Journal articles on the topic 'Childbirth Victoria'

1) Congenital cyst, emanating from the spine, as an obstacle to childbirth. In 30-year-olds, I-women in labor, the baby's head sank into the pelvic cavity, the cervix opened, but despite the good contractions, labor was delayed. Examining the pelvis of a woman in labor with his finger to find out the reason for stopping labor, Mueller felt a fluctuating tumor in the lower part of the sacral cavity, the size of a hen's egg. Dr. M .. checked the result of examination of the per rectum and found it more convenient to pierce the tumor with a test trocar from the rectum. In the fluid released from the tumor, the light, straw color turned out to be epithelial, cylindrical cells, indicating that the cyst was congenital (Eulenburg) and communicated with the cavity of the fetal spine. Childbirth ended with forceps, with great effort in the course of half an hour. The postpartum period went well.

New mothers and their infants are high frequency users of primary health care services in Australia providing opportunities for GPs to engage with women about common postnatal morbidities. This study aimed to explore women’s views of GP care in the first year following birth. We used semistructured interviews with a subsample of women who had participated in a population-based survey of women who gave birth in two Australian states (Victoria and South Australia) in 2007. Twenty-nine women were interviewed. Prominent themes that emerged were around issues of disclosure, including women’s views on ways practitioner interactions and systems of care facilitate or hinder disclosure and subsequent discussion of health problems. Women reflected on the role GPs played in their health and wellbeing after childbirth, the importance of enquiry, communication style and the way access to, and time in, consultations impact on disclosure, perceived support and discussions. To improve care for women after childbirth we need to know the contexts that facilitate disclosure. Findings from this qualitative study deliver an important message to clinicians: women value primary care, identify issues that facilitate and hinder disclosure and describe ‘good’ encounters as ones where they feel understood, supported and reassured.

The influence of Queen Victoria on the acceptance of obstetric anesthesia has been overstated, and the role of John Snow has been somewhat overlooked. It was his meticulous, careful approach and his clinical skills that influenced many of his colleagues, Tyler-Smith and Ramsbotham and the Queen's own physicians. The fact that the Queen received anesthesia was a manifestation that the conversion of Snow's colleagues had already taken place. This is not to say that this precipitated a revolution in practice. Medical theory may have changed, but practice did not, and the actual number of women anesthetized for childbirth remained quite low. This, however, was a reflection of economic and logistical problems, too few women were delivered of newborn infants during the care of physicians or in hospitals. Conversely, it is important to recognize that John Snow succeeded in lifting theoretical restrictions on the use of anesthesia.

Objectives: To explore whether community health worker household-based maternal health visits improve antenatal care and skilled birth attendance among hard-to-reach fishing villages on Lake Victoria, Uganda. Methods: This quasi-experimental 18-month prospective study involved 486 consenting women aged 15–49 years, who were pregnant or had a pregnancy outcome in the past 6 months, from 6 island fishing communities. The community health worker household-based intervention (community health workers’ household visits to provide counseling, blood pressure measurement, anemia, and HIV testing) involved 243 women from three fishing communities. Random effects logistic regression was used to determine the association between the community health worker intervention and antenatal care and skilled birth attendance among women who had at least 5 months of pregnancy or childbirth at follow-up. Results: Almost all women accepted the community health worker intervention (90.9% (221/243)). Hypertension was at 12.5% (27/216) among those who accepted blood pressure measurements, a third (33.3% (9/27)) were pregnant. HIV prevalence was 23.5% (52/221). Over a third (34.2% (69/202)) of women tested had anemia (hemoglobin levels less than 11 g/dL). The community health worker intervention was associated with attendance of first antenatal care visit within 20 weeks of pregnancy (adjusted odd ratio = 2.1 (95% confidence interval 0.6–7.6)), attendance of at least four antenatal care visits (adjusted odd ratio = 0.9 (95% confidence interval 0.4–2.0)), and skilled birth attendance (adjusted odd ratio = 0.5 (95% confidence interval 0.1–1.5)), though not statistically significant. Conclusion: Community health workers have a crucial role in improving early antenatal care attendance, early community-based diagnosis of anemia, hypertensive disorders, and HIV among women in these hard-to-reach fishing communities.

Prenatal prognosis is an important part of obstetric care, which aims to reduce fetal and neonatal losses. A differentiated approach to the management of different risk groups allows you to optimize existing approaches.The objective: to identify antenatal factors that correlate with perinatal losses, by conducting a retrospective cohort study of women at high perinatal risk, to build a multifactorial prognostic model of adverse pregnancy outcomes.Materials and methods. A retrospective cohort study was conducted from 2014 to 2016 on the basis of the medical center LLC «Uniclinic», Medical Genetics Center «Genome», Clinic of Reproductive Genetics «Victoria», Kyiv City Maternity Hospital №2. 2154 medical cards of pregnant women from the group of high perinatal risk were selected and analyzed. Of these, 782 pregnant women were included in the final protocol after verification of compliance with the criteria.Results. Cesarean delivery occurred in 115 cases (14.7%). In 50 cases (6.4%) the caesarean section was performed in a planned manner, in 65 (8.3%) – in an emergency. In 39 (5%) cases, the indication for surgical delivery was acute fetal distress. Antenatal fetal death occurred in 11 (1.4%) cases: one case in terms of <34 weeks and <37 weeks of gestation, the remaining 9 cases – in terms of> 37 weeks. Intranatal death of two fetuses (0.3%) was due to acute asphyxia on the background of placental insufficiency. In the early neonatal period, 14 (1.8%) newborns died. Hospitalization of the newborn to the intensive care unit for the first 7 days was registered in 64 (8.2%) cases.The need for mechanical ventilation was stated in 3.96% (31/782) of newborns. The method of construction and analysis of multifactor models of logistic regression was used in the analysis of the relationship between the risk of perinatal losses (antenatal death, intranatal death, early neonatal death) and factor characteristics.Conclusion. Signs associated with the risk of perinatal loss: the presence of chronic hypertension, preeclampsia in previous pregnancies, type of fertilization (natural or artificial), the concentration of PAPP-A (MoM), the concentration of free β-HCG (MoM) in the second trimester, average PI in the uterine arteries in 28–30 weeks of pregnancy, PI in the middle cerebral arteries in 28–30 weeks of pregnancy, episodes of low fetal heart rate variability in the third trimester of pregnancy, episodes of high fetal heart rate variability in the third trimester of pregnancy. The model, built on selected features, allows with a sensitivity of 73.1% (95% CI: 52.2% – 88.4%) and a specificity of 72.7% (95% CI: 69.3% – 75.9%) to predict risk perinatal loss.

This article explores the experiences of imprisoned mothers in the Victorian convict prison system. It argues that motherhood, of central importance to the ideals of Victorian femininity, was disrupted and fractured by women’s long-term imprisonment. Using ‘whole life’ history methodology, the article draws on research into 288 women imprisoned and then released from the prison system, of whom half were mothers. It illuminates how the long-term prison system dealt with pregnancy, childbirth and family contact for female prisoners. It argues that while institutional or state care was often an inevitable consequence for children of single or widowed mothers, women used their limited resources and agency to assert their identity as mothers and direct outcomes for their children. But for others, prolific offending and multiple long sentences would render any chance of motherhood impossible.

Women suffer significant morbidity following childbirth and there is a lack of focussed, primary maternal health care to support them. Victorian Maternal and Child Health (MCH) nurses are ideally suited to provide additional care for women when caring for the family with a new baby. With additional training and support, MCH nurses could better fill this health demand and practice gap. This discussion paper reviews what we know about maternal morbidity, current postnatal services for women and the maternal healthcare gap, and makes recommendations for enhancing MCH nursing practice to address this deficit.

Abstract The maternal role and its associated practices were subject to much scrutiny throughout the Victorian period. Whilst motherhood was seen as the natural destiny of the (respectable) woman, mothers were nonetheless deemed in need of strict guidance on how best to raise their offspring. This was offered in an extensive range of advice and conduct books, via newspapers, journals, and fiction, and from medical practitioners, and covered pregnancy, childbirth, and all aspects of care for babies and young children. This article considers Victorian advice on infant feeding, focusing in particular on the various strategies deployed to encourage mothers to breastfeed. Advice literature for mothers frequently invoked patriarchal – religious, medical, and (pseudo-) scientific – authority, in line with broader Victorian discourses on femininity. Much of this advice was produced by, or drew on, the authority of (male) medical practitioners, whilst comparatively little emphasis was placed on maternal experience as a source of expertise. Set within the wider historical context of shifting trends in infant feeding, this article analyses the various persuasive techniques employed by the authors of advice literature, which ultimately served as an attempt to control women’s maternal behaviours and to suppress their own maternal authority.

Background: Several state governments are once again reviewing policies for the provision of maternity care. This paper presents findings from a state-wide Victorian survey of recent mothers conducted in 2000 regarding women?s experiences of antenatal care. We also offer some reflections on the way in which results from this and earlier Victorian surveys have been used, somewhat selectively, to support the State Government?s new framework for maternity services, while other issues highlighted in the survey results have been overlooked. Design: Population-based postal survey mailed to Victorian women who gave birth in a 2-week period in September 1999, 5?6 months after childbirth. Results: 42% of women attending a public hospital clinic described their antenatal care as ?very good? compared with 73% of women attending a birth centre, 59% attending private practitioners for antenatal care but receiving public intrapartum care (combined care), 56% attending a midwives clinic, 53% receiving shared care and 84% of women receiving private maternity care. The social characteristics of women enrolling in different models of care do not explain these differences. Immigrant women were much less likely to be happy with their care in pregnancy than Australian- born women, with no improvement in ratings of care over more than a decade.

While collaborative, multidisciplinary teamwork is widely espoused as the goal of contemporary hospitals, it is hard to achieve. In maternity care especially, professional rivalries and deep-seated philosophical differences over childbirth generate significant tensions. This article draws on qualitative research in several Victorian public maternity units to consider the challenges to inter-professional collaboration. It reports what doctors and midwives looked for in colleagues they liked to work with ? the attributes of a ?good doctor? or a ?good midwife?. Although their ideals did not entirely match, both groups respected skill and hard work and sought mutual trust, respect and accountability. Yet effective working together is limited both by tensions over role boundaries and power and by incivility that is intensified by increasing workloads and a fragmented labour force. The skills and qualities that form the basis of ?professional courtesy? need to be recognised as essential to good collaborative practice.

Two bronze hands associated with the confession of oriental cults are very interesting archaeological items found on theterritoryofUkraine. The first one comes from the village Myshkiv inWestern Podillya, another – from the territory of the Ukrainian steppe. These artifacts are well studied by specialists in archeology, ancient history, theologians, but most of the works on this subject are written in German, Polish and Russian and, because of different reasons, are inaccessible to the Ukrainian reader. The main thesis of the article is an attempt to generalize diverse approaches, versions and concepts and to represent a relatively integral picture of the origin and religious purpose of these cult hands. The main idea of the article is to publish some quite new conclusions and clarifications made during the author's own research. The author examines the history of the discovery of these monuments, indicates the places of their storage, presents detailed sculptural descriptions. While speaking about the hand from Myshkiv, the text of the inscription is clearly reproduced. Three different interpretations of this inscription, offered in the works of T. Rybicki (ego), E. Bormann (a), M. Bandrivsky and O. Bandrovsky, are given, as well as their translations into Ukrainian. The approaches of various scientists on the issue of the sacred purpose of the hand from Myshkiv were analyzed in the article. T. Rybicki considered that it is the top of a Roman military standard. According to J. Zingerle, it is the hand of a contributor who has made a dedication to Jupiter Dolichenus for his military success. But D. Lusthaus thinks it is a symbol of the deity himself, which was also served as the top. J. Kolendo and J. Trynkowski defended the opinion of using of this hand only for religious purposes in the sanctuary at Orheiu Bistriței. Figures from Cătunele in Romaniaand Kavarna in Bulgariaare considered to be similar. It is important that the last one has a figure of Victoria, which is absent on the hands from Myshkiv and Cătunele. Basing on the interpretation of the sign V engraved on the hand as – miliaria (the thousandth), T. Rybicki, E. Bormann, J. Zingerle, J. Kolendo and J. Trynkowski believe that it is “cohorsprima Flavia Ulpia Hispanorum miliaria equitat civium Romanorum”. Instead, M. Bandrovsky and O. Bandrovsky interpret this sign as “equitataquingenaria” (the five hundredth cavalry) and correlate it with “prima I Hispanorum pia fidelis equitata quingenaria”. B. Farmakovsky's position about the appointment of a hand from the territory of the former Ekaterinoslav province is considered. His thought that such objects may be associated not only with Sabazios or Serapis, but also with the cults of other deities, has been proved. But there is no answer yet, whom exactly the hand from the territory of the Ukrainian steppe was dedicated. Instead, it is known that the cause of the donation was the childbirth of an unknown woman. B. Farmakovsky's characteristic of all available reliefs on the hand is presented. According to these arguments, the images of animals on the statuette had to turn away the harmful effects of the evil eye. Basing on this, the hand can be defined as a cult object that has an apotropaic character. The results of the study include detailed analysis of historiography devoted to the study of bronze cult hands found in Ukraine, the involvement of a large amount of additional literature, the presentation of a number of images of similar monuments. The votive character of the Myshkiv hand and the apotropaic character of the Ekaterinoslav one is determined. There are many strong arguments in favour of the statement that the hand from Myshkiv has a direct connection with the thousandth cohort of Spaniards.

Abstract It is a truism that Victorians were prudish about pregnant bodies. Interrogating this assumption, this paper provides a case study of one of the century’s most public pregnancies: that of Queen Victoria with her first child. It tracks press speculations about and discussions of Victoria’s pregnancy from weeks after her 10 February 1840 marriage to Princess Victoria’s 21 November birth. During this period, Victoria’s body was subject to relentless press scrutiny, ranging from speculations about possible pregnancy shortly after marriage to comments about her sex life with Albert. In summer 1840, concern shifted to possible miscarriage after an unsuccessful assassination attempt and the need for a regency if she died in childbirth. Finally, Princess Victoria’s birth prompted surprisingly detailed descriptions of Victoria’s labour and delivery as well as speculations about when the child was conceived. Victorian periodicals demonstrated awareness of their own coverage, accusing other papers of ‘grossness’ and objecting to the ‘minute particularity’ of accounts of her labour. Repeatedly invoking delicacy even as they detailed Victoria’s body, the national press captures the stakes of writing about the queen’s ‘interesting condition’. Clearly, it was not impossible for Victorians to speak about pregnancy.

Abstract It is a truism that Victorians were prudish about pregnant bodies. Interrogating this assumption, this paper provides a case study of one of the century’s most public pregnancies: that of Queen Victoria with her first child. It tracks press speculations about and discussions of Victoria’s pregnancy from weeks after her 10 February 1840 marriage to Princess Victoria’s 21 November birth. During this period, Victoria’s body was subject to relentless press scrutiny, ranging from speculations about possible pregnancy shortly after marriage to comments about her sex life with Albert. In summer 1840, concern shifted to possible miscarriage after an unsuccessful assassination attempt and the need for a regency if she died in childbirth. Finally, Princess Victoria’s birth prompted surprisingly detailed descriptions of Victoria’s labour and delivery as well as speculations about when the child was conceived. Victorian periodicals demonstrated awareness of their own coverage, accusing other papers of ‘grossness’ and objecting to the ‘minute particularity’ of accounts of her labour. Repeatedly invoking delicacy even as they detailed Victoria’s body, the national press captures the stakes of writing about the queen’s ‘interesting condition’. Clearly, it was not impossible for Victorians to speak about pregnancy.

Abstract Background Maternal mortality is still a challenge in Uganda, at 336 deaths per 100,000 live births, especially in rural hard to reach communities. Distance to a health facility influences maternal deaths. We explored women’s mobility for maternal health, distances travelled for antenatal care (ANC) and childbirth among hard-to-reach Lake Victoria islands fishing communities (FCs) of Kalangala district, Uganda. Methods A cross sectional survey among 450 consenting women aged 15–49 years, with a prior childbirth was conducted in 6 islands FCs, during January-May 2018. Data was collected on socio-demographics, ANC, birth attendance, and distances travelled from residence to ANC or childbirth during the most recent childbirth. Regression modeling was used to determine factors associated with over 5 km travel distance and mobility for childbirth. Results The majority of women were residing in communities with a government (public) health facility [84.2 %, (379/450)]. Most ANC was at facilities within 5 km distance [72 %, (157/218)], while most women had travelled outside their communities for childbirth [58.9 %, (265/450)]. The longest distance travelled was 257.5 km for ANC and 426 km for childbirth attendance. Travel of over 5 km for childbirth was associated with adolescent girls and young women (AGYW) [AOR = 1.9, 95 % CI (1.1–3.6)], up to five years residency duration [AOR = 1.8, 95 % CI (1.0-3.3)], and absence of a public health facility in the community [AOR = 6.1, 95 % CI (1.4–27.1)]. Women who had stayed in the communities for up to 5 years [AOR = 3.0, 95 % CI (1.3–6.7)], those whose partners had completed at least eight years of formal education [AOR = 2.2, 95 % CI (1.0-4.7)], and those with up to one lifetime birth [AOR = 6.0, 95 % CI (2.0-18.1)] were likely to have moved to away from their communities for childbirth. Conclusions Despite most women who attended ANC doing so within their communities, we observed that majority chose to give birth outside their communities. Longer travel distances were more likely among AGYW, among shorter term community residents and where public health facilities were absent. Trial registration PACTR201903906459874 (Retrospectively registered). https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=5977.

Abstract Background South Asian women are at a high risk of developing gestational diabetes mellitus than other women in Australia. Gestational diabetes affects up to 14–19% of all pregnancies among South Asian, South East Asian, and Arabic populations placing women at risk of adverse pregnancy outcomes. Although, gestational diabetes resolves after childbirth, women with gestational diabetes are up to seven times more likely to develop type 2 diabetes within five to ten years of the index pregnancy. Increasingly, South Asian women are being diagnosed with gestational diabetes in Australia. Therefore, we aimed to gain a better understanding of the lived experiences of South Asian women and their experiences of self-management and their health care providers’ perspectives of treatment strategies. Methods Using an ethnographic qualitative research methodology, semi-structured one-on-one, face-to-face interviews were conducted with 21 health care providers involved in gestational diabetes management and treatment from the three largest tertiary level maternity hospitals in Melbourne, Victoria, Australia. In-depth interviews were conducted with 23 South Asian women post diagnosis between 24–28 weeks gestation in pregnancy. Results Health care providers had challenges in providing care to South Asian women. The main challenge was to get women to self-manage their blood glucose levels with lifestyle modification. Whilst, women felt self-management information provided were inadequate and inappropriate to their needs. Women felt ‘losing control over their pregnancy’, because of being preoccupied with diet and exercise to control their blood glucose level. Conclusions The gestational diabetes clinical practice at the study hospitals were unable to meet consumer expectations. Health care providers need to be familiar of diverse patient cultures, rather than applying the current ‘one size fits all’ approach that failed to engage and meet the needs of immigrant and ethnic women. Future enabling strategies should aim to co-design and develop low Glycaemic Index diet plans of staple South Asian foods and lifestyle modification messages.

Abstract Introduction Postpartum depression has costly consequences for the mother, baby, and society. Numerous pharmacological and non-pharmacological interventions are available for the prevention and treatment of postpartum depression. To date, no attempt has been made to synthesize the evidence from comparisons of interventions both within and across these categories. Methods We will perform a systematic review of the literature and perform network meta-analysis of interventions to (a) prevent and (b) treat postpartum depression. This review will include studies of primiparous or multiparous women during pregnancy or within 12 months of delivery of their baby that assess either interventions initiated during pregnancy or within 1 year of childbirth. Comparators will be other eligible interventions or control conditions. The outcome of interests will be related to the antidepressant efficacy of the interventions as well as their acceptability. The published literature will be searched in Ovid MEDLINE 1946-, Embase.com 1947-, Scopus 1823-, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. The search will use a combination of standardized terms and keywords for postpartum depression, a sensitive search filter to limit for randomized controlled trials, and a librarian-created “humans” filter. The search results will be uploaded to the Covidence online systematic review platform (Veritas Health Information Ltd., Victoria, Australia) where two review team members will independently screen articles. We will extract data to include year of publication, language, country, participants (number, demographic data, eligibility criteria, psychiatric symptoms, and co-morbidities), characteristics of the intervention and control conditions, and reported outcomes. Risk of bias for each study will be assessed independently by two review authors using the RoB 2: A revised Cochrane risk of bias tool for randomized trials. Network meta-analysis will be performed using a Bayesian hierarchical model supplemented with a Markov chain Monte Carlo approach. Discussion Postpartum depression is a devastating disease with long-lasting consequences. Given the numerous available interventions to both prevent and treat postpartum depression and the great number of studies comparing them, it is imperative that clinicians and patients are provided with an assessment of their comparative efficacy and acceptability. Systematic review registration Prospero registration (CRD42022303247).

IntroductionLike other forms of embodiment, pregnancy has increasingly become subject to representation and interpretation via digital technologies. Pregnancy and the unborn entity were largely private, and few people beyond the pregnant women herself had access to the foetus growing within her (Duden). Now pregnant and foetal bodies have become open to public portrayal and display (Lupton The Social Worlds of the Unborn). A plethora of online materials – websites depicting the unborn entity from the moment of conception, amateur YouTube videos of births, social media postings of ultrasounds and self-taken photos (‘selfies’) showing changes in pregnant bellies, and so on – now ensure the documentation of pregnant and unborn bodies in extensive detail, rendering them open to other people’s scrutiny. Other recent digital technologies directed at pregnancy include mobile software applications, or ‘apps’. In this article, we draw on our study involving a critical discourse analysis of a corpus of pregnancy-related apps offered in the two major app stores. In so doing, we discuss the ways in which pregnancy-related apps portray pregnant and unborn bodies. We place a particular focus on the ludification and gamification strategies employed to position pregnancy as a playful, creative and fulfilling experience that is frequently focused on consumption. As we will demonstrate, these strategies have wider implications for concepts of pregnant and foetal embodiment and subjectivity.It is important here to make a distinction between ludification and gamification. Ludification is a broader term than gamification. It is used in the academic literature on gaming (sometimes referred to as ‘ludology’) to refer to elements of games reaching into other aspects of life beyond leisure pursuits (Frissen et al. Playful Identities: The Ludification of Digital Media Cultures; Raessens). Frissen et al. (Frissen et al. "Homo Ludens 2.0: Play, Media and Identity") for example, claim that even serious pursuits such as work, politics, education and warfare have been subjected to ludification. They note that digital technologies in general tend to incorporate ludic dimensions. Gamification has been described as ‘the use of game design elements in non-game contexts’ (Deterding et al. 9). The term originated in the digital media industry to describe the incorporation of features into digital technologies that not explicitly designed as games, such as competition, badges, rewards and fun that engaged and motivated users to make them more enjoyable to use. Gamification is now often used in literatures on marketing strategies, persuasive computing or behaviour modification. It is an important element of ‘nudge’, an approach to behaviour change that involves persuasion over coercion (Jones, Pykett and Whitehead). Gamification thus differs from ludification in that the former involves applying ludic principles for reasons other than the pleasures of enjoying the game for their own sake, often to achieve objectives set by actors and agencies other than the gamer. Indeed, this is why gamification software has been described by Bogost (Bogost) as ‘exploitationware’. Analysing Pregnancy AppsMobile apps have become an important medium in contemporary digital technology use. As of May 2015, 1.5 million apps were available to download on Google Play while 1.4 million were available in the Apple App Store (Statista). Apps related to pregnancy are a popular item in app stores, frequently appearing on the Apple App Store’s list of most-downloaded apps. Google Play’s figures show that many apps directed at pregnant women have been downloaded hundreds of thousands, or even millions, of times. For example, ‘Pregnancy +’, ‘I’m Expecting - Pregnancy App’ and ‘What to Expect - Pregnancy Tracker’ have each been downloaded between one and five million times, while ‘My Pregnancy Today’ has received between five and ten million downloads. Pregnancy games for young girls are also popular. Google Play figures show that the ‘Pregnant Emergency Doctor’ game, for example, has received between one and five million downloads. Research has found that pregnant women commonly download pregnancy-related apps and find them useful sources of information and support (Hearn, Miller and Fletcher; Rodger et al.; Kraschnewski et al.; Declercq et al.; Derbyshire and Dancey; O'Higgins et al.). We conducted a comprehensive analysis of all pregnancy-related smartphone apps in the two major app stores, Apple App Store and Google Play, in late June 2015. Android and Apple’s iOS have a combined market share of 91 percent of apps installed on mobile phones (Seneviratne et al.). A search for all pregnancy-related apps offered in these stores used key terms such as pregnancy, childbirth, conception, foetus/fetus and baby. After eliminating apps listed in these searches that were clearly not human pregnancy-related, 665 apps on Google Play and 1,141 on the Apple App Store remained for inclusion in our study. (Many of these apps were shared across the stores.)We carried out a critical discourse analysis of these apps, looking closely at the app descriptions offered in the two stores. We adopted the perspective that sees apps, like any other form of media, as sociocultural artefacts that both draw on and reproduce shared norms, ideals, knowledges and beliefs (Lupton "Quantified Sex: A Critical Analysis of Sexual and Reproductive Self-Tracking Using Apps"; Millington "Smartphone Apps and the Mobile Privatization of Health and Fitness"; Lupton "Apps as Artefacts: Towards a Critical Perspective on Mobile Health and Medical Apps"). In undertaking our analysis of the app descriptions in our corpus, attention was paid to the title of each app, the textual accounts of its content and use and the images that were employed, such as the logo of the app and the screenshots that were used to illustrate its content and style. Our focus in this article is on the apps that we considered as including elements of entertainment. Pregnancy-related game apps were by far the largest category of the apps in our corpus. These included games for young girls and expectant fathers as well as apps for ultrasound manipulation, pregnancy pranks, foetal sex prediction, choosing baby names, and quizzes. Less obviously, many other apps included in our analysis offered some elements of gamification and ludification, and these were considered in our analysis. ‘Pregnant Adventures’: App Games for GirlsOne of the major genres of apps that we identified was games directed at young girls. These apps invited users to shop for clothes, dress up, give a new hair style, ‘make-over’ and otherwise beautify a pregnant woman. These activities were directed at the goal of improving the physical attractiveness and therefore (it was suggested) the confidence of the woman, who was presented as struggling with coming to terms with changes in her body during pregnancy. Other apps for this target group involved the player assuming the role of a doctor in conducting medical treatments for injured pregnant women or assisting the birth of her baby.Many of these games represented the pregnant woman visually as looking like an archetypal Barbie doll, with a wardrobe to match. One app (‘Barbara Pregnancy Shopping’) even uses the name ‘Barbara’ and the screenshots show a woman similar in appearance to the doll. Its description urges players to use the game to ‘cheer up’ an ‘unconfident’ Barbara by taking her on a ‘shopping spree’ for new, glamorous clothes ‘to make Barbara feel beautiful throughout her pregnancy’. Players may find ‘sparkly accessories’ as well for Barbara and help her find a new hairstyle so that she ‘can be her fashionable self again’ and ‘feel prepared to welcome her baby!’. Likewise, the game ‘Pregnant Mommy Makeover Spa’ involves players selecting clothes, applying beauty treatments and makeup and adding accessories to give a makeover to ‘Pregnant Princess’ Leila. The ‘Celebrity Mommy’s Newborn Baby Doctor’ game combines the drawcard of ‘celebrity’ with ‘mommy’. Players are invited to ‘join the celebrities in their pregnancy adventure!’ and ‘take care of Celebrity Mom during her pregnancy!’.An app by the same developer of ‘Barbara Pregnancy Shopping’ also offers ‘Barbara’s Caesarean Birth’. The app description claims that: ‘Of course her poor health doesn’t allow Barbara to give birth to her baby herself.’ It is up to players to ‘make everything perfect’ for Barbara’s caesarean birth. The screenshots show Barbara’s pregnant abdomen being slit open, retracted and a rosy, totally clean infant extracted from the incision, complete with blonde hair. Players then sew up the wound. A final screenshot displays an image of a smiling Barbara standing holding her sleeping, swaddled baby, with the words ‘You win’.Similar games involve princesses, mermaids, fairies and even monster and vampire pregnant women giving birth either vaginally or by caesarean. Despite their preternatural status, the monster and vampire women conform to the same aesthetic as the other pregnant women in these games: usually with long hair and pretty, made-up faces, wearing fashionable clothing even on the operating table. Their newborn infants are similarly uniform in their appearance as they emerge from the uterus. They are white-skinned, clean and cherubic (described in ‘Mommy’s Newborn Baby Princess’ as ‘the cutest baby you probably want’), a far cry from the squalling, squashed-faced infants smeared in birth fluids produced by the real birth process.In these pregnancy games for girls, the pain and intense bodily effort of birthing and the messiness produced by the blood and other body fluids inherent to the process of labour and birth are completely missing. The fact that caesarean birth is a major abdominal surgery requiring weeks of recovery is obviated in these games. Apart from the monsters and vampires, who may have green- or blue-hued skin, nearly all other pregnant women are portrayed as white-skinned, young, wearing makeup and slim, conforming to conventional stereotypical notions of female beauty. In these apps, the labouring women remain glamorous, usually smiling, calm and unsullied by the visceral nature of birth.‘Track Your Pregnancy Day by Day’: Self-Monitoring and Gamified PregnancyElements of gamification were evident in a large number of the apps in our corpus, including many apps that invite pregnant users to engage in self-tracking of their bodies and that of their foetuses. Users are asked to customise the apps to document their changing bodies and track their foetus’ development as part of reproducing the discourse of the miraculous nature of pregnancy and promoting the pleasures of self-tracking and self-transformation from pregnant woman to mother. When using the ‘Pregnancy+’ app, for example, users can choose to construct a ‘Personal Dashboard’ that includes details of their pregnancy. They can input their photograph, first name and their expected date of delivery so that that each daily update begins with ‘Hello [name of user], you are [ ] weeks and [ ] days pregnant’ with the users’ photograph attached to the message. The woman’s weight gain over time and a foetal kick counter are also included in this app. It provides various ways for users to mark the passage of time, observe the ways in which their foetuses change and move week by week and monitor changes in their bodies. According to the app description for ‘My Pregnancy Today’, using such features allows a pregnant woman to: ‘Track your pregnancy day by day.’ Other apps encourage women to track such aspects of physical activity, vitamin and fluid intake, diet, mood and symptoms. The capacity to visually document the pregnant user’s body is also a feature of several apps. The ‘Baby Bump Pregnancy’, ‘WebMD Pregnancy’, ‘I’m Expecting’,’iPregnant’ and ‘My Pregnancy Today’ apps, for example, all offer an album feature for pregnant bump photos taken by the user of herself (described as a ‘bumpie’ in the blurb for ‘My Pregnancy Today’). ‘Baby Buddy’ encourages women to create a pregnant avatar of themselves (looking glamorous, well-dressed and happy). Some apps even advise users on how they should feel. As a screenshot from ‘Pregnancy Tracker Week by Week’ claims: ‘Victoria, your baby is growing in your body. You should be the happiest woman in the world.’Just as pregnancy games for little girls portrayal pregnancy as a commodified and asetheticised experience, the apps directed at pregnant women themselves tend to shy away from discomforting fleshly realities of pregnant and birthing embodiment. Pregnancy is represented as an enjoyable and fashionable state of embodiment: albeit one that requires constant self-surveillance and vigilance.‘Hello Mommy!’: The Personalisation and Aestheticisation of the FoetusA dominant feature of pregnancy-related apps is the representation of the foetus as already a communicative person in its own right. For example, the ‘Pregnancy Tickers – Widget’ app features the image of a foetus (looking far more like an infant, with a full head of wavy hair and open eyes) holding a pencil and marking a tally on the walls of the uterus. The app is designed to provide various icons showing the progress of the user’s pregnancy each day on her mobile device. The ‘Hi Mommy’ app features a cartoon-like pink and cuddly foetus looking very baby-like addressing its mother from the womb, as in the following message that appears on the user’s smartphone: ‘Hi Mommy! When will I see you for the first time?’ Several pregnancy-tracking apps also allow women to input the name that they have chosen for their expected baby, to receive customised notifications of its progress (‘Justin is nine weeks and two days old today’).Many apps also incorporate images of foetuses that represent them as wondrous entities, adopting the visual style of 1960s foetal photography pioneer Lennart Nilsson, or what Stormer (Stormer) has referred to as ‘prenatal sublimity’. The ‘Pregnancy+’ app features such images. Users can choose to view foetal development week-by-week as a colourful computerised animation or 2D and 3D ultrasound scans that have been digitally manipulated to render them aesthetically appealing. These images replicate the softly pink, glowing portrayals of miraculous unborn life typical of Nilsson’s style.Other apps adopt a more contemporary aesthetic and allow parents to store and manipulate images of their foetal ultrasounds and then share them via social media. The ‘Pimp My Ultrasound’ app, for example, invites prospective parents to manipulate images of their foetal ultrasounds by adding in novelty features to the foetal image such as baseball caps, jewellery, credit cards and musical instruments. The ‘Hello Mom’ app creates a ‘fetal album’ of ultrasounds taken of the user’s foetus, while the ‘Ultrasound Viewer’ app lets users manipulate their 3/4 D foetal ultrasound images: ‘Have fun viewing it from every angle, rotating, panning and zooming to see your babies [sic] features and share with your family and friends via Facebook and Twitter! … Once uploaded, you can customise your scan with a background colour and skin colour of your choice’.DiscussionPregnancy, like any other form of embodiment, is performative. Pregnant women are expected to conform to norms and assumptions about their physical appearance and deportment of their bodies that expect them to remain well-groomed, fit and physically attractive without appearing overly sexual (Longhurst "(Ad)Dressing Pregnant Bodies in New Zealand: Clothing, Fashion, Subjectivities and Spatialities"; Longhurst "'Corporeographies’ of Pregnancy: ‘Bikini Babes'"; Nash; Littler). Simultaneously they must negotiate the burden of bodily management in the interests of risk regulation. They are expected to protect their vulnerable unborn from potential dangers by stringently disciplining their bodies and policing to what substances they allow entry (Lupton The Social Worlds of the Unborn; Lupton "'Precious Cargo': Risk and Reproductive Citizenship"). Pregnancy self-tracking apps enact the soft politics of algorithmic authority, encouraging people to conform to expectations of self-responsibility and self-management by devoting attention to monitoring their bodies and acting on the data that they generate (Whitson; Millington "Amusing Ourselves to Life: Fitness Consumerism and the Birth of Bio-Games"; Lupton The Quantified Self: A Sociology of Self-Tracking).Many commentators have remarked on the sexism inherent in digital games (e.g. Dickerman, Christensen and Kerl-McClain; Thornham). Very little research has been conducted specifically on the gendered nature of app games. However our analysis suggests that, at least in relation to the pregnant woman, reductionist heteronormative, cisgendered, patronising and paternalistic stereotypes abound. In the games for girls, pregnant women are ideally young, heterosexual, partnered, attractive, slim and well-groomed, before, during and after birth. In self-tracking apps, pregnant women are portrayed as ideally self-responsible, enthused about their pregnancy and foetus to the point that they are counting the days until the birth and enthusiastic about collecting and sharing details about themselves and their unborn (often via social media).Ambivalence about pregnancy, the foetus or impending motherhood, and lack of interest in monitoring the pregnancy or sharing details of it with others are not accommodated, acknowledged or expected by these apps. Acknowledgement of the possibility of pregnant women who are not overtly positive about their pregnancy or lack interest in it or who identify as transgender or lesbian or who are sole mothers is distinctly absent.Common practices we noted in apps – such as giving foetuses names before birth and representing them as verbally communicating with their mothers from inside the womb – underpin a growing intensification around the notion of the unborn entity as already an infant and social actor in its own right. These practices have significant implications for political agendas around the treatment of pregnant women in terms of their protection or otherwise of their unborn, and for debates about women’s reproductive rights and access to abortion (Lupton The Social Worlds of the Unborn; Taylor The Public Life of the Fetal Sonogram: Technology, Consumption and the Politics of Reproduction). Further, the gamification and ludification of pregnancy serve to further commodify the experience of pregnancy and childbirth, contributing to an already highly commercialised environment in which expectant parents, and particularly mothers, are invited to purchase many goods and services related to pregnancy and early parenthood (Taylor "Of Sonograms and Baby Prams: Prenatal Diagnosis, Pregnancy, and Consumption"; Kroløkke; Thomson et al.; Taylor The Public Life of the Fetal Sonogram: Technology, Consumption and the Politics of Reproduction; Thomas).In the games for girls we examined, the pregnant woman herself was a commodity, a selling point for the app. The foetus was also frequently commodified in its representation as an aestheticised entity and the employment of its image (either as an ultrasound or other visual representations) or identity to market apps such as the girls’ games, apps for manipulating ultrasound images, games for predicting the foetus’ sex and choosing its name, and prank apps using fake ultrasounds purporting to reveal a foetus inside a person’s body. As the pregnant user engages in apps, she becomes a commodity in yet another way: the generator of personal data that are marketable in themselves. In this era of the digital data knowledge economy, the personal information about people gathered from their online interactions and content creation has become highly profitable for third parties (Andrejevic; van Dijck). Given that pregnant women are usually in the market for many new goods and services, their personal data is a key target for data mining companies, who harvest it to sell to advertisers (Marwick).To conclude, our analysis suggests that gamification and ludification strategies directed at pregnancy and childbirth can serve to obfuscate the societal pressures that expect and seek to motivate pregnant women to maintain physical fitness and attractiveness, simultaneously ensuring that they protect their foetuses from all possible risks. In achieving both ends, women are encouraged to engage in intense self-monitoring and regulation of their bodies. These apps also reproduce concepts of the unborn entity as a precious and beautiful already-human. These types of portrayals have important implications for how young girls learn about pregnancy and childbirth, for pregnant women’s experiences and for concepts of foetal personhood that in turn may influence women’s reproductive rights and abortion politics.ReferencesAndrejevic, Mark. Infoglut: How Too Much Information Is Changing the Way We Think and Know. New York: Routledge, 2013. Print.Bogost, Ian. "Why Gamification Is Bullshit." The Gameful World: Approaches, Issues, Applications. Eds. Steffen Walz and Sebastian Deterding. Boston, MA: MIT Press, 2015. 65-80. Print.Declercq, E.R., et al. Listening to Mothers III: Pregnancy and Birth. New York: Childbirth Connection, 2013. Print.Derbyshire, Emma, and Darren Dancey. "Smartphone Medical Applications for Women's Health: What Is the Evidence-Base and Feedback?" International Journal of Telemedicine and Applications (2013).Deterding, Sebastian, et al. "From Game Design Elements to Gamefulness: Defining Gamification." Proceedings of the 15th International Academic MindTrek Conference: Envisioning Future Media Environments. ACM, 2011. Dickerman, Charles, Jeff Christensen, and Stella Beatríz Kerl-McClain. "Big Breasts and Bad Guys: Depictions of Gender and Race in Video Games." Journal of Creativity in Mental Health 3.1 (2008): 20-29. Duden, Barbara. Disembodying Women: Perspectives on Pregnancy and the Unborn. Trans. Lee Hoinacki. Cambridge, MA: Harvard University Press, 1993. Frissen, Valerie, et al. "Homo Ludens 2.0: Play, Media and Identity." Playful Identities: The Ludification of Digital Media Cultures. Eds. Valerie Frissen et al. Amsterdam: University of Amsterdam Press, 2015. 9-50. ———, eds. Playful Identities: The Ludification of Digital Media Cultures. Amsterdam: Amsterdam University Press, 2015. Hearn, Lydia, Margaret Miller, and Anna Fletcher. "Online Healthy Lifestyle Support in the Perinatal Period: What Do Women Want and Do They Use It?" Australian Journal of Primary Health 19.4 (2013): 313-18. Jones, Rhys, Jessica Pykett, and Mark Whitehead. "Big Society's Little Nudges: The Changing Politics of Health Care in an Age of Austerity." Political Insight 1.3 (2010): 85-87. Kraschnewski, L. Jennifer, et al. "Paging “Dr. Google”: Does Technology Fill the Gap Created by the Prenatal Care Visit Structure? Qualitative Focus Group Study with Pregnant Women." Journal of Medical Internet Research. 16.6 (2014): e147. Kroløkke, Charlotte. "On a Trip to the Womb: Biotourist Metaphors in Fetal Ultrasound Imaging." Women's Studies in Communication 33.2 (2010): 138-53. Littler, Jo. "The Rise of the 'Yummy Mummy': Popular Conservatism and the Neoliberal Maternal in Contemporary British Culture." Communication, Culture & Critique 6.2 (2013): 227-43. Longhurst, Robyn. "(Ad)Dressing Pregnant Bodies in New Zealand: Clothing, Fashion, Subjectivities and Spatialities." Gender, Place & Culture 12.4 (2005): 433-46. ———. "'Corporeographies’ of Pregnancy: ‘Bikini Babes'." Environment and Planning D: Society and Space 18.4 (2000): 453-72. Lupton, Deborah. "Apps as Artefacts: Towards a Critical Perspective on Mobile Health and Medical Apps." Societies 4.4 (2014): 606-22. ———. "'Precious Cargo': Risk and Reproductive Citizenship." Critical Public Health 22.3 (2012): 329-40. ———. The Quantified Self: A Sociology of Self-Tracking. Cambridge: Polity Press, 2016. ———. "Quantified Sex: A Critical Analysis of Sexual and Reproductive Self-Tracking Using Apps." Culture, Health & Sexuality 17.4 (2015): 440-53. ———. The Social Worlds of the Unborn. Houndmills: Palgrave Macmillan, 2013. Marwick, Alice. "How Your Data Are Being Deeply Mined." The New York Review of Books (2014). Millington, Brad. "Amusing Ourselves to Life: Fitness Consumerism and the Birth of Bio-Games." Journal of Sport & Social Issues 38.6 (2014): 491-508. ———. "Smartphone Apps and the Mobile Privatization of Health and Fitness." Critical Studies in Media Communication 31.5 (2014): 479-93. Nash, Meredith. Making 'Postmodern' Mothers: Pregnant Embodiment, Baby Bumps and Body Image. Houndmills: Palgrave Macmillan, 2013. O'Higgins, A., et al. "The Use of Digital Media by Women Using the Maternity Services in a Developed Country." Irish Medical Journal 108.5 (2015). Raessens, Joost. "Playful Identities, or the Ludification of Culture." Games and Culture 1.1 (2006): 52-57. Rodger, D., et al. "Pregnant Women’s Use of Information and Communications Technologies to Access Pregnancy-Related Health Information in South Australia." Australian Journal of Primary Health 19.4 (2013): 308-12. Seneviratne, Suranga, et al. "Your Installed Apps Reveal Your Gender and More!" Mobile Computing and Communications Review 18.3 (2015): 55-61. Statista. "Number of Apps Available in Leading App Stores as of May 2015." 2015. Stormer, Nathan. "Looking in Wonder: Prenatal Sublimity and the Commonplace 'Life'." Signs 33.3 (2008): 647-73. Taylor, Janelle. "Of Sonograms and Baby Prams: Prenatal Diagnosis, Pregnancy, and Consumption." Feminist Studies 26.2 (2000): 391-418. ———. The Public Life of the Fetal Sonogram: Technology, Consumption and the Politics of Reproduction. New Brunswick, NJ: Rutgers University Press, 2008. Thomas, Gareth M. "Picture Perfect: ‘4d’ Ultrasound and the Commoditisation of the Private Prenatal Clinic." Journal of Consumer Culture. Online first, 2015. Thomson, Rachel, et al. Making Modern Mothers. Bristol: Policy Press, 2011. Thornham, Helen. “'It's a Boy Thing'.” Feminist Media Studies 8.2 (2008): 127-42. Van Dijck, José. "Datafication, Dataism and Dataveillance: Big Data between Scientific Paradigm and Ideology." Surveillance & Society 12.2 (2014): 197-208. Whitson, Jennifer. "Gaming the Quantified Self." Surveillance & Society 11.1/2 (2013): 163-76.