| 1. |
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| 2. |
- Bergh, Ingrid H. E., et al.
(författare)
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Assessment and documentation of women's labour pain : A cross-sectional study in Swedish delivery wards
- 2015
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 28:2, s. E14-E18
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Tidskriftsartikel (refereegranskat)abstract
- Background: A woman's pain during labour plays a dominant role in childbirth. The midwife's role is to assess the degree of pain experienced during labour. When professionals respond to labour pain with acknowledgement and understanding, the woman's sense of control and empowerment is increased, which could contribute to a positive experience of childbirth. The aim of this study is to describe how labour pain in Swedish delivery wards is assessed and documented. Methods: This quantitative descriptive study was designed as a national survey performed through telephone interviews with the representatives of 34 delivery wards in Sweden. Results and conclusion: The majority of the participating delivery wards assessed and documented women's labour pain, but in an unstructured manner. The wards differed in how the assessments and documentation were performed. In addition, almost all the delivery wards that participated in the survey lacked guidelines for the assessment and documentation of the degree of pain during labour. The findings also showed that the issue of labour pain was sometimes discussed in the delivery wards, but not in a structured or consistent way. (C) 2015 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.
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| 3. |
- Bäck, Lena, 1962-, et al.
(författare)
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Developing competence and confidence in midwifery-focus groups with Swedish midwives
- 2017
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 30:1, s. E32-E38
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Tidskriftsartikel (refereegranskat)abstract
- Background: Midwives have a significant impact on the clinical outcome and the birthing experience of women. However,there has been a lack of research focusing specifically on clinical midwives' learning and development of professional competence.Aim: The objective of the study was to describe how midwives reflect on learning and the development of professional competence and confidence.Methods: A qualitative study based on focus groups with midwives employed in maternity services.Findings: Four categories describe the results: (1) Feelings of professional safety evolve over time; (2) Personal qualities affect professional development; (3) Methods for expanding knowledge and competence; and (4) Competence as developing and demanding.The meaning of competence is to feel safe and secure in their professional role.There was a link between the amount of hands-on intrapartum experience and increasing confidence that is, assisting many births made midwives feel confident.Internal rotation was disliked because the midwives felt they had less time to deepen their knowledge and develop competence in a particular field.The midwives felt they were not seen as individuals, and this system made them feel split between different assignments.Discussion: External factors that contribute to the development of knowledge and competence include the ability to practise hands-on skills in an organisation that is supportive and non-threatening. Internal factors include confidence, self-efficacy, and a curiosity for learning.Conclusions: Midwives working within an organisation should be supported to develop their professional role in order to become knowledgeable, competent and confident.
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| 4. |
- Bäckström, Caroline A., et al.
(författare)
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"It's like a puzzle" : Pregnant women's perceptions of professional support in midwifery care
- 2016
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 29:6, s. e110-e118
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Tidskriftsartikel (refereegranskat)abstract
- ProblemPregnant women are not always satisfied with the professional support they receive during their midwifery care. More knowledge is needed to understand what professional support pregnant women need for childbirth and parenting.BackgroundChildbearing and the transition to becoming a parent is a sensitive period in one's life during which one should have the opportunity to receive professional support. Professional support does not always correspond to pregnant women's needs. To understand pregnant women's needs for professional support within midwifery care, it is crucial to further illuminate women's experiences of this support.AimTo explore pregnant women's perceptions of professional support in midwifery care.MethodsA qualitative study using semi-structured interviews. Fifteen women were interviewed during gestational weeks 36–38. Data was analysed using phenomenography.FindingsThe women perceived professional support in midwifery care to be reassuring and emotional, to consist of reliable information, and to be mediated with pedagogical creativity. The professional support facilitated new social contacts, partner involvement and contributed to mental preparedness. The findings of the study were presented in six categories and the category Professional support contributes to mental preparedness was influenced by the five other categories.ConclusionPregnant women prepare for childbirth and parenting by using several different types of professional support in midwifery care: a strategy that could be described as piecing together a puzzle. When the women put the puzzle together, each type of professional support works as a valuable piece in the whole puzzle. Through this, professional support could contribute to women's mental preparedness for childbirth and parenting.
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| 5. |
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| 6. |
- Hansson, Malin, 1975, et al.
(författare)
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Veiled midwifery in the baby factory - A grounded theory study
- 2019
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Ingår i: Women and Birth. - Amsterdam : Elsevier BV. - 1871-5192 .- 1878-1799. ; 32:1, s. 80-86
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Tidskriftsartikel (refereegranskat)abstract
- Background: Midwives' professional role has been changing drastically over time, from handling births in home settings to being part of a team in labour wards in hospitals. This demands a greater effort of interprofessional collaboration in childbirth care. Aim: Explore midwives' work in a hospital-based labour ward from the perspectives of other professions, working in the same ward. Method: Classical grounded theory, using a constant comparative analysis, was applied to focus group interviews with obstetricians, assistant nurses and managers to explore their views of midwifery work during childbirth. Findings: The substantive theory of 'veiled midwifery' emerged as an explanation of the social process between the professions in the 'baby factory' context. The other professionals perceive midwifery through a veil that filters the reality and only permits fragmentary images of the midwives' work. The main concern for the other professions was that the midwives were 'marching to own drum'. The midwives were perceived as both in dissonance with the baby factory, and therefore hard to control, or, alternatively more compliant with the prevailing rhythm. This caused an unpredictability and led to feelings of frustration and exclusion. Which in turn resulted in attempts to cooperate and gain access to the midwifery world, by using three unveiling strategies: Streamlining, Scrutinising and Collaborating admittance. Conclusions: Findings provide a theoretical conceptualisation of a 'veiled midwifery ' that causes problems for the surrounding team. This generates a desire to streamline and control midwifery in order to increase interprofessional collaboration. (c) 2018 The Authors. Published by Elsevier Ltd on behalf of Australian College of Midwives. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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| 7. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Exploring the Fear of Birth Scale in a mixed population of women of childbearing age : A Swedish pilot study
- 2018
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 31:5, s. 407-413
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this pilot study was to explore the Fear of Birth Scale in a mixed sample of women of childbearing age, by investigating the levels of childbirth fear and the content of women's thoughts when completing the scale. Methods: A cross-sectional mixed method study of 179 women who completed a short questionnaire and a think aloud interview. Results: The mean score of the Fear of Birth Scale was 40.80 (SD 27.59) and 28.5% were classified as having fear of childbirth (>= 60). The internal consistency showed a Cronbach's alpha > 0.92, and a mean inter-item correlation of 0.85. The highest scores were found in women younger than 25 years (mean 60.10), foreignborn women (mean 54.30) and women who did not have any previous children (48.72). The lowest scores were found in women who had recently given birth (mean 34.82) and women older than 35 years (mean 34.85). The content analysis categorization matrix clearly accommodated all 436 statements into the five pre-existing categories. The largest categories were: the content of fear and worry with 138 statements and strategies to cope with fear or worry (122 statements). Conclusion: The Fear of Birth Scale seems to be a useful instrument for different subgroups of women. The construct of fear of childbirth may be universally understood and experienced by women of childbearing age irrespective of whether they are currently pregnant, have recently given birth or do not have children. Identifying fear of birth is important in clinical practice in order to support women's reproductive needs.
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| 8. |
- Hildingsson, Ingegerd, et al.
(författare)
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Presence and process of fear of birth during pregnancy - Findings from a longitudinal cohort study
- 2017
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Ingår i: Women and Birth. - : ELSEVIER SCIENCE BV. - 1871-5192 .- 1878-1799. ; 30:5, s. E242-E247
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Tidskriftsartikel (refereegranskat)abstract
- Background: The prevalence of fear of birth has been estimated between 8–30%, but there is considerable heterogeneity in research design, definitions, measurement tools used and populations. There are some inconclusive findings about the stability of childbirth fear.Aim: to assess the prevalence and characteristics of women presenting with scores ≥60 on FOBS-The Fear of Birth Scale, in mid and late pregnancy, and to study change in fear of birth and associated factors.Methods: A prospective longitudinal cohort study of a one-year cohort of 1212 pregnant women from a northern part of Sweden, recruited in mid pregnancy and followed up in late pregnancy. Fear of birth was assessed using FOBS-The fear of birth scale, with the cut off at ≥60.Findings: The prevalence of fear of birth was 22% in mid pregnancy and 19% in late pregnancy, a statistically significant decrease. Different patterns were found where some women presented with increased fear and some with decreased fear. The women who experienced more fear or less fear later in pregnancy could not be differentiated by background factors.Conclusions: More research is needed to explore factors important to reduce fear of childbirth and the optimal time to measure it.
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| 9. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Women with fear of childbirth might benefit from having a known midwife during labour
- 2019
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 32:1, s. 58-63
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Having a known midwife at birth is valued by women across the world, however it is unusual for women with fear of childbirth to have access to this model of care. The aim of this study was to describe the prevalence and factors related to having access to a known midwife for women referred to counseling due to childbirth fear. We also wanted to explore if women's levels of childbirth fear changed over time.Methods: A pilot study of 70 women referred to counseling due to fear of birth in 3 Swedish hospitals, and where the counseling midwife, when possible, also assisted during labour and birth.Results: 34% of the women actually had a known midwife during labour and birth. Women who had a known midwife had significantly more counseling visits, they viewed the continuity of care as more important, were more satisfied with the counseling and 29% reported that their fear disappeared. Fear of birth decreased significantly over time for all women irrespective of whether they were cared for in labour by a known midwife or not.Conclusions: Although the women in the present study had limited access to a known midwife, the results indicate that having a known midwife whom the women met on several occasions made them more satisfied with the counseling and had a positive effect on their fear. Building a trustful midwife-woman relationship rather than counseling per se could be the key issue when it comes to fear of birth.
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| 10. |
- Hildingsson, Ingegerd
(författare)
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Women's birth expectations, are they fulfilled? : Findings from a longitudinal Swedish cohort study
- 2015
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 28:2, s. E7-E13
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Tidskriftsartikel (refereegranskat)abstract
- Background: The importance of women's expectations on the experience of birth has shown contradictory results regarding fulfilment. The aim of this study was to describe pregnant women's expectations of birth and to investigate if these expectations were fulfilled. An additional aim was to determine if unfulfilled expectations were related to the mode of birth, use of epidural and the birth experience. Methods: This research investigated a prospective regional cohort study of 1042 Swedish-speaking women who completed a questionnaire about birth expectations in late pregnancy and were followed up with two months after birth. Five areas were under study: support from partner, support from midwife, control, participation in decision making and the midwife's presence during labour and birth. An index combining expectations and experiences was created. Results: Certain background characteristics were associated with expectations as well as experiences. Statistically significant differences were shown between expectations and experiences in support from midwife (mean 3.41 vs 3.32), support from partner (mean 3.70 vs 3.77), and midwife's presence (mean 3.00 vs 3.39). Experiences 'worse than expected' regarding decision making and control were associated with modes of birth other than vaginal and four out of five areas were associated with a less positive birth experience. Conclusion: Some women had high birth expectations of which some were fulfilled. An expectation on support from the midwife was less likely to be achieved, while support from partner and the midwives' presence were fulfilled. If the woman's expectations were not fulfilled, e.g. became 'worse than expected' this was associated with a less positive overall birth experience as well as with instrumental or surgical mode of birth. (C) 2015 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.
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| 11. |
- Höglund, Berit, et al.
(författare)
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Midwives' comprehension of care for women with intellectual disability during pregnancy and childbirth : An open-ended questionnaire study in Sweden
- 2015
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 28:3, s. E57-E62
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Tidskriftsartikel (refereegranskat)abstract
- Background: Few studies have investigated midwifery care for women with intellectual disability (ID). Aim: To gain a deeper understanding of midwives' comprehension of care for women with ID during pregnancy and childbirth. Methods: A cross-sectional study among 375 midwives at antenatal clinics and delivery wards in Sweden. Findings 2476 quotations were sorted into six categories: information; communication and approach; the role of the midwife; preparing for and performing interventions and examinations; methods and assessments; and organisation of care. The midwives affirmed that individual, clear and repeated information together with practical and emotional support was important for women with ID. The midwives planned the care as to strengthen the capacity of the women, open doors for the unborn child and reinforce the process of becoming a mother. Extra time could be needed. They tried to minimise interventions. The midwives felt a dual responsibility, to support the mother-child contact but also to assess and identify any deficits in the caring capacity of the mother and to involve other professionals if needed. Conclusions: The midwives described specially adapted organisation of care, models of information, practical education and emotional support to facilitate the transition to motherhood for women with ID. They have a dual role and responsibility in supporting the woman, while making sure the child is properly cared for. Healthcare services should offer a safe and trusted environment to enable such midwifery care. When foster care is planned, the society should inform and co-operate with midwives in the care of these women.
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| 12. |
- 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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| 13. |
- Johansson, Margareta, et al.
(författare)
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Swedish fathers' experiences of childbirth in relation to maternal birth position : a mixed method study.
- 2015
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 28:4, s. e140-e147
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Fathers often want to be involved in labour and birth.AIM: To investigate how maternal birth position during second stage of labour may influence fathers' experience of childbirth.METHODS: Mixed method study with 221 Swedish fathers completing an on-line questionnaire. Descriptive statistics and qualitative content analysis were used.RESULTS: In total 174 (78.7%) had a positive overall birth experience. The theme An emotional life-changing event influenced by the birth process and the structure of obstetrical care was revealed and included the categories; Midwives ability to be professional, The birth process' impact, and Being prepared to participate. The most frequently utilised birth position during a spontaneous vaginal birth was birth seat (n=83; 45.1%), and the fathers in this group were more likely to assess the birth position as very positive (n=40; 54.8%) compared to other upright and horizontal birth positions. Fathers with a partner having an upright birth position were more likely to have had a positive birth experience (p=0.048), to have felt comfortable (p=0.003) and powerful (p=0.019) compared to women adopting a horizontal birth position during a spontaneous vaginal birth. When the women had an upright birth position the fathers deemed the second stage of labour to have been more rapid (mean VAS 7.01 vs. 4.53) compared to women in a horizontal birth position.CONCLUSION: An upright birth position enhances fathers' experience of having been positively and actively engaged in the birth process. Midwives can enhance fathers' feelings of involvement and participation by attentiveness through interaction and communicating skills.
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| 14. |
- Jonsdottir, Sigridur Sia, et al.
(författare)
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Partner relationship, social support and perinatal distress among pregnant Icelandic women
- 2017
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 30:1, s. e46-e55
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is inferred that perinatal distress has adverse effects on the prospective mother and the health of the foetus/infant. More knowledge is needed to identify which symptoms of perinatal distress should be assessed during pregnancy and to shed light on the impact of women's satisfaction with their partner relationship on perinatal distress.AIM: The current study aimed to generate knowledge about the association of the partner relationship and social support when women are dealing with perinatal distress expressed by symptoms of depression, anxiety and stress.METHODS: A structured interview was conducted with 562 Icelandic women who were screened three times during pregnancy with the Edinburgh Depression Scale and the Depression, Anxiety, Stress Scale. Of these, 360 had symptoms of distress and 202 belonged to a non-distress group. The women answered the Multidimensional Scale of Perceived Social Support and the Dyadic Adjustment Scale. The study had a multicentre prospective design allowing for exploration of association with perinatal distress.FINDINGS: Women who were dissatisfied in their partner relationship were four times more likely to experience perinatal distress. Women with perinatal distress scored highest on the DASS Stress Subscale and the second highest scores were found on the Anxiety Subscale.CONCLUSION: Satisfaction in partner relationship is related to perinatal distress and needs to be assessed when health care professionals take care of distressed pregnant women, her partner and her family. Assessment of stress and anxiety should be included in the evaluation of perinatal distress, along with symptoms of depression.
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| 15. |
- Larsson, Birgitta, et al.
(författare)
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Birth preference in women undergoing treatment for childbirth fear : A randomised controlled trial
- 2017
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 30:6, s. 460-467
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment. Methods: Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n = 258) were recruited at one university hospital and two regional hospitals over one year. The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n = 127) or standard care (face-to-face counselling) (n = 131). Data were collected by questionnaires in pregnancy week 20-25 (baseline), week 36 and two months after birth. Results: Caesarean section preference decreased from 34% to 12% in the ICBT group and from 24% to 20% in the counselling group. Two months after birth, the preference for caesarean increased to 20% in the ICBT group and to 29% in the counselling group, and there was no statistically significant change over time. Women in the ICBT group were less satisfied with the treatment (OR 4.5). The treatment had no impact on or worsened their childbirth fear (OR 5.5). There were no differences between the groups regarding birth experience. Conclusion: Women's birth preferences fluctuated over the course of pregnancy and after birth regardless of treatment method. Women felt their fear was reduced and were more satisfied with face-to-face counselling compared to ICBT. A higher percentage were lost to follow-up in ICBT group suggesting a need for further research.
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| 16. |
- Larsson, Birgitta, et al.
(författare)
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Women's experience of midwife-led counselling and its influence on childbirth fear : A qualitative study
- 2019
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 32:1, s. e88-e94
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women with childbirth fear have been offered counseling by experienced midwives in Sweden for decades without evidence for its effectiveness, in terms of decrease in childbirth fear. Women are usually satisfied with the counselling. However, there is a lack of qualitative data regarding women’s views about counselling for childbirth fear.Aim: To explore women’s experiences of midwife-led counselling for childbirth fear.Method: A qualitative interview study using thematic analysis. Twenty-seven women assessed for childbirth fear who had received counselling during pregnancy at three different hospitals in Sweden were interviewed by telephone one to two years after birth.Findings: The overarching theme ‘Midwife-led counselling brought positive feelings and improved confidence in birth’ was identified. This consisted of four themes describing ‘the importance of the midwife’ and ‘a mutual and strengthening dialogue’ during pregnancy. ‘Coping strategies and support enabled a positive birth’ represent women’s experiences during birth and ‘being prepared for a future birth’ were the women’s thoughts of a future birth.Conclusions: In this qualitative study, women reported that midwife-led counselling improved their confidence for birth through information and knowledge. The women experienced a greater sense of calm and preparedness, which increased the tolerance for the uncertainty related to the birthing process. This, in turn, positively affected the birth experience. Combined with a feeling of safety, which was linked to the professional support during birth, the women felt empowered. The positive birth experience strengthened the self-confidence for a future birth and the childbirth fear was described as reduced or manageable.
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| 17. |
- Linde, Anders, et al.
(författare)
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"Better safe than sorry"-Reasons for consulting care due to decreased fetal movements
- 2017
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 30:5, s. 376-381
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Experience of reduced fetal movements is a common reason for consulting health care in late pregnancy. There is an association between reduced fetal movements and stillbirth.AIM: To explore why women decide to consult health care due to reduced fetal movements at a specific point in time and investigate reasons for delaying a consultation.METHODS: A questionnaire was distributed at all birth clinics in Stockholm during 2014, to women seeking care due to reduced fetal movements. In total, 3555 questionnaires were collected, 960 were included in this study. The open-ended question; "Why, specifically, do you come to the clinic today?" was analyzed using content analysis as well as the complementary question "Are there any reasons why you did not come to the clinic earlier?"RESULTS: Five categories were revealed: Reaching dead line, Receiving advice from health care professionals, Undergoing unmanageable worry, Contributing external factors and Not wanting to jeopardize the health of the baby. Many women stated that they decided to consult care when some time with reduced fetal movements had passed. The most common reason for not consulting care earlier was that it was a new experience. Some women stated that they did not want to feel that they were annoying, or be perceived as excessively worried. Not wanting to burden health care unnecessarily was a reason for prehospital delay.CONCLUSION: Worry about the baby is the crucial reason for consulting care as well as the time which has passed since the women first experienced decreased fetal movements.
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| 18. |
- Lundgren, Ingela, 1957, et al.
(författare)
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Health professionals' perceptions of a Midwifery Model of Woman-Centred Care implemented on a hospital labour ward
- 2019
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799.
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTheoretical models as a basis for midwives’ care have been developed over recent decades. Although there are similarities between these models, their usefulness in practice needs to be researched in specific cultural contexts.AimTo explore whether, when adopted by midwives on labour wards, a midwifery model of woman-centred care (MiMo) was useful in practice from the viewpoint of a variety of health professionals.MethodsData were collected from a variety of health professionals before and after an intervention of implementating MiMo at a hospital-based labour ward in Sweden, using nine focus group interviews with a total of 43 participants: midwives (n = 16), obstetricians (n = 8), assistant nurses (n = 11) and managers (n = 8). The text from interviews was analysed using content analysis.FindingsFrom expressing no explicit need of a midwifery model of woman-centred care before the intervention, there was a shift in midwives, obstetricians and managers perceptions towards identifying advantages of using the MiMo as it gives words to woman-centred midwifery care. Such shift in perception was not found among the assistant nurses.DiscussionClarification of the various roles of health professionals is needed to develop the model. Heavy workloads and stress were barriers to implementing the model. Thus, more support is needed from organisational management.ConclusionsThe model was useful for all professional groups, except for assistant nurses. Further studies are needed in order to clarify the various professional roles and interdisciplinary collaborations in making the MiMo more useful in daily maternity care.
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| 19. |
- Malm, Mari-Cristin, et al.
(författare)
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Prenatal attachment and its association with foetal movement during pregnancy - A population based survey
- 2016
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 29:6, s. 482-486
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the association between the magnitude of foetal movements and level of prenatal attachment within a 24 h period among women in the third trimester of pregnancy. Design: a prospective population-based survey. Setting: A county in central Sweden. Participants: Low risk pregnant women from 34 to 42 weeks gestation, N = 456, 299 multiparous and 157 primiparous women. Measurements: The revised version of the Prenatal Attachment Inventory (PAI-R) and assessment of the perception of foetal movements per 24 h in the current gestational week. Findings: A total of 81 per cent of the eligible women completed the questionnaire. The overall sample of women found that the majority (96%) felt their baby move mostly in the evening. More than half of the respondents (55%) stated that they perceived frequent foetal movement on two occasions during a 24 h period, while almost a fifth (18%) never or only once reported frequent foetal movement in a 24 h period. Just over a quarter (26%) of respondents perceived frequent movement at least three times during a 24 h period. Perceiving frequent foetal movements on three or more occasions during a 24 h period, was associated with higher scores of prenatal attachment in all the three subscales. Key conclusion: Perceiving frequent foetal movements at least during three occasions per 24 h periods in late pregnancy was associated with prenatal attachment. Implications for practice: encouraging women to focus on foetal movements may positively affect prenatal attachment, especially among multiparous women > 35 years.
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| 20. |
- Mukwenda, Annamagreth M., et al.
(författare)
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Women's experiences of having had, and recovered from, eclampsia at a tertiary hospital in Tanzania
- 2017
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 30:2, s. 114-120
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Tidskriftsartikel (refereegranskat)abstract
- Background: Eclampsia is a major cause of maternal and perinatal mortality that requires advanced care and long hospital stays with uncertain outcomes for mother and baby. Care of eclamptic women is particularly challenging in low-income settings. Standards for medical care for eclampsia are established but the psychosocial needs of women are under-researched. Aim: To explore and describe women's experiences of having had, and recovered from, eclampsia at a tertiary hospital in Tanzania. Methods: Qualitative semi-structured interviews were held with a purposive sample of 10 women recovering from eclampsia. Thematic analysis informed the interpretation of the data. Findings: The women had experienced eclamptic seizure as painful and unreal as they were unable to control their body or actions despite sensing what happened. At hospital they felt being cared for and recovered but concerned because they had not been provided with enough information about the disorder. Being separated from the baby during hospitalisation was troublesome and they worried about infant feeding and health. The women experienced being connected to God and they were grateful for being alive and having recovered. However, they expressed fears over the possible recurrence of eclampsia in future pregnancies and wanted information about prevention strategies. Conclusion: Experiencing eclampsia is painful and gives a sense of bodily disconnectedness. It involves worrisome separation from the newborn, not being adequately informed and concerns over future health. More holistic care would benefit eclamptic women and their newborns.
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| 21. |
- Mårtensson, Lena B., 1958-, et al.
(författare)
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Sterile water injections for childbirth pain : An evidenced based guide to practice
- 2018
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 31:5, s. 380-385
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Tidskriftsartikel (refereegranskat)abstract
- Background: About 30% of women in labour suffer from lower back pain. Studies of sterile water injectionsfor management of low back pain have consistently shown this approach to be effective. The objective ofthis evidence-based guide is to facilitate the clinical use of sterile water injections to relieve lower backpain in labouring women.Methods: To identify relevant publications our search strategy was based on computerised literaturesearches in scientific databases. The methodological quality of each study was assessed using themodified version of the Jadad scale, 12 studies were included.Findings: Recommendations regarding the clinical use of sterile water injections for pain relief in labourare reported in terms of the location of injection administration, various injection techniques, number ofinjections used, amount of sterile water in each injection and adverse effects.Discussion: Both injection techniques provide good pain relief for lower back pain during labour. Thesubcutaneous injection technique is possibly less painful than the intracutaneous techniqueadministered, but we are unsure if this impacts on effectiveness. The effect seems to be related tothe number of injections and the amount of sterile water in each injection.Conclusion: The recommendation at present, based on the current state of knowledge, is to give fourinjections. Notwithstanding the differences in injection technique and number of injections the methodappears to provide significant levels of pain relief and can be repeated as often as required with noadverse effect (apart from the administration pain) on the woman or her foetus.
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| 22. |
- Nilsson, Christina, et al.
(författare)
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Causes and outcomes in studies of fear of childbirth: A systematic review
- 2018
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Ingår i: Women and Birth. - 1871-5192 .- 1878-1799.
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Forskningsöversikt (refereegranskat)abstract
- PROBLEM:Fear of childbirth negatively affects women during pregnancy and after birth.AIM:To summarise the findings of published studies regarding possible causes/predisposing factors and outcomes of fear of childbirth for childbearing women.DESIGN:A systematic review, searching five databases in March 2015 for studies on causes/predisposing factors and outcomes of fear of childbirth, as measured during pregnancy and postpartum. Quality of included studies was assessed independently by pairs of authors. Data were extracted independently by reviewer pairs and described in a narrative analysis.FINDINGS:Cross-sectional, register-based and case-control studies were included (n=21). Causes were grouped into population characteristics, mood-related aspects, and pregnancy and birth-related aspects. Outcomes were defined as mood-related or pregnancy and birth-related aspects. Differing definitions of fear of childbirth were found and meta-analysis could only be performed on parity, in a few studies.CONCLUSIONS:Stress, anxiety, depression and lack of social support are associated with fear during pregnancy. Need for psychiatric care and presence of traumatic stress symptoms are reported outcomes together with prolonged labour, longer labours, use of epidural and obstetric complications. Nulliparous and parous women have similar levels of fear but for different reasons. Since the strongest predictor for fear in parous women is a previous negative birth experience or operative birth, we suggest it is important to distinguish between fear of childbirth and fear after birth. Findings demonstrate the need for creating woman-centred birthing environments where women can feel free and secure with low risk of negative or traumatic birth experiences and consequent fear.
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| 23. |
- Nilsson, Christina, 1959, et al.
(författare)
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Vaginal Birth After Caesarean: Views of women from countries with low VBAC rates
- 2017
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 30:6, s. 481-490
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Tidskriftsartikel (refereegranskat)abstract
- Problem and background: Vaginal birth after caesarean section is a safe option for the majority of women. Seeking women´s views can be of help in understanding factors of importance for achieving vaginal birth in countries where the vaginal birth rates after caesarean is low. Aim: To investigate women’s views on important factors to improve the rate of vaginal birth after caesarean in countries where vaginal birth rates after caesarean rates are low. Methods: A qualitative study using content analysis. Data were gathered through focus groups and individual interviews with 51 women, in their native languages, in Germany, Ireland and Italy. The women were asked five questions about vaginal birth after caesarean. Data were translated to English, analysed together and finally validated in each country. Findings: Important factors for the women were that all involved in caring for them were of the same opinion about vaginal birth after caesarean section, thet they experience shared decision-making with clinicians supportive of vaginal birth, receive correct information, are sufficently prepared for a vaginal birth, and experience a culture that supports vaginal birth after caesarean section. Discussion and conclusion: Women’s decision-making about vaginal birth after caesarean in these countries involves a complex, multidimensional interplay of medical, psychological, social, cultural, personal and practical considerations. Further research is needed to explore if the information deficit women report negatively affects their ability to make informed choices, and to understand what matters most to women when making decisions about vaginal birth after caesarean as a mode of birth.
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| 24. |
- Nystedt, Astrid, et al.
(författare)
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Women's and men's negative experience of child birth-A cross-sectional survey
- 2018
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 31:2, s. 103-109
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Tidskriftsartikel (refereegranskat)abstract
- Background: A negative birth experience may influence both women and men and can limit their process of becoming a parent. Aims: This study aimed to analyze and describe women's and men's perceptions and experiences of childbirth. Design: A cross-sectional study of women and their partners living in one Swedish county were recruited in mid pregnancy and followed up two months after birth. Women (n = 928) and men (n = 818) completed the same questionnaire that investigated new parents' birth experiences in relation to socio-demographic background and birth related variables. Results: Women (6%) and men (3%) with a negative birth experiences, experienced longer labours and more often emergency caesarean section compared to women (94%) and men (97%) with a positive birth experience. The obstetric factors that contributed most strongly to a negative birth experience were emergency caesarean and was found in women (OR 4.7, 95% CI 2.0-10.8) and men (OR 4.5, Cl 95% 1.4-17.3). In addition, pain intensity and elective caesarean section were also associated with a negative birth experiences in women. Feelings during birth such as agreeing with the statement; 'It was a pain to give birth' were a strong contributing factor for both women and men. Conclusions: A negative birth experience is associated with obstetric factors such as emergency caesarean section and negative feelings. The content of negative feelings differed between women and men. It is important to take into account that their feelings differ in order to facilitate the processing of the negative birth experience for both partners.
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| 25. |
- Palmqvist, Hanna, et al.
(författare)
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Fathers' and co-mothers' voices about breastfeeding and equality - A Swedish perspective
- 2015
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 28:3, s. E63-E69
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Tidskriftsartikel (refereegranskat)abstract
- Background: Breastfeeding has benefits for mother and child and the partner's support influences the decision as well as the duration of breastfeeding. The aim of this study was to describe partners' knowledge and feelings regarding breastfeeding and how they reason about equality and involvement during the lactation period. Methods: A qualitative study using semi-structured interviews with 7 male and 2 female partners (labelled co-mothers) of breastfeeding mothers. The interviews were transcribed and analysed using a phenomenological approach. Results: The main theme Wish for the child to be breastfed/get breast milk described the informants' desire that their child was breastfed and this desire was based on knowledge of benefits of breastfeeding but also on intuitive feelings of breastfeeding as something natural. The main theme Effect of breastfeeding on fathers/co-mothers described how breastfeeding affected the informants and their relationship to the child and the mother in different ways. The main theme Adaptation and acceptance described how informants accepted the impact that breastfeeding had and/or adapted to it and continued to wish for the child to receive breast milk. Conclusion: The informants desired that their children be breastfed/get breast milk. Breastfeeding affected the informants in different ways, which they handled by adapting to and accepting the situation, and they expressed a continued desire that their children be breastfed/get breast milk. Parental classes should include both parents to be and address how breastfeeding can be successfully performed and supported without threatening the equality between the parents.
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| 26. |
- Selin, Lotta, et al.
(författare)
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High-dose versus low-dose of oxytocin for labour augmentation : a randomised controlled trial
- 2019
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Ingår i: Women and Birth. - : ELSEVIER. - 1871-5192 .- 1878-1799. ; 32:4, s. 356-363
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Tidskriftsartikel (refereegranskat)abstract
- Problem: Delayed labour progress is common in nulliparous women, often leading to caesarean section despite augmentation of labour with synthetic oxytocin.Background: High-or low-dose oxytocin can be used for augmentation of delayed labour, but evidence for promoting high-dose is weak.Aim: To ascertain the effect on caesarean section rate of high-dose versus low-dose oxytocin for augmentation of delayed labour in nulliparous women.Methods: Multicentre parallel double-blind randomised controlled trial (ClinicalTrials.gov: NCT01587625) in six labour wards in Sweden. Healthy nulliparous women at term with singleton cephalic fetal presentation, spontaneous labour onset, confirmed delay in labour and ruptured membranes (n = 1351) were randomised to labour augmentation with either high-dose (6.6 mU/minute) or low-dose (3.3 mU/minute) oxytocin infusion.Findings: 1295 women were included in intention-to-treat analysis (high-dose n = 647; low-dose n = 648). Caesarean section rates did not differ between groups (12.4% and 12.3%, 95% Confidence Interval -3.7 to 3.8). Women with high-dose oxytocin had: shorter labours (-23.4 min); more uterine tachysystole (43.2% versus 33.5%); similar rates of instrumental vaginal births, with more due to fetal distress (43.8% versus 22.7%) and fewer due to failure to progress (39.6% versus 58.8%). There were no differences in neonatal outcomes.Discussion: Our study could not confirm results of two systematic reviews indicating, with weak evidence, that use of high-dose oxytocin was associated with lower frequency of caesarean section.Conclusion: We found no advantages for routine use of high-dose oxytocin in the management of delay in labour. Low-dose oxytocin regimen is recommended to avoid unnecessary events of tachysystole and fetal distress.
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| 27. |
- Sharma, Bharati, et al.
(författare)
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The association of teaching-learning methods and self-confidence of nurse-midwives. A survey from one province in India
- 2019
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 32:3, s. e376-e383
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study aimed to investigate the association between self-confidence of final-year students in selected midwifery skills and teaching-learning methods used in the two formally recognized education programs for nurse-midwives in India. Design: A cross-sectional survey Participants: 633 final-year students, from 25 educational institutions randomly selected, stratified by type of program (diploma/bachelor), and ownership (private/government) in Gujarat. Data collection and analysis: Students assessed their confidence on a 4-point scale, in four midwifery competency domains-antepartum, intrapartum, postpartum, and newborn care recommended by the International Confederation of Midwives (ICM). Explorative factor analysis was used to reduce skill statements into subscales separately for each domain. Odds ratios with 95% CI were calculated for students with high confidence (≥75th percentile on each subscale) and not high confidence (all others) between diploma and bachelor students. Results: Classroom teaching was the most practiced method. ‘Laboratory demonstrations’, ‘Practice on models’, ‘Demonstrations at clinical sites’, ‘Births Attended’ (Hands-on clinical practice), and ‘Satisfaction with clinical supervision’ were practiced less, lesser in the bachelor's compared to the diploma program. High confidence was associated with ‘Births Attended’ (Hands-on clinical practice), ‘Practice on models’, and ‘Satisfaction with clinical supervision’ for all subscales of all four domains of competencies. Conclusions: Hands on skills practice in the laboratory and supervised clinical practice during clinical placements were associated with high confidence for basic clinical midwifery skills amongst students. The diploma program followed better pedagogoical approaches than the bachelor's program.
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| 28. |
- Sjödin, Marie, et al.
(författare)
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A qualitative study showing women's participation and empowerment in instrumental vaginal births
- 2018
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 31:3, s. e185-e189
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: An instrumental birth with a ventouse or forceps is a complicated birth, possibly resulting in fear of childbirth which could influence the entire birth experience negatively. Patients who are actively involved in their care have a stronger sense of satisfaction and a sense of participation can contribute to shorter hospital stays.AIM: To describe the experience of participation for women involved in an instrumental delivery with ventouse or forceps.METHOD: Qualitative semi-structured interviews with 16 women who gave birth aided by a ventouse or forceps. Their answers were analyzed through qualitative content analysis. In addition the women were asked to evaluate their experience during the delivery. Using a numerical scale (NRS) the birth experience was graded by choosing a number between 0 (worst possible experience) and 10 (best conceivable experience).FINDINGS: Two themes were extracted from the data: To be part of a team and To feel empowered. Five categories were identified from the women's descriptions of the experience of involvement during the instrumental delivery: to cooperate; to understand; to have contact; to participate, and to not be involved. Those women who rated their experience as low grade, described a lack of involvement in their childbirth compared to those women who rated their experience as high.CONCLUSION: This study shows how cooperation and empowerment of the woman are two key factors in order for the women to have a positive experience of their instrumental vaginal births. The study also shows that empowerment is created when the woman is actively engaged and participates in the birth process which gives her the feeling of being part of the team, creating an environment based on mutual understanding.
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| 29. |
- Ternström, Elin, 1982-, et al.
(författare)
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Pregnant women's thoughts when assessing fear of birth on the Fear of Birth Scale
- 2016
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 29:3, s. E44-E49
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fear of childbirth is common during pregnancy but rarely assessed in clinical practice. The Fear of Birth Scale has been proposed as a valid measure suitable for assessing fear of birth in an antenatal clinical context. To make sure that the scale makes sense in relation to the known constructs of fear of birth, it is important to find out what women think when responding to the Fear of Birth Scale. Aim: To report what women in mid-pregnancy think when assessing fear of birth on the Fear of Birth Scale. Methods: A qualitative design using semi-structured interviews with a think aloud technique was used. Thirty-one women were recruited in gestational week 17-20. Content analysis was conducted to describe the different dimensions of fear of birth. Findings: Worry was described as unspecific feelings and thoughts, often with a negative loading. Fear was described as a strong feeling connected to something specific. Furthermore, the women thought about aspects that influence their worries and fears and explained the strategies that helped them to cope with their fear of birth. Conclusion: Women could clearly assess, describe, and discuss fear of birth using the Fear of Birth Scale. This supports the use of the Fear of Birth Scale in clinical settings as a starting point for further dialogue about women's fear of birth. The dialogue may identify women's need for information, treatment, and referral when necessary. (C) 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
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| 30. |
- Thies-Lagergren, Li, et al.
(författare)
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Intrapartum midwifery care impact Swedish couple's birth experiences — A cross-sectional study
- 2019
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 32:3, s. 213-220
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Tidskriftsartikel (refereegranskat)abstract
- Background: Parents’ birth experiences affect bonding with their infant, which in turn may influence the child's future health. Parents’ satisfaction with childbirth is multi-dimensional and dependent on both expectations and experiences. Increasing involvement of partners in intrapartum care may lead to an assumption that the birthing couple shares attitudes and expectations of intrapartum care. There is a limited knowledge regarding the uniformity of couples’ experiences of labour and birth. Aim: To describe and compare uniformity in couples’ birth experiences of the quality of intrapartum midwifery care. Method: A quantitative cross-sectional study nested within a randomised controlled trial. In total 209 healthy primiparous mothers and their partners were recruited. A quality of care index was generated from an on-line questionnaire administered as a follow-up to the randomised controlled trial. Uniformity and differences were identified regarding the coupleś experiences of birth and their preferences for intrapartum care Results: A high level of uniformity between the mothers and their partners was revealed. Birth was a positive experience for 79% of partners and 73% of mothers whom were more likely to have experienced a spontaneous vaginal birth. Partners and mothers with a less positive birth experienced deficiencies regarding: being in control, receiving information about labour progress and midwife's presence in labour room. Discussion: Midwives can enhance couples’ feeling of being in control during labour and birth by being attentive, present and continuously providing adequate information and emotional support.
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| 31. |
- Wahlbeck, Helén, et al.
(författare)
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Gaining hope and self-confidence - An interview study of women's experience of treatment by art therapy for severe fear of childbirth
- 2018
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Ingår i: Women and Birth. - : Elsevier BV. - 1878-1799 .- 1871-5192. ; 31:4, s. 299-306
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Fear of childbirth is a serious problem that can have negative effects on both women and babies and to date treatment options are limited. The aim of this study was to elucidate the experience of undergoing art therapy in women with severe fear of childbirth.METHOD: Nineteen women residing in Sweden, who had undergone art therapy for severe fear of childbirth, were interviewed during 2011-2013 about their experiences of the treatment. All women had received both support from a specialist team of midwives and treatment by an art therapist who was also a midwife. The women were interviewed three months after giving birth. The transcribed interviews were analysed with a phenomenological hermeneutical method.FINDINGS: A main theme and three themes emerged from the analysis. The main theme was Gaining hope and self confidence. The three themes were; Carrying heavy baggage, Creating images as a catalyst for healing and Gaining new insights and abilities. Through the use of images and colours the women gained access to difficult emotions and the act of painting helped them visualize these emotions and acted as a catalyst for the healing process.DISCUSSION: Art therapy was well accepted by the women. Through sharing their burden of fear by creating visible images, they gained hope and self-confidence in the face of their impending childbirth.CONCLUSION: The results may contribute to knowledge about the feasibility of treating fear of childbirth by art therapy.
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| 32. |
- Wrammert, Johan, 1974-, et al.
(författare)
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Teamwork among midwives during neonatal resuscitation at a maternity hospital in Nepal
- 2017
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 30:3, s. 262-269
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Tidskriftsartikel (refereegranskat)abstract
- PROBLEM: The ability of health care providers to work together is essential for favourable outcomes in neonatal resuscitation, but perceptions of such teamwork have rarely been studied in low-income settings.BACKGROUND: Neonatal resuscitation is a proven intervention for reducing neonatal mortality globally, but the long-term effects of clinical training for this skill need further attention. Having an understanding of barriers to teamwork among nurse midwives can contribute to the sustainability of improved clinical practice.AIM: To explore nurse midwives' perceptions of teamwork when caring for newborns in need of resuscitation.METHODS: Nurse midwives from a tertiary-level government hospital in Nepal participated in five focus groups of between 4 and 11 participants each. Qualitative Content Analysis was used for analysis.FINDINGS: One overarching theme emerged: looking for comprehensive guidelines and shared responsibilities in neonatal resuscitation to avoid personal blame and learn from mistakes. Participants discussed the need for protocols relating to neonatal resuscitation and the importance of shared medical responsibility, and the importance of the presence of a strong and transparent leadership.DISCUSSION: The call for clear and comprehensive protocols relating to neonatal resuscitation corresponded with previous research from different contexts.CONCLUSION: Nurse midwives working at a maternity health care facility in Nepal discussed the benefits and challenges of teamwork in neonatal resuscitation. The findings suggest potential benefits can be made from clarifying guidelines and responsibilities in neonatal resuscitation. Furthermore, a structured process to deal with clinical incidents must be considered. Management must be involved in all processes.
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| 33. |
- Åhlund, Susanne, et al.
(författare)
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Midwives experiences of participating in a midwifery research project: A qualitative study
- 2018
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 31:2
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Tidskriftsartikel (refereegranskat)abstract
- Problem and background: In an earlier research project midwives were asked to perform women-centered care focusing on the assumption that the physiological process in the second stage of labour could be trusted and that the midwives role should be encouraging and supportive rather than instructing. There is no knowledge about how midwives participating in such a research project, uses their skills and experience from the study in their daily work. Aim: The aim in this study was to investigate how midwives experienced implementing woman-centered care during second stage of labour. Methods: A qualitative study was designed. Three focus groups and two interviews were conducted. The material was analysed using content analysis. Findings: The participating midwives' experiences were understood as increased awareness of their role as midwives. The overarching theme covers three categories 1) establishing a new way of working, 2) developing as midwife, 3) being affected by the prevailing culture. The intervention was experienced as an opportunity to reflect and strengthen their professional role, and made the midwives see the women and the birth in a new perspective. Conclusions: Implementing woman-centered care during second stage of labour gave the midwives an opportunity to develop in their professional role, and to enhance their confidence in the birthing women and her ability to have a physiological birth. To promote participation in, as well as conduct midwifery research, can enhance the development of the midwives professional role as well as contribute new knowledge to the field.
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| 34. |
- Begley, Cecily, 1954, et al.
(författare)
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A qualitative exploration of techniques used by expert midwives to preserve the perineum intact
- 2019
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192. ; 32:1, s. 87-97
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Tidskriftsartikel (refereegranskat)abstract
- Background: The perineum stretches during birth to allow passage of the baby, but 85% of women sustain some degree of perineal trauma during childbirth, which is painful post-partum. Episiotomy rates vary significantly, with some countries having rates of >60%. Recent Irish and New Zealand studies showed lower severe perineal trauma and episiotomy rates than other countries. Aim: To explore expert Irish and New Zealand midwives' views of the skills that they employ in preserving the perineum intact during spontaneous vaginal birth. Methods: Following ethical approval a qualitative, descriptive study was undertaken. Semi-structured, recorded, interviews were transcribed and analysed using the constant comparative method. Expert midwives employed in New Zealand and one setting in Ireland, were invited to join the study. "Expert" was defined as achieving, in the preceding 3.5 years, an episiotomy rate for nulliparous women of <11.8%, a `no suture' rate of 40% or greater, and a severe perineal tear rate of < 3.2%. Twenty-one midwives consented to join the study. Results: Fourcore themes emerged: 'Calm, controlled birth', 'Position and techniques in early second stage', 'Hands on or off?' and 'Slow, blow and breathe the baby out.' Using the techniques described enabled these midwives to achieve rates, in nulliparous women, of 3.91% for episiotomy, 59.24% for 'no sutures', and 1.08% for serious lacerations. Conclusions: This study provides further understanding of the techniques used by expert midwives at birth. These findings, combined with existing quantitative research, increases the evidence on how to preserve the perineum intact during spontaneous birth. (c) 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
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| 35. |
- Lundgren, Ingela, 1957, et al.
(författare)
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Cultural perspectives on vaginal birth after previous caesarean sectionin countries with high and low VBAC rates – a hermeneutic study
- 2019
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Ingår i: Women & Birth. - : Elsevier BV. - 1871-5192.
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCaesarean section (CS) rates are increasing worldwide, an increase that is multifactorial and not well understood. There is considerable variation in the rates of vaginal birth after previous Caesarean section (VBAC). Cultural differences could be one explanation of the varying rates.ObjectiveTo interpret cultural perspectives on VBAC.MethodsA hermeneutic approach for analysing findings from four published qualitative studies that were part of the OptiBIRTH study, focusing on clinicians and women’s views of important factors for improving the rate of VBAC. 115 clinicians and 73 women participated in individual interviews and focus group interviews in countries with low rates (Germany, Italy and Ireland) and countries with high rates (Sweden, Finland and the Netherlands), in the original studies.ResultsThree themes demonstrated how the culture differs between the high and low VBAC rate countries; from being an obvious first alternative to an issue dependent on many factors; from something included in the ordinary care to something special; and from obstetrician making the final decision to a choice by the woman. The fourth theme, preparing for a new birth by early follow-up and leaving the last birth behind, reflects coherence between the cultures.DiscussionThe findings deepen our understanding of why the VBAC rates vary across countries and healthcare settings, and can be used for improving the care for women.ConclusionIn order to improve VBAC rates both maternity care settings and individual professionals need to reflect on their VBAC culture, and make make changes to develop a ‘pro-VBAC culture’.
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| 36. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Consumption of alcohol during pregnancy-A multinational European study
- 2017
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192. ; 30:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although single-country studies indicate alcohol consumption among some pregnant European women, it is difficult to interpret European differences. Few multinational studies exist using the same methodology. Aim: To estimate the proportion of women consuming alcohol during pregnancy in Europe, and to analyze whether between country variations could be explained by sociodemography and smoking. Methods: An anonymous online questionnaire was accessible for pregnant women and new mothers in 11 European countries during two months between October 2011 and February 2012 in each country. The questionnaire covered alcohol consumption, sociodemographic factors, and smoking habits during pregnancy. Descriptive analyses and logistic regression models were conducted. Findings: The study population consisted of 7905 women, 53.1% pregnant and 46.9% new mothers. On average, 15.8% reported alcohol consumption during pregnancy. The highest proportion of alcohol consumption during pregnancy was found in the UK (28.5%), Russia (26.5%), and Switzerland (20.9%) and the lowest in Norway (4.1%), Sweden (7.2%), and Poland (9.7%). When reporting alcohol consumption during pregnancy, 39% consumed at least one unit per month. In Italy, Switzerland, and the UK, over half consumed at least one alcohol unit per month. Higher education and smoking before pregnancy were predictors of alcohol consumption during pregnancy. Conclusions: Almost 16% of women resident in Europe consumed alcohol during pregnancy with large cross-country variations. Education and smoking prior to pregnancy could not fully explain the differences between the European countries. A united European strategy to prevent alcohol consumption during pregnancy is needed with focus on countries with the highest consumption. (C) 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
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| 37. |
- Rasmussen, Bodil, et al.
(författare)
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Breastfeeding practices in women with type 1 diabetes: A discussion of the psychosocial factors and policies in Sweden and Australia
- 2015
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192. ; 28:1, s. 71-75
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women with type 1 diabetes (T1DM) face many challenges during their pregnancy, birth and in the postnatal period, including breastfeeding initiation and continuation while maintaining stable glycaemic control. In both Sweden and Australia the rates of breastfeeding initiation are high. However, overall there is limited information about the breastfeeding practices of women with T1DM and the factors affecting them. Similarities in demographics, birth rates and health systems create bases for discussion. Aim: The aim of this paper is to discuss psychosocial factors, policies and practices that impact on the breastfeeding practices of women with T1DM. Findings: Swedish research indicates that the overall breastfeeding rate in women with T1DM remains significantly lower than in women without diabetes in the first 2 and 6 months after childbirth with no differences in exclusive breastfeeding. Breastfeeding initiation and continuation among women with T1DM in Sweden has been shown to be influenced by health services delivery, supportive breastfeeding polices and socio-economic factors, particular perceived support from social networks and health professionals. Conclusion: There is limited research on the impact of attitudes towards breastfeeding, emotional and social well-being and diabetes-related stress on the decision of women with T1DM to initiate and continue to breastfeed for at least 6 months. A more comprehensive understanding of the breastfeeding practices and psychosocial factors operating during the first 6 months after birth for women with T1DM will be instrumental in the future design of interventions promoting initiation and continuation of breastfeeding in Sweden, Australia and elsewhere.
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| 38. |
- Risa, Christina Furskog, et al.
(författare)
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Norwegian nurse-midwives' perspectives on the provision on antenatal diabetes care in an outpatient setting: A qualitative study
- 2015
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192. ; 28:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is limited research related to nurse-midwives’ accounts of their provision of antenatal diabetes care in hospital outpatient settings. This study explored the perspectives and experiences of eight Norwegian nurse-midwives regarding the provision of the midwifery aspect of an antenatal consultation as part of the diabetes specialist team. Methods: A qualitative descriptive study was used. Eight nurse-midwives aged between 37 and 58 years, representing four Norwegian hospital outpatient clinics, participated in individual interviews. Transcribed interviews were analysed in accordance with a qualitative thematic analysis. Results: Three main themes were developed: ‘‘Approaching the women as persons in order to frame strengths and normalcy’’, ‘‘Managing different tasks judiciously’’ and ‘‘Balancing conflicting values’’. Some of the barriers were found to be related to the organisation of care, such as short timeframes with a medical focus, which overshadowed or forced the normalcy aspects of childbearing into the background. Managing risk and evidence-based knowledge were demanding tasks to fulfil in a judicious way. Some midwives experienced ambiguity while being forced to prioritise medical factors over woman-focused care while running others’ errands, an act of balancing conflicting values. Conclusions: The contextual conditions related to the organisation present barriers for pregnant women to receive woman-focused care beyond the medical approach. The midwifery contribution in this care setting should be clearly recognised and defined so that women can capitalise on the different professionals and their expert competencies and contributions in this setting.
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