| 1. |
- Elden, Helen, 1959, et al.
(författare)
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Demanding and challenging: Men's experiences of living with a pregnant woman with pelvic girdle pain: An interview study
- 2014
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Ingår i: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 2:4, s. 17-29
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pelvic girdle pain (PGP) is a universally disabling condition affecting approximately 50% of pregnant women. Qualitative research describes how PGP leads to struggle in women’s daily lives, makes them question and doubt their roles and identities as professionals and mothers, and test their (marital) relationships. The purpose of this study was to describe men’s experiences of living with a pregnant woman with PGP. Methods: Participants were men whose pregnant partners participated in a project containing both qualitative and quantitative studies in 2009 to 2011. Interviews were conducted in person (n=18) or by telephone (n=8), lasting approximately 20-50 minutes. Sixteen men were interviewed during their wive’s pregnancies (M age = 30 years), eight men were re-interviewed within 12 months postpartum and two men were interviewed only postpartum (26 interviews). Results: Three major categories emerged: having no knowledge of PGP, a period of emotional and physical strain, and merging. Pregnancy in a woman with PGP caused men to alter focus from themselves to their partners and family. They expressed worry, powerlessness, inadequacy, and a need for support. They had to adapt and cope, both demanding and challenging. However, they stressed that relationships with their older children improved, and that they and their partners had succeeded in becoming a team. Conclusions: The findings indicated a need for greater focus from midwives and other health care providers on the psychological impact of PGP on the man/partner. This is important, not only for men but for their respective women as well, whereby men influence their partner’s health.
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| 2. |
- 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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| 3. |
- Lundgren, Ingela, 1957, et al.
(författare)
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Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): a qualitative study from countries with high VBAC rates
- 2015
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 15:196
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Tidskriftsartikel (refereegranskat)abstract
- Background The most common reason for caesarean section (CS) is repeat CS following previous CS. Vaginal birth after caesarean section (VBAC) rates vary widely in different healthcare settings and countries. Obtaining deeper knowledge of clinicians’ views on VBAC can help in understanding the factors of importance for increasing VBAC rates. Interview studies with clinicians and women in three countries with high VBAC rates (Finland, Sweden and the Netherlands) and three countries with low VBAC rates (Ireland, Italy and Germany) are part of ‘OptiBIRTH’, an ongoing research project. The study reported here is based on interviews in high VBAC countries. The aim of the study was to investigate the views of clinicians working in countries with high VBAC rates on factors of importance for improving VBAC rates. Methods Individual (face-to-face or telephone) interviews and focus group interviews with clinicians (in different maternity care settings) in three countries with high VBAC rates were conducted during 2012–2013. In total, 44 clinicians participated: 26 midwives and 18 obstetricians. Five central questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language and then translated into English. All data were then analysed together and final categories were validated in each country. Results The findings are presented in four main categories with subcategories. First, a common approach is needed, including: feeling confident with VBAC, considering VBAC as the first alternative, communicating well, working in a team, working in accordance with a model and making agreements with the woman. Second, obstetricians need to make the final decision on the mode of delivery while involving women in counselling towards VBAC. Third, a woman who has a previous CS has a similar need for support as other labouring women, but with some extra precautions and additional recommendations for her care. Finally, clinicians should help strengthen women’s trust in VBAC, including building their trust in giving birth vaginally, recognising that giving birth naturally is an empowering experience for women, alleviating fear and offering extra visits to discuss the previous CS, and joining with the woman in a dialogue while leaving the decision about the mode of birth open. Conclusions This study shows that, according to midwives and obstetricians from countries with high VBAC rates, the important factors for improving the VBAC rate are related to the structure of the maternity care system in the country, to the cooperation between midwives and obstetricians, and to the care offered during pregnancy and birth. More research on clinicians’ perspectives is needed from countries with low, as well as high, VBAC rates
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| 4. |
- Nilsson, Christina, 1959, et al.
(författare)
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An effort to make all the pieces come together: Women’s long-term perspectives on their experiences of intense fear of childbirth
- 2012
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Ingår i: International Journal of Childbirth. - 2156-5287 .- 2156-5295. ; 2:4, s. 255-68
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Tidskriftsartikel (refereegranskat)abstract
- Women's experiences of childbirth can be both empowering and traumatic, and negative experiences might lead to fear of forthcoming births. Our aim with this phenomenological study was to describe the meaning of fear of childbirth and of birth drawing on women's long-term perspectives. Six women who had sought help for intense fear of childbirth because of a negative birth experience during their second or third pregnancy 7-11 years ago were interviewed. The essential structure of the phenomenon is "an effort to make all the pieces come together" with the constituents: Every childbirth is a narrative that lingers on, fear of childbirth is connected to the period of childbearing, and the experiences of childbirth are central life experiences. Our findings suggest that fear of childbirth and childbirth experiences have been linked together and integrated as important life experiences. It seems like the meaning of the childbirth experiences can be expressed by women in several nuances and tones, indicating the complexity of the experience. The fear of childbirth has lost its importance and is connected to the previous difficult childbirth experience. It is important to understand women's fear of childbirth and birth experiences with respect to individual needs.
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| 5. |
- 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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| 6. |
- Berg, Marie, 1955, et al.
(författare)
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Evidensbaserat yrkesutövande : Hur mäter vi sexuell, reproduktiv och perinatal hälsa?
- 2016
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Ingår i: Reproduktiv hälsa - barnmorskans kompetensområde. Helena Lindgren et al. Del 1, 4.2, s. 60-64. - Lund : Studentlitteratur AB. - 9789144090054 ; , s. 60-64
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Bokkapitel (refereegranskat)abstract
- Reproduktiv, perinatal och sexuell hälsa är ett självständigt huvudområde knutet till livets början och området för mänsklig reproduktion i ett livscykel- och genusperspektiv. Inom huvudområdet studeras och utvecklas kunskap om den normala processen och dess avvikelser i samband med graviditet, förlossning och nyföddhetsperiod samt föräldraskapets utveckling. Vidare studeras och utvecklas kunskap och teorier om kvinnors reproduktiva hälsa, sexualitet och fertilitetskontroll samt barnmorskans främjande, förebyggande, vårdande och behandlande arbete - med och för - kvinnan, barnet och familjen. Reproduktiv hälsa omfattar barnmorskans verksamhet inom reproduktiv, perinatal och sexuell hälsa. Boken är uppbyggd utifrån ICM:s (International Confederation of Midwives) beskrivning av barnmorskans kompetensområden, och den omfattar även ett webbmaterial med bland annat sammanfattningar i form av bildspel, tester och undervisningsfilmer. Boken riktar sig till barnmorskestudenter och yrkes verk samma barnmorskor samt till övriga hälsoprofessioner verksamma inom reproduktiv hälsa. Reproduktiv hälsa är framtagen i dialog med, och granskad av, vårt vetenskapliga råd. Vi rekommenderar att den används som lärobok i barnmorskeutbildningen fortsättningsvis.
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| 7. |
- Berg, Marie, 1955, et al.
(författare)
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Värdegrunden för vårdandet vid barnafödande : Att stödja och stärka. Vårdande vid barnafödande
- 2010
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Många är rädda för att föda, trots att förutsättningarna i vårt land oftast är de bästa för att få en normal och lyckad förlossning. I denna bok, som är en revidering av 2004 års upplaga med tre helt nya kapitel, skriver elva författare om sin egen forskning kring möte, stöd och vårdorganisation vid barnafödande. Detta kunskapsområde lämpar sig framför allt för barnmorskor, men även för andra inom vården. Den professionella vårdaren bör tänka på att de egna grundvärderingarna påverkar både förhållningssättet och vården. Att ge tid och att möta föräldrar i en öppen dialog med förståelse och respekt är centralt för att kunna stärka dem. Det kan även innebära en balansgång mellan naturligt födande och att se till de medicinska behoven. P S-K
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| 8. |
- Bergbom, Ingegerd, 1947, et al.
(författare)
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First-time pregnant women’s experiences of their body in early pregnancy
- 2017
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 31:3, s. 579-586
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Tidskriftsartikel (refereegranskat)abstract
- Background: The body of first-time pregnant women is affected in many ways, and the women may not know what to expect. Conversations between women and healthcare personnel about women’s bodily experience in early pregnancy can contribute to increased body knowledge, which may have a positive impact in later stages of their pregnancy and in relation to delivery. The aim of the study was to describe first-time pregnant women’s experiences of their body in early pregnancy (pregnancy weeks 10–14). Method: Twelve women were asked to draw pictures and answer questions freely about their experiences of their first pregnant body. Hermeneutical text interpretation was used to obtain an overall view of the experiences. Findings: A main theme emerged: ‘the body is connected to the cycle of life’. This theme comprised five subthemes: ‘bodily longing and a sense of ambivalence’, ‘being 'doubtful’, ‘welcoming changes in body and mind’, ‘feeling inner strength and struggle to find strength’ and ‘accepting a different body and mind’. This main theme and the subthemes were further interpreted and were understood as an experience of ‘me and my body’. Conclusions: The body reminded the women to take care of it and gave rise to positive thoughts. When the body exhibited uncomfortable reactions and sensations, these were taken as evidence of pregnancy, which was also seen positive but it also triggered a sense of dissatisfaction with the body and a feeling of it becoming alien.
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| 9. |
- Clarke, Mike, et al.
(författare)
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OptiBIRTH: a cluster randomised trial of acomplex intervention to increase vaginalbirth after caesarean section
- 2020
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite evidence supporting the safety of vaginal birth after caesarean section (VBAC), rates are lowin many countries.Methods: OptiBIRTH investigated the effects of a woman-centred intervention designed to increase VBAC ratesthrough an unblinded cluster randomised trial in 15 maternity units with VBAC rates < 35% in Germany, Ireland andItaly. Sites were matched in pairs or triplets based on annual birth numbers and VBAC rate, and randomised, 1:1 or 2:1, intervention versus control, following trial registration. The intervention involved evidence-based education ofclinicians and women with one previous caesarean section (CS), appointment of opinion leaders, audit/peer review,and joint discussions by women and clinicians. Control sites provided usual care. Primary outcome was annualhospital-level VBAC rates before the trial (2012) versus final year of the trial (2016). Between April 2014 and October2015, 2002 women were recruited (intervention 1195, control 807), with mode-of-birth data available for 1940women.Results: The OptiBIRTH intervention was feasible and safe across hospital settings in three countries. There was nostatistically significant difference in the change in the proportion of women having a VBAC between interventionsites (25.6% in 2012 to 25.1% in 2016) and control sites (18.3 to 22.3%) (odds ratio adjusted for differences betweenintervention and control groups (2012) and for homogeneity in VBAC rates at sites in the countries: 0.87, 95% CI:0.67, 1.14, p = 0.32 based on 5674 women (2012) and 5284 (2016) with outcome data. Among recruited womenwith birth data, 4/1147 perinatal deaths > 24 weeks gestation occurred in the intervention group (0.34%) and 4/782in the control group (0.51%), and two uterine ruptures (one per group), a rate of 1:1000.Conclusions: Changing clinical practice takes time. As elective repeat CS is the most common reason for CS inmultiparous women, interventions that are feasible and safe and that have been shown to lead to decreasingrepeat CS, should be promoted. Continued research to refine the best way of promoting VBAC is essential. Thismay best be done using an implementation science approach that can modify evidence-based interventions inresponse to changing clinical circumstances.Trial registration: The OptiBIRTH trial was registered on 3/4/2013. Trial registration number ISRCTN10612254.
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| 10. |
- 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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