideration of women's 'family clock' is necessary in personalised fertility awareness interventions to enable women to achieve their family goals. [ABSTRACT FROM AUTHOR]

Paternal stress is often assessed by maternal report and is posited to influence infant development indirectly by contributing to a mother's stress and experiences during pregnancy. Far less is known about how direct effects of prenatal paternal stress, as described by fathers themselves, are related to an infant's physiological functioning. We assessed fathers' own experiences of stress and examined its direct impact on infant respiratory sinus arrhythmia (RSA), a biological index of self-regulation, at seven-month postpartum. During the third trimester of pregnancy, the UCLA Life Stress Interview was conducted to assess chronic stress in mothers and fathers (N = 90). Infant baseline RSA and RSA reactivity in response to the Still-Face paradigm were assessed at seven-month postpartum. Infants of fathers with high prenatal stress showed lower baseline RSA, possibly reflective of poor infant psychophysiological regulation. The predictive role of paternal stress remained significant after controlling for maternal stress. Our findings provide emerging empirical evidence to support the influence of prenatal paternal stress on infant RSA, highlighting the important role of fathers for child development. [ABSTRACT FROM AUTHOR]

LGBTQIA+ people building families face many health service barriers, often turning to online consumer health information in addition to or instead of navigating heteronormative and cisnormative health care systems. This research evaluated available online resources about family building for LGBTQIA + health consumers, in order to improve awareness of quality resources among librarians, while also highlighting an existing information research and services gap. Librarians located resources that explicitly addressed pregnancy and assisted reproduction information needs of the LGBTQIA + community. Included resources focused on pregnancy and assisted reproduction; excluded resources focused on sexual health, contraception, or unwanted pregnancies. Identified resources were assessed by findability (ease of locating), readability, accessibility, understandability, actionability, and inclusivity. [ABSTRACT FROM AUTHOR]

The present study examines how substance-using women in the street sex trade formulate understandings of pregnancy at the intersections of healthcare, social services, and family systems in ways that reflect internalized dominant cultural assumptions about substance use, motherhood, and the street sex trade. Three primary frameworks emerged with respect to pregnancy-related decision-making as prompted by heightened scrutiny, intensified stigma, and prioritization of fetal over maternal wellbeing. Healthcare, social services, and family systems can improve care for pregnant substance-using women in the street sex trade by acknowledging the dynamic interplay between women's substance use, relationships, and pregnancy-related decision-making as well as the intersectional harms compounded by child custody loss and persistent lack of support to low-income women. [ABSTRACT FROM AUTHOR]

Objective Determine the relationship characteristics, sexual health attitudes, and demographic factors associated with dual contraceptive use among college students. Participants: September–October 2018 via campus email, we recruited College of Public Health students attending a large, urban, public university (N = 424). Methods: Respondents completed a cross-sectional, Web-based sexual health questionnaire. Descriptive statistics were calculated. Multiple logistic regression models were run to determine the association between relationship characteristics, pregnancy and condom attitudes, demographics, and dual use the last time having sex. Results: In independent models, one-unit increase in trust (aOR = 0.982; 95% CI: 0.966–0.998) and commitment score (aOR = 0.987, 95% CI: 0.976–0.999) was inversely associated with dual use while sex with a casual date/acquaintance (aOR = 3.149; 95% CI: 1.550–6.397) was positively associated. In a fully adjusted model for all correlates, only trust score was significant (aOR = 0.982; 95% CI: 0.966, 0.998). Conclusions: Emotion-based constructs may be more influential on dual use behaviors than discrete relationship factors. [ABSTRACT FROM AUTHOR]

Determinants for women's care seeking for birth in low-income setting are multifactorial and remain poorly understood. A life course approach can assist to structure the interplay of the different factors that lead to women seeking care or not. In this study we aimed to explore individual women's reproductive pathways, and increase understanding of how important life events including previous pregnancy and birth experiences can help us to understand individual choices made for care seeking during childbirth. The study took place in Tanzania between 2015 and 2017. 14 women were followed throughout their pregnancy, birth and postpartum period through participant observation and in-depth interviews. In total 94 in-depth interviews were held (between 5–7 interviews per woman). Analysis occurred continuous throughout the data collection period resulting in detailed narratives of crucial events across women's life course, with specific attention to their current pregnancy. Of the 14 women, seven had a facility birth, six a home birth and one woman gave birth at the home of a local birth attendant. Four different story plots were identified: expected home birth, expected facility birth, unexpected facility birth and unexpected home birth. Birth narratives of four women representative of the different story plots are presented. Narratives illustrate women's individual reproductive pathways including the various factors influencing women's expectations and justifications for their actions during their pregnancy and birth. Women's agency, including women's perception of self, the self in relation to the social environment and reflection on risks associated with the range of options, influences the final decision made for birth. Women's narratives suggest that quality of care can function as a primary pull factor for facility birth. As long as home birth is by some perceived to be a better alternative, achieving skilled care for all will be difficult to achieve. [ABSTRACT FROM AUTHOR]

Pregnancy is an opportune time for women to make healthy changes to their lifestyle, however, many women struggle to do so. Multiple reasons have been posited as to why this may be. This review aimed to synthesise this literature by identifying factors that influence women's health behaviour during pregnancy, specifically in relation to dietary behaviour, physical activity, smoking, and alcohol use. Bibliographic databases (MEDLINE, PsycINFO, CINAHL-P, MIDIRS) were systematically searched to retrieve studies reporting qualitative data regarding women's experiences or perceptions of pregnancy-related behaviour change relating to the four key behaviours. Based on the eligibility criteria, 30,852 records were identified and 92 studies were included. Study quality was assessed using the CASP tool and data were thematically synthesised. Three overarching themes were generated from the data. These were (1) A time to think about 'me', (2) Adopting the 'good mother' role, and (3) Beyond mother and baby. These findings provide an improved understanding of the various internal and external factors influencing women's health behaviour during the antenatal period. This knowledge provides the foundations from which future pregnancy-specific theories of behaviour change can be developed and highlights the importance of taking a holistic approach to maternal behaviour change in clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: Miscarriage is a stressful life event with negative consequences that can last into the subsequent gestation, increasing women's risk for psychological symptoms. Less clear in literature is whether having a living child may buffer the psychological impact of miscarriage on subsequent pregnancies. Objective: explore levels of depression, anxiety and fear of delivery in women with and without a previous miscarriage, taking into consideration the presence of a living child. Method: 208 women (M = 34.68) were recruited during the third trimester of gestation. The sample was composed of 159 women without a previous miscarriage (72.3% primiparae and 27.7% multiparae) and 49 women with a history of miscarriage (53.1% primiparae and 46.9% multiparae). Participants filled out a battery of questionnaires aimed at assessing anxiety, depression, and fear of delivery. Results: Primiparae reported higher levels of fear of childbirth than multiparae. Moreover, women without a history of previous perinatal loss showed lower levels of depression and fear of childbirth than women with a previous perinatal loss. Conclusions: Data highlight the importance of developing specific support groups, for primiparae, due to their great emotional vulnerability, and for women with past miscarriage, to help them cope in adaptive ways with a new pregnancy. [ABSTRACT FROM AUTHOR]

Women who experience stillbirth often report anxiety, depression, and loss of self-esteem afterward, but aspects of the pregnancy, such as length of pregnancy, seeing the baby after delivery, and seeing the baby as long as they wished might be associated with symptoms of depression. So, we sent an online, detailed questionnaire about their stillbirth experience and their current depression to two Facebook child loss support groups. A total of 66 women answered anonymously through SurveyMonkey. The women delivered their babies at about seven months gestation, on average 2.5 years earlier. The women reported moderately severe depression symptoms, which was related to being single, length of time between diagnosis and delivery, seeing the baby immediately after delivery and as long as they wished and secondary infertility after the stillbirth. Although this sample may have been unique, these women report long-term negative ramifications of their experience. An implication is that the specific details surrounding their stillbirth experience in the hospital can have long-term implications for depression. [ABSTRACT FROM AUTHOR]

Unintended pregnancy impacts many young women in South Africa, and rates of consistent contraceptive use among this population are suboptimal. Limited empirical work has investigated reasons for inconsistency between pregnancy intention and contraceptive use behaviour with data collected during pregnancy. We explored pregnancy intentions and discordance between intentions and contraceptive use prior to conception among young pregnant women in KwaZulu-Natal, South Africa. In-depth qualitative interviews were conducted with 35 women during pregnancy (mean age = 19.3; range = 18–21) in 2011 and 2012. Data were analysed using content analysis. All participants reported unintended pregnancies; almost half were not using contraception near conception. Reasons for not intending to become pregnant spanned personal, social, health, and economic domains. Participants living with HIV (n = 13) expressed specific concerns related to impacts of pregnancy on HIV disease management and fear of transmission of HIV to the infant. Discordance between pregnancy intentions and contraceptive use prior to conception was attributed to personal, social, health and structural domains. Findings indicate a need for interventions that address barriers to contraceptive use in order to minimise unintended pregnancy and support safe, desired pregnancies among young women. [ABSTRACT FROM AUTHOR]

Providing care to women following stillbirth affects the well-being of midwifery staff. In this grounded theory study, the authors used focus groups and individual interviews to explore the experiences of midwifery students at a faith-based university in Papua New Guinea. Balancing it Out is the process students used to balance social, cultural and professional factors to achieve their aim of providing the best possible care to women following stillbirth. Provision of holistic care to women following stillbirth and cross-sector health promotion are crucial to attain the best outcomes for women and the midwifery staff who provide their care. [ABSTRACT FROM AUTHOR]

A phenomenological study was conducted to explore the lived experience of pregnancy in Iranian adolescent mothers. Participants were recruited from three healthcare centers in Ahvaz, Iran. Data were collected through semi-structured, face-to-face interviews with eleven adolescents who had experienced their first pregnancy. A thematic analysis approach was used to analyze the data. The overarching theme that emerged from the data analysis was "withering while blossoming", presenting a picture of struggle with duality imposed on the lives of pregnant adolescents due to the coincidence of three evolutionary events of adolescence, marriage and pregnancy. Pregnancy was experienced by the adolescents as an event that led to losing their other opportunities in life while developing their potential capabilities. Healthcare providers should consider adolescent mothers' experiences to provide comprehensive and appropriate health services to empower these mothers for successful transition from the multiple developmental stages. [ABSTRACT FROM AUTHOR]

Narratives can bring about related discussions, which can influence narrative comprehension and future conversations – though little is known about how these processes interact. This study considers the interplay of exposure to a teen pregnancy narrative and subsequent mother-daughter discussion in an experiment with mothers and their teenage daughters. Participants watched a teen pregnancy narrative or a control narrative. After watching, they either participated in a mother-daughter discussion of sexual health or completed a distractor activity. The teen pregnancy narrative led to greater endorsement of teen pregnancy myths on the part of daughters – particularly when identifying with the pregnant teen character – but maternal discussion mitigated their effects on overall attitudes toward pregnancy prevention. Moreover, participants who viewed the teen pregnancy narrative were more satisfied with their discussions afterwards than were those who discussed sexual health without first watching the teen pregnancy narrative. This conversational satisfaction, in turn, led to more frequent mother-daughter conversations about sexuality in the following weeks. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the interaction between pregnancy loss and pregnancy intentions on women's happiness about a subsequent pregnancy. Background: Anxiety about prior loss persist for women, even during subsequent pregnancies. It is unclear from prior research, whether a prior pregnancy loss shapes attitudes towards and feelings about a subsequent birth. Methods: Using data from the 2002–2013 National Survey of Family Growth (NSFG), we used logistic regression analyses to explore the implications of a prior pregnancy loss for happiness about a subsequent pregnancy that ends in a live birth. We compared births classified as on-time, mistimed, unwanted, and ambivalent. Results: Births were more likely to be characterised as on-time if they occurred following a pregnancy loss, and women were less likely to report being happy about a conception if they were ambivalent about the conception and experienced a previous loss. Overall, pregnancy loss alone was not associated with lower levels of happiness about a subsequent birth. Conclusions: Pregnancy loss can be a highly distressing experience, women's happiness about a subsequent pregnancy is not reduced due to prior pregnancy loss. Future research should explore why women who were ambivalent about pregnancy reported lower levels of happiness following a loss. [ABSTRACT FROM AUTHOR]

Sexual minority women (SMW) face both increased risk for unintended pregnancy and barriers to achieving wanted pregnancy, but little research investigates SMW's pregnancy desires. To fill this gap, we conducted five focus groups and 11 in-depth interviews with 20-30-year-old SMW in three US cities. Findings highlight that the heteronormative pregnancy planning paradigm lacks salience for SMW. While some SMW clearly wish to avoid pregnancy, many others are unsure, and factors influencing this uncertainty include relationship context, anticipating logistical barriers, and discord between queer identity and pregnancy. [ABSTRACT FROM AUTHOR]

Many countries have adopted abstinence guidelines for pregnant women, due to uncertainty around the risk of harm caused by small amounts of alcohol. There is a lack of research exploring frontline midwives' attitudes towards alcohol use during pregnancy and comparisons of practices in different countries. Sixteen semi-structured interviews were conducted with midwives working in Liverpool, England (n = 7) and Örebro County, Sweden (n = 9). Data were analysed inductively, using thematic analysis with thematic networks. The findings show that all midwives believed pregnant women should be advised not to consume any alcohol during pregnancy and there is a need to tailor their approach to the individual. A key concern among midwives in both countries was how to advise about alcohol exposure that occurs before the pregnancy is known to the woman. English midwives discussed the uncertainty around the risk of consuming small amounts of alcohol, whereas Swedish midwives believed any amount of alcohol was associated with risk. Discussing alcohol was viewed as part of the health professional's role, but routine questions for all women were perceived to aid discussions about alcohol. Future research should further explore the impact of wider social and political environment on midwives' attitudes around risks with prenatal alcohol use. [ABSTRACT FROM AUTHOR]

Victims of violence come from various backgrounds; however, the intersection of gender combined with poverty, belonging to a racial minority, [dis]ability, and youth, put women at greater risk for experiencing violence and trauma. Many of these features are also high-risk markers for women who experience addictions to substances. Considering the risk factors and prevalence of violence and addictions experienced by young women, it is important to consider the comorbidity of complex trauma and substance use disorder and their combined effects on women's reproductive health. The experience of pregnancy, combined with the experience of past trauma and addictions, presents a complex and compelling situation in which women struggle to balance their intentions to maintain a healthy pregnancy, with the drive to use substances as a way to cope with unresolved past traumatic experiences. By reviewing the literature regarding addictions, pregnancy, and complex trauma, this article aims to demonstrate that pregnancy presents a unique opportunity for trauma intervention among addicted women, and to establish how a missed opportunity for trauma-focused intervention can contribute to intergenerational trauma, creating a cycle of harm for women and their children. [ABSTRACT FROM AUTHOR]

In this article, we contribute to a growing body of literature that explores how risk discourse functions in the (globalised) neoliberal era of ‘intensive mothering’. A comparison of traditional Chinese medicine and Western biomedicine indicates that in these two approaches to medicine, pregnancy-related risks are derived from different sources and seen in different ways. In this article, we examine how women with a Chinese background living in North America negotiate these differences. More specifically, we use data from a qualitative research study to examine how 15 pregnant Chinese Canadian women living in Vancouver, British Columbia, understand and experience pregnancy-related risk and lifestyle directives. Examining data from a Foucauldian perspective that views ‘risk’ as a biopolitical technique of governance, we show that the ways in which the majority of the participants use traditional Chinese medicine and Western biomedicine – and identify risk – change as they move through the stages of pregnancy. While many of them integrated aspects of both traditional Chinese medicine and Western medicine prior to pregnancy (using Western medicine for acute issues and traditional Chinese medicine to restore bodily balance and strength), once pregnant the majority of the women in the study used biomedical ‘proof’ to guide them through a healthy pregnancy. They tended to avoid traditional Chinese remedies due to the ‘risk’ of teratogenic effects, and also avoided family advice intended to ensure bodily balance. Once the child was born, the participants viewed the (maternal) body in a different way: as a body out of balance in the yin-yang sense – and in need of traditionally ordained practices (typically called ‘doing the month’). [ABSTRACT FROM AUTHOR]