| 1. |
- Gunnervik, Christina, 1953-, et al.
(författare)
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Attitudes towards cesarean section in a nationwide sample of obstetricians and gynecologists
- 2008
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 87:4, s. 438-444
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The Swedish cesarean section (CS) rate has increased dramatically over the last decades, but remains relatively low compared to several other countries in the Western world. The reasons for this continuous increase are multifactorial and difficult to investigate. That pregnant women are demanding CS more frequently does not appear to be the major explanatory factor for the increasing CS rate. Since Swedish CS rates are relatively low, it is important to study attitudes to CS in a nationwide population of Swedish obstetricians and gynecologists in order to determine the possible concerns of this group. Methods. In 2006, a study-specific questionnaire was created and posted to Swedish obstetricians and gynecologists. In total, 1,280 obstetricians and gynecologists received a questionnaire and replied with a response rate of 66%. Results. In general, older and longer work experience physicians had a more positive attitude towards providing CS on maternal request or elective CS for women who fear vaginal delivery. In addition, these colleagues were more positive in expressing their belief that elective CS is as safe as vaginal delivery for the mother and her child. The main difference between female and male physicians was that males were more positive toward providing CS on maternal request (p<0.001). Conclusion. We have shown that female physicians differ from their male colleagues in their attitudes toward providing CS on maternal request. Female physicians were more reluctant than males to provide CS on maternal request. © 2008 Taylor & Francis.
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| 2. |
- Gunnervik, Christina, et al.
(författare)
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Attitudes towards mode of birth among Swedish midwives
- 2010
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Ingår i: MIDWIFERY. - : Elsevier BV. - 0266-6138. ; 26:1, s. 38-44
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to investigate midwives attitudes and opinions on mode of birth. Design: exploratory descriptive study. Data were collected via study-specific questionnaires during 2006. Setting: southeastern Sweden. Participants: all midwives working in two counties. Findings: regardless of age, experience and working field, the midwives considered a reasonable caesarean rate to be around 11.5 per cent. None of the participants thought that the caesarean rate was too low. Midwives younger than 50 years tended to consider the current caesarean rate to be too high (p = 0.059). Midwives working on labour wards stated that they thought the current caesarean rate was too high compared with midwives working at antenatal care clinics (ACCs)(pandlt;0.001). Midwives working at ACCs agreed with the statements one should agree to a womans right to have an elective caesarean (pandlt;0.001) and elective caesarean is the best choice for a woman with fear of birth (p = 0.046) more often than midwives working on labour wards, regardless of age or working experience. Key conclusions and implications for practice: midwives working at ACCs are more willing to accept caesarean section at the womans request and for women with fear of birth. It is of importance that ACC caregivers and professionals on labour wards increase their collaboration and have continuous discussions with one another in an attempt to reach consensus about the appropriate caesarean rates on evidence-based grounds.
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| 3. |
- Josefsson, Ann, et al.
(författare)
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A Comparison Between Swedish Midwives and Obstetricians and Gynecologists Opinions on Cesarean Section
- 2011
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Ingår i: MATERNAL AND CHILD HEALTH JOURNAL. - : Springer Science Business Media. - 1092-7875 .- 1573-6628. ; 15:5, s. 555-560
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Tidskriftsartikel (refereegranskat)abstract
- To compare Swedish obstetricians/gynecologists and midwives attitudes and opinions on different aspects of cesarean section (CS). In total 330 midwives from the south east of Sweden and 1280 Swedish obstetricians/gynecologists were asked to answer a study-specific questionnaire anonymously about their opinions on different issues concerning CS. The majority of obstetricians/gynecologists and midwives had more than 10 years of experience in their professions (75.2% vs. 73.6%). The midwives thought that a reasonable CS rate would be 11.5% whereas the corresponding figures for the obstetricians/gynecologists was 13.8% (P andlt; 0.001). There are differences in opinions and attitudes concerning both CS rates and other aspects in connection with CS. There are evident differences in attitudes towards CS and mode of delivery between midwives and obstetricians/gynecologists. These need to be explored and discussed in relation to state-of-the-art knowledge and should become a part of the curriculum for both groups of professionals both in training as well as on a regular clinical basis.
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| 4. |
- Josefsson, Ann, et al.
(författare)
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Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms
- 2002
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Ingår i: Obstetrics and gynecology. - 0029-7844. ; 99:2, s. 223-228
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To identify and test the predictive power of potential independent risk factors of postpartum depressive symptoms during pregnancy and the perinatal period. METHODS: We conducted a case-control study where 132 women with postpartum depressive symptoms were selected as an index group and 264 women without depressive symptoms as a control group. Data related to sociodemographic status, medical, gynecologic, and obstetric history, pregnancy, and perinatal events were collected from standardized medical records. RESULTS: The strongest risk factors for postpartum depressive symptoms were sick leave during pregnancy and a high number of visits to the antenatal care clinic. Complications during pregnancy, such as hyperemesis, premature contractions, and psychiatric disorder were more common in the postpartum depressed group of women. No association was found between parity, sociodemographic data, or mode of delivery and postpartum depressive symptoms. CONCLUSION: Women at risk for postpartum depression can be identified during pregnancy. The strongest risk factors, sick leave during pregnancy and many visits to the antenatal care clinic, are not etiologic and might be of either behavioral or biologic origin. The possibilities of genetic vulnerability and hormonal changes warrant further investigation to reach a more thorough understanding.
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| 5. |
- Mernelius, Sara, et al.
(författare)
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The effect of improved compliance with hygiene guidelines on transmission of Staphylococcus aureus to newborn infants: The Swedish Hygiene Intervention and Transmission of S aureus study
- 2013
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Ingår i: American Journal of Infection Control. - : Elsevier. - 0196-6553 .- 1527-3296. ; 41:7, s. 585-590
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Tidskriftsartikel (refereegranskat)abstract
- Background: Newborn infants are often colonized with Staphylococcus aureus originating from health care workers (HCWs). We therefore use colonization with S aureus of newborn infants to determine the effect of an improved compliance with hygiene guidelines on bacterial transmission. Methods: Compliance with hygiene guidelines was monitored prior to (baseline) and after (follow-up) a multimodal hygiene intervention in 4 departments of obstetrics and gynecology. spa typing was used to elucidate transmission routes of S aureus collected from newborn infants, mothers, fathers, staff members, and environment. Results: The compliance with hygiene guidelines increased significantly from baseline to follow-up. The transmission of S aureus from HCWs to infants was however not affected. Fathers had the highest colonization rates. Persistent carriage was indicated in 18% of the HCWs. The most commonly isolated spa type was t084, which was not detected in a previous study from the same geographic area. Conclusion: It is possible to substantially improve the compliance with hygiene guidelines, by using multimodal hygiene intervention. The improved compliance did not decrease the transmission of S aureus from sources outside the own family to newborn infants. Furthermore, we show the establishment of a new spa type (t084), which now is very common in our region. Copyright (C) 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
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| 6. |
- Möller, Louise, et al.
(författare)
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Reproduction, fear of childbirth and obstetric outcomes in women treated for fear of childbirth in their first pregnancy: A historical cohort
- 2019
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : WILEY. - 0001-6349 .- 1600-0412. ; 98:3, s. 374-381
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Tidskriftsartikel (refereegranskat)abstract
- Introduction About 8% of the pregnant women in Sweden receive counseling for fear of childbirth (FOC) during pregnancy. Little is known about the long-term reproductive and obstetric outcomes after counseling for FOC: Therefore, the objective of this historical cohort study was to compare the long-term reproductive and obstetric outcomes in women treated for FOC in their first pregnancy to women without FOC. Material and methods All nulliparas consecutively referred for treatment of severe FOC between 2001 and 2007 (n = 608) were compared with all other nulliparas giving birth on the same day (n = 431). Women who were not fluent in Swedish, missing a postal address, had moved out of the area, given birth at another hospital or had a late spontaneous abortion were excluded (n = 555). A total of 235 women agreed to participate in the study, 63 (39%) women in the index group and 172 (53%) in the reference group. The women were contacted by letter in 2015, ie 7-14 years after first childbirth, and asked to permit access to their medical charts from pregnancies and childbirths and to fill out a study specific questionnaire. Based on data from the medical charts and questionnaire, the mode of delivery, birth experience, obstetric complications, FOC, counseling for FOC and number of childbirths were compared in the two groups. Results Women in the index group less often gave birth more than twice compared with the reference group (8.2% vs 22.0%, P = 0.012). We found no significant differences in complications during subsequent pregnancies and deliveries. Women in the index group more often gave birth by CS in their first (P = 0.002) and second childbirth (P = 0.001), more often had a less positive birth experience (index group NRS: median 6.0, interquartile range 6 vs reference group NRS: 7.0, interquartile range 5, P = 0.004) in their first delivery and more often received counseling for FOC (58.7% vs 12.5%, P amp;lt; 0.001) in subsequent pregnancies. Women in the index group more often experienced FOC (18% vs 5.3%, P = 0.001) 7-14 years after first childbirth. Conclusions FOC is not easily treated. Despite treatment and exposure to childbirth many women received treatment in their next pregnancy and still suffered from FOC 7-14 years after the first childbirth.
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| 7. |
- Sydsjö, Gunilla, et al.
(författare)
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Obstetric outcome for women who received individualized treatment for fear of childbirth during pregnancy
- 2012
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Informa Healthcare / Wiley-Blackwell. - 0001-6349 .- 1600-0412. ; 91:1, s. 44-49
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To compare obstetric outcomes for women with fear of childbirth who received counseling during pregnancy with women without fear of childbirth. Design. Descriptive, retrospective case-control study. Setting. University Hospital, Linkoping, Sweden. Sample. 353 women who were referred to a unit for psychosocial obstetrics and gynecology because of fear of childbirth constituted the index group and 579 women without fear of childbirth formed a reference group. Methods. Data were collected from standardized antenatal and delivery records. Main outcome measures. Delivery data. Results. Elective cesarean sections (CS) were more frequent in the index group (pandlt;0.001). Induction of delivery was also more common among the women with fear of childbirth (16.5 compared with 9.6%, pandlt;0.001). Women with fear of childbirth who were scheduled for vaginal delivery were more often delivered by emergency CS (p=0.007). Elective CS was more common among the parous women with fear of childbirth and instrumental delivery was more common among nulliparous women with fear of childbirth. There were no differences in complications during pregnancy, delivery or postpartum between the two groups. Conclusion. Fear of childbirth is a predisposing factor for emergency and elective CS even after psychological counseling. Maximal effort is necessary to avoid traumatizing deliveries and negative experiences, especially for nulliparous women.
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