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Hildingsson, IngegerdORCID iD iconorcid.org/0000-0001-6985-6729
Publications (10 of 88) Show all publications
Hildingsson, I., Karlström, A., Rubertsson, C. & Haines, H. (2019). A known midwife can make a difference for women with fear of childbirth- birth outcome and experience of intrapartum care. Sexual and Reproductive healthcare, 21, 33-38
Open this publication in new window or tab >>A known midwife can make a difference for women with fear of childbirth- birth outcome and experience of intrapartum care
2019 (English)In: Sexual and Reproductive healthcare, Vol. 21, p. 33-38Article in journal (Refereed) Published
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-400592 (URN)10.1016/j.srhc.2019.06.004 (DOI)
Funder
Swedish Research Council
Available from: 2019-12-28 Created: 2019-12-28 Last updated: 2020-01-29Bibliographically approved
Hildingsson, I., Rubertsson, C., Karlström, A. & Haines, H. (2019). A known midwife can make a difference for women with fear of childbirth-birth outcome and women's experiences of intrapartum care. Sexual & Reproductive HealthCare, 21, 33-38
Open this publication in new window or tab >>A known midwife can make a difference for women with fear of childbirth-birth outcome and women's experiences of intrapartum care
2019 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 21, p. 33-38Article in journal (Refereed) Published
Abstract [en]

Background: There is evidence that continuity of midwifery care is beneficial to women. Women with fear of childbirth in Sweden are offered counselling, but receiving care from a known midwife during labour is unusual, despite its effects in reducing interventions and increasing birth satisfaction. The aim of this study was to describe and compare birth outcome and experience of intrapartum care among women with fear of childbirth who received intrapartum care from a known midwife, versus those who did not.

Methods: An experimental study of 70 women referred to counselling due to fear of birth during pregnancy wherein the counselling midwife, when possible, also assisted during labour and birth.

Results: Having a known midwife during labour and birth had a positive impact on fearful women’s birth experience and their perception of pain, but there was no difference in onset of labour or mode of birth. Women who received care from a known midwife experienced better care with regards to information, participation in decision making and perception of control.

Conclusion: This study indicates that having access to a known midwife might have an impact on women’s birth experience. This study was limited by its small sample size and further research would need to randomise fearful women to counselling or continuity of care to determine the contribution of each to reducing fear.

 

Keywords
Fear of childbirth, Intrapartum care, Continuity, Counseling, Birth experience
National Category
Nursing Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-395432 (URN)10.1016/j.srhc.2019.06.004 (DOI)000485335500007 ()31395231 (PubMedID)
Funder
Swedish Research Council
Available from: 2019-10-23 Created: 2019-10-23 Last updated: 2019-10-23Bibliographically approved
Hildingsson, I., Lindgren, H., Karlström, A., Christensson, K., Bäck, L., Mudokwenyu-Rawdon, C., . . . Sharma, B. (2019). African midwifery students' self-assessed confidence in antenatal care: a multi-country study. Global Health Action, 12(1), Article ID 1689721.
Open this publication in new window or tab >>African midwifery students' self-assessed confidence in antenatal care: a multi-country study
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2019 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, no 1, article id 1689721Article in journal (Refereed) Published
Abstract [en]

Background: Evidence-based antenatal care is one cornerstone in Safe Motherhood and educated and confident midwives remain to be optimal caregivers in Africa. Confidence in antenatal midwifery skills is important and could differ depending on the provision of education among the training institutions across Africa. Objective: The aim of the study was to describe and compare midwifery students' confidence in basic antenatal skills, in relation to age, sex, program type and level of program. Methods: A survey in seven sub-Saharan African countries was conducted. Enrolled midwifery students from selected midwifery institutions in each country presented selfreported data on confidence to provide antenatal care. Data were collected using a selfadministered questionnaire. The questionnaire consisted of 22 antenatal skills based on the competency framework from the International Confederation of Midwives. The skills were grouped into three domains; Identify fetal and maternal risk factors and educate parents; Manage and document emergent complications and Physical assessment and nutrition. Results: In total, 1407 midwifery students from seven Sub-Saharan countries responded. Almost one third (25-32%) of the students reported high levels of confidence in all three domains. Direct entry programs were associated with higher levels of confidence in all three domains, compared to post-nursing and double degree programs. Students enrolled at education with diploma level presented with high levels of confidence in two out of three domains. Conclusions: A significant proportion of student midwives rated themselves low on confidence to provide ANC. Midwifery students enrolled in direct entry programs reported higher levels of confidence in all domains. It is important that local governments develop education standards, based on recommendations from the International Confederation of midwives. Further research is needed for the evaluation of actual competence.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
Keywords
Midwifery students, confidence, education
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-398575 (URN)10.1080/16549716.2019.1689721 (DOI)000497448900001 ()31747850 (PubMedID)
Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2019-12-09Bibliographically approved
Hildingsson, I. & Rubertsson, C. (2019). Childbirth Experience in women randomized to internet based cognitive therapy or midwife counseling. Journal of Psychosomatic Obstetrics & Gynecology
Open this publication in new window or tab >>Childbirth Experience in women randomized to internet based cognitive therapy or midwife counseling
2019 (English)In: Journal of Psychosomatic Obstetrics & Gynecology, ISSN 0167-482XArticle in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Although women with fear of birth often report negative birth experiences, few studies have focused on their experiences in the long term. The aim of this study was to compare birth experiences a year after childbirth in two groups of women receiving treatment for experiencing fear of birth during pregnancy.

Methods: As part of the U-CARE: Pregnancy Trial, a prospective multicenter randomized controlled trial comparing the effects of internet-based cognitive behavioral therapy (iCBT) and standard care among pregnant women with fear of birth. Women were recruited at three Swedish hospitals following a screening procedure that assessed their fear of birth. Data were collected online with the Childbirth Experience Questionnaire (CEQ), one question about the overall birth experience, and questions about personal background, collected before randomization.

Results: A total of 181 women responded to the follow-up questionnaire a year after childbirth. Approximately half of participants reported a less positive birth experience. Preferred mode of birth, actual mode of birth, marital status and psychiatric history were associated with the domains of the CEQ. However, no statistically significant differences emerged between the treatment groups.

Conclusions: Being randomized to receive iCBT or counseling with midwives for fear of birth was not associated with perceptions of the birth experience assessed a year after birth. Most participants reported less-than-positive birth experiences and scored low on the domain of the CEQ reflecting Own capacity. In response, additional research remains necessary to identify the best model of care that might facilitate positive experiences with giving birth among women with fear of birth.

National Category
Health Sciences
Identifiers
urn:nbn:se:uu:diva-400591 (URN)10.1080/0167482X.2019.1634047 (DOI)31244352 (PubMedID)
Funder
Swedish Research Council
Available from: 2019-12-28 Created: 2019-12-28 Last updated: 2020-01-31Bibliographically approved
Höglund, B., Radestad, I. & Hildingsson, I. (2019). Few women receive a specific explanation of a stillbirth - an online survey of women's perceptions and thoughts about the cause of their baby's death. BMC Pregnancy and Childbirth, 19, Article ID 139.
Open this publication in new window or tab >>Few women receive a specific explanation of a stillbirth - an online survey of women's perceptions and thoughts about the cause of their baby's death
2019 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 19, article id 139Article in journal (Refereed) Published
Abstract [en]

Background: In Sweden, three to four out of every 1000 pregnancies end in stillbirth each year. The aim of this study was to investigate whether women who had experienced stillbirth perceived that they had received an explanation of the death and whether they believed that healthcare professionals were responsible for the death of the baby.

Methods: An online survey of 356 women in Sweden who had experienced a stillbirth from January 2010 to April 2014. A mixed-methods approach with qualitative content analysis was used to examine the women's responses.

Results: Nearly half of the women (48.6%) reported that they had not received any explanation as to why their babies had died. Of the women who reported that they had received an explanation, 84 (23.6%) had a specific explanation, and 99 (27.8%) had a vague explanation. In total, 73 (30.0%) of the 243 women who answered the question Do you believe that healthcare personnel were responsible for the stillbirth? stated Yes. The women reported that the healthcare staff had not acknowledged their intuition that the pregnancy was proceeding poorly. Furthermore, they perceived that the staff met them with nonchalance and arrogance. Additionally, the midwife had ignored or normalised the symptoms that could indicate that their pregnancy was proceeding poorly. Some women added that neglect and avoidance among the healthcare staff could have led to a lack of monitoring, which could have been crucial for the outcome of the pregnancy.

Conclusions: Half of the women surveyed reported that they had not received an explanation of their baby's death, and more than one-fourth held healthcare professionals responsible for the death.

Place, publisher, year, edition, pages
BMC, 2019
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-383852 (URN)10.1186/s12884-019-2289-4 (DOI)000466991400001 ()31027483 (PubMedID)
Available from: 2019-05-24 Created: 2019-05-24 Last updated: 2019-05-24Bibliographically approved
Sharma, B., Hildingsson, I. & Christensson, K. (2019). The association of teaching-learning methods and self-confidence of nurse-midwives: A survey from one province in India. Women and Birth, 32(3), E366-E373
Open this publication in new window or tab >>The association of teaching-learning methods and self-confidence of nurse-midwives: A survey from one province in India
2019 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 32, no 3, p. E366-E373Article in journal (Refereed) Published
Abstract [en]

Background: This study aimed to investigate the association between self-confidence of final-year students in selected midwifery skills and teaching-learning methods used in the two formally recognized education programs for nurse-midwives in India. Design: A cross-sectional survey Participants: 633 final-year students, from 25 educational institutions randomly selected, stratified by type of program (diploma/ bachelor), and ownership (private/government) in Gujarat. Data collection and analysis: Students assessed their confidence on a 4-point scale, in four midwifery competency domains-antepartum, intrapartum, postpartum, and newborn care recommended by the International Confederation of Midwives (ICM). Explorative factor analysis was used to reduce skill statements into subscales separately for each domain. Odds ratios with 95% CI were calculated for students with high confidence (>= 75th percentile on each subscale) and not high confidence (all others) between diploma and bachelor students. Results: Classroom teaching was the most practiced method. 'Laboratory demonstrations', 'Practice on models', 'Demonstrations at clinical sites', 'Births Attended' (Hands-on clinical practice), and 'Satisfaction with clinical supervision' were practiced less, lesser in the bachelor's compared to the diploma program. High confidence was associated with 'Births Attended' (Hands-on clinical practice), 'Practice on models', and 'Satisfaction with clinical supervision' for all subscales of all four domains of competencies. Conclusions: Hands on skills practice in the laboratory and supervised clinical practice during clinical placements were associated with high confidence for basic clinical midwifery skills amongst students. The diploma program followed better pedagogoical approaches than the bachelor's program. (C) 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Confidence, India, Midwifery skills, Education, Teaching methods
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-389817 (URN)10.1016/j.wombi.2018.07.015 (DOI)000470848100010 ()30098978 (PubMedID)
Funder
Sida - Swedish International Development Cooperation Agency
Available from: 2019-07-30 Created: 2019-07-30 Last updated: 2019-07-30Bibliographically approved
Hildingsson, I., Karlstrom, A., Rubertsson, C. & Haines, H. (2019). Women with fear of childbirth might benefit from having a known midwife during labour. Women and Birth, 32(1), 58-63
Open this publication in new window or tab >>Women with fear of childbirth might benefit from having a known midwife during labour
2019 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 32, no 1, p. 58-63Article in journal (Refereed) Published
Abstract [en]

Aim: Having a known midwife at birth is valued by women across the world, however it is unusual for women with fear of childbirth to have access to this model of care. The aim of this study was to describe the prevalence and factors related to having access to a known midwife for women referred to counseling due to childbirth fear. We also wanted to explore if women's levels of childbirth fear changed over time.

Methods: A pilot study of 70 women referred to counseling due to fear of birth in 3 Swedish hospitals, and where the counseling midwife, when possible, also assisted during labour and birth.

Results: 34% of the women actually had a known midwife during labour and birth. Women who had a known midwife had significantly more counseling visits, they viewed the continuity of care as more important, were more satisfied with the counseling and 29% reported that their fear disappeared. Fear of birth decreased significantly over time for all women irrespective of whether they were cared for in labour by a known midwife or not.

Conclusions: Although the women in the present study had limited access to a known midwife, the results indicate that having a known midwife whom the women met on several occasions made them more satisfied with the counseling and had a positive effect on their fear. Building a trustful midwife-woman relationship rather than counseling per se could be the key issue when it comes to fear of birth.

Keywords
Counseling, Continuity, Fear of childbirth, Pregnancy, Intrapartum care
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-375809 (URN)10.1016/j.wombi.2018.04.014 (DOI)000455681800026 ()29773474 (PubMedID)
Funder
Swedish Research Council
Available from: 2019-02-08 Created: 2019-02-08 Last updated: 2019-02-08Bibliographically approved
Blixt, I., Johansson, M., Hildingsson, I., Papoutsi, Z. & Rubertsson, C. (2019). Women's advice to healthcare professionals regarding breastfeeding: "offer sensitive individualized breastfeeding support"- an interview study. International Breastfeeding Journal, 14(51)
Open this publication in new window or tab >>Women's advice to healthcare professionals regarding breastfeeding: "offer sensitive individualized breastfeeding support"- an interview study
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2019 (English)In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 14, no 51Article in journal (Refereed) Published
Abstract [en]

Background

The World Health Organization recommends exclusive breastfeeding for 6 months followed by continued breastfeeding with complementary food up to 2 years of age or beyond. Few women achieve this recommendation in Sweden, and they often stop breastfeeding earlier than they would like. Investigating women's advice to healthcare professionals is important for the provision of optimal breastfeeding support. The aim of this study was to explore women's advice to healthcare professionals regarding support for continuing to breastfeed for at least 6 months.

Methods

This investigation used an exploratory study design, and a purposive sample of women was recruited between 2015 and 2016 through social media platforms. The work is a follow-up of an earlier study exploring women's perceptions of the factors that assisted them in breastfeeding for at least 6 months. Telephone interviews were conducted with 139 Swedish women who reported that they had breastfed for at least 6 months. Women were asked the question, "Do you have any advice that you would like to give to healthcare professionals regarding breastfeeding support?". The data were analysed using content analysis.

Results

The theme, "Professionals need to offer women sensitive, individualized breastfeeding support to promote a positive breastfeeding experience", describes the women's advice based on five categories: 1) providing evidence-based care, 2) preparing expectant parents during pregnancy, 3) creating a respectful and mutual dialogue, 4) offering individual solutions to breastfeeding problems, and 5) offering practical support.

Conclusions

This study highlights the importance of professionals providing evidence-based breastfeeding support in a sensitive and individualized manner. This consideration is an important prerequisite to strengthening women's self-confidence and assisting them in reaching their breastfeeding goals, which may enhance the positive nature of their breastfeeding experience.

Keywords
Breastfeeding, Healthcare professionals, Support, Women’sadvice
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-400080 (URN)10.1186/s13006-019-0247-4 (DOI)
Available from: 2019-12-18 Created: 2019-12-18 Last updated: 2019-12-20Bibliographically approved
Larsson, B., Hildingsson, I., Ternström, E., Rubertsson, C. & Karlström, A. (2019). Women's experience of midwife-led counselling and its influence on childbirth fear: A qualitative study. Women and Birth, 32(1), e88-e94
Open this publication in new window or tab >>Women's experience of midwife-led counselling and its influence on childbirth fear: A qualitative study
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2019 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 32, no 1, p. e88-e94Article in journal (Refereed) Published
Abstract [en]

Background: Women with childbirth fear have been offered counseling by experienced midwives in Sweden for decades without evidence for its effectiveness, in terms of decrease in childbirth fear. Women are usually satisfied with the counselling. However, there is a lack of qualitative data regarding women’s views about counselling for childbirth fear.

Aim: To explore women’s experiences of midwife-led counselling for childbirth fear.

Method: A qualitative interview study using thematic analysis. Twenty-seven women assessed for childbirth fear who had received counselling during pregnancy at three different hospitals in Sweden were interviewed by telephone one to two years after birth.

Findings: The overarching theme ‘Midwife-led counselling brought positive feelings and improved confidence in birth’ was identified. This consisted of four themes describing ‘the importance of the midwife’ and ‘a mutual and strengthening dialogue’ during pregnancy. ‘Coping strategies and support enabled a positive birth’ represent women’s experiences during birth and ‘being prepared for a future birth’ were the women’s thoughts of a future birth.

Conclusions: In this qualitative study, women reported that midwife-led counselling improved their confidence for birth through information and knowledge. The women experienced a greater sense of calm and preparedness, which increased the tolerance for the uncertainty related to the birthing process. This, in turn, positively affected the birth experience. Combined with a feeling of safety, which was linked to the professional support during birth, the women felt empowered. The positive birth experience strengthened the self-confidence for a future birth and the childbirth fear was described as reduced or manageable.

Keywords
Childbirth fear, Counselling, Experience, Midwifery, Qualitative research
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-325924 (URN)10.1016/j.wombi.2018.04.008 (DOI)000455681800012 ()29709431 (PubMedID)
Note

Title in thesis list of papers: Women’s experience of midwife-led counselling and its influence on childbirth fear

Available from: 2017-06-29 Created: 2017-06-29 Last updated: 2019-02-05Bibliographically approved
Hildingsson, I., Rubertsson, C., Karlström, A. & Haines, H. (2018). Caseload midwifery for women with fear of birth is a feasible option. Sexual & Reproductive HealthCare, 16, 50-55
Open this publication in new window or tab >>Caseload midwifery for women with fear of birth is a feasible option
2018 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 16, p. 50-55Article in journal (Refereed) Published
Abstract [en]

Objective: Continuity with a known midwife might benefit women with fear of birth, but is rare in Sweden. The aim was to test a modified caseload midwifery model of care to provide continuity of caregiver to women with fear of birth. Methods: A feasibility study where women received antenatal and intrapartum care from a known midwife who focused on women's fear during all antenatal visits. The study was performed in one antenatal clinic in central Sweden and one university hospital labor ward. Data was collected with questionnaires in mid and late pregnancy and two months after birth. The main outcome was fear of childbirth. Result Eight out of ten women received all antenatal and intrapartum care from a known midwife. The majority had a normal vaginal birth with non-pharmacological pain relief. Satisfaction was high and most women reported that their fear of birth alleviated or disappeared. Conclusion: Offering a modified caseload midwifery model of care seems to be a feasible option for women with elevated levels of childbirth fear as well as for midwives working in antenatal clinics as it reduces fear of childbirth for most women. Women were satisfied with the model of care and with the care provided.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2018
Keywords
Caseload, Fear of birth, Intrapartum care, Midwifery, Pregnancy
National Category
Nursing Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-363073 (URN)10.1016/j.srhc.2018.02.006 (DOI)000440877700009 ()29804775 (PubMedID)
Available from: 2018-10-12 Created: 2018-10-12 Last updated: 2018-10-12Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6985-6729

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