| 1. |
- Carlsson, Ing-Marie, 1961-, et al.
(författare)
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Maintaining power : women's experiences from labour onset before admittance to maternity ward
- 2012
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Ingår i: Midwifery. - Oxon, United Kingdom : Elsevier. - 0266-6138 .- 1532-3099. ; 28:1, s. 86-92
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Tidskriftsartikel (refereegranskat)abstract
- Background: in Sweden pregnant women are encouraged to remain at home until the active phase of labour. Recommendation is based on evidence, that women who seek care and are admitted in the latent phase of labour are subjected to more obstetric interventions and suffer more complications than women who remain at home until the active phase of labour. The aim of this study was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset until admission to labour ward.Method: interviews were conducted with 19 women after they had given birth to their first child. A Constructivist Grounded theory method was used.Findings: ‘Maintaining power’ was identified as the core category, explaining the women's experience of having enough power, when the labour started. Four related categories: ‘to share the experience with another’, ‘to listen to the rhythm of the body’, ‘to distract oneself’ and ‘to be encased in a glass vessel’, explained how the women coped and thereby maintained power.Conclusions: the first time mothers in this study, who managed to stay at home during the latent phase of labour, had a sense of power that was expressed as a driving force towards the birth, a bodily and mental strength and the right to decide over their own bodies. This implies that women who maintain power have the ability to make choices during the birth process. The professionals need to be sensitive, supportive and respectful to women's own preferences in the health-care encounter, to promote the existing power throughout the birthing process.
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| 2. |
- Olsson, Ann, et al.
(författare)
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Assessing women's sexual life after childbirth : the role of the postnatal check
- 2011
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 27:2, s. 195-202
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to describe midwives' reflections on counselling women at the postnatal check with special focus on sexual life after childbirth. Design: qualitative descriptive study with focus group discussions as the method of data collection. Setting: antenatal clinics in Stockholm greater catchments' area. Participants: during 2006 and 2007, a voluntary sample of midwives from 10 different antenatal clinics were invited. Analysis: content analysis was undertaken through identification of codes, categories and themes. Findings: Two themes emerged: balancing between personal perceptions of the woman's needs and the health system restrictions and strategies for counselling about sexual life after childbirth'. The midwives tried to create a picture for themselves of the woman coming for the postnatal check and her needs before the consulation. This picture guided the midwives, but lack of time and knowledge restricted them when counselling on sexual life after childbirth. Two different strategies in counselling were identified, one task-oriented and one subject-oriented. Demands and time restrictions led midwives to distance themselves from their clients. A task-oriented approach was more visible in midwives' encounters with foreign-born women, where linguistic difficulties, cultural diversity and narrow time frames restricted the midwives' effectiveness and/or sensitivity as caregivers. In contrast, the subject-oriented strategy meant 'getting in tune', i.e. listening to the woman when she expressed her feelings and emotions, encouraging the woman to be an active participant in decisions involving her care. This strategy is used for women who arouse midwives' empathy and when there is some form of recognition and understanding. Conclusion: The picture created of the woman and her needs guided the midwives, but lack of knowledge and time limitations restricted counselling on sexual life after childbirth. Two counselling strategies were identified, one task-oriented and one subject-oriented. Balancing these two counselling strategies improves both the ethical aspects and the quality of the counselling. (C) 2009 Elsevier Ltd. All rights reserved.
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| 3. |
- Olsson, Ann, et al.
(författare)
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Fatherhood in focus, sexual activity can wait : New fathers' experience about sexual life after childbirth
- 2010
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 24:4, s. 716-725
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Tidskriftsartikel (refereegranskat)abstract
- Background: Becoming a parent is overwhelming for most men and women and alters the sexual relationship for many couples. Aim: To describe fathers’ experience about sexual life after childbirth within the first 6 months after childbirth. Method: A descriptive design, using content analysis with a qualitative approach, based on focus group discussions and one-to-one interviews. Participants: Eight first-time and two subsequent fathers participated. Results: Three subthemes were identified: Struggling between stereotypes and personal perceptions of male sexuality during transition to fatherhood; new frames for negotiating sex; a need to feel safe and at ease in the new family situation. The over-arching theme emerged as ‘transition to fatherhood brings sexual life to a crossroads’ and guided us to a deeper understanding of the difficulties men experience during the transition to fatherhood. To get sexual life working, a number of issues had to be resolved, such as getting involved in the care of the baby and the household and getting in tune with their partners in regard to sexual desire. The men needed to be reassured and prepared for this new situation by health care professionals. Conclusions: New fathers in our study put the baby in focus in early parenthood and were prepared to postpone sex until both parties were ready, although they needed reassurance to feel at ease with the new family situation. The fathers’ perceptions of sexual life extended to include all kinds of closeness and touching, and it deviated from the stereotype of male sexuality. This is important information for health care providers and midwives to be aware of for their encounters with men (and women) during the transition to fatherhood, and parenthood and can contribute to caring science with a gender perspective on adjustment of sexual life after childbirth.
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| 4. |
- Rådmark, Lina, et al.
(författare)
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Autonomic function and inflammation in pregnant women participating in a randomized controlled study of mindfulness based childbirth and parenting
- 2023
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Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central (BMC). - 1471-2393 .- 1471-2393. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Pregnancy and childbirth are significant events in many women's lives, and the prevalence of depressive symptoms increases during this vulnerable period. Apart from well documented cognitive, affective, and somatic symptoms, stress and depression are associated with physiological changes, such as reduced heart-rate variability (HRV) and activation of the inflammatory response system. Mindfulness Based Interventions may potentially have an effect on both HRV, inflammatory biomarkers, and self-assessed mental health. Therefore, the aim of this study was to assess the effects of a Mindfulness Childbirth and Parenting (MBCP) intervention on HRV, serum inflammatory marker levels, through an RCT study design with an active control group.METHODS: This study is a sub-study of a larger RCT, where significant intervention effects were found on perinatal depression (PND) and perceived stress. Participants were recruited through eight maternity health clinics in Stockholm, Sweden. In this sub-study, we included altogether 80 women with increased risk for PND, and blood samples and HRV measures were available from 60 of the participants (26 in the intervention and 34 in the control group).RESULTS: Participants who received MBCP reported a significantly larger reduction in perceived stress and a significantly larger increase in mindfulness, compared to participants who received the active control treatment. However, in this sub-study, the intervention had no significant effect on PND, inflammatory serum markers or measures of HRV.CONCLUSIONS: No significant differences were found regarding changes in HRV measures and biomarkers of inflammation, larger studies may be needed in the future.
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| 5. |
- Binder, Pauline, 1965-, et al.
(författare)
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Hi-TENS combined with PCA-morphine as post caesarean pain relief
- 2011
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 27:4, s. 547-552
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: to examine effectiveness and overall opiate consumption between high-sensory transcutaneous electrical nerve stimulation (Hi-TENS) combined with patient-controlled analgesia with morphine and patient-controlled analgesia with morphine alone following elective (e.g. scheduled) caesarean birth. Design: randomised, controlled study. Setting: a county hospital in south-west Sweden. Participants: 42 multiparous women. Measurements and findings: participants were randomly assigned and connected to patient-controlled analgesia with morphine alone or in combination with Hi-TENS apparatus. Levels of morphine consumed were calculated every third hour during the first 24 hours post partum. Pain and sedation were assessed by visual analogue scale at one, three, six, nine, 12 and 24 hours post partum. Total consumption of morphine differed significantly between the groups: morphine with TENS was 16.2+/-12.6 mg and morphine alone was 33.1+/-20.9 mg (p = 0.007). Assessment of pain relief showed no significant difference. Sedation differed significantly between the groups (p = 0.045), especially between three and 12 hours post partum (p = 0.011). Key conclusions and implications for practice: pain relief from a combination of Hi-TENS and patient-controlled analgesia with morphine was as effective as patient-controlled analgesia with morphine alone, produced less sedation and reduced morphine use by approximately 50%. Women undergoing a caesarean section should be given the opportunity to make an informed choice about post operative pain relief before surgery. A presumed benefit of this treatment combination is that the mother is more alert and better able to interact with her newborn during the first hours after birth without drowsiness due to large doses of opiates.
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| 6. |
- Carlsson, Ing-Marie, et al.
(författare)
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Psychometric properties of the Swedish childbirth self-efficacy inventory (Swe-CBSEI)
- 2014
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Ingår i: BMC Pregnancy and Childbirth. - London : BioMed Central. - 1471-2393 .- 1471-2393. ; 14, s. 1-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous research has reported that women who are admitted to delivery wards in early labour process before an active stage of labour has started run an increased risk of instrumental deliveries. Therefore, it is essential to focus on factors such as self-efficacy that can enhance a woman's own ability to cope with the first stage of labour. However, there was no Swedish instrument measuring childbirth self-efficacy available. Thus, the aim of the study was to translate the Childbirth Self-efficacy Inventory and to psychometrically test the Swedish version on first-time mothers within the Swedish culture. Methods: The method included a forward-backward translation with face and content validity. The psychometric properties were evaluated using a Principal Component Analysis and by using Cronbach's alpha coefficient and inter-item correlations. Descriptive statistics and non-parametric tests were used to describe and compare the scales. All data were collected from January 2011 to June 2012, from 406 pregnant women during the gestational week 35-42. Results: The Swedish version of the Childbirth Self-Efficacy Inventory indicated good reliability and the Principal Component Analysis showed a three-component structure. The Wilcoxon Signed-Ranks Test indicated that the women could differentiate between the concepts outcome expectancy and self-efficacy expectatancy and between the two labour stages, active stage and the second stage of labour. Conclusions: The Swedish version of Childbirth Self-efficacy Inventory is a reliable and valid instrument. The inventory can act as a tool to identify those women who need extra support and to evaluate the efforts of improving women's self-efficacy during pregnancy.
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| 7. |
- Carlsson, Ing-Marie, 1961-
(författare)
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The movement towards birth : A study of women's childbirth self-efficacy and early labour
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this thesis was to increase the understanding of early labour, the latency phase of labour, based on women’s experiences and ability to handle the situation. Furthermore, the aim was to perform a psychometric testing of an instrument measuring childbirth self-efficacy and to explore the relationships to women´s well-being and number of obstetric interventions and birth outcomes.Methods: In study I, a grounded theory method was used to obtain a deeper understanding of how women who seek care at an early stage experience the latent phase of labour. The same method, grounded theory was used in study II, but in this study, the aim was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset before admission to maternity ward. In both these studies (I & II) interviews were used to collect data. Study III and IV were cross sectional studies with a consecutive data collection. In study III, a forward-backward translation was used to translate the childbirth self-efficacy inventory (CBSEI) into a Swedish version. An explorative factor analysis with principal component analysis was used to test the psychometric properties of the inventory and reliability tests with Cronbach's alpha and inter item total correlation was performed. In study IV, chi-2 test, Fisher's exact test and student's t-test for independent samples was performed between women´s estimated childbirth self-efficacy and demographics, obstetric interventions and birth outcomes. Correlations were also performed between different scales measuring well-being during pregnancy and childbirth self-efficacy. Finally a logistic regression analysis was performed to predict the probability for low or high childbirth self-efficacy.Findings: Being in a safe place is essential for the women in the early labour process. But a safe place has different meanings for different women, depending on how they assess their own ability to handle their impending labour. For some women, the hospital is a secure place, a place where somebody else can take over the responsibility for themselves, the labour process or their child’s well-being. Some women choose to remain in their homes, which they consider as a kind of base camp which they can leave and go back to whenever they please. There is also a difference in how women ascribe ability to their own bodies and women´s belief in their own ability to cope and deal with the impending birth, their self-efficacy. These differences together with the women´s choice of seeking care or not, during the early labour process, affect the women´s experience of the labour process. The women's experience during the early labour process varies from feeling powerful and strong, to perceiving themselves as victims and feeling totally powerless. Women with high self-efficacy as measured by CBSEI had less previous mental illness and had more often been told their sister´s birth story. During the labour process, women with a higher childbirth self-efficacy have a lower frequency of epidural analgesia than women with low childbirth self-efficacy.Conclusion: Women´s belief in their childbirth self-efficacy affects their choice of place to be, during the early labour process. The place in turn, affects the women´s experiences and the way they handle the early labour process. The early labour process is a sensitive period that requires attention and should not be neglected. Through increased knowledge and understanding of the problematic issues related to the early labour process, the birth preparation and antenatal obstetric care, as well as the care during labour can be improved.
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| 8. |
- Carlsson, Ing-Marie, 1961-, et al.
(författare)
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The relationship between childbirth self-efficacy and aspects of well-being, birth interventions and birth outcomes
- 2015
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Ingår i: Midwifery. - London : Elsevier. - 0266-6138 .- 1532-3099. ; 31:10, s. 1000-1007
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: this study aimed to examine how women׳s childbirth self-efficacy beliefs relate to aspects of well-being during the third trimester of pregnancy and whether there was any association between childbirth self-efficacy and obstetric factors.DESIGN: a cross-sectional design was used. The data was obtained through the distribution of a composite questionnaire and antenatal and birth records.SETTING: data were recruited from antenatal health-care clinics in Halland, Sweden.PARTICIPANTS: a consecutive sample of 406 pregnant women was recruited at the end of pregnancy at gestational weeks of 35-42.MEASUREMENTS: five different measures were used; the Swedish version of Childbirth Self-Efficacy Inventory, the Wijma Delivery Expectancy/Experience Questionnaire, the Sense of Coherence Questionnaire, the Maternity Social Support Scale and finally the Profile of Mood States.FINDINGS: results showed that childbirth self-efficacy was correlated with positive dimensions as vigour, sense of coherence and maternal support and negatively correlated with previous mental illness, negative mood states and fear of childbirth. Women who reported high childbirth self-efficacy had less epidural analgesia during childbirth, compared to women with low self-efficacy.KEY CONCLUSIONS: this study highlights that childbirth self-efficacy is a positive dimension that interplays with other aspects and contributes to well-being during pregnancy and thereby, acts as an asset in the context of childbirth. © 2015 Elsevier Ltd.
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| 9. |
- Cato, Karin, 1977-
(författare)
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Breastfeeding – Initiation, duration, attitudes and experiences
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to increase knowledge about factors that influence breastfeeding initiation and duration, as well as about women’s attitudes towards breastfeeding during pregnancy.The first two studies were a part of the UPPSAT project, a population-based cohort study conducted in Uppsala, Sweden. The women answered questionnaires five days, six weeks and six months postpartum, including questions on breastfeeding initiation and duration. Eight hundred and seventy-nine women and 679 women were included in the first study (Paper I) and second study (Paper II), respectively. The third study (Paper III) was part of the BASIC study, a large cohort following women from pregnancy and up to one year postpartum. In BASIC, the women completed web-questionnaires, and 1217 women participated during mid-pregnancy and postpartum. The fourth study (Paper IV) was part of a qualitative project, “Narratives of breastfeeding”, and included 11 women, interviewed individually in late pregnancy.The prevalence of the hands-on approach was 38%. Women who received the hands-on approach were more likely to report a negative experience of the first breastfeeding session (Paper I). Seventy-seven percent of the women reported exclusive breastfeeding up to, at least, two months postpartum. Being a first-time mother, reporting emotional distress during pregnancy, and giving birth by cesarean section were factors independently associated with exclusive breastfeeding lasting less than two months postpartum (Paper II). Women with depressive symptoms during pregnancy who breastfed for the first time later than two hours postpartum had the highest odds of not breastfeeding exclusively at six weeks postpartum (Paper III). When pregnant women thought about their future breastfeeding, they were balancing between social norms and personal desires (Paper IV).These results can help to develop clinical practice to improve women’s experience of the first breastfeeding session. Additionally, the results may facilitate identifying women in need for targeted support, in order to promote longer exclusive breastfeeding duration. By acknowledging pregnant women’s thoughts and attitudes about breastfeeding, breastfeeding information and support, health care professionals can meet the needs and desires of women.
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| 10. |
- Ekström, Anette, et al.
(författare)
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A Mother's feelings for Her Infant Are Strengthened by Excellent Breastfeeding Counseling and Continuity of Care
- 2006
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Ingår i: Pediatrics. - : American Academy of Pediatrics. - 0031-4005 .- 1098-4275. ; 118:2, s. e309-e314
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE. Continuous support during the childbirth process ultimately may strengthen the mother's self-esteem and her capacity to interact with and nurture her infant and also may improve paternal involvement in general. In the present study, we investigated whether mothers, who were attended by midwives and nurses who had had a process-oriented training program in breastfeeding counseling, perceived stronger maternal feelings for their infant than mothers who had received only routine care.METHODS. In a previous study, an intervention that included a process-oriented program on breastfeeding counseling for health professionals and continuity in family classes through childbirth was conducted. The 10 largest municipalities were classified in pairs that were similar in size and had similar figures of breastfeeding duration. The municipalities were randomized pairwise to either an intervention or a control group. The present study is a follow-up study on women's feelings for their infants in relation to the kind of care that they had had and was undertaken between April 2000 and January 2003. The sampling frame was based on women who were cared for at either the intervention clinic or control clinics. The mothers at the control clinics had received standard routine care and had attended family classes through the point of birth. Data collection for control group A started before effects of the intervention could be studied. Data for control group B were collected simultaneously with data collection for the intervention group (n = 540). The mothers responded to 3 questionnaires at 3 days and at 3 and 9 months postpartum. Background data of the mothers were collected. The perception of support that was provided by the health professionals and the perception of mother–infant relationship and feelings for the infant were rated on Likert scales.RESULTS. At 3 days postpartum, both the intervention group and control group B versus the control group A thought that their understanding of the infant was better, they perceived more strongly that the infant as their own, and they enjoyed more breastfeeding and resting with the infant. Although there was no significant difference between the intervention group and control group B at 3 days and 3 months observation, mothers in the intervention group talked more to their infant, perceived their infant to be more beautiful than other infants, and perceived more strongly that the infant was their own than did the mothers in control group B at 9 months observation. In addition, the mothers in the intervention group felt significantly more confident with the infant and felt the infant to be closer than did the mothers in control group B.CONCLUSION. A process-oriented breastfeeding training program for antenatal midwives and postnatal nurses that included an intervention that guaranteed continuity of care strengthened the maternal relationship with the infant and the feelings for the infant.
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