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- Lundgren, Ingela, 1957, et al.
(författare)
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Women’s experiences of childbirth, care and support – a metasynthesis
- 2009
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Ingår i: 15th Qualitative Health Research, International Institute for Qualitative Methodology's, University of Alberta, Vancouver, Canada, 4-6 October 2009.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Physical indicators have been the measure of the success of childbirth by professionals educated in a medical perspective, while the experiences of the childbearing families in different cultures have been considered of minor importance. The medicalization has the consequence of regarding every birth as potentially risky and abnormal, and requiring medical interventions. However, life changes for good, especially for women embodied through their childbirth, and the memories of the events and caring and uncaring encounters are well kept. The childbirth experiences also influence the relationships with their baby and their partner in the postpartum period, and the onset of postnatal depression, anxiety and PSTD. Several qualitative studies have described women’s experiences of childbirth, care and support in varied ways and a metasynthesis is warranted to integrate the findings. The aim is also to reflect on the findings and the theories and the methods that implicit or explicit have guided the research. The intention is to influence clinical practice, and also to push the theory and the research designs, and ask new meaningful research questions. The threefold interpretative metastudy developed by Paterson and colleagues was chosen for this collaborative metasynthesis research program in childbearing. Inclusion and exclusion criteria were developed, and seven health related databases were searched in different disciplines and findings from different cultures with the chosen keywords. Previous literature reviews were reviewed, and author and ancestry search was performed to access studies not identified through the database search. The presentation will focus on the preliminary findings from this study.
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| 2. |
- Begley, Cecily, 1954, et al.
(författare)
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Evaluation of an intervention to increase vaginal birth after caesarean section through enhanced women-centred care: The OptiBIRTH randomised trial (ISRCTN10612254)
- 2017
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Ingår i: 31th ICM Triennial Congress.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Vaginal birth after a previous caesarean (VBAC) is a safe alternative to repeat caesarean section (CS), is the preferred option of most women and may reduce overall CS rates.1 However, VBAC rates vary; e.g., rates in Germany, Ireland and Italy are considerably lower (29-36%) than those in the Netherlands, Sweden and Finland (45-55%). Purpose/Objective: To evaluate the effectiveness of an intervention to maximise VBAC rates. The OptiBIRTH Project was funded by a European Union Grant: FP7-HEALTH-2012-INNOVATION-1-HEALTH.2012.3.2-1. Agreement No:305208 Method: A cluster randomised trial was used. A sample size of 12 maternity units was required, each recruiting 120 consenting women, to detect an absolute 15% difference in successful VBACs (increase from 25% in control to 40% in intervention groups), using an ICC of 0.05, with power of >80% and an alpha of 0.05. To allow for loss to follow-up, 15 trial units were randomised across three countries with low VBAC rates (Germany, Ireland and Italy) and the trial commenced April 2014. An evidence-based intervention was introduced in all intervention sites. Control sites had usual care. Interim analysis by an independent Data Monitoring Committee at mid-point permitted continuation. Data were analysed using intention to treat. Key Findings: Recruitment closed October 2015, with the last babies born in December 2015, and data analysis will be completed in April 2016. The primary outcome, comparison of annual VBAC rates for each hospital before and after introduction of the intervention will be presented, and selected secondary outcomes for the recruited women including: mode of birth, perineal trauma, breastfeeding, uterine rupture, wound breakdown, perinatal mortality, Apgar scores, and admission to neonatal intensive care unit. Discussion: If the OptiBIRTH intervention increases VBAC rates safely, its introduction across Europe could prevent 160,000 unnecessary CSs every year, saving maternity services >€150 million annually and contributing to the normalisation of birth for thousands of women. References: 1 Cunningham et al (2010). National Institute of Health Consensus Development Conference Statement: Vaginal birth after caesarean. Obstet & Gynecol 115(6): 1279-1295. 2 EURO-PERISTAT 2008: CD006066.EURO-PERISTAT Project (2008). European Perinatal Health Report. (www.europeristat.com).
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| 3. |
- Berg, Marie, 1955, et al.
(författare)
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A midwifery model of childbirth care - Development and implementation in Sweden and Iceland
- 2014
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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..
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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.
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| 4. |
- Berg, Marie, 1955, et al.
(författare)
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A midwifery model of intrapartum care - development and implementation
- 2014
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Ingår i: Leadership, learning and research in nursing and midwifery. Sigma Theta Tau International Honor Society, 2nd European regional conference. 16-18 June 2014 Gothenburg, Sweden..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 5. |
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| 6. |
- Elden, Helen, 1959, et al.
(författare)
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The pelvic ring of pain: Pregnant women’s experiences of pelvic girdle pain as related to embodied experiences and experiences of the healthcare care system: A Swedish interview study
- 2013
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Ingår i: Nordisk jordmor kongress, 13-15 June 2013, Oslo.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives Pelvic girdle pain (PGP) is a universal disabling condition that affects three of 10 pregnant women. Qualitative studies on the subject are lacking .The aim with this study was to describe pregnant women’s experiences of PGP related to everyday life. Method In all, 27 women with PGP participating in a randomised controlled study were interviewed during 2010 to 2011. Content analysis was used. Results Five main categories emerged; Pelvic girdle pain affects ability to cope with everyday life; Coping with motherhood; Often personal relationships between partners reached breaking point; To question the identity defined by profession and work and; Lessons-learned from living with PGP. The categories illustrate that women’s everyday life stopped. Not being able to meet their own and others expectations putting a strain on their being and made them disappointed, sad and frustrated. It made them question and doubt their roles and identities as mothers, partners and professionals. They we’re not looking forward to another pregnancy, without any effective treatment for PGP at hand. Lessons learned were that women with PGP should seek help immediately, listen to their bodies and acknowledge their own limitations. Conclusion PGP severely affects pregnant women’s everyday life. There seems to be a lack of knowledge and awareness of PGP and how to support these women both general in society, among caregivers and employers that needs to be highlighted and rectified. Appropriate support during this important and rare phase in a woman’s life is warranted.
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| 7. |
- Elden, Helen, 1959, et al.
(författare)
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The pregnant pause of pain: Pregnant women’s experiences of pelvic girdle pain as related to daily life: A Swedish interview study
- 2013
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Ingår i: BfIn (Barnafödande i Norden). March 2013, Gothenborg. ..
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Konferensbidrag (refereegranskat)abstract
- Introduction Pelvic girdle pain (PGP) is a universally disabling condition affecting three of 10 pregnant women. Qualitative studies on the subject are lacking. Objective To describe pregnant women’s experiences of PGP as related to daily life. Methods In all, 27 women with PGP participating in a randomised controlled study were interviewed during 2010–2011. Qualitative content analysis was used. Results Five main categories emerged: PGP affects the ability to cope with everyday life; Coping with motherhood; Relationships between partners often reached the breaking point; Questioning one’s identity as defined by profession and work, and Lessons learned from living with PGP. The categories illustrate how women’s everyday lives were interrupted. Their inability to meet their own and others’ expectations put a strain on their lives causing disappointment, sadness and frustration. It made them question and doubt their roles and identities as mothers, partners and professionals, and kept them from looking forward to future pregnancies, in the absence of effective treatment for PGP. Knowledge gained was that women with PGP should seek help immediately, listen to their bodies, and acknowledge their limitations. Conclusion PGP severely affects pregnant women’s everyday lives. There appears to be a lack of knowledge and awareness in general, as well as among caregivers and employers of PGP that needs to be highlighted and rectified. There is also a great need to learn how to support those suffering from it. Appropriate support during this important and rare phase in a woman’s life is highly warranted.
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| 8. |
- Gross, Mechthild M., et al.
(författare)
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Women's experiences on VBAC: results of a metasynthesis
- 2014
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Ingår i: Optimising Childbirth Across Europe, 9-10 April 2014. Brussels, Belgium..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: More and more women experience a caesarean section with their first, or later, birth. During a subsequent pregnancy they experience a challenging period of decision making on the mode of birth. Vaginal birth after caesarean section (VBAC) is a relevant option for a large number of women. Despite lots of quantitative studies on VBAC there is a lack of studies that report the experiences of women. Aim of review: To report the main themes of women’s experiences of VBAC. Search strategy: The following databases were searched: CINAHL, EBSCO, Journals@ OVID, Pubmed, PSYCHINFO, using the keywords VBAC, vaginal birth after caesarean section, qualitative study, experiences, qualitative and women´s experiences in various combinations. Review methodology: In total, 1981 papers were identified; of these, 1959 had to be excluded. From the remaining 22 papers eleven were excluded at this stage, as not focusing on women´s experiences, or only focusing on experiences of CS in relation to VBAC. A metasynthesis based on the interpretative meta ethnography method was conducted. Main findings: Four final themes became obvious: ‘to be involved in decision about mode of delivery is difficult but important,’ ‘vaginal birth has several positive aspects mainly described by women,’ ‘vaginal birth after CS is a risky project,’ and ‘own strong responsibility for giving birth vaginally’. The papers discussed issues such as the women´s experience in relation to different aspects of VBAC, decision-making whether to give birth vaginally, the influence of health professionals on decision-making, reason for trying a vaginal birth, experiences when choosing VBAC, experiences of giving birth vaginally, and giving birth with CS when preferring VBAC. Conclusion: It became obvious that women may feel as though they are in a fog when preparing for a VBAC. Women need evidence-based information not only about the risks involved but also about positive aspects of VBAC.
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| 10. |
- Hansson, Malin, 1975, et al.
(författare)
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Midwives marching to own drum : other professions perspective of midwifery work in labour wards
- 2018
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Ingår i: COST Action BIRTH Conference : Lisbon, Sept 17-18, 2018.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- There has been a paradigm shift in midwifery over time where different professions now work together in childbirth care. There is little research on midwives’ work from other professionals’ perspectives, which is of importance to improve midwives work situation and women-centred care. Therefore, the aim of this article was to explore other professions´ views of midwifery work during childbirth. Classical Grounded Theory, using a constant comparative analysis, was applied to focus group interviews with obstetricians, assistant nurses and managers to explore their views of midwifery work during childbirth. The substantive theory of ‘veiled midwifery’ emerged as an explanation of the social process between the professions in the ‘baby factory’ context. The other professionals perceive midwifery through a veil that filters the reality and only permits fragmentary images of the midwives´ work. The main concern for the other professions was that the midwives were ‘marching to own drum’. The midwives were perceived as both in dissonance with the baby factory, and therefore hard to control, or, alternatively more compliant with the prevailing rhythm. This caused an unpredictability and led to feelings of frustration and exclusion. Which in turn resulted in attempts to cooperate and gain access to the midwifery world, by using three unveiling strategies: Streamlining, Scrutinising and Collaborating admittance. The theory of veiled midwifery could be used as a theoretical basis for future studies, and could be a foundation for a dialogue of philosophical differences in the way birth is viewed in the clinical setting, to improve the work situation.
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