Fertility intentions and child health in India: Women's use of health services, breastfeeding, and official birth documentation following an unwanted birth.

This study examines the relationship between women's prospective fertility intentions and child health, measured via access to healthcare facilities for children and postpartum maternal behaviors that are indicative of future child health. We analyze two waves of nationally representative data (2005 and 2012) from the India Human Development Survey (IHDS). The analytic sample includes 3,442 non-pregnant, currently married women aged 18-40 in 2005 who participated in both rounds of the IHDS, and had at least one birth between 2005 and 2012. We investigate the influence of women's prospective fertility intentions on access to benefits from the Integrated Child Development Services (ICDS), indicators of breastfeeding as recommended by the World Health Organization, and official documentation of births via birth certificates or registration. We find that 58 percent of births among women in the sample were labeled as unwanted. We use an adaptation of propensity score matching-the inverse-probability-weighted regression adjustment (IPWRA) estimator-and show that, after accounting for maternal and household characteristics that are known to be associated with maternal and child health, children who resulted from unwanted births were less likely to obtain any benefits or immunizations from the ICDS, to be breastfed within one hour of birth, and to have an official birth certificate. Results from this study have direct policy significance given the evidence that women's fertility intentions can have negative implications for child health and wellbeing in the short and longer term.

Unintended Childbearing and Child Growth in Northern Malawi.

Objective The study aims to assess whether unintended children experience slower growth than intended children. Methods We analysed longitudinal data linked to the Karonga Health and Demographic Surveillance Site collected over three rounds between 2008 and 2011 on women's fertility intentions and anthropometric data of children. Using the prospective information on fertility intention we assessed whether unintended children are more likely to be stunted than intended children. We applied Propensity Score Matching technique to control for endogenous factors affecting both the probability that a family has an unwanted birth and a child with poor health outcomes. Results We found that 24 % of children from unwanted pregnancies were stunted compared with 18 % of mistimed pregnancies and 17 % of those from wanted pregnancies. However, these differences in probability of children being stunted, though in the expected direction, were not significant either for large or small families, after controlling for age. The number of children in the household was associated with stunting and boys were substantially more likely to be stunted than girls. Conclusion We found no significance difference in probability of being stunted by mother's fertility intention.

Experiences of the first days of postpartum psychosis: an interview study with women and next of kin in Sweden.

The aim of this study was to explore accounts of the first days of postpartum psychosis from different perspectives, that is, that of the women and their next of kin. Interviews were conducted with seven women with postpartum psychosis and six interviews were done with the next of kin. The overall theme was Shades of Black with A Ray of Light, revealing a difficult experience of darkness, despair, and suffering. For the women, the experience cannot be shared fully other than with those who have lived through it themselves. For the next of kin, the illness is incomprehensible and it proved difficult to express in words what these relatives believe the women were going through. The women and their next of kin spoke about loss of sleep, being in an unreal world, thoughts that moved from having a wanted to an unwanted baby, being infanticidal, and having suicidal ideation. The women and their next of kin described the situations in different ways. The women gave an account of their illness in the strongest of terms, while the language used by the next of kin was much milder. The findings underscore the importance of recognizing the next of kin as key sources in early recognition of the disorder, which would make early treatment possible and support recovery.

Children abandoned and taken back: children, women, and families in dire straits in Lyon in the nineteenth century.

Abandoning a child was no rare deed in European towns in the nineteenth century, mostly among single women in underprivileged environments. On the other hand, taking this same child back was more unusual. By analyzing the registers of the Lyon hospitals, it is possible to determine the percentage of children taken back by their mothers, how this was actually achieved, and to examine the family status of the mothers at the time of both events. Both of these acts -- abandoning a child and then taking it back -- can be put back in their context in these women's lives, for instance, by looking into the length of time separating the two procedures. To finish with, it appears that the 'Hospices civils de Lyon' encouraged mothers to take the children back and generally had a conciliatory attitude toward them, supposedly in the children's interest.

Dead infants, cruel mothers, and heroic popes: the visual rhetoric of foundling care at the hospital of Santo Spirito, Rome.

The fresco cycle painted at the behest of Pope Sixtus IV in the late 1470s in the main ward of the hospital of Santo Spirito in rome comprises an extended pictorial biography of Sixtus, prefaced by scenes representing the legendary foundation of the hospital by his predecessor Innocent III. The legend, which tells how Innocent established Santo Spirito as a foundling hospital in response to the discovery of victims of infanticide in the Tiber River, positions the pope as the savior of the city's unwanted children. This article elucidates how the construction and renovation of the hospital is presented in the cycle as a generative product of papal will, with the care of foundlings situated as an integral part of the image of the pope as both Father of the Church and restorer of past glory to the city of Rome. While the frescoes engage with both widespread conventions for representing infanticide and commonplace notions of the social value of caring for abandoned children, I demonstrate that the ideologically potent visual rhetoric of foundling care was also flexible, and could be adapted to meet the specific needs of a particular institutional and patronal context.

Risky adolescent sexual behaviors and reproductive health in young adulthood.

CONTEXT: Little research links adolescent risk behaviors to reproductive health outcomes beyond adolescence, although young adults--men and women in their early 20s--bear a disproportionate burden of STDs and unintended childbearing. METHODS: To assess whether individuals who engaged in risk behaviors during adolescence had increased risk of negative reproductive health outcomes in young adulthood, data from Waves 1-4 of the National Longitudinal Study of Adolescent Health on 5,798 sexually active respondents were analyzed. Logistic and multinomial logistic regressions examined associations between risk behaviors (cumulatively and individually) and each of three outcomes. RESULTS: Four in 10 youth reported at least three risk factors during adolescence. Women who were exposed to an increasing number of risks had an elevated likelihood of having had multiple sex partners in the last year, rather than none (relative risk ratio, 1.3); having had an STD (odds ratio, 1.1); and having had an intended or unintended birth, as opposed to no birth (relative risk ratio, 1.1 for each). Inconsistent contraceptive use and having had multiple partners, a non-monogamous partner or a non-romantic partner were associated with reporting multiple partners in the last year; inconsistent use, sexual debut after age 16 and not discussing contraception with a partner were associated with having any birth. CONCLUSIONS: Teenagers' sexual behaviors have both short-term and long-term consequences, and interventions that focus on multiple domains of risk may be the most effective in helping to promote broad reproductive health among young adults.

The other woman and her child: extra-marital affairs and illegitimacy in twentieth-century Britain.

This article investigates the numbers of 'other women' and their children up until the 1960s in Britain. It analyses 'irregular and illicit unions' in the records of the National Council for the Unmarried Mother and her Child (now One Parent Families/Gingerbread), and explores evidence on these unions in the debates over the passage of the Divorce Acts of 1923 and 1937 as well as the Legitimacy Acts of 1926 and 1959. It suggests that the prevalence of illicit unions throughout the twentieth century and before allows us to question contemporary concerns about our supposed 'divorcing society' and the decline of family life in modern Britain.

[Abortion and crime]. / Aborto e crimine.

In this article we address the issue, with a tentative empirical application to the Italian data, of the relationship, very debated mainly in north America, between abortion legalization and reduction of crime rates of youth. The rationale of this relationship is that there is a causal factor at work: the more unwanted pregnancies aborted, the less unwanted children breeding their criminal attitude in an hostile/deprived family environment. Many methodological and empirical criticisms have been raised against the proof of the existence of such a relationship: our attempt to test if this link is valid for Italy cannot endorse its existence. The data we used made necessary some assumptions and the reliability of official estimates of crime rates was debatable (probably downward biased). We conclude that, at least for Italy, the suggested relationship is unproven: other reasons for the need of legal abortion have been and should be put forward.

Abandoned in Brussels, delivered in Paris: long-distance transports of unwanted children in the eighteenth century.

The study uses examinations and other documents produced in the course of a large-scale investigation undertaken by the central authorities of the Austrian Netherlands in the 1760s on the transportation of about thirty children from Brussels to the Parisian foundling house by a Brussels shoemaker and his wife. It combines the rich archival evidence with sparse indications in the literature to demonstrate that long-distance transports of abandoned children were a common but historiographically neglected by-product of the ambiguities of foundling policies in eighteenth-century Europe and provides insight into the functioning of the associated networks and the motives of parents, doctors, midwives, transporters, and local officials involved.

[Unwanted children]. / Nechtené deti.

OBJECTIVE: Aim of the study is review of knowledges about psychosocial aspects of unwanted pregnancy for child. DESIGN: Literary review. SETTING: Department of psychology, Faculty of psychology, Charles University Prague. SUBJECT AND METHODS: In our review article we give results of studies which evaluate physical, psychological and social aspects of beeing unwanted baby. Especially we show unique results of Prague study. CONCLUSION: The majority of studies confirm that unwanted children are significantly discriminated against wanted children. Unwanted children have more diseases, worse school result with identical inteligence quotient, higher frequency of nervous and psychosomatic disables and worse social adaptibility. Results of studies confirm order to find for every women safe and effective method for familly planning.

Home and parenting resources available to siblings depending on their birth intention status.

This study examines the differential availability of family and parenting resources to children depending on their birth planning status. The National Longitudinal Survey of Youth data were analyzed, 3,134 mothers and their 5,890 children (M = 7.1 years, range = 1 month-14.8 years), of whom 63% were intended at conception, 27% were mistimed, and 10% were unwanted. Fixed-effects models show that unwanted and mistimed children had fewer resources than intended siblings. Parents' emotional resources to older children decreased after the birth of a mistimed sibling. Findings suggest that cognitive and emotional resources are differentially available to children within a family depending on intention status and that unintended births lead to decreased parental resources for older children in the household.

Having a child to save a sibling: reassessing risks and benefits of creating stem cell donors.

This manuscript assesses the risks, benefits, and ethical concerns regarding the use of assisted reproductive techniques (ART) to create a new donor for stem cell transplantation. We address ethical literature, the medical and psychosocial impact on patient, donor, family, and medical caregivers, and the appropriate decision-making process. We conclude that the use of ART to create a stem cell donor can be ethically acceptable. The decision to conceive a donor has medical and psychosocial implications. The family is the appropriate decision-maker and must consider risks and benefits to all parties with input from medical caregivers.

El duelo y las fantasías de filicidio en la adopción / Mourning and filicidal fantasies in adoption

Se exponen algunas de las características de las relaciones padres-hijo en la adopción. Lo más específico es que el niño adoptado ha sufrido, de modo real, el rechazo-abandono por parte de los padres que lo engendraron. Es decir, se han hecho presentes actuaciones filicidas de los padres. Los niños adoptados también suelen actuar el interjuego filicidio/parricidio con los padres adoptivos, que son los que están a su alcance. El par "abandono-adopción" será positivo si sus términos están ligados. Pero si esos términos se desligan (se disocian), se vuelven destructivos y pueden dar lugar a ataques mutuos o a una sobreprotección que aprisiona. Se termina con dos caso clínicos, poniendo el acento en la posibilidad de hacer o no el duelo por el abandono real (AU)

This paper examines some of the characteristics of the parentchild relationships in adoption. What is most specific is that the adopted child has suffered, in a real form, the rejectionabandonment by the parents who engendered him. In other words, the filicidal behaviours of the parents have come to fore. Likewise, adopted children also enact the filicide/parricide interplay with their adoptive parents, who are the ones within their reach. The "abandonment-adoption" pair will be positive if its terms are bound. However, if such terms are unbound (dissociated), they become destructive and can give rise to mutual attacks or a trapping overprotection. The paper ends with two clinical cases presentations that focus on the possibility, or not, of working through the mourning for the real abandonment (AU)

Born unwanted, 35 years later: the Prague study.

A long-held belief among mental health practitioners is that being born unwanted carries a risk of negative psychosocial development and poor mental health in adulthood. The Prague Study was designed to test this hypothesis. It followed the development and mental well-being of 220 children (now adults) born in 1961-63 in Prague to women twice denied abortion for the same unwanted pregnancy. The children were individually pair-matched at about age nine with 220 children born from accepted pregnancies when no abortion had been requested. This article brings together in one place the theoretical assumptions and hypotheses, the criteria for selecting the study participants and major findings from five follow-up waves conducted among the children around the ages of 9, 14-16, 21-23, 28-31 and 32-35 years, plus a sub-study of married unwanted pregnancy subjects and accepted pregnancy controls at ages 26-28. To control for potential confounding factors in data interpretation, all siblings of all subjects were included in the last two waves. It was found that differences in psychosocial development widened over time but lessened at around age 30. All the differences consistently disfavoured the unwanted pregnancy subjects, especially only children (no siblings). They became psychiatric patients (especially in-patients) more frequently than the accepted pregnancy controls and also more often than their siblings. The overall findings suggest that, in the aggregate, denial of abortion for unwanted pregnancy entails an increased risk for negative psychosocial development and mental well-being in adulthood.

Perception of rearing circumstances relates to course of illness in patients with therapy-refractory affective disorders.

BACKGROUND: Qualitative aspects of childhood experiences are believed to have an impact on course in affective disorder. Does perception of parental rearing correlate to persistence of affective illness? METHODS: In retrospective life charts were recorded every previous illness episode for 38 consecutive patients with treatment-refractory affective disorder. A semi-structured interview was used for collecting information about perception of parental rearing. RESULTS: Ten patients perceived themselves as "unwanted" during childhood, and 28 as "wanted". These former were found to have a more malignant illness course, as measured by total days in illness, percent of life in illness, and illness days per episode. LIMITATIONS: The patient sample was small and the findings require replication. CONCLUSIONS: Perception of not having been wanted by parents during upbringing might be an important vulnerability factor in the persistence of depressive symptomatology into adult life.

Determinantes de la aceptación-rechazo parental / Determinants of parenteral acceptance-rejection

Un aspecto escasamente estudiado en el ámbito de la socialización familiar ha sido el análisis de los determinantes de la conducta parental. Este estudio analiza, desde un enfoque ecológico, los determinantes (individuales, familiares y sociales) de la aceptación y el rechazo parental. La muestra está compuesta por 444 padres y madres. Las variables analizadas en este estudio se corresponden con tres niveles ecológicos relevantes en la explicación de la conducta parental: sistema individual (sintomatología psicopatológica y problemas de conducta del niño), sistema familiar (clima familiar y fuentes familiares de estrés) y sistema social (fuentes extrafamiliares de estrés, apoyo social comunitario y estatus socioeconómico). Los resultados muestran la importancia de considerar factores pertenecientes a los tres sistemas de forma conjunta para explicar la conducta parental

Family socialization studies have paid little attention to the determinants of parental behaviour. This study analyzes from an ecological model individual, family, and social determinants of parental acceptance and rejection. The sample consisted of 444 parents. Variables analyzed correspond with three ecological levels explaining parental behaviour: individual system (psychopathological symptoms and child behaviour problems), family system (family environment and intra-family sources of stress) and social system (extra-family sources of stress, community support and socioeconomic status). Results underlie the importance to take into account simultaneously variables at different ecological level in order to better explain parental behaviour

A meta-synthesis of filicide classification systems: psychosocial and psychodynamic issues in women who kill their children.

Filicide is the killing of a child by a parent. To protect potential homicide victims, it is necessary to examine and identify intrapsychic and interpersonal dynamics that result in filicide. The current filicide classification systems have intended to yield better etiological understanding of the crime and ultimately lead to prevention strategies and accurate death certification. A framework of motives and precipitating factors that lead to filicide by mothers offers a starting point to examine this emotionally evocative and complex phenomenon.

Hijos especiales: ¿padres diferentes? / Special children: ¿different parents?

Es habitual que a los niños y jóvenes que presentan alguna discapacidad se los nomine como "especiales". Cabe preguntarse, desde el psicoanálisis, si cuando está en juego la discapacidad, las funciones parentales son diferentes o tienen algo de particular. En este contexto, los talleres con padres constituyen un espacio privilegiado porque ofrece la posibilidad de ligar el dolor a través del placer y la creatividad. Esto no sólo beneficia a los padres sino que enriquece la tarea cotidiana de quienes trabajamos con sus hijos

Filicidal mothers and the impact of psychosis on maternal filicide.

The objective of this study was to examine a sample (n = 55) of filicidal mothers to compare those with and without psychotic symptoms at the time of the filicide. Clinical data were gathered through retrospective chart review of filicidal women referred for criminal responsibility/competence to stand trial evaluations from 1974 to 1996 at Michigan's Center for Forensic Psychiatry. Most (52.7%) women had psychotic symptoms at the time of filicide. Women with psychosis were more likely than those without to have a history of substance abuse; to have past and ongoing psychiatric treatment; and to be older, unemployed, more educated, and divorced or separated. They were less likely to be first time mothers or to have had prior contact with Children's Protective Services. The psychotic mothers more often confessed, attempted suicide at the time of the filicide, used weapons, killed multiple children, and expressed homicidal thoughts and/or concerns about their children to psychiatrists and family before the filicide. Psychotic women were as likely as nonpsychotic women to have used alcohol or illegal drugs at the time of the filicide.