| 1. |
|
|
| 2. |
- Fabian, Helena, et al.
(författare)
-
Characteristics of Swedish women who do not attend childbirth and parenthood education classes during pregnancy
- 2004
-
Ingår i: Midwifery. - : Elsevier BV. - 0266-6138. ; 20:3, s. 226-235
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: to investigate the attendance rate at childbirth and parenthood education classes during pregnancy in a national Swedish sample and describe the characteristics of women who did not attend. DESIGN: a cohort study utilising a postal questionnaire in early pregnancy and at 2 months after birth. SETTING: women were recruited from 97% of all antenatal clinics in Sweden at their first 'booking' visit during three different weeks spread over 1 year in 1999-2000. PARTICIPANTS: 2546 women, who were 77% of those who consented to participate in the study and 55% of all women eligible for the study. MEASUREMENT AND FINDINGS: most primiparous women (93%) attended classes and the majority of the multiparae (81%) did not. Having a native language other than Swedish was associated with non-attendance in both primiparae and multiparae (OR 2.7, 95% CI 1.3-5.4; OR 2.1, 95% CI 1.4-3.1). In addition, the following factors were associated with non-attendance in the primiparae: unemployment (OR 2.0, 95% CI 1.1-3.8), smoking during pregnancy (OR 2.7, 95% CI 1.2-5.8), having considered abortion (OR 4.3, 95% CI 1.2-16.1), and having had few antenatal check-ups (OR 2.0, 95% CI 1.1-3.7). The following factors were associated with non-attendance in the multiparae: age older than 35 years (OR 1.6, 95% CI 1.1-2.3), low level of education (OR 3.6, 95% CI 2.3-5.7), and pregnancy unplanned but welcome (OR 1.5, 95% CI 1.1-2.0), having had counselling because of fear of childbirth (OR 1.6, 95% CI 1.1-2.4), and expressing a need of such counselling (OR 1.9, 95% CI 1.1-3.1). KEY CONCLUSIONS: the childbirth and parenthood education programme reached the majority of pregnant women, and that non-attendees were more disadvantaged in terms of socio-demographic background and feelings about the approaching birth. These women should be given special attention during the antenatal check-ups so that childbirth and parenthood education could be adapted to their specific needs.
|
|
| 3. |
- Hildingsson, Ingegerd, et al.
(författare)
-
Few women wish to be delivered by caesarean section
- 2002
-
Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 109:6, s. 618-623
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate how many women wish to have a caesarean section when asked in early pregnancy, and to identify background variables associated with such a wish. DESIGN: National survey. SETTING: Swedish antenatal clinics. POPULATION: 3,283 Swedish-speaking women booked for antenatal care, at approximately 600 Swedish antenatal clinics, during three weeks spread over one year (1999-2000). METHODS: A questionnaire was mailed shortly after the first antenatal visit. MAIN OUTCOME MEASURES: Women's preferences for mode of delivery. RESULTS: 3,061 women completed the first questionnaire, corresponding to 94% of those who consented to participate after exclusion of reported miscarriages. The background characteristics of the study sample were very similar to a one-year cohort of women giving birth in Sweden during 1999. The result showed that 8.2% of the women would prefer to have a caesarean section. A wish for caesarean section was associated with parity, age, civil status, residential area and obstetric history. Women preferring caesarean section were more depressed and worried, not only about giving birth, but also about other things in life. A multivariate logistic regression model showed three factors being statistically associated with a wish for caesarean section: a previous caesarean section, fear of giving birth and a previous negative birth experience. CONCLUSIONS: Relatively few women wish to have a caesarean section when asked in early pregnancy, and these women seem to be a vulnerable group.
|
|
| 4. |
- Hildingsson, Ingegerd, et al.
(författare)
-
Swedish women's interest in homebirth and in- hospital birth center care
- 2003
-
Ingår i: Birth. - 0730-7659 .- 1523-536X. ; 30:1, s. 11-22
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine women's interest in home birth and in-hospital birth center care in Sweden, and to describe the characteristics of these women. METHODS: Three questionnaires, completed after the first booking visit in early pregnancy, at 2 months, and 1 year after the birth, asked about the women's interest in two alternative birth options. RESULTS: One percent of participants consistently expressed an interest in home birth on all three occasions, and 8 percent expressed an interest in birth center care. A regression analysis showed five factors that were associated with an interest in home birth: a wish to have the baby's siblings (OR 20.2; 95% CI 6.2-66.5) and a female friend (OR 15.2; 95% CI 6.2-37.4) present at the birth, not wanting pharmacological pain relief during labor and birth (OR 4.7; 95% CI 1.4-15.3), low level of education (OR 4.5; 95% CI 1.8-11.4), and dissatisfaction with medical aspects of intrapartum care (OR 3.6; 95% CI 1.4-9.2). An interest in birth center care was associated with experience of being in control during labor and birth (OR 8.3; 95% CI 3.2-21.6), not wanting pharmacological pain relief (OR 2.3; 95% CI 1.3-4.1), and a preference to have a known midwife at the birth (OR 2.2; 95% CI 1.6-2.9). CONCLUSION: If Swedish women were offered free choice of place of birth, the home birth rate would be 10 times higher, and the 20 largest hospitals would need to have a birth center. Women interested in alternative models of care view childbirth as a social and natural event, and their needs should be considered.
|
|
| 5. |
- Hildingsson, Ingegerd, et al.
(författare)
-
Women's expectations on antenatal care as assessed in early pregnancy : Number of visits, continuity of caregiver and general content.
- 2002
-
Ingår i: Acta Obstetrica et Gynecologica Scandinavica. - : Wiley. - 0001-6349. ; 81:2, s. 118-125
-
Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to explore women's expectations on antenatal care, preferences regarding number of visits and attitudes to continuity of midwife caregiver in a national sample of Swedish-speaking women. METHODS: All Swedish-speaking women booked for antenatal care during 3 weeks spread over 1 year (1999-2000) were invited to participate in the study. A questionnaire was mailed shortly after the first visit. RESULTS: Three thousand and sixty-one women completed the questionnaire, (91%). Checking the baby's health was the most important aspect of antenatal care, followed by checking the mother's health and making the partner feel involved. Seventy per cent preferred to follow the standard schedule of antenatal visits, 23% preferred more and 7% fewer visits. In primiparas, age < 25 years, a previous miscarriage and assisted conception were associated with a wish for more visits; in multiparas, previous miscarriage, previous stillbirth and a previous negative birth experience. A wish for fewer antenatal visit was associated with age over 35 years and unfortunate timing of pregnancy among primiparas, and with having more than two children and unfortunate timing of pregnancy in multiparas. Most women (97%) saw continuity of midwife caregiver during pregnancy as important. CONCLUSION: Women had high expectations of antenatal care in terms of possibilities of preventing fetal morbidity, a result that may reflect worries about the baby's health rather than a realistic assessment of the potential of antenatal care procedures. One-third of the women wanted more or fewer visits than the standard schedule, and special attention should be paid to women with a previous stillbirth, miscarriage or a negative birth experience. The Swedish system with continuity of midwife carer during pregnancy was much appreciated.
|
|
| 6. |
- Rådestad, Ingela, et al.
(författare)
-
What factors in early pregnancy indicate that the mother will be hit by her partner during the year after childbirth? : A nationwide Swedish survey.
- 2004
-
Ingår i: Birth: issues in perinatal care. - : Wiley. - 0730-7659 .- 1523-536X. ; 31:2, s. 84-92
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To be hit by one's intimate partner during the first year after childbirth may affect a woman's health and ability to take care of her newborn. The purpose of this study was to document the prevalence and indicators in early pregnancy of a woman being hit by her partner during the year after childbirth. METHOD: Information was collected by a postal questionnaire in early pregnancy and 12 months after childbirth from the approximately 5,550 women in Sweden who visited an antenatal care clinic for the first time during one of three chosen weeks in 1999 and 2000. RESULTS: Of the 3,266 recruited women, 2,563 returned the follow-up questionnaire. Being hit during the first year after childbirth was reported by 52 of the 2,563 (2%) women: 32 (61%) had been hit by their partner once, 12 (23%) twice, and 8 (15%) three or more times. Risk increased in women who were age 24 years or younger (3.9% had been hit), unmarried (7.1%), born in countries outside Europe (6.8%), with a partner born outside Europe (5.4%), had a low level of education (8.9%), and were unemployed (5.0%). In early pregnancy, women with back pain (4.0%), a chronic illness (4.1%), coital pain (6.1%), frequent depression-related symptoms (8.1%), stomach pain (3.8%), or a urinary tract problem (6.3%) were hit more often than others after childbirth. CONCLUSIONS: At least 2 percent of Swedish women giving birth in 2000 were hit by their partner during the year after childbirth. Using identified predictors during antenatal care may increase the likelihood of finding women at risk, thereby enhancing the possibility of interventions to prevent this crime and health hazard.
|
|
| 7. |
- Stenson, Kristina, 1952-
(författare)
-
Men's Violence against Women – a Challenge in Antenatal Care
- 2004
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Men’s violence against women is a universal issue affecting health, human rights and gender-equality. In pregnancy, violence is a risk for both the mother and her unborn child.The overall aims were: to determine the prevalence of such violence in a Swedish pregnant population, to investigate pregnant women’s attitudes to questioning about exposure to violence, and to evaluate experience gained by antenatal care midwives having routinely questioned pregnant women regarding violence.All women registered for antenatal care in Uppsala, Sweden, during 6 months were assessed regarding acts of violence. The Abuse Assessment Screen (AAS) was used twice during pregnancy and again after delivery when the women were asked an open-ended written question regarding attitudes to questioning about violence. Midwives’ experiences regarding routine assessment were evaluated in focus group discussions.The AAS questions were answered by 93% (1,038) of those eligible. Physical abuse by a partner or relative during or shortly after pregnancy was reported by 1.3%, and by 2.8% when the year preceding pregnancy was included. Lifetime sexual abuse was reported by 8.1%. Repeated questioning increased the abuse detection rate. Abused women reported more previous ill-health, and women physically abused during pregnancy more pregnancy terminations than did non-abused women. Abuse assessment was found entirely acceptable by 80%, both acceptable and unacceptable/disagreeable by 5% and solely unacceptable/ disagreeable by 3%, while 12% were neural. Abused and non-abused women did not differ regarding disinclination to answer the abuse questions. According to the midwives the delicacy of the subject and the male partners’ presence were the most prominent remaining obstacles to routine determination of violence. Routines are required to make questioning about violence an integral part of antenatal care. This would necessitate a private appointment for the woman, knowledge among care providers about the nature of men’s violence, and awareness of referral options.
|
|
| 8. |
- Trulsson, O., et al.
(författare)
-
The silent child - : Mother´s experiences before, during and after stillbirth
- 2004
-
Ingår i: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 31:3, s. 189-195
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The quality of care received by a woman who gives birth to a dead baby is crucial for her long-term well-being, and limiting the period between diagnosis of intrauterine death and induction of delivery decreases her anxiety risk. The primary objective of this study was to explore why induction of delivery for most women should not be delayed more than 24 hours from the diagnosis of intrauterine death. A secondary objective was to determine how the time between diagnosis and delivery should be spent. METHODS: Twelve women were interviewed about their experience before and during the diagnosis of their baby's death and the event of birth. Interviews took place 6 to 18 months after the delivery and were analyzed using a phenomenological methodology. RESULTS: Women experienced premonition, difficulty communicating their worry, cessation of verbal communication with staff, unreality and numbing, desire to get rid of the dead child immediately, going through childbirth, and total silence. Many women believed that they were not respected as a human being during the process of diagnosing the intrauterine death. Themes emerged indicating caregivers should not reduce to zero the time between diagnosis of intrauterine death and induction of delivery. Time may be needed to obtain medical information about the delivery and to prepare the woman for meeting with and saying goodbye to her long-awaited but now silent baby. CONCLUSION: The period between diagnosis of intrauterine death and induction of delivery may give health professionals a major opportunity to improve a woman's ability to cope with the event of stillbirth and prepare her to meet with her loved but now silent baby. Further clinical research can identify supportive mechanisms for parents, and sources of iatrogenic psychological trauma that should be eliminated.
|
|
| 9. |
- Waldenström, Ulla, et al.
(författare)
-
A negative birth experience : prevalence and risk factors in a national sample.
- 2004
-
Ingår i: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 31:1, s. 17-27
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A woman's dissatisfaction with the experience of labor and birth may affect her emotional well-being and willingness to have another baby. The aim of this study was to investigate the prevalence and risk factors of a negative birth experience in a national sample. METHODS: A longitudinal cohort study of 2541 women recruited from all antenatal clinics in Sweden during 3 weeks spread over 1 year was conducted. Data were collected by three questionnaires, which measured women's global experience of labor and birth 1 year after the birth, and obtained information on possible risk factors during pregnancy and 2 months after the birth. RESULTS: Seven percent of the women had a negative birth experience. The following risk factors were found: (1) factors related to unexpected medical problems, such as emergency operative delivery, induction, augmentation of labor, and infant transfer to neonatal care; (2) factors related to the woman's social life, such as unwanted pregnancy and lack of support from partner; (3) factors related to the woman's feelings during labor, such as pain and lack of control; and (4) factors that may be easier to influence by the caregivers, such as insufficient time allocated to the woman's own questions at antenatal checkups, lack of support during labor, and administration of obstetric analgesia. CONCLUSIONS: Many risk factors were related to unexpected medical problems and participants' social background. Of the established methods to improve women's birth experience, childbirth education and obstetric analgesia seemed to be less effective, whereas support in labor and listening to the woman's own issues may be underestimated.
|
|
