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To Plan or Not to Plan: Gender Perspectives on Pregnancy Planning, Fertility Awareness and Preconception Health and Care
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
2018 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The level of pregnancy planning is of importance to the well-being of parents and children. Unintended and/or unwanted pregnancies are often associated with less health promoting behavior during pregnancy, poorer health of the new born, and relationship dissatisfaction. Preconception care is a health service with the purpose to encourage people to become mindful about their reproductive intentions and raise fertility awareness, in order to maintain or improve reproductive health.

Reproductive health is a highly gendered area, both due to biological conditions and social expectations on gender. In most cases, the focus of reproductive health and health promotion is on cis-women and their bodies. This thesis mainly focuses on persons self-identifying as men. The aim is to scrutinize the area of preconception health, investigate what pregnancy planning means to men and explore the relationship between pregnancy planning and fertility awareness.

In Study I, 136 couples who attended their first antenatal visit answered questions about pregnancy planning. Most pregnancies were planned and couples had similar perceptions of the level of their planning. Study II describes pregnancy planning behavior and fertility knowledge among 796 recent fathers. Also in this study, most pregnancies were planned and 17% of the men had made at least one preconception lifestyle adjustment to improve health and fertility. Fertility knowledge varied greatly, although men with higher education demonstrated higher knowledge. Study III explores if Reproductive Life Plan-based counselling during a sexual health visit could increase men’s fertility awareness. The counselling had a moderate effect on participants’ fertility knowledge but managed to raise new thoughts about their own fertility, and was well received. Study IV follows up on the results from the first three studies, through in-depth interviews and focus group discussions with 25 men aged 23-49. Most participants took their fertility for granted. To cis-men in heterosexual relationships, the meaning of pregnancy planning usually meant taking the decision to try to become pregnant, and not much more. Trans-men and gay men where more invested in practical planning issues. In conclusion, this thesis shows how pregnancy planning is gendered, and that it is a more complex phenomenon than previously acknowledged.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2018. , s. 71
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1451
Nyckelord [en]
Reproductive Health, Preconception Care, Fertility Awareness, Pregnancy Planning, Men, Fathers
Nationell ämneskategori
Medicin och hälsovetenskap Genusstudier
Forskningsämne
Medicinsk vetenskap; Patologi
Identifikatorer
URN: urn:nbn:se:uu:diva-346125ISBN: 978-91-513-0298-0 (tryckt)OAI: oai:DiVA.org:uu-346125DiVA, id: diva2:1193497
Disputation
2018-05-18, Humanistiska teatern, Thunbergsvägen 3, Uppsala, 13:15 (Svenska)
Opponent
Handledare
Tillgänglig från: 2018-04-26 Skapad: 2018-03-27 Senast uppdaterad: 2018-10-08
Delarbeten
1. Coherence of pregnancy planning within couples expecting a child
Öppna denna publikation i ny flik eller fönster >>Coherence of pregnancy planning within couples expecting a child
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2015 (Engelska)Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 31, nr 10, s. 973-978Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: joint planning and decision-making within couples have evident effects on the well-being of the family. The purpose of this study was to investigate the level of pregnancy planning among pregnant women and their partners and to compare the coherence of pregnancy planning within the couples. Methods: pregnant women and their partners were recruited from 18 antenatal clinics in seven Swedish counties between October 2011 and April 2012. Participants, 232 pregnant women and 144 partners, filled out a questionnaire with questions about pregnancy planning, lifestyle and relationship satisfaction. 136 couples were identified and the women's and partners' answers were compared. Results: more than 75% of the pregnancies were very or rather planned and almost all participants had agreed with their partner to become pregnant There was no significant difference in level of pregnancy planning between women and partners, and coherence within couples was strong. Level of planning was not affected by individual socio-demographic variables. Furthermore, 98 % of women and 94 % of partners had non distressed relationships. Conclusion: one of the most interesting results was the strong coherence between partners concerning their pregnancy and relationship. Approaching these results from a social constructivist perspective brings to light an importance of togetherness and how a sense and impression of unity within a couple might be constructed in different ways. As implications for practice, midwives and other professionals counselling persons in fertile age should enquire about and emphasise the benefits of equality and mutual pregnancy planning for both women and men.

Nyckelord
Pregnancy planning, Relationship satisfaction, Gender
Nationell ämneskategori
Omvårdnad Reproduktionsmedicin och gynekologi Genusstudier
Identifikatorer
urn:nbn:se:uu:diva-265689 (URN)10.1016/j.midw.2015.06.009 (DOI)000362093300012 ()26165170 (PubMedID)
Tillgänglig från: 2015-11-09 Skapad: 2015-11-02 Senast uppdaterad: 2018-03-27Bibliografiskt granskad
2. Exploring men's pregnancy-planning behaviour and fertility knowledge: a survey among fathers in Sweden
Öppna denna publikation i ny flik eller fönster >>Exploring men's pregnancy-planning behaviour and fertility knowledge: a survey among fathers in Sweden
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2017 (Engelska)Ingår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 122, nr 2, s. 127-135Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Introduction: Research about pregnancy-planning behaviour mostly focuses on women, even though pregnancy planning usually also concerns men. The purpose of this study was to investigate how men plan for family, and to measure their fertility knowledge after having become fathers. Material and methods: Data were collected in 2014 as part of a Swedish longitudinal pregnancy-planning study. Men were recruited through their female partner one year after childbirth. Participants were asked to fill out a questionnaire about pregnancy planning, lifestyles, and fertility. Results: Of the 796 participants, 646 (81%) stated that the pregnancy had been very or fairly planned, and 17% (n=128) had made a lifestyle adjustment before pregnancy to improve health and fertility. The most common adjustments were to reduce/quit the consumption of alcohol, cigarettes, or snuff, and to exercise more. First-time fathers and those who had used assisted reproductive technology to become pregnant were more likely to have made an adjustment. Fertility knowledge varied greatly. Men with university education had better fertility knowledge than men without university education. Conclusion: Our findings indicate that there is variation in how men plan and prepare for pregnancy. Most men did not adjust their lifestyle to improve health and fertility, while some made several changes. Both pregnancy-planning behaviour and fertility knowledge seem to be related to level of education and mode of conception. To gain deeper understanding of behaviour and underlying factors, more research is needed.

Ort, förlag, år, upplaga, sidor
TAYLOR & FRANCIS LTD, 2017
Nyckelord
Fathers, fertility knowledge, gender equality, lifestyle, preconception health, pregnancy planning
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:uu:diva-323499 (URN)10.1080/03009734.2017.1316531 (DOI)000401756500009 ()28471260 (PubMedID)
Tillgänglig från: 2017-06-21 Skapad: 2017-06-21 Senast uppdaterad: 2018-03-27Bibliografiskt granskad
3. Evaluating Reproductive Life Plan-Based Counseling with Men During a Sexual Health Visit: a Randomized Controlled Trial
Öppna denna publikation i ny flik eller fönster >>Evaluating Reproductive Life Plan-Based Counseling with Men During a Sexual Health Visit: a Randomized Controlled Trial
(Engelska)Ingår i: Artikel i tidskrift (Refereegranskat) Submitted
Nyckelord
Preconception health
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:uu:diva-346117 (URN)
Tillgänglig från: 2018-03-14 Skapad: 2018-03-14 Senast uppdaterad: 2018-04-09
4. ‘It’s not a problem until it’s a problem’: A study on men, masculinities and fertility awareness
Öppna denna publikation i ny flik eller fönster >>‘It’s not a problem until it’s a problem’: A study on men, masculinities and fertility awareness
(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Nationell ämneskategori
Medicin och hälsovetenskap Genusstudier
Forskningsämne
Genusvetenskap
Identifikatorer
urn:nbn:se:uu:diva-346123 (URN)
Tillgänglig från: 2018-03-14 Skapad: 2018-03-14 Senast uppdaterad: 2018-04-09

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