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  • 1.
    Aarnio, Pauliina
    et al.
    Univ Tampere, Fac Social Sci Global Hlth & Dev, Kalevantie 4, FI-33014 Tampere, Finland;Univ Tampere, Med Sch, Dept Int Hlth, Tampere, Finland.
    Kulmala, Teija
    Univ Tampere, Med Sch, Child Hlth Res Unit, Tampere, Finland;Univ Tampere, Med Sch, Dept Int Hlth, Tampere, Finland.
    Olsson, Pia
    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.
    Husband's role in handling pregnancy complications in Mangochi District, Malawi: A call for increased focus on community level male involvement2018Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 16, s. 61-66Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The objective of the current study is to provide information about husbands' role in decision-making and healthcare seeking in cases of pregnancy complications in Mangochi district, Malawi with an analysis of qualitative interviews using the concepts of "capital" and "field" from Bourdieu's social field theory. Study design: Twelve husbands and wives who had experienced pregnancy complications and six key informants from a semi-rural area of Mangochi district were interviewed individually. Thematic analysis was conducted based on the concepts of capital and field in Bourdieu's social field theory. Results: Husbands have significant economic and symbolic capital in decisions about healthcare seeking during instances of pregnancy complications as a result of their roles as father, head of the household and main income earner. Lack of money is the only acceptable reason for husbands to deny their wives healthcare. Husbands have limited access to knowledge of maternal health, which can compromise their decisions about seeking healthcare. Joint decision-making within families can be bypassed to allow for prompt healthcare seeking in emergencies. Conclusions: Husbands are important decision makers regarding seeking healthcare for pregnancy complications because of their economic and symbolic power and despite their limited access to knowledge of maternal health. Maternal healthcare seeking practices would benefit from wives gaining an empowered role as well as improved knowledge of maternal health among husbands.

  • 2.
    Amark, Hanna
    et al.
    Karolinska Institute, Department of Clinical Science and Education, Unit of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden.
    Millde-Luthander, Charlotte
    Karolinska Institute, Department of Clinical Science and Education, Unit of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden.
    Ajne, Gunilla
    Department of Obstetrics and Gynecology, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
    Högberg, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Pettersson, Hans
    Karolinska Institute, Department of Clinical Science and Education, Unit of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden.
    Wiklund, Ingela
    Department of Clinical Sciences, Division of Obstetrics and Gynecology, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.
    Grunewald, Charlotta
    Karolinska Institute, Department of Clinical Science and Education, Unit of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden.
    Single versus pairwise interpretation of cardiotochography, a comparative study from six Swedish delivery units2014Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, nr 4, s. 195-198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The aim of the study was to evaluate whether interpreting CTG pairwise brings about a higher level of correctly classified CTG recordings in a non-selected population of midwives and physicians.

    STUDY DESIGN: A comparative study.

    SETTING: Five delivery units in Stockholm and one delivery unit in Uppsala, with 1589, 3740, 3908, 4539, 6438, and 7331 deliveries in 2011, respectively.

    SUBJECTS: 536 midwives and physicians classified one randomly selected CTG recording individually followed by a pairwise classification. The pairs consisted of two midwives (119 pairs) or one midwife and one physician (149 pairs), a total of 268 pairs.

    MAIN OUTCOME MEASURE: The proportion of individually correctly classified CTG recordings versus the proportion of pairwise correctly classified CTG recordings.

    RESULTS: The proportion of individually correctly classified CTG's was 75% and the proportion of pairwise correctly classified CTG's was 80% (difference 5%, p = 0.12).

    CONCLUSIONS: There was no statistically significant difference when CTG's were classified pairwise compared to individual classifications. The proportion of individually correctly classified CTG's was high (75%). There were differences in the proportion of correctly classified CTG recordings between the delivery units, indicating potential areas of improvement.

  • 3. Andersson, Ewa
    et al.
    Christensson, Kyllike
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Mothers' satisfaction with group antenatal care versus individual antenatal care: A clinical trial2013Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 4, nr 3, s. 113-120Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of this study was to compare women's satisfaction with group based antenatal care and standard care. Design: A randomised control trial where midwives were randomized to perform either GBAC or standard care. Women were invited to evaluate the two models of care. Data was collected by two questionnaires, in early pregnancy and six months after birth. Crude and adjusted odds ratios with a 95% confidence interval were calculated by model of care. Settings: Twelve antenatal clinics in Sweden between September 2008 and December 2010. Participants: Women in various part of Sweden (n = 700). Findings: In total, 8:16 variables in GBAC versus 9:16 in standard care were reported as deficient. Women in GBAC reported significantly less deficiencies with information about labour/birth OR 0.16 (0.10-0.27), breastfeeding OR 0.58 (0.37-0.90) and time following birth OR 0.61 (0.40-0.94). Engagement from the midwives OR 0.44 (0.25-0.78) and being taken seriously OR 0.55 (0.31-0.98) were also found to be less deficient. Women in GBAC reported the highest level of deficiency with information about pregnancy OR 3.45 (2.03-5.85) but reported less deficiency with time to plan the birth OR 0.61 (0.39-0.96). In addition, women in GBAC more satisfied with care in supporting contact with other parents OR 3.86 (2.30-6.46) and felt more support to initiate breastfeeding OR 1.75 (1.02-2.88). Conclusions: Women in both models of care considered the care as deficient in more than half of all areas. Variables that differed between the two models favoured group based antenatal care.

  • 4.
    Angeby, Karin
    et al.
    Cent Hosp Karlstad, Womens Dept, Karlstad, Sweden.;Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, SE-61588 Karlstad, Sweden..
    Wilde-Larsson, Bodil
    Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, SE-61588 Karlstad, Sweden.;Hedmark Univ Coll, Fac Publ Hlth, Dept Nursing & Mental Hlth, Elverum, Norway..
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. Mid Sweden Univ, Sundsvall, Sweden. Karoliniska Inst, Stockholm, Sweden..
    Sandin-Bojo, Ann-Kristin
    Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, SE-61588 Karlstad, Sweden.;Univ Boras, Sch Hlth Sci, Boras, Sweden..
    Primiparous women's preferences for care during a prolonged latent phase of labour2015Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 6, nr 3, s. 145-150Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate primiparous women's preferences for care during a prolonged latent phase of labour. Methods: A qualitative study based on focus groups and individual interviews and analysed with inductive content analysis. Results: Sixteen primiparous women with a prolonged latent phase of labour >18 hours were interviewed in five focus groups (n = 11) or individually (n = 5). One main category emerged "Beyond normality - a need of individual adapted guidance in order to understand and manage an extended latent phase of labour" which covers the women's preferences during the prolonged latent phase. Five categories were generated from the data: "A welcoming manner and not being rejected", "Individually adapted care", "Important information which prepares for reality and coping", "Participation and need for feedback" and "Staying nearby the labour ward or being admitted for midwifery support". Women with a prolonged latent phase of labour sought to use their own resources, but their needs for professional support increased as time passed. A welcoming attitude from an available midwife during the latent phase created a feeling of security, and personally adapted care was perceived positively. Conclusions: Women with a prolonged latent phase of labour preferred woman-centred care. Midwives play an important role in supporting these women. Women's need for midwifery-support increases as the time spent in latent phase increases.

  • 5.
    Binder-Finnema, Pauline
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Mahmud, Asha Omar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Johnsdotter, Sara
    Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Essén, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    ‘I have made children, so what's the problem?’ Retrospective self-circumcision and the sexual and urological health needs of some Somali men in Sweden2017Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 11, s. 36-40Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Unskilled traditional healers are widely blamed for complications to male circumcision performed in low- and middle-income settings. However, attributions of culpability are mostly anecdotal. We identify self-circumcision in adults that was performed during adolescence, hereby termed retrospective self circumcision, and unexpectedly discovered during interviews with Somali men in Sweden in 2010. This study explores the phenomenon with the aim to increase our understanding about the health needs of this group. Two focus group discussions (six and seven participants), one informal discussion with three participants, and 27 individual interviews were conducted in 2010 and 2011 with Somali-Swedish fathers, guided by a hermeneutic, comparative natural inquiry method. Eight participants had performed retrospective self-circumcision while living in rural Somalia. Actions were justified according to strong faith in Islam. Genital physiology was described as adequate for producing children, but physical sensation or characteristics were implied as less than optimal. Few had heard about penile reconstruction. There was hesitation to openly discuss concerns, but men nevertheless encouraged each other to seek care options. Presently no medical platform is available for retrospective self-circumcision. Further systematic exploration is recommended in sexual, reproductive and urological health to increase interest in this phenomenon. Our findings suggest approachability if health communication is enabled within an Islamic context.

  • 6.
    Biskop, Emilia
    et al.
    Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Paulsdotter, Therese
    Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Ågren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Parental participation during therapeutic hypothermia for neonatal hypoxicischemic encephalopathy2019Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 20, s. 77-80Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To examine parental participation in the care of newborn infants receiving therapeutic hypothermia, and to explore the possible impact of in-born vs out-born status, and location of hospital accommodation. Study design: Retrospective, quantitative and descriptive design. Main outcome measures: Infants medical charts were reviewed for defined aspects of parental participation (infant holding, tube feeding, and diaper change), and related to their in-born vs out-born status, and whether the parents were accommodated in the NICU or elsewhere. All infants have been cared for at the University Hospital Neonatal Intensive Care Unit, serving as a regional referral center for hypothermia treatment. This study is a part of a population-based regional cohort of asphyxiated newborn infants (n = 112) that received therapeutic hypothermia in 2007-2015. Results: Parents engaged in holding (60/112, 54%) or tube feeding (59/112, 53%) their infant. Parents of inborn infants (24/112, 21%) were more likely to check the placement of the feeding tube (11/24, 46% vs 15/88, 17%; p < 0.01) and change diapers (9/24, 38% vs 14/88, 16%; p < 0.05) than parents of out-born infants (88/112, 79%). A similar pattern of more extensive involvement was observed for both mothers and fathers who stayed at the neonatal intensive care compared to those accommodated elsewhere (p < 0.05). Conclusions: Active parental participation is feasible at the NICU even during therapeutic hypothermia. Timely postnatal transfer of parents of out-born/transported infants, and the provision of on-site accommodation may influence the quality of parental involvement.

  • 7.
    Bäck, Lena
    et al.
    Mid Sweden Univ, Dept Nursing, Kunskapens Vag 8, S-83140 Ostersund, Sweden..
    Sharma, Bharati
    Indian Inst Publ Hlth Gandhinagar, Gandhinagar, Gujarat, India..
    Karlström, Annika
    Mid Sweden Univ, Dept Nursing, Holmgatan 10, S-85230 Sundsvall, Sweden..
    Tunon, Katarina
    Umea Univ, Ostersunds Sjukhus, Inst Clin Sci, Kyrkgatan 16, S-83150 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, Holmgatan 10, S-85230 Sundsvall, Sweden.
    Professional confidence among Swedish final year midwifery students - A cross-sectional study2017Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 14, s. 69-78Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Previous international studies have shown that midwifery students do not feel confident in many areas where they are supposed to practice independently. The knowledge about Swedish midwifery students' confidence is fairly under investigated. The purpose of the present study was to explore final years' midwifery students' professional confidence in basic midwifery skills according to ICM competencies and associated factors.

    Methods: A cross-sectional survey where all midwifery programs in Sweden were invited to participate. Data was collected by a questionnaire that measured midwifery students self-reported assessment of confidence against four selected domains of ICM competencies; antenatal, intrapartum, postpartum and new-born care.

    Result: The main findings of this study showed that Swedish midwifery students were confident in managing normal pregnancy, labour and birth. Midwifery students at a school with a medical faculty were more confident in handling obstetric emergency situations. Some background variables were also associated with confidence.

    Conclusion: This study highlighted some midwifery skills that needs further training and reflection. More training and developing confidence in complicated and emergency situations are needed. There seem to be a need of midwifery education reforms if we believe that high levels of confidence at the time of graduation is equal to competent and skilled midwives in the future.

  • 8.
    Christianson, Monica
    et al.
    Umea Univ, Dept Nursing, SE-90185 Umea, Sweden..
    Boman, Jens
    Umea Univ, Dept Clin Microbiol, SE-90185 Umea, Sweden..
    Essén, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    "Men don't think that far" - Interviewing men in Sweden about chlamydia and HIV testing during pregnancy from a discursive masculinities construction perspective2017Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 12, s. 107-115Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: We used qualitative research design to discursively explore expectant fathers' perceptions of chlamydia and HIV, and their masculinity constructions about testing, and explored how they talked about their potential resistance towards testing and their pre-test emotions.

    Study design: Twenty men were offered chlamydia and HIV testing at the beginning of their partner's pregnancy. Those who agreed to be tested were interviewed in-depth; those who declined testing were also interviewed. The interviews were tape recorded and transcribed verbatim. The analysis was inspired by discourse analysis on masculinity.

    Main outcome: Three discursive themes: Men prefer to suppress their vulnerability to STIs, Body and biology differ between men and women and Men have mixed emotions around STI testing underscore the informants' conversations and sometimes conflicting thoughts about STI testing.

    Conclusion: The majority of men talked about pregnancy as a feminine territory, raised uncertainties about men's roles in the transmission of STIs, and talked about women's and men's essentially different bodies and biology, where few men realised that they could infect both their partner and the unborn child. This knowledge gap that men have must become apparent to healthcare providers, and policy makers must give men equal access to the reproductive arena.

  • 9.
    Darj, Elisabeth
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH), Internationell kvinno- och mödrahälsovård och migration. Norwegian Univ Sci & Technol, NTNU, Dept Publ Hlth & Nursing, NO-7491 Trondheim, Norway;St Olavs Hosp, Dept Obstet & Gynecol, NO-7030 Trondheim, Norway.
    Chalise, Pratibha
    Norwegian Univ Sci & Technol, NTNU, Dept Publ Hlth & Nursing, NO-7491 Trondheim, Norway;Kathmandu Univ, Sch Med Sci, Dept Nursing, Dhulikhel, Nepal.
    Shakya, Sunila
    Kathmandu Univ, Sch Med Sci, Dhulikhel Hosp, Dept Obstet & Gynaecol, Dhulikhel, Nepal.
    Barriers and facilitators to cervical cancer screening in Nepal: A qualitative study2019Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 20, s. 20-26Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Despite being preventable, cervical cancer remains the most common cancer among women in Nepal, a country where there is no nationwide screening programme. Hence, the objective was to investigate and better understand Nepali women's perceptions on barriers to participation in cervical cancer screening and what might facilitate their participation. Methods: A qualitative study design with focus group discussions was employed and women were purposively invited. The interviews were tape-recorded, transcribed verbatim, and analysed using manifest content analysis. Findings: Women had misconceptions about the screening and low levels of knowledge. Sociocultural barriers, service providers' behaviour, geographical challenges, and limited finances were all perceived as obstacles to attending screening centres. Facilitating factors, such as participation in awareness programmes and support from family and women's groups, may convince women to attend screening clinics. Conclusions: The findings contribute information on Nepalese women's perceptions of cervical cancer screening. They may serve to support the Government of Nepal's promotion of cervical cancer screening and treatment as a right for all Nepali women, whenever necessary.

  • 10.
    Darj, Elisabeth
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Mirembe, Florence M.
    Dept of Obstetrices and Gynaecology, Makerere University, Kampala, Uganda.
    Råssjö, Eva-Britta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    STI-prevalence and differences in social background and sexual behavior among urban and rural young women in Uganda2010Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 1, nr 3, s. 111-115Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Adolescents in Uganda carry a heavy burden of reproductive health problems. Different environment creates different problems.

    Objectives: To study the prevalence of STI and to compare social and behavioral risk factors for Neisseria gonorrhoea (NG) and Chlamydia trachomatis (CT) among sexually experienced young women in one urban and one rural area in Uganda.

    Methods: Consenting, sexually experienced women, below 20 years, visiting two different youth clinics were asked about social background, genital symptoms and sexual experiences. Vaginal samples were taken for NG and CT and analyzed by PCR.

    Results: The prevalence of NG and/or CT was 20 (6.8%) in the urban and 23 (7.8%) in the rural study site, a non-significant difference. The rural women were often in marital union, 25.3% compared to 12.2% of the urban women (OR 2.4, 95% CI 1.6-3.8) and had experienced more pregnancies and had more children. Their partners were often more than 10 years older. More urban women (42.2%) knew their HIV status compared to rural women (16.2%), OR 2.1 (1.6–2.7), reported more condom use and more sexual partners.

    Conclusions: Marital status and few sexual partners does not appear to protect young rural women from sexually transmitted infections (STIs), implying that male sexual behavior may have an important impact on women’s risk to be infected.

  • 11.
    Donevan, Meghan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Mattebo, Magdalena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Malardalen Univ, Sch Hlth Care & Social Welf, Box 883, SE-72123 Vasteras, Sweden..
    The relationship between frequent pornography consumption, behaviours, and sexual preoccupancy among male adolescents in Sweden2017Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 12, s. 82-87Artikel i tidskrift (Refereegranskat)
  • 12.
    Edelstam, Greta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi. Danderyd Hosp, Dept Obstet & Gynaecol & Clin Sci, SE-18288 Stockholm, Sweden.
    Makdessi, Lollo
    Vrinnevi Hosp, S-60379 Norrkoping, Sweden.
    Hagmar, Magnus
    Danderyd Hosp, Dept Obstet & Gynaecol & Clin Sci, SE-18288 Stockholm, Sweden.
    Moberg, Christian
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktionsbiologi.
    Spira, Jack
    InSpira Med AB, Tyresö, Sweden.
    Optimised gynaecological examination with a new pelvic examination chair2019Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 19, s. 84-87Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The present aim was to contribute to improving the traditional pelvic examination chair with vertical leg support and to evaluate patients' and examiners' experience of a new gyneacological and urological examination chair with heated upholstery.

    Study design: A new gynaecological and urological examination chair was constructed with laterally adjustable leg support, a foot-plate and the perineum exposed only during the examination procedure. Patients (n = 131) with or without endometriosis were invited to participate in an anonymous questionnaire survey concerning how they experienced a gynaecological examination.

    Main outcome measures: The patients and the gynaecologists who performed the examinations answered questionnaires evaluating the examination procedure in the traditional and in the new gynaecological and urological examination chair, respectively. The questionnaires asked about comfort, heating, integrity and the experience of pelvic examination with vertical or lateral leg support. The examination times were measured with a stopwatch.

    Results: The majority of the answers (n = 131) were significantly (p < 0.05-0.001) in favour of the new concept with lateral leg support and with increased comfort and integrity. The average examination time was significantly shortened and the patients more relaxed in the new gynaecological and urological examination chair.

    Conclusion: The traditional gynaecological chair with vertical leg support has remained basically unchanged for many years. The present study showed that the pelvic examination procedure can be significantly optimized with easy patient-friendly adaptations.

  • 13.
    Edelstam, Greta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. Karolinska Inst, Stockholm, Sweden..
    Sjösten, Anette
    Karolinska Inst, Stockholm, Sweden..
    Jablonowska, Barbara
    Linkoping Univ Hosp, S-58185 Linkoping, Sweden..
    Kjellberg, Svante
    Gothenburg Primary Care, Gothenburg, Sweden..
    Spira, Jack
    InSpira Med AB, Tyreso, Sweden..
    Pertubation with lidocaine - a non-hormonal, long-term treatment of dysmenorrhea due to endometriosis2012Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 3, nr 2, s. 93-94Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The major symptoms of endometriosis are dysmenorrhea and infertility. Pertubations with lidocaine have been shown to reduce dysmenorrhea and have an enhancing effect on fertility. Different concentrations of lidocaine were evaluated in a randomized, double-blind study of pre-ovulatory pertubations with lidocaine solutions in women with dysmenorrhea. The patients had laparoscopically diagnosed endometriosis and normal fallopian tubes. Ninety pertubations were carried out without complications on 26 patients during up to six cycles. The effect was evaluated by means of questionnaires where a clinically significant reduction of dysmenorrhea was reported. Pertubation with lidocaine can be a non-hormonal treatment option for dysmenorrhea.

  • 14.
    Edvardsson, Kristina
    et al.
    Umeå University, Umeå, Sweden; La Trobe University, Melbourne, Victoria, Australia.
    Åhman, Annika
    Umeå University, Umeå, Sweden.
    Fagerli, Tove Anita
    St. Olavs Hospital Trondheim University Hospital, Trondheim, Norway.
    Darj, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). St Olavs Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway.
    Holmlund, Sophia
    Umeå University, Umeå, Sweden.
    Small, Rhonda
    La Trobe University, Melbourne, Victoria, Australia; Karolinska Institute, Stockholm, Sweden.
    Mogren, Ingrid
    Umeå University, Umeå, Sweden; La Trobe University, Melbourne, Victoria, Australia.
    Norwegian obstetricians’ experiences of the use of ultrasound in pregnancy management: A qualitative study2018Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 15, s. 69-76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    To explore obstetricians’ experiences and views of the use of obstetric ultrasound in clinical management of pregnancy.

    Methods

    A qualitative interview study was undertaken in 2015 with obstetricians (N = 20) in Norway as part of the CROss Country Ultrasound Study (CROCUS).

    Results

    Three categories developed during analyses. ‘Differing opinions about ultrasound and prenatal diagnosis policies’ revealed divergent views in relation to Norwegian policies for ultrasound screening and prenatal diagnosis. Down syndrome screening was portrayed as a delicate and frequently debated issue, with increasing ethical challenges due to developments in prenatal diagnosis. ‘Ultrasound’s influence on the view of the fetus’ illuminated how ultrasound influenced obstetricians’ views of the fetus as a ‘patient’ and a ‘person’. They also saw ultrasound as strongly influencing expectant parents’ views of the fetus, and described how ultrasound was sometimes used as a means of comforting women when complications occurred. ‘The complexity of information and counselling’ revealed how obstetricians balanced the medical and social aspects of the ultrasound examination, and the difficulties of ‘delivering bad news’ and counselling in situations of uncertain findings.

    Conclusion

    This study highlights obstetricians’ experiences and views of ultrasound and prenatal diagnosis in Norwegian maternity care and the challenges associated with the provision of these services, including counselling dilemmas and perceived differences in expectations between caregivers and expectant parents. There was notable diversity among these obstetricians in relation to their support of, and adherence to Norwegian regulations about the use of ultrasound, which indicates that the care pregnant women receive may vary accordingly.

  • 15.
    Fabian, Helena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Sarkadi, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Åhman, Annika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Challenges and benefits of conducting parental classes in Sweden: Midwives’ perspectives2015Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 6, nr 4, s. 236-242Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    There is lack of knowledge regarding antenatal care midwives' perspectives concerning parental classes provided during pregnancy, and this study aimed to explore midwives' experiences and thoughts about these parental class activities.

    Methods

    Twenty-six semi-structured, individual, telephone interviews were carried out with midwives at antenatal clinics across Sweden, and the data were analysed using systematic text condensation (STC).

    Results

    The midwives noted that parental classes were a demanding task, and they appeared to lack the confidence and skills required to manage the classes. They expressed a “need for collaborators to achieve the objectives” (theme 1). The midwives felt that “creating new networks is most valuable for parents” (theme 2), and they were also “striving to give the ‘whole picture’ to both parents” (theme 3), i.e. looking beyond just the delivery. Although they had the ambition, midwives realised it was “not possible to reach all” (theme 4).

    Conclusions

    Organisational resources as well as developing skills to lead groups are imperative for midwives to fulfil the goals of the parental classes. The midwives are aware that they cannot reach all parents with the group format; thus, it is important to acknowledge the needs of minority populations and develop multidisciplinary collaborations to be able to better address their needs.

    Abbreviation

    STC, Systematic Text Condensation

  • 16.
    Flacking, Renée
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Thomson, G.
    Ekenberg, L.
    Loewegren, L.
    Wallin, L.
    Influence of NICU co-care facilities and skin-to-skin contact on maternal stress in mothers of preterm infants2013Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 4, nr 3, s. 107-112Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate the influence of co-care facilities and amount of skin-to-skin contact during Neonatal Intensive Care Unit (NICU) stay on maternal stress in mothers of preterm infants at two months corrected age. Methods: A prospective cohort study that involved 300 mothers of pre-term infants was conducted in four NICUs (two with co-care facilities and two with non co-care) in Sweden. Data on duration of skin-to-skin contact per day for all days admitted to the NICU were collected using self-reports. Maternal stress was measured by the Swedish Parental Stress Questionnaire (SPSQ) at two months of infant's corrected age. Results: Mothers whose infants were cared for in a NICU with co-care facilities reported significantly lower levels of stress in the dimension of 'incompetence' compared to mothers whose infants had been cared for in non co-care NICUs. The amount of skin-to-skin experienced during the neonatal stay was not significantly associated with levels of maternal stress at two months corrected age. Conclusion: The finding that mothers who do not experience co-care facilities experience greater levels of stress in relation to feelings of incompetence is of concern. Improvements to NICU environments are needed to ensure that mother-infant dyads are not separated.

  • 17.
    Haines, H M
    et al.
    Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
    Pallant, J F
    Rural Health Academic Centre, The University of Melbourne, 49 Graham St, Shepparton, Victoria, Australia.
    Fenwick, J
    Griffith Health Institute and School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia.
    Gamble, J
    Griffith Health Institute and School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia.
    Creedy, D K
    Griffith Health Institute and School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia.
    Toohill, J
    Griffith Health Institute and School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia.
    Hildingsson, Ingegerd
    Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
    Identifying women who are afraid of giving birth: A comparison of the fear of birth scale with the WDEQ-A in a large Australian cohort.2015Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 6, nr 4, s. 204-210Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The WDEQ-A is the most widely used measure of childbirth fear in pregnant women; however there is increasing discussion in the literature that simpler, more culturally transferrable tools may offer a better solution to identifying fearful women in clinical practice.

    AIM: To compare the two item Fear of Birth Scale (FOBS) with the 33 item WDEQ-A in a large cohort of Australian pregnant women.

    METHOD: Self-report questionnaires during second trimester including Wijma Delivery Expectancy Questionnaire (WDEQ-A) and Fear of Birth Scale (FOBS). Correlation of FOBS and WDEQ-A was tested using Spearman's correlation coefficients. Receiver operating characteristic (ROC) curve assessed the sensitivity and specificity of possible cut-points on the FOBS against WDEQ-A cut-point of ≥85. Sensitivity, specificity, positive and negative predictive values were determined. Fearful and non-fearful women as classified by both instruments were compared for differences in demographic, psycho-social and obstetric characteristics.

    RESULTS: 1410 women participated. The correlation between the instruments was strong (Spearman's Rho = 0.66, p < 0.001). The area under the ROC was 0.89 indicating high sensitivity with a FOBS cut-point of 54. Sensitivity was 89%, specificity 79% and Youden index 0.68. Positive predictive value was 85% and negative predictive value 79%. Both instruments identified high fear as significantly associated with first time mothers, previous emergency caesarean and women with self-reported anxiety and/or depression. Additionally FOBS identified a significant association between fearful women and preference for caesarean.

    CONCLUSION: This study supports the use of the FOBS in clinical practice to identify childbirth fear in pregnant women.

  • 18.
    Halfdansdottir, Berglind
    et al.
    Univ Iceland, Fac Nursing, Eiriksgata 34, IS-101 Reykjavik, Iceland..
    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.
    Smarason, Alexander Kr.
    Univ Akureyri, Inst Hlth Sci Res, IS-600 Akureyri, Iceland..
    Sveinsdottir, Herdis
    Univ Iceland, Fac Nursing, Eiriksgata 34, IS-101 Reykjavik, Iceland..
    Olafsdottir, Olof A.
    Univ Iceland, Fac Nursing, Eiriksgata 34, IS-101 Reykjavik, Iceland..
    Contraindications in planned home birth in Iceland: A retrospective cohort study2018Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 15, s. 10-17Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Icelandic national guidelines on place of birth list contraindications for home birth. Few studies have examined the effect of contraindication on home birth, and none have done so in Iceland. The aim of this study was to examine whether contraindications affect the outcome of planned home birth or have a different effect at home than in hospital.

    Methods: The study is a retrospective cohort study on the effect of contraindications for home birth on the outcome of planned home (n = 307) and hospital (n = 921) birth in 2005-2009. Outcomes were described for four different groups of women, by exposure to contraindications (unexposed vs. exposed) and planned place of birth (hospital vs. home). Linear and logistic regression analysis was used to evaluate the effect of the contraindications under study and to detect interactions between contraindications and planned place of birth.

    Results: The key findings of the study were that contraindications were related to higher rates of adverse maternal and neonatal outcomes, regardless of place of birth; women exposed to contraindications had higher rates of adverse outcomes in planned home birth; and healthy, unexposed women had higher rates of adverse outcomes in planned hospital birth. Contraindications significantly increased the risk of transfer in labour and postpartum haemorrhage in planned home births.

    Conclusion: The defined contraindications for home birth had a negative effect on maternal and neonatal outcomes in Iceland, regardless of place of birth. The study results do not contradict the current national guidelines on place of birth.

  • 19.
    Hedqvist, Maria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Brolin, Lina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Tyden, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Women's experiences of having an early medical abortion at home2016Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 9, s. 48-54Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: The aim of this study was to assess women's experiences of having an early medical abortion at home and to investigate their perceptions of the information provided before the abortion. The study also aimed to investigate possible differences between groups of women.

    Study design: The study is cross-sectional with a descriptive and comparative design. Semi-structured telephone interviews were conducted with 119 women who had undergone a medical abortion at home.

    Results: Almost half of the women (43%, n = 51) experienced the bleeding as more than expected and one-fourth (26%, n = 31) bled for more than four weeks. One-third (34%, n = 41) stated a lack of information, especially about the bleeding and pain. The experience of pain differed between groups. Women who had undergone an earlier abortion and women who had previously given birth experienced the abortion as being less painful than that experienced by first-time gravidae (p <0.05).

    Conclusions: The finding that women experience information about the pain and bleeding to be insufficient suggests that information in those areas can be improved. The result that women without previous experience of abortion or childbirth stated the pain as being worse than other groups investigated suggests that special attention should be paid to those women.

  • 20.
    Hildingsson, Ingegerd
    Mid Sweden University, Department of Health Science, Sundsvall, Sweden.
    Mental training during pregnancy. Feelings and experiences during pregnancy and birth and parental stress 1 year after birth - a pilot study.2012Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 3, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Parental stress has been recognized as a problem despite governmental support of parent education programs aiming to prepare parents for parenthood.

    AIM: to compare parents who underwent a mental training program during pregnancy with a control group to measure feelings and experiences during pregnancy and birth and perceived parental stress.

    METHODS: A comparative pilot study of 46 self-selected parents who underwent a mental training program during pregnancy, and 1408 parents living in the same catchment area (control group). Data was collected in mid-pregnancy, 2 months and 1 year after birth. The main outcome was parental stress.

    RESULTS: Parents in the mental training group were more often expecting their first baby and had a higher level of education compared to parents in the control group. Parents participating in the mental training program had less positive feelings about expecting a baby (OR 14.0; 6.7-29.3), the upcoming birth (OR 2.0; 1.1-3.8) and the newborn baby (OR 3.1; 1.6-6.2). Parents who attended the mental training program attended an antenatal parent education to a higher degree (OR 2.0; 1.6-2.4) and were more likely to stay in contact with other participants in the antenatal education (OR 4.1; 1.9-8.6). Mothers in the mental training program used psycho prophylaxis to a higher extent (OR 3.0; 1.2-7.1) There was no difference in the birth experience or the perceived parental stress.

    CONCLUSION: Participating in a mental training program for birth and parenthood was not associated with the birth experience or the assessment of parental stress 1 year after birth.

  • 21.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden..
    Sense of coherence in pregnant and new mothers - A longitudinal study of a national cohort of Swedish speaking women2017Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 11, s. 91-96Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Previous research shows inconsistent results about the stability of SOC during the childbearing period, and few studies have focused on longitudinal measures. There are contradictory results regarding the association between SOC and birth outcome. The link between levels of SOC and parental stress needs to be further explored. Aim: The aim of this study was to investigate changes in SOC from early pregnancy to one year after birth and associations with background characteristics, birth outcome and parental stress. Methods: A longitudinal survey of a national cohort of Swedish speaking women during 3 weeks in 1999-2000. Data were collected by questionnaires in early pregnancy, 2 months and 1 year after birth. Results: SOC increased from pregnancy to 2 months after birth but decreased 1 year after birth. SOC was associated with women's background characteristics, emotional wellbeing and attitudes, but not with labour outcome. Women with low SOC reported higher parental stress after one year. Conclusion: Sense of coherence is not stable during the childbearing period and is associated with women's sociodemographic background, emotional health and attitudes, but not with reproductive history or birth outcome. Parental stress is negatively correlated with SOC, and some important characteristics are similar in women having low SOC and high parental stress. Identifying women with low SOC in early pregnancy could be a means to prevent later parental stress.

  • 22.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Swedish couples’ attitudes towards birth, childbirth fear and birth preferences and relation to mode of birth: A longitudinal cohort study2014Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, nr 2, s. 75-80Artikel i tidskrift (Refereegranskat)
  • 23.
    Hildingsson, Ingegerd
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Andersson, Ewa
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
    Christensson, Kyllike
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
    Swedish women’s expectations about antenatal care and change overtime: A comparative study of two cohorts of women2014Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, nr 2, s. 51-57Artikel i tidskrift (Refereegranskat)
  • 24.
    Hildingsson, Ingegerd
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. Mid Sweden Univ, Dept Nursing, SE-85170 Sundsvall, Sweden..
    Fenwick, Jennifer
    Griffith Univ, Griffith Hlth Inst, Hlth Practice Innovat, Brisbane, Qld 4111, Australia.;Gold Coast Univ Hosp, Southport, Qld, Australia..
    Swedish midwives' perception of their practice environment - A cross sectional study2015Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 6, nr 3, s. 174-181Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There is a shortage of midwives in Sweden. Evidence suggests that the work environment is likely to play a part in retention and attrition rates. Objective: To explore the practice environment of Swedish midwives and factors associated with the perception of an unfavorable work environment. Methods: 475/1000 (48.6%) members of the Swedish Midwifery association completed a questionnaire including the Practice Environment Scale (PES). Differences in mean scores were calculated for the subscales of PES and midwives' background characteristics. Logistic regression was used to investigate factors most strongly associated with unfavorable working environment. Results: The two domains that showed significant differences in terms of participant characteristics were the Staffing and resources adequacy subscale and the Foundations of quality care subscale. Midwives younger than 40 years, those with less than 10 years' experience and those with an additional academic degree rated these two domains more unfavorably. Protective factors for assessing the work environment unfavorable were mainly internal such as high quality of life and high self-efficacy. Swedish midwives were most satisfied with the midwife-doctor relationship and least satisfied with their participation in work place or hospital affairs. Midwives suffering from burnout, those who provided hospital based care and those without leadership position were more likely to assess their work environment as unfavorable. Conclusions: This study identified personal factors as well as work related factors to be associated with midwives' assessment of their practice work environment. Establishing healthy work places where midwives feel recognized and valued could prevent midwives from leaving the profession.

  • 25.
    Hildingsson, Ingegerd
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Karlstrom, Annika
    Nystedt, Astrid
    Parents' experiences of an instrumental vaginal birth findings from a regional survey in Sweden2013Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 4, nr 1, s. 3-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: An instrumental vaginal birth is known to affect women's birth experience, few studies have explored the fathers' experiences of attending such a birth. The aim of this study is to compare birth outcome and parents' feelings in parents with instrumental vaginal birth or a spontaneous vaginal birth. Methods: A regional survey was conducted of 936 mothers and 827 fathers recruited in mid-pregnancy and followed up 2 months after birth. Data was collected by questionnaires. Crude and adjusted odds ratios with a 95% confidence interval were used in the analysis. Results: The prevalence for instrumental vaginal birth was 9%. Prolonged labour (OR 8.3; 95% CI 5.0-13.9), augmentation with synthetic oxytocin (OR 5.1; 2.9-8.9), and birth complications (OR 2.5; 1.5-2.6) were more common in the instrumental vaginal group. An instrumental vaginal birth was associated with a negative birth experience for mothers (OR 3.2; 1.3-8.1) and fathers (OR 5.2; 1.2-21.5). Mothers who had an instrumental vaginal birth were more likely to report feelings that the baby would be damaged during birth (OR 3.0; 1.7-5.5) and that the birth experience made them decide not to have any more children (OR 3.4; 1.1-10.7). Fathers reported a near-panic feeling when attending an instrumental vaginal birth (OR 5.2; 1.7-15.5). Conclusion: An instrumental vaginal birth was correlated with longer and more complicated births, epidurals and oxytocin augmentation. It affected the birth outcome and parents' feelings and was associated with future reproductive thoughts and a negative birth experience.

  • 26.
    Hildingsson, Ingegerd
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden..
    Karlström, Annika
    Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden..
    Haines, Helen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Univ Melbourne, Rural Hlth Acad Ctr, Melbourne Med Sch, Northeast Hlth Wangaratta Educ & Res Unit, Melbourne, Vic, Australia. Karolinska Inst, Dept Clin Sci & Educ, Stockholm, Sweden..
    Johansson, Margareta
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden..
    Swedish women's interest in models of midwifery care - Time to consider the system?: A prospective longitudinal survey2016Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 7, s. 27-32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Sweden has an international reputation for offering high quality maternity care, although models that provide continuity of care are rare. The aim was to explore women's interest in models of care such as continuity with the same midwife, homebirth and birth center care. Methods: A prospective longitudinal survey where 758 women's interest in models such as having the same midwife throughout antenatal, intrapartum and postpartum care, homebirth with a known midwife, and birth center care were investigated. Results: Approximately 50% wanted continuity of care with the same midwife throughout pregnancy, birth and the postpartum period. Few participants were interested in birth center care or home birth. Fear of giving birth was associated with a preference for continuity with midwife. Conclusions: Continuity with the same midwife could be of certain importance to women with childbirth fear. Models that offer continuity of care with one or two midwives are safe, cost-effective and enhance the chance of having a normal birth, a positive birth experience and possibly reduce fear of birth. The evidence is now overwhelming that all women should have maternity care delivered in this way.

  • 27.
    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.
    Karlström, 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, Dept Rural Hlth, Wangaratta, Vic, Australia.
    A known midwife can make a difference for women with fear of childbirth-birth outcome and women's experiences of intrapartum care2019Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 21, s. 33-38Artikel i tidskrift (Refereegranskat)
    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.

     

  • 28.
    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.
    Karlström, 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.
    Caseload midwifery for women with fear of birth is a feasible option2018Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 16, s. 50-55Artikel i tidskrift (Refereegranskat)
    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.

  • 29.
    Hildingsson, Ingegerd
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Westlund, Kajsa
    Wiklund, Ingela
    Burnout in Swedish midwives2013Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 4, nr 3, s. 87-91Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: In many countries midwives tend to leave their profession. Factors associated with workforce attrition include high workload, stress, poor management and a lack of promotional opportunities. The aim of the study was to investigate Swedish midwives' levels of burnout and their attitudes towards leaving the profession. Method: A random sample of 1000 midwives who are members of the Swedish Midwifery Association were sent a questionnaire. Burnout was measured using the Copenhagen Burnout Inventory. In addition the midwives were asked if they had experienced any situation that made them consider leaving their work and to give a comment about the reason. Results: 475 of 978 Eligible midwives (48.6%) returned the questionnaire. The Cronbach alpha values ranged from 0.81 to 0.93 for the burnout subscales. One hundred and eighty four (39.5%) scored high in the subscale Personal burnout, while Work burnout and Client burnout was around 15%. The strongest associations between Burnout and midwives' characteristics were age <40, work and work experience <10 years. One in three midwives had considered leaving the profession. Lack of staff and resources and a stressful work environment was associated with all three subscales of midwives' burnout. Other important explanatory variables were conflict with work mates and/or mangers and worries about the future and own health. Conclusion: More than one third of the midwives included in this survey reported some kind of burnout. Paying attention to midwives work is important in order to maintain a healthy, motivated midwifery workforce that will continue serving women and their families.

  • 30. Holmberg, Karin S. M.
    et al.
    Peterson, Ulla M. C.
    Oscarsson, Marie G.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    A two-decade perspective on mothers' experiences and feelings related to breastfeeding initiation in Sweden2014Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, nr 3, s. 125-130Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The purpose was to examine mothers' experiences and feelings related to breastfeeding initiation from a two-decade perspective. Methods: A repeated cross-sectional survey was conducted at a maternity ward before and after introduction of Baby Friendly Hospital Initiative (BFHI) and in a follow-up survey. Women participated in 1992 (n = 83), 1993 (n = 74) and 2011 (n = 94). Results: The duration of time at the first suckling differed; in 2011, the baby sucked 24.4 minutes compared to 12.7 minutes in 1992 (p < .001) and 13.6 minutes in 1993 (p < .001). In 1992, 34.6% of the women reported using supplementary formula compared with 5.9% in 1993 and 9.3% in 2011 (p < .001). The mothers' contacts with the child or the father as well as their moods did not vary during the years. Mothers rated their feelings towards breastfeeding as being lower in 2011 than in 1992 and 1993 (p = .008). In 2011, mothers experienced breastfeeding as being more difficult and reported a higher degree of tension, insecurity and anxiety. Conclusions: Supplementation was given to healthy newborn infants, which does not conform to BFHIs intentions. Routines and support in relation to breastfeeding initiation need to be continuously evaluated in order to strengthen and sustain the BFHI.

  • 31.
    Jansson, Caroline
    et al.
    Division of Reproductive and Perinatal Health Care, Department of Women’s and Children’s Health, Karolinska Institutet, SE 171 77, Stockholm, Sweden.
    Adolfsson, Annsofie
    School of Life Sciences, University of Skovde, P.O. Box 408, SE 541 28, Skovde, Sweden.
    A Swedish study of midwives' and nurses' experiences when women are diagnosed with a missed miscarriage during a routine ultrasound scan2010Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 1, nr 2, s. 67-72Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The aim was to describe midwives' and nurses' experiences when women are diagnosed with a missed miscarriage during a routine ultrasound scan in pregnancy weeks 18-20.

    STUDY DESIGNS: A qualitative content analysis with an inductive approach and 13 semi-structured interviews were used for data collection from these three domains: midwives at an ultrasound department, midwives at a maternity clinic and nurses at a gynecological ward. Content analysis resulted in six codes, four categories and one primary theme.

    MAIN OUTCOME MEASURES: The four categories identified were: the interviewees' experiences of women's reactions, support from the midwife and nurse, the interviewees' experiences of men's reactions and communication between care providers and women. The main theme focused on the interviewees' noting that women had a premonition that something was wrong with their pregnancy. This could for example have been in the form of minor bleeding or the fact that pregnancy symptoms had receded and there were no movements by the fetus. The midwives carried out a follow-up with assessment.

    CONCLUSIONS: Women need confirmation of their premonitions of a missed miscarriage so that a diagnosis can be made as early as possible in their pregnancy. Women and their partners who have suffered a missed miscarriage need extended support on an individual basis in addition to follow-up assistance as assessed by the midwives.

  • 32.
    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.
    Fenwick, Jennifer
    School of Nursing and Midwifery, Griffith University, Australia.
    Fathers want to stay close to their partner and new baby in the early postnatal period: The importance of being able to room in after a surgical birth2013Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 4, nr 1, s. 35-36Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The early postnatal period can be challenging for new fathers especially when their partner has experienced a caesarean section. The aim of this study was to describe men's perceptions and feelings of staying with their partner and new baby in the context of having experienced a surgical birth. Thematic analysis was employed" to analyse telephone interviews collected from 21 Swedish fathers who had experienced elective or emergency caesarean section. Being involved, receiving support and providing support were main reasons men considered it important they be facilitated to stay with their partners. Postnatal care should be oriented towards the whole family.

  • 33.
    Johansson, Margareta
    et al.
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Rådestad, Ingela
    Department of Caring Sciences, Sophiahemmet University College, Stockholm, Sweden.
    Hildingsson, Ingegerd
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Childbirth - an emotionally demanding experience for fathers.2012Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 3, nr 1, s. 11-20Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: While attending birth mostly has a positive impact on becoming a father, it has also been described as including feelings of discomfort and is more demanding than expected.

    OBJECTIVE: The objective was to explore Swedish fathers' birth experiences, and factors associated with a less-positive birth experience.

    METHODS: Mixed methods including quantitative and qualitative data were used. Two months after birth 827 fathers answered a questionnaire and 111 (13%) of these commented on the birth experience. Data were analysed with descriptive statistics, chi-square test for independence, risk ratios with a 95% confidence interval, logistic regression and content analysis.

    RESULTS: In total, 604 (74%) of the fathers had a positive or very positive birth experience. Used method identified a less-positive birth experience associated with emergency caesarean section (RR 7.5; 4.1-13.6), instrumental vaginal birth (RR 4.2; 2.3-8.0), and dissatisfaction with the partner's medical care (RR 4.6; 2.7-7.8). Healthcare professionals' competence and approach to the fathers were also related to the birth experience.

    CONCLUSIONS: As the fathers' birth experiences were associated with mode of birth and experiences of the intrapartum medical care fathers should be respectfully and empathically treated during labour and birth. It is essential to better engage fathers during the intrapartum period through involvement and support to improve the likelihood of a positive birth experience.

  • 34.
    Johansson, Margareta
    et al.
    Karolinska Inst, Dept Clin Sci & Educ, Sjukhusbacken 10, SE-11883 Stockholm, Sweden.;Karolinska Inst, Dept Womens & Childrens Hlth, SE-11883 Stockholm, Sweden..
    Thomas, Jan
    Kenyon Coll, Dept Sociol, Gambier, OH 43022 USA..
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. Karolinska Inst, Dept Womens & Childrens Hlth, SE-11883 Stockholm, Sweden.;Mid Sweden Univ, Dept Nursing, Sundsvall, Sweden..
    Haines, Helen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. Karolinska Inst, Dept Womens & Childrens Hlth, SE-11883 Stockholm, Sweden.;Univ Melbourne, Rural Hlth Acad Ctr, Melbourne Med Sch, Northeast Hlth Wangaratta Educ & Res Unit, Melbourne, Vic, Australia..
    Swedish fathers contemplate the difficulties they face in parenthood2016Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 8, s. 55-62Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim was to explore what concerns Swedish fathers had about parenting difficulties at two months after the birth of their baby. Methods: Self-report questionnaires were used and data were analyzed with mixed methods. Results: Thirty percent of the 827 fathers reported concerns about the difficulties of parenthood. The theme 'Managing the demands of being a father' emerged and was based on concerns about how to raise the baby, having enough money, health issues, lack of time and finding balance in the new family pattern. Financial worries, feeling less positive about expecting a baby, and self-reported poor emotional health were related to fathers who perceived parenthood as difficult. Conclusion: Experienced fathers as well as new fathers expressed similar concerns about parenthood. Preparation classes for reassurance and skills coaching about child raising may provide important support for fathers. This is especially important for fathers who may have poor emotional health or who may not be feeling positive about expecting a baby. Policy-makers and health care providers should recognize that offering support for all fathers benefits not only men, but also their children, and their partners and can help encourage egalitarian practices at home and work.

  • 35.
    Jordal, Malin
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Historisk-filosofiska fakulteten, Centrum för genusvetenskap.
    Wahlberg, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Challenges in providing quality care for women with female genital cutting in Sweden: A literature review2018Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 17, s. 91-96Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Due to migration, health care needs in relation to female genital cutting (FGC) are increasingly emerging in European health care contexts, with Sweden being no exception. Recent estimates suggest that up to 38 000 girls and women with some form of FGC are living in Sweden, the majority from Somalia. Despite receiving high numbers of immigrants from FGC practising countries, health care services in many European countries seem largely unprepared in caring for circumcised patients. This literature review aims to identify challenges involved in providing quality care for circumcised women in Sweden. Two themes were identified; lacking technical skills and communication problems and ethnocentric attitudes. Lacking technical skills involved midwives and gynaecologists feeling insecure in how to technically deal with infibulated women during childbirth, something that often resulted in ad hoc solutions and improvisation. They related this insecurity to a lack of theoretical and practical training of FGC related health problems. In communication problems and ethnocentric attitudes both health care professionals and circumcised women reported facing difficulties in communicating about FGC, largely due to language barriers and perceived sensitivity of the issue. In conclusion, skills among health care professionals in Sweden caring for circumcised patients could be strengthened. This should be taken into consideration when planning midwifery and gynaecology curricula, and in providing in-service training for health care professionals likely to meet circumcised women in their practice.

  • 36.
    Kiruja, Jonah
    et al.
    College of Health Science and Medicine, Faculty of Nursing and Midwifery, Hargeisa University, Somaliland.
    Osman, Fatumo
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Egal, Jama Ali
    College of Health Science and Medicine, Faculty of Nursing and Midwifery, Hargeisa University, Somaliland.
    Essén, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Klingberg-Allvin, Marie
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Erlandsson, Kerstin
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Maternal near-miss and death incidences - Frequencies, causes and the referral chain in Somaliland: A pilot study using the WHO near-miss approach.2017Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 12, s. 30-36Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Somaliland is a self-declared country with a population of 3.5 million. Most of its population reside in rural areas. The objective of this pilot near-miss study was to monitor the frequency and causes of maternal near-miss and deaths and the referral chain for women to access Skilled Birth Attendants (SBA).

    Method: A facility-based study of all maternal near-miss and mortality cases over 5months using the WHO near-miss tool in a main referral hospital. Reasons for bypassing the Antenatal Care facility (ANC) and late arrival to the referral hospital were investigated through verbal autopsy.

    Results: One hundred and thirty-eight (138) women with severe maternal complications were identified: 120 maternal near-miss, 18 maternal deaths. There were more near-miss cases on arrival (74.2%) compared with events that developed inside the hospital (25.8%). Likewise, there were more maternal deaths (77.8%) on arrival than was the case during hospitalization (22.2%). The most common mode of referral among maternal near-miss events was family referrals (66.7%). Of 18 maternal deaths, 15 were family referrals. Reasons for bypassing ANC were as follows: lack of confidence in the service provided; lack of financial resources; and lack of time to visit ANC. Reasons for late arrival to the referral hospital were as follows: lack of knowledge and transportation; and poor communication.

    Conclusion and clinical implication: To increase the utilization of ANC might indirectly lower the number of near-miss and death events. Collaboration between ANC staff and referral hospital staff and a more comprehensive near-miss project are proposed.

  • 37.
    Larsson, Birgitta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Karlström, Annika
    Rubertsson, Christine
    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.
    Counseling for childbirth fear: a national survey2016Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 8, s. 82-87Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Counseling by experienced midwives is offered to women with childbirth fear in most obstetric clinics in Sweden, but information about the content of such counseling is lacking. Aim To study comprehensiveness, content and organization of the midwife-led counseling for childbirth fear in all obstetric clinics in Sweden.

    Methods

    In this cross-sectional study, data were collected using a questionnaire sent to all obstetric clinics in Sweden (n = 45); a total of 43 clinics responded. Descriptive and one-way ANOVA was used in the analysis.

    Results

    All responding obstetric clinics in Sweden offer midwife-led counseling to women with childbirth fear. Major differences were found regarding the time allocated to counseling, with a range between 5.7 and 47.6 minutes per childbirth. Supplementary education for midwives and the availability of treatment options varied at the different clinics and were not associated with the size of the clinic.

    Conclusion

    The midwife-led counseling conducted at the different Swedish obstetric clinics showed considerable disparities. Women with childbirth fear would benefit from care on equal terms irrespective of place of residence. Consequently, it would be valuable to develop a national healthcare program for childbirth fear.

  • 38.
    Larsson, Elin C.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
    Fried, Sarah
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
    Essén, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Klingberg-Allvin, Marie
    Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.
    Equitable abortion care - A challenge for health care providers. Experiences from abortion care encounters with immigrant women in Stockholm, Sweden2016Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 10, s. 14-18Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To explore health care providers' experiences of providing care to immigrant women seeking abortion care.

    METHODS: A qualitative study including interviews with ten midwives and three medical doctors at four abortion clinics in the Stockholm area. Interviews were analysed using thematic analysis.

    RESULTS: Initially, health care providers were reluctant to make statements concerning the specific needs among immigrant women. Yet, the health care providers sometimes found it challenging to deal with the specific needs among immigrant, mostly non-European, women. Three themes were identified: (1) Reluctance to acknowledge specific needs among immigrant women; (2) Striving to provide contraceptive counselling to immigrant women; (3) Organizational barriers hindering patient-centred abortion care to immigrant women CONCLUSIONS: Health care providers' experiences of the specific needs among non-European, immigrant women are not openly discussed, although they are acknowledged. To achieve equitable access to sexual and reproductive health (SRH), health care providers need to be better equipped when encountering immigrant women in abortion care, especially regarding contraceptive counselling. The potential impact of patients' knowledge, norms and values is not adequately dealt with in the clinical encounter. Moreover, to provide patient-centred care, it is crucial to understand how to develop and implement SRH care that ensures equal access to high-quality care.

  • 39.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Editorial2013Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 4, nr 3, s. 85-85Artikel i tidskrift (Övrigt vetenskapligt)
  • 40.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Interventions during pregnancy and birth - Call for papers2014Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, nr 1, s. 1-1Artikel i tidskrift (Övrigt vetenskapligt)
  • 41.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Interventions during pregnancy and childbirth - Challenges and opportunities2014Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, nr 4, s. 159-159Artikel i tidskrift (Övrigt vetenskapligt)
  • 42.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Midwife-led care before, during and after childbirth: the best option for most women and babies2016Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 7, s. 1-1Artikel i tidskrift (Övrigt vetenskapligt)
  • 43.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Migration - A global challenge with implications for sexual and reproductive health and care2016Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 9, s. A1-A1Artikel i tidskrift (Övrigt vetenskapligt)
  • 44.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Untitled2013Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 4, nr 4, s. 127-127Artikel i tidskrift (Övrigt vetenskapligt)
  • 45.
    Lindholm, Annika
    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, Obstetrik & gynekologi.
    Women's preferences and received pain relief in childbirth: A prospective longitudinal study in a northern region of Sweden2015Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 6, nr 2, s. 74-81Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: A range of alternatives in pain management during childbirth are available in the western countries. Women's preferences for and use of pain relief methods during labour is not fully investigated. The aim of this study was to describe what pain relief methods pregnant women preferred when asked in late pregnancy and to identify factors associated with preferred and received pain relief methods. Methods: A prospective longitudinal study in a northern region of Sweden (n = 936). Data were collected by three questionnaires. Odds ratios with a 95% confidence interval were calculated between preferred and received pain relief methods for several explanatory variables. Findings: The most preferred pain relief methods were also the most common received pain relief methods; nitrous oxide, bathing, breathing techniques, epidural analgesia and massage. The strongest factors for using different pain relief methods were primiparity and preferences. Women who used epidural analgesia, regardless of preference, were two to four times more likely to have a less positive birth experience. Conclusions: Women's preferences for a certain pain relief method were largely met. Greater differences were seen between background factors and preferences than the received pain relief methods. Preferences and primiparity were the most important factors for actually using pain relief. Epidural analgesia was associated with a less positive birth experience.

  • 46.
    Malm, Mari-Cristin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Lindgren, Helena
    School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Rubertsson, Christine
    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.
    Rådestad, Ingela
    Sophiahemmet University College, Stockholm, Sweden.
    Development of a tool to evaluate fetal movements in full-term pregnancy2014Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, nr 1, s. 31-35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    To study women's description of fetal movements in full-term pregnancy. Further to investigate if their descriptions could be sorted with regard to intensity and type of movements, using a matrix under development to be a tool for evaluating fetal movements in clinical praxis.

    METHODS:

    Data were collected by distributing questionnaires including an open question: "Please describe your perception of the baby's movements during this gestational week." A matrix listed seven categories of movements divided into powerful and non-powerful movements, was used for the content analysis.

    RESULTS:

    393 (78%) women responded to the open question. The movements were split into two domains: Powerful movements and Non-powerful movements. Altogether, 383 (96%) women perceived fetal movements that were sorted as powerful movement: firm, slow stretching, large and side to side. Ten (4%) women described movements exclusively, i.e. movements that did not include any of the movements in the powerful domain. Most women perceived movements that corresponded to more than one type of category, and all movements described by the women could be referred to at least one of the categories in the matrix.

    CONCLUSION:

    The matrix was useful for identification of the women's perceptions of fetal movements in full-term pregnancy. Further studies are needed in order to develop the tool and its potential to evaluate the well-being of the fetus before it is to be used in clinical praxis.

  • 47.
    Millde-Luthander, C.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Hogberg, U.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Nystrom, M. E.
    Pettersson, H.
    Wiklund, I.
    Grunewald, C.
    The impact of a computer assisted learning programme on the ability to interpret cardiotochography: A before and after study2012Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 3, nr 1, s. 37-41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate if a computer assisted learning programme could bring about a higher degree of individuals who correctly classified cardiotochography (CTG) recordings in a non-selected population of midwives and physicians. Study design: A before and after study. Setting: Sodersjukhuset, Stockholm, Sweden. Subjects: One hundred and thirty midwives and 49 physicians at the maternity unit, September 2009-April 2010. A computer assisted learning programme for interpreting CTG patterns has been created. All 179 individuals included made the first interpretation and the 135 individuals also completing the education made the second interpretation. A third randomly selected interpretation was performed immediately following the second: permitting two participants to classify a CTG together. Comparison between the before and after-test was based on the Fisher exact test. Main Outcome measure: The proportion of individuals who correctly classified CTGs before and after the training. Results: Sixty four percentage of the individuals classified the CTGs correctly before and 66% after the training (P = 0.76). There was no difference between the two professional groups. Normal CTGs were correctly identified by 36% of the individuals before and in 80% after the training (P = 0.065). Corresponding figures for pathological CTGs were 83% and 85% (P = 1.00), respectively. Conclusion: We found no improvement in the proportion of individuals who classified CTGs correctly after the completion of a computer assisted learning programme in fetal monitoring. The baseline level of competence was higher than expected.

  • 48. Mode, R. Ignell
    et al.
    Mard, E.
    Nyqvist, Kerstin Hedberg
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Blomqvist, Ylva Thernström
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Fathers' perception of information received during their infants' stay at a neonatal intensive care unit2014Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, nr 3, s. 131-136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore fathers' perception of information received during their infants' care at a neonatal intensive care unit (NICU). Methods: An inductive, qualitative and descriptive study. Eight fathers in two units were interviewed. The infants' gestational age at birth ranged between 23 and 36 weeks. Data were collected through semi-structured, individual interviews and were analyzed by qualitative content analysis. Results: Three categories were identified: perception of information, perception of the source of information, and circumstances influencing the perception of information. Information had an important impact; comprehensible and adequate information increased the fathers' knowledge, which generated a sense of control. Early information about the infant's care was particularly important and positively affected father and infant bonding. Conclusion and practical implications: Ensuring a high quality of information is an important task for NICU staff. Fathers' perception of the quality of information depended on the contents of the information and how it was conveyed. Comprehensible information at the onset of the infant's hospital stay increased the fathers' sense of security, and made them feel in control. It is important that the staff strive to identify what information the father requires, and prevent situations when fathers feel uncertainty about what the staff expect from them.

  • 49.
    Målqvist, Mats
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH), Internationell barnhälsa och nutrition.
    Hultstrand, Jenny Niemeyer
    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).
    KC, Ashish
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH), Internationell barnhälsa och nutrition.
    High levels of unmet need for family planning in Nepal.2018Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 17, s. 1-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Providing access to family planning services is a basic component and a cost-effective intervention to reduce maternal mortality worldwide. It is closely linked to women's decision-making power and female emancipation. Unmet need for family planning is thus an indicator going beyond maternal health with far reaching societal implications. This study examines the level of unmet need for family planning in Nepal and its distribution along structural determinants.

    METHODS: Data from the Multiple Indicator Cluster Survey 2014 was utilized for analysis. Prevalence of unmet need for family planning was calculated and logistic regression models used to ascertain inequity.

    RESULTS: A total unmet need for family planning of 40.9% among the 10,688 included women was observed. No major differences between socioeconomic groups could be detected, except for a somewhat higher rate of unmet need among the least educated. Total fertility rate among the women included was 2.59. Contraceptive use among adolescents was alarmingly low, with almost none reporting using any type of contraception.

    CONCLUSION: The lack of major inequity implies that the high level of unmet need for contraception is a general problem in society and must be addressed broadly. A special focus on education and provision for adolescents is needed in Nepal.

  • 50.
    Nalwadda, Gorrette
    et al.
    Department of Nursing, Makerere University College of Health Sciences, Kampala, Uganda.
    Namutebi, Mariam
    Department of Nursing, Makerere University College of Health Sciences, Kampala, Uganda.
    Volgsten, Helena
    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. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Health care providers’ perceptions of family planning and contraception education for adolescents in Kampala, Uganda – A qualitative study2019Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 21, s. 15-20Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives

    Unsafe abortions are a reproductive health problem in low-income countries, but can be prevented by decreasing unintended pregnancies. The objective was to describe health care providers’ (HCPs) perceptions of family planning and contraception education for adolescents in Kampala, Uganda.

    Study design

    A qualitative study with a semi-structured interview guide was used for individual face-to-face interviews. Eight participants from two different Non-governmental organisations were interviewed. Qualitative content analysis was used to analyse the data.

    Results

    Data analysis resulted in three main categories of HCP perceptions: counseling, education and availability; peer-educators and community leaders; and stigma, inequality and myths. The providers emphasized the importance to discuss and eradicate the myths and misconceptions among adolescents regarding family planning methods by giving information, preferably at early ages. Peer-educators and community leaders were the most successful methods for accessing and involving the community. Approaches mentioned for reaching out to adolescents included involving parents, using social media, and offering education in schools. Furthermore, the providers highlighted to involve the males in family planning.

    Conclusions

    Health care providers emphasized the importance to discuss and eradicate the myths and misconceptions among adolescents regarding different family planning methods by education in school and information in sexual and reproductive health.

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