| 1. |
- Edqvist, Malin, 1971, et al.
(författare)
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Midwives' Management during the Second Stage of Labor in Relation to Second-Degree Tears-An Experimental Study
- 2017
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Ingår i: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 44:1, s. 86-94
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Most women who give birth for the first time experience some form of perineal trauma. Second-degree tears contribute to long-term consequences for women and are a risk factor for occult anal sphincter injuries. The objective of this study was to evaluate a multifaceted midwifery intervention designed to reduce second-degree tears among primiparous women.METHODS: An experimental cohort study where a multifaceted intervention consisting of 1) spontaneous pushing, 2) all birth positions with flexibility in the sacro-iliac joints, and 3) a two-step head-to-body delivery was compared with standard care. Crude and Adjusted OR (95% CI) were calculated between the intervention and the standard care group, for the various explanatory variables.RESULTS: A total of 597 primiparous women participated in the study, 296 in the intervention group and 301 in the standard care group. The prevalence of second-degree tears was lower in the intervention group: [Adj. OR 0.53 (95% CI 0.33-0.84)]. A low prevalence of episiotomy was found in both groups (1.7 and 3.0%). The prevalence of epidural analgesia was 61.1 percent. Despite the high use of epidural analgesia, the midwives in the intervention group managed to use the intervention.CONCLUSION: It is possible to reduce second-degree tears among primiparous women with the use of a multifaceted midwifery intervention without increasing the prevalence of episiotomy. Furthermore, the intervention is possible to employ in larger maternity wards with midwives caring for women with both low- and high-risk pregnancies.
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| 2. |
- Edqvist, Malin, 1971, et al.
(författare)
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Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth
- 2016
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. Methods: A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. Results: Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included. The prevalence of SPT was 0.7 % and the prevalence of episiotomy was 1.0 %. There were differences between the countries regarding all maternal characteristics. No association between flexible sacrum positions and sutured perineal injuries was found (OR 1.02; 95 % CI 0.86-1.21) or SPT (OR 0.68; CI 95 % 0.26-1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10-0.54). Conclusion: A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum positions. No associations were found between flexible sacrum positions and SPT. Flexible sacrum positions were associated with fewer episiotomies.
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| 3. |
- Hildingsson, Ingegerd, et al.
(författare)
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A longitudinal survey of childbirth-related fear and associated factors
- 2011
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Ingår i: Journal of Obstetric, Gynecologic, & Neonatal Nursing. - : Elsevier BV. - 1552-6909 .- 0884-2175. ; 40:5, s. 532-543
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the prevalence of childbirth-related fear from pregnancy to one year after childbirth and to identify factors associated with being cured of childbirth-related fear. Design: A longitudinal regional survey. Setting: Three hospitals in a northern part of Sweden. Participants: Six hundred ninety-seven (697) women who completed four questionnaires. Methods: Data were collected by questionnaires in mid and late pregnancy and at 2 months and one year after birth. Childbirth related fear was measured 3 times. Results: There was a statistically significant increase in childbirth fear from 12.4% in mid-pregnancy to 15.1% one year after childbirth (p < .001). Women who were cured of childbirth fear reported a better birth experience and would prefer a vaginal birth in a subsequent pregnancy. These women were also more likely to experience a feeling of control during birth and were more satisfied with information about the progress of labor, but there was no difference in prenatal counseling or having an elective cesarean between the groups. Conclusion: Women with prenatal fear of childbirth may be cured of this fear by having a better birth experience. If women feel in control of their bodies and are well informed about the progress of labor, the chances of being cured will increase. Prenatal counseling or having an elective cesarean birth does not seem to be a solution for relieving childbirth fear.
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| 4. |
- Hildingsson, Ingegerd, et al.
(författare)
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How Long Is a Normal Labor? Contemporary Patterns of Labor and Birth in a Low-Risk Sample of 1,612 Women from Four Nordic Countries
- 2015
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Ingår i: Birth-Issues in Perinatal Care. - : Wiley. - 0730-7659 .- 1523-536X. ; 42:4, s. 346-353
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Normal progress of labor is a subject for discussion among professionals. The aim of this study was to assess the duration of labor in women with a planned home birth and spontaneous onset who gave birth at home or in hospital after transfer. Methods: This is a population-based study of home births in four Nordic countries (Denmark, Iceland, Norway, and Sweden). All midwives assisting at a home birth from 2008 to 2013 were asked to provide information about home births using a questionnaire. Results: Birth data from 1,612 women, from Denmark (n = 1,170), Norway (n = 263), Sweden (n = 138), and Iceland (n = 41) were included. The total median duration from onset of labor until the birth of the baby was approximately 14 hours for primiparas and 7.25 hours for multiparas. The duration of the different phases varied between countries. Blood loss more than 1,000 mL and perineal ruptures that needed suturing were associated with a longer pushing phase and the latter with country of residence, parity, single status, and the baby's weight. Conclusion: In this population of healthy women with a low prevalence of interventions, the total duration of labor was fairly similar to what is described in the literature for multiparas, but longer for primiparas. Although the duration of the phases of labor differed among countries, it was to a minor extent associated with severe outcomes. (BIRTH 42:4 December 2015)
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| 5. |
- Karlström, Annika, et al.
(författare)
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Maternal and infant outcome after caesarean section without recorded medical indication: findings from a Swedish casecontrol study
- 2013
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Ingår i: Bjog-an International Journal of Obstetrics and Gynaecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 120:4, s. 479-486
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare maternal complications and infant outcomes for women undergoing elective caesarean sections based on a maternal request and without recorded medical indication with those of women who underwent spontaneous onset of labour with the intention to have a vaginal birth. DESIGN: Retrospective register study. SETTING: Sweden; Medical Birth Register used for data collection. METHODS: A case-control study of 5877 birth records of women undergoing caesarean sections without medical indication and a control group of 13 774 women undergoing births through spontaneous onset of labour. The control group was further divided into women who actually had a vaginal birth and women who ended up with an emergency caesarean section. RESULTS: Maternal complications occurred more frequently among women undergoing caesarean section with odds ratios (OR) for bleeding complications of 2.5 (95% CI 2.1-3.0) in the elective caesarean group and 2.0 (95% CI 1.5-2.6) in the emergency caesarean group. The OR for infections was 2.6 in both groups. Breastfeeding complications were most common in women having an elective caesarean section: 6.8 (95% CI 3.2-14.5). Infant outcomes showed a higher incidence of respiratory distress with an OR of 2.7 (95% CI 1.8-3.9) in the elective caesarean section group compared with infants born by emergency caesarean section. The risk of hypoglycaemia was at least twice as high for infants in the caesarean group. CONCLUSIONS: Caesarean sections without medical indication as well as emergency caesarean sections were associated with higher risks for maternal and infant morbidity.
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| 6. |
- Lindgren, Helena, 1965, et al.
(författare)
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Transfer in planned home births in Sweden - effects on the experience of birth : A nationwide population-based study
- 2011
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Ingår i: Sexual & Reproductive HealthCare. - Amsterdam : Elsevier BV. - 1877-5756 .- 1877-5764. ; 2:3, s. 101-105
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Tidskriftsartikel (refereegranskat)abstract
- Objective: More than 10% of all planned home births in high-income countries are completed in the hospital. The aim of this study was to compare the birth experiences among women who planned to give birth at home and completed the birth at home and women who were transferred to hospital during or immediately after the birth. Methods: All women in Sweden who had a planned home birth between 1998 and 2005 (n = 671) were invited to participate in the study. The women who agreed to participate received one questionnaire for each planned home birth. Mixed methods were used for the analysis. Results: Women who had been transferred during or immediately after the planned home birth had a more negative birth experience in general. In comparison with women who completed the birth at home, the odds ratio for being less satisfied was 13.5, CI 8.1-22.3. Reasons for being dissatisfied related to organizational factors, the way the women were treated or personal ability. Conclusion: Being transferred during a planned home birth negatively affects the birth experience. Treatments as well as organizational factors are considered to be obstacles for a positive birth experience when transfer is needed. Established links between the home birth setting and the hospital might enhance the opportunity for a positive birth experience irrespective of where the birth is completed. © 2011.
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| 7. |
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Lärobok för Barnmorskor
- 2009. - 3
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Detta är den tredje omarbetningen av Lärobok för barnmorskor, vilken är den första i sitt slag i Norden. I boken finns koncentrerat barnmorskeyrkets kunskapskärna. Ett stort antal experter har medverkat i boken varav majoriteten är barnmorskor med olika yrkeskunskaper och akademisk erfarenhet. Boken är unik i det att den tydliggör och lyfter fram, både på ett teoretiskt och praktiskt plan, barnmorskans kunskaper och färdigheter för yrkesutövningen. Boken har delats in i tre stora huvudområden där den första delen tar upp barnmorskans historia, arbets- och forskningsfält samt globala aspekter. Den andra delen - barnafödande, börjar med ett nytt kapitel om professionellt förhållningssätt som berör barnmorskans roll när det gäller mötet med kvinnan och hennes närstående inom olika verksamhetsgrenar. Vidare finns teorier om bemötande, värdegrund och metoder för samtal under graviditet och förlossning, vid depression, vid föräldraförberedelse och variationer i föräldraskap. Dessutom behandlar den andra delen mödrahälsovård, graviditet, förlossning, barnsängstid samt förlossning med komplicerat förlopp. Det tredje avsnittet - reproduktiv och sexuell hälsa - inkluderar fertilitetsreglering, infertilitet, klimakteriet, ungdomars sexuella utveckling och hälsa samt gynekologi och gynekologisk undersökningsteknik. Sist i boken finns ett avsnitt om gynekologisk cancer samt ett nytt avsnitt om sexualitet.
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| 8. |
- Malm, Mari-Cristin, et al.
(författare)
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Development of a tool to evaluate fetal movements in full-term pregnancy
- 2014
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 5:1, s. 31-35
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 9. |
- Malm, Mari-Cristin, et al.
(författare)
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Women's experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy - a crossover trial
- 2014
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Ingår i: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 14:349
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Tidskriftsartikel (refereegranskat)abstract
- Background: Low maternal awareness of fetal movements is associated with negative birth outcomes. Knowledge regarding pregnant women's compliance with programs of systematic self-assessment of fetal movements is needed. The aim of this study was to investigate women's experiences using two different self-assessment methods for monitoring fetal movements and to determine if the women had a preference for one or the other method. Methods: Data were collected by a crossover trial; 40 healthy women with an uncomplicated full-term pregnancy counted the fetal movements according to a Count-to-ten method and assessed the character of the movements according to the Mindfetalness method. Each self-assessment was observed by a midwife and followed by a questionnaire. A total of 80 self-assessments was performed; 40 with each method. Results: Of the 40 women, only one did not find at least one method suitable. Twenty of the total of 39 reported a preference, 15 for the Mindfetalness method and five for the Count-to-ten method. All 39 said they felt calm, relaxed, mentally present and focused during the observations. Furthermore, the women described the observation of the movements as safe and reassuring and a moment for communication with their unborn baby. Conclusions: In the 80 assessments all but one of the women found one or both methods suitable for self-assessment of fetal movements and they felt comfortable during the assessments. More women preferred the Mindfetalness method compared to the count-to-ten method, than vice versa.
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| 10. |
- Nilsson, Christina, et al.
(författare)
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Self reported fear of childbirth and its association with women´s birth experience and mode of delivery : a longitudinal population-based study
- 2012
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 25:3, s. 114-121
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo explore fear of childbirth (FOC) during pregnancy and one year after birth and its association to birth experience and mode of delivery.DesignA longitudinal population-based study.PopulationPregnant women who were listed for a routine ultrasound at three hospitals in the middle-north part of Sweden.MethodDifferences between women who reported FOC and who did not were calculated using risk ratios with a 95% confidence interval. In order to explain which factors were most strongly associated to suffer from FOC during pregnancy and one year after childbirth, multivariate logistic regression analyses were used.ResultsFOC during pregnancy in multiparous women was associated with a previous negative birth experience (RR 5.1, CI 2.5–10.4) and a previous emergency caesarean section (RR 2.5, CI 1.2–5.4). Associated factors for FOC one year after childbirth were: a negative birth experience (RR 10.3, CI 5.1–20.7), fear of childbirth during pregnancy (RR 7.1, CI 4.4–11.7), emergency caesarean section (RR 2.4, CI 1.2–4.5) and primiparity (RR 1.9, CI 1.2–3.1).ConclusionFOC was associated with negative birth experiences. Women still perceived the birth experience as negative a year after the event. Women's perception of the overall birth experience as negative seems to be more important for explaining subsequent FOC than mode of delivery. Maternity care should focus on women's experiences of childbirth. Staff at antenatal clinics should ask multiparous women about their previous experience of childbirth. So that FOC is minimized, research on factors that create a positive birth experience for women is required.
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