Problems in the Latina paradox: measuring social support for pregnant immigrant women from Mexico

The Interaction and Impact of Social Support and Father Absence on Breastfeeding

Background: Behaviors related to early childhood nutrition are influenced by a mother's social environment. In many low- and middle-income countries, breastfeeding rates have steadily declined. At the same time, many communities have a history of domestic or international migration that affects the family support systems for women and children remaining in these communities. While social support has been shown to be important to health behaviors conducive to maternal and child health, scant research examines whether social support moderates the impact of an absent father on breastfeeding. Objective: We aim to assess the relationship between father absence and breastfeeding duration and test whether social support moderates the impact of father absence on breastfeeding duration. Methods: We use data from the Social Networks and Health Information Survey (n = 292), a random household survey conducted in a municipality in Guanajuato, Mexico, to estimate Poisson regression models of breastfeeding duration. Results: In multivariate models, an absent father is negatively associated with breastfeeding, whereas social support is positively associated. A significant and positive interaction between father absence and social support suggests that at high levels of support, breastfeeding duration for women with absent fathers does not appear to be meaningfully different from women with present fathers. This suggests that receiving high levels of social support during pregnancy may mitigate the absence of the child's father. Conclusions: Social support interventions for mothers of infants should target mothers and children in households without a father. More research should also be directed at understanding how social support processes during pregnancy can affect breastfeeding in other low- and middle-income countries with high rates of emigration.

Social Support and Perinatal Depression: The Perspectives of Mexican-American Adolescent Mothers

Perinatal depression is estimated to affect one in seven pregnant women. As such, social support has been shown to impact the mental health of women during the perinatal period. The purpose of this qualitative descriptive study was to examine the types of social support received by pregnant and parenting Mexican-American adolescent mothers and their perceptions of how it can influence perinatal mental health. Deductive content analysis was used to analyze the data using emotional, instrumental, and informational support as primary categories. Positive and negative aspects of the adolescent's social network were also included to understand how individuals impact their mental health. A convenience sample of 20 perinatal Mexican-American adolescents were interviewed. Emotional support, such as encouragement and affirmation, as well as instrumental support, via financial assistance and help with infant care, were primarily sought from significant others, which consisted of family members and their partner. Having strained relationships with their significant others primarily contributed to emotional distress. Health care providers were often sought out for informational support concerning perinatal depression. However, some adolescents were unable to establish rapport with their health care provider, making it difficult to inquire about pertinent mental health information. Study findings suggest that identifying support needs and expectations is an important component of facilitating positive mental health outcomes for Mexican-American adolescent mothers. Future efforts to promote mental health and prevent perinatal depression among Mexican-American adolescent mothers should consider integrating a strong focus on social support.

A Qualitative Description of Pregnancy-Related Social Support Experiences of Low-Income Women with Low Birth Weight Infants in the Midwestern United States

Objective Low birth weight (LBW) is a significant health problem in the United States, and the incidence is higher in women with low socioeconomic status. Observational and epidemiological studies have revealed that social support reduces the risk of adverse pregnancy outcomes. However, the current literature lacks research regarding the perceived social support of pregnant women in relation to birth weight from a qualitative perspective. This study explored the perceptions and experiences of social support during pregnancy among low-income women who had recently given birth to a LBW infant. Method A qualitative descriptive design was used to explore women's social support experiences during pregnancy. The sample comprised 15 women who had given birth to a LBW infant within the past 9 months from the five urban and rural WIC clinics in the Midwest United States and a university hospital neonatal clinic. In-depth semi-structured interviews were used to collect data. Results Three themes emerged: women's experience of pregnancy; challenges faced by women during pregnancy; and availability of essential supports for women during pregnancy. The father of the infant and female relatives were identified as major sources of support during pregnancy, and the women in the sample expressed a desire to obtain social support from family and friends. Conclusion for Practice Women from low socioeconomic backgrounds face various challenges that could adversely affect birth outcomes. Social support may minimize the impact of adverse life situations. Providing adequate social support requires addressing the multiple dimensions of social support and strengthening the existing support system.

Healthy foods prepared at home: Diet and support as protective strategies during pregnancy for Hispanic women

Birth outcomes tend to be better among Hispanics than among other ethnic groups, even when matched for poverty and education, and foreign-born Latinas compared to their US-born counterparts. These patterns suggest that sociocultural factors exhibited by recent immigrants have the potential to protect birth outcomes against the instability of minority and low socioeconomic status. To discover potential sociocultural factors, a pilot qualitative study was carried out in Tucson, Arizona, with 18 Hispanic mothers. The two most prevalent factors reported were (1) a healthy diet prepared at home from minimally processed ingredients, and (2) constant and comprehensive social support. When comparing responses related to diet by interview language preference, a proxy for acculturation, there was very little difference between participants who interviewed in Spanish and those who interviewed in English. This result may be explained by greater maternal social support and higher education levels among those who interviewed in English.

Systematic Review of Immigrant Women's Experiences With Perinatal Care in North America

OBJECTIVE

To understand the perinatal care experiences of pregnant immigrant women in North America.

DATA SOURCES

We searched five electronic databases: MEDLINE, PsycINFO, SocINDEX, CINAHL, and Social Work Abstracts. Two categories of search terms, pregnancy and immigrant, were used to conduct a title/abstract and subject heading search. We manually searched the reference lists of all relevant articles to identify additional articles.

STUDY SELECTION

Inclusion criteria were qualitative or mixed methods study design, focus on immigrant women's experiences of accessing perinatal care, and data collection in North America. Two reviewers were involved in a three-stage selection process: title/abstract screen, full text review, and data extraction and quality appraisal.

DATA EXTRACTION

Data on authors, date, location, methodology, sample characteristics, data collection, and themes or topics were extracted from 19 articles.

DATA SYNTHESIS

We followed the Thomas and Harden (2008) thematic synthesis methodology, which involved a three-stage data analysis approach: free line-by-line coding, organization of free codes into descriptive themes, and construction of analytical themes. We developed three meta-themes from the 19 articles included in our review: Expectations of Pregnancy as Derived From Home, Reality of Pregnancy in the Host Health Care System, and Support.

CONCLUSION

Immigration is a relevant issue in North America, and pregnancy can be an entry point into the health care system for immigrant women. We provide relevant information for health care providers, policy makers, program planners, and researchers about opportunities to explain models of health care delivery, improve communication, and facilitate social support to improve the experiences of immigrant women who interact with the health care system during pregnancy.

Refugee and Immigrant Women’s Experience of Postpartum Depression: A Meta-Synthesis

The aim of this work is to synthesize qualitative research on refugee and immigrant women’s experiences of postpartum depression (PPD) to gain insight into the unique needs of this group of women. This population is more at risk of developing PPD due to a complexity of issues including pre- and postmigratory stressors; however, there is currently little research on this topic available to health care providers and policy makers. Thirteen articles met inclusion criteria, and five themes emerged from the meta-synthesis: (a) suffering in solitude, (b) the invisible illness, (c) cultural conceptualizations, (d) barriers to help seeking, and (e) facilitators of help seeking. Conclusions suggest immigrant women with PPD may lack understanding of their condition, are often isolated, are alone, fear stigmatization, and risk being considered an unfit mother. Raising awareness with health care providers of the meaning of PPD for immigrant women is key to the provision of effective care.

Anguish, Yearning, and Identity

The purpose of this phenomenological study was to seek a better understanding of needs and access issues among pregnant, low-income Hispanic women. Hispanic women who attended a community prenatal education program participated in follow-up focus groups to explore their experiences regarding prenatal education, pregnancy resources, access to, and satisfaction with, the care available to them. Focus groups were facilitated by a leader, bilingual in English and Spanish, with knowledge of the Hispanic culture. Sessions were audiotaped, then translated into English for transcription. Data were analyzed according to guidelines by Colaizzi and three themes emerged: pregnant Hispanic women experienced a sense of anguish ( la angustia) from questions and unknowns rampant during pregnancy, leading to a yearning ( el anhelo) to learn and understand more, but with a desire to do so without sacrificing native identity ( la identidad). Implications of these themes for improving prenatal care for this population are explored.

Getting By With a Little Help From My Friends: A Pilot Study of the Measurement and Stability of Positive Social Support From Significant Others for Adolescents

Based on research into adult social support and the ecological model of development, we sought to redefine and establish the levels and nature of support provided to Year 7 (n= 52), 9 (n= 52) and Year 11 (n= 33) adolescents over a period of 3 months. A questionnaire to identify who provided support to adolescents was developed to measure instrumental, informational and emotional support, and add siblings to the primary support network. Factor analysis confirmed the expected four-factor model of support, with parents, teachers, siblings and friends providing different levels and priorities of support. Results indicated high levels of internal consistency and test–retest reliability. Trends in the amount of social support generally showed a decrease from Time 1 to Time 2, significantly so from parents and teachers. Females indicated they received significantly more support from friends in comparison with males, regardless of year level. Year 7 students indicated significantly higher support from parents and teachers. Importantly, this study showed the general decline of social support from early to late adolescence, and the relative consistency of social support for male and female adolescents. The different types of supports provided to the individuals in the adolescents’ social network are discussed.