1.
Björnson Skogström, Lisa, 1980, et al.
(författare)
Women’s Experiences of Physical Features in a Specially Designed Birthing Room: A Mixed-Methods Study in Sweden
2022
Ingår i: HERD. - : SAGE Publications. - 2167-5112 .- 1937-5867. ; 15:3, s. 193-205
Tidskriftsartikel (refereegranskat) abstract
Aim: To explore women’s experiences of physical features in a birthing room designed to be adaptable to personal wishes and needs during labor and birth. Background: Childbirth is a central life event influenced by numerous factors, including the healthcare environment; however, there is insufficient knowledge on how the physical design affects women during birth. Methods: This study was part of a randomized controlled trial in the Room4Birth research project, including women randomized to receive care in a new birthing room designed with physical features changeable according to personal wishes. Data consisted of responses to two questions analyzed with descriptive statistics (n = 202) and semi-structured interviews analyzed for content (n = 19). Results: A total of 93.6% (n = 189) assessed the physical features in the birthing room as meaningful to a very high or high extent. The overall impression of the room was positive and exceeded women’s expectations. They felt welcomed and strengthened by the room, which shifted the focus to a more positive emotional state. The room differed from traditional hospital birthing rooms, contained familiar features that maintained integrity, and had space for companions. The variety of physical features was appreciated. Of nine listed physical features, the bathtub was ranked most important, followed by the projection of nature scenery, and dimmable lighting, but the room as a whole appeared most important. Conclusions: When planning and designing hospital-based birthing rooms, it is crucial to offer possibilities to adapt the room and physical features according to personal wishes.
2.
Berg, Marie, 1955, et al.
(författare)
Room4Birth - the effect of an adaptable birthing room on labour and birth outcomes for nulliparous women at term with spontaneous labour start: study protocol for a randomised controlled superiority trial in Sweden
2019
Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215 .- 1745-6215. ; 20:1
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: An important prerequisite for optimal healthcare is a secure, safe and comfortable environment. There is little research on how the physical design of birthing rooms affects labour, birth, childbirth experiences and birthing costs. This protocol outlines the design of a randomised controlled superiority trial (RCT) measuring and comparing effects and experiences of two types of birthing rooms, conducted in one labour ward in Sweden. METHODS/DESIGN: Following ethics approval, a study design was developed and tested for feasibility in a pilot study, which led to some important improvements for conducting the study. The main RCT started January 2019 and includes nulliparous women presenting to the labour ward in active, spontaneous labour and who understand either Swedish, Arabic, Somali or English. Those who consent are randomised on a 1:1 ratio to receive care either in a regular room (control group) or in a newly built birthing room designed with a person-centred approach and physical aspects (such as light, silencer, media installation offering programmed nature scenes with sound, bathtub, birth support tools) that are changeable according to a woman's wishes (intervention group). The primary efficacy endpoint is a composite score of four outcomes: no use of oxytocin for augmentation of labour; spontaneous vaginal births (i.e. no vaginal instrumental birth or caesarean section); normal postpartum blood loss (i.e. bleeding < 1000 ml); and a positive overall childbirth experience (7-10 on a scale of 1-10). To detect a difference in the composite score of 8% between the groups we need 1274 study participants (power of 80% with significance level 0.05). Secondary outcomes include: the four variables in the primary outcome; other physical outcomes of labour and birth; women's self-reported experiences (the birthing room, childbirth, fear of childbirth, health-related quality of life); and measurement of costs in relation to the hospital stay for mother and neonate. Additionally, an ethnographic study with participant observations will be conducted in both types of birthing rooms. DISCUSSION: The findings aim to guide the design of birthing rooms that contribute to optimal quality of hospital-based maternity care. TRIAL REGISTRATION: ClinicalTrials.gov NCT03948815. Registered 13 May 2019-retrospectively registered.
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5.
Rasmussen, Bodil, et al.
(författare)
Breastfeeding practices in women with type 1 diabetes: A discussion of the psychosocial factors and policies in Sweden and Australia
2015
Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192. ; 28:1, s. 71-75
Tidskriftsartikel (refereegranskat) abstract
Background: Women with type 1 diabetes (T1DM) face many challenges during their pregnancy, birth and in the postnatal period, including breastfeeding initiation and continuation while maintaining stable glycaemic control. In both Sweden and Australia the rates of breastfeeding initiation are high. However, overall there is limited information about the breastfeeding practices of women with T1DM and the factors affecting them. Similarities in demographics, birth rates and health systems create bases for discussion. Aim: The aim of this paper is to discuss psychosocial factors, policies and practices that impact on the breastfeeding practices of women with T1DM. Findings: Swedish research indicates that the overall breastfeeding rate in women with T1DM remains significantly lower than in women without diabetes in the first 2 and 6 months after childbirth with no differences in exclusive breastfeeding. Breastfeeding initiation and continuation among women with T1DM in Sweden has been shown to be influenced by health services delivery, supportive breastfeeding polices and socio-economic factors, particular perceived support from social networks and health professionals. Conclusion: There is limited research on the impact of attitudes towards breastfeeding, emotional and social well-being and diabetes-related stress on the decision of women with T1DM to initiate and continue to breastfeed for at least 6 months. A more comprehensive understanding of the breastfeeding practices and psychosocial factors operating during the first 6 months after birth for women with T1DM will be instrumental in the future design of interventions promoting initiation and continuation of breastfeeding in Sweden, Australia and elsewhere.
6.
Patel, Harshida, 1958, et al.
(författare)
What do we know about women with Peripartum Cardiomyopathy?
2017
Ingår i: Virginia Henderson Global Nursing e-Repository. - USA : Sigma Theta Tau.
Konferensbidrag (refereegranskat) abstract
Peripartum Cardiomyopathy (PPCM) is a form of cardiac disease often associated with cardiac failure, occurring in late pregnancy or after childbirth (Sliwa et al., 2010). The anatomical and physiological changes in the mother associated with normal pregnancy are profound, and this may result in symptoms and signs that overlap with PPCM, leading to missed or delayed diagnosis (Germain and Nelson-Piercy, 2011). The aim of the study was to describe women’s experiences of symptoms of PPCM and received care, and identify the areas for improvement. Nineteen women were interviewed. The key themes were identified using content analysis. The main theme emerged is, The eternal suffering. The meaning of onset and occurrence of symptoms is captured in the metaphor: being caught in a spider web, comprising subthemes, invasion of the body by experienced symptoms and feeling of helplessness (Patel et al., 2016). The care experiences are captured in exacerbated suffering, comprising subthemes, not being cared about, not being cared for and not feeling secure (Patel et al., 2016). Symptoms related to Peripartum Cardiomyopathy started for 17 women during pregnancy and in 2 postpartum, and time from symptoms to diagnosis varied between 3–190 days (median 40). Although women expressed miscellaneous experiences of care, majority of them described being not cared in adequate manner. The suffering was present in relation to the illness with failing health symptoms, but most of all in relation to not being taken seriously and adequately cared for by healthcare professionals. The deprecation of symptoms and missed diagnosis of PPCM can lead to a life threatening consequences. To prompt timely diagnosis and avoid unnecessary suffering it is important to listen seriously to, and respect, women’s narratives and act on expressions of symptoms of peripartum cardiomyopathy, even those overlapping normal pregnancy symptoms. The analyses shows the importance of respecting women’s narratives and positive interactions with midwives and obstetricians as well as the knowledge gap is highlighted in the maternity care personnel.
7.
Morris, Ann, 1964, et al.
(författare)
Professional´s skills in assment of perineal tears after childbirth - a systematic review
2013
Ingår i: Open Journal of Obstetrics and Gynecology. - 2160-8792 .- 2160-8806. ; 2013:3, s. 7-15
Tidskriftsartikel (refereegranskat) abstract
Perineal tears are one of the most common complications of vaginal births and may cause discomfort and pain long time after childbirth. Visual and digital examination of perineal tears is the most common way to assess and classify a perineal tear. Recent research indicates that many tears diagnosed are misclassified. The aim of this systematic literature review was to outline research that investigates healthcare professionals’ clinical knowledge in assessment and classification of perineal tears in connection with childbirth. Searches were performed in PubMed and CINAHL. Six studies on the topic were identified and used to collect data for questionnaires. An integrative review was used in the analysis. Poor knowledge in perineal anatomy and lack of training in clinical assessment and classification of perineal trauma was evident among both physicians and midwives. These findings indicate that healthcare providers lack adequate knowledge and that they make incorrect assessments and errors in classification of perineal tears. The training in assessment and classification is crucial. Midwives are in a unique position to improve the standard of care in this field since they are often the first and many times the only to assess the injury.
8.
Premberg, Åsa, 1955, et al.
(författare)
First-time fathers' experiences of childbirth-A phenomenological study.
2011
Ingår i: Midwifery. - : Elsevier BV. - 1532-3099 .- 0266-6138. ; 27:6, s. 848-853
Tidskriftsartikel (refereegranskat) abstract
OBJECTIVE: to describe fathers' experiences during childbirth. DESIGN: qualitative method with phenomenological lifeworld approach. A re-enactment interview method, with open-ended questions analysed with a phenomenological method, was used. PARTICIPANTS AND SETTING: 10 first-time fathers from two hospitals were interviewed four to six weeks after childbirth in Southwest Sweden during the autumn of 2008. FINDINGS: the essential meaning of first-time fathers' lived experience of childbirth was described as an interwoven process pendulating between euphoria and agony. The four themes constituting the essence was: 'a process into the unknown', 'a mutually shared experience', 'to guard and support the woman' and 'in an exposed position with hidden strong emotions'. KEY CONCLUSIONS: childbirth was experienced as a mutually shared process for the couple. The fathers' high involvement in childbirth, in cooperation with the midwife, and being engaged in support and care for his partner in her suffering is fulfilling for both partners, although the experience of the woman's pain, fear of the unknown and the gendered preconceptions of masculine hegemony can be difficult to bear for the father-to-be. IMPLICATIONS FOR PRACTICE: in order to maintain and strengthen childbirth as a mutually shared experience for the couple, the father needs to be recognised and supported as a parent-to-be. Midwives have to acknowledge fathers as valued participants and support their significant position.
9.
Begley, Cecily, 1954, et al.
(författare)
A systematic review identifying outcomes to measure the effect of oxytocin used in treating delay in labour
2014
Ingår i: Optimizing childbirth across Europe - an intedisciplinary maternity care conference. 9-10 April 2014, Brussels. Part of COST Action IS0907: Childbirth Cultures, Concerns & Consequences: Creating a dynamic EU framework for Optimal maternity care..
Konferensbidrag (övrigt vetenskapligt/konstnärligt) abstract
Background: Different outcome measures have been used in studies examining the effects of oxytocin used to treat delay in labour. Comparison of study results is thus difficult, and evidence is inconsistent. Aims of review: To identify outcomes, including salutogenic, positive, health-focussed outcomes, used in systematic reviews and randomised trials designed to measure the effectiveness of oxytocin used to treat delay in labour. This review was supported by the European Commission under COST Action:IS0907. Search and review methodology: A comprehensive search strategy was employed, and eight relevant citation databases were searched up to January 2013. randomised trials, and systematic reviews of randomised trials, that measured effectiveness of oxytocin in treating delay in labour were included. Trials comparing different action lines on partograms or active management of labour were excluded. Two reviewers screened a total of 1918 citations identified and data were extracted independently. no results were to be used, therefore no quality assessment of papers was required. five systematic reviews and 26 randomised trials were included. Primary and secondary outcomes were recorded and frequency distributions calculated. Findings: Primary outcomes used most frequently were caesarean section (n=15, 46%), labour length (n=14, 42%), measurements of uterine activity (n=13, 39%) and mode of vaginal birth (n=9, 27%). maternal satisfaction was identified a priori by only one review and included by four papers as a secondary outcome. no further salutogenic or positive health-focussed outcomes were identified. Conclusions: heterogeneous outcomes were used to measure the effectiveness of oxytocin in treating delay in labour. Additional salutogenic, women-centred and health-focussed outcomes should be included in future randomised trials of oxytocin used as a treatment for delayed labour. An improved focus on salutogenesis in childbirth may result, with potential for increased resilience in women. A core outcome dataset, based on evidence and applicable for evaluating the effects of oxytocin in prolonged labour, should be generated to support future research.
10.
Berg, Marie, 1955, et al.
(författare)
A midwifery model of childbirth care - Development and implementation in Sweden and Iceland
2014
Ingår i: Optimizing childbirth across Europe - an intedisciplinary maternity care conference. 9-10 April 2014, Brussels. Part of COST Action IS0907: Childbirth Cultures, Concerns & Consequences: Creating a dynamic EU framework for Optimal maternity care..
Konferensbidrag (övrigt vetenskapligt/konstnärligt) abstract
Introduction: Theoretical models are important as tools for guiding health care practice, also when optimising quality of maternity care. Aim of study: The aim was to identify and implement an evidence based woman centred midwifery model of childbirth care in the cultural context of Sweden and Iceland. Research methodology: With a qualitative hermeneutic approach a woman centred model of care was developed by a synthesis and meta-interpretation of own published qualitative studies (n=12) about women´s and midwives´ experiences of child birthing. for purposes of validity and reliability the model was assessed in six focus group interviews with practising midwives (n=30). for implementation of the model in praxis we had discussions with midwives in practice and with midwifery teachers. Ethical approval: Ethical approval was obtained in the earlier studies. Study findings: The model includes five main themes. Three central intertwined themes with sub-themes that involve interactions with each woman and family are: a reciprocal relationship; a birthing atmosphere; and grounded knowledge. The remaining two themes around the others, which likewise influence care, are the cultural context with hindering and promoting norms of a midwifery approach and the balancing act in basing work on midwifery philosophies, facilitating woman-centred maternity care in cooperation with other health professionals. Implementation and evaluation of this salutogenic woman centred midwifery model is in progress. Conclusion: In an era of rising technicality, the model with its balancing act could have positive impact on provision and outcome of childbirth care, raise normality of all birth and interdisciplinary care. This midwifery model of care could be a broad theoretical framework in maternity care and applied to other cultural contexts for the benefit of the women, babies and families.
