Sociological Images

Cross-posted at Family Inequality.

There’s an interesting example of how to interpret scientific results — and draw policy implications from them — from the world of birth practices and safety.

The subject of the debate is a major new study from the British Medical Journal. The study followed more than 60,000 women in England with uncomplicated pregnancies, excluding those who had planned caesarean sections and caesarean sections before the start of labor. They compared the number of bad outcomes — from death to broken clavicles – for women depending on where they had their births.

One comparison stands out in the results. From the abstract: “For nulliparous women [those having their first birth], the odds of the primary outcome [that is, any of the negative events] were higher for planned home births” than among those planned for delivery in obstetric units. That is, the home births had higher rates of negative events. The difference is large. Here’s a figure to illustrate:

The error bars show 95% confidence intervals, so you can see the difference between home births and obstetric-unit births is statistically significant at that level. These are the raw comparisons, but the home-versus-obstetric comparison was unchanged when the analysts controlled for age, ethnicity, understanding of English, marital or partner status, body mass index, “deprivation score,” previous pregnancies, and weeks of gestation. Further, by restricting the comparison to uncomplicated pregnancies and excluded all but last-minute c-sections, it seems to be a very strong result.

But what to make of it?

In their conclusion, the authors write:

Our results support a policy of offering healthy nulliparous and multiparous women with low risk pregnancies a choice of birth setting. Adverse perinatal outcomes are uncommon in all settings, while interventions during labour and birth are much less common for births planned in non-obstetric unit settings. For nulliparous women, there is some evidence that planning birth at home is associated with a higher risk of an adverse perinatal outcome.

But in what way do the results “support a policy”? The “higher risks” they found for planned home births are still “uncommon,” by comparison, with those in poor countries, for example. But the home birth risk is 2.7-times greater.

The Skeptical OB, who is a reliable proponent of modern medical births, titled her post, “It’s official: homebirth increases the risk of death.” She added some tables from the supplemental material, showing the type of negative events and conditions that occurred. Her conclusion:

“In other words, any way you choose to look at it, no matter how carefully you slice and dice the data, there is simply no getting around the fact that homebirth increases the risk of perinatal death and brain damage.”

I guess the policy options might include include whether home births should be encouraged, more regulated, covered by public and/or private health insurance, banned, penalized or (further) stigmatized.

Home birth seems safer than letting children ride around unrestrained in the back of pickup trucks, which is legal in North Carolina – as long as they’re engaged in agricultural labor. On the other hand, we have helmet laws for kids on bicycles in many places. And if a child is injured in either situation, hopefully an ambulance would take them to the hospital even if the accident were preventable.

In other words, I don’t think policy questions can be resolved by a comparison of risks, however rigorous.

Cross-posted at Jezebel.

The U.S. Census Bureau recently released a report on employment and parental leave for first-time mothers. The mean age at first birth is now 25 years. And while a few decades ago the norm was for women to quit work upon getting pregnant, from 2006 to 2008, 56.1% of women worked full time during their pregnancy, leaving work only as the due date approaches. However, this varies widely by educational level, largely because women with the lowest levels of education are less likely to be working regardless:

The graph on the left below shows how many months before the birth working women left their work; the graph on the left shows how many months after the birth they returned. As we see, over time women have stayed at their paid jobs longer and returned more quickly:

During the 2006-2008 reporting period, for the first time a majority — but a bare one, at 50.8% — of first-time mothers in the labor force used paid leave (maternity leave, sick days, etc.). Not surprisingly, access to paid leave also varied greatly by educational level, and that gap has widened significantly over time:

So nearly half of first-time mothers in the U.S. still do not have paid leave from their jobs.

PBS created an interactive program based on the data that allows you to see the patterns more clearly. You select a race/ethnicity and educational level and get a detailed breakdown of the data. For instance, here’s the info for White non-Hispanic women with a 4-year college degree or higher:

Adoption is a complicated system that both builds and separates families, frequently across lines of social privilege.  It involves ideas about who society believes should be parents and under what conditions we believe children should be raised.  And, as adoption becomes more open, it also becomes a lifelong process of constantly redefining family.  Unsurprisingly, most television representations fall short of representing adoption with the nuance it deserves. Many, such as Glee, Parenthood, 16 and Pregnant, and Teen Mom, present problematic portrayals of adoption.

ABC’s Once Upon a Time involves dual plotlines: one story evolving in fairytale-land, the other taking place in Storybrooke, Maine, where fairytale characters are trapped and unaware of their past identities.  While the series’ story arc is extremely complicated, suffice it to say that the main character is a birth mother, Emma, whose son was adopted by Regina.  Regina, is — quite literally — the Evil Queen, poised to do epic battle with Emma.  Regina actively threatens and insults Emma in her attempt to exclude her from their shared son’s life; Emma, who is presented as the hero, blatantly ignores Regina’s wishes and develops a secretive relationship with Henry:

The message is clear: birth and adoptive parents are opposing parties, with a child’s attachment to one serving as a threat to the other.  Representations such as these make open adoption, or any type of cooperative and supportive relationship between the parents, seem like such an oddity, even as it becomes more of the norm within adoption communities.

In the video, Regina presents Emma as an unfit mother who cavalierly “tossed him away,” leaving her to do the hard work of parenting. Her remark, “who knows what you’ve been doing,” further presents Emma as unfit, presumably living a lifestyle that precludes her from any claim as a loving mother.

However, on a more recent episode, Once Upon a Time delved into explored adoption from a bit of a different angle. Emma assisted a character who was being coerced into giving her child up for adoption. Despite the many layers and plot devices, this example is one of very few mainstream media representations of a manipulative adoption.  Ashley is told she can’t parent, that she shouldn’t parent, that her daughter would have a better life if someone else parented her; ultimately, she’s subjected to financial coercion. It’s left up to Emma — herself a birth mother — to convince Ashley that if she wants to parent, she should take control of her own life and do so.

So often adoption is represented purely as a joyful resolution, with a focus on a family being formed.  But the complex realities behind adoption can’t be ignored in favor of only considering the happy ending.  Ann Fessler’s The Girls Who Went Away: The Hidden History of Women Who Surrendered Children for Adoption in the Decades before Roe v. Wade, shows how, before abortion was legal and single motherhood was visible, young, unmarried, pregnant women were subjected to the same manipulation and coercion that Ashley deals with on Once Upon a Time.  And these abuses aren’t just things of the past; even today many young women end up placing children for adoption because they simple can’t navigate through barriers like classism and sexism that set up adoption as a fundamental way to “redeem” herself for the “sin” of being unmarried and pregnant.

More nuanced portrayals of adoption could make viewers questions their presumptions about who birth mothers are, why they make the choices they do, and what their lives look like afterward, as well as how adoption can work.  Once Upon a Time, then, both gives and takes: it allows viewers to more carefully consider the power dynamics behind adoption, while at the same time clinging to old ideas of birth and adoptive parents in opposition.  These are challenges first mothers deal with every day: how do they do the work of openness in a world where their relationship with their child’s adoptive family is still viewed as suspect?  Forming a lifelong relationship with strangers and finding a balance of contact that meets everyone’s needs is complicated enough, without images everywhere portraying openness as, at best, an unnecessary oddity, and, at worst, a threat to the child or adoptive family.

How can birth and adoptive parents form beneficial relationships if we frame their interests as mutually exclusive, and consistently portray them as alternately undermining and being threatened by each other? While Once Upon a Time is far from the careful discussion adoption deserves, it does perhaps move us closer to a world where more productive dialogues around the issue are not a fairytale.

———-

Gretchen Sisson recently completed her doctorate at Boston College, and is currently working as an independent researcher and freelance writer. Her work focuses on the “right” to parenthood: who has it, why some don’t, and how society enforces its ideal of an acceptable pursuit of parenthood. To examine these questions, her qualitative research has examined couples pursuing infertility treatments, teen parents and teen pregnancy prevention frameworks, and parents who have placed (voluntarily or otherwise) infants for adoption.  For December and January, she’ll be writing on social class and inequality in popular culture for Bitch Magazine’s blog.  You can find her on Twitter @gesisson.

If you would like to write a post for Sociological Images, please see our Guidelines for Guest Bloggers.

The image below is an advertisement for Essure, a sterilization procedure for women. It vividly illustrates the heterosexual male gaze in the marketing of birth control: the female observes his leisure experience, while their children play in the background. She sits upright, supporting his head as he lays with his eyes closed. The male’s need to avoid “worrying about unplanned pregnancy”, so he can relax and enjoy a day in the park, takes priority, despite the fact that this procedure permanently modifies the female’s body.

The following video uploaded by Essure offers a more blatant effort to use male perspectives in their marketing:

Using male fears about having their scrotums operated on, the appeal of female sterilization over vasectomies is made clear. “Let’s face it: when it comes to their balls, guys just don’t have any… Essure: because you can only wait so long for him to man up.” While the narrator is addressing potential female consumers, the gaze is again fixed on the (unwanted) male experience of sterilization.  Her experience of the surgical and emotional process of sterilization is erased, meanwhile indulging men’s fears is used as justification for forcing women to take responsibility for birth control.

With all the emphasis on Halloween, you may or may not have heard that this year, October 31st was noteworthy for another reason: according to the United Nations, that’s the day the global population hit 7 billion. The UN has set up a website to provide information about population trends and estimates for the future. Here’s the current world population, by region:

The map is interactive, so you can click on a region to find out its population, as well as its percentage of the total world population.

You can also estimate the population through 2100 based on various fertility scenarios. In the default medium scenario, fertility is expected to follow past trends, leveling out at a little over 10 billion by 2100:

On the other hand, if we saw no further reductions in global fertility, the 2100 population would be over 26.8 billion:

There’s an enormous amount of data available at the site. For instance, if you select the Births tab, you can click on either a region or a specific country and find out what percent of births are to women in different age groups. Here’s the % of all births to women aged 15-19, by country:

And the chart showing the total age breakdown for Finland (at the site you can hover over the graph to get the actual %):

A chart of deaths by age and sex, illustrating the continued high mortality in infancy and early childhood:

There’s also a section of the site where you can enter information about your own date and place of birth and then get a snapshot of what the global population was when you were born. Since I entered the world:

Overall, it’s a pretty great resource, and another one of those websites that can easily eat up a significant amount of your time without you realizing it.

Cross-posted at Ms. and Jezebel.

In a previous post I’ve argued against framing a preference for boy children as “culturally Asian.” New data from Gallup, sent in by Kari B., shows that this preference is alive and well among Americans, at least among young men.  While women are most likely to have no opinion and about equally likely to prefer a girl or boy, men are significantly more likely to prefer a boy.  This preference is strongest among younger men, but still present among men over 50.  Whereas women become increasingly indifferent with age and, secondarily, begin to prefer girls.

The editors at CNN note that, since children are mostly born to young people, and indifferent women may bend to men’s preferences, new sex selection technologies threaten to create a gender imbalance in the U.S.

Cross-posted at Scientopia.

As demonstrated by some figures posted at Family Inequality, the U.S. birthrate has dropped during the recession:

But the birth rate hasn’t dropped for all American women equally.  Women who’ve already had two children were most likely to skip having a child during this period, and women who already had one child were more likely to delay or end childbearing than women with no children.   But women who already had three children were relatively ready to plow forward with a fourth, even more ready than childless women.

To make an even stronger case that the recession inhibited childbearing, Philip Cohen correlated birth data by state and state unemployment rates (both from the Bureau of Labor Statistics).  His figure shows that “fertility fell more where the recession hit harder”:

Great stuff, as always, from Family Inequality.

—————————

Lisa Wade is a professor of sociology at Occidental College. You can follow her on Twitter and Facebook.