Contraceptive Use and Controlled Fertility Health Issues for Women and Children (1989) / Chapter Skim
Currently Skimming:
Psychosocial Consequences to Women of Contraceptive Use and Controlled Fertility
Psychosocial Consequences to Women of Contraceptive Use and Controlled Fertility
Pages 140-160
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 140... ...
Indeed, neither the multicountry World Fertility Survey nor the Demographic and Health Survey includes questions that would permit analysis of the relationship between reproductive behavior and psychosocial stress or disorder. In examining the health consequences for women of contraceptive use and controlled fertility, we should adopt the broadest conceptual approach in order to capture the full range of costs and benefits of different reproductive behaviors.
|
From page 141... ...
Each may also be related to or perceived and expressed as physical disorders, as, for example, when a woman anxious about whether she can provide adequate food for her children complains of dizziness, headaches, or nervous exhaustion. Depression is usually assessed by respondents' self-reported emotional symptoms, such as feelings of despair, helplessness, worthlessness, shame, being in a Elvis discussion draws generally on the literature on the connections between psychosocial stress and physical disorders, notably Levine and Scotch (1970)
|
From page 142... ...
The penalties for failure are indeed high, and they are firmly embedded in the social system. PSYCHOSOCIAL STRESS AND ROLE PERFORMANCE The relationship between social structures, social roles, gender, and psychological distress has been studied in Western populations (Barrett et al., 1987~.
|
From page 143... ...
and the nature of the overall role profile; that is, it depends on the resulting waves or ripples that flow through the "grid" of a woman's multidimensional role performance (Figure 1~. It follows that reproductive behaviors that intensify rather than reduce role strain or role conflict-particularly among those roles that a woman defines as most salient to her security and survival are likely to be perceived as the most stressful.
|
From page 144... ...
The resulting psychosocial distress may or may not translate directly into physical disorders. I suggest, however, that its effects are likely to be no less pervasive than those mortality and morbidity indicators with which we are most familiars When we consider that poverty, powerlessness, and physical illness are also identified as major sources of psychosocial stress, we can better understand how certain reproductive events interwoven as they are with other insecurities and threats-can engender such high levels of emotional disturbance, particularly among low-income women.
|
From page 145... ...
affect a woman's conjugal role performance and the levels of stress associated with her relationship with her sexual partner? Ethnographic literature from both industrialized and developing countries suggests that the conjugal relationship itself is frequently a source of psychosocial stress.5 Houston's (1979)
|
From page 146... ...
A woman's fear of unwanted pregnancy naturally extends to a fear of intercourse, but refusing sex poses its own threats and anxieties. Among a sample of women attending a family planning clinic in Lebanon, well over half said they had refused on some occasions to have intercourse during the previous 5 years because of fear of pregnancy (Chamie, 19773.
|
From page 147... ...
The extent to which such threats become personally devastating depends on her access to adaptive mechanisms such as economic resources and social support The effects of controlled fertility on conjugal roles are also pervasive. Postponing the first birth can eliminate the psychosocial stress associated with a premarital pregnancy that results in an out-of-wedlock birth or a forced marriage in which one or both partners feel trapped or the stress incurred within marriage by an early birth for which a couple is emotionally or financially unprepared.
|
From page 148... ...
It is not clear how this might be linked to the timing or number of children, however. Occupational Roles Perhaps the most clear-cut area in which contraceptive use and controlled fertility can reduce psychosocial stress is in women's educational and occupational roles.
|
From page 149... ...
In mm, whether fertility limitation actually reduces the stress of combining employment with childbearing depends on such factors as the time and locational flexibility of the job and the availability and cost of acceptable child care. Several qualifications to the generalization about controlled fertility reducing psychosocial stress associated with occupational roles are in order here.
|
From page 150... ...
A sample of educated Ghanaian women ranked the maternal role as of highest priority for their well-being (an average score of 2.9 of 3.0) and as most satisfying (2.5 of 3.0~; at the same time motherhood was associated with high levels of strain (inadequate resources of time and energy, among others)
|
From page 151... ...
In other words, the nature and severity of the stresses relating to maternal role performance are strongly related to social class and cultural expe~ctations. In addition, as Figure 1 suggests, stresses induced by maternal role strain or role conflict can be mediated by adaptive mechanisms such as social support networks (e.g., assistance from a husband or other family members with child care)
|
From page 152... ...
The domestic role refers to women's housekeeping obligations such as cooking, cleaning, washing, shopping, etc. The sample of educated Ghanaian women ranked this sixth of the seven roles in priority, the lowest in derived satisfaction, and the highest in role strain (inadequate time, energy, and money)
|
From page 153... ...
We might include women's concerns about who will support and take care of them in their old age under the general topic of kin roles, although such concerns relate more specifically to the maternal and conjugal roles. The absence of sons or daughters who are able and willing to care for an aged parent creates a strong potential for anxiety or depression among women without alternative means of support.
|
From page 154... ...
In some respects it could act in a manner similar to women's occupational roles. In other respects, however, having more rather than fewer children could encourage community involvement, given that many community activities are child related and children often involve adults in social interactions that transcend other roles.
|
From page 155... ...
in her role profile. Where opportunities are plentiful and priorities high, fertility limitation should reduce individual role strain and thus the stress engendered by having "no time for myself' or wondering "who am I?
|
From page 156... ...
Women may consequently experience considerable anxiety about their worth as persons if their reproductive behavior deviates significantly from the social norms of their group. Once again, however, psychosocial stress can be diluted by the adaptive mechanisms identified In Figure 1.
|
From page 157... ...
Reproductive behaviors that intensify rather than reduce role strain or role conflict, particularly among those roles that a woman defines as most salient to her security and survival, are likely to be the most stressful. Negative outcomes may be reduced or avoided by adaptive mechanisms such as social support networks, economic resources, information, and structural changes that alleviate role strain or conflict and the resulting psychosocial stress.
|
From page 158... ...
1987 Organizing for Elective Family Planning Programs. Washington, D.C.: National Academy Press.
|
From page 159... ...
Polgar, eds., Culture, Natality, and Family Planning. Chapel Hill: Carolina Population Center, University of North Carolina.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.