| 1. |
- 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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| 2. |
- Berg, Marie, 1955, et al.
(författare)
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A midwifery model of woman-centred childbirth care – In Swedish and Icelandic settings
- 2012
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Ingår i: Sexual & Reproductive Healthcare. - : Elsevier BV. - 1877-5756. ; 3:2, s. 79-87
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Tidskriftsartikel (refereegranskat)abstract
- Background: Theoretical models for health care practice are important both as tools for guiding daily practice and for explaining the philosophical basis for care. Aim: The aim of this study was to define and develop an evidence-based midwifery model of womancentred care in Sweden and Iceland. Method: Using a hermeneutic approach we developed a model based on a synthesis of findings from 12 of our own published qualitative studies about women’s and/or midwives’ experiences of childbirth. For validity testing, the model was assessed in six focus group interviews with 30 practising midwives in Iceland and Sweden. Findings: The model includes five main themes. Three central intertwined themes are: a reciprocal relationship; a birthing atmosphere; and grounded knowledge. The remaining two themes, which likewise influence care, are the cultural context (with hindering and promoting norms); and the balancing act involved in facilitating woman-centred care. Conclusion: The model shows that midwifery care in this era of modern medical technology entails a balancing act for enhancing the culture of care based on midwifery philosophies. The next step will be to implement the model in midwifery programmes and in clinical practice, and to evaluate its applicability.
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| 3. |
- Blix, Ellen, et al.
(författare)
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Midwifery in a Nordic context
- 2022
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Ingår i: Theories and perspectives for midwifery. - Lund : Studentlitteratur. - 9789144143194
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Bokkapitel (refereegranskat)abstract
- In this chapter, we present the Nordic countries and people, and the Nordic welfare model. Maternity care and midwifery within the welfare state model are presented, and challenges in Nordic midwifery are discussed. Organisation of maternity care is in some aspects fairly similar in the Nordic countries but there are differences between and within countries. However, all countries have a long tradition of midwifery care with professional and licensed midwives practising autonomously and being the most central healthcare professional in maternity care.
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| 4. |
- Halfdansdottir, Berglind, et al.
(författare)
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Autonomy in place of birth : a concept analysis
- 2015
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Ingår i: Medicine, Health care and Philosophy. - : Springer Science and Business Media LLC. - 1386-7423 .- 1572-8633. ; 18:4, s. 591-600
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Tidskriftsartikel (refereegranskat)abstract
- This article examines one of the relevant concepts in the current debate on home birth-autonomy in place of birth-and its uses in general language, ethics, and childbirth health care literature. International discussion on childbirth services. A concept analysis guided by the model of Walker and Avant. The authors suggest that autonomy in the context of choosing place of birth is defined by three main attributes: information, capacity and freedom; given the antecedent of not harming others, and the consequences of accountability for the outcome. Model, borderline and contrary cases of autonomy in place of birth are presented. A woman choosing place of birth is autonomous if she receives all relevant information on available choices, risks and benefits, is capable of understanding and processing the information and choosing place of birth in the absence of coercion, provided she intends no harm to others and is accountable for the outcome. The attributes of the definition can serve as a useful tool for pregnant women, midwives, and other health professionals in contemplating their moral status and discussing place of birth.
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| 5. |
- Halfdansdottir, Berglind, et al.
(författare)
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Contraindications in planned home birth in Iceland : A retrospective cohort study
- 2018
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 15:March, s. 10-17
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesIcelandic national guidelines on place of birth list contraindications for home birth. Few studies have examined the effect of contraindication on home birth, and none have done so in Iceland. The aim of this study was to examine whether contraindications affect the outcome of planned home birth or have a different effect at home than in hospital.MethodsThe study is a retrospective cohort study on the effect of contraindications for home birth on the outcome of planned home (n = 307) and hospital (n = 921) birth in 2005–2009. Outcomes were described for four different groups of women, by exposure to contraindications (unexposed vs. exposed) and planned place of birth (hospital vs. home). Linear and logistic regression analysis was used to evaluate the effect of the contraindications under study and to detect interactions between contraindications and planned place of birth.ResultsThe key findings of the study were that contraindications were related to higher rates of adverse maternal and neonatal outcomes, regardless of place of birth; women exposed to contraindications had higher rates of adverse outcomes in planned home birth; and healthy, unexposed women had higher rates of adverse outcomes in planned hospital birth. Contraindications significantly increased the risk of transfer in labour and postpartum haemorrhage in planned home births.ConclusionThe defined contraindications for home birth had a negative effect on maternal and neonatal outcomes in Iceland, regardless of place of birth. The study results do not contradict the current national guidelines on place of birth.
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| 6. |
- Halfdansdottir, Berglind, et al.
(författare)
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Maternal attitudes towards home birth and their effect on birth outcomes in Iceland : A prospective cohort study
- 2016
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 34, s. 95-104
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to examine the relationship between attitudes towards home birth and birth outcomes, and whether women's attitudes towards birth and intervention affected this relationship. Design: a prospective cohort study. Setting: the study was set in Iceland, a sparsely populated island with harsh terrain, 325,000 inhabitants, high fertility and home birth rates, and less than 5000 births a year. Participants: a convenience sample of women who attended antenatal care in Icelandic health care centres, participated in the Childbirth and Health Study in 2009-2011, and expressed consistent attitudes towards home birth (n=809). Findings: of the participants, 164 (20.3%) expressed positive attitudes towards choosing home birth and 645 (79.7%) expressed negative attitudes. Women who had a positive attitude towards home birth had significantly more positive attitudes towards birth and more negative attitudes towards intervention than did women who had a negative attitude towards home birth. Of the 340 self-reported low-risk women that answered questionnaires on birth outcomes, 78 (22.9%) had a positive attitude towards home birth and 262 (77.1%) had a negative attitude. Oxytocin augmentation (19.2% (n=15) versus 39.1% (n=100)), epidural analgesia (19.2% (n=15) versus 33.6% (n=88)), and neonatal intensive care unit admission rates (0.0% (n=0) versus 5.0% (n=13)) were significantly lower among women who had a positive attitude towards home birth. Women's attitudes towards birth and intervention affected the relationship between attitudes towards home birth and oxytocin augmentation or epidural analgesia. Key conclusions and implications for practice: the beneficial effect of planned home birth on maternal outcome in Iceland may depend to some extent on women's attitudes towards birth and intervention. Efforts to de-stigmatise out-of-hospital birth and de-medicalize women's attitudes towards birth might increase women's use of health-appropriate birth services.
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| 7. |
- Halfdansdottir, Berglind, et al.
(författare)
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Outcome of planned home and hospital births among low-risk women in Iceland in 2005-2009: A retrospective cohort study
- 2015
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Ingår i: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 42:1, s. 16-26
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Tidskriftsartikel (refereegranskat)abstract
- Background: At 2.2 percent in 2012, the home birth rate in Iceland is the highest in the Nordic countries and has been rising rapidly in the new millennium. The objective of this study was to compare the outcomes of planned home births and planned hospital births in comparable low-risk groups in Iceland. Methods: The study is a retrospective cohort study comparing the total population of 307 planned home births in Iceland in 2005-2009 to a matched 1:3 sample of 921 planned hospital births. Regression analysis, adjusted for confounding variables, was performed for the primary outcome variables. Results: The rate of oxytocin augmentation, epidural analgesia, and postpartum hemorrhage was significantly lower when labor started as a planned home birth. Differences in the rates of other primary outcome variables were not significant. The home birth group had lower rates of operative birth and obstetric anal sphincter injury. The rate of 5-minute Apgar score < 7 was the same in the home and hospital birth groups, but the home birth group had a higher rate of neonatal intensive care unit admission. Intervention and adverse outcome rates in both study groups, including transfer rates, were higher among primiparas than multiparas. Oxytocin augmentation, epidural analgesia, and postpartum hemorrhage rates were significantly interrelated. Conclusions: This study adds to the growing body of evidence that suggests that planned home birth for low-risk women is as safe as planned hospital birth.
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| 8. |
- Lundgren, Ingela, 1957, et al.
(författare)
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Evaluation of a midwifery model of woman-centred care during childbirth
- 2016
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Ingår i: NJF (Nordiskt Jordemoderförbund) Congress. Programme and abstracts. Gothenburg, May 12-14, 2016. - 9789163742699
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Based on a synthesis of 12 qualitative studies on women’s and midwives’ experiences of childbearing, a model of woman-centred care has been developed. The model has three central intertwined themes: a reciprocal relationship, a birthing atmosphere, and grounded knowledge; and two overall themes: the cultural context and the balancing act. Aim: To evaluate the use and effects of the model of woman-centred care provided by midwives during childbirth. Methods: A mixed methods, before-after controlled study is currently underway at two units for normal deliveries at Sahlgrenska University Hospital, Sweden, and an ethnographic actions research study is ongoing at the labour ward of Landspitali, University Hospital in Iceland. The intervention in Sweden comprises a one-day (8 hours) education about the model together with regularly scheduled reflection groups for midwives. The effects are studied by evaluating delivery outcomes, mothers’ childbirth experiences and midwives’ work-related experiences. The primary outcomes are augmentation with oxytocin and mothers’ childbirth experiences assessed with the Childbirth Experience Questionnaire (CEQ 2.0). The secondary outcomes are midwives’ experiences, assessed by means of questionnaires, including stress, burn-out, work satisfaction, and sense of coherence before and one year after the intervention. The qualitative part will study if the model is considered applicable by midwives, obstetricians, assistant nurses and managers at delivery wards, and to the content of midwifery care. An ethnographic field study with midwives and a focus-group study with assistant nurses, obstetricians, midwives and managers have been conducted before start and will be performed after the intervention. The ethnographic action research study in Iceland is focusing on midwives’ experiences and the development of guidelines for implementing the model in practice. Results: Preliminary findings from the study will be presented at the conference. Conclusion: A midwifery model of woman-centred care based on previous research is now evaluated in clinical practice.
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| 9. |
- Lundgren, Ingela, 1957, et al.
(författare)
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Evaluation of a midwifery model of woman-centred care during childbirth – a mixed method study
- 2019
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Ingår i: NJF Congress 2019 Reykjavik Conference app.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Midwifery models of woman-centred care have been developed in different cultural context but few have been evaluated. A theoretical Midwifery Model of woman-centred care (MiMo) based on research in Sweden and Iceland was evaluated and assessed with the overall aim to explore the applicability of the model and the impact it has on outcome of childbirth care. Aim: To evaluate the effects and the applicability of a model of woman-centred care provided by midwives during childbirth. Methods: A mixed methods, before-after controlled study at two units for normal deliveries at Sahlgrenska University Hospital, Sweden,. The intervention comprised a one-day (8 hours) education about the model together with regularly scheduled reflection groups for midwives 2015-2016. The effects were studied by evaluating delivery outcomes, and mothers’ childbirth experiences. The primary outcomes were augmentation with oxytocin (n=.1600) and mothers’ childbirth experiences assessed with the Childbirth Experience Questionnaire (CEQ 2.0) (n=800). The applicability was studied by focus group interviews with a total of 43 participants: midwives (n=16), obstetricians (n = 8), assistant nurses (n= 11) and managers (n=8), before and after the intervention. Results: Findings from the study will be presented at the conference. Conclusion: A midwifery model of woman-centred care based on previous research has been evaluated in clinical practice.
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| 10. |
- Lundgren, Ingela, 1957, et al.
(författare)
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Evaluation of a model of woman-centred care during childbirth
- 2017
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Ingår i: 31th ICM Triennieal Congress 18-22 June 2017.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Based on a synthesis of 12 qualitative studies on women’s and midwives’ experiences of childbearing, a model of woman-centred care has been developed. The model has three central intertwined themes: a reciprocal relationship, a birthing atmosphere, and grounded knowledge; and two overall themes: the cultural context and the balancing act. Purpose/Objective: To evaluate the use and effects of the model of woman-centred care provided by midwives during childbirth. Method: A mixed methods, before-after controlled study at two units for normal deliveries at Sahlgrenska University Hospital, Sweden, and an ethnographic actions research study at the labour ward of Landspitali, University Hospital in Iceland. The intervention in Sweden comprised a one-day (8 hours) education about the model together with regularly scheduled reflection groups for midwives. The effects are studied by evaluating delivery outcomes, mothers’ childbirth experiences and midwives’ work-related experiences. The primary outcomes are augmentation with oxytocin (n=1600) and mothers’ childbirth experiences assessed with the Childbirth Experience Questionnaire (CEQ 2.0) (n=801). The secondary outcomes are midwives’ experiences, assessed by means of questionnaires, including stress, burn-out, work satisfaction, and sense of coherence before and one year after the intervention (n=120). The qualitative part will study if the model is considered applicable by midwives, obstetricians, assistant nurses and managers at delivery wards, and to the content of midwifery care. An ethnographic field study with midwives and a focus-group study with assistant nurses, obstetricians, midwives and managers have been conducted before start and will be performed after the intervention. The ethnographic action research study in Iceland is focusing on midwives’ experiences and the development of guidelines for implementing the model in practice. The study period was Mars 2015-Mars 2016. Key Findings: Findings from the study will be presented at the conference. Discussion: The findings will present knowledge about the clinical relevans of a theretical midwifery model of woman-centred care. References: Berg M, Olofsdottir O, & Lundgren I. (2012). A midwifery model of woman-centred childbirth care – In Swedish and Icelandic settings. Sexual and Reproductive Healthcare, 3(2), 79-87. Bryar R, & Sinclair M. (2011). Theory for midwifery practice (andra upplagan). NY: Palgrave Macmillan Cohen S, Kamarck T, Mermelstein R. (1983). A global measure of perceived stress. Health Soc Behav, 24, 385-396. Hildingsson I, Westlund K, Wiklund I. (2013). Burnout in Swedish midwives. Sex Reprod Healthcare. 4(3), 87-91. doi: 10.1016/j.srhc.2013.07.001. Epub 2013 Jul 30. Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. (2013). Continuous support for women during childbirth. Cochrane Database Syst Rev. Jul 15;7:CD003766. [Epub ahead of print] Karasek R, Theorell T. (1990). Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Book Inc. Kristensen T, Borritz M, Villadsen E, Christensen, K. (2005). The Copenhagen burnout inventory: A new tool for the assessment of burnout. Work & Stress, 19 (3), 192-207. Morse Jm & Niehaus L (2009). Mixed Method Design: Principles and Procedures. Walnut Creek, CA, USA: Left Coast Press Inc.
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