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Background: The birth experience plays a pivotal role in the mother´s mental well-being and has a crucial effect on the mother-child bond. Unanticipated medical interventions, including fundal pressure, episiotomy, assisted vaginal delivery (AVD), or unplanned cesarean section (CS) during labor, may adversely affect the birth experience. The objective of this study is to identify factors contributing to the diminished evaluation of the birth experience after assessing the prevalence of unplanned obstetrical interventions in Germany. Methods: For this cross-sectional analysis, 4000 mothers whose children were born 8 or 12 months before were asked about their birth experience via a paper-based questionnaire. Overall 1102 mothers participated in the study, representing a response rate of 27.6%. The revised Childbirth Experience Questionnaire (CEQ2) was used to measure the childbirth experience. In addition to descriptive and bivariate analyses using the Wilcoxon rank-sum test and Kruskal-Wallis-test, we calculated multivariate linear regression models for each dimension of the CEQ2. Results: In general, the participants evaluated their childbirth experience favorably, assigning an average rating of 3.09 on a scale ranging from 1 to 4. Women who experienced fundal pressure, an AVD, or an unplanned CS rated their birth experience significantly worse compared to women who gave birth without interventions. Unplanned CSs received the lowest ratings for "personal capability" and "perceived safety," and an AVD resulted in lower scores for "professional support" and "participation." However, the interventions we studied did not account for much of the variation in how the childbirth experience plays out for different individuals. Conclusion: Obstetric interventions have a significant effect on different dimensions of the birth experience. If a high level of birth satisfaction is to be achieved, it is important to know which dimension of satisfaction is affected by the intervention so that explicit measures, like fostering communication, participation or safety can be taken to promote improvement. German Clinical Trial Register: DRKS00029214, retrospectively registered (Registration Date 22.06.2023). [ABSTRACT FROM AUTHOR]

This paper focuses on the diversity in patients' experience of biomedicine and contrasts it with the normative view characteristic of health professionals. Ethnographic fieldwork among Polish migrant women in London, Barcelona and Berlin included interviews about their experiences with local healthcare and health professionals. Themes drawn from the narratives are differences between the cities in terms of communication between patients and health professionals, respect for patients' choices and dignity, attitudes to pregnancy and birth (different levels of medicalization), and paediatric care. It is argued that patients continuously negotiate among their own views and expectations based on previous experiences and knowledge from personal communication; internet forums and publications; and the offer of medical services in the countries of their settlement. Patients experience pluralism of therapeutic traditions within and outside bio-medicine. In turn, representatives of bio-medicine are rarely aware of other medical practices and beliefs and this leads to various misunderstandings. By highlighting the pluralism of medical practices in European countries and the increasing mobility of patients, this case study has useful implications for medical anthropologists and health professionals in a broader Western context, such as raising sensitivity to different communication strategies and a diversity of curing traditions and expectations. [ABSTRACT FROM AUTHOR]

BACKGROUND Recently it has been claimed that gender equality and gender equity in the family tend to increase fertility. The strength of this association, however, depends on prevailing gender relations and the level of social support of employment and family within a society. OBJECTIVE We wish to improve our understanding of the relationship between gender equality, gender equity, and fertility by investigating the impact of the actual division of paid and unpaid labor on first- and second-birth fertility in Germany while including in our analyses a repeatedly measured indicator of gender equity that captures the subjective perception of fairness of this division. METHODS Using nine waves of the German Family Panel (pairfam), we apply discrete-time logistic regression models to cohorts of young women and men in coresidential unions to determine whether a birth occurs in a given year while using measures of gender equality and gender equity as lagged time-varying covariates. RESULTS We find that an arrangement in which the woman is in charge of routine housework and the division of paid and unpaid work is perceived as fair is positively associated with family formation. The perception of a fair division of work is no prerequisite for continued childbearing. Yet women's responsibility for domestic work facilitates family extension. CONTRIBUTION This paper extends the literature on the relationship between gender equality, gender equity, and family outcomes by using prospective panel data to capture attitudinal and behavioral changes over the life course more fully than has previously been done. [ABSTRACT FROM AUTHOR]

INTRODUCTION This study aimed to review and pilot-test feedback from childbearing women who completed the German short version of the Childbirth Self-Efficacy Inventory (CBSEI-C32), which is widely used and validated in different languages. METHODS Ten pregnant nulliparas, who planned a natural childbirth, completed the German CBSEI-C32 and provided comments about the comprehensibility of the tool. RESULTS When applying the standardized translated German CBSEI-C32, we discovered that women generally gave positive feedback, and reported that the items made them think about coping strategies for labor and birth. Some pregnant woman had problems in understanding two items: 'Mich beherrschen' (original English item: 'Keep myself in control'), and 'Mich ruhig halten' (original English item: 'Keep myself calm'). Some of the items were not comprehensible for pregnant women and might not represent contemporary concepts of childbirth self-efficacy. CONCLUSIONS Two items of the German CBSEI-C32 were interpreted ambiguously by the pilot testers. The CBSEI should be checked to identify which items could serve as the basis for a new questionnaire because there are clear and appropriate coping strategies when dealing with labour pain such as item 3 on breathing. These could be complemented with other coping behaviours that are positively worded and serve to empower rather than restrain women. For measuring self-efficacy beliefs in childbirth nowadays, it appears that health-oriented aspects, such as concentrating on the pauses between contractions or mentally staying in the present moment, are more important for women than focusing on control during childbirth. [ABSTRACT FROM AUTHOR]

Economic theory suggests that incentives matter for people's decisions. This paper investigates whether this also holds for less self-evident areas of life such as the timing of births. We use a natural experiment when the German government changed its parental benefit system on January 1, 2007. The policy change strongly increased economic incentives for women to postpone delivery provided that they were employed. Applying a difference-in-difference-in-difference approach, we find very strong evidence that women with an employment history near to the end of their term indeed succeeded to shift births to the New Year and, therefore, could benefit from the new and more generous parental benefit system. Suggesting a model of chain reactions, we also report evidence that some women with due dates earlier in December tried but did not succeed to shift births to the New Year. [ABSTRACT FROM AUTHOR]

The author presents a response to a comment by Anke Franz and colleagues on her article "British Policy on Teenage Pregnancy and Childbearing: The Limitations of Comparisons With Other European Countries." Franz and colleagues observes that comparative research can be advantageous and that sexual openness and sex education are important determinants of teenage pregnancy. It compares Great Britain with Germany and other European countries in terms of fertility culture, income inequality and youth transitions.

Trans and intersex individuals are often not considered in obstetric care—neither in practice nor in research. This quantitative study used an online survey to compare the experiences of pregnant trans men, non-binary individuals, and intersex people with those of endosex cisgender individuals who received care in obstetrics. Trans men and non-binary individuals reported discrimination during pregnancy and childbirth on the interactional, institutional, and structural level: for example, they reported more unsatisfactory encounters with health care personnel and more barriers in the structure of health care services and facilities. Trans and intersex individuals had less access to information relevant to them concerning pregnancy and birth compared to cisgender endosex individuals. Although it happened less frequently, cisgender endosex individuals also reported negative experiences, such as discrimination or violence during birth in a hospital. Our findings indicate a need for change concerning several aspects of the obstetric care spectrum—especially, but not exclusively, for trans, non-binary, and intersex people. Some suggestions for improvement include the following: On the hospital level, measures should be implemented to reduce structural discrimination and to ascertain one-on-one care during active labor. Inclusive information material should be developed and disseminated and health care institutions should raise awareness among their staff regarding care for their LGBTIQ patients. More studies on obstetric issues concerning queer, trans, and especially intersex people should be conducted and diversity and inclusion should be implemented as core topics in the training curricula for midwives, physicians, and nurses. [ABSTRACT FROM AUTHOR]

This study investigates the conceptual argument that constructive and explicit couple communication may reduce gender inequalities in couples' division of family work. We focus on the transition to parenthood which for most couples in Germany results in a shift towards a more traditional division of labour. Using 314 first-time parents from the German Family Panel, we apply growth curve models to assess whether partners' prenatal characteristics explain the division of housework and childcare around the time of childbirth and in the following years. After controlling for gender ideologies and economic resources, male partners' frequency of positive communication is associated with greater father involvement in housework and childcare from the start. However, neither men's nor women's communication behaviours dampen the shift towards a more traditional division of housework and childcare in the first years after childbirth. The frequency of negative communication does not correlate with the division of family work. [ABSTRACT FROM AUTHOR]

Postpartum mothers have to decide whether to leave the workforce for some time and, if so, when to return to paid work. Two kinds of regrets might evolve as a result of women's leave‐related decisions: stay‐at‐home and return‐to‐work regrets. The present research investigates how these forms of regrets are associated with women's affective organizational commitment. We conducted a four‐wave longitudinal study with female participants mostly living in Switzerland (61%) and Germany (37%). The first measurement occasion took place during pregnancy (N = 294), and the subsequent three postnatal measurement points were at 6 (n = 281), 12 (n = 254), and 24 months (n = 230) after childbirth. As expected, higher organizational commitment during pregnancy predicted stronger stay‐at‐home regrets. By contrast, women's prenatal organizational commitment did not turn out to be predictive for lowered return‐to‐work regrets. We further assumed cross‐lagged associations between post‐birth organizational commitment and return‐to‐work regrets. Our results suggest that return‐to‐work regrets are predictive of decreases in affective organizational commitment. Reversed causation, that is, effects from postnatal organizational commitment to return‐to‐work regrets, could not be confirmed. Results are discussed regarding theoretical, methodological, and practical implications. [ABSTRACT FROM AUTHOR]

Gender inequalities in paid and unpaid work are well documented, but patterns of advantage or disadvantage in further job-related training have been less explored. Previous cross-sectional studies indicate gender differences in further training, with lower participation rates and shorter training sessions for women, especially mothers. Based on the National Educational Panel Study for Germany (adult cohort, 2008–2020), this study is the first to examine gendered parenthood effects on participation in non-formal further job-related training using panel analyses. The results from fixed-effects regressions provide evidence of parenthood training penalties that are particularly pronounced for mothers and in the first years after childbirth. While fatherhood training penalties are mostly explained, motherhood gaps remain robust when accounting for a large number of time-varying characteristics. The results point towards further relevant changes in mothers' aspirations or employer support. Thus, they underline the importance of training opportunities for reducing childbirth-related inequalities later in life. [ABSTRACT FROM AUTHOR]

Various studies have shown that immigrant women in comparison to non-immigrant women of the same parity have lower rates of epidural anesthesia (EDA). Data from two studies on immigrant obstetric care in Berlin, Germany were analyzed to answer the following question: What reasons do the medical staff see for the lower rate of EDA in immigrant women? Between May and August 2017, 34 interviews with obstetricians and midwives in four obstetric clinics in Berlin were conducted on the topic of obstetric care for immigrant women. After anonymizing the more than 20 h of interview material, transcripts were coded with MaxQDa and analyzed according to the qualitative content analysis.The quantitative data is from an online survey conducted between May and October 2017, in all but one obstetric clinic in Berlin with obstetricians and midwives. Regarding the research question, 121 questionnaires could be analyzed. In the online survey, (multiple answers were possible), the top reason for a lower rate of EDA given was mostly fear on the part of the immigrant women (64%). A language barrier, which results in logistic and time constrictions, is mentioned as the second most frequent reason (50%). The explorative analysis of the interviews shows that doctors and midwives regard cultural aspects such as different expectations on the birth experience as a reason for a lower EDA rate. Furthermore, within the medical staff the impression persists that in some cases the companion decides on the behalf of the patient about the application of an EDA, which from time to time is against the wish of the immigrant woman giving birth. In the view of the medical staff, the reasons for a lower rate of EDA during birth for immigrant women were varied. On one side, this is attributed to the wishes of the respective women ("demand") but on the other side this can be attributed to the health care system ("supply"). In the case of a language barrier, the "supply" and the access of EDA for immigrant women is limited and can be then shifted to the German-speaking companion to make a decision regarding EDA ("structural deprivation of self-determination"). [ABSTRACT FROM AUTHOR]

In recent years, the Internet has become an increasingly important venue for meeting partners. While meeting online may have a range of effects on family-related outcomes, studies on the link between meeting online and family-related outcomes are scarce. Using eight follow-up waves of the German Family Panel (Pairfam), with observations from 8177 persons from three birth cohorts between 2009 and 2016, this study investigates whether meeting online is associated with relationship satisfaction, intention to separate, separation, moving in together, intentions to have a child, and entry into parenthood. More specifically, a series of between-person regressions are used to compare those who met their partners offline and those who met their partners online. Results show that meeting online is associated with likelihood to separate and intentions to have a child in the youngest birth cohort, and transition to parenthood in the oldest birth cohort. These findings are discussed with the concepts of selectivity and intentionality in searching for and meeting partners online. [ABSTRACT FROM AUTHOR]

Individuals typically traverse several life phases before forming a family. We analyze whether changing the duration of one of these phases, the education phase, affects the timing of marriage and childbearing. For this purpose, we exploit the introduction of short school years (SSYs) in Germany in 1966–1967, which compressed the education phase without affecting the curriculum. Based on difference-in-differences regressions and German Micro Census data, we find that SSY exposure affects the timing of marriage for individuals in all secondary school tracks and shifts forward the birth of the first child mainly for academic-track graduates. This highlights that education policies might not only affect family formation through human capital accumulation, but also through changing the duration of earlier life phases. This is important as not only age at marriage and first birth increases in many countries, but also the duration of the education phase. (JEL codes: I26, J12, J13, J24) [ABSTRACT FROM AUTHOR]

In line with the social investment principle, becoming a parent should lead to more mature behaviour and an increase in conscientiousness, agreeableness, and emotional stability. However, previous research provided mixed results that do not support this idea. Here, we used data from a nationally representative household panel study from Germany (N = 19875) to examine whether becoming a parent relates to personality maturation. Whether a child was born was assessed yearly, and the Big Five personality traits were measured in four waves from 2005 to 2017. We used multilevel analyses to investigate whether personality differs between individuals who will or will not become parents, whether personality differs before and after becoming a parent, and whether these effects vary by gender, age, and living status. In sum, our findings revealed that less open and more extraverted individuals were more likely to start a family, and openness and extraversion both decreased after the transition to parenthood. Some other effects varied by gender, age, and living status. Taken together, our findings suggest that the Big Five personality traits differ before and across the transition to parenthood and that these differences especially apply to openness and extraversion. [ABSTRACT FROM AUTHOR]

How do national-level work–life balance policies shape the role of flextime in maternal labor market re-entry after childbirth? It is well known that such policies influence the adoption, provision, and support of flexible work arrangements by organizations, but whether they shape the relevance of these arrangements for workers has been neglected in past research. This article analyzes whether mothers' and partners' flextime facilitates maternal labor market re-entry after childbirth in Germany, where family policy reforms have been implemented in the last two decades. Event history analysis based on German Socio-Economic Panel (SOEP) data from the years 2003–2013 revealed that mothers were more likely to re-enter the labor market if they had used flextime before childbirth. However, this effect existed only before the implementation of family policy reforms, namely the introduction of parental leave in 2007 and the expansion of public childcare. Moreover, the use of flextime before childbirth did not encourage mothers to maintain previous work hours (the legal right to work part time has existed in Germany since 2001). Partners' use of flextime before childbirth was found to be less relevant for mothers' return to work after childbirth. The analysis indicates that generous national-level work–life balance policies can diminish the effectiveness of organizational work–life balance policies for mothers' employment behavior. [ABSTRACT FROM AUTHOR]

Does part-time work support first-time mothers’ employment by providing a stepping-stone into full-time work in Germany? Using data from the German Socio-Economic Panel from 1984–2012, this study compares three different age cohorts of first-time East and West German mothers to investigate whether there has been any convergence between East and West Germany in the way women use part-time employment. Results show that mothers in West Germany in all cohorts tended to remain in part-time employment for longer periods than those in East Germany. Part-time employment more often provided a stepping-stone into full-time employment in East Germany than in West Germany. East German women who gave birth after reunification were less likely than older cohorts to experience a transition from part-time to full-time work. Thus, part-time employment not followed by subsequent full-time work has become more common in the East. [ABSTRACT FROM PUBLISHER]

As a result of strong financial incentives created by the German parental leave reform on January 1, 2007, some 1000 births have been shifted from the last days of 2006 to the first days of 2007, especially by working mothers. This fact is already described in the literature, yet there is no evidence as to the mechanisms and only scarce evidence regarding the effects on newborn health. I use new data to study the timing of C-sections and the induction of births around the day the reform took effect. I estimate that postponed C-sections and inductions account for nearly 80 % of the pre-reform shortfall and nearly 90 % of the post-reform excess number of births. Despite concerns voiced by doctors before the reform, hardly any evidence can be found for detrimental health effects of those shifts, as measured by changes in gestational age, birth weight, APGAR scores, neonatal mortality, or hospitalization. [ABSTRACT FROM AUTHOR]

The past few decades have seen a considerable increase in caesarean section rates, which have now reached unprecedented levels. Concerns have been raised about the possibility of medically unnecessary procedures having negative consequences for mothers and infants (WHO, 2015). The aim of this report is to show that a properly implemented hospital-level policy may be a powerful tool for reducing the rates of unnecessary C-sections without inflicting harm on mothers or newborns. Reducing the rates of unnecessary procedures helps lower the excessive healthcare costs that present a major concern for public policy. This report analyzes the implications of a 2005 reform introduced in the Italian region of Piedmont that increased malpractice pressure and reduced C-section rates. Empirical evidence indicates that this reform led to a 2.3 percentage point (approximately seven percent at the mean of C-sections) reduction in the use of C-sections in treated hospitals. This suggests that physicians will also alter their behavior in response to hospital-level policies-- even though such policies do not directly influence individual insurance liability. Presuming that C-section rates in Germany are partially influenced by economic and legal incentives, the Italian findings imply that increased malpractice pressure may also reduce the C-section rates in Germany, which currently exceed 30 percent--a share that is ten points higher than it was in the early 2000s. Should Germany implement a similar reform to the one introduced in Piedmont, one might expect positive effects in terms of reducing healthcare costs without affecting healthcare outcomes. This expectation presumes that there are a sufficient number of practitioners who can competently assist in a natural delivery. [ABSTRACT FROM AUTHOR]

The struggle that women face in reconciling their work and family roles is one of the main explanations proposed for the rapid decline in fertility rates in some developed countries. This study examines the role of the outsourcing of housework in reducing such role incompatibility and in increasing fertility among women in Germany-a country with below-replacement fertility rates, which enacted a series of large-scale schemes from the beginning of the 1990s that give incentives to households to outsource housework. Based on Goode's role strain theory and by using data from the German Socio-Economic Panel, this study analyzed whether women who outsourced housework after the birth of their first child had a higher probability of having a second child. A survival analysis of 3990 person years demonstrates that, controlling for observables, the outsourcing of domestic labor is positively associated with a higher probability of a subsequent second birth in German women. [ABSTRACT FROM AUTHOR]

Fertility decisions typically involve two persons. This raises the question of how individual desires or preferences for further children transform into joint action. Previous research has proposed different approaches to this question, emphasizing gender, joint utility, consensus, or bargaining power. We use data from the German Family Panel (pairfam) to test competing hypotheses found in the literature. Our results show symmetrical effects of both partners’ desires and expected utilities for children on proceptive behaviour, indicating that neither women nor men dominate fertility decisions per se. Instead, it is joint utility that matters. One partner will exercise a ‘veto’ only if the expected loss of utility from a further child is very high. When partners have opposed desires, bargaining power due to advantageous partner market conditions can play a pivotal role for imposing one's will on the partner. [ABSTRACT FROM PUBLISHER]

Iyer and Velu (2006) have convincingly argued that contemporary analyses of fertility behaviour fail to explain why a woman (or a couple) will choose to postpone childbirth, and in particular to consider the role of uncertainty in this regard. They have addressed this lacuna in the literature by using a real options approach to model fertility decisions by relating uncertainty experienced by individuals to the likelihood of childbirth. However, they did not present empirical evidence. Since the theory implies the existence of two offsetting effects of uncertainty on fertility decisions, a positive insurance effect and a negative option value effect, it is not easy to reject the theory on the basis of empirical analysis, when one of these effects offsets the other. We construct such a test for East (and also West) Germany during that country's reunification, which takes advantage of the fact that because of the country's strong welfare system, the insurance effect should be dominated by the option value effect, thereby suggesting that the net relationship should be negative. The results provide rather strong support for the real options link, especially for Eastern Germany. [ABSTRACT FROM AUTHOR]

Using data from the German Socio-Economic Panel, we investigated the role of childbearing history in later-life health and mortality, paying particular attention to possible differences by sex and region. Higher parity is associated with better self-rated health in West German mothers and fathers aged 50+, but its relationship with East German women's physical health and survival is negative. Early motherhood is paralleled by poorer physical health in West Germany, whereas late motherhood is associated with lower psychological well-being in Eastern Germany. Moreover, among West German women, having had a non-marital first birth is weakly correlated with poorer physical health. Our findings support the notion of biosocial pathways playing an important role in shaping the fertility-health nexus. Specifically, the West German 'male-breadwinner' model of specialization appears to have buffered the stresses associated with childrearing, whereas fertility off the 'normative' life-course track appears to have had adverse effects on women's health in West Germany. [ABSTRACT FROM AUTHOR]

The negative effect of childbirth on mothers' labour supply is well documented, though most studies examine only the short-term effects. This study uses retrospective life history data for Germany, the Netherlands and Great Britain to investigate the long-term effects of childbirth on mothers' labour supply for successive birth cohorts. Probit estimates with correction for selection into motherhood and the number of births show strong drops in participation before first childbirths and strong recovery after the birth of the last child, especially in Great Britain. Younger cohorts display a less sharp decline in participation around childbirth and a faster increase in participation in the 20 years after childbirth, especially in the Netherlands. However, mothers' participation rates do not return to pre-birth levels in any of the countries studied here. Labour market conditions and institutional public support seem to contribute to explaining the cross-country variation in participation after childbirth. [ABSTRACT FROM AUTHOR]

Martin Luther's views on disability have been widely misapprehended and caricatured on the basis of a few items in a dubious edition of shorthand notes of conversations. His written and spoken arguments across 30 years (1517-1546) concerned with childbirth and infancy, devils, superstitions, changelings, prodigies, folly, disablement, deafness, participation in Christian sacraments, and exegesis of Biblical texts on disabled people, give a more reliable and interesting guide to his views, in the context of Luther's personal involvement with sickness, disability and practical care. Historically, European social and religious developments contained a broader range of views on disability than is commonly supposed, with some challenges for 21st century thought and practice. [ABSTRACT FROM PUBLISHER]

Examination of the reproductive histories of a sample of German married couples during the 18th and 19th centuries provides insights into behavioral changes involved in the shift from natural fertility to deliberate marital fertility control. A simple accounting scheme is used to assess the relative contributions of starting, spacing, and stopping to changes in family size during the initial phases of the fertility transition. The results suggest that in rural Germany, attempts to terminate childbearing prior to the end of the reproductive span were far more important in initiating the onset of fertility transition than efforts to deliberately prolong intervals between births or changes in the timing of the start of childbearing. [ABSTRACT FROM AUTHOR]

Objectives. The influence a job—including its physical and psychological aspects—has on pregnant woman's chances of delivering prematurely. Methods. Seven hundred and seven women who had given birth participated. Statements regarding her job and its stresses were obtained with a standardised questionnaire. Results. Two hundred and thirty-seven of the 707 women delivered prematurely (<37 weeks), 471 at term. No increased incidence of premature deliveries was observed in working mothers or found in relation to physical stress. A link was observed due to a mother's dissatisfaction with her job (p<0.001). Conclusion. With changes in the workplace and adherence to laws protecting pregnant women, effective factors are in place that help prevent premature births. A prerequisite for this is the pregnant woman's contentment with her work. [ABSTRACT FROM AUTHOR]

The article examines the effects of maternal reproductive patterns on the mortality of infants and children in Germany during the 18th and 19th centuries. The researchers discovered extensive literature related to maternal fertility which depicts the increased risks of death among children of younger and older mothers and those with a short preceding or succeeding birth interval. However, several researchers question the precise relationships of maternal reproductive patterns and child survival.