The Biomedical Subjectification of Women of Advanced Maternal Age: Reproductive Risk, Privilege, and the Illusion of Control

The biomedicalization of pregnancy prevention, neoliberal feminism, and college women's experiences of the contraceptive paradox

Research examining the "contraceptive paradox" has illuminated how contraception can be a source of empowerment for some and oppression for others. This study advances theorizing of the contraceptive paradox by illustrating how 45 young women experience contraception as both liberating and constraining due to a confluence of biomedicalization processes, gender inequality, and neoliberal feminism. Drawing on focus group data, we find that the biomedicalization of pregnancy prevention and neoliberal feminist discourse, in combination with experiences of social and economic privilege and gender inequality in fertility work, shape participants' interpretation of contraceptive technology as a key resource for individually liberating themselves from undesired pregnancy. At the same time, their experiences indicate prescription contraception plays an oppressive role in their lives. In addition to blaming themselves and their bodies for negative contraceptive side effects, participants take for granted that assuming sole responsibility for contraceptive use in their relationships with men is the price they must pay to feel free. The findings indicate that addressing a social problem using an individualized biomedical solution obscures the power that structural inequalities exert over pregnancy-capable people, including relatively privileged young women. As an expression of biopower, these dynamics prompted participants to emphasize distributive justice over social justice, foreclosing their engagement in collective action.

The right time: women, medicine and maternal age in 1980s Aotearoa New Zealand

In the late twentieth century, increasing numbers of women in wealthy nations waited until they were aged in their 30s to give birth and become parents. This article examines responses to the changing demographics of maternity among social researchers, doctors, pregnant women and mothers in Aotearoa New Zealand. The article analyses raw research data from historical social survey projects The Right Time (interviews completed in 1982-1983) and Motherhood After 30 (1987) by the grassroots organisation the Society for Research on Women in New Zealand.Surveys, statistics and increasingly direct evidence from research participants symbolised modern social life in the mid-twentieth century. Yet, in 1966, women in Wellington, New Zealand concluded that they had been largely ignored in this endeavour. A group of volunteers pledged to produce the missing data and therefore improve policy making. This article analyses the Society's publications and interview schedules to uncover how researchers, medics, pregnant women and mothers forged new connections between age, pregnancy and parenting during the 1980s. During this time, pregnant women advocated for a new model of prepared and mature maternity. A few years on, however, many among them identified the persistence of traditional gender roles that disrupted their plans. At the same time, physicians and public health officials in wealthy nations began to teach women to associate conception at older ages with increased risks, especially of genetic anomalies. Social research archives reveal tensions between these new, population-level recommendations and women's proactive approaches to planning their lives and families. New Zealand's distinctive survey records help to explain the impacts of new medical tests, reproductive technologies and public health recommendations in the context of women's fresh approaches to maternity during the 1980s.

Experiencing birth trauma: Individualism and isolation in postpartum

Approximately 25-35% of individuals report experiencing a traumatic birth in the United States. Birth trauma has commonly been focused on the experience of labor and delivery itself, with definitions frequently pointing to specific clinical interventions, interactions with providers, and individual expectations during labor and delivery. These definitions however remain too limited, assuming that birth trauma has a discrete temporality-emerging in childbirth-and largely underestimate the social and structural factors that drive trauma. Drawing from interviews conducted between November 2021 and April 2023 with thirty cisgender women who have given birth at least once in the United States, I reveal how the postpartum period is a particularly vulnerable time for trauma emergence, even when absent of difficult delivery experiences. I reveal how social and structural factors in the postpartum period trigger trauma that remains largely invisible, leaving individuals isolated. I situate these women's experiences within the sociological scholarship on trauma, (bio)medicalization, neoliberalism, and risk, to reveal a critical need to expand definitions of, and approaches to, birth trauma.

Prevalence and factors of urinary incontinence among postpartum: systematic review and meta-analysis

BACKGROUND

Postpartum urinary incontinence substantially impacts the psychophysical well-being of women. The influencing factors contributing to postpartum urinary incontinence remain a subject of contention in clinical investigation. By elucidating the factors contributing to postpartum urinary incontinence, more efficacious interventions for laboring women can be devised. Consequently, this review endeavored to scrutinize the repercussions of maternal postpartum urinary incontinence to furnish empirical references for the clinical advancement of preventive strategies.

METHOD

The investigation employed bibliographic databases: Embase, PubMed, Web of Science, Cochrane Library, CBM, VIP, CNKI, and Wan Fang Data for article retrieval. A comprehensive consideration of all study designs was undertaken during the examination of the effects of postpartum urinary incontinence. The temporal limitation was set at all articles prior to February 2023. Studies incorporated laboring mothers experiencing normative labor and parturition. A total of 28,303 women were encompassed in the reviewed investigations.

RESULTS

A total of 5,915 putative citations were identified, from which 32 articles were selected for evaluating the effects of postpartum urinary incontinence. Meta-analyses revealed that the incidence of postpartum urinary incontinence was 26% [95%CI: (21% ~ 30%)]. Twelve pivotal variables were identified to influence postpartum urinary incontinence: cesarean delivery, vaginal delivery, age ≥ 35 years, multiparty (number of deliveries ≥ 2), neonatal weight > 4 kg, perineal dystonia, antecedents of urological incontinence-related pathology, maternal pre-conception BMI ≥ 24 kg/m^2, perineal laceration, instrumental parturition, historical pelvic surgical procedures, and protracted second stage of labor. Among these, cesarean delivery was identified as a protective factor against postpartum urinary incontinence.

CONCLUSION

The study corroborated that anamnestic factors pertinent to urinary incontinence, vaginal parturitions, and neonates with a weight exceeding 4 kg serve as significant risk factors for postpartum urinary incontinence. Cesarean delivery emerged as a protective factor against postpartum urinary incontinence. Based on the prevalence of postpartum urinary incontinence, proactive intervention is requisite to mitigate the risk of postpartum urinary incontinence in postpartum women possessing these risk factors.

TRIAL REGISTRATION

CRD42023412096.