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  • 1.
    Baylis, Rebecca
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Ekdahl, Johanna
    Mid Sweden Univ, Dept Psychol, Ostersund, Sweden..
    Haines, Helen
    Univ Melbourne, Dept Rural Hlth, Melbourne, Vic, Australia..
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Lund Univ, Fac Med, Dept Hlth Sci, Box 188, S-22100 Lund, Sweden..
    Women's experiences of internet-delivered Cognitive Behaviour Therapy (iCBT) for Fear of Birth2020Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 33, nr 3, s. E227-E233Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Fear of Birth is common in pregnant women and associated with negative physical and mental health. There is a clear comorbidity with anxiety and depression. Internet-delivered Cognitive Behaviour Therapy has been suggested as a treatment option for Fear of Birth and a randomized controlled trial comparing internet-delivered Cognitive Behaviour Therapy with midwifery led counselling as standard care has been conducted.

    Objective: The aim of this study was to describe women's experiences of guided internet-delivered Cognitive Behaviour Therapy for Fear of Birth and to describe the content of their fear.

    Methods: The present study is a qualitative, follow-up interview study following the randomized controlled trial, the U-CARE Pregnancy Trial. In total 19 women allocated to internet-delivered Cognitive Behaviour Therapy for Fear of Birth were interviewed by telephone. A semi-structured interview guide was used and the transcripts were analyzed with thematic analysis.

    Results: The women's descriptions of Fear of Birth differed, however their fear was most often associated with fear of losing control, fear for the baby's life or health or own life threatening events. The experiences of internet-delivered Cognitive Behaviour Therapy for Fear of Birth varied, some women were positive to its flexibility although most women preferred a face-to face meeting. The treatment did not pin-point their fears, it was challenging to maintain motivation and to work with the treatment in solitude.

    Conclusions: Women's descriptions of Fear of Birth varied. Most women undergoing internet-delivered Cognitive Behaviour Therapy would have preferred a face-to-face meeting which they imagined would have soothed their fear. Internet-delivered Cognitive Behaviour Therapy for Fear of Birth may be an alternative for some women. 

  • 2.
    Bäck, Lena
    et al.
    Mid Sweden Univ, Dept Nursing, Kunskapens Vag 8, S-83140 Ostersund, Sweden.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Mid Sweden Univ, Dept Nursing, Kunskapens Vag 8, S-83140 Ostersund, Sweden.
    Sjoqvist, Carina
    Cty Hosp Ostersund, Matern Unit, Ostersund, Sweden.
    Karlstrom, Annika
    Mid Sweden Univ, Dept Nursing, Kunskapens Vag 8, S-83140 Ostersund, Sweden.
    Developing competence and confidence in midwifery-focus groups with Swedish midwives2017Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, nr 1, s. E32-E38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Midwives have a significant impact on the clinical outcome and the birthing experience of women. However,there has been a lack of research focusing specifically on clinical midwives' learning and development of professional competence. Aim: The objective of the study was to describe how midwives reflect on learning and the development of professional competence and confidence. Methods: A qualitative study based on focus groups with midwives employed in maternity services. Findings: Four categories describe the results: (1) Feelings of professional safety evolve over time; (2) Personal qualities affect professional development; (3) Methods for expanding knowledge and competence; and (4) Competence as developing and demanding.The meaning of competence is to feel safe and secure in their professional role.There was a link between the amount of hands-on intrapartum experience and increasing confidence that is, assisting many births made midwives feel confident.Internal rotation was disliked because the midwives felt they had less time to deepen their knowledge and develop competence in a particular field.The midwives felt they were not seen as individuals, and this system made them feel split between different assignments. Discussion: External factors that contribute to the development of knowledge and competence include the ability to practise hands-on skills in an organisation that is supportive and non-threatening. Internal factors include confidence, self-efficacy, and a curiosity for learning. Conclusions: Midwives working within an organisation should be supported to develop their professional role in order to become knowledgeable, competent and confident.

  • 3.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Women's birth expectations, are they fulfilled?: Findings from a longitudinal Swedish cohort study2015Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 28, nr 2, s. e7-e13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    The importance of women's expectations on the experience of birth has shown contradictory results regarding fulfilment. The aim of this study was to describe pregnant women's expectations of birth and to investigate if these expectations were fulfilled. An additional aim was to determine if unfulfilled expectations were related to the mode of birth, use of epidural and the birth experience.

    METHODS:

    This research investigated a prospective regional cohort study of 1042 Swedish-speaking women who completed a questionnaire about birth expectations in late pregnancy and were followed up with two months after birth. Five areas were under study: support from partner, support from midwife, control, participation in decision making and the midwife's presence during labour and birth. An index combining expectations and experiences was created.

    RESULTS:

    Certain background characteristics were associated with expectations as well as experiences. Statistically significant differences were shown between expectations and experiences in support from midwife (mean 3.41 vs 3.32), support from partner (mean 3.70 vs 3.77), and midwife's presence (mean 3.00 vs 3.39). Experiences 'worse than expected' regarding decision making and control were associated with modes of birth other than vaginal and four out of five areas were associated with a less positive birth experience.

    CONCLUSION:

    Some women had high birth expectations of which some were fulfilled. An expectation on support from the midwife was less likely to be achieved, while support from partner and the midwives' presence were fulfilled. If the woman's expectations were not fulfilled, e.g. became 'worse than expected' this was associated with a less positive overall birth experience as well as with instrumental or surgical mode of birth.

  • 4.
    Hildingsson, Ingegerd
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Haines, Helen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Cross, Maddalena
    Rural Health Academic Centre, University of Melbourne, Victoria, Australia.
    Pallant, Julie F
    Rural Health Academic Centre, University of Melbourne, Victoria, Australia.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Women's satisfaction with antenatal care: Comparing women in Sweden and Australia2013Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 26, nr 1, s. e9-e14Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Satisfaction with antenatal care could differ depending on the organisation and the context of care.

    AIM:

    To compare antenatal care in Australia and Sweden, to identify deficiencies in the content of antenatal care and what aspects contributed most in dissatisfaction with antenatal care.

    METHODS:

    A longitudinal survey of 123 Australian and 386 Swedish women recruited during one year in regional hospitals in Sweden and Australia. Data collected by three questionnaires.

    RESULTS:

    Women in Australia had more antenatal visits, less continuity of midwife caregiver but were more satisfied with antenatal education and the emotional aspects of antenatal care. Although the overall satisfaction was high, deficiencies were found in more than half of the studied variables in the content of care. Women in Sweden were more dissatisfied with information about labour and birth (OR 3.1; 1.8-5.3) and information about the time following birth (OR 3.8; 2.2-6.3), but more satisfied with the involvement of the father (OR 0.3; 0.2-0.6). Factors that contributed most to dissatisfaction with antenatal care overall were deficiency in information about pregnancy related issues (OR 3.4; 1.3-8.7) and not being taken seriously by the midwife (OR 4.1; 1.6-10.1).

    CONCLUSION:

    Satisfaction with antenatal care was high in both groups of women. Australian women were more satisfied than the Swedish women with the emotional aspects of care. Deficiencies were found in more than half of the variables measured relating to the specific aspects of care. Lack of information and not being treated seriously were important factors for not being satisfied.

  • 5.
    Hildingsson, Ingegerd
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden..
    Haines, Helen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Univ Melbourne, Rural Hlth Acad Ctr, Melbourne, Vic, Australia..
    Karlström, Annika
    Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden..
    Nystedt, Astrid
    Umea Univ, Dept Nursing, Umea, Sweden..
    Presence and process of fear of birth during pregnancy: Findings from a longitudinal cohort study2017Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, nr 5, s. E242-E247Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The prevalence of fear of birth has been estimated between 8-30%, but there is considerable heterogeneity in research design, definitions, measurement tools used and populations. There are some inconclusive findings about the stability of childbirth fear.

    Aim: to assess the prevalence and characteristics of women presenting with scores >= 60 on FOBS-The Fear of Birth Scale, in mid and late pregnancy, and to study change in fear of birth and associated factors.

    Methods: A prospective longitudinal cohort study of a one-year cohort of 1212 pregnant women from a northern part of Sweden, recruited in mid pregnancy and followed up in late pregnancy. Fear of birth was assessed using FOBS-The fear of birth scale, with the cut off at >= 60.

    Findings: The prevalence of fear of birth was 22% in mid pregnancy and 19% in late pregnancy, a statistically significant decrease. Different patterns were found where some women presented with increased fear and some with decreased fear. The women who experienced more fear or less fear later in pregnancy could not be differentiated by background factors.

    Conclusions: More research is needed to explore factors important to reduce fear of childbirth and the optimal time to measure it.

  • 6.
    Hildingsson, Ingegerd
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden.
    Karlstrom, Annika
    Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Lund Univ, Dept Hlth Sci, Fac Med, Lund, Sweden.
    Haines, Helen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Univ Melbourne, Dept Rural Hlth, Wangaratta, Vic, Australia.
    Women with fear of childbirth might benefit from having a known midwife during labour2019Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 32, nr 1, s. 58-63Artikel i tidskrift (Refereegranskat)
    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.

  • 7.
    Hildingsson, Ingegerd
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Lund Univ, Dept Nursing, Lund, Sweden.
    Karlstrom, Annika
    Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden.
    Haines, Helen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Univ Melbourne, Rural Hlth Acad Ctr, Melbourne, Vic, Australia.
    Exploring the Fear of Birth Scale in a mixed population of women of childbearing age: A Swedish pilot study2018Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 31, nr 5, s. 407-413Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim of this pilot study was to explore the Fear of Birth Scale in a mixed sample of women of childbearing age, by investigating the levels of childbirth fear and the content of women's thoughts when completing the scale. Methods: A cross-sectional mixed method study of 179 women who completed a short questionnaire and a think aloud interview. Results: The mean score of the Fear of Birth Scale was 40.80 (SD 27.59) and 28.5% were classified as having fear of childbirth (>= 60). The internal consistency showed a Cronbach's alpha > 0.92, and a mean inter-item correlation of 0.85. The highest scores were found in women younger than 25 years (mean 60.10), foreignborn women (mean 54.30) and women who did not have any previous children (48.72). The lowest scores were found in women who had recently given birth (mean 34.82) and women older than 35 years (mean 34.85). The content analysis categorization matrix clearly accommodated all 436 statements into the five pre-existing categories. The largest categories were: the content of fear and worry with 138 statements and strategies to cope with fear or worry (122 statements). Conclusion: The Fear of Birth Scale seems to be a useful instrument for different subgroups of women. The construct of fear of childbirth may be universally understood and experienced by women of childbearing age irrespective of whether they are currently pregnant, have recently given birth or do not have children. Identifying fear of birth is important in clinical practice in order to support women's reproductive needs.

  • 8. Hildingsson, Ingegerd
    et al.
    Tingvall, Maria
    Rubertsson, Christine
    Mälardalen University, Department of Caring and Public Health Science, Västerås, Sweden.
    Partner support in the childbearing period: a follow up study2008Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 21, nr 4, s. 141-148Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Social support is important during pregnancy and childbirth and the partner is usually the main source of support. Lack of partner support is associated with less emotional well-being and discontinuation of breastfeeding.

    Research problem

    The purpose of the study was to investigate the proportion of women dissatisfied with partner support in early pregnancy, and to identify risk factors associated with dissatisfaction through a follow up 2 months and 1 year after childbirth.

    Participants and methods

    A national cohort of 2430 Swedish speaking women recruited in early pregnancy and followed up 2 months and 1 year postpartum. Data were collected by means of three postal questionnaires.

    Results

    Five percent of women were dissatisfied with partner support in early pregnancy. Women dissatisfied with partner support were more likely to be multiparas, not living with their partner in early pregnancy and to report unfavorable timing of pregnancy. They experienced more physical symptoms, and less emotional well-being in terms of more depressive symptoms, more major worries and a lower sense of coherence. One year after childbirth a higher rate of divorces and disappointment with the partner's participation in childcare and household chores and understanding from partner was found in women being dissatisfied in early pregnancy.

    Discussion and conclusions

    This study shows that it might be possible to identify women who are lacking partner support already in early pregnancy. Women's social network and their support from partner should be investigated by health care providers and women in need of additional support should be refereed to available community resources.

  • 9.
    Höglund, Berit
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. Uppsala Univ, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden..
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Midwives' comprehension of care for women with intellectual disability during pregnancy and childbirth: An open-ended questionnaire study in Sweden2015Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 28, nr 3, s. E57-E62Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Few studies have investigated midwifery care for women with intellectual disability (ID). Aim: To gain a deeper understanding of midwives' comprehension of care for women with ID during pregnancy and childbirth. Methods: A cross-sectional study among 375 midwives at antenatal clinics and delivery wards in Sweden. Findings 2476 quotations were sorted into six categories: information; communication and approach; the role of the midwife; preparing for and performing interventions and examinations; methods and assessments; and organisation of care. The midwives affirmed that individual, clear and repeated information together with practical and emotional support was important for women with ID. The midwives planned the care as to strengthen the capacity of the women, open doors for the unborn child and reinforce the process of becoming a mother. Extra time could be needed. They tried to minimise interventions. The midwives felt a dual responsibility, to support the mother-child contact but also to assess and identify any deficits in the caring capacity of the mother and to involve other professionals if needed. Conclusions: The midwives described specially adapted organisation of care, models of information, practical education and emotional support to facilitate the transition to motherhood for women with ID. They have a dual role and responsibility in supporting the woman, while making sure the child is properly cared for. Healthcare services should offer a safe and trusted environment to enable such midwifery care. When foster care is planned, the society should inform and co-operate with midwives in the care of these women.

  • 10.
    Jha, Paridhi
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Christensson, Kyllike
    Karolinska Institutet Dept. of Women's and Children's Health.
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Fear of Childbirth and Depressive Symptoms among Postnatal Women: A Cross-sectional Survey from Chhattisgarh, India2018Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 31, nr 2, s. 122-133Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Prevalence rates of Fear of Birth and postnatal depressive symptoms have not been explored in Chhattisgarh, India.

    Objective: To validate Hindi Wijma Delivery Experience Questionnaire and to study the prevalence of Fear of Birth and depressive symptoms among postnatal women.

    Methods: A cross-sectional survey at seventeen public health facilities in two districts of Chhattisgarh, India among postnatal women who gave birth vaginally or through C-section to a live neonate. Participants were recruited through consecutive sampling based on health facility records of daily births. Data were collected through one-to-one interviews using the Wijma Delivery Experience Questionnaire Version B and the Edinburgh Postnatal Depression Scale. Non-parametric associations and linear regression data analyses were performed.

    Results: The Hindi Wijma Delivery Experience Questionnaire Version B had reliable psychometric properties. The prevalence of Fear of Birth and depressive symptoms among postnatal women were 13.1% and 17.1%, respectively, and their presence had a strong association (p < 0.001). Regression analyses revealed that, among women having vaginal births: coming for institutional births due to health professionals' advice, giving birth in a district hospital and having postnatal depressive symptoms were associated with presence of FoB; while depressive symptoms were associated with having FoB, perineal suturing without pain relief, and giving birth to a low birth-weight neonate in a district hospital.

    Conclusion: The prevalence of Fear of Birth and depressive symptoms is influenced by pain management during childbirth and care processes between women and providers. These care practices should be improved for better mental health outcomes among postnatal women.

  • 11.
    Johansson, Margareta
    et al.
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Intrapartum care could be improved according to Swedish fathers: Mode of birth matters for satisfaction2013Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 26, nr 3, s. 195-201Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Intrapartum care is expected to be shaped by parents' need and preferences. Aim: The aim was to explore Swedish fathers' intrapartum care quality experiences, with a specific focus on care deficiencies in relation to birth mode. A secondary aim was to explore which issues of quality that contributed most to dissatisfaction with the overall assessment of the care. Methods: Cross-sectional design, part of a prospective longitudinal survey in Sweden. A quality of care index was developed, based on perceived reality and subjective importance of given intrapartum care. Two months after birth 827 fathers answered nine questions related to quality of care. Descriptive statistics and logistic regression analysis were used. Results: Dissatisfaction with overall intrapartum care was related to deficiencies in partner's medical care (OR 5.6; 2.7-11.2), involvement in decision-making during childbirth (OR 2.6; 1.3-4.9), midwives presence in the labour room (OR 2.4; 1.2-4.7), and ability to discuss the birth afterwards (OR 2.0; 1.1-3.8). After emergency caesarean section 46% judged the partner's medical intrapartum care as most deficient (OR 1.73; 1.05-2.86), and after elective caesarean section 40% of the fathers judged involvement in decision-making as deficient (OR 4.07; 1.95-8.50). When the fathers had participated in a spontaneous vaginal birth they were dissatisfied with the presence of the midwife in the labour room (OR 1.72; 1.03-2.87). Conclusions: Deficiencies existed in the intrapartum care and were judged differently depending on mode of birth. The fathers needed to feel secure about the women's medical care, and wanted to be involved and supported.

  • 12.
    Johansson, Margareta
    et al.
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Fenwick, Jennifer
    School of Nursing and Midwifery, Maternity and Family Unit, Research Centre for Clinical and Community Practice Innovation (RCCCPI), Griffith Health Institute, Griffith University, Meadowbrook, Queensland, Australia f Gold Coast Hospital, Australia.
    'As long as they are safe - Birth mode does not matter' Swedish fathers' experiences of decision-making around caesarean section2014Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 27, nr 3, s. 208-213Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Decision-making in childbirth involves considerations about both the mother and her unborn baby's wellbeing. For men the safety of both is paramount. Aim: To explore and describe Swedish fathers' beliefs and attitudes around the decision for a caesarean section. Methods: Qualitative descriptive study. Twenty one Swedish men whose partners had experienced elective or emergency caesarean participated in a telephone interview. Thematic data analysis was used. Findings: The theme, 'Childbirth is Risky', included "Caesarean birth has lots of advantages" and "Birth mode does not matter". In the context of having experienced a caesarean section male partners considered birth mode to be irrelevant. The majority considered caesarean to be a quick and efficient way of giving birth which equated to being safer. Most men could articulate some risks associated with caesarean but these were mainly minimised. The second theme, 'Simply a matter of trust: Birth mode is not my decision', reflected men's belief that they had little to contribute to the decisions made around birth mode. The decision for a caesarean section was considered to lie with the medical practitioner. Conclusion: Mode of birth was regarded as unimportant. The recommendation for a caesarean section was readily accepted and appreciated, and shifted responsibility for birth to the medical practitioner. Involving men in the decision-making process by means of giving them information was valued. Men's limited knowledge about the risks of a caesarean may contribute to birth mode decisions. Professionals need to provide balanced and correct information within the context of individual circumstances. (C) 2014 Australian College of Midwives.

  • 13.
    Johansson, Margareta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
    Thies-Lagergren, Li
    Swedish fathers' experiences of childbirth in relation to maternal birth position: a mixed method study.2015Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 28, nr 4, s. e140-7, artikel-id S1871-5192(15)00056-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Fathers often want to be involved in labour and birth.

    AIM: To investigate how maternal birth position during second stage of labour may influence fathers' experience of childbirth.

    METHODS: Mixed method study with 221 Swedish fathers completing an on-line questionnaire. Descriptive statistics and qualitative content analysis were used.

    RESULTS: In total 174 (78.7%) had a positive overall birth experience. The theme An emotional life-changing event influenced by the birth process and the structure of obstetrical care was revealed and included the categories; Midwives ability to be professional, The birth process' impact, and Being prepared to participate. The most frequently utilised birth position during a spontaneous vaginal birth was birth seat (n=83; 45.1%), and the fathers in this group were more likely to assess the birth position as very positive (n=40; 54.8%) compared to other upright and horizontal birth positions. Fathers with a partner having an upright birth position were more likely to have had a positive birth experience (p=0.048), to have felt comfortable (p=0.003) and powerful (p=0.019) compared to women adopting a horizontal birth position during a spontaneous vaginal birth. When the women had an upright birth position the fathers deemed the second stage of labour to have been more rapid (mean VAS 7.01 vs. 4.53) compared to women in a horizontal birth position.

    CONCLUSION: An upright birth position enhances fathers' experience of having been positively and actively engaged in the birth process. Midwives can enhance fathers' feelings of involvement and participation by attentiveness through interaction and communicating skills.

  • 14.
    Kildea, Sue
    et al.
    Australian Catholic University and Mater Medical Research Institute Level 1, Aubigny Place, Raymond Terrace, South Brisbane, Australia.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Govind, Salik
    Office in Mongolia Ministry of Health, Ulaanbaatar, Mongolia.
    A review of midwifery in Mongolia utilising the 'Strengthening Midwifery Toolkit'2012Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 25, nr 4, s. 166-173Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The World Health Organization (WHO) developed the 'Strengthening Midwifery Toolkit' in response to an international emphasis on increasing midwifery's role in providing maternal newborn health services. It was used to assist a review of midwifery in Mongolia.

    METHOD: A rapid situational assessment included site visits to eight health facilities and four educational institutions resulting in 30 key informant interviews and six focus group discussions (67 midwives and students). A desk review of pertinent documents (n=19) was undertaken. Data collected included assessments of: midwife competency (n=96), scope of practice (n=2), health facilities (n=8), educational institutions (n=4), legislation and regulation (n=1), and midwifery (n=4) Feldsher-Nurse (n=4) and Bachelor-Nurse (n=1) curricula.

    FINDINGS: Stakeholders in Mongolia are committed to strengthening midwifery across the country to better align with international standards. This requires: a long-term investment in reorientating the health workforce and educational institutions, regulatory changes, educational investment, job description changes which will impact on other maternal newborn health service providers. Additional support and incentives for providers in rural and remote areas is needed and investment in health facilities to enable appropriate infection control; and adequate provision of essential equipment and drugs, are important strategies needed to protect staff. Maternity emergency training is required across the country.

    CONCLUSION: The Midwifery Toolkit was adapted to suit the local context and provided an excellent framework for this review.

  • 15.
    Larsson, Birgitta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Research and Development Centre, Sundsvall Hospital, 846 53 Sundsvall, Sweden.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Department of Nursing Sciences, Mid-Sweden University, 851 70 Sundsvall, Sweden.
    Ternström, Elin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Department of Health Sciences, Faculty of Medicine, Lund University, 221 00 Lund, Sweden.
    Karlström, Annika
    Department of Nursing Sciences, Mid-Sweden University, 851 70 Sundsvall, Sweden.
    Women's experience of midwife-led counselling and its influence on childbirth fear: A qualitative study2019Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 32, nr 1, s. e88-e94Artikel i tidskrift (Refereegranskat)
    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.

  • 16.
    Larsson, Birgitta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Sundsvall Hosp, Res & Dev Ctr, S-84653 Sundsvall, Sweden.
    Karlström, Annika
    Mid Sweden Univ, Dept Nursing Sci, S-85170 Sundsvall, Sweden.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
    Ternström, Elin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
    Ekdahl, Johanna
    Mid Sweden Univ, Dept Psychol, S-83125 Ostersund, Sweden.
    Segebladh, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Mid Sweden Univ, Dept Nursing Sci, S-85170 Sundsvall, Sweden.
    Birth preference in women undergoing treatment for childbirth fear: A randomised controlled trial2017Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, nr 6, s. 460-467Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason.  The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment.

    Methods: Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n=258) were recruited at one university hospital and two regional hospitals over one year.  The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n=127) or standard care (face-to-face counselling) (n=131). Data were collected by questionnaires in pregnancy week 20-25 (baseline), week 36 and two months after birth.

    Results: Caesarean section preference decreased from 34% to 12% in the ICBT group and from 24% to 20% in the counselling group. Two months after birth, the preference for caesarean increased to 20% in the ICBT group and to 29% in the counselling group, and there was no statistically significant change over time. Women in the ICBT group were less satisfied with the treatment (OR 4.5). The treatment had no impact on or worsened their childbirth fear (OR 5.5). There were no differences between the groups regarding birth experience.

    Conclusion: Women’s birth preferences fluctuated over the course of pregnancy and after birth regardless of treatment method. Women felt their fear was reduced and were more satisfied with face-to-face counselling compared to ICBT. A higher percentage were lost to follow-up in ICBT group suggesting a need for further research.  

  • 17.
    Malm, Mari-Cristin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Mittuniversitetet .
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Rådestad, I
    Sophiahemmet Högskola.
    Lindgren, H
    Karolinska Institutet .
    Prenatal attachment and it´s association with fetal movement during pregnancy: A population based surveyIngår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: to investigate the association between the magnitude of fetal movements and level of prenatal attachment within a 24 hour period among women in the third trimester of pregnancy Design: a prospective population-based survey. Setting: A county in central Sweden Participants: Low risk pregnant women from 34 to 42 weeks gestation, N = 456, 299 multiparous and 157 primiparous women. Measurements: the revised version of the Prenatal Attachment Inventory (PAI-R) and assessment of the perception of fetal movements per 24 hours in the current gestational week. Findings: a total of 81 per cent of the eligible women completed the questionnaire. The overall sample of women found that the majority (96%) felt their baby move mostly in the evening as compared with other time periods in the 24 hour period. More than half of the respondents (55%) stated that they perceived frequent fetal movement on two occasions during a 24 hour period, while almost a fifth (18%) never or only once reported frequent fetal movement in a 24 hour period. Just over a quarter (26%) of respondents perceived frequent movement at least three times during a 24 hour period. Perceiving frequent fetal movements on three or more occasions during a 24 hour period in the third trimester, was associated with higher scores of prenatal attachment in all the three subscales on the PAI-R; “Anticipation”, “Differentiation” and “Interaction”.  Key conclusion: Perceiving frequent fetal movements at least during three occasions per 24 hours periods in late pregnancy was associated with prenatal attachment. Implications for practice: encouraging women to focus on fetal movements may positively affect prenatal attachment, especially among multiparous women > 35 years. 

  • 18.
    Malm, Mari-Cristin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Rådestad, Ingela
    Lindgren, Helena
    Prenatal attachment and its association with foetal movement during pregnancy: A population based survey2016Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 29, nr 6, s. 482-486Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    To investigate the association between the magnitude of foetal movements and level of prenatal attachment within a 24h period among women in the third trimester of pregnancy.

    DESIGN:

    a prospective population-based survey.

    SETTING:

    A county in central Sweden.

    PARTICIPANTS:

    Low risk pregnant women from 34 to 42 weeks gestation, N=456, 299 multiparous and 157 primiparous women.

    MEASUREMENTS:

    The revised version of the Prenatal Attachment Inventory (PAI-R) and assessment of the perception of foetal movements per 24h in the current gestational week.

    FINDINGS:

    A total of 81 per cent of the eligible women completed the questionnaire. The overall sample of women found that the majority (96%) felt their baby move mostly in the evening. More than half of the respondents (55%) stated that they perceived frequent foetal movement on two occasions during a 24h period, while almost a fifth (18%) never or only once reported frequent foetal movement in a 24h period. Just over a quarter (26%) of respondents perceived frequent movement at least three times during a 24h period. Perceiving frequent foetal movements on three or more occasions during a 24h period, was associated with higher scores of prenatal attachment in all the three subscales.

    KEY CONCLUSION:

    Perceiving frequent foetal movements at least during three occasions per 24h periods in late pregnancy was associated with prenatal attachment.

    IMPLICATIONS FOR PRACTICE:

    encouraging women to focus on foetal movements may positively affect prenatal attachment, especially among multiparous women >35 years.

  • 19.
    Mbekenga, Columba K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Christensson, Kyllike
    Karolinska Institute, Stockholm, Sweden.
    Lugina, Helen
    Weill Bugando University College of Health Sciences, Mwanza, Tanzania.
    Olsson, Pia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Joy, struggle and support: postpartum experiences of first-time mothers in a Tanzanian suburb2011Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 24, nr 1, s. 24-31Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The first-time mothers enjoyed motherhood and the respectful status it implied. To understand and handle the infant's needs and own bodily changes were important during postpartum. The tradition of abstaining from sex up to 4 years during breastfeeding was a concern as male's faithfulness was questioned and with HIV a threat to family health. Partner relationship changed towards shared parental and household work and the man's active participation was appreciated. Support from family members and others in the neighbourhood were utilised as a resource by the mothers. In instances of uncertainties on how to handle things, their advice was typically followed. The new mothers generally had good experiences of health care during the childbearing period. However, they also experienced insufficiencies in knowledge transfer, disrespectful behaviour, and unofficial fees. KEY CONCLUSIONS AND IMPLICATION FOR PRACTICE: The mothers' perspective of postpartum revealed that they actively searched for ways to attain infants' and own health needs, and family health in general. Prolonged sexual abstinence was considered a risk for the partner having other sexual partners and contracting HIV. The mothers relied heavily on the informal support network, which sometimes meant risking family health due to misinformation and harmful practices. Health care and informal support systems should complement each other to attain adequate support for the families postpartum.

  • 20.
    Mukwenda, Annamagreth M.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Mbekenga, Columba K
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Muhimbili Univ Hlth & Allied Sci, Sch Nursing, Dept Community Hlth Nursing, Dar Es Salaam, Tanzania..
    Pembe, Andrea
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Muhimbili Univ Hlth & Allied Sci, Sch Med, Dept Obstet & Gynaecol, Dar Es Salaam, Tanzania..
    Olsson, Pia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Women's experiences of having had, and recovered from, eclampsia at a tertiary hospital in Tanzania2017Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, nr 2, s. 114-120Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Eclampsia is a major cause of maternal and perinatal mortality that requires advanced care and long hospital stays with uncertain outcomes for mother and baby. Care of eclamptic women is particularly challenging in low-income settings. Standards for medical care for eclampsia are established but the psychosocial needs of women are under-researched. Aim: To explore and describe women's experiences of having had, and recovered from, eclampsia at a tertiary hospital in Tanzania. Methods: Qualitative semi-structured interviews were held with a purposive sample of 10 women recovering from eclampsia. Thematic analysis informed the interpretation of the data. Findings: The women had experienced eclamptic seizure as painful and unreal as they were unable to control their body or actions despite sensing what happened. At hospital they felt being cared for and recovered but concerned because they had not been provided with enough information about the disorder. Being separated from the baby during hospitalisation was troublesome and they worried about infant feeding and health. The women experienced being connected to God and they were grateful for being alive and having recovered. However, they expressed fears over the possible recurrence of eclampsia in future pregnancies and wanted information about prevention strategies. Conclusion: Experiencing eclampsia is painful and gives a sense of bodily disconnectedness. It involves worrisome separation from the newborn, not being adequately informed and concerns over future health. More holistic care would benefit eclamptic women and their newborns.

  • 21.
    Nilsson, Christina
    et al.
    Linnaeus University, Växjö, Sweden.
    Lundgren, Ingela
    Institute of Health and Care Sciences, University of Gothenburg, Sweden.
    Karlström, Annika
    Department of Health Science, Mid Sweden University, Sundsvall, Sweden.
    Hildingsson, Ingegerd
    Department of Health Science, Mid Sweden University, Sundsvall, Sweden.
    Self reported fear of childbirth and its association with women's birth experience and mode of delivery: a longitudinal population-based study.2012Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 25, nr 3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To explore fear of childbirth (FOC) during pregnancy and one year after birth and its association to birth experience and mode of delivery.

    DESIGN: A longitudinal population-based study.

    POPULATION: Pregnant women who were listed for a routine ultrasound at three hospitals in the middle-north part of Sweden.

    METHOD: Differences between women who reported FOC and who did not were calculated using risk ratios with a 95% confidence interval. In order to explain which factors were most strongly associated to suffer from FOC during pregnancy and one year after childbirth, multivariate logistic regression analyses were used.

    RESULTS: FOC during pregnancy in multiparous women was associated with a previous negative birth experience (RR 5.1, CI 2.5-10.4) and a previous emergency caesarean section (RR 2.5, CI 1.2-5.4). Associated factors for FOC one year after childbirth were: a negative birth experience (RR 10.3, CI 5.1-20.7), fear of childbirth during pregnancy (RR 7.1, CI 4.4-11.7), emergency caesarean section (RR 2.4, CI 1.2-4.5) and primiparity (RR 1.9, CI 1.2-3.1).

    CONCLUSION: FOC was associated with negative birth experiences. Women still perceived the birth experience as negative a year after the event. Women's perception of the overall birth experience as negative seems to be more important for explaining subsequent FOC than mode of delivery. Maternity care should focus on women's experiences of childbirth. Staff at antenatal clinics should ask multiparous women about their previous experience of childbirth. So that FOC is minimized, research on factors that create a positive birth experience for women is required.

  • 22.
    Nystedt, Astrid
    et al.
    Umea Univ, Dept Nursing, S-90187 Umea, Sweden..
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Mid Sweden Univ, Dept Nursing, S-85170 Sundsvall, Sweden..
    Women's and men's negative experience of child birth-A cross-sectional survey2018Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 31, nr 2, s. 103-109Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: A negative birth experience may influence both women and men and can limit their process of becoming a parent.

    Aims: This study aimed to analyze and describe women's and men's perceptions and experiences of childbirth.

    Design: A cross-sectional study of women and their partners living in one Swedish county were recruited in mid pregnancy and followed up two months after birth. Women (n = 928) and men (n = 818) completed the same questionnaire that investigated new parents' birth experiences in relation to sociodemographic background and birth related variables.

    Results: Women (6%) and men (3%) with a negative birth experiences, experienced longer labours and more often emergency caesarean section compared to women (94%) and men (97%) with a positive birth experience. The obstetric factors that contributed most strongly to a negative birth experience were emergency caesarean and was found in women (OR 4.7, 95% CI 2.0-10.8) and men (OR 4.5, Cl 95% 1.4-17.3). In addition, pain intensity and elective caesarean section were also associated with a negative birth experiences in women. Feelings during birth such as agreeing with the statement; 'It was a pain to give birth' were a strong contributing factor for both women and men.

    Conclusions: A negative birth experience is associated with obstetric factors such as emergency caesarean section and negative feelings. The content of negative feelings differed between women and men. It is important to take into account that their feelings differ in order to facilitate the processing of the negative birth experience for both partners.

  • 23.
    Omer-Salim, Amal
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Suri, Shobha
    Breastfeeding Promotion Network of India (BPNI), New Delhi, India.
    Dadhich, Jai Prakash
    Breastfeeding Promotion Network of India (BPNI), New Delhi, India.
    Faridi, Mohammad Moonis Akbar
    Department of Paediatrics, University College of Medical Sciences & Guru Tegh Bahadur (GTB) Hospital, New Delhi, India.
    Olsson, Pia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Theory and social practice of agency in combining breastfeeding and employment: A qualitative study among health workers in New Delhi, India2014Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 27, nr 4, s. 298-306Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Women's agency, or intentional actions, in combining breastfeeding and employment is significant for health and labour productivity. Previous research in India showed that mothers use various collaborative strategies to ensure a "good enough" combination of breastfeeding and employment. Bandura's theoretical agency constructs previously applied in various realms could facilitate the exploration of agency in an Indian context.

    AIM:

    To explore manifestations of agency in combining breastfeeding and employment amongst Indian health workers using Bandura's theoretical constructs of agency and women's experiences.

    METHODS:

    Qualitative semi-structured interviews were conducted with ten women employees within the governmental health sector in New Delhi, India. Both deductive and inductive qualitative content analyses were used.

    FINDINGS:

    Bandura's features and modes of agency revealed that intentionality is underpinned by knowledge, forethought means being prepared, self-reactiveness includes collaboration and that self-reflectiveness gives perspective. Women's interviews revealed four approaches to agency entitled: 'All within my stride or the knowledgeable navigator'; 'Much harder than expected, but ok overall'; This is a very lonely job'; and 'Out of my control'.

    CONCLUSIONS:

    Agency features and their elements are complex, dynamic and involve family members. Bandura's theoretical agency constructs are partially useful in this context, but additional social practice constructs of family structure and relationship quality are needed for better correspondence with women's experiences of agency. The variation in individual approaches to agency has implications for supportive health and workplace services.

  • 24.
    Palmqvist, Hanna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Zather, Josefine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Fathers' and co-mothers' voices about breastfeeding and equality - A Swedish perspective2015Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 28, nr 3, s. E63-E69Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Breastfeeding has benefits for mother and child and the partner's support influences the decision as well as the duration of breastfeeding. The aim of this study was to describe partners' knowledge and feelings regarding breastfeeding and how they reason about equality and involvement during the lactation period. Methods: A qualitative study using semi-structured interviews with 7 male and 2 female partners (labelled co-mothers) of breastfeeding mothers. The interviews were transcribed and analysed using a phenomenological approach. Results: The main theme Wish for the child to be breastfed/get breast milk described the informants' desire that their child was breastfed and this desire was based on knowledge of benefits of breastfeeding but also on intuitive feelings of breastfeeding as something natural. The main theme Effect of breastfeeding on fathers/co-mothers described how breastfeeding affected the informants and their relationship to the child and the mother in different ways. The main theme Adaptation and acceptance described how informants accepted the impact that breastfeeding had and/or adapted to it and continued to wish for the child to receive breast milk. Conclusion: The informants desired that their children be breastfed/get breast milk. Breastfeeding affected the informants in different ways, which they handled by adapting to and accepting the situation, and they expressed a continued desire that their children be breastfed/get breast milk. Parental classes should include both parents to be and address how breastfeeding can be successfully performed and supported without threatening the equality between the parents.

  • 25.
    Selin, Lotta
    et al.
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, S-40530 Gothenburg, Sweden;NU Hosp Grp, Dept Obstet & Gynecol, Trollhattan, Sweden.
    Wennerholm, Ulla-Britt
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Obstet & Gynecol, Gothenburg, Sweden.
    Jonsson, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk obstetrik.
    Dencker, Anna
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, S-40530 Gothenburg, Sweden;Univ Gothenburg, Sahlgrenska Acad, Ctr Person Ctr Care, Gothenburg, Sweden.
    Wallin, Gunnar
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Obstet & Gynecol, Gothenburg, Sweden.
    Wiberg-Itzel, Eva
    Karolinska Inst, Soder Hosp, Sect Obstet & Gynaecol, Dept Clin Sci & Educ, Stockholm, Sweden.
    Almström, Elisabeth
    NU Hosp Grp, Dept Obstet & Gynecol, Trollhattan, Sweden.
    Petzold, Max
    Univ Gothenburg, Sahlgrenska Acad, Hlth Metr Unit, Gothenmurg, Sweden.
    Berg, Marie
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, S-40530 Gothenburg, Sweden;Sahlgrens Univ Hosp, Obstet Unit, Gothenburg, Sweden.
    High-dose versus low-dose of oxytocin for labour augmentation: a randomised controlled trial2019Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 32, nr 4, s. 356-363Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Problem: Delayed labour progress is common in nulliparous women, often leading to caesarean section despite augmentation of labour with synthetic oxytocin.

    Background: High-or low-dose oxytocin can be used for augmentation of delayed labour, but evidence for promoting high-dose is weak.

    Aim: To ascertain the effect on caesarean section rate of high-dose versus low-dose oxytocin for augmentation of delayed labour in nulliparous women.

    Methods: Multicentre parallel double-blind randomised controlled trial (ClinicalTrials.gov: NCT01587625) in six labour wards in Sweden. Healthy nulliparous women at term with singleton cephalic fetal presentation, spontaneous labour onset, confirmed delay in labour and ruptured membranes (n = 1351) were randomised to labour augmentation with either high-dose (6.6 mU/minute) or low-dose (3.3 mU/minute) oxytocin infusion.

    Findings: 1295 women were included in intention-to-treat analysis (high-dose n = 647; low-dose n = 648). Caesarean section rates did not differ between groups (12.4% and 12.3%, 95% Confidence Interval -3.7 to 3.8). Women with high-dose oxytocin had: shorter labours (-23.4 min); more uterine tachysystole (43.2% versus 33.5%); similar rates of instrumental vaginal births, with more due to fetal distress (43.8% versus 22.7%) and fewer due to failure to progress (39.6% versus 58.8%). There were no differences in neonatal outcomes.

    Discussion: Our study could not confirm results of two systematic reviews indicating, with weak evidence, that use of high-dose oxytocin was associated with lower frequency of caesarean section.

    Conclusion: We found no advantages for routine use of high-dose oxytocin in the management of delay in labour. Low-dose oxytocin regimen is recommended to avoid unnecessary events of tachysystole and fetal distress. 

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  • 26.
    Sharma, Bharati
    et al.
    Karolinska Inst, Div Reprod Hlth, Dept Womens & Childrens Hlth, 14a,B,Berzilius Vag, SE-17177 Stockholm, Sweden;Indian Inst Publ Hlth Gandhinagar, Opposite Air Force Head Quarters, Gandhinagar 382042, Gujarat, India.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Mid Sweden Univ, OMV, Dept Nursing, SE-85170 Sundsvall, Sweden.
    Christensson, Kyllike
    Karolinska Inst, Div Reprod Hlth, Dept Womens & Childrens Hlth, 14a,B,Berzilius Vag, SE-17177 Stockholm, Sweden.
    The association of teaching-learning methods and self-confidence of nurse-midwives: A survey from one province in India2019Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 32, nr 3, s. E376-E383Artikel i tidskrift (Refereegranskat)
    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.

  • 27.
    Sjöström, Kaisa
    et al.
    Karolinska Institutet, Department of Women’s and Children’s Health, Stockholm, Sweden.
    Welander, Sara
    Karolinska Institutet, Department of Women’s and Children’s Health, Stockholm, Sweden.
    Haines, Helen
    University of Melbourne, School of Rural Health, Shepparton, Victoria, Australia.
    Andersson, Ewa
    Karolinska Institutet, Department of Women’s and Children’s Health, Stockholm, Sweden.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Comparison of breastfeeding in rural areas of Sweden and Australia - a cohort study2013Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 26, nr 4, s. 229-234Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Breastfeeding rates in Sweden and Australia appears to be decreasing in both countries. National statistics shows that 87% of infants in Sweden and 73% in Australia receive any breastfeeding two months of age.

    AIM: To compare women's experiences of breastfeeding in Sweden and Australia and to identify factors associated with breastfeeding two months after birth.

    METHODS: A cohort study in two rural hospitals in mid Sweden (n=300) and north-eastern Victoria in Australia (n=91) during 2007-2009. Participants responded to questionnaires in mid pregnancy and two months after birth. Crude and adjusted odds ratios with a 95% confidence interval were used to detect differences between women in both cohorts.

    FINDINGS: Women in Sweden (88.3%) were more likely to report any breastfeeding of the baby two months after birth (OR 2.41; 95% CI: 1.33-4.38) compared to women in Australia (75.8%) but were less satisfied with breastfeeding support and information. The most important factor associated with breastfeeding at two months postpartum for the Swedish women was to have received sufficient information about breastfeeding on the postnatal ward (OR 2.3; 95% CI 1.41-4.76) while for the Australian women receiving the best possible help when breastfeeding for the first time was most important (OR 4.3; 95% CI 1.50-12.46).

    CONCLUSION: The results indicate that Swedish women were more likely than their Australian counterparts to breastfeed the baby two months after birth. The findings demonstrated the importance of sufficient information and help when breastfeeding is initiated.

  • 28.
    Ternström, Elin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Haines, Helen
    Rural Health Academic Centre, University of Melbourne, Victoria, Australia.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Pregnant women's thoughts when assessing fear of birth on the Fear of Birth Scale2016Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 29, nr 3, s. E44-E49Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Fear of childbirth is common during pregnancy but rarely assessed in clinical practice. The Fear of Birth Scale has been proposed as a valid measure suitable for assessing fear of birth in an antenatal clinical context. To make sure that the scale makes sense in relation to the known constructs of fear of birth, it is important to find out what women think when responding to the Fear of Birth Scale.

    AIM:

    To report what women in mid-pregnancy think when assessing fear of birth on the Fear of Birth Scale.

    METHODS:

    A qualitative design using semi-structured interviews with a think aloud technique was used. Thirty-one women were recruited in gestational week 17-20. Content analysis was conducted to describe the different dimensions of fear of birth.

    FINDINGS:

    Worry was described as unspecific feelings and thoughts, often with a negative loading. Fear was described as a strong feeling connected to something specific. Furthermore, the women thought about aspects that influence their worries and fears and explained the strategies that helped them to cope with their fear of birth.

    CONCLUSION:

    Women could clearly assess, describe, and discuss fear of birth using the Fear of Birth Scale. This supports the use of the Fear of Birth Scale in clinical settings as a starting point for further dialogue about women's fear of birth. The dialogue may identify women's need for information, treatment, and referral when necessary.

  • 29.
    Thies-Lagergren, Li
    et al.
    Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden.
    Hildingsson, Ingegerd
    Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden.
    Christensson, Kyllike
    Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden.
    Kvist, Linda J
    Department of Obstetrics and Gynaecology, Helsingborg Hospital, Sweden.
    Who decides the position for birth? A follow-up study of a randomised controlled trial.2013Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 26, nr 4, s. e99-104Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Physical benefits are suggested for women and their babies when women adopt an upright position of their choice at birth. Available care options during labour influence women's impressions of what intrapartum care is. This indicates that choice of birth positions may be determined more by midwives than by women's preferences.

    QUESTION: The aims of this study were to investigate factors associated with adherence to allocated birth position and also to investigate factors associated with decision-making for birth position.

    METHOD: An invitation to answer an on-line questionnaire was mailed.

    FINDINGS: Despite being randomised, women who gave birth on the seat were statistically significantly more likely to report that they participated in decision-making and that they took the opportunity to choose their preferred birth position. They also reported statistically significantly more often than non-adherers that they felt powerful, protected and self-confident.

    CONCLUSIONS: Midwives should be conscious of the potential impact that birth positions have on women's birth experiences and on maternal outcomes. Midwives should encourage women's autonomy by giving unbiased information about the birth seat. An upright birth position may lead to greater childbirth satisfaction. Women's experience of and preferences for birth positions are consistent with current evidence for best practice.

  • 30.
    Thies-Lagergren, Li
    et al.
    Department of Midwifery Research - Reproductive, Perinatal and Sexual Health, Lund University, Sweden; Department of Obstetrics and Gynaecology, Helsingborg Lasarett, Sweden.
    Johansson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Department of Obstetrics and Gynaecology, Södersjukhuset, Sweden.
    Intrapartum midwifery care impact Swedish couple's birth experiences: A cross-sectional study2019Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 32, nr 3, s. 213-220Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Parents' birth experiences affect bonding with their infant, which in turn may influence the child's future health. Parents' satisfaction with childbirth is multi-dimensional and dependent on both expectations and experiences. Increasing involvement of partners in intrapartum care may lead to an assumption that the birthing couple shares attitudes and expectations of intrapartum care. There is a limited knowledge regarding the uniformity of couples' experiences of labour and birth.

    AIM: To describe and compare uniformity in couples' birth experiences of the quality of intrapartum midwifery care.

    METHOD: A quantitative cross-sectional study nested within a randomised controlled trial. In total 209 healthy primiparous mothers and their partners were recruited. A quality of care index was generated from an on-line questionnaire administered as a follow-up to the randomised controlled trial. Uniformity and differences were identified regarding the coupleś experiences of birth and their preferences for intrapartum care RESULTS: A high level of uniformity between the mothers and their partners was revealed. Birth was a positive experience for 79% of partners and 73% of mothers whom were more likely to have experienced a spontaneous vaginal birth. Partners and mothers with a less positive birth experienced deficiencies regarding: being in control, receiving information about labour progress and midwife's presence in labour room.

    DISCUSSION: Midwives can enhance couples' feeling of being in control during labour and birth by being attentive, present and continuously providing adequate information and emotional support.

  • 31.
    Wrammert, Johan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Sapkota, Sabitri
    Marie Stopes International.
    Baral, Kedar
    Patan Academy of Health Sciences.
    KC, Ashish
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Målqvist, Mats
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Teamwork among midwives during neonatal resuscitation at a maternity hospital in Nepal2017Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, nr 3, s. 262-269, artikel-id S1871-5192(16)30120-2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PROBLEM: The ability of health care providers to work together is essential for favourable outcomes in neonatal resuscitation, but perceptions of such teamwork have rarely been studied in low-income settings.

    BACKGROUND: Neonatal resuscitation is a proven intervention for reducing neonatal mortality globally, but the long-term effects of clinical training for this skill need further attention. Having an understanding of barriers to teamwork among nurse midwives can contribute to the sustainability of improved clinical practice.

    AIM: To explore nurse midwives' perceptions of teamwork when caring for newborns in need of resuscitation.

    METHODS: Nurse midwives from a tertiary-level government hospital in Nepal participated in five focus groups of between 4 and 11 participants each. Qualitative Content Analysis was used for analysis.

    FINDINGS: One overarching theme emerged: looking for comprehensive guidelines and shared responsibilities in neonatal resuscitation to avoid personal blame and learn from mistakes. Participants discussed the need for protocols relating to neonatal resuscitation and the importance of shared medical responsibility, and the importance of the presence of a strong and transparent leadership.

    DISCUSSION: The call for clear and comprehensive protocols relating to neonatal resuscitation corresponded with previous research from different contexts.

    CONCLUSION: Nurse midwives working at a maternity health care facility in Nepal discussed the benefits and challenges of teamwork in neonatal resuscitation. The findings suggest potential benefits can be made from clarifying guidelines and responsibilities in neonatal resuscitation. Furthermore, a structured process to deal with clinical incidents must be considered. Management must be involved in all processes.

  • 32.
    Åhlund, Susanne
    et al.
    Karolinska Inst, Dept Womens & Childrens Hlth, Retzius Vag 13 B, S-17177 Solna, Sweden..
    Zwedberg, Sofia
    Karolinska Inst, Dept Womens & Childrens Hlth, Retzius Vag 13 B, S-17177 Solna, Sweden.;Karolinska Univ Hosp, Dept Obstet, Stockholm, Sweden..
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden.
    Edqvist, Malin
    Univ Gothenburg, Sahlgrenska Acad, Gothenburg, Sweden..
    Lindgren, Helena
    Karolinska Inst, Dept Womens & Childrens Hlth, Retzius Vag 13 B, S-17177 Solna, Sweden.;Univ Gothenburg, Sahlgrenska Acad, Gothenburg, Sweden..
    Midwives experiences of participating in a midwifery research project: A qualitative study2018Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 31, nr 2, s. E115-E121Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Problem and background: In an earlier research project midwives were asked to perform women-centered care focusing on the assumption that the physiological process in the second stage of labour could be trusted and that the midwives role should be encouraging and supportive rather than instructing. There is no knowledge about how midwives participating in such a research project, uses their skills and experience from the study in their daily work.

    Aim: The aim in this study was to investigate how midwives experienced implementing woman-centered care during second stage of labour.

    Methods: A qualitative study was designed. Three focus groups and two interviews were conducted. The material was analysed using content analysis.

    Findings: The participating midwives' experiences were understood as increased awareness of their role as midwives. The overarching theme covers three categories 1) establishing a new way of working, 2) developing as midwife, 3) being affected by the prevailing culture. The intervention was experienced as an opportunity to reflect and strengthen their professional role, and made the midwives see the women and the birth in a new perspective.

    Conclusions: Implementing woman-centered care during second stage of labour gave the midwives an opportunity to develop in their professional role, and to enhance their confidence in the birthing women and her ability to have a physiological birth. To promote participation in, as well as conduct midwifery research, can enhance the development of the midwives professional role as well as contribute new knowledge to the field.

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