| 1. |
- Finnbogadottir, Hafrún, et al.
(author)
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The Consequences of A History of Violence on Women's Pregnancy and Childbirth in the Nordic Countries : A Scoping Review
- 2024
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In: Trauma, Violence, & Abuse. - : Sage Publications. - 1524-8380 .- 1552-8324.
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Journal article (peer-reviewed)abstract
- Violence against women (VAW) is a global challenge also in the childbearing period. Despite high gender equality, there is a high prevalence of VAW in the Nordic countries. This scoping review aims to explore predictors for and consequences of a history of violence on women's pregnancy and childbirth in the Nordic countries, including women's experience of the impact of violence and the interventions used to detect, address consequences, and prevent further violence. The framework by Arksey and O'Malley was followed, and English, Finnish, Icelandic, Norwegian, Danish, and Swedish literature was included. The population was women aged ≥18 residing in the Nordic countries during the perinatal period. Eight databases were searched: MEDLINE, CINAHL, PubMed, PsycINFO, Web of Science, ASSIA, Social Services-, and Sociological abstracts. There was no limitation of the search time frame. The initial screening resulted in 1,104 records, and after removing duplicates, 452 remained. Finally, 61 papers met the inclusion criteria. The results covering the past 32 years indicated that childbearing women with a history of violence are at greater risk of common complaints and hospitalization during pregnancy, fear of childbirth, Cesarean section, breastfeeding difficulties, and physical and mental health problems. While extensive research was found on the associations between a history of and current violence and outcomes related to pregnancy, there was a lack of intervention studies and studies from Finland. Efforts must be made to scientifically test the methods used to reduce and treat the adverse effects of a history of violence and prevent further violence.
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| 2. |
- Larsson, Birgitta, 1965-
(author)
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Treatment for childbirth fear with a focus on midwife-led counselling : A national overview, women’s birth preferences and experiences of counselling
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Background: Many women experience childbirth fear to such an extent that it seriously interferes with the woman’s daily life and affects her mental well-being.Aim: The overall aim was to conduct an overview of the midwife-led counselling for childbirth fear in Sweden, to investigate women’s birth preferences and to describe their experiences of treatment on childbirth fear, with focus on midwife-led counselling.Methods: Study I is a cross-sectional study where 43 out of 45 maternity clinics responded to a questionnaire regarding midwife-led counselling. Study II is a longitudinal survey where 889 women participated of whom 70 received counselling. Data were collected by questionnaires in mid-pregnancy, two months and finally, one year after birth. Study III is a randomised controlled study with 258 participating women assessed with childbirth fear. It compares Internet-based cognitive behaviour therapy (ICBT) with midwife-led counselling. Data were collected by questionnaires twice during pregnancy and two months after birth. Study IV is a qualitative interview study using thematic analysis, including 27 women who received midwife-led counselling during pregnancy.Results: Overall, midwife-led counselling was perceived as empowering by the women and increased their confidence when facing birth. The preference for a caesarean section decreased during pregnancy and the majority had a normal vaginal birth but an increase in preference for caesarean section appeared after birth. Half of the women who received treatment for childbirth fear experienced a less than positive birth. Women who had a positive birth experience voiced that the contributing factors were the self-confidence received from counselling and the support from the midwife during birth. Decreased or manageable fear was expressed by the women after counselling and birth, which in turn brought a strengthened confidence for a future pregnancy and birth. Furthermore, major differences exist in counselling for childbirth fear throughout the clinics in Sweden.Conclusion: Midwife-led counselling improved women’s confidence toward giving birth and fear was perceived as manageable. Continuous support is crucial to experience birth as positive. Although women’s preferences for caesarean section did not change over time, few women gave birth with a caesarean section without medial reason.
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| 3. |
- Lukasse, Mirjam, et al.
(author)
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Childhood abuse and fear of childbirth - a population-based study
- 2010
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In: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 37:4, s. 267-274
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Journal article (peer-reviewed)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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| 4. |
- Lukasse, Mirjam, et al.
(author)
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Pregnancy intendedness and the association with physical, sexual and emotional abuse : a European multi-country cross-sectional study
- 2015
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In: BMC Pregnancy and Childbirth. - : BioMed Central. - 1471-2393 .- 1471-2393. ; 15
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Journal article (peer-reviewed)abstract
- BACKGROUND: Unintended pregnancies are common and when not resulting in a termination of pregnancy may lead to unintended childbirth. Unintended pregnancies are associated with increased health risks, also for women for whom pregnancy continues to childbirth. Our objective was to present the prevalence of unintended pregnancy in six European countries among pregnant women attending routine antenatal care, and to investigate the association with a history of physical, sexual and emotional abuse. METHODS: A prospective cross-sectional study, of 7102 pregnant women who filled out a questionnaire during pregnancy as part of a multi-country cohort study (Bidens) with the participating countries: Belgium, Iceland, Denmark, Estonia, Norway and Sweden. A validated instrument, the Norvold Abuse Questionnaire (NorAq) consisting of 10 descriptive questions measured abuse. Pregnancy intendedness was assessed using a single question asking women if this pregnancy was planned. Cross-tabulation, Chi-square tests and binary logistic regression analysis were used. RESULTS: Approximately one-fifth (19.2 %) of all women reported their current pregnancy to be unintended. Women with an unintended pregnancy were significantly younger, had less education, suffered economic hardship, had a different ethnic background from the regional majority and more frequently were not living with their partner. The prevalence of an unintended pregnancy among women reporting any lifetime abuse was 24.5 %, and 38.5 % among women reporting recent abuse. Women with a history of any lifetime abuse had significantly higher odds of unintended pregnancy, also after adjusting for confounding factors, AOR for any lifetime abuse 1.41 (95 % CI 1.23-1.60) and for recent abuse AOR 2.03 (95 % CI 1.54-2.68). CONCLUSION: Women who have experienced any lifetime abuse are significantly more likely to have an unintended pregnancy. This is particularly true for women reporting recent abuse, suggesting that women living in a violent relationship have less control over their fertility.
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| 5. |
- Lukasse, Mirjam, et al.
(author)
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Prevalence of emotional, physical and sexual abuse among pregnant women in six European countries
- 2014
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In: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 93:7, s. 669-677
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Journal article (peer-reviewed)abstract
- Objectives The primary objective was to investigate the prevalence of a history of abuse among women attending routine antenatal care in six northern European countries. Second, we explored current suffering from reported abuse. Design A prospective cohort study. Setting Routine antenatal care in Belgium, Iceland, Denmark, Estonia, Norway, and Sweden between March 2008 and August 2010. Population A total of 7174 pregnant women. Methods A questionnaire including a validated instrument measuring emotional, physical and sexual abuse. Main outcome measure Proportion of women reporting emotional, physical and sexual abuse. Severe current suffering defined as a Visual Analogue Scale score of ≥6. Results An overall lifetime prevalence of any abuse was reported by 34.8% of the pregnant women. The ranges across the six countries of lifetime prevalence were 9.7–30.8% for physical abuse, 16.2–27.7% for emotional abuse, and 8.3–21.1% for sexual abuse. Few women reported current sexual abuse, 0.4% compared with 2.2% current physical abuse and 2.7% current emotional abuse. Current severe suffering was reported by 6.8% of the women who reported physical abuse, 9.8% of those who reported sexual abuse and 13.5% for emotional abuse. Conclusion A high proportion of pregnant women attending routine antenatal care report a history of abuse. About one in ten of them experiences severe current suffering from the reported abuse. In particular, these women might benefit from being identified in the antenatal care setting and being offered specialized care.
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| 6. |
- Pun, Kunta Devi, et al.
(author)
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Domestic violence and perinatal outcomes - a prospective cohort study from Nepal
- 2019
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In: BMC Public Health. - : BioMed Central. - 1471-2458. ; 19
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Journal article (peer-reviewed)abstract
- Background: Domestic violence is one of the most common forms of violence against women. Domestic violence during pregnancy is associated with adverse perinatal and maternal outcomes. We aimed to assess whether domestic violence was associated with mode of delivery, low birthweight and preterm birth in two sites in Nepal. Methods: In this prospective cohort study we consecutively recruited 2004 pregnant women during antenatal care at two hospitals between June 2015 and September 2016. The Abuse Assessment Screen (modified) was used to assess fear and violence. Having ever experienced either fear or violence was defined as any domestic violence. Obstetric outcomes were obtained from hospital records for 1381 (69%) women, selecting singleton pregnancies only. Mode of delivery was assessed as birth by cesarean section or not. A birthweight of less than 2500g was defined as low birthweight and preterm birth as birth before completion of 37weeks gestation. Descriptive and multiple logistic regression analyses were performed to assess associations. Results: Twenty percent of the women reported any domestic violence. Among all 1381 women, 37.6% gave birth by cesarean section. Of those women who delivered by cesarean section, 84.7% had an emergency cesarean section. Less than 10% of the babies were born prematurely and 13.5% were born with low birthweight. We found no significant association between exposure to any domestic violence during pregnancy and risk of a low birthweight baby or birth by cesarean section. However, having experienced both violence and fear was significantly associated with giving birth to a preterm infant [aOR 2.33 (95% CI;1.10-4.73)]. Conclusions: Domestic violence is common in Nepal. This is a potential risk factor for severe morbidity and mortality in newborns. We found that the risk of having a preterm baby was higher for pregnant women who experienced both fear and violence. This should be recognized by the health sector. In this study, no significant differences were found in the rate of cesarean section nor low birthweight for women who had experienced any domestic violence compared to those who did not.
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| 7. |
- Rishal, Poonam, et al.
(author)
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Improving Safety Among Pregnant Women Reporting Domestic Violence in Nepal - A Pilot Study
- 2020
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:7, s. 1-13
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Journal article (peer-reviewed)abstract
- Introduction: Domestic violence (DV) during pregnancy is associated with poor health outcomes for both the mother and newborn, and sometimes death. In a low-income country like Nepal, women have few options to leave abusive situations. Therefore, there is a need for interventions to improve their safety. The aim of our study was to explore the use of safety measures before and after an educational intervention among women who have reported DV during pregnancy. Materials and methods: Of 1010 pregnant women screened consecutively for DV using the Abuse Assessment Screen (AAS) during routine antenatal care, 181 women reported domestic violence. All 1010 participating pregnant women were taught 15 safety measures using a locally developed flipchart. We obtained contact with 80 of the 181 eligible women postpartum, of whom 62 completed the follow-up assessment. We explored and described the use of safety measures at baseline and follow-up, using a standardized instrument called the Safety Behavior Checklist. Results: At follow-up, less than half of the women (n = 30, or 48.3%) reported any form of DV. Of the women who reported DV at follow-up, significantly more reported the experience of both violence and fear at baseline (21.9%, p = 0.01) compared with the women who did not report DV at follow-up (3.3%, p = 0.01). Women reporting DV at baseline and follow-up used more safety measures at baseline (56) and follow-up (80) compared with women reporting DV at baseline only (36 and 46). Women reporting DV at baseline and follow-up used more safety measures for the first time at follow-up, 57 new measures compared with the 28 new measures used by women reporting DV at baseline only. Conclusions: The use of a flipchart teaching session on safety measures within antenatal care may increase the number of safety measures women use to protect themselves during pregnancy and decrease the risks of adverse health effects of DV.
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| 8. |
- Rishal, Poonam, et al.
(author)
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Prevalence and associated factors of domestic violence among pregnant women attending routine antenatal care in Nepal
- 2018
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 46:8, s. 785-793
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Journal article (peer-reviewed)abstract
- Aims: The primary aim of this study was to assess the prevalence of domestic violence (DV) and its associated factors among pregnant women in Nepal. The secondary aims were to investigate disclosure of DV by women to health-care personnel and to assess whether health-care personnel had asked women about their experience of DV.Methods: This cross-sectional study included 2004 pregnant women between 12 and 28 weeks of gestation attending routine antenatal care at two hospitals in Nepal from August 2014 to November 2015. In this study, DV was defined as fear of a family member and/or an experience of physical, emotional or sexual violence. Associated risk factors were analysed using logistic regression analyses.Results: Twenty-one per cent of the women had experienced DV; 12.5% experienced fear only, 3.6% violence only and 4.9% experienced both violence and fear. Less than 2% per cent reported physical violence during pregnancy. This study found that just 17.7% had ever been asked by health-care personnel about DV, and of the women who had reported DV, only 9.5% had disclosed their experience to health-care personnel. Women of young age and low socio-economic status were more likely to have experienced DV. Women who reported having their own income and the autonomy to use it were at significantly lower risk of DV compared to women with no income.Conclusions: A substantial proportion of women reported having experienced DV. Victims had rarely disclosed their experience of DV to health-care personnel. This study underlines the importance of integrating systematic assessment of DV in antenatal care.
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| 9. |
- Rishal, Poonam, et al.
(author)
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'They just walk away' - women's perception of being silenced by antenatal health workers : a qualitative study on women survivors of domestic violence in Nepal
- 2016
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In: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 9, s. 1-10
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Journal article (peer-reviewed)abstract
- Background: Domestic violence during pregnancy has detrimental effects on the health of the mother and the newborn. Antenatal care provides a 'window of opportunity' to identify and assist victims of domestic violence during pregnancy. Little is known about the experience, needs, and expectations from the women's perspective in relation to domestic violence in Nepal. Objective: Our study aims to explore how women who have experienced domestic violence evaluate their antenatal care and their expectations and needs from health centers. Design: Twelve in-depth interviewswere conducted among women who had experienced domestic violence during pregnancy and utilized antenatal care. The women were recruited from two different organizations in Nepal. Results: Women in our study concealed their experience of domestic violence due to fear of being insulted, discriminated, and negative attitudes of the health care providers. The women wished that the health care providers were compassionate and asked them about their experience, ensured confidentiality and privacy, and referred them to services that is free of cost. Conclusions: Findings from our study may help the health care providers to change their attitudes toward women survivors of domestic violence. Identifying and assisting these women through antenatal care could result in improved services for them and their newborns.
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| 10. |
- Ryding, Elsa Lena, et al.
(author)
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Fear of Childbirth and Risk of Cesarean Delivery : A Cohort Study in Six European Countries
- 2015
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In: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 42:1, s. 48-55
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Journal article (peer-reviewed)abstract
- Background Few studies have examined the mode of birth among women with fear of childbirth, and the results are conflicting. The objective of this study was to assess the association between fear of childbirth and cesarean delivery in North European women. Methods A longitudinal cohort study was conducted among 6,422 pregnant women from Belgium, Iceland, Denmark, Estonia, Norway, and Sweden. Fear of childbirth was measured by the Wijma Delivery Expectancy Questionnaire during pregnancy and linked to obstetric information from hospital records. ResultsAmong 3,189 primiparous women, those reporting severe fear of childbirth were more likely to give birth by elective cesarean, (OR, 1.66 [95% CI 1.05-2.61]). Among 3,233 multiparous women, severe fear of childbirth increased the risk of elective cesarean (OR 1.87 [95% CI 1.30-2.69]). Reporting lack of positive anticipation, one of six dimensions of fear of childbirth, was most strongly associated with elective cesarean (OR 2.02 [95% CI 1.52-2.68]). A dose-effect pattern was observed between level of fear and risk of emergency cesarean in both primiparous and multiparous women. Indications for cesarean were more likely to be reported as nonmedical among those with severe fear of childbirth; 16.7 versus 4.6 percent in primiparous women, and 31.7 versus 17.5 percent in multiparous women. ConclusionHaving severe fear of childbirth increases the risk of elective cesarean, especially among multiparous women. Lack of positive anticipation of the upcoming childbirth seems to be an important dimension of fear associated with cesarean delivery. Counseling for women who do not look forward to vaginal birth should be further evaluated.
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| 11. |
- Schei, Berit, et al.
(author)
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A history of abuse and operative delivery : results from a European multi-country cohort study
- 2014
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In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 9:1
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Journal article (peer-reviewed)abstract
- Objective The main aim of this study was to assess whether a history of abuse, reported during pregnancy, was associated with an operative delivery. Secondly, we assessed if the association varied according to the type of abuse and if the reported abuse had been experienced as a child or an adult. Design The Bidens study, a cohort study in six European countries (Belgium, Iceland, Denmark, Estonia, Norway, and Sweden) recruited 6724 pregnant women attending routine antenatal care. History of abuse was assessed through questionnaire and linked to obstetric information from hospital records. The main outcome measure was operative delivery as a dichotomous variable, and categorized as an elective caesarean section (CS), or an operative vaginal birth, or an emergency CS. Non-obstetrically indicated were CSs performed on request or for psychological reasons without another medical reason. Binary and multinomial regression analysis were used to assess the associations. Results Among 3308 primiparous women, sexual abuse as an adult (≥18 years) increased the risk of an elective CS, Adjusted Odds Ratio 2.12 (1.28–3.49), and the likelihood for a non-obstetrically indicated CS, OR 3.74 (1.24–11.24). Women expressing current suffering from the reported adult sexual abuse had the highest risk for an elective CS, AOR 4.07 (1.46–11.3). Neither physical abuse (in adulthood or childhood <18 years), nor sexual abuse in childhood increased the risk of any operative delivery among primiparous women. Among 3416 multiparous women, neither sexual, nor emotional abuse was significantly associated with any kind of operative delivery, while physical abuse had an increased AOR for emergency CS of 1.51 (1.05–2.19). Conclusion Sexual abuse as an adult increases the risk of an elective CS among women with no prior birth experience, in particular for non-obstetrical reasons. Among multiparous women, a history of physical abuse increases the risk of an emergency CS.
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| 12. |
- Ternström, Elin, 1982-
(author)
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Identification and Treatment of Women with a Fear of Birth
- 2018
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Doctoral thesis (other academic/artistic)abstract
- Although a fear of birth affects many women during pregnancy and is associated with adverse birth outcomes, it is rarely measured in clinical practice and evidence-based treatments are lacking. The aim of this thesis was to assess the clinical utility of the Fear of Birth Scale, and to evaluate the effect of guided Internet-based cognitive behavior therapy compared with standard care on the levels of fear of birth in pregnant and postpartum women.This thesis consists of four papers originating from three studies. The Fear of Birth Scale was used to measure fear of birth among pregnant women in all three studies. In Study I, prevalence of fear of birth among Swedish-born and foreign-born pregnant women was measured, and in Study II, 31 pregnant women were interviewed about their thoughts when assessing fear of birth. In Study III, a multicenter randomized controlled trial was conducted to compare guided Internet-based cognitive behavior therapy (ICBT) with standard care for pregnant women with a fear of birth.Fear of birth was identified among 22% of the pregnant women. Prevalence was twice as high among the foreign-born women (37%) compared to the Swedish-born women (18%). When asking the participants what they thought when assessing their fear on the Fear of Birth Scale, they confirmed that they had understood the measurement intent of the scale. The randomized controlled trial showed that fear of birth decreased during pregnancy and postpartum in both groups. However, the levels of fear decreased more in the guided ICBT-group when measuring fear of birth up to one year postpartum. The changes in fear of birth over time did not differ between parity groups.Altogether, these results suggest that the Fear of Birth Scale is a suitable screening instrument for identifying pregnant women with a fear of birth in a clinical setting and that such screening would be beneficial, as it probably would increase the chance of achieving a more equitable care. As the effect of time during pregnancy and postpartum was most evident in reducing fear of birth, this can be communicated to pregnant women, along with a continuous dialogue about how the women experience fear during pregnancy.
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| 13. |
- Viirman, Frida
(author)
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Mother, how are you? : Studies on self-rated health and childbirth experience
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Pregnancy and childbirth are characterised by emotional and physical changes, which can affect the mother’s mental health postpartum, as well as the infant. One step towards alleviating adverse consequences is to measure health status and childbirth experience. The aim of this thesis was to investigate women’s subjective health prior to pregnancy in relation to infant birth outcomes and childbirth experience, and to explore childbirth experience and its measurement from different perspectives.The thesis consists of four papers, of which the first two were based on data from the Swedish Pregnancy Register 2013-2018. In Paper I, self-rated health (SRH) prior to pregnancy was explored in relation to adverse birth outcomes, while Paper II investigated risk factors for negative childbirth experience. In Paper III, 112 written descriptions of negative childbirth experience were qualitatively explored in relation to events during labour and birth. In Paper IV, a single-item question about overall childbirth experience was compared to the validated four-dimensional Childbirth Experience Questionnaire 2, completed by 2,953 women.Overall, the prevalence of poor SRH prior to pregnancy was 9.9%. Among primiparas, 8.5% reported poor SRH, and 8.4% negative childbirth experience. Poor SRH was independently associated with small for gestational age, preterm birth, and negative childbirth experience. It was also associated with stillbirth, but not after adjustment for other risk factors. The main contributing factors to negative childbirth experience were related to labour and birth, with operative birth modes being the most prominent. Poor SRH was the only pre-gestational factor independently associated with negative childbirth experience. Only small differences between type of negative childbirth experience, in terms of qualitative sub-themes, were found between birth modes and complications during labour. Fear-based emotions was the most common sub-theme. The single-item measurement of overall childbirth experience mainly captured experiences of perceived safety, to a lesser extent own capacity and participation, but not experiences related to professional support.In conclusion, findings show the potential of using SRH assessments clinically to identify women in need of more extensive attention during pregnancy and childbirth. This thesis provides further proof of negative childbirth experience being multidimensional and subjective, and dominated by fear. When using single-item ratings of childbirth experience clinically, one must be aware that experiences of support are not well represented.
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| 14. |
- Wahlberg, Åsa, 1973-
(author)
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Second Victims in Swedish Obstetrics
- 2018
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Doctoral thesis (other academic/artistic)abstract
- The term “second victim” implies that healthcare providers can be pro-foundly affected by severe events in which a patient is badly injured or dies. The patient is the first victim. This thesis investigates the magnitude, riskfactors and consequences of becoming a second victim in Swedish delivery care.We examined self-reported exposure to severe events in a survey among 1459 midwives and 706 obstetricians. A severe event was defined as severe injury or death to a mother or child or other stressful events, such as threats or violence, during delivery. Of the midwives and obstetricians who responded, 71% and 84%, respectively, had experienced one or several severe events during their career. Post-traumatic stress symptoms following the perceived worst event were measured. Fifteen percent of the midwives and obstetricians reported symptoms equivalent to partial post-traumatic stress disorder (PTSD), and 5% of the midwives and 7% of the obstetricians reported symptoms commensurable with PTSD. Increased risk was correlated with emotions of guilt, and negative experience or support from friends. Professionals with partial PTSD left delivery care significantly more often than their less traumatised colleagues.Experiences of severe events were, furthermore, investigated, using qualitative content analysis, leading to an overarching theme “acting in an illusory system of control and safety”. This reflected how midwives and obstetricians retrospectively identified factors that had contributed to the course of events leading to such detrimental consequences. The process that the midwives and obstetricians followed in the aftermath of a severe event, were investigated using a Grounded Theory analysis. A core category, “regaining of a professional self-image”, was constructed. Six main categories illustrated an erratic pathway which might lead to full regaining, reconsidering, reconstructing professional self-image or deciding to leave the profession, depending on level of regained professional self-image.In summary, the majority of midwives and obstetricians will experience severe obstetric events that might affect them, sometimes severely. The vulnerability that healthcare professionals are exposed to should not be underestimated and preparedness in terms of collegial support, as well as an awareness in the workplace of how badly affected employees might be, is important.
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| 15. |
- Wangel, Anne-Marie, et al.
(author)
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Emotional, physical, and sexual abuse and the association with depressive and posttraumatic stress symptoms in a multi-ethnic pregnant population in Southern Sweden
- 2016
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In: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 9, s. 7-13
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Journal article (peer-reviewed)abstract
- Objectives This study aims to describe the prevalence of emotional, physical, and sexual abuse and analyze associations with symptoms of depression and posttraumatic stress (PTS) in pregnancy, by ethnic background. Study design This is a cross-sectional study of the Swedish data from the Bidens cohort study. Ethnicity was categorized as native and non-native Swedish-speakers. Women completed a questionnaire while attending routine antenatal care. The NorVold Abuse Questionnaire (NorAQ) assessed a history of emotional, physical or sexual abuse. The Edinburgh Depression Scale-5 measured symptoms of depression. Symptoms of Posttraumatic Stress (PTS) included intrusion, avoidance and numbness. Results Of 1003 women, 78.6% were native and 21.4% were non-native Swedish-speakers. Native and non-native Swedish-speakers experienced a similar proportion of lifetime abuse. Moderate emotional and physical abuse in childhood was significantly more common among non-native Swedish-speakers. Sexual abuse in adulthood was significantly more prevalent among native Swedish-speakers. Emotional and sexual abuse were significantly associated with symptoms of depression for both natives and non-natives. Physical abuse was significantly associated with symptoms of depression for non-natives only. All types of abuse were significantly associated with symptoms of PTS for both native and non-native Swedish-speakers. Adding ethnicity to the multiple binary regression analyses did not really alter the association between the different types of abuse and symptoms of depression and PTS. Conclusion The prevalence of lifetime abuse did not differ significantly for native and non-native Swedish-speakers but there were significant differences on a more detailed level. Abuse was associated with symptoms of depression and PTS. Being a non-native Swedish-speaker did not influence the association much.
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