| 1. |
- Ekström, Anette, et al.
(författare)
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Breastfeeding support from partners and grandmothers : Perceptions of Swedish women
- 2003
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Ingår i: Birth. - : Wiley-Blackwell. - 0730-7659 .- 1523-536X. ; 30:4, s. 261-266
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Tidskriftsartikel (refereegranskat)abstract
- Background: Support from the mother’s network of relatives, friends, and professional caregivers during childbirth is likely to be important for breastfeeding success. Few studies have been conducted to examine mothers’ perceptions of breastfeeding support. The objective of this study was to describe breastfeeding support and feelings of confidence of primiparas and multiparas in relation to duration of breastfeeding. Methods: Mothers whodelivered vaginally were eligible for inclusion. After receiving a questionnaire when their children were 9 to 12 months of age, 194 primiparas and 294 multiparas responded to questions onbreastfeeding history and on perceived and overall breastfeeding support and feelings of confidence. Results: Feelings of overall breastfeeding support were correlated with duration ofexclusive breastfeeding in both primiparas (p < 0.001) and multiparas (p < 0.001). Multiparas who knew how long they were breastfed as a child showed a longer duration of exclusive(p ¼ 0.006) and total (p ¼ 0.007) breastfeeding than multiparas who did not know. The time during which the partner was present after labor was correlated with the duration of exclusive(p < 0.001) and total breastfeeding (p ¼ 0.002) in primiparas. Feelings of confidence when the baby was 6 to12 months old, as retrospectively rated on a visual analog scale, was correlatedwith feelings of confidence in the partner during childbirth in both primiparas (p < 0.001) and multiparas (p < 0.001) and the experience of overall breastfeeding support (primiparas,p ¼ 0.002; multiparas, p < 0.001). Both groups were more content with breastfeeding information they received from midwives in the maternity wards, compared with that from antenatal midwives and postnatal nurses (p < 0.001). Conclusions: A helpful support strategy for mothers with respect to breastfeeding outcome is for health professionals to discuss the grandmother’s perception of breastfeeding with the mother. It is important for perinatalcaregivers to provide an environment that enables the family to stay together after delivery. A helpful support strategy for health professionals might be to mobilize grandmothers with positive breastfeeding perception to provide support for their daughters’ breastfeeding. (BIRTH 30:4 December 2003)
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| 2. |
- Avelin, Pernilla, et al.
(författare)
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Swedish parents' experiences of parenthood and the need for support to siblings when a baby is stillborn
- 2011
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Ingår i: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 38:2, s. 150-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It has been argued that having a stillborn baby in the family affects older siblings more than parents realize. The aim of this study was to describe parenthood and the needs of siblings after stillbirth from the parents' perspective.METHODS: Six focus groups were held with 27 parents who had experienced a stillbirth and who had had children before the loss. The discussion concerned parents' support to the siblings, and the sibling's meeting, farewell, and memories of their little sister or brother. Data were analyzed using qualitative content analysis.RESULTS: The overall theme of the findings was parenthood in a balance between grief and everyday life. In the analysis, three categories emerged that described the construction of the theme: support in an acute situation, sharing the experiences within the family, and adjusting to the situation.CONCLUSIONS: The siblings' situation is characterized by having a parent who tries to maintain a balance between grief and everyday life. Parents are present and engaged in joint activities around the stillbirth together with the siblings of the stillborn baby. Although parents are aware of the sibling's situation, they feel that they are left somewhat alone in their parenthood after stillbirth and therefore need support and guidance from others.
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| 3. |
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| 4. |
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| 5. |
- Bystrova, Ksenia, et al.
(författare)
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Early Contact versus Separation : Effects on Mother-Infant Interaction One Year Later
- 2009
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Ingår i: Birth. - 0730-7659 .- 1523-536X. ; 36:2, s. 97-109
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Tidskriftsartikel (refereegranskat)abstract
- Background: A tradition of separation of the mother and baby after birth still persists in many parts of the world, including some parts of Russia, and often is combined with swaddling of the baby. The aim of this study was to evaluate and compare possible long-term effects on mother-infant interaction of practices used in the delivery and maternity wards, including practices relating to mother-infant closeness versus separation. Methods: A total of 176 mother-infant pairs were randomized into four experimental groups: Group I infants were placed skin-to-skin with their mothers after birth, and had rooming-in while in the maternity ward. Group II infants were dressed and placed in their mothers' arms after birth, and roomed-in with their mothers in the maternity ward. Group III infants were kept in the nursery both after birth and while their mothers were in the maternity ward. Group IV infants were kept in the nursery after birth, but roomed-in with their mothers in the maternity ward. Equal numbers of infants were either swaddled or dressed in baby clothes. Episodes of early suckling in the delivery ward were noted. The mother-infant interaction was videotaped according to the Parent-Child Early Relational Assessment (PCERA) 1 year after birth. Results: The practice of skin-to-skin contact, early suckling, or both during the first 2 hours after birth when compared with separation between the mothers and their infants positively affected the PCERA variables maternal sensitivity, infant's self-regulation, and dyadic mutuality and reciprocity at 1 year after birth. The negative effect of a 2-hour separation after birth was not compensated for by the practice of rooming-in. These findings support the presence of a period after birth (the early ""sensitive period"") during which close contact between mother and infant may induce long-term positive effect on mother-infant interaction. In addition, swaddling of the infant was found to decrease the mother's responsiveness to the infant, her ability for positive affective involvement with the infant, and the mutuality and reciprocity in the dyad. Conclusions: Skin-to-skin contact, for 25 to 120 minutes after birth, early suckling, or both positively influenced mother-infant interaction 1 year later when compared with routines involving separation of mother and infant.
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| 6. |
- Bystrova, Ksenia, et al.
(författare)
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Maternal axillar and breast temperature after giving birth : Effects of delivery ward practices and relation to infant temperature
- 2007
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Ingår i: Birth. - 0730-7659 .- 1523-536X. ; 34:4, s. 291-300
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little is known about the development and control of skin temperature in human mothers after birth. The purpose of this study was to explore the effects of delivery ward practices and early suckling on maternal axillar and breast temperatures during the first 2 hours postpartum and to relate them to the infant's foot and axillar temperatures. Methods: Three groups of 176 mother-infant pairs were randomized as follows-group I: infants lying prone in skin-to-skin contact on their mother's chest, named the ""skin-to-skin group"" (n = 44), group II: infants who were dressed and lying prone on their mother's chest, named the ""mother's arms group"" (n = 44), and group III: infants who were dressed and kept in the nursery, named the ""nursery group"" (n = 88). Maternal axillar and breast temperatures and infants' axillar and foot temperatures were measured at 15-minute intervals from 30 to 120 minutes after birth. Episodes of early suckling were noted. Results: The axillar and breast temperatures rose significantly in all mothers. The rise of temperature over time was significantly higher in multiparas than in primiparas but was influenced only slightly by group assignment. The variation in breast temperature was highest in mothers in the skin-to-skin group and lowest in mothers in the nursery group. In the mother's arms group, variation in breast temperature was larger in those mothers exposed to early suckling than in those not exposed. A positive relationship was found between the maternal axillar temperature and the infant foot and axillar temperature 90 minutes after the start of the experiment (120 min after birth) in the skin-to-skin and mother's arms groups. The rise in temperature in the infant's foot was nearly twice that in the axilla. No such relationship was established in the nursery group. In addition, foot temperature in infants from the skin-to-skin group was nearly 2 degrees C higher than that in infants from the mother's arms group. Conclusions: Maternal temperature rose after birth, and the rise was higher in multiparas than in primiparas. Skin-to-skin contact and early suckling increased temperature variation. Maternal temperature was related to infant foot and axillar temperatures.
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| 7. |
- Cacciatore, Joanne, et al.
(författare)
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Effects of contact with stillborn babies on maternal anxiety and depression
- 2008
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Ingår i: Birth. - 0730-7659 .- 1523-536X. ; 35:4, s. 313-320
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Some guidelines encourage mothers to see and hold their babies after stillbirth, which might be traumatizing. The study objective was to investigate the effects of women seeing and holding their stillborn baby on the risk of anxiety and depression in a subsequent pregnancy and in the long term. METHODS: Thirty-seven organizations recruited women who had experienced stillbirth (N = 2,292 of whom 286 reported being pregnant). Anxiety and depressive symptoms were assessed by using the 25-item Hopkins Symptom Check List. RESULTS: Among nonpregnant women, seeing and holding their stillborn baby were associated with lower anxiety symptoms (OR 0.68, 95% CI 0.49-0.95) and a tendency toward fewer symptoms of depression (OR 0.72, 95% CI 0.51-1.02), compared with pregnant women. Participants who were pregnant also had less depressive symptomatology (OR 0.57, 95% CI 0.43-0.75), but more symptoms of anxiety if they had seen and held their baby (OR 3.79, 95% CI 1.42-10.1). CONCLUSIONS: Seeing and holding the baby are associated with fewer anxiety and depressive symptoms among mothers of stillborn babies than not doing so, although this beneficial effect may be temporarily reversed during a subsequent pregnancy.
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| 8. |
- Ekström, Anette, et al.
(författare)
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Does Continuity of Care by Well-Trained Breastfeeding Counselors Improve a Mother´s Perception of Support?
- 2006
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Ingår i: Birth. - : Wiley-Blackwell. - 0730-7659 .- 1523-536X. ; 33:2, s. 123-130
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Tidskriftsartikel (refereegranskat)abstract
- Background:Social support has been shown to be greatly important for breastfeeding success. The objective of this study was to investigate if mothers who were attended by midwives and nurses specially trained in breastfeeding counseling perceived better continuity of care and emotional and informative breastfeeding support than mothers who received only routine care. Method:Ten municipalities, each with an antenatal center and child health center, in southwest Sweden were randomized either to intervention or control municipalities. The intervention included a process-oriented training in breastfeeding counseling and continuity of care at the antenatal and child health centers. Primiparas were asked to evaluate the care given, and those living in the control municipalities were divided into control groups A and B. Data collection took place at different points in time for the two control groups. The 540 mothers responded to 3 questionnaires at 3 days and at 3 and 9 months postpartum. The perception of support provided by the health professionals and from the family classes was rated on Likert scales. Results:Intervention group mothers rated the breastfeeding information given during the family class as significantly better during pregnancy than both control groups, and better than control group B mothers at 3 months postpartum; compared with both control groups, intervention group mothers perceived that they received significantly better overall support and that postnatal nurses provided better information about breastfeeding and the baby's needs. At 9 months, intervention group mothers were more satisfied with knowledge about social rights, information about the baby's needs, and their social network than control group B mothers. Both intervention group and control group B mothers perceived better overall support than control group A during pregnancy. At 3 and 9 months, intervention group mothers perceived that postnatal nurses were more sensitive and understanding compared with both control groups. Conclusions:After implementation of a process-oriented breastfeeding training program for antenatal midwives and postnatal nurses that included an intervention guaranteeing continuity of care, the mothers were more satisfied with emotional and informative support during the first 9 months postpartum. The results lend support to family classes incorporating continuity of care. (BIRTH 33:2 June 2006)
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| 9. |
- Erlandsson, Kerstin, et al.
(författare)
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Skin-to-skin care with the father after cesarean birth and its effect on newborn crying and prefeeding behavior.
- 2007
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Ingår i: Birth. - : Wiley-Blackwell. - 0730-7659 .- 1523-536X. ; 34:2, s. 105-14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous reports have shown that skin-to-skin care immediately after vaginal birth is the optimal form of care for full-term, healthy infants. Even in cases when the mother is awake and using spinal analgesia, early skin-to-skin contact between her and her newborn directly after cesarean birth might be limited for practical and medical safety reasons. The aim of the present study was to compare the effects of skin-to-skin contact on crying and prefeeding behavior in healthy, full-term infants born by elective cesarean birth and cared for skin-to-skin with their fathers versus conventional care in a cot during the first 2 hours after birth. METHODS: Twenty-nine father-infant pairs participated in a randomized controlled trial, in which infants were randomized to be either skin-to-skin with their father or next to the father in a cot. Data were collected both by tape-recording crying time for the infants and by naturalistic observations of the infants' behavioral response, scored every 15 minutes based on the scoring criteria described in the Neonatal Behavioral Assessment Scale (NBAS). RESULTS: The primary finding was the positive impact the fathers' skin-to-skin contact had on the infants' crying behavior. The analysis of the tape recordings of infant crying demonstrated that infants in the skin-to-skin group cried less than the infants in the cot group (p<0.001). The crying of infants in the skin-to-skin group decreased within 15 minutes of being placed skin-to-skin with the father. Analysis of the NBAS-based observation data showed that being cared for on the father's chest skin-to-skin also had an impact on infant wakefulness. These infants became drowsy within 60 minutes after birth, whereas infants cared for in a cot reached the same stage after 110 minutes. Rooting activity was more frequent in the cot group than in the skin-to-skin group (p<0.01), as were sucking activities (p<=0.001) and overall duration of wakefulness (p<0.01). CONCLUSIONS: The infants in the skin-to-skin group were comforted, that is, they stopped crying, became calmer, and reached a drowsy state earlier than the infants in the cot group. The father can facilitate the development of the infant's prefeeding behavior in this important period of the newborn infant's life and should thus be regarded as the primary caregiver for the infant during the separation of mother and baby.
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| 10. |
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| 11. |
- Fransson, Emma, et al.
(författare)
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Antenatal depressive symptoms and preterm birth : a prospective study of a Swedish national sample.
- 2011
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Ingår i: Birth. - 0730-7659 .- 1523-536X. ; 38:1, s. 10-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Preterm birth is the principal risk factor for neonatal morbidity and mortality. The objective of this study was to investigate the association between antenatal depressive symptoms and preterm birth.METHODS: The study included a national sample of 2,904 pregnant women who were recruited at their first booked visit to antenatal clinics in Sweden. Data on depressive symptoms, and sociodemographic and reproductive background were collected by questionnaires. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS). The average length of gestation at the time for completion of the questionnaire was 16 weeks. Data on gestational length were extracted from the Swedish Medical Birth Register. Multiple logistic regression analyses were conducted to estimate the risk of preterm birth associated with antenatal depressive symptoms.RESULTS: The presence of antenatal depressive symptoms above a cutoff score of 12 or higher on the EPDS increased the risk for preterm birth (OR: 1.56; 95% CI: 1.03-2.35). Being of age 35 years and over, being a primipara, and having experienced a previous miscarriage were also shown to be significant predictors in a multivariate model.CONCLUSION: Pregnant women reporting antenatal depressive symptoms are at elevated risk of preterm birth.
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| 12. |
- Georgsson Öhman, Susanne, et al.
(författare)
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Pregnant women's responses to information about an increased risk of carrying a baby with Down syndrome
- 2006
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Ingår i: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 33:1, s. 64-73
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Fetal screening for Down syndrome by an ultrasound examination, including measurement of fetal nuchal translucency, at 12 to14 weeks' gestation is presently being evaluated in a Swedish randomized controlled trial. Women at high risk were offered an amniocentesis to obtain a definite diagnosis. The aim of this study was to explore women's reactions and responses to information about being at high risk after the scan, with a special focus on reactions to a false positive test. METHOD: Interviews were conducted with 24 women within 1 week after the scan, in midpregnancy, and 2 months after the birth. The interviews were analyzed qualitatively. Down syndrome was confirmed in 4 women, who chose to terminate the pregnancy. The remaining 20 women had a false positive test. RESULTS: For the majority, the risk information caused strong reactions of anxiety and worries about the future. A typical way for women to cope was to "withhold" the pregnancy, to take a "timeout," and try to live as if they were not pregnant any longer. Some weeks later, when the women received normal results from the chromosome analysis, they resumed being pregnant. Six women ages more than 35 years who had a risk score lower than their age-related risk did not express similarly strong reactions. Two months after the birth of a healthy baby, most stated they would undergo the same procedure in a subsequent pregnancy. One woman still suffered from the experience when interviewed at 2 months after the birth, and another said she regretted participating in the fetal screening program. CONCLUSIONS: A false positive test of fetal screening for Down syndrome by ultrasound examination may cause strong reactions of anxiety and even rejection of the pregnancy. The prevalence of such reactions and possible long-term effects need further investigation.
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| 13. |
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| 14. |
- Hildingsson, Ingegerd, et al.
(författare)
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Birth preferences that deviate from the norm in Sweden - planned home birth versus planned cesarean section
- 2010
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Ingår i: Birth. - 0730-7659 .- 1523-536X. ; 37:4, s. 288-295
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Tidskriftsartikel (refereegranskat)abstract
- Background:Opting for a home birth or requesting a cesarean section in a culture where vaginal birth in a hospital is the norm challenges the health care system. The aim of this study was to compare background characteristics of women who chose these very different birth methods and to see how these choices affected factors of care and the birth experience.Methods:This descriptive study employed a secondary data analysis of a sample of women who gave birth from 1997 to 2008, including 671 women who had a planned home birth and 126 women who had a planned cesarean section based on maternal request. Data were collected by means of questionnaires. Logistic regression with crude and adjusted odds ratios (OR) with a 95 percent confidence interval (95% CI) was calculated.Results:Women with a planned home birth had a higher level of education (OR: 2.3; 95% CI: 1.5-3.6), were less likely to have a high body mass index (OR: 0.1; 95% CI: 0.01-0.6), and were less likely to be smokers (OR: 0.2; 95% CI: 0.1-0.4) when compared with women who had planned cesarean sections. When adjusted for background variables, women with a planned home birth felt less threat to the baby's life during birth (OR: 0.1; 95% CI: 0.03-0.4), and were more satisfied with their participation in decision making (OR: 6.0; 95% CI: 3.3-10.7) and the support from their midwife (OR 3.9; 95% CI: 2.2-7.0). They also felt more in control (OR: 3.3; 95% CI: 1.6-6.6), had a more positive birth experience (OR: 2.9; 95% CI: 1.7-5.0), and were more satisfied with intrapartum care (OR: 2.3; 95% CI: 1.3-4.1) compared with women who had a planned cesarean section on maternal request.Conclusions:Women who planned a home birth and women who had a cesarean section based on maternal request are significantly different groups of mothers in terms of sociodemographic background. In a birth context that promotes neither home birth nor cesarean section without medical reasons, we found that those women who had a planned home birth felt more involvement in decision making and had a more positive birth experience than those who had a requested, planned cesarean section.
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| 15. |
- Hildingsson, Ingegerd, et al.
(författare)
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Swedish women's interest in homebirth and in- hospital birth center care
- 2003
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Ingår i: Birth. - 0730-7659 .- 1523-536X. ; 30:1, s. 11-22
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine women's interest in home birth and in-hospital birth center care in Sweden, and to describe the characteristics of these women. METHODS: Three questionnaires, completed after the first booking visit in early pregnancy, at 2 months, and 1 year after the birth, asked about the women's interest in two alternative birth options. RESULTS: One percent of participants consistently expressed an interest in home birth on all three occasions, and 8 percent expressed an interest in birth center care. A regression analysis showed five factors that were associated with an interest in home birth: a wish to have the baby's siblings (OR 20.2; 95% CI 6.2-66.5) and a female friend (OR 15.2; 95% CI 6.2-37.4) present at the birth, not wanting pharmacological pain relief during labor and birth (OR 4.7; 95% CI 1.4-15.3), low level of education (OR 4.5; 95% CI 1.8-11.4), and dissatisfaction with medical aspects of intrapartum care (OR 3.6; 95% CI 1.4-9.2). An interest in birth center care was associated with experience of being in control during labor and birth (OR 8.3; 95% CI 3.2-21.6), not wanting pharmacological pain relief (OR 2.3; 95% CI 1.3-4.1), and a preference to have a known midwife at the birth (OR 2.2; 95% CI 1.6-2.9). CONCLUSION: If Swedish women were offered free choice of place of birth, the home birth rate would be 10 times higher, and the 20 largest hospitals would need to have a birth center. Women interested in alternative models of care view childbirth as a social and natural event, and their needs should be considered.
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| 16. |
- Jangsten, Elisabeth, 1954, et al.
(författare)
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Afterpains : A Comparison Between Active and Expectant Management of the Third Stage of Labor
- 2011
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Ingår i: Birth. - : Wiley-Blackwell. - 0730-7659 .- 1523-536X. ; 38:4, s. 294-301
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Tidskriftsartikel (refereegranskat)abstract
- Background: Management of the third stage of labor, the period following the birth of the infant until delivery of the placenta, is crucial. Active management using synthetic oxytocin has been advocated to decrease blood loss. It has been suggested, but not studied, that oxytocin may increase afterpains. The aim of this study was to compare womens experience of pain intensity when the third stage of labor was managed actively and expectantly and their experience of afterpains. Methods: A single-blind, randomized, controlled trial was performed at two delivery units in Sweden in a population of healthy women with normal, singleton pregnancies, gestational age of 34 to 43 weeks, cephalic presentation, and expected vaginal delivery. Women (n = 1,802) were randomly allocated to either active management or expectant management of the third stage of labor. Afterpains were assessed by Visual Analog Scale (VAS) and the Pain-o-Meter (POM-WDS) 2 hours after delivery of the placenta and the day after childbirth. Results: At 2 hours after childbirth, women in the actively managed group had lower VAS pain scores than expectantly managed women (p = 0.014). Afterpains were scored as more intense the day after, compared with 2 hours after, childbirth in both groups. Multiparas scored more intense afterpains, compared with primiparas, irrespective of management (p < 0.001). Conclusions: Active management of the third stage of labor does not provoke more intense afterpains than expectant management. (BIRTH 38: 4 December 2011)
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| 17. |
- Karlström, Annika, et al.
(författare)
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Cesarean section without medical reason, 1997 to 2006 : a Swedish register study
- 2010
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Ingår i: Birth. - : Wiley-Blackwell. - 0730-7659 .- 1523-536X. ; 37:1, s. 11-20
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cesarean section performed in the absence of medical indication is of concern in many countries, but studies focusing on its prevalence are inconclusive. The objective of this study was, first, to describe the prevalence of cesarean section without medical reason in terms of the diagnostic code listed in the Swedish Medical Birth Register, and to assess its contribution to the general increase in the number of cesarean sections; and second, to study regional differences and differences in the maternal characteristics of women having a cesarean birth with this diagnostic code. Methods: Birth records of 6,796 full-term cesarean sections in two Swedish regions with the diagnostic code O828 were collected from the Swedish Medical Birth Register. Descriptive data, t test, and logistic regression analysis were used to analyze data. Results: The rate of cesarean sections without medical indication increased threefold during the 10-year period, but this finding represents a minor contribution to the general increase in the number of cesarean sections. The diagnostic code O828 was more common in the capital area (p < 0.001). Secondary diagnoses were found, the most frequent of which were previous cesarean section and childbirth-related fear. Regional differences existed concerning prevalence, classification, maternal sociodemographic, obstetric, and health variables. Conclusions: The rate of cesarean sections without medical reasons in terms of the diagnostic code O828 increased during the period. The prevalence and maternal characteristics differed between the regions. Medical code classification is not explicit when it comes to defining cesarean sections without medical reasons and secondary diagnoses are common. (BIRTH 37:1 March 2010).
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| 18. |
- Lindgren, Helena, et al.
(författare)
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Transfers in planned home births related to midwife availability and continuity: : a nationwide population-based study
- 2008
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Ingår i: Birth. - 0730-7659 .- 1523-536X. ; 35:1, s. 9-15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Planning a home birth does not necessarily mean that the birth will take place successfully at home. The object of this study was to describe reasons and risk factors for transfer to hospital during or shortly after a planned home birth. METHODS: A nationwide study including all women who had given birth at home in Sweden between January 1, 1992, and July 31, 2005. A total of 735 women had given birth to 1,038 children. One questionnaire for each planned home birth was sent to the women. Of the 1,038 questionnaires, 1,025 were returned. Reasons for transfer and obstetric, socioeconomic, and care-related risk factors for being transferred were measured using logistic regression. RESULTS: Women were transferred in 12.5 percent of the planned home births. Transfers were more common among primiparas compared with multiparas (relative risk [RR] 2.5; 95% CI 1.8-3.5). Failure to progress and unavailability of the chosen midwife at the onset of labor were the reasons for 46 and 14 percent of transfers, respectively. For primiparas, the risk was four times greater if a midwife other than the one who carried out the prenatal checkups assisted at the birth (RR 4.4; 95% CI 2.1-9.5). A pregnancy exceeding 42 weeks increased the risk of transfer for both primiparas (RR 3.0; 95% CI 1.1-9.4) and multiparas (RR 3.4; 95% CI 1.3-9.0). CONCLUSIONS: The most common reasons for transfer to hospital during or shortly after delivery were failure to progress followed by the midwife's unavailability at the onset of labor. Primiparas whose midwife for checkups during pregnancy was different from the one who assisted at the home birth were at increased risk of being transferred.
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| 19. |
- Lindgren, Helena, et al.
(författare)
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Women’s experiences of empowerment in a planned home birth : a Swedish population-based study
- 2010
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Ingår i: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 37:4, s. 309-317
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childbirth can be an empowering event in a woman’s life. However, we know little about women’s own perceptions of power and empowering sources during childbirth. This study aims to describe the factors experienced as empowering during a planned home birth.Method and material: The inclusion criteria were women in Sweden who had a planned home birth between 1992 and 2005. All the women (n=735) who agreed to participate received one questionnaire for each planned home birth. A total of 1038 questionnaires were sent to the women. The written birth stories were analyzed using content analysis and descriptive statistics.Results: In the analysis of the participants’ birth experience four categories and one overall theme emerged from the stories. The categories identified were 1) sensations, 2) guidance, 3) tacit support and 4) identification of needs. Greater emphasis was put on guidance among first-time mothers than among with multiparas, for whom tacit support was identified as the most empowering factor. The overall theme was identified as “resting in acceptance of the process”. The empowerment they express by achieving and maintaining a sense of control allows them to rest in acceptance of the efforts that are part of a normal birth.Conclusion: Women who choose to give birth at home find empowering sources within themselves, from their environment and from the active and passive support of persons they have chosen to be present at the birth. They create their own birth setting ahead of the birth, so that they can let go of control when it actually happens.
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| 20. |
- Lukasse, Mirjam, et al.
(författare)
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Childhood abuse and fear of childbirth - a population-based study
- 2010
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Ingår i: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 37:4, s. 267-274
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Tidskriftsartikel (refereegranskat)abstract
- Abstract: Background: Childhood abuse affects adult health. The objective of this study was to examine the association between a self-reported history of childhood abuse and fear of childbirth. Methods: A population-based, cross-sectional study was conducted of 2,365 pregnant women at five obstetrical departments in Norway. We measured childhood abuse using the Norvold Abuse Questionnaire and fear of childbirth using the Wijma Delivery Expectancy Questionnaire. Severe fear of childbirth was defined as a Wijma Delivery Expectancy Questionnaire score of ≥85. Results: Of all women, 566 (23.9%) had experienced any childhood abuse, 257 (10.9%) had experienced emotional abuse, 260 (11%) physical abuse, and 290 (12.3%) sexual abuse. Women with a history of childhood abuse reported severe fear of childbirth significantly more often than those without a history of childhood abuse, 18 percent versus 10 percent (p = 0.001). The association between a history of childhood abuse and severe fear of childbirth remained significant after adjustment for confounding factors for primiparas (adjusted OR: 2.00; 95% CI: 1.30–3.08) but lost its significance for multiparas (adjusted OR: 1.17; 95% CI: 0.76–1.80). The factor with the strongest association with severe fear of childbirth among multiparas was a negative birth experience (adjusted OR: 5.50; 95% CI: 3.77–8.01). Conclusions: A history of childhood abuse significantly increased the risk of experiencing severe fear of childbirth among primiparas. Fear of childbirth among multiparas was most strongly associated with a negative birth experience.
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| 21. |
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| 22. |
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| 23. |
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| 24. |
- Mårtensson, Lena
(författare)
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The Patient Observer : Sterile Water Injections for Labor Pain
- 2010
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Ingår i: Birth. - : Wiley-Blackwell. - 0730-7659 .- 1523-536X. ; 37:4, s. 334-336
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Tidskriftsartikel (refereegranskat)abstract
- Several studies have reported a good pain relief effect from sterile water injections, especially for low back pain, during labor. The aim of this paper was to illustrate the use of the method in a clinical childbirth situation by means of a descriptive case report. The woman in the report described that the method provided a powerful pain relief effect, measured by a visual analog scale, and that her experience was highly positive.
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| 25. |
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| 26. |
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| 27. |
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| 28. |
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| 29. |
- Rådestad, Ingela, et al.
(författare)
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Tears in the vagina, perineum, sphincter ani, and rectum and first sexual intercourse after childbirth : A Nationwide Follow-up
- 2008
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Ingår i: Birth. - : Wiley Interscience. - 0730-7659 .- 1523-536X. ; 35:2, s. 98-106
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Tidskriftsartikel (refereegranskat)abstract
- Background: The first sexual intercourse after childbirth may be challenging for women, especially if the birth resulted in injuries in the genital area. The purpose of this study was to investigate whether or not tears in the vagina, perineum, sphincter ani, or rectum hindered sexual intercourse during the year after childbirth. Methods: We obtained information from 2,490 women in a population-based cohort identified at antenatal care. Information about first sexual intercourse was collected by means of a questionnaire sent 1 year after birth to the women and about women's tears reported in the population-based Swedish Medical Birth Register. Results: Adjusted relative risks with 95 percent confidence intervals for not having had sexual intercourse within 3 and 6 months, respectively, after childbirth were 1.5 (95% CI 1.2–1.8) and 1.6 (95% CI 1.2–2.3) for tears in the vagina, 1.4 (95% CI 1.1–1.6) and 1.5 (95% CI 1.1–2.1) for tears in the perineum, and 2.1 (95% CI 1.4–3.1) and 2.2 (95% CI 1.1–4.6) for tears in the sphincter ani and rectum. No statistically significant differences were found at 1-year follow-up. No associations between episiotomy and delay in resuming intercourse were found after adjusting the relative risks. Conclusions: Tears in the vagina, perineum, sphincter ani, or rectum are associated with a delay in women's resumption of sexual intercourse 6 months after childbirth in Sweden
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| 30. |
- Rådestad, Ingela, et al.
(författare)
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What factors in early pregnancy indicate that the mother will be hit by her partner during the year after childbirth? : A nationwide Swedish survey.
- 2004
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Ingår i: Birth: issues in perinatal care. - : Wiley. - 0730-7659 .- 1523-536X. ; 31:2, s. 84-92
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To be hit by one's intimate partner during the first year after childbirth may affect a woman's health and ability to take care of her newborn. The purpose of this study was to document the prevalence and indicators in early pregnancy of a woman being hit by her partner during the year after childbirth. METHOD: Information was collected by a postal questionnaire in early pregnancy and 12 months after childbirth from the approximately 5,550 women in Sweden who visited an antenatal care clinic for the first time during one of three chosen weeks in 1999 and 2000. RESULTS: Of the 3,266 recruited women, 2,563 returned the follow-up questionnaire. Being hit during the first year after childbirth was reported by 52 of the 2,563 (2%) women: 32 (61%) had been hit by their partner once, 12 (23%) twice, and 8 (15%) three or more times. Risk increased in women who were age 24 years or younger (3.9% had been hit), unmarried (7.1%), born in countries outside Europe (6.8%), with a partner born outside Europe (5.4%), had a low level of education (8.9%), and were unemployed (5.0%). In early pregnancy, women with back pain (4.0%), a chronic illness (4.1%), coital pain (6.1%), frequent depression-related symptoms (8.1%), stomach pain (3.8%), or a urinary tract problem (6.3%) were hit more often than others after childbirth. CONCLUSIONS: At least 2 percent of Swedish women giving birth in 2000 were hit by their partner during the year after childbirth. Using identified predictors during antenatal care may increase the likelihood of finding women at risk, thereby enhancing the possibility of interventions to prevent this crime and health hazard.
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| 31. |
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| 32. |
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| 33. |
- Trulsson, O., et al.
(författare)
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The silent child - : Mother´s experiences before, during and after stillbirth
- 2004
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Ingår i: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 31:3, s. 189-195
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The quality of care received by a woman who gives birth to a dead baby is crucial for her long-term well-being, and limiting the period between diagnosis of intrauterine death and induction of delivery decreases her anxiety risk. The primary objective of this study was to explore why induction of delivery for most women should not be delayed more than 24 hours from the diagnosis of intrauterine death. A secondary objective was to determine how the time between diagnosis and delivery should be spent. METHODS: Twelve women were interviewed about their experience before and during the diagnosis of their baby's death and the event of birth. Interviews took place 6 to 18 months after the delivery and were analyzed using a phenomenological methodology. RESULTS: Women experienced premonition, difficulty communicating their worry, cessation of verbal communication with staff, unreality and numbing, desire to get rid of the dead child immediately, going through childbirth, and total silence. Many women believed that they were not respected as a human being during the process of diagnosing the intrauterine death. Themes emerged indicating caregivers should not reduce to zero the time between diagnosis of intrauterine death and induction of delivery. Time may be needed to obtain medical information about the delivery and to prepare the woman for meeting with and saying goodbye to her long-awaited but now silent baby. CONCLUSION: The period between diagnosis of intrauterine death and induction of delivery may give health professionals a major opportunity to improve a woman's ability to cope with the event of stillbirth and prepare her to meet with her loved but now silent baby. Further clinical research can identify supportive mechanisms for parents, and sources of iatrogenic psychological trauma that should be eliminated.
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| 34. |
- Velandia, Marianne, et al.
(författare)
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Onset of Vocal Interaction Between Parents and Newborns in Skin-to-Skin Contact Immediately After Elective Cesarean Section
- 2010
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Ingår i: Birth. - : Wiley Periodicals Inc.. - 0730-7659 .- 1523-536X. ; 7:3, s. 192-201
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cesarean section is associated with delayed mother-infant interaction because neither the mother nor the father routinely maintains skin-to-skin contact with the infant after birth. The aim of the study was to explore and compare parent-newborn vocal interaction when the infant is placed in skin-to-skin contact either with the mother or the father immediately after a planned cesarean section. Methods: A total of 37 healthy infants born to primiparas were randomized to 30 minutes of skin-to-skin contact either with fathers or mothers after an initial 5 minutes of skin-to-skin contact with the mothers after birth. The newborns’ and parents’ vocal interaction were recorded on a vid-eotape and audiotape. The following variables were explored: newborns’ and parents’ soliciting, newborns’ crying and whining, and parental speech directed to the other parent and to the newborn. Results: Newborns’ soliciting increased over time (p = 0.032). Both fathers and mothers in skin-to-skin contact communicated more vocally with the newborn than did fathers (p = 0.003) and mothers (p = 0.009) without skin-to-skin contact. Fathers in skin-to-skin contact also communicated more with the mother (p = 0.046) and performed more soliciting responses than the control fathers (p = 0.010). Infants in skin-to-skin con-tact with their fathers cried significantly less than those in skin-to-skin contact with their mothers (p = 0.002) and shifted to a relaxed state earlier than in skin-to-skin contact with mothers (p = 0.029). Conclusions: Skin-to-skin contact between infants and parents immediately after planned cesarean section promotes vocal interaction. When placed in skin-to-skin contact and exposed to the parents’ speech, the infants initiated communication with soliciting calls with the parents within approximately 15 minutes after birth. These findings give reason to encourage parents to keep the newborn in skin-to-skin contact after cesarean section, to support the early onset of the first vocal communication.
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| 35. |
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| 36. |
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| 37. |
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| 38. |
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| 39. |
- Waldenström, Ulla, et al.
(författare)
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A negative birth experience : prevalence and risk factors in a national sample.
- 2004
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Ingår i: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 31:1, s. 17-27
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A woman's dissatisfaction with the experience of labor and birth may affect her emotional well-being and willingness to have another baby. The aim of this study was to investigate the prevalence and risk factors of a negative birth experience in a national sample. METHODS: A longitudinal cohort study of 2541 women recruited from all antenatal clinics in Sweden during 3 weeks spread over 1 year was conducted. Data were collected by three questionnaires, which measured women's global experience of labor and birth 1 year after the birth, and obtained information on possible risk factors during pregnancy and 2 months after the birth. RESULTS: Seven percent of the women had a negative birth experience. The following risk factors were found: (1) factors related to unexpected medical problems, such as emergency operative delivery, induction, augmentation of labor, and infant transfer to neonatal care; (2) factors related to the woman's social life, such as unwanted pregnancy and lack of support from partner; (3) factors related to the woman's feelings during labor, such as pain and lack of control; and (4) factors that may be easier to influence by the caregivers, such as insufficient time allocated to the woman's own questions at antenatal checkups, lack of support during labor, and administration of obstetric analgesia. CONCLUSIONS: Many risk factors were related to unexpected medical problems and participants' social background. Of the established methods to improve women's birth experience, childbirth education and obstetric analgesia seemed to be less effective, whereas support in labor and listening to the woman's own issues may be underestimated.
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| 40. |
- Ashish, K.C. 1982-, et al.
(författare)
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Coverage, associated factors, and impact of companionship during labor : A large-scale observational study in six hospitals in Nepal
- 2019
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Ingår i: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 47:1, s. 80-88
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Companionship at the time of birth is a nonclinical intervention that has been proven to improve the quality of intrapartum care. This study aims to evaluate the coverage, associated factors, and impact of companionship during labor at public hospitals in Nepal.METHODS: We conducted a cross-sectional observational study in six public hospitals in Nepal. The study was conducted from July 2018 to August 2018. Data were collected on sociodemographic, maternal, obstetric, and neonatal characteristics from patient case notes and through predischarge interviews. Coverage of companionship during labor and its association with intrapartum care was analyzed. Bivariate and multivariate analyses were done to assess the association between companionship during labor and demographic, obstetric, and neonatal characteristics.RESULTS: A total of 63 077 women participated in the study with 19% of them having a companion during labor. Women aged 19-24 years had 65% higher odds of having a companion during labor compared with women aged 35 years and older (aOR 1.65 [95% CI, 1.40-1.94]). Women who were from an advantaged ethnic group (Chhetri/Brahmin) had fourfold higher odds of having a companion than women from a disadvantaged group (aOR 3.84; [95% CI, 3.24-4.52]). Women who had companions during labor had fewer unnecessary cesarean births than those who had no companions (5.2% vs 6.8%, P < .001).CONCLUSIONS: In Nepal, sociodemographic factors affect women's likelihood of having a companion during labor. As companionship during labor is associated with improved quality of care, health facilities should encourage women's access to birth companions.
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| 41. |
- Bakken, K. S., et al.
(författare)
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Higher risk for adverse obstetric outcomes among immigrants of African and Asian Descent: A comparison study at a low-risk maternity hospital in Norway
- 2015
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Ingår i: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 42:2, s. 132-140
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Tidskriftsartikel (refereegranskat)abstract
- Background: Immigrants have higher risks for some adverse obstetric outcomes, and 40 percent of women giving birth at the low-risk maternity ward in Baerum Hospital, Norway, are immigrants. This study compared obstetric outcomes between immigrants and ethnic Norwegians giving birth in a low-risk setting. Methods: This was a population-based study linking the Medical Birth Registry of Norway to Statistics Norway. The study included the first registered birth during the study period to immigrant and ethnic Norwegian women at Baerum Hospital from 2006 to 2010. The main outcome measures were onset of labor, operative vaginal delivery, cesarean delivery, episiotomy, postpartum bleeding >500mL, epidural analgesia, labor dystocia, gestational age, meconium-stained liquor, 5-minute Apgar score, birthweight, and transfer to a neonatal intensive care unit. Results: A total of 11,540 women originating from 141 countries were divided into seven groups. Compared with Norwegians, women from East, Southeast, and Central Asia had increased risk for operative vaginal delivery, postpartum bleeding, and low Apgar score. The African women had increased risk for postterm birth, meconium-stained liquor, episiotomy, operative vaginal delivery, emergency cesarean delivery, postpartum bleeding, low Apgar score, and low birthweight. Women from South and Western Asia had increased risk for low birthweight. Conclusion: Obstetric outcomes of immigrants differ significantly from those of Norwegians, even in a low-risk maternity unit. Thus, immigrant women would benefit from more targeted care during pregnancy and childbirth, even in low-risk settings. © 2015 Wiley Periodicals, Inc.
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| 42. |
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| 43. |
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| 44. |
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| 45. |
- Edqvist, Malin, 1971, et al.
(författare)
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Midwives' Management during the Second Stage of Labor in Relation to Second-Degree Tears-An Experimental Study
- 2017
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Ingår i: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 44:1, s. 86-94
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Most women who give birth for the first time experience some form of perineal trauma. Second-degree tears contribute to long-term consequences for women and are a risk factor for occult anal sphincter injuries. The objective of this study was to evaluate a multifaceted midwifery intervention designed to reduce second-degree tears among primiparous women.METHODS: An experimental cohort study where a multifaceted intervention consisting of 1) spontaneous pushing, 2) all birth positions with flexibility in the sacro-iliac joints, and 3) a two-step head-to-body delivery was compared with standard care. Crude and Adjusted OR (95% CI) were calculated between the intervention and the standard care group, for the various explanatory variables.RESULTS: A total of 597 primiparous women participated in the study, 296 in the intervention group and 301 in the standard care group. The prevalence of second-degree tears was lower in the intervention group: [Adj. OR 0.53 (95% CI 0.33-0.84)]. A low prevalence of episiotomy was found in both groups (1.7 and 3.0%). The prevalence of epidural analgesia was 61.1 percent. Despite the high use of epidural analgesia, the midwives in the intervention group managed to use the intervention.CONCLUSION: It is possible to reduce second-degree tears among primiparous women with the use of a multifaceted midwifery intervention without increasing the prevalence of episiotomy. Furthermore, the intervention is possible to employ in larger maternity wards with midwives caring for women with both low- and high-risk pregnancies.
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| 46. |
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| 47. |
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| 48. |
- Elvander, Charlotte, et al.
(författare)
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Severe perineal trauma among women undergoing vaginal birth after cesarean delivery : A population-based cohort study
- 2019
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Ingår i: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 46:2, s. 379-386
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Tidskriftsartikel (refereegranskat)abstract
- Background: To examine risk of severe perineal trauma among nulliparous women and those undergoing vaginal birth after cesarean delivery (VBAC). Methods: This is a population-based cohort study of all births to women with their two first consecutive singleton pregnancies in Stockholm-Gotland Sweden between 2008 and 2014. Risk of severe perineal trauma was compared between nulliparous women and those undergoing VBAC with severe perineal trauma being the main outcome measure. Associations between indication and timing of primary cesarean delivery and risk of severe perineal trauma in subsequent vaginal birth were analyzed using Poisson regression analysis. Results: The rate of severe perineal trauma among nulliparous women and those undergoing VBAC was 7.0% and 12.3%, respectively. Compared with nulliparous women, those undergoing VBAC were significantly older, had a shorter stature, and gave birth in a non-upright position to heavier infants with larger head circumferences. The rate of instrumental vaginal delivery among nulliparous women and those undergoing VBAC was 19.3% and 20.2%, respectively (P = 0.331). An increased risk of severe perineal trauma remained after adjustments among those undergoing VBAC (adjusted risk ratio 1.42, 95% CI 1.23-1.63). Level of risk was not associated with indication (dystocia or signs of fetal distress) of primary cesarean delivery, nor how far the woman had progressed in labor (fully dilated versus planned cesarean delivery) before delivering by cesarean. Conclusions: Compared with nulliparous women, those undergoing VBAC are at increased risk of severe perineal trauma, irrespective of indication and timing of primary cesarean delivery.
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| 49. |
- 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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| 50. |
- Hildingsson, Ingegerd, et al.
(författare)
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How Long Is a Normal Labor? Contemporary Patterns of Labor and Birth in a Low-Risk Sample of 1,612 Women from Four Nordic Countries
- 2015
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Ingår i: Birth-Issues in Perinatal Care. - : Wiley. - 0730-7659 .- 1523-536X. ; 42:4, s. 346-353
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Normal progress of labor is a subject for discussion among professionals. The aim of this study was to assess the duration of labor in women with a planned home birth and spontaneous onset who gave birth at home or in hospital after transfer. Methods: This is a population-based study of home births in four Nordic countries (Denmark, Iceland, Norway, and Sweden). All midwives assisting at a home birth from 2008 to 2013 were asked to provide information about home births using a questionnaire. Results: Birth data from 1,612 women, from Denmark (n = 1,170), Norway (n = 263), Sweden (n = 138), and Iceland (n = 41) were included. The total median duration from onset of labor until the birth of the baby was approximately 14 hours for primiparas and 7.25 hours for multiparas. The duration of the different phases varied between countries. Blood loss more than 1,000 mL and perineal ruptures that needed suturing were associated with a longer pushing phase and the latter with country of residence, parity, single status, and the baby's weight. Conclusion: In this population of healthy women with a low prevalence of interventions, the total duration of labor was fairly similar to what is described in the literature for multiparas, but longer for primiparas. Although the duration of the phases of labor differed among countries, it was to a minor extent associated with severe outcomes. (BIRTH 42:4 December 2015)
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