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Rethinking the biological clock: eleventh-hour moms, miracle moms and meanings of age-related infertility.

Soc Sci Med. 2006 Sep;63(6):1550-60

Authors: Friese C, Becker G, Nachtigall RD

Over the past generation, aging and female reproduction have been lodged within the gendered and gendering debates regarding women’s involvement in the workforce and demographic shifts toward delayed parenting that culminate in discourses on the “biological clock”. Technological solutions to the biological clock, specifically in vitro fertilization, have led to clinical attempts to assess “ovarian reserve”, or qualitative and quantitative changes in the ovary that correlate with aging and with successful infertility treatment. Rupturing the longstanding historical connections between menstruation and female reproductive capacity by specifically focusing on the aging of a woman’s eggs, the clinical designation of “diminished ovarian reserve” has come to imply that a woman has “old eggs”. This is associated in practitioners’ and patients’ minds with the eclipse of a woman’s reproductive potential and with hidden harbingers of menopause. In an ethnographic interview study of 79 couples in the US who conceived after using donor oocytes, we found that women voiced two different narratives that described their experience and attitudes when confronted with an apparent age-related decline in their fertility. The “eleventh-hour mom” narrative was voiced by women who initially tried to become pregnant with their own eggs and turned to donated oocytes as a second-choice option, whereas the “miracle mom” narrative was expressed by women who were generally older, some of whom had entered infertility treatment hoping to conceive with their own eggs, but some who knew from the outset that it was not going to be possible. Through their narratives women not only embodied and made meaningful “diminished ovarian reserve” in varying ways that connect with cultural, social, structural/organizational, symbolic and physical aspects of aging, they reproduced the socio-biological project of the biological clock, but rooted this social project in the metaphor of “old eggs” rather than menopause.

PMID: 16713666 [PubMed - indexed for MEDLINE]

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HealthNet promotes Strong Starts with rewards as incentive to moms. Rewards include a 60-minute phone card, photo frame magnet, stationery products and notepads.

Profiles Healthc Mark. 1998 Nov-Dec;14(6):39-41, 3

Authors: Herreria J

HealthNet promotes its prenatal program through a rewards system. Those rewards come in the form of promotional components such as a photo frame magnet, phone card, stationery, and notepads.

PMID: 10387288 [PubMed - indexed for MEDLINE]

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A home visitation program welcomes home first-time moms and their infants.

Home Healthc Nurse. 2005 May;23(5):286-9

Authors: Hedges S, Simmes D, Martinez A, Linder C, Brown S

This article describes a creative maternal and infant home visiting program for first-time parents. Two-year outcomes indicate the program improved parents’ infant safety knowledge, positively affected the mother’s decision to breastfeed, and promoted infant primary care visits in a cost-effective way.

PMID: 15891472 [PubMed - indexed for MEDLINE]

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Multiple Objective Measures of Skill (MOMS): a new approach to the assessment of technical ability in surgical trainees.

Ann Surg. 2003 Aug;238(2):291-300

Authors: Mackay S, Datta V, Chang A, Shah J, Kneebone R, Darzi A

OBJECTIVE: The assessment of surgical technical skills has become an important topic in recent years. This study presents the validation of a 6-task skills examination for junior surgical trainees (at the level of the Membership of the Royal College of Surgeons). SUMMARY BACKGROUND DATA: Six tasks were evaluated in a project that also examined the feasibility of this method of assessment. The tasks were knowledge of sutures and instruments; knowledge of surgical devices; knot formation; skin-pad suturing, closure of an enterotomy; excision of a skin lesion; and laparoscopic manipulation. Comparisons were made between a group of junior trainees (n = 13), and a group of seniors (n = 8). RESULTS: Each of the 6 tasks was able to be used to discriminate between the 2 groups. In all, there were 19 primary analyses across the 6 tasks, and 17 of these showed significant differences between the groups (P values ranging from 0.037 to < 0.001). There was generally a strong correlation between the analyses, and when a mean rank was calculated, the difference between groups was significant (P = 0.005 on Mann-Whitney U test; mean ranks 13.9 and 6.3 [of 21], for juniors and seniors respectively). Reliability of the 6-task assessment was very good at 0.70 (Cronbach’s Alpha). CONCLUSIONS: A skills examination is a feasible and effective method of assessing the technical ability of basic surgical trainees.

PMID: 12894024 [PubMed - indexed for MEDLINE]

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