This study was based on in-depth qualitative interviews with 40 francophone Québécois family caregivers of frail elderly or mentally ill relatives and focused on the caregiving relation rather than on the specificities of aging and mental illness. Fourteen factors (love, guilt and duty, women's social identity built around caring, absence of appropriate public or private care alternatives, women's socioeconomic dependence, etc.) emerged from an analysis of informants' accounts of how they came to be the primary caregiver. Data indicate that analyses attempting to understand women's caregiving must take into account the sexual division of labor, its reinforcement through social policy, and how women internalize ideas and norms regarding appropriate gender-role behavior.
Iceland is a rugged subarctic island 600 miles from Norway and 500 miles from Scotland. From the mid-14th to the end of the 18th century the island was virtually isolated. Isolation and sociocultural factors interacted to delay the fertility transition in Iceland until late in the 20th century. In 1983 Iceland had the highest crude birth rate of any developed country -- 18.4/1000. Between 1890-1982, the population almost tripled, to 235,501 inhabitants. The total fertility rate is 2.2, down from 4.17 in 1960. Combined with a high birth rate was a low mortality rate of 7.0/1000 of the population and a life expectancy of 79.5 years for women and 73.9 years for men -- the highest in the world. Infant mortality is only 6.2/1000 live births. This combination of high fertility, low mortality, and low emigration caused the high population growth. By the end of the 18th century, Iceland had achieved near universal literacy, and education through university is free, but not until 1960 did a woman receive a doctorate from the University of Iceland. By 198, 2/3 of women in Iceland participated in the labor force, but their earnings were only 2/3 those of men. In 1983 a Women's Party was formed, and women now hold 15% of the seats in the Althing (Parliament). Marriage rates have declined to 5.22/1000 of the population. The unique marital pattern of Iceland contributes to the high (41%) illegitimacy rate. Icelandic couples cohabit and have a child or 2 before they marry. They therefore tend to marry late (25.5 for men, 23.3 for women). Health care, including family planning services, is free in Iceland; and there is a medical school, a school of pharmacy, and 2 nursing schools. 35% of Icelandic women 20-40 years of age use either the pill or the IUD. Over-the-counter contraceptives are also available, and an average of 358 women are sterilized each year. The abortion rate is only 10.6/1000 females 15-49 years of age. The Birth Control Act of 1975 calls for the provision of sex education and counseling, including contraception, sterilization and abortion. Nurses can assist in family planning program by observing needs, offering birth planning for couples, and carrying out research in the factors that affect family planning in Iceland.