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| 2. |
- Sjöblom, Ingela, et al.
(författare)
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Being a homebirth midwife in the Nordic countries – a phenomenological study
- 2015
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 2015:6, s. 126-131
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe the lived experience of being a homebirth midwife in the Nordic countries. Methods: Interviews conducted with 21 homebirth midwives from the five Nordic countries were analyzed with a phenomenological approach. Results: The essential structure of being a homebirth midwife in the Nordic countries can be understood as realizing altruistic values and fulfilling one’s own desires for working life, by facilitating the desires of the women giving birth. By being “active-passive” – using all her senses and letting her intuition lead her – the midwife supports women during labor and birth. Medical skills, evidence-based knowledge and experience are important for providing the optimal care in each situation. Further this becomes the midwife’s chosen lifestyle, which alters her own self, making her available to assist the mother-to-be in fulfilling her wishes for a good birth. Finally, being able to use one’s own full potential during a home birth is experienced as the ideal way of working as a midwife, practicing the art of midwifery. Conclusion: The experience of being a homebirth midwife in the Nordic countries includes making an adaption to a lifestyle that is considered the basis for a satisfactory and rewarding way of working. A sense of fulfillment is achieved through experiencing the possibility to work according to one’s own ideals concerning the art of midwifery. The beliefs about a woman’s ability to give birth and understanding the importance of a positive birth for both the mother and the newborn baby are essential.
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| 3. |
- Edqvist, Malin, 1971, et al.
(författare)
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Midwives’ lived experience of a birth where the woman suffers an obstetric anal sphincter injury - a phenomenological study
- 2014
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 14:258
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Tidskriftsartikel (refereegranskat)abstract
- Background: The occurrence of obstetric anal sphincter injuries (OASIS) has increased in most high-income countries during the past twenty years. The consequences of these injuries can be devastating for women and have an impact on their daily life and quality of health. The aim of this study was to obtain a deeper understanding of midwives’ lived experiences of attending a birth in which the woman gets an obstetric anal sphincter injury. Methods: A qualitative study using phenomenological lifeworld research design. The data were collected through in-depth interviews with 13 midwives. Results: The essential meaning of the phenomenon was expressed as a deadlock difficult to resolve between a perceived truth among midwives that a skilled midwife can prevent severe perineal trauma and at the same time a coexisting more complex belief. The more complex belief is that sphincter injuries cannot always be avoided. The midwives tried to cope with their feelings of guilt and wanted to find reasons why the injury occurred. A fear of being exposed and judged by others as severely as they judged themselves hindered the midwives from sharing their experience. Ultimately the midwives accepted that the injury had occurred and moved on without any definite answers. Conclusions: Being caught between an accepted truth and a more complex belief evoked various emotions among the midwives. Feelings of guilt, shame and the midwife’s own suspicion that she is not being professionally competent were not always easy to share. This study shows the importance of creating a safe working environment in which midwives can reflect on and share their experiences to continue to develop professionally. Further research is needed to implement and evaluate the effect of reflective practices in relation to midwifery care and whether this could benefit women in childbirth.
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| 4. |
- 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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| 5. |
- Halldén, BM, et al.
(författare)
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Ten Swedish Midwives' Lived Experiences of the Care of Teenagers' Early Induced Abortions
- 2011
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Ingår i: Health Care for Women International. - : Taylor & Francis. - 0739-9332 .- 1096-4665. ; 32:5, s. 420-440
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Tidskriftsartikel (refereegranskat)abstract
- This phenomenological hermeneutic study of 10 Swedish midwives illuminates the internal conflicts of values that arise when midwives' professional and personal belief systems clash in encounters with teenagers. Midwives may react emotionally in situations where teenagers ignore advice on contraception by rejecting the use of contraceptives and preferring early abortions as a contraceptive method. The results strengthen the suggestion that caregivers need support in reflecting on how to deal with conflicts of values that may otherwise hinder them in communicating effectively with teenagers and encounter their life-worlds and in challenging their individual assumptions on the shortcomings of using contraceptives.
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| 6. |
- 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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| 7. |
- Lindgren, Helena, 1965, et al.
(författare)
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Taking the matter into one’s own hands –Women’s experiences of unassited homebirths in Sweden
- 2017
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 11, s. 31-35
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Tidskriftsartikel (refereegranskat)abstract
- Objective: There are no national guidelines or financial support for planned homebirths in Sweden. Some women choose to give birth at home without the assistance of a midwife. The objective of this study was to describe eight women’s experience of unassisted planned homebirth in Sweden. Design: Women who had the experience of an unassisted planned home birth were interviewed. The material was analysed using a phenomenological approach. Results: The essential meaning of the phenomenon giving birth at home without the assistance of a midwife is understood as a conflict between, on one hand, inner responsibility, power and control and on the other hand insecurity in relation to the outside, to other people and to the social system. A wish to be cared for by a midwife is in conflict with the fear of not maintaining integrity and respect in this precious moment of birth. Conclusion: Some women may be more sensitive to attitudes and activities that are routinely performed during pregnancy and childbirth and therefore choose not to turn to any representatives of the medical system. The challenge should be to provide safe care to allwomen so that assistance from a midwife becomes a reality in all settings.
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| 8. |
- 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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| 9. |
- Nilvér, Helena, et al.
(författare)
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Women's childbirth experiences in the Swedish Post-term Induction Study (SWEPIS) : a multicentre, randomised, controlled trial
- 2021
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare childbirth experiences in women randomly assigned to either induction of labour at 41 weeks or to expectant management until 42 weeks, in the Swedish Post-term Induction Study.DESIGN: A register-based, multicentre, randomised, controlled, superiority trial.SETTING: Women were recruited at 14 hospitals in Sweden, 2016-2018.PARTICIPANTS: Women with an uncomplicated singleton pregnancy were recruited at 41 gestational weeks.INTERVENTIONS: The women were randomly assigned to induction of labour at 41 weeks (induction group, n=1381) or expectant management until 42 weeks (expectant management group, n=1379).OUTCOME MEASURES: As main outcome, women's childbirth experiences were measured using the Childbirth Experience Questionnaire version 2 (CEQ2), in 656 women, 3 months after the birth at three hospitals. As exploratory outcome, overall childbirth experience was measured in 1457 women using a Visual Analogue Scale (VAS 1-10) within 3 days after delivery at the remaining eleven hospitals.RESULTS: The total response rate was 77% (2113/2760). There were no significant differences in childbirth experience measured with CEQ2 between the groups (induction group, n=354; expectant management group, n=302) in the subscales: own capacity (2.8 vs 2.7, p=0.09), perceived safety (3.3 vs 3.2, p=0.06) and professional support (3.6 vs 3.5, p=0.38) or in the total CEQ2 score (3.3 vs 3.2, p=0.07), respectively. Women in the induction group scored higher in the subscale participation (3.6 vs 3.4, p=0.02), although with a small effect size (0.19). No significant difference was observed in overall childbirth experience according to VAS (8.0 (n=735) vs 8.1 (n=735), p=0.22). CONCLUSIONS: There were no differences in childbirth experience, according to CEQ2 or overall childbirth experience assessed with VAS, between women randomly assigned to induction of labour at 41 weeks or expectant management until 42 weeks. Overall, women rated their childbirth experiences high.TRIAL REGISTRATION NUMBER: ISRCTN26113652.
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| 10. |
- Soederberg, Malin, et al.
(författare)
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Attitudes toward fertility and childbearing scale : an assessment of a new instrument for women who are not yet mothers in Sweden
- 2013
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 13, s. 197-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women in high-resource countries often postpone childbearing. Postponed childbearing may lead to increased health risks for both mother and child and may also result in childlessness. Attitudes among men and women about fertility and childbearing have been studied in different phases of fertile life, but instruments that assess attitudes toward fertility and childbearing among women without children are lacking. The aim of this study is to develop and evaluate a specific instrument, the Attitudes toward Fertility and Childbearing Scale (AFCS), to assess and compare attitudes toward fertility and childbearing using a national sample of Swedish women, who are not yet mothers. Methods: This study reports on the development of a new instrument and was carried out in three steps: (1) Statements were constructed based on two qualitative studies; (2) Data were collected through web-based questionnaires, and (3) Data were analyzed using statistical tests for construct validity with exploratory factor analysis, internal consistency reliability, and comparative statistics. Student's t-test and analysis of variance (ANOVA) were performed to analyze differences between the components and background characteristics. One hundred and thirty-eight women participated; they were 20-30 years of age, not mothers, and able to read and speak Swedish. Results: The instrument showed acceptable sample adequacy, factorability, and reliability using Cronbach's alpha. Three components were revealed, each one representing a specific underlying dimension of the construct: 1) importance of fertility for the future (Cronbach's a, 0.901); 2) childbearing as a hindrance at present (Cronbach's a, 0.908); and 3) social identity (Cronbach's a, 0.805). Women who were students scored higher in importance of fertility for the future than did women who were unemployed. Women living in metropolitan areas and larger cities were more likely to score highly in childbearing as a hindrance at present than women living in middle-sized cities or in the countryside. Women in the age group from 25-26 agreed to the largest extent with childbearing as a hindrance at present. Conclusions: The instrument shows acceptable factorability and reliability. Three components were found to be the best solution. Further evaluation is necessary.
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