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BackgroundWomen’s fears and attitudes to childbirth may influence the maternity care they receive and the outcomes of birth. This study aimed to develop profiles of women according to their attitudes regarding birth and their levels of childbirth related fear. The association of these profiles with mode and outcomes of birth was explored.MethodsProspective longitudinal cohort design with self report questionnaires containing a set of attitudinal statements regarding birth (Birth Attitudes Profile Scale) and a fear of birth scale (FOBS). Pregnant women responded at 18-20 weeks gestation and two months after birth from a regional area of Sweden (n = 386) and a regional area of Australia (n = 123). Cluster analysis was used to identify a set of profiles. Odds ratios (95% CI) were calculated, comparing cluster membership for country of care, pregnancy characteristics, birth experience and outcomes.ResultsThree clusters were identified – ‘Self determiners’ (clear attitudes about birth including seeing it as a natural process and no childbirth fear), ‘Take it as it comes’ (no fear of birth and low levels of agreement with any of the attitude statements) and ‘Fearful’ (afraid of birth, with concerns for the personal impact of birth including pain and control, safety concerns and low levels of agreement with attitudes relating to women’s freedom of choice or birth as a natural process). At 18 -20 weeks gestation, when compared to the ‘Self determiners’, women in the ‘Fearful’ cluster were more likely to: prefer a caesarean (OR = 3.3 CI: 1.6-6.8), hold less than positive feelings about being pregnant (OR = 3.6 CI: 1.4-9.0), report less than positive feelings about the approaching birth (OR = 7.2 CI: 4.4-12.0) and less than positive feelings about the first weeks with a newborn (OR = 2.0 CI 1.2-3.6). At two months post partum the ‘Fearful’ cluster had a greater likelihood of having had an elective caesarean (OR = 5.4 CI 2.1-14.2); they were more likely to have had an epidural if they laboured (OR = 1.9 CI 1.1-3.2) and to experience their labour pain as more intense than women in the other clusters. The ‘Fearful’ cluster were more likely to report a negative experience of birth (OR = 1.7 CI 1.02- 2.9). The ‘Take it as it comes’ cluster had a higher likelihood of an elective caesarean (OR 3.0 CI 1.1-8.0).ConclusionsIn this study three clusters of women were identified. Belonging to the ‘Fearful’ cluster had a negative effect on women’s emotional health during pregnancy and increased the likelihood of a negative birth experience. Both women in the ‘Take it as it comes’ and the ‘Fearful’ cluster had higher odds of having an elective caesarean compared to women in the ‘Self determiners’. Understanding women’s attitudes and level of fear may help midwives and doctors to tailor their interactions with women.

Participatory ergonomics is reported in an increasing number of case studies, but there is little evidence of emerging supportive theory and relatively little generic advice or guidance. The paper describes an effort to provide clarity and organization to the field of participatory ergonomics. A framework has been developed to define a range of different participatory ergonomics initiatives, establishing a number of levels at which to operate. This participatory ergonomics framework (the PEF) was validated through retrospective description of seven independently conducted case studies and through peer evaluation. The exercise suggests that the PEF can be used as a first basis to produce practical guidance on participatory ergonomics programmes.

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Objective: The objective of this study was to evaluate attachment and its association to obstetric and demographic factors as well as emotional well-being using a standard measure of prenatal attachment during pregnancy. Background: The strength of the mothers' relationship with her baby has important implications in the postnatal period, influencing the relationship she develops with her child, and the quality of the care she provides. Methods: This was a population-based longitudinal survey comprising a consecutive sample from a one-year cohort in a Swedish county. In this study the three subscales of PAI-R (Prenatal Attachment Inventory -Revised) were used for evaluation of attachment. In total, 718 pregnant women participated in this study. Results: Women with elevated levels of depression (HADS-D > 8) recorded lower attachment scores across all three PAI-R subscales. Lack of perceived support from partner was associated with lower scores on Interaction. Lack of support from own mother and own father were also associated with lower scores on all subscales. Attachment was also associated with feelings about the approaching birth and about the first weeks with the newborn, with women who reported less than positive feelings recording lower scores on each of the PAI-R subscales. Conclusion: A focus on attachment during antenatal care and the use of PAI-R during pregnancy provides a means of identifying those women who show lower levels of attachment and possible emotional problems that may impact on emotional health and the birth process.

Marsupials occupy a phylogenetic middle ground that is very valuable in genome comparisons of mammal and other vertebrate species. For this reason, whole genome sequencing is being undertaken for two distantly related marsupial species, including the model kangaroo species Macropus eugenii (the tammar wallaby). As a first step towards the molecular characterization of the tammar genome, we present a detailed description of the tammar karyotype, report the development of a set of molecular anchor markers and summarize the comparative mapping data for this species.