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Psycho-Socio-Cultural Risk Factors for Breech Presentation Caroline Peterson University of South Florida

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Psycho-Socio-Cultural Risk Factors for Breech Presentation Caroline Peterson University of South Florida University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School 7-2-2008 Psycho-Socio-Cultural Risk Factors for Breech Presentation Caroline Peterson University of South Florida Follow this and additional works at: https://scholarcommons.usf.edu/etd Part of the American Studies Commons Scholar Commons Citation Peterson, Caroline, "Psycho-Socio-Cultural Risk Factors for Breech Presentation" (2008). Graduate Theses and Dissertations. https://scholarcommons.usf.edu/etd/451 This Dissertation is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. Psycho-Socio-Cultural Risk Factors for Breech Presentation by Caroline Peterson A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Anthropology College of Arts and Science University of South Florida Major Professor: Lorena Madrigal, Ph.D. Wendy Nembhard, Ph.D. Nancy Romero-Daza, Ph.D. David Himmelgreen, Ph.D. Getchew Dagne, Ph.D. Date of Approval: July 2, 2008 Keywords: Maternal Fetal Attachment, Evolution, Developmental Plasticity, Logistic Regression, Personality © Copyright 2008, Caroline Peterson Dedication This dissertation is dedicated to all the moms who long for answers about their babys‟ presentation and to the babies who do their best to get here. Acknowledgments A big thank you to the following folks who made this dissertation possible: Jeffrey Roth who convinced ACHA to let me use their Medicaid data then linked it with the birth registry data. David Darr who persuaded the Florida DOH to let me use the birth registry data for free. Shane Troutman who figured out the reason no computer on campus would run my program was because they weren‟t powerful enough. He also rescued my hard drive and my dissertation after I destroyed my laptop by spilling coffee on it. David at the SAS Institute who patiently answered all my questions about programming code for logistic regression. Peter who was a thoughtful listener to my early conjectures about the influence of relationships on fetal position. My mom and dad who funded this dissertation and believed in me even when it seemed like I was doing something very strange. Sandy & Cheryl who always knew I would finish even when I thought I couldn‟t. My kitty Elsie who sat by me (or on my papers) through it all. TABLE OF CONTENTS LIST OF TABLES ................................................................................................. vi LIST OF FIGURES ............................................................................................. viii ABSTRACT .......................................................................................................... ix CHAPTER ONE: INTRODUCTION ...................................................................... 1 Statement of the Problem .......................................................................... 1 Purpose of the Research ........................................................................... 3 Research Questions .................................................................................. 3 Significance of the Study ........................................................................... 4 Complementariness of Anthropology and Epidemiology............................ 4 Role of Applied Anthropology in Study ............................................ 5 Role of Epidemiology in Study ........................................................ 8 Relevance of Study to Applied Anthropology .................................. 8 Relevance of Study to Epidemiology ............................................... 8 CHAPTER TWO: LITERATURE REVIEW .......................................................... 10 Explanatory Models of Adverse Pregnancy Outcomes ............................ 10 Biomedicine & Epidemiology ......................................................... 10 Western History of Childbirth .............................................. 10 Risk Factors for Breech Presentation ................................. 18 Maternal Socio-Demographic Characteristics .................................................... 19 Fetal Characteristics ................................................ 19 Breech Delivery ....................................................... 21 Chinese Medicine .......................................................................... 23 Ayurvedic Medicine ....................................................................... 24 Direct Entry Midwifery & Breech Delivery ...................................... 24 Ethnographic Record .................................................................... 25 Emotions ............................................................................ 25 ` Work ................................................................................... 26 Malpresentation .................................................................. 27 Dominant Explanatory Model Themes for Breech Presentation .............. 28 Mechanical Explanatory Model ..................................................... 28 Psycho-Social-Cultural Explanatory Model ................................... 29 Physiological Aspects of Gestation, Development and Delivery .............. 30 Fetal Neurobehavioral Development ............................................. 30 i Breech Neurobehavioral Development ......................................... 31 Breech Descent and Vaginal Delivery ........................................... 33 Ethnographic Record of Birth ................................................................... 33 “Normal” Birth ................................................................................ 34 “Abnormal” Birth ............................................................................ 36 Dystocia .............................................................................. 36 Retained Placenta .............................................................. 38 Malpresentation .................................................................. 39 CHAPTER THREE: THEORETICAL ORIENTATION ......................................... 44 Introduction .............................................................................................. 44 Evolutionary Ecological Reproductive Theory .......................................... 45 Developmental Plasticity .......................................................................... 46 Attachment Theory .................................................................................. 47 Integration of Theories ............................................................................. 50 Summary and Relevance to Breech Presentation ................................... 51 CHAPTER FOUR: SECONDARY DATA ............................................................ 52 Introduction .............................................................................................. 52 Secondary Data Hypotheses Tested ....................................................... 53 Secondary Data Methods ........................................................................ 53 Study Design (1992-2003) Florida Birth Certificate ....................... 53 Independent Variables (1992-2003) Florida Birth Certificate ........................................................................ 54 Covariates (1992-2003) Florida Birth Certificate ................ 57 Study Population (1992-2003) Florida Birth Certificate ................. 61 Collection Method (1992-2003) Florida Birth Certificate ................ 61 Statistical Methods (1992-2003) Florida Birth Certificate .............. 62 Evaluation for Confounders and Effect Modifiers ............... 62 Logistic Regression ............................................................ 63 Summary of Steps Taken to Fit the Model ......................... 64 Study Design (1999-2003) Florida Birth Certificate and Medicaid/WIC Linked Data ......................................................... 66 Study Population (1999-2003) Florida Birth Certificate and Medicaid/WIC Linked Data ......................................................... 66 Collection Methods and Linking (1999-2003) Florida Birth Certificate and Medicaid/WIC Linked Data ................................. 67 Statistical Methods (1999-2003) Florida Birth Certificate and Medicaid/WIC Linked Data .................................................. 67 Secondary Data Results .......................................................................... 67 Sample (1992-2003) Florida Birth Certificate ................................ 68 Descriptive Characteristics (1992-2003) Florida Birth Certificate ............................................................. 69 Maternal Socio-Demographic Characteristics (1992-2003) Florida Birth Certificate ............................. 69 ii Maternal Health & Obstetric History (1992-2003) Florida Birth Certificate .................................................. 73 Newborn Characteristics (1992-2003) Florida Birth Certificate ............................................................. 75 Null Hypotheses 1 & 2 (1992-2003) Florida Birth Certificate Data ........................................................................ 78 Analytic Statistics (1992-2003) Florida Birth Certificate ................ 78 Confounders (1992-2003) Florida Birth Certificate ............
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