| 1. |
- Ayala, Ana, et al.
(författare)
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Newborn infants who received skin-to-skin contact with fathers after Caesarean sections showed stable physiological patterns.
- 2021
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 110:5, s. 1461-1467
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Separating infants and their parents after a Caesarean section is still the routine care worldwide. This study investigated three caregiving models on the wakefulness and physiological parameters of full-term infants after an elective Caesarean section.METHODS: Newborn infants born in a Chilean public hospital in 2009-12 were randomised to three groups: cot, fathers' arms or skin-to-skin contact with their father. They were assessed at 15-minute intervals, from 45 to 120 minutes after the Caesarean section. Their physiological parameters were measured, and their wakefulness was assessed using the Neonatal Behavioural Assessment Scale.RESULTS: We studied 95 infant (53% girls) born at a mean gestational age of 38.9 ± 0.9 weeks. Heart rates were significantly higher in the skin-to-skin than cot or fathers' arms groups and showed greater stability over time. Wakefulness was initially higher in the skin-to-skin group, but there were no significant differences by the end of the observation. There were no differences between the groups in peripheral oxygen saturation. Skin-to-skin contact had no negative impact on the infants.CONCLUSION: The skin-to-skin group showed some advantages over the cot and fathers' arms groups when it came to establishing stable physiological parameters and wakefulness. This approach should be supported during mother-infant separation.
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| 2. |
- Andersson, Ewa, et al.
(författare)
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Mothers' satisfaction with group antenatal care versus individual antenatal care : A clinical trial
- 2013
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 4:3, s. 113-120
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to compare women's satisfaction with group based antenatal care and standard care. Design: A randomised control trial where midwives were randomized to perform either GBAC or standard care. Women were invited to evaluate the two models of care. Data was collected by two questionnaires, in early pregnancy and six months after birth. Crude and adjusted odds ratios with a 95% confidence interval were calculated by model of care. Settings: Twelve antenatal clinics in Sweden between September 2008 and December 2010. Participants: Women in various part of Sweden (n = 700). Findings: In total, 8:16 variables in GBAC versus 9:16 in standard care were reported as deficient. Women in GBAC reported significantly less deficiencies with information about labour/birth OR 0.16 (0.10-0.27), breastfeeding OR 0.58 (0.37-0.90) and time following birth OR 0.61 (0.40-0.94). Engagement from the midwives OR 0.44 (0.25-0.78) and being taken seriously OR 0.55 (0.31-0.98) were also found to be less deficient. Women in GBAC reported the highest level of deficiency with information about pregnancy OR 3.45 (2.03-5.85) but reported less deficiency with time to plan the birth OR 0.61 (0.39-0.96). In addition, women in GBAC more satisfied with care in supporting contact with other parents OR 3.86 (2.30-6.46) and felt more support to initiate breastfeeding OR 1.75 (1.02-2.88). Conclusions: Women in both models of care considered the care as deficient in more than half of all areas. Variables that differed between the two models favoured group based antenatal care.
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| 3. |
- Andersson, Ewa, et al.
(författare)
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Parents' experiences and perceptions of group-based antenatal care in four clinics in Sweden
- 2012
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 28:4, s. 442-448
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Tidskriftsartikel (refereegranskat)abstract
- Background: group-based antenatal care consists of six to nine two-hour sessions in which information is shared and discussed during the first hour and individual examinations are conducted during the second hour. Groups generally consist of six to eight pregnant women. Parent education is built into the programme, which originated in the United States and was introduced in Sweden at the beginning of the year of 2000. Objective: to investigate parents' experiences of group antenatal care in four different clinics in Sweden. Method: a qualitative study was conducted using content analysis five group interviews and eleven individual interviews with parents who experienced group-based antenatal care. An interview guide was used. Settings: the study was set in four antenatal clinics that had offered group-based antenatal care for at least one year. The clinics were located in three different areas of Sweden. Participants: the participants were women and their partners who had experienced group-based antenatal care during pregnancy. Other criteria for participation were mastery of the Swedish language and having followed the care programme. Findings: three themes emerged, 'The care-combining individual physical needs with preparation for parenthood, refers to the context, organisation, and content of care'. Group antenatal care with inbuilt parent education was appreciated, but respondents reported that they felt unprepared for the first few weeks after birth. Their medical needs (for physical assessment and screening) were, however, fulfilled. The theme, 'The group-a composed recipient of care', showed the participants role and experience. The role could be passive or active in groups or described as sharers. Groups helped parents normalise their symptoms. The theme, 'The midwife-a controlling professional', showed midwives are ignorant of gender issues but, for their medical knowledge, viewed as respectable professionals. Key conclusions: in the four clinics studied, group-based antenatal care appeared to meet parents' needs for physical assessment and screening. Parents identified that the groups helped them prepare for birth but not for parenthood. The group model created a forum for sharing experiences and helped participants to normalise their pregnancy symptoms. Implications for practise: the midwife's role in facilitating group-based antenatal care demands new pedagogical strategies and approaches.
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| 4. |
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| 5. |
- Ayala, Ana, et al.
(författare)
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Fathers' care of the newborn infant after caesarean section in Chile : A qualitative study
- 2016
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 8, s. 75-81
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Tidskriftsartikel (refereegranskat)abstract
- Background: In Chilean hospitals the current model of care after caesarean section is to separate newborn infants from both parents. The care of newborn infants and the parents' experience immediately after caesarean section requires further exploration. Aim: To describe fathers' experiences and perceptions of being the primary caregiver to their newborn infant during the first 90 minutes after caesarean section in a public general maternity hospital setting in Santiago de Chile. Method: The questionnaire was one part of a larger research programme named: "Caregiving Models after Elective Caesarean Section Parents' perceptions and effects on infants' wellbeing". Four open ended questions were used to gather written text on the experiences and perceptions of 95 fathers who were the primary caregiver to their newborn infant. Ethical approval was obtained from the Ethics Committee, Scientific Assessment Metropolitan Health Service South East. Systematic text condensation according to Malterud's description was used for analysis of the written text. Findings: Two themes were identified: "understanding the first moment of life" and "shared responsibility for future family life" with each theme divided into six categories. Conclusion: This study concludes by arguing that in situations where the mother is unavailable or unable to provide basic care, the father should be supported to care for the newborn infant. Clinical implications: Parents should be made aware of the benefits of this caring model especially when mother and baby have been separated after birth.
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| 6. |
- Ayala, Ana, et al.
(författare)
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Mother’s Experiences and Perceptions of a Continuous Caring Model with Fathers after Caesarean Section : A Qualitative Study
- 2015
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Ingår i: The Open Women's Health Journal. - : Openventio Publishers. - 1874-2912. ; 1:3, s. 63-71
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Tidskriftsartikel (refereegranskat)abstract
- Background: In Chile, mothers and newborns are separated after caesarean sections. The caesarean section rate in Chile is approximately 40%. Once separated, newborns will miss out on the benefits of early contact unless a suitable model of early newborn contact after caesarean section is initiated.Aim: To describe mothers experiences and perceptions of a continuous parental model of newborn care after caesarean section during mother-infant separation.Methods: A questionnaire with 4 open ended questions to gather data on the experiences and perceptions of 95 mothers in the obstetric service of Sótero Del Rio Hospital in Chile between 2009 and 2012. Data were analyzed using qualitative content analysis.Results: One theme family friendly practice after caesarean section and four categories. Mothers described the benefits of this model of caring. The fathers presence was important to mother and baby. Mothers were reassured that the baby was not left alone with staff. It was important for the mothers to see that the father could love the baby as much as the mother. This model of care helped create ties between the father and newborn during the period of mother-infant separation and later with the mother.Conclusions: Family friendly practice after caesarean section was an important health care intervention for the whole family. This model could be stratified in the Chilean context in the case of complicated births and all caesarean sections.Clinical Implications: In the Chilean context, there is the potential to increase the number of parents who get to hold their baby immediately after birth and for as long as they like. When the mother and infant are separated after birth, parents can be informed about the benefits of this caring model. Further research using randomized control trials may support biological advantages.
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| 7. |
- Berg, Marie, 1955
(författare)
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Genuine Caring in Caring for the Genuine : Childbearing and high risk as experienced by women and midwives
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The experience of pregnancy and childbirth is a central life event with special implications for women at high risk. This thesis describes the meaning of pregnancy, childbirth and midwifery care in four qualitative interview studies based on the lifeworld theory. Women were interviewed during pregnancy and within one week after childbirth. Midwives were interviewed concerning midwifery care for women at high risk. In an intervention study, childbirth experience as reported through a post partum questionnaire was compared between women receiving standard care and women who had formulated a birth plan preceded by a questionnaire on their expectations and feelings about childbirth.The findings emphasise that childbearing women at high risk live in an extremely vulnerable situation. The vulnerability is obvious in the use of an individual birth plan, where negative feelings become more frequent in women at high risk than in those with normal pregnancy and childbirth. During pregnancy the women feel a moral commitment towards the child, including feelings of objectification and of exaggerated responsibility. During an obstetrically complicated childbirth the essential meaning is the women’s desire to be recognised and affirmed as individual persons. Like women with normal pregnancy and childbirth, they need an emotionally present midwife who sees, give trust and supports.Good midwifery care of childbearing women at high risk is synthesised as "genuine caring in caring for the genuine". The ethos of caring constitutes the basis of caring. Women’s transition during pregnancy and childbirth is described as a genuinely natural process. Midwives have a special responsibility to encourage and preserve this process within women at high risk. The caring relationship is the core and the most essential tool in the care. Distinctive features in the midwifery care are embodied knowledge, physical as well as emotional presence, sensitivity, a mutual dialogue including shared control between midwife and woman, and confirmation and support of the genuine in each woman. The midwifery care is a struggle and a balance between natural and medical perspectives.
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| 8. |
- Blix-Lindström, S, et al.
(författare)
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Midwives' navigation and perceived power during decision-making related to augmentation of labour
- 2007
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138. ; 24:2, s. 190-198
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: to explore and understand how midwives perceive and experience decision-making about augmentation of labour. DESIGN: focus-group discussions. SETTING: Stockholm, Sweden. PARTICIPANTS: 20 midwives experienced in working in labour wards. FINDINGS: five categories were identified that illustrate the factors considered by the midwives to influence decision-making during augmentation of labour: 'regulations and guidelines'; 'shortage of delivery rooms'; 'influence of obstetricians'; 'women in labour'; and 'midwives' professional selves'. The theme identified was how midwives managed to 'navigate' these factors, which provided midwives with a decisive influence during the decision-making process. KEY CONCLUSIONS AND IMPLICATIONS: midwife job satisfaction can result from a sense of professional power over the possibility of navigating factors that influence decision-making during augmentation of labour. This sense of power can subsequently influence co-operation with both obstetricians and women during labour.
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| 9. |
- Blix- Lindström, S., et al.
(författare)
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Women's satisfaction with decision-making related to augmentation of labour
- 2004
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138. ; 20:1, s. 104-112
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: to describe women's experiences of participating in decision-making related to augmentation of labour. DESIGN: a qualitative approach using modified grounded theory technique. Open-ended interviews were conducted 1-3 days after childbirth. SETTING: the interviews were performed in the postnatal wards in five hospitals (tertiary level) in Stockholm, Sweden. PARTICIPANTS: 20 newly delivered women who had received oxytocin infusion for augmentation of labour during childbirth. FINDINGS AND KEY CONCLUSIONS: support and guidance from midwives in combination with knowledge and expectations about the intervention seemed to be important for women's satisfaction with decision-making concerning augmentation of labour. Four patterns of decision-making were found. One group of women participated in the decision-making regarding augmentation of labour while a second group was invited, but refrained from participation. These women were satisfied with the decisions made. A third group of women did not participate, but wanted to and they were dissatisfied with the decisions made. The fourth group did not participate in the decision-making-and did not want to. These women accepted the decisions made. The desire for information exceeded the desire for involvement in decision-making and the majority of women had confidence in the midwives' assessment.
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| 10. |
- Christensson, Kyllike, et al.
(författare)
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The Challenge of Improving Perinatal Care in settings with Limited Resources : Observations of Midwifery Practices in Mozambique
- 2006
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Ingår i: African Journal of Reproductive Health. - Benin City, Edo State, Nigeria : Women's Health and Action Research Centre. - 1118-4841. ; 10:1, s. 47-61
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to observe and analyze midwifery care routine related to asphyxia and hypothermia during the perinatal period and to investigate the effect of an in-service education program. A direct non-participant pre-and post intervention observation study of midwifery a performance during childbirth was conducted at a labour ward in Maputo. The observed groups consisted of 702 and 616 midwifery –attended deliveries. Examination was also conducted of the partographs (702 vs. 616). The quality of midwifery care related to prevention and early detection of asphyxia and hypothermia was found to be inadequate and the intervention had no significant effect upon the midwives' performances. This could be attributed to the quality of the intervention itself or to failure of implementing managerial decisions such as transfer to partograph documentation from obstetricians to midwives. Change in professional performance does not automatically follow awareness of evidence-based midwifery practices, but requires behavioural change, which may be more difficult to achieve.
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| 11. |
- Dsilna, Ann, et al.
(författare)
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Behavioral stress is affected by the mode of tube feeding in very low birth weight infants
- 2008
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Ingår i: The Clinical journal of pain. - 1536-5409. ; 24:5, s. 447-55
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the effect of continuous versus bolus feeding on behavioral responses of stress in very low birth weight infants during early postnatal life. METHODS: In a randomized, controlled trial conducted at 3 neonatal units, 70 premature infants with gestational age 24 to 29 weeks and birth weight <1200 g were randomly assigned to 1 of 3 feeding methods: continuous nasogastric feeding, bolus nasogastric feeding, and bolus orogastric feeding. Behavioral responses were video recorded during feeding at 7 and 15 days of postnatal age and at 32 weeks of postmenstrual age. The odds ratio (OR) of manifest behavioral stress was calculated by means of logistic regression. RESULTS: A significantly higher risk of a behavioral stress response in bolus-fed infants compared with continuous-fed infants at 15 days of age was observed, [adjusted OR=4.1 (95% confidence interval: 1.1-15.4)]. A similar difference was observed at 32 weeks of postmenstrual age [adjusted OR=4.2 (95% confidence interval: 1.0-17.8)]. In addition, bolus-fed infants showed statistically significant higher need of behavioral and physiologic stabilization during feeding. DISCUSSION: This trial suggests that continuous feeding is associated with lower behavioral stress response as compared with bolus feeding among very low birth weight infants, in early postnatal life.
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| 12. |
- Dsilna, Ann, et al.
(författare)
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Continuous feeding promotes gastrointestinal tolerance and growth in very low birth weight infants
- 2005
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Ingår i: Journal of Pediatrics. - : Elsevier BV. - 0022-3476 .- 1097-6833. ; 147:1, s. 43-49
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the effects of continuous versus intermittent feeding on gastrointestinal tolerance and growth in very low birth weight (VLBW) infants. STUDY DESIGN: In a randomized, controlled trial conducted at 3 neonatal units, 70 premature infants with a gestational age 24 to 29 weeks and birth weight < 1200 g were assigned to 1 of 3 feeding methods: continuous nasogastric feeding, intermittent nasogastric feeding, or intermittent orogastric feeding. Feeding was initiated within 30 hours of birth. Daily enteral and parenteral volumes, caloric and protein intakes, growth, enteral intolerance, and clinical complications were recorded. Cox regression analysis was used to determine primary outcome, the time to achieve full enteral feeding. RESULTS: The continuously fed infants achieved full enteral feeding significantly faster than the intermittently fed infants (hazard ratio [HR] = 1.86; 95% confidence interval [CI] = 1.07 to 3.22). In stratified analysis according to birth weight, the improvement was even more pronounced in the smallest infants, those with birth weight < or = 850 g (adjusted HR = 4.13; 95% CI = 1.48 to 11.53). Growth rate was significantly faster in the continuously fed infants ( P = .002). CONCLUSION: In VLBW infants, continuous feeding seems to be better than intermittent feeding with regard to gastrointestinal tolerance and growth.
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| 13. |
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| 14. |
- Erlandsson, Kerstin, 1961-, et al.
(författare)
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Do caregiving models after caesarean birth influence the infant's breathing adaptation and crying? A pilote study
- 2008
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Ingår i: Journal of Children's and Young People's Nursing. - : MA Healthcare. - 1753-1594 .- 2052-2886. ; 2:1, s. 7-12
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Tidskriftsartikel (refereegranskat)abstract
- Cesarean birth is a mode of delivery that often minimizes the mothers’ possibility to handle her term baby skin-to-skin while the father takes care of the baby for part, or all, of the first hours. No attention has, as far as we know, been given to different caregiving models and their eventual effects on the adaptation of breathing for the term infant born by elective cesarean. Previous publications on breathing patterns in newborn infants have mostly been conducted on premature infants in kangaroo care. The aim of this pilot study was to compare the effects of two caregiving models on the adaptation of breathing and infant crying after elective cesarean section, in term infants during the first hours after birth. Term infants born by elective cesarean were held skin-to-skin on their father’s chest or cared for in a cot during the mother’s post-operative observation stay. Thirteen father-infant pairs participated in a pilot sub-study with a randomized control trial design. Data were collected both by respiratory inductance plethysmography (RIP) and by tape-recorded crying time. The data raises important questions about the effects on breathing adaptation in relation to caregiving models. The infants in the skin-to-skin group showed significantly higher inspiratory and expiratory air flows, larger breath volume (all p<0.001) and minute ventilation, compared with the cot group. The infants in the skin-to-skin group cried less than the infants in the cot group (p<0.001). A caregiving model where fathers hold their infants skin-to-skin in an upright position on their chest has a positive impact on the infants’ respiratory adaptation and reduced infant crying. Larger studies of caregiving models after elective cesarean birth on the adaptation of breathing need to be conducted.
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| 15. |
- Erlandsson, Kerstin, et al.
(författare)
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Fatherhood as Taking the Child to Oneself : a Phenomenological Observation Study after Caesarean Birth
- 2006
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Ingår i: Indo-Pacific journal of phenomenology. - 1445-7377. ; 6:2, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- This paper describes the meaning of a father’s presence with a full-term healthy child delivered by caesarean section, as observed during the routine post-operative separation of mother and child. Videotaped observations recorded at a maternity clinic located in the metropolitan area of Stockholm, Sweden formed the basis for the study, in which fifteen fathers with their infants participated within two hours of elective caesarean delivery in the 37th - 40th week of pregnancy. A phenomenological analysis based on Giorgi’s method was conducted on the data. The description of the new father’s experiences that emerged pointed to a process of being and becoming in taking the child to himself. Fatherhood developed gradually as a result of recurrent experiences of the child’s expressions. There was an ebb and flow between taking on the role of being a father and physical withdrawal from the role. The findings of this study not only confirm previous accounts of new fathers’ experiences, but go further in revealing an ebb and flow variation in the fathers’ involvement. What this indicates is that the process of transition to fatherhood requires not only presence but time. The period required for this process thus must not be disturbed, but supported, trusting in the father’s ability to assume his role as a father. It is suggested that, in addition to their relevance in guiding the attitudes and expectations of those professionally involved in postnatal care and community health, these findings could be useful in antenatal courses for parents, and especially in instances when caesarean birth is planned, to highlight the meaning of the role of fathers as caregivers
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| 16. |
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| 17. |
- Erlandsson, Kerstin, et al.
(författare)
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Fathers’ lived experiences of getting to know their baby while acting as primary caregivers immediately following birth
- 2008
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Ingår i: The Journal of perinatal education.. - : Springer Publishing Company. - 1058-1243. ; 17:2, s. 28-36
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to describe the meaning of the father’s lived experiences when taking care of his infant as the primary caregiver during the first hours after birth, when the infant was apart from the mother due to the mother’s postoperative care. Fifteen fathers were interviewed between 8 days to 6 weeks after birth. The results describe a movement towards father-child togetherness characterized by an immediate and gradual change within the father as he undertakes increasing responsibility while getting to know his child. The results can be reflected upon in antenatal classes in order to integrate the father’s important role in the care of his infant, in a situation where the mother-infant dyad has been interrupted.
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| 18. |
- 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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| 19. |
- Flygare Wallén, Eva, 1956-, et al.
(författare)
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A school-based intervention associated with improvements in cardiometabolic risk profiles in young people with intellectual disabilities
- 2013
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Ingår i: Journal of Intellectual Disabilities. - : SAGE Publications. - 1744-6295 .- 1744-6309. ; 17:1, s. 38-50
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluates a multifactorial school-based intervention with the aim of decreasing cardiometabolic risk factors by means of a healthy lifestyle, primarily with daily physical activity and healthy food during school hours, at an upper secondary school for students with intellectual disabilities. The outcome is measured in terms of cardiometabolic risk factors and cardiovascular fitness, both known to increase the risk of future cardiovascular disease, type 2 diabetes and cancer. Two years of intervention resulted in a positive trend in several measured cardiometabolic risk factors, with no increase in fat mass. Cardiovascular fitness levels were unchanged. We conclude that a healthy school environment can contribute to a deceleration of both fat mass gain and loss of cardiovascular fitness.
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| 20. |
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| 21. |
- Halldén, Britt-Marie, et al.
(författare)
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Early abortion as narrated by young Swedish women
- 2009
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 23:2, s. 243-250
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the study was to illuminate meanings of having had an induced abortion among young Swedish women. METHODS: Narrative interviews were conducted with ten 18-20-year-old women 2-6 weeks after a medical or surgical abortion in the sixth to twelfth week of pregnancy. Data were analysed according to a phenomenological hermeneutic method. RESULTS: The study disclosed a multitude of complex meanings in the young women's lived experiences of induced abortion. Four themes were revealed: having cared for and protected the unimagined pregnancy, taking the life of my child-to-be with pain, being sensitive to the approval of others and imagining the taken away child-to-be. The results are discussed in light of Nussbaum's theory of development ethics. The young women's ability to be responsible for their choices regarding their own welfare and others' well-being in a life cycle perspective was disclosed, despite the pain inherent in the responsibility of taking the life of their own child-to-be. CONCLUSIONS: The young women's narratives were replete with ethical reasoning regarding existential matters related to their responsibility of choosing between induced abortion and parenthood and how to live their lives with this experience. Health-care professionals could promote young women's capability to be responsible, as well as the development of trust in their own fertility and constructive relationships with significant others. In the development of the prevention of unintended pregnancies and the sexual education of young people in Sweden existential dimensions of undergoing an abortion should be given attention.
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| 22. |
- Halldén, Britt-Marie, et al.
(författare)
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Meanings of being pregnant and having decided on abortion : young Swedish women's experiences.
- 2005
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Ingår i: Health Care for Women International. - : Informa UK Limited. - 0739-9332 .- 1096-4665. ; 26:9, s. 788-806
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Tidskriftsartikel (refereegranskat)abstract
- In-depth interviews about the experience of being pregnant and having decided on abortion were conducted with 10 young Swedish women. A phenomenological-hermeneutic study disclosed a complex life world summarised as "I'm happy about my fertility but I choose not to give life now." Four themes were revealed: encountering an unexpected understanding of oneself and one's fertility, desiring to be understood by trusted others, trying out different positions in relation to pregnancy and abortion, and approaching planned adult motherhood. The results indicate that addressing young women's concerns about fertility might be important in reproductive care.
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| 23. |
- Halldén, Britt-Marie, et al.
(författare)
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Swedish young men's lived experiences of a girlfriend's early induced abortion
- 2010
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Ingår i: International Journal of Men's Health. - : Men's Studies Press, LLC. - 1532-6306 .- 1933-0278. ; 9:2, s. 126-143
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Tidskriftsartikel (refereegranskat)abstract
- Abortion rates worldwide suggest that a large number of young men are in fact exposed to the experience of an abortion. This phenomenological hermeneutic study illuminates ten young men's experiences of the abortion process including the abortion itself. In view of their different cultural backgrounds and their stable or merely casual relationship with the girlfriend, their experiences are illuminated in four main themes as; having interrupted a life-giving process, having wished to relieve the girlfriend's pain, having struggled with feelings of helplessness, and standing up for made decisions. The interpreted whole is expressed as; a wish to compensate the girlfriend for her suffering and share with her the responsibility for the abortion. With a view to promoting gender equality in reproductive health the results are discussed in the light of relational ethics and contribute to reflections on current praxis in health-care settings.
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| 24. |
- Halldén, BM, et al.
(författare)
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Ten Swedish Midwives' Lived Experiences of the Care of Teenagers' Early Induced Abortions
- 2011
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Ingår i: Health Care for Women International. - : Taylor & Francis. - 0739-9332 .- 1096-4665. ; 32:5, s. 420-440
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Tidskriftsartikel (refereegranskat)abstract
- This phenomenological hermeneutic study of 10 Swedish midwives illuminates the internal conflicts of values that arise when midwives' professional and personal belief systems clash in encounters with teenagers. Midwives may react emotionally in situations where teenagers ignore advice on contraception by rejecting the use of contraceptives and preferring early abortions as a contraceptive method. The results strengthen the suggestion that caregivers need support in reflecting on how to deal with conflicts of values that may otherwise hinder them in communicating effectively with teenagers and encounter their life-worlds and in challenging their individual assumptions on the shortcomings of using contraceptives.
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| 25. |
- Harder, Maria, et al.
(författare)
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Exploring three-year-old children in a primary child health care situation
- 2009
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Ingår i: Journal of Child Health Care. - : SAGE Publications. - 1367-4935 .- 1741-2889. ; 13:4, s. 383-400
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Tidskriftsartikel (refereegranskat)abstract
- In the Swedish Primary Child Health Care (PCHC) children participate in regular health visits. In these visits children as actors demonstrate their subjective maturity through bodily and verbal expressions. The aim of this study was to explore three-year-old children's expressions when they take part as actors in a PCHC situation. An explorative design with a hermeneutic approach and video observations was used. Twenty-nine children participated. The findings exhibit a variation of expressions in the situation conceptualized as actions in a progression of states: from a state of getting ready to a state of being ready and further to a state where the child strengthens their own self. This progression is dynamic and coloured with the states of not being ready or of being adverse. The conceptualization of children's expressions can contribute towards encouraging nurses' sensitivity when inviting and guiding children in PCHC situations.
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| 26. |
- Harder, Maria, et al.
(författare)
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Five-year-old Children's Tuning-in and Negotiation Staregies in an Immunization Situation
- 2011
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Ingår i: Qualitative Health Research. - : SAGE. - 1049-7323 .- 1552-7557. ; 21:6, s. 818-829
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Tidskriftsartikel (refereegranskat)abstract
- In this article, we have explored 5-year-old children's expressions when they as actors took part in an immunization situation in the Primary Child Health Care (PCHC) service in Sweden. Although children's health and development are the main concern in the PCHC service, their perspectives in such a setting have not been explored fully. To capture children's perspectives we used a hermeneutic design and video observations. The findings revealed children as competent and active participants, contributing to the construction of the PCHC situation in mutuality with the nurse and the parent. The conceptualization of children's expressions and actions revealed how they influenced and dealt with a PCHC situation by using strategies of tuning-in, affirmative negotiation, and delaying negotiation. Understanding children's actions will assist nurses to act with sensitivity when they encounter and support children.
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| 27. |
- Harder, Maria, 1970-, et al.
(författare)
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Four year old children's negotiation strategies to influence and deal with a Primary Health Care situation
- 2013
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Ingår i: Children & society. - : Wiley. - 0951-0605 .- 1099-0860. ; 27:1, s. 35-47
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, children’s health and development are promoted through Primary Child Health Care (PCHC) visits. The children participate in these visits from their own perspective through bodily and verbal expressions. This study explores four-year-old children’s expressions when they as actors take part in a PCHC situation. The conceptualisation of the children’s expressions reveals various actions that exhibit their affirmative and delaying negotiation strategies to influence and deal with these situations. For PCHC nurses, these findings may encourage to view children as negotiating participants and inspire to sensitivity when inviting children and guiding them through health visits
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| 28. |
- Harder, Maria, et al.
(författare)
-
Four year old Children’s strategies of negotiation when they are holding a Primary Child Health Care situation
- 2009
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Konferensbidrag (refereegranskat)abstract
- Four year old Children’s strategies of negotiation when they are holding a Primary Child Health Care situationThe Swedish Primary Child Health Care (PCHC) is assigned to promote children’s (age 0-5) health and development through regular health visits. A child’s first year involves several health checkups, then planned health visits take place at 3, 4 and 5,5 years of age. These health visits is a part of a monitory program to examine the child’s speech development, motor and cognitive functions. During the health visit the child and the parent will meet a PCHC nurse. Recently, the child’s perspective as an actor in the health visit was explored. The result demonstrated how three year old children exhibit various actions in a progression of states. The child progress from a state of getting ready to a state of being ready and further to a state where the child strengthens the own self. This progression is dynamic and coloured with the states of not being ready or of being adverse. The aim of present study is to describe the four year old children’s strategies when they are holding a PCHC situation. The study has an explorative design with a hermeneutic approach and video-observations are used. Twenty-nine children participate and the selection is strategically. Informed consent was gained in writing from all children, parents and nurses. The findings exhibit how the children use various strategies of negotiation when they are holding a PCHC situation. Illuminating children’s perspective by conceptualizing their expressions and strategies may contribute towards encouraging the PCHC nurse’s sensitivity when inviting and guiding children in the health visit.
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| 29. |
- Harder, Maria, et al.
(författare)
-
Preschool children's expression of participation in Primary Child Health Care
- 2008
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Konferensbidrag (refereegranskat)abstract
- Preschool children's expression of participation in primary child health careIntroductionAccording to The Convention on the Rights of Child children have the right to have their voice heard and to participate in situations that involve them.Aim of the studyThe aim of this study was to explore and describe the expression of participation of 3-year old children during their annual primary health care visit.MethodsThe study employed qualitative research design using video-observation, and focused on the actions of twenty-nine 3-year olds in their interaction with the nurse. The varying expressions of the children were captured using hermeneutic analysis.ResultsThe findings demonstrate how 3-year old children prepare themselves for particiaption prior to their health care visit. They arrange their bodies in different positions, ask questions, seek contact with their parent or are absorbed in their thoughts. The children then direct their attention towards the health care activity, by using bodily and/or spoken expressions they respond to the nurse´s invitations. When the children have replyed to the invitation they confirm them self. Findings also show children´s expressions of unpreparedness and reluctance in the health care situation.Conclusion / discussionChildren’s participation occupies either all or part of the body and bodily expressions replace each other in a rapid progression. Children´s spoken expression strengthens their bodily expression.Practical relevanceStudying pre-school children’s expressions in the child health care environment can contribute to promote their participation in their interaction with nursing staff.Research implicationsThis research project will continue by studying the expression of perceived participation of children at 4 and 5,5 years of age during their annual primary health care visit.ReferencesAllmark, P. (2002). The ethics of research with children. Nurse researcher, 10 (2), 7-20.Bronfenbrenner, U. (1979). The ecology of Human Development. Cambridge, Mass. Harward university press.FA, Ministry for Foreign Affairs, (1989). The Convention on the Rights of the Child.Fraser, S., Lewis, V., Ding, S., Kellet, M. & Robinsson, C. (2004). Doing research with children and young people. London: Sage Publications.Hammersley, M. & Atkinson, P. (1995). Ethnography. Principles in Practice. London: RoutledgeMinistry for Health and Social Affairs. (2005). Mötet med barnet. Barnkompetens inom hälso-och sjukvården. 2005.031National Board of Health and Welfare. (1991). Allmänna råd från socialstyrelsen 1991:8. Hälsoundersökningar inom barnhälsovården. Stockholm: Allmänna förlaget.Schutz, A. (1967). The phenomenology of the Social World. Evanston: North-western Univ. Press.
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| 30. |
- Harder, Maria, et al.
(författare)
-
Preschool children's expressions of engagement in Primary Child Health Care
- 2008
-
Ingår i: Archives of Disease in Childhood. ; , s. 114-
-
Konferensbidrag (refereegranskat)abstract
- Preeschool children’s expressions of engagement in primary child health careChildren have their right to give their voice and participate in situations which they are engaged in, according to The Convention on the Rights of Child. The aim of this study was to explore and describe 3 year old children’s expressions of engagement during annual child health care visit.A qualitative research design with video-observations was used. Twenty-nine 3 year old children’s actions were focused when interplaying with the nurse. A hermeneutic analysis was carried out to grasp the children’s varied expressions.The findings demonstrate how 3 year old children, when invited to the health care activity, are preparing themselves to readiness for engagement. They arrange their bodies in different positions, ask questions, seek contact with parent or are absorbed in thoughtfulness. Then the children direct their attention towards the nurse and/or the health care activity with spoken and/or bodily readiness. Children’s engagement occupies the whole body or separate parts of the body. Further, findings demonstrate how bodily expressions replace each other in a rapid process and how the same expressions can have different meaning depending on actual situation. The children’s spoken expressions: strengthen bodily expressions, are responding to nurses’ invitations or are spontaneously conversation.This research project will continue to study expressions of engagement and perceived participation of the children at 4 and 5,5 years of age at their annual primary child health care visits. To take preschool children’s engagement in primary child health care settings into consideration can contribute to promote their participation when interacting with the nurse.
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| 31. |
- Hildingsson, Ingegerd, et al.
(författare)
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African midwifery students’ self-assessed confidence in antenatal care : a multi-country study
- 2019
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Evidence-based antenatal care is one cornerstone in Safe Motherhood and educated and confident midwives remain to be optimal caregivers in Africa. Confidence in antenatal midwifery skills is important and could differ depending on the provision of education among the training institutions across Africa. Objective: The aim of the study was to describe and compare midwifery students’ confidence in basic antenatal skills, in relation to age, sex, program type and level of program. Methods: A survey in seven sub-Saharan African countries was conducted. Enrolled midwifery students from selected midwifery institutions in each country presented selfreported data on confidence to provide antenatal care. Data were collected using a selfadministered questionnaire. The questionnaire consisted of 22 antenatal skills based on the competency framework from the International Confederation of Midwives. The skills were grouped into three domains; Identify fetal and maternal risk factors and educate parents; Manage and document emergent complications and Physical assessment and nutrition. Results: In total, 1407 midwifery students from seven Sub-Saharan countries responded. Almost one third (25-32%) of the students reported high levels of confidence in all three domains. Direct entry programs were associated with higher levels of confidence in all three domains, compared to post-nursing and double degree programs. Students enrolled at education with diploma level presented with high levels of confidence in two out of three domains. Conclusions: A significant proportion of student midwives rated themselves low on confidence to provide ANC. Midwifery students enrolled in direct entry programs reported higher levels of confidence in all domains. It is important that local governments develop education standards, based on recommendations from the International Confederation of midwives. Further research is needed for the evaluation of actual competence.
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| 32. |
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| 33. |
- Jha, Paridhi, et al.
(författare)
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Cashless childbirth, but at a cost : A grounded theory study on quality of intrapartum care in public health facilities in India
- 2016
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 39, s. 78-86
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Tidskriftsartikel (refereegranskat)abstract
- Aim: this study aimed to explore and understand the perceptions and experiences of women regarding quality of care received during childbirth in public health facilities. Design: qualitative in-depth interviews were conducted and analysed using the Grounded Theory approach. Participants: thirteen women who had given vaginal birth to a healthy newborn infant. Setting: participants were interviewed in their homes in one district of Chhattisgarh, India. Data collection: the interview followed a pre-tested guide comprising one key question: How did the women experience and perceive the care provided during labour and childbirth? Findings: 'cashless childbirth but at a cost: subordination during childbirth' was identified as the core category. Women chose a public health facility due to their socio-economic limitations, and to have a cashless and safe childbirth. Participants expressed a sense of trust in public health facilities, and verbalised that free food and ambulance services provided by the government were appreciated. Care during normal birth was medicalised, and women lacked control over the process of their labour. Often, the women experienced verbal and physical abuse, which led to passive acceptance of all the services provided to avoid confrontation with the providers. Conclusions: increasingly higher numbers of women give birth in public health facilities in Chhattisgarh, India, and women who have no alternative place to have a safe and normal birth are the main beneficiaries. The labour rooms are functional, but there is a need for improvement of interpersonal processes, information-sharing, and sensitive treatment of women seeking childbirth services in public health facilities.
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| 34. |
- Jha, Paridhi, et al.
(författare)
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Evaluation of the psychometric properties of Hindi-translated Scale for Measuring Maternal Satisfaction among postnatal women in Chhattisgarh, India
- 2019
-
Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Satisfaction with childbirth services is a multi-dimensional phenomenon, providing relevant insights into women's opinion on quality of services received. Research studies report a dearth of standardised scales that quantify this phenomenon; and none have been tested in India to the best of authors' knowledge. The current study was undertaken to evaluate psychometric properties of Hindi version of the Turkish Scale for Measuring Maternal Satisfaction: Normal and Caesarean Births versions in order to fill this gap. A cross-sectional survey was conducted in selected public health facilities in Chhattisgarh, India. Healthy women (n = 1004) who gave birth to a single, live neonate, vaginally or via Caesarean section participated. Psychometric assessment was carried out in four steps: 1) scales translated from Turkish to Hindi; 2) Content Validity Index scores calculated for Hindi scales; 3) data collection; 4) statistical analyses for Hindi scales (Normal and Caesarean Birth).A 10-factor model with 36 items emerged for both scales. The Hindi- translated Normal Birth and Caesarean Birth scales had good internal reliability (Cronbach’s α coefficients of 0.85 and 0.80, respectively).The Hindi Scales for Measuring Maternal Satisfaction (Normal and Caesarean Birth) are valid and reliable tools for utilization in Indian health facilities. Their multi-dimensional nature presents an opportunity for the care providers and health administrators to incorporate women's opinions in intervention to improve quality of childbirth services. Having an international tool validated within India also provides a platform for comparing cross-country findings.
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| 35. |
- Jha, Paridhi, et al.
(författare)
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Fear of Childbirth and Depressive Symptoms among Postnatal Women : A Cross-sectional Survey from Chhattisgarh, India
- 2018
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 31:2, s. 122-133
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prevalence rates of Fear of Birth and postnatal depressive symptoms have not been explored in Chhattisgarh, India.Objective: To validate Hindi Wijma Delivery Experience Questionnaire and to study the prevalence of Fear of Birth and depressive symptoms among postnatal women.Methods: A cross-sectional survey at seventeen public health facilities in two districts of Chhattisgarh, India among postnatal women who gave birth vaginally or through C-section to a live neonate. Participants were recruited through consecutive sampling based on health facility records of daily births. Data were collected through one-to-one interviews using the Wijma Delivery Experience Questionnaire Version B and the Edinburgh Postnatal Depression Scale. Non-parametric associations and linear regression data analyses were performed.Results: The Hindi Wijma Delivery Experience Questionnaire Version B had reliable psychometric properties. The prevalence of Fear of Birth and depressive symptoms among postnatal women were 13.1% and 17.1%, respectively, and their presence had a strong association (p < 0.001). Regression analyses revealed that, among women having vaginal births: coming for institutional births due to health professionals' advice, giving birth in a district hospital and having postnatal depressive symptoms were associated with presence of FoB; while depressive symptoms were associated with having FoB, perineal suturing without pain relief, and giving birth to a low birth-weight neonate in a district hospital.Conclusion: The prevalence of Fear of Birth and depressive symptoms is influenced by pain management during childbirth and care processes between women and providers. These care practices should be improved for better mental health outcomes among postnatal women.
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| 36. |
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| 37. |
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| 38. |
- Kempe, Annica, et al.
(författare)
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Exploring women's fear of childbirth in a high maternal mortality setting on the Arabian Peninsula
- 2015
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Ingår i: Global Mental Health. - Stockholm : Karolinska Institutet, Dept of Public Health Sciences. - 2054-4251.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Few studies from low-income countries have addressed women's fear of childbirth (FOC) although likely to affect women during both pregnancy and childbirth. The aim of this study was to explore FOC in a high maternal mortality setting in the Arab region, Yemen. Methods: A multi-stage (stratified–purposive–random) sampling process was used. We interviewed 220 women with childbirth experience in urban/rural Yemen. Answers to the question ‘Were you afraid of giving birth?’ were analyzed using qualitative content analysis. Results: Women perceived childbirth as a place of danger. Fear of death and childbirth complications stemming from previous traumatic childbirth and traumatic experience in the community was rampant. Husbands’ and in-laws’ disappointment in a girl infant constituted a strong sociocultural component of FOC. Women's perception of living in tension ‘between worlds’ of tradition and modernity reinforced fear of institutional childbirth. Women without FOC gave reasons of faith, social belonging and trust in either traditional or modern childbirth practice, past positive experience of childbirth and the desire for social status associated with children. Conclusions: The numerous maternal and infant deaths have a strong impact on women's FOC. Antenatal care has an important role in reducing fear including that of institutional childbirth and in strengthening a couple in welcoming a female infant. Staff should be sensitized to the fears of both husband and wife and women be allowed support during childbirth. Within the scope of the Millennium Development Goals and strengthening of reproductive mental health programs, FOC urgently needs to be addressed.
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| 39. |
- Kempe, Annica, et al.
(författare)
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Yemeni women's perceptions of own authority during childbirth : what does it have to do with achieving the Millennium Development Goals?
- 2013
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Ingår i: Midwifery. - Edinburgh : Churchill Livingstone. - 0266-6138 .- 1532-3099. ; 29:10, s. 1182-1189
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Tidskriftsartikel (refereegranskat)abstract
- Background: women's underutilisation of professional care during childbirth in many low-income countries is a serious concern in terms of achievement of maternal Millennium Development Goal 5.Objective: to explore women's perceived own authority within the modern and traditional spheres of childbirth in a high maternal mortality setting on the Arab peninsula. Yemen is a signatory to the Millennium Development Goals and one of 10 countries chosen for the United Nations Millennium Project. In Yemen, home birth has remained the norm for several decades in spite of high maternal mortality and morbidity rates.Design: a multistage (stratified-purposive-random) sampling process was used. Two hundred and twenty women with childbirth experience in urban/rural Yemen were selected at random for interview. Answers to the question 'Did you feel that you were the authority during childbirth?' were analysed using qualitative content analysis.Setting: the governorates of Aden, Lahej, Hadramout, Taiz and Hodeidah.Findings: three main themes emerged from the analysis: (i) 'Being at the centre', including two categories 'being able to follow through on own wants' and its opposite 'to be under the authority of others'; (ii) 'A sense of belonging' with the categories 'belonging and support among women in the community' and 'the denial of support, the experience of separation' and (iii) 'Husband's role in childbirth' including one category 'opportunity to show authority over the husband'. Authority was experienced primarily among women within the traditional childbirth sector although a general complaint among women delivered by trained medical staff was the loss of own authority.Key conclusions and implications for practice: these findings show that women's authority during childbirth is decreasing in the context of Safe Motherhood and the expansion of modern delivery care. This is likely to be an important reason why women underutilise professional care. Acquisition of knowledge from the traditional childbirth sector regarding how women exercise authority to facilitate childbirth would constitute an asset to skilled delivery and Safe Motherhood. The findings from Yemen are likely to be relevant for other low-income countries with similar persistent high home delivery rates, low status of women, and high maternal mortality and morbidity rates.
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| 40. |
- Kvist, Linda
(författare)
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Care and treatment of women with inflammatory symptoms of the breast during lactation
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Care and treatment of women with inflammatory symptoms of the breast during lactationInflammation of the breast during lactation causes considerable discomfort to mothers and carries a risk of early abandonment of breastfeeding. Little is known about the effects of care interventions, including acupuncture, used for these mothers or about mothers’ experiences of the complaint. Aim: to study care and treatment given at a midwife-led breastfeeding clinic to mothers with inflammatory symptoms of the breast during lactation, to gain knowledge of mothers’ experiences of being afflicted by breast inflammation and to investigate factors which may be associated with the development of breast abscess. Methods: method triangulation was used to study different aspects of the phenomenon of inflammatory symptoms of the breast during lactation; two randomised controlled trials I (n = 88) and II (n = 210), a descriptive study III (n = 210), an interview study with a Grounded Theory approach IV (n = 14), and a population-based register study V (n = 1,454,068 singleton deliveries). Results: mothers’ symptoms were more effectively relieved when acupuncture was used but acupuncture treatment did not shorten contact with health services. Nine percent (I) and 15 % (II) respectively, of mothers were prescribed antibiotics. Twelve percent experienced renewed symptoms requiring health care contact within 6 weeks (III). Seven mothers (0.1% of breastfeeding mothers) developed breast abscess, which was comparable to the figure in the population-based study (V). The presence of Group B streptococci in the breast milk was related to longer contact with health care (II). Mothers’ “will to breastfeed” may make it possible for them to withstand physical and emotional difficulties caused by the illness. Mothers considered access to clinical expertise to be an important factor in their care (IV). Primiparous mothers, those over the age of 30 years and those who give birth after 41 weeks gestation appear to be at a significantly increased risk for the development of breast abscess (V).Conclusions: mothers’ symptoms were more effectively dissipated when acupuncture treatment was used. However, acupuncture treatment did not shorten mothers’ contact with health care services. Interventions, including acupuncture treatment for relief of symptoms may help mothers to withstand their discomfort and await the body’s own anti-inflammatory response and therefore make it possible to substantially reduce the use of antibiotic therapy for this group. The results indicate a need for a better understanding of the influence on breastfeeding of hormones administered to birthing and breastfeeding women. The availability of immediate clinical expertise is an important factor for these mothers, which health care planners should be aware of. Information on potential breastfeeding problems should be improved.Key words: acupuncture, antibiotics, breast abscess, breastfeeding, care interventions, inflammatory symptoms, lactation mastitis
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| 41. |
- Lindberg, Inger, et al.
(författare)
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Expectations of post-partum care among pregnant women living in the north of Sweden
- 2008
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Ingår i: International Journal of Circumpolar Health. - : Informa UK Limited. - 1239-9736 .- 2242-3982. ; 67:5, s. 472-483
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To describe expectations of post-partum care among pregnant women living in the north of Sweden and whether personality determines preference for care systems. The time for post-partum care on maternity wards has been reduced in Western countries. This, along with the reduction in special medical treatments offered and the closure of small hospitals has affected pregnant women and their families. Study Design. Data was extracted from a questionnaire and a personality instrument (SSP) that were completed during November 2002.Methods. In the northernmost county of Sweden, 140 pregnant women completed the questionnaire; of these, 120 completed the SSP instrument. Results. Of the women who participated, 61.3% wanted to be discharged 72 hours after childbirth, irrespective of the distance between the hospital and home. To have access to maternity ward staff and the decision to be discharged were described as being the most important issues in maternity ward care. The infant’s father was expected to be the most important person in the post-partum period.Conclusions. Women ranked the opportunity to decide for themselves when to be discharged from the maternity ward as important, which can be interpreted as a strong signal that the women want to be in control of the care they receive. Midwives have to focus more on the woman and her family’s individual needs, and to include the father as a person who also needs support and to provide resources for him.
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| 42. |
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| 43. |
- Lindberg, Inger, et al.
(författare)
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Midwives' experience of organisational and professional change
- 2005
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 21:4, s. 355-64
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: to describe midwives' experiences of changes in their caring role and professional function in postpartum wards in the northern part of Sweden. In this part of the country, three out of eight maternity departments have been closed over the last 5 years. During the same period, hospital stays have reduced in length, and an early discharge model has been introduced. DESIGN: focus-group discussions. SETTING: four focus groups at two hospitals in northern Sweden. PARTICIPANTS: 21 midwives experienced in midwifery practice in maternity wards. FINDINGS: the analysis revealed four categories of comments: 'to have limited time when caring for the mother and the baby'; 'no longer being valued as the expert'; 'a wish to have responsibility for childbirth in its entirety'; 'to see future possibilities in the development of the profession'. The theme identified is 'being ahead in ideas about caring but still partly caught up in the past'. KEY CONCLUSIONS AND IMPLICATIONS: the identified theme of being ahead in ideas about caring but still partly caught up in the past can be understood as representing a transition. The midwives experienced loss and grief over their former midwifery practice, but had ideas and visions for developing and expanding their future professional role. A healthy transition requires support, participation and skilled management.
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| 44. |
- Lindberg, Inger, et al.
(författare)
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Midwives' experience of using videoconferencing as support in early discharge after childbirth
- 2007
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Ingår i: Journal of Telemedicine and Telecare. - : SAGE Publications. - 1357-633X .- 1758-1109. ; 13:4, s. 202-205
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Tidskriftsartikel (refereegranskat)abstract
- Videoconferencing was used to support parents who were discharged early after childbirth. In a one-year pilot study, 23 videoconferences took place between midwives and parents at home. To ensure good picture quality, a high-speed, 10 Mbit/s broadband connection was used. We used a combination of quantitative and qualitative research methods to describe the participants' experience. Seven midwives with experience of supporting nine couples/new parents completed a questionnaire. The 20 responses (87%) showed that the main reason for contact was routine and the most frequent advice concerned breastfeeding. The quality of sound and picture were judged to be good and very good, respectively. The experience of communicating with the parents via videoconferencing was also investigated through semi-structured interviews. Analysis of the interviews revealed that videoconferencing was: easy to handle and useful for making assessments; a valuable and functional complement to usual practice; almost like a real-life encounter. The results suggest that videoconferencing may be a useful tool in postpartum care.
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| 45. |
- Lindberg, I, et al.
(författare)
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Midwives' experience of using videoconferencing to support parents who were discharged early after childbirth
- 2007
-
Ingår i: Journal of Telemedicine and Telecare. - : SAGE Publications. - 1357-633X .- 1758-1109. ; 13:4, s. 202-205
-
Tidskriftsartikel (refereegranskat)abstract
- Videoconferencing was used to support parents who were discharged early after childbirth. In a one-year pilot study, 23 videoconferences took place between midwives and parents at home. To ensure good picture quality, a high-speed, 10 Mbit/s broadband connection was used. We used a combination of quantitative and qualitative research methods to describe the participants' experience. Seven midwives with experience of supporting nine couples/new parents completed a questionnaire. The 20 responses (87%) showed that the main reason for contact was routine and the most frequent advice concerned breastfeeding. The quality of sound and picture were judged to be good and very good, respectively. The experience of communicating with the parents via videoconferencing was also investigated through semi-structured interviews. Analysis of the interviews revealed that videoconferencing was: easy to handle and useful for making assessments; a valuable and functional complement to usual practice; almost like a real-life encounter. The results suggest that videoconferencing may be a useful tool in postpartum care.
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| 46. |
- Lindberg, Inger, et al.
(författare)
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Parents' experiences of using videoconferencing as a support in early discharge after childbirth
- 2009
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 25:4, s. 357-365
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to describe parents' experiences of using videoconferencing (VC) when discharged early from a maternity unit. Design: a combination of quantitative and qualitative methods was used to describe parents' experiences. Data were collected via questionnaires and interviews. Setting: a pilot study involving a maternity department and new parents in their homes was conducted. Through VC, parents discharged early were able to maintain follow-up contact with the midwife via sound and picture at the department. Participants: nine couples/new parents participated. Findings: the analysis revealed four categories of responses: 'feeling confident with the technology'; 'feeling confident of having control of their privacy'; 'feeling confident being face-to-face on the VC'; and 'feeling confident when worries and concerns were met and answers were received'. Key conclusions: using VC as a support in cases of early discharge after childbirth can facilitate a meeting that makes it possible for new parents to be guided by the midwife in their transition into parenthood. Implications for practice: the findings of this study indicate that VC equipment may be helpful for parents discharged from hospital early after childbirth. The findings can also be used as a foundation for further development of the application of VC within maternal health care and in health care in rural areas.
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| 47. |
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| 48. |
- Lindgren, Helena, et al.
(författare)
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Outcome of planned home births compared to hospital births in Sweden between 1992 and 2004 : A population-based register study
- 2008
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 87:8, s. 797-799
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this population-based study was to measure the risk of adverse outcome for mother and child in planned home births in a Swedish population irrespective of where the birth actually occurred, at home or in hospital after transfer. DESIGN: A population-based study using data from the Swedish Medical Birth Register. SETTING: Sweden 1992-2004. PARTICIPANTS: A total of 897 planned home births were compared with a randomly selected group of 11,341 planned hospital births. MAIN OUTCOME MEASURES: Prevalence of mortality and morbidity among mothers and children, emergency conditions, instrumental and operative delivery and perineal lacerations were compared. RESULTS: During this period in Sweden the neonatal mortality rate was 2.2 per thousand in the home birth group and 0.7 in the hospital group (RR 3.6, 95% CI 0.2-14.7). No cases of emergency complications were found in the home birth group. The risk of having a sphincter rupture was lower in the planned home birth group (RR 0.2, 95% CI 0.0-0.7). The risk of having a cesarean section (RR 0.4, 95% CI 0.2-0.7) or instrumental delivery (RR 0.3, 95% CI 0.2-0.5) was significantly lower in the planned home birth group. CONCLUSION: In Sweden, between 1992 and 2004, the intrapartum and neonatal mortality in planned home births was 2.2 per thousand. The proportion is higher compared to hospital births but no statistically significant difference was found. Women in the home birth group more often experienced a spontaneous birth without medical intervention and were less likely to sustain pelvic floor injuries.
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| 49. |
- Lindgren, Helena, et al.
(författare)
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Outcome of planned home births vs hospital births in Sweden between 1992 and 2004.
- 2008
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - England : Informa Healthcare. - 0001-6349 .- 1600-0412. ; 87:7, s. 751-759
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Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of this population based study was to measure the risk of adverse outcome for mother and child in planned home births in a Swedish population, irrespective of where the birth actually occurred, at home or in hospital after transfer. Design A population based study using data from the Swedish Medical Birth Register. Setting Sweden 1992-2004. Participants A total of 897 planned home births were compared with a randomly selected group of 11 341 planned hospital births. We also compared mortality rates with a national sample of 1 122 250 singleton, full-term babies. Main outcome measures Prevalence of mortality and morbidity among mothers and children, emergency conditions, instrumental and operative delivery and perineal lacerations were compared. Results During this period in Sweden the neonatal mortality rate was 2.2 per thousand in the home birth group and 0.7 in the hospital group (RR 3.6, 95% CI 0.2-14.7). No cases of emergency complications were found in the home birth group. The risk of having a sphincter rupture was lower in the planned home birth group (RR 0.2, 95% CI 0.0-0.7). The risk of having a caesarean section (RR 0.4, 95% CI 0.2-0.7) or instrumental delivery (RR 0.3, 95% CI 0.2-0.5) was significantly lower in the planned home birth group. Conclusion In Sweden, between 1992 and 2004, the intrapartum and neonatal mortality in planned home births was 2.2 per thousand. The proportion is higher compared to hospital births but no statistically significant difference. Women in the home birth group more often experienced a spontaneous birth without medical intervention and were less likely to sustain pelvic floor injuries.
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| 50. |
- Lindgren, Helena, et al.
(författare)
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Perceptions of risk and risk management among 735 women who opted for a home birth
- 2010
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 26:2, s. 163-172
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Tidskriftsartikel (refereegranskat)abstract
- Home birth is not included in the Swedish health care system and the rate for planned home births is less than one in a thousand. The aim was to describe women’s perceptions of risk related to childbirth and the strategies for managing these perceived risks. Design and setting A nationwide study including all women who had given birth at home in Sweden was conducted between 1 January 1992 and 31 July 2005. Participants A total of 735 women had given birth to 1038 children. Of the 1038 questionnaires sent to the women, 1025 (99%) were returned. Measurements Two open questions regarding risk related to childbirth and two questions answered by using a scale were investigated by content analysis. Findings Regarding perceived risks in a hospital birth, three categories, all related to loss of autonomy, were identified: 1) being in the hands of strangers; 2) being in the hands of routines and unnecessary interventions and 3) being in the hands of structural conditions. Perceived risks related to a home birth were associated with a sense of being beyond help; 1) worst case scenario and 2) distance to the hospital. The perceived risks were managed by using extrovert activities and introvert behaviour and by avoiding discussions concerning risks with health care professionals. Conclusion Women who plan for a home birth in Sweden do consider risks related to childbirth but they avoid talking about the risks with health care professionals. Implications for practice To understand why women choose to give birth at home, health care professionals must learn about the perceived beneficial effect of doing so.
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