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Objective To gain an understanding of womens' views surrounding decisions on the timing of childbearing. Study Design This study was based on interviews with 18 childless women, from North-West England, in three age groups: Six women aged between 18 and 24; Six women aged between 25 and 34; and six women aged 35 or more. Data were analysed using a hermeneutic phenomenological approach with thematic analysis. Results Three main themes were identified. Women perceived themselves as living within boundaries , defined internally and externally; they aspired to being a great mother or no mother ; and had a desire to contribute to family and society, at multiple levels. Risks associated with delaying childbearing had little or no influence on decision-making. The overarching phenomenon was social comparability; decisions were made in the context of women's knowledge and perceptions of others and a high degree of critical self-evaluation. Conclusion We conclude that social reality dominates womens' reproductive decisions. Whilst the biological reality is that fertility reduces and medical complications increase with maternal age, social discourses deter women from acknowledging this. Medical risks associated with advanced maternal age are undermined by the notion that women can choose when to start a family. [ABSTRACT FROM AUTHOR]

Objectives Despite increased risks of infertility and poor outcomes, women in high-income countries are increasingly deferring pregnancy beyond age 35.The underlying causes are incompletely understood. The mass media is recognised as a powerful influence on health-related behaviour; therefore media representations warrant critical examination. Study design Qualitative thematic analysis of portrayals of pregnancy and birth in women over 35 in UK national newspapers, popular magazines and television programmes Results Extensive media interest in childbearing and a preponderance of coverage related to celebrities was confirmed. Three main themes were identified; delayed childbearing was portrayed positively, as part of a life plan allowing women have the “best of both worlds”. The media did not acknowledge age per sé as an obstacle to pregnancy and endorsed reproductive technologies suggesting ‘it's never too late’. Images and descriptions of ideal post-pregnancy bodies in women over 35 reinforced the message that “you can regain your beautiful body”. Conclusion Delayed childbearing was represented positively, as it facilitated conformity with dominant ideologies surrounding motherhood. Within these boundaries, the effects of age were disregarded. This study provides evidence of restrictive framing of the issues surrounding delayed childbearing in the UK media which militate against communication of important public health messages. [ABSTRACT FROM AUTHOR]

Background: perineal suturing is a common event which affects women across a variety of international settings. Women have expressed pain related to perineal trauma in the postnatal period but little is known about pain during suturing. In addition, there is a lack of evidence to identify how professional decisions are made about pain management during the suturing process. Objective: to explore women and clinician's response to pain during the suturing of second degree tears and episiotomies. Design: mixed method feasibility study which included observation, questionnaires and interviews. Setting: a Hospital Trust in Northwest England. Participants: 40 women and 21 clinicians participated. Measurements and findings: mild, moderate and severe pain was measured via the McGill Pain Questionnaire-Short Form (MCPQ-SF). Psychological distress was identified via the Hospital Anxiety and Depression Scale (HADS). Semi-structured face to face interviews identified three themes, Psychological distress and future functioning; Variation in practice and Style of communication. Key conclusions: women who experienced psychological distress during previous or current childbirth scored higher on HADS and MCPQ-SF, and appeared to express more concerns about future functioning and healing. Variation in practice exists and style of communication had the potential to make the difference for women. Implications for practice and research: the process of suturing is complex and is not a standalone event for a woman. It is crucial that health professionals consider previous and subsequent experience of perineal suturing. Future research aims to develop a decision tree to support pain management during suturing. [ABSTRACT FROM AUTHOR]

Introduction: maternal obesity [body mass index (BMI)≥30 kg/m2] is a cause for concern because of increasing rates and risk of associated complications. However, little is known about how to improve the health of women with a BMI≥30 kg/m2. Objective and methods: a 10-week antenatal lifestyle programme (The Lifestyle Course -- TLC), underpinned by behaviour change theory, was developed in a programme of research which included a prospective, multicentred, feasibility phase (n=227). Participants had a BMI≥30 kg/m2 at the start of their pregnancy, planned to deliver in two areas of Greater Manchester and were aged 18 or over. The objectives were to (1) assess the feasibility of the intervention and (2) to pilot the trial processes and outcome measures. Findings: (1) Trial intervention: only 22% of women in the feasibility phase had received gestational weight advice prior to the study. One or more TLC sessions were attended by 79% of women and 97% said they would recommend TLC to a friend due to the content suitability, perceived personal gains and extra care received. Changes to the TLC were suggested and implemented in the pilot phase. (2) Trial processes: recruitment rates (36%), retention rates (100%) and questionnaire completion rates up to one year (33%) were found. Daily general ‘lifestyle’ diaries and pedometers were not acceptable data collection tools (response rates of 32% and 16% respectively). However, specific food diaries were acceptable (response rates of 80–81%). The major challenge was the collection of maternal weight data at the follow-up points. Conclusions and implications: the antenatal intervention (TLC) designed for this programme of work appears to suit the needs of women with a BMI≥30 kg/m2. The need for an antenatal intervention is clear from this study and also highlights reflections on effective communication with pregnant women with a BMI≥30 kg/m2. Lessons learnt for designing a future trial include effective ways to communicate with pregnant women with a BMI≥30 kg/m2. Trial registration: ISRCTN29860479. [ABSTRACT FROM AUTHOR]