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Ekstrand, Maria
Publications (10 of 12) Show all publications
Stern, J., Salih Joelsson, L., Tydén, T., Berglund, A., Ekstrand, M., Hegaard, H., . . . Kristiansson, P. (2016). Is pregnancy planning associated with background characteristics and pregnancy planning behavior?. Acta Obstetricia et Gynecologica Scandinavica, 95(2), 182-189
Open this publication in new window or tab >>Is pregnancy planning associated with background characteristics and pregnancy planning behavior?
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2016 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 95, no 2, p. 182-189Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Prevalence of planned pregnancies varies between countries but is often measured in a dichotomous manner. The aim of this study was to investigate to what level pregnant women had planned their pregnancies and whether pregnancy planning was associated with background characteristics and pregnancy planning behavior.

MATERIAL AND METHODS: A cross-sectional study that utilized the baseline measurements from the Swedish Pregnancy Planning (SWEPP) study. Pregnant women (n= 3390) recruited at antenatal clinics answered a questionnaire. Data were analyzed with multinomial logistic regression, Kruskal-Wallis H and χ(2) tests.

RESULTS: Three out of four pregnancies were very or fairly planned and 12 % fairly or very unplanned. Of women with very unplanned pregnancies, 32 % had considered an induced abortion. Women with planned pregnancies were more likely to have a higher level of education, higher household income, to be currently working ≥50 %, and to have longer relationships than women with unplanned pregnancies. The level of pregnancy planning was associated with planning behavior, such as information seeking and intake of folic acid, but without a reduction in alcohol consumption. One third of all women took folic acid one month prior to conception, 17 % used tobacco daily and 11 % used alcohol weekly three months before conception.

CONCLUSIONS: A majority rated their pregnancy as very or fairly planned, with socio-economic factors as explanatory variables. The level of pregnancy planning should be queried routinely to enable individualized counselling, especially for women with unplanned pregnancies. Preconception recommendations need to be established and communicated to the public to increase health promoting planning behavior.

Keyword
Planned pregnancy; unplanned pregnancy; preconception care; folic acid; health behavior
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-270500 (URN)10.1111/aogs.12816 (DOI)000368004300007 ()26566076 (PubMedID)
Available from: 2015-12-29 Created: 2015-12-29 Last updated: 2018-01-19Bibliographically approved
Ekstrand, M., Tyden, T., Kihlbom, U. & Larsson, M. (2016). Swedish parents’ interest in preconception genetic carrier screening. Upsala Journal of Medical Sciences, 121(4), 289-294
Open this publication in new window or tab >>Swedish parents’ interest in preconception genetic carrier screening
2016 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 121, no 4, p. 289-294Article in journal (Refereed) Published
Abstract [en]

Introduction: Genetic technologies advance rapidly. It is possible to undergo genetic carrier screening before pregnancy to examine genetic risks to future offspring. We aimed to investigate parents’ interest and motives towards preconception genetic carrier screening (PCS) as well as factors associated with interest in PCS.

Material and methods: Our study sample consists of 777 parent couples within the longitudinal Swedish Pregnancy Planning study. Women responded to questionnaires at three occasions: in early pregnancy, late pregnancy, and one year after childbirth. Male partners responded to one questionnaire one year after childbirth.

Results: One-third of the parents were positive (30% versus 34% of women and men, respectively), less than a third were negative (26% versus 28%), and 45% versus 38% were uncertain about whether to consider PCS before a future pregnancy. No differences in PCS interest were found between women and men (P = 0.091), but a higher proportion of women were concerned about negative consequences (53% versus 46%, P < 0.003) and were ‘opposed to such a way of child selection’ (31.8% versus 25.2%,P = 0.002). Factors associated with PCS interest were experiences of prenatal diagnostics and positive attitudes towards finding out or choosing sex of one’s child (women), and prenatal diagnostics, self-rated poor health, and pregnancy planning (men).

Conclusion: Both women and men had relatively high uncertainty towards PCS, but women were more concerned about negative consequences. The future extent of the clinical utility of PCS is currently unknown, but parents’ interests and doubts are important aspects to consider.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keyword
Interest, motives, parents, preconception genetic carrier screening
National Category
Health Sciences Medical Ethics
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-303545 (URN)10.1080/03009734.2016.1218575 (DOI)000387292600016 ()27647125 (PubMedID)
Available from: 2016-09-20 Created: 2016-09-20 Last updated: 2017-11-21Bibliographically approved
Shawe, J., Delbaere, I., Ekstrand, M., Hegaard, H. K., Larsson, M., Mastroiacovo, P., . . . Tydén, T. (2015). Preconception care policy, guidelines, recommendations and services across six European countries: Belgium (Flanders), Denmark, Italy, the Netherlands, Sweden and the United Kingdom. European journal of contraception & reproductive health care, 20(2), 77-87
Open this publication in new window or tab >>Preconception care policy, guidelines, recommendations and services across six European countries: Belgium (Flanders), Denmark, Italy, the Netherlands, Sweden and the United Kingdom
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2015 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 20, no 2, p. 77-87Article in journal (Refereed) Published
Abstract [en]

Objectives Preconception care is important for the screening, prevention and management of risk factors that affect pregnancy outcomes. We aimed to investigate pre-pregnancy care policies, guidelines, recommendations and services in six European countries. Methods In 2013, an electronic search and investigation was undertaken of preconception policy, guidelines, recommendations and services available to healthcare professionals and the general public in six European countries: Belgium (Flanders), Denmark, Italy, the Netherlands, Sweden and the United Kingdom. Findings were compared within five categories: Governmental policy and legislation; Professional bodies and organisations; Healthcare providers; Charitable organisations; Web-based public information and internet sites. Results All countries had preconception recommendations for women with chronic diseases, such as diabetes and epilepsy. Recommendations for healthy women and men were fragmented and inconsistent. Preconception guidance was often included in antenatal and pregnancy guidelines. Differences between countries were seen with regard to nutritional and lifestyle advice particularly in relation to fish, caffeine and alcohol consumption, and vitamin supplementation. Conclusions Current guidelines are heterogeneous. Collaborative research across Europe is required in order to develop evidence-based guidelines for preconception health and care. There is a need to establish a clear strategy for promoting advice and guidance within the European childbearing population.

Keyword
Preconception care, Pre-pregnancy health and care, Pregnancy, Policy, Guidelines, Europe
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-252391 (URN)10.3109/13625187.2014.990088 (DOI)000351398300002 ()25548961 (PubMedID)
Available from: 2015-05-06 Created: 2015-05-06 Last updated: 2017-12-04
Tydén, T., Hegaard, H., Hedegaard, M., Kristiansson, P., Stern, J., Aarts, C., . . . Rosenblad, A. (2015). Pregnancy planning and among women attending antenatal care in Sweden and Denmark. Paper presented at 31st Annual Meeting of the European-Society-of-Human-Reproduction-and-Embryology (ESHRE), JUN 14-17, 2015, Lisbon, PORTUGAL. Human Reproduction, 30(Suppl. 1), 444-444
Open this publication in new window or tab >>Pregnancy planning and among women attending antenatal care in Sweden and Denmark
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2015 (English)In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 30, no Suppl. 1, p. 444-444Article in journal, Meeting abstract (Other academic) Published
Keyword
pregnancy planning, folic acid supplement, pregnancy outcome
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-264925 (URN)000359740303124 ()
Conference
31st Annual Meeting of the European-Society-of-Human-Reproduction-and-Embryology (ESHRE), JUN 14-17, 2015, Lisbon, PORTUGAL
Note

Meeting Abstract: P-754

Available from: 2015-11-02 Created: 2015-10-19 Last updated: 2018-01-19Bibliographically approved
Backhausen, M. G., Ekstrand, M., Tydén, T., Magnussen, B. K., Shawe, J., Stern, J. & Hegaard, H. K. (2014). Pregnancy planning and lifestyle prior to conception and during early pregnancy among Danish women. European journal of contraception & reproductive health care, 19(1), 57-65
Open this publication in new window or tab >>Pregnancy planning and lifestyle prior to conception and during early pregnancy among Danish women
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2014 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 19, no 1, p. 57-65Article in journal (Refereed) Published
Abstract [en]

Objective To investigate the extent to which Danish women attending antenatal care plan their pregnancies and to determine the association between pregnancy planning and the intake of folic acid, alcohol consumption and smoking habits prior to conception and before the 16th week of gestation. Methods A cross-sectional survey of 258 women. Main outcome measures: intake of folic acid, alcohol consumption and smoking. Pregnancy planning was assessed by the London Measure of Unplanned Pregnancy (LMUP) and the five graded Swedish Pregnancy Planning Scale. Results Most (77%) of the participants reported that their pregnancies were very or fairly well planned. Higher median LMUP scores were observed in women taking folic acid (p < 0.001), in those consuming less alcohol, and in women who stopped smoking prior to pregnancy (p = 0.043). However, 43% of the respondents with a high degree of pregnancy planning and 98% of those with a low degree of planning had not taken folic acid prior to pregnancy. Binge drinking during early pregnancy was reported by 20% of women with a high degree of planned pregnancy and 31% of those with a low degree (p = 0.1). Conclusion Pregnancy planning was associated with a healthier lifestyle but still many women could improve their lifestyle in connection to pregnancy. Their level of alcohol consumption is higher than that recommended for best pregnancy outcome.

National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-214706 (URN)10.3109/13625187.2013.851183 (DOI)000331288300009 ()24229390 (PubMedID)
Available from: 2014-01-09 Created: 2014-01-09 Last updated: 2017-12-06Bibliographically approved
Ekstrand, M., Tyden, T., Darj, E. & Larsson, M. (2013). Twelve-month follow-up of advance provision of emergency contraception among teenage girls in Sweden-a randomized controlled trial. Upsala Journal of Medical Sciences, 118(4), 271-275
Open this publication in new window or tab >>Twelve-month follow-up of advance provision of emergency contraception among teenage girls in Sweden-a randomized controlled trial
2013 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 118, no 4, p. 271-275Article in journal (Refereed) Published
Abstract [en]

Objective. The objective of this study was to evaluate the effect of an intervention with advance provision of emergency contraceptive pills (ECP), condoms, and extended information to a targeted group of teenage girls, compared with a control group, 12 months after intervention. Material and methods. A randomized controlled trial among 420 girls, 15-19 years old, requesting emergency contraception at a youth clinic in Sweden was carried out. Data were collected by a questionnaire at the initial visit and structured telephone interviews 12 months after enrolment. Differences between the intervention group and the control group regarding ECP use, time interval from unprotected intercourse to ECP intake, contraceptive use, and sexual risk-taking were analysed. Results. One year after the intervention 62% of the girls could be reached for follow-up. The girls in the intervention group reported a shorter time interval (mean 15.3 hours) from unprotected intercourse to ECP intake compared to the control group (mean 25.8 hours) (p = 0.019), without any evidence of decreased use of contraceptives or increased sexual risk-taking. Conclusion. Even up to 12 months following the intervention, advance provision of ECP at one single occasion, to a specific target group of adolescent girls, shortens the time interval from unprotected intercourse to pill intake, without jeopardizing contraceptive use or increasing sexual risk-taking. Considering the clinical relevance of these results, we suggest that advance provision of ECP could be implemented as a routine preventive measure for this target group.

Keyword
Adolescents, advance provision, emergency contraception, sexual risk-taking
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-210567 (URN)10.3109/03009734.2013.841308 (DOI)000325527300010 ()
Available from: 2013-11-13 Created: 2013-11-11 Last updated: 2017-12-06Bibliographically approved
Liljas Stålhandske, M., Ekstrand, M. & Tydén, T. (2011). Existential Experiences and Strategies in Relation to Induced Abortion: an Interview Study With 24 Swedish Women. Archive for the Psychology of Religion/ Archiv für Religionspsychologie, 33(3), 345-370
Open this publication in new window or tab >>Existential Experiences and Strategies in Relation to Induced Abortion: an Interview Study With 24 Swedish Women
2011 (English)In: Archive for the Psychology of Religion/ Archiv für Religionspsychologie, ISSN 0084-6724, E-ISSN 1573-6121, Vol. 33, no 3, p. 345-370Article in journal (Refereed) Published
Abstract [en]

Induced abortion is as common in religious as secular cultures, but interpretations and ways to handle abortion differ. This study focuses existential aspects of abortion, in relation to a secularized context, through in-depth interviews with 24 Swedish women. Existential questions belonging to four areas were found: Life and Death, Meaning of Life, Morality and Self Image. Furthermore, four different existential strategies were found: (1) Detaching Strategies (creating distance to the pregnancy), (2) Meaning-Making Strategies (relating the abortion to one’s worldview), (3) Social Strategies (sharing the abortion with others), and (4) Symbolic Strategies (expressing the experience in bodily ways). Existential questions and strategies did not imply that the woman regretted her abortion. However, while some women easily processed existential questions, others seemed to be more at loss. In a secularized country, where many people are unaccustomed to deal with existential issues, greater existential competence among abortion personnel thus might be needed.

Keyword
abortion, existential questions, meaning-making, secularity, Sweden, worldview, worldview typology
National Category
Religious Studies
Research subject
Psychology of Religion
Identifiers
urn:nbn:se:uu:diva-159165 (URN)10.1163/157361211X594177 (DOI)000297798900006 ()
Available from: 2012-01-20 Created: 2011-09-23 Last updated: 2017-12-08Bibliographically approved
Ekstrand, M., Tydén, T. & Larsson, M. (2011). Exposing oneself and one's partner to sexual risk-taking as perceived by young Swedish men who requested a Chlamydia test. European journal of contraception & reproductive health care, 16(2), 100-107
Open this publication in new window or tab >>Exposing oneself and one's partner to sexual risk-taking as perceived by young Swedish men who requested a Chlamydia test
2011 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, no 2, p. 100-107Article in journal (Refereed) Published
Abstract [en]

Objectives: To explore young men's perceptions of (i) the risk for themselves and their partners in connection with unprotected intercourse, and (ii) the main barriers to practising safe sex. Methods: Qualitative latent content analysis of interviews involving 22 Swedish males aged 16-20, who requested a Chlamydia test. Results:The main categories identified were: (1) Low perceived threat regarding sexual risk-taking - personal consequences in focus. Threats could be both immediate and distant with varying preventative strategies. The young men worried more about their personal consequences than about the consequences for their partner. They were confident that an unintended pregnancy would be terminated, leading to decreased motivation for sharing pregnancy-preventing practices with their partner. (2) Perceived barriers to practising safe sex. Main barriers to condom use were interference with spontaneity, pleasure reduction, fear of loosing one's erection, and embarrassment or distrust. Other obstacles were the girl's use of hormonal contraception, and difficulties in communicating about safe sex. Conclusion The young men did not seem to worry about risks when having unprotected sex. To protect men's - and women's - sexual and reproductive health, efforts are needed to increase the former's contraceptive responsibilities and awareness of consequences related to unprotected sex.

Keyword
Sexual risk-taking, Attitudes, Men, Chlamydia, Abortion, Condom use
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-145026 (URN)10.3109/13625187.2010.549253 (DOI)000288610200007 ()21281095 (PubMedID)
Available from: 2011-02-04 Created: 2011-02-04 Last updated: 2017-12-11Bibliographically approved
Liljas Stålhandske, M., Ekstrand, M. & Tydén, T. (2011). Women’s existential experiences within Swedish abortion care. Journal of Psychosomatic Obstetrics and Gynaecology, 32(1), 35-41
Open this publication in new window or tab >>Women’s existential experiences within Swedish abortion care
2011 (English)In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 32, no 1, p. 35-41Article in journal (Refereed) Published
Abstract [en]

Objective: To explore Swedish women’s experiences of clinical abortion care in relation to their need for existential support.

Methods: Individual in-depth interviews with 24 women with previous experience of unwanted pregnancy and abortion. Participants were recruited between 2006 and 2009. Interviews were analysed by latent content analysis.

Findings: Although the women had similar experiences of the abortion care offered, the needs they expressed differed. Swedish abortion care was described as rational and neutral, with physical issues dominating over existential ones. For some women, the medical procedures triggered existential experiences of life, meaning, and morality. While some women abstained from any form of existential support, others expressed a need to reflect upon the existential aspects and/or to reconcile their decision emotionally.

Conclusion: As women’s needs for existential support in relation to abortion vary, women can be disappointed with the personnel’s ability to respond to their thoughts and feelings related to the abortion. To ensure abortion care personnel meet the physical, psychological, and existential needs of each patient, better resources and new lines of education are needed to ensure abortion personnel are equipped to deal with the existential aspects of abortion care.

Keyword
abortion, abortion care, psychological wellbeing, women’s health, existential support, existential experience, Sweden
National Category
Religious Studies Nursing
Research subject
Psychology of Religion
Identifiers
urn:nbn:se:uu:diva-137801 (URN)10.3109/0167482X.2010.545457 (DOI)000286993800006 ()
Projects
Impact of Religion
Available from: 2011-02-01 Created: 2010-12-15 Last updated: 2017-12-11Bibliographically approved
Ekstrand, M., Tydén, T., Darj, E. & Larsson, M. (2009). An illusion of power: Qualitative Perspectives On Abortion Decision-Making Among Teenage Women In Sweden. Perspectives on sexual and reproductive health, 41(3), 173-180
Open this publication in new window or tab >>An illusion of power: Qualitative Perspectives On Abortion Decision-Making Among Teenage Women In Sweden
2009 (English)In: Perspectives on sexual and reproductive health, ISSN 1538-6341, E-ISSN 1931-2393, Vol. 41, no 3, p. 173-180Article in journal (Refereed) Published
Abstract [en]

CONTEXT:Swedish law permits abortion at the request of a pregnant woman untilthe 18th week of gestation. However, the extent to which the decision istruly the woman's own is subject to debate; women are often influenced,directly or indirectly, by the attitudes of their partners, family andfriends or by social norms. METHODS: Individual in-depth interviewsabout the pregnancy and the abortion decision were conducted 3-4 weekspostabortion with 25 women aged 16-20 at different periods in 2003, 2005and 2007. Interviews were audio-taped, transcribed verbatim andanalyzed using latent content analysis. RESULTS: The main reasons forunplanned pregnancy were underestimation of pregnancy risk andinconsistent contraceptive use. Pregnancy prevention was perceived asthe woman's responsibility. The abortion decision was accompanied bymixed emotions, and was seen as a natural yet difficult choice. Socialnorms and the negative attitudes of family and friends stronglyinfluenced the decision. Partners and parents were regarded as the mostimportant sources of support. After the abortion, the women feltpressured by contraceptive counselors to use highly effectivecontraceptives despite their previous negative experiences or worriesabout side effects. CONCLUSIONS: Swedish teenagers' basic right todecide whether to have an abortion may be limited by societal norms anddisapproval of teenage childbearing. Given the perception that women areresponsible for contraception, programs need to emphasize thatpregnancy prevention is a shared responsibility; greater efforts toinclude males in prevention practices are needed.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-96961 (URN)10.1363/4117309 (DOI)000269543000005 ()19740236 (PubMedID)
Available from: 2008-04-03 Created: 2008-04-03 Last updated: 2017-12-14Bibliographically approved
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