尼泊尔低地农村孕产妇心理健康与经济自主:公婆提供约束还是支持?

IF 3.3 3区 医学 Q2 EVOLUTIONARY BIOLOGY Evolution, Medicine, and Public Health Pub Date : 2023-01-01 DOI:10.1093/emph/eoad020
Akanksha A Marphatia, Laura K Busert-Sebela, Lu Gram, Mario Cortina-Borja, Alice M Reid, Dharma S Manandhar, Jonathan C K Wells, Naomi M Saville
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摘要

背景和目的:在父系社会中,已婚妇女通常与公婆共同居住,公婆可能会为儿子的生育利益行事。这些关系可能影响产妇的心理健康和自主。很少有研究从进化的角度考察这些动态。从理论上讲,婚姻亲属可以通过增加母亲的投入或减少父亲的不确定性来增加他们的适合度。我们探讨了与公公婆婆和丈夫共同居住与产妇结局的关系,以评估婚姻亲属是否提供支持或限制。方法:我们分析了尼泊尔低地农村444户家庭的数据。采用《一般健康问卷》评估产妇心理健康状况。在调整了社会经济因素后,Logistic回归模型调查了与丈夫和公婆共同生活的母亲相比,与其他亲属组合共同居住的母亲的心理健康状况是否较差,家庭经济自主权(决策、议价能力)是否较低。结果:只与丈夫同居,或者既不与丈夫也不与公公婆婆同居,与母亲报告自己没有价值、失眠的几率更高有关,但也与赚取收入和做出家庭支出决定的几率更高有关。丈夫共同居住与总体的母亲痛苦有关,但也与较少的无偿护理工作和更多的决策责任有关。与与丈夫和公婆同住的母亲相比,仅与公婆同住的母亲的产妇结局没有差异。结论和意义:公公婆婆和丈夫同住与母亲心理健康和经济自主的差异模式相关。我们认为,不同的婚姻亲属对母亲提出了不同的经济要求,同时以不同的方式限制她们的自主权,作为“配偶保护”的形式。
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Maternal mental health and economic autonomy in lowland rural Nepal: Do parents-in-law provide constraint or support?

Background and objectives: In patrilocal societies, married women typically co-reside with their parents-in-law, who may act in their son's reproductive interests. These relationships may shape maternal mental health and autonomy. Few studies have examined these dynamics from an evolutionary perspective. Theoretically, marital kin may increase their fitness by increasing maternal investment or by reducing paternity uncertainty. We explored how co-residence with parents-in-law and husband is associated with maternal outcomes to evaluate whether marital kin provide support or constraint.

Methodology: We analysed data from 444 households in rural lowland Nepal. Maternal mental health was assessed by General Health Questionnaire. Logistic regression models investigated whether, relative to mothers living with both husband and parents-in-law, those co-resident with other combinations of relatives had poorer mental health and lower household economic autonomy (decision-making, bargaining power), adjusting for socio-economic confounders.

Results: Co-residence with husband only, or neither husband nor parents-in-law, was associated with higher odds of mothers reporting feeling worthless and losing sleep but also earning income and making household expenditure decisions. Husband co-residence was associated with overall maternal distress but also with less unpaid care work and greater decision-making responsibility. There were no differences in maternal outcomes for mothers living with parents-in-law only, relative to those living with both husbands and parents-in-law.

Conclusions and implications: Co-residence of parents-in-law and husbands was associated with contrasting patterns of maternal mental health and economic autonomy. We suggest that different marital kin place different economic demands on mothers, while restricting their autonomy in different ways as forms of 'mate-guarding'.

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来源期刊
Evolution, Medicine, and Public Health
Evolution, Medicine, and Public Health Environmental Science-Health, Toxicology and Mutagenesis
CiteScore
5.40
自引率
2.70%
发文量
37
审稿时长
8 weeks
期刊介绍: About the Journal Founded by Stephen Stearns in 2013, Evolution, Medicine, and Public Health is an open access journal that publishes original, rigorous applications of evolutionary science to issues in medicine and public health. It aims to connect evolutionary biology with the health sciences to produce insights that may reduce suffering and save lives. Because evolutionary biology is a basic science that reaches across many disciplines, this journal is open to contributions on a broad range of topics.
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