| 1. |
- Avelin, Pernilla, et al.
(författare)
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Make the stillborn baby and the loss real for the siblings : parents' advice on how the siblings of a stillborn baby can be supported
- 2012
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Ingår i: Journal of Perinatal Education. - : Springer Publishing Company. - 1058-1243 .- 1548-8519. ; 21:2, s. 90-98
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to investigate parents' advice to other parents on the basis of their own experiences of siblings' taking leave of a stillborn sister or brother. The study was a Web questionnaire study of 411 parents. The thematic content analysis resulted in two categories: "Make the stillborn baby and the loss real for the siblings" and "Take the siblings' resources and prerequisites into account." Parents' advised that siblings should see and hold the stillborn baby and, thus, be invited and included into the leave-taking process with respect to the siblings' feelings, resources, and prerequisites. Based on these findings, professional caregivers can usefully be proactive in their approach to facilitate and encourage the involvement of siblings.
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| 2. |
- Fahlbeck, Hanna, et al.
(författare)
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'A longing for a sense of security' - women's experiences of continuity of midwifery care in rural Sweden : A qualitative study
- 2022
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 33
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is evidence that continuity models of midwifery care benefit women and babies in terms of less birth interventions and higher maternal satisfaction. Studies about continuity models in a Swedish context are lacking.OBJECTIVE: The aim of this study was to describe how women experience continuity of midwifery care in a Swedish rural area, and thereby provide a deeper understanding of what this care entails for women.METHODS: A qualitative interview study using thematic analysis was carried out. Telephone interviews were conducted with 33 women who participated in a continuity of midwifery care project in a rural area of Sweden.RESULTS: The overarching theme 'a longing for a sense of security', pervaded the three main themes: 'The importance of professional midwifery care', 'Continuity of midwifery - fulfilled expectations or full of disappointments' and 'New prerequisites - acceptable to some, but not a substitute for everyone', which explains different aspects affecting the feeling of security. The endeavour to feel secure during pregnancy, birth and postpartum was a continually recurring subject that cannot be overstated.CONCLUSION: Continuity of midwifery care strengthened women's feelings of security during pregnancy, birth and postpartum. The deepened relationship developed over time was a central part of the positive aspects of the experience of continuity in midwifery care. Expectations and prerequisite circumstances are important to consider when developing and introducing new care models. Service providers and decision makers should pay attention to and prioritise this relational aspect when planning care for women during the childbearing period.
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| 3. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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A continuity of care project with two on-call schedules : Findings from a rural area in Sweden
- 2020
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 26
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn many countries, various continuity models of midwifery care arrangements have been developed to benefit women and babies. In Sweden, such models are rare.AimTo evaluate two on-call schedules for enabling continuity of midwifery care during labour and birth, in a rural area of Sweden.MethodA participatory action research project where the project was discussed, planned and implemented in collaboration between researchers, midwives and the project leader, and refined during the project period. Questionnaires were collected from participating women, in mid pregnancy and two months after birth.ResultOne of the models resulted in a higher degree of continuity, especially for women with fear of birth. Having a known midwife was associated with higher satisfaction in the medical (aOR 2.02 (95% CI 1.14–4.22) and the emotional (aOR 2.05; 1.09–3.86) aspects of intrapartum care, regardless of the model.ConclusionThis study presented and evaluated two models of continuity with different on-call schedules and different possibilities for women to have access to a known midwife during labour and birth. Women were satisfied with the intrapartum care, and those who had had a known midwife were the most satisfied. Introducing a new model of care in a rural area where the labour ward recently closed challenged both the midwives’ working conditions and women’s access to evidence-based care.
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| 4. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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'A perfect fit' : Swedish midwives' interest in continuity models of midwifery care
- 2023
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 36:1, s. 86-92
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Midwifery continuity models of care are highly recommended yet rare in Sweden, although approximately 50% of pregnant women request them. Before introducing and scaling up continuity models in Sweden, midwives' attitudes about working in continuity models must be investigated.OBJECTIVE: to investigate Swedish midwives' interests in working in midwifery continuity models of care and factors influencing the midwifery workforce's readiness for such models.METHODS: A cross-sectional online survey was utilised and information collected from a national sample of midwives recruited from two unions regarding background and work-related variables. Crude and adjusted odds ratios and logistic regression analysis were used in the analysis.RESULTS: A total of 2084 midwives responded and 56.1% reported an interest. The logistic regression model showed that respondents' ages 24-35 years (OR 1.73) or 35-45 years (OR 1.46); years of work experience 0-3 years (OR 5.81) and 3-10 years (OR 2.04); rotating between wards or between tasks (OR 2.02) and working temporary (OR 1.99) were related to interest in continuity models. In addition, working daytime only (OR 1.59) or on a two-shift schedule (OR 1.93) was associated with such interest.CONCLUSION: A sufficient number of midwives in Sweden appear to be interested in working in continuity models of midwifery care to align with women's interest in having a known midwife throughout pregnancy, birth and postpartum period. Developing strategies and continuity models that will address the preferences of women in various areas of Sweden is important for offering evidence-based maternity services.
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| 5. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Anxiety and depressive symptoms in women with fear of birth : A longitudinal cohort study
- 2021
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Ingår i: European Journal of Midwifery. - : European Publishing. - 2585-2906. ; 5:August
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Anxiety and depression during pregnancy could imply difficulties in the attachment to the unborn baby. The objective of this study was to investigate the prevalence and change in anxiety and depressive symptoms in pregnant women with fear of birth. Another aim was to explore associations between symptoms of anxiety and depression on prenatal attachment.Methods: This is a longitudinal cohort study of 77 pregnant women with fear of birth in three hospitals in Sweden. Data were collected by three questionnaires in mid and late pregnancy and two months after birth.Results: Anxiety symptoms were more often reported than depressive symptoms, significantly decreasing over time in both conditions. Anxiety symptoms were associated with low education level, negative feelings towards the upcoming birth, and levels of fear of birth. Depressive symptoms were associated with levels of fear of birth. One in five women presented with fear of birth, anxiety, and depressive symptoms, suggesting that co-morbidity was quite common in this sample. Depressive symptoms and co-morbidity were negatively associated with prenatal attachment.Conclusions: This study shows that symptoms of anxiety and depression in women with fear of birth vary over time and that co-morbidity is quite common. Lack of emotional well-being was related to prenatal attachment. Healthcare professionals must identify and support women with anxiety and depressive symptoms and fear of birth so that difficulties in the relationship between the mother and the newborn baby might be reduced.
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| 6. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Childbirth experience in women participating in a continuity of midwifery care project
- 2021
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 34:3, s. e255-e261
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Tidskriftsartikel (refereegranskat)abstract
- Background: Continuity models of care are rare in Sweden, despite the evidence of their benefit to women and babies. Previous studies have shown certain factors are associated with a positive birth experience, including continuity of midwifery care.Aim: The aim was to investigate women's childbirth experiences in relation to background data, birth outcome and continuity with a known midwife, in a rural area of Sweden.Methods: An experimental cohort study. Participating women were offered continuity of midwifery care in pregnancy and birth, during selected time periods. Data were collected in mid-pregnancy and two months after birth. The Childbirth Experience Questionnaire was used to determine women's birth experiences.Result: A total of 226 women responded to the follow-up questionnaire. Not living with a partner, fear of giving birth, and a birth preference other than vaginal were associated with a less positive birth experience. Having had a vaginal birth with no epidural, no augmentation and no birth complication all yield a better birth experience. Women who had had a known midwife were more likely to have had a positive birth experience overall, predominantly in the domain Professional support.Conclusions: The results of this study showed that women who received care from a known midwife in labour were more likely to have a positive birth experience. The results also pointed out the benefits of a less medicalized birth as important for a good birth experience, and that some women may need extra support to avoid a less positive birth experience.
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| 7. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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How midwives' perceptions of work empowerment have changed over time : A Swedish comparative study
- 2023
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 118
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this paper was to compare current perceptions of empowerment in their work with results from a sample of midwives recruited 2012.Design: A comparative cross-sectional cohort study of national samples of midwives in Sweden from 2012 to 2022.Participants: 475 midwives recruited from the Swedish midwifery association in 2012 and 1782 through two midwifery unions in 2022.Methods: Data were collected using a questionnaire with background information and the revised version of the Perception of Empowerment Scale (PEMS). Mean scores and domains of the PEMS were compared between the years.Findings: Midwives' perceptions of empowerment changed over time, in both directions. Their perception of their skills and education, advocating for and empowering women as well as support from the team and manager increased over the years. Midwives in 2022 were less likely to perceive that they were involved in a midwifery-led practice, and the communication with managers was rated lower. Midwives sensed a lack of professional recognition from the medical profession and their contribution to the care of birthing women. Access to resources for birthing women was perceived lower in 2022 compared to 2012. Younger age, shorter work experience and working in labour wards or postnatal wards were associated with lower perceptions of empowerment.Conclusions: Midwives need to have the authority and reality to practice midwife-led care, to receive control over their work. Good communication and recognition from the medical profession is essential to be empowered. This is important in order to maintain a healthy workforce.
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| 8. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Quality of intrapartum care assessed by women participating in a midwifery model of continuity of care
- 2021
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Ingår i: European Journal of Midwifery. - : E.U. European Publishing. - 2585-2906. ; 5:4, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION Continuity models are rare in Sweden. The aim was to compare the intrapartum care experiences between women who had or not a known midwife attending their birth. METHODS A cohort study was conducted in a rural area with long distance to a labor ward in Sweden. From August 2017 to June 2019, a continuity model with a known midwife was offered between 7 a.m. and 11 p.m. daily. Questions about intrapartum care were assessed in two aspects; the perceived reality and the subjective importance. RESULTS A total of 226 women recruited in early pregnancy were followed up two months after giving birth. Women who had a known midwife providing labor care reported higher overall satisfaction and were more likely to value the subjective importance and the perceived reality significantly higher than women who received intrapartum care without a known midwife assisting. When analyzing the medical aspects of intrapartum care, the most important factors for not being satisfied were deficiencies in the partner’s involvement and insufficient pain relief. For the emotional aspects, deficiencies in participation in decision making was the most important aspect. CONCLUSIONS Having a known midwife assisting at birth reduced discrepancies between women’s subjective importance and perceived reality of intrapartum care, especially regarding support and the involvement of the partner. A known midwife generated higher overall satisfaction with the medical and emotional aspects of intrapartum care. To improve satisfaction and the quality of intrapartum care, continuity midwifery models of care should be implemented.
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| 9. |
- Hildingsson, Ingegerd, et al.
(författare)
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Women's worries during pregnancy : A cross-sectional survey using the Cambridge Worry Scale in a rural area with long distance to hospital
- 2021
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 28
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Worries are common during pregnancy, but there is sparse knowledge of worries when the distance to hospital is long.AIM: To assess the extent and content of worries during pregnancy. Another aim was to evaluate the psychometric properties of the Swedish version of the Cambridge Worry Scale.METHOD: Cross-sectional study of 280 women recruited to a continuity project and completed a questionnaire in mid pregnancy.RESULT: Women were most worried about something being wrong with the baby, giving birth and the risk of miscarriage. Women also reported worries about giving birth on the road or in the car. Two domains of the Cambridge Worry scale were identified; Socio-medical and health aspects and Socio-economic and relationship aspects. Women with high fear and depressive symptoms were most at risk for major worries.CONCLUSION: Worries during pregnancy were mainly related to issues about pregnancy and birth, and specifically, to long distance to the labour ward. Women with depressive symptoms and fear of birth showed the highest levels of worries. When a woman expresses worries in connection to labour and birth, caregivers must be sensitive to the presence of underling fears or depressive symptoms and act to refer women to treatment or support.
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| 10. |
- Höglund, Berit, 1955-, et al.
(författare)
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Few women receive a specific explanation of a stillbirth : An online survey of women's perceptions and thoughts about the cause of their baby's death
- 2019
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In Sweden, three to four out of every 1000 pregnancies end in stillbirth each year. The aim of this study was to investigate whether women who had experienced stillbirth perceived that they had received an explanation of the death and whether they believed that healthcare professionals were responsible for the death of the baby.METHODS: An online survey of 356 women in Sweden who had experienced a stillbirth from January 2010 to April 2014. A mixed-methods approach with qualitative content analysis was used to examine the women's responses.RESULTS: Nearly half of the women (48.6%) reported that they had not received any explanation as to why their babies had died. Of the women who reported that they had received an explanation, 84 (23.6%) had a specific explanation, and 99 (27.8%) had a vague explanation. In total, 73 (30.0%) of the 243 women who answered the question "Do you believe that healthcare personnel were responsible for the stillbirth?" stated Yes. The women reported that the healthcare staff had not acknowledged their intuition that the pregnancy was proceeding poorly. Furthermore, they perceived that the staff met them with nonchalance and arrogance. Additionally, the midwife had ignored or normalised the symptoms that could indicate that their pregnancy was proceeding poorly. Some women added that neglect and avoidance among the healthcare staff could have led to a lack of monitoring, which could have been crucial for the outcome of the pregnancy.CONCLUSIONS: Half of the women surveyed reported that they had not received an explanation of their baby's death, and more than one-fourth held healthcare professionals responsible for the death.
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