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BackgroundMaternal problems in the postpartum period may lead to suboptimal long-term health for women and could affect mother–child attachment. Social disadvantage is a risk factor for preterm birth, which carries its own burden of health issues and stress. The main aim of this study was to investigate the role for social factors in mothers’ physical and emotional health-related quality of life (HRQoL) at 1 year after a preterm birth.MethodsEPIPAGE-2 is a French nationwide, prospective, population-based cohort of preterm children born before 35 weeks’ gestation (N=3614 women). At birth, detailed data on the family’s social status were collected. At 1 year after birth, mothers completed a mailed questionnaire to report information on their HRQoL, assessed by the Medical Outcomes Study 12-item Short Form. We used multivariate linear regression models to assess the association between social factors and maternal HRQoL.ResultsAt 1 year after childbirth, the emotional HRQoL of mothers of preterm children was worse than their physical HRQoL, even in women without any previous signs of psychological distress at the infant’s discharge from hospital. Baseline social characteristics were the most important factors influencing the physical component of HRQoL. None of the studied social factors had any clear association with the mental component of HRQoL.ConclusionOur study underlines the importance of social disadvantage during pregnancy as risk factors for poor physical HRQoL at 1 year after a preterm birth.

Violence against women often continues after couples separate. Although the involvement of children in intimate partner violence is known, no study has investigated the role of children in postseparation violence in southern Europe. The aim of this study was to analyze male perpetrators’ strategies to maintain control over the woman after couples separate and the involvement of children in this process. We designed a multimethod research with a sample of women attending five anti-violence centers in Italy: In the quantitative part, women were interviewed with a questionnaire (N= 151) at baseline and followed up 18 months later (N= 91); in the qualitative part, in-depth interviews were carried out with women (N= 13) attending the same centers. Results showed that women experienced high levels of violence and that children were deeply involved. When women with children were no longer living with the violence perpetrator, threats, violence, manipulation, and controlling behaviors occurred during father–child contacts: 78.9% of women in the longitudinal survey and all women in the qualitative study reported at least one of these unsettling behaviors. The qualitative study allowed for discovering some specific perpetrator strategies. Making the woman feel guilty, threatening, denigrating, and impoverishing her; preventing her from living a normal life; and trying to destroy the mother–child bond were key elements of a complex design aimed at maintaining coercive control over the ex-partner. Results from this multimethod study provided a deeper understanding of the mechanisms of coercive control and postseparation violence and how perpetrators use children to fulfill their aims.

While mediation is commonly used in custody negotiation, there is no consensus regarding its applicability in domestic violence cases. The aim of this qualitative study in Italy was to explore the role of family mediation in the management of child custody in cases involving domestic violence. Semistructured interviews were conducted with lawyers (N= 5), social workers (N= 15), and abused women who had separated from their children’s fathers (N= 13). Legal documents were also analyzed. The results showed that violence against women and children had often been concealed during mediation, as the professionals involved had failed to detect domestic violence or had labeled it as conflicts. Moreover, the “parental couple” had been dissociated from the “marital couple,” and the responsibility for the abuse had been attributed to both parents. As a result, women and children had been blamed and had experienced secondary victimization, while the perpetrators’ patterns of power and control had continued. The results also revealed that those professionals had not known about and had not applied the Istanbul Convention, which provides guidelines to ensure women’s and children’s safety. Recommendations highlight the need to account for the complexity of domestic violence cases, to hold perpetrators responsible for the abuse, and to support the victims.

Objective To describe the prevalence of various symptoms five months and twelve months after childbirth in two European countries, according to employment, financial difficulties and relationship with partner.

Hospital workers completed a questionnaire on domestic and professional working conditions and health symptoms. Workers were asked to estimate the number of domestic work hours, and the degree of sharing of laundry, cleaning, meal preparation and childcare. Responses from the 532 women workers showed an average professional work week of 31.2 hours and an average domestic work week of 19.2 hours. The length of the domestic work week increased with the number of children, and the degree of sharing diminished. Among couples with children, the reported length of the domestic work week correlated highly with an index calculated from the degree of sharing of domestic tasks, and the number and ages of children. Exhaustion and insomnia were associated with work speed and shift work, respectively, at the hospital job, but also with the number of hours of domestic work. Backache, which was related to lifting weights in the workplace, was not associated with the number of reported hours of domestic work. Due to errors in formulating some questions, the study underestimates total hours of domestic work, and, probably, effects of domestic work on health. However, it is the first North American study to show the combined effects of domestic work and paid work on physical health symptoms among women.

In this article, we contend that the standard definition of risk factors in pregnancy is not the neutral or technical process that women may assume it to be, but is colored by the prejudice of its context: a capitalist and patriarchal society. In such a society, only paid work is valued, and thus there is little study of the ill effects of housework on pregnant women; such a study would mean considering and possibly changing our sex-biased division of labor. Physicians and the mass media stress risk factors such as smoking, while omitting to mention that drugs prescribed by doctors are not always safe, and some are prescribed for years before—and even after—their harmful effects are known. Further examples are given from the field of childbirth, and we advance the hypothesis that, especially in fee-for-service medical systems, the physician can represent a risk factor. “Information” is often offered as the solution for pregnancy risks, the responsibility for this being the woman's. The mystification and narrowness of such a victim-blaming approach are evident. The key factor in prenatal preventive care is the mother's level of education: to admit this would be to acknowledge the need for change of a social system that keeps women in ignorance. We point out the limitations of the proposed individualistic solutions and conclude that, in redefining risk factors for women and their babies, we must analyze our society in feminist terms and in terms of social class.

Although most mothers of young children work, we do not know much about the effect of this work on the mothers' health. The aim of this article is to review and discuss some of the findings on this subject, in order to understand whether paid and unpaid work are associated with mothers' health. Results from available studies show that, while employment tends to be associated with better physical and mental health in mothers, its effects are inconsistent when mothers of babies or young children are specifically examined. For physical health, employment is likely to have a negative effect for working-class mothers and a positive effect for middle-class ones. For mental health, the trend is unclear; mothers' psychological well-being is negatively affected, however, by the presence of one or more preschoolers, a lack of involvement by the husband, difficulties linked to child care, and the women's preferences concerning their professional status. Moreover, variables such as education, income, social class, housing, and marital status are likely to affect the health of mothers of young children, just as they affect the health of other women.

The aims of this article are to describe breast-feeding patterns in a sample of 141 Italian first-time mothers who had all done paid work during pregnancy, and to place these results in the context of Italian Maternity legislation. Data show a relatively high frequency of initiation and long duration of breast-feeding: 87% of mothers put the baby to the breast during their hospital stay; of the whole sample, 38% breast-fed for at least 24 weeks, and 33% for longer. Mothers who had resumed their job after the birth breast-fed longer than those who stayed at home. Type of job and working hours had no effect on breast-feeding duration, while post-partum leave did: the longer the leave, the longer mothers breast-feed.

Forty-four French primiparae were interviewed in a longitudinal study of the transition to motherhood. Quantitative and qualitative data were gathered. Only results concerned with feeding topics are presented. When pregnant, 75 per cent of women wanted to breastfeed: social and demographic variables did not clearly differentiate between prospective breast-and bottle-feeders. After the birth and during the hospital stay, one third of the mothers who had wanted to breastfeed had difficulties linked to an operative birth or to the staff's behaviour and, at five weeks postpartum, had switched to the bottle. At that time, 41 per cent of mothers were breastfeeding. Results indicate that they had more difficulties than bottle-feeders: their babies woke up more often to be fed in the night; they had fewer outings without the baby; their husbands helped less in baby-care; they resumed sexual relationship later and were more often depressed. In spite of that, many of them also expressed great pleasure and joy in breastfeeding. These data suggest that most of the difficulties mothers experience in breastfeeding are linked to the social organization of motherhood, and could be avoided, provided that changes are made in the way society defines the role of the mother.