| 1. |
- Alehagen, Siw, 1953-, et al.
(författare)
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Can women's cognitive appraisals be registered throughout childbirth?
- 2000
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Ingår i: Gynecologic and Obstetric Investigation. - : S. Karger AG. - 0378-7346 .- 1423-002X. ; 49:1, s. 31-35
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were: (a) to examine whether it was possible to measure women’s cognitive appraisals hourly during the whole process of labor and delivery, and (b) to explore how the appraisals varied during labor. Measurements from 12 nulliparous women are presented. The findings indicate that it is possible to study psychological appraisals directly, in detail and continuously during the process of labor and delivery. The women’s cognitive appraisals varied throughout labor both per individual woman and between the participating women.
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| 2. |
- Alehagen, Siw, 1953-, et al.
(författare)
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Catecholamine and cortisol reaction to childbirth
- 2001
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Ingår i: International Journal of Behavioral Medicine. - 1070-5503 .- 1532-7558. ; 8:1, s. 50-65
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Tidskriftsartikel (refereegranskat)abstract
- One way to study the stressfulness of childbirth is to examine the output of stress hormones. In this study, urinary catecholamines and salivary cortisol from 50 primiparous women were collected for 1 day during gestational weeks 37 to 39, hourly during labor and delivery, and 2 hr and 2 days postpartum. All three stress hormones increased statistically significantly from pregnancy to labor. The increase in adrenaline and cortisol was more than 500%, and the increase in noradrenaline was about 50%. After labor, the output decreased but not statistically significantly below the levels during late pregnancy. Hormone levels during late pregnancy, during labor and delivery, and during the period postpartum mostly did not correlate systematically. However, noradrenaline and adrenaline, as well as adrenaline and cortisol, were positively correlated during labor. After administration of epidural analgesia, there was a moderate but significant decrease in noradrenaline and adrenaline, whereas cortisol did not change. In conclusion, the results of this study support the assumption that childbirth is a very stressful event and that the stress responses vary considerably among women. The substantial increase of adrenaline and cortisol compared with noradrenaline indicates that mental stress is more dominant than physical stress during labor.
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| 3. |
- Alehagen, Siw, 1953-, et al.
(författare)
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Fear during labor
- 2001
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 80:4, s. 315-320
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Tidskriftsartikel (refereegranskat)abstract
- Background. The aims of the present study were to compare primiparous and multiparous women’s experiences of fear of delivery during an early stage of active labor (cervix dilatation 3–5 centimeters) and to study whether fear of delivery, measured during the early stage of active labor, was a predictor of the amount of pain relief received during the remaining part of labor (cervix dilatation 5 cm – partus), of the duration of the remaining part of labor, and of the occurrence of instrumental vaginal delivery and emergency cesarean section.Method. Thirty-five primiparous and 39 multiparous women answered the Delivery Fear Scale (DFS) once during the early stage of labor and before they had received any pain relief.Results. Primiparous women reported higher levels of fear than multiparous women did. Fear during the first phase of labor predicted only the total amount of pain relief received during labor.Conclusion. The clinical implications of the study are that the delivery staff should consider women’s fear during labor and pay attention especially to primiparous women’s increased risk of higher levels of fear during an early stage of active labor, as compared with multiparous women’s. The challenge for staff of a delivery ward is to support the woman in labor in a way that decreases fear, which in turn might reduce the woman’s need of pain relief.
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| 4. |
- Alehagen, Siw, 1953-, et al.
(författare)
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Fear of childbirth before, during, and after childbirth
- 2006
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 85:1, s. 56-62
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Tidskriftsartikel (refereegranskat)abstract
- Background. Only scanty research exists about the relationship between women's expectations during pregnancy and their experiences as reported during the actual process of labor and afterwards. The aims of the present study were: 1. to investigate the associations between fear of childbirth during pregnancy and postpartum and fear and pain during early active labor (phase 1: cervix dilatation 3–5 cm), and 2. to explore possible differences regarding fear of childbirth during pregnancy and postpartum between women who did or did not receive epidural analgesia during labor.Methods. Fear of childbirth was measured in 47 nulliparous women during gestation weeks 37–39 by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ version A). During early active labor we measured women's fear (Delivery Fear Scale) and their experiences of pain (a pain intensity scale). Finally, fear after childbirth (W-DEQ version B) was measured two hours, two days, and five weeks after delivery.Results. A positive correlation appeared between fear of childbirth during pregnancy, postpartum, and early active labor. There were no differences in fear of childbirth during late pregnancy between women who received epidural analgesia and those who did not. Postpartum fear was higher in the women who had received epidural analgesia.Conclusions. Pregnant women who fear childbirth are prone to report fear during the actual labor and postpartum. The administration of epidural analgesia is not a sufficient response to women's fear during the process of labor.
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| 5. |
- Alehagen, Siw, 1953-, et al.
(författare)
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Fear, pain and stress hormones during childbirth
- 2005
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 26:3, s. 153-165
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Tidskriftsartikel (refereegranskat)abstract
- Aims. To investigate the course of fear, pain and stress hormones during labor, and the associations between fear, pain, stress hormones and duration of labor in nulliparous women with and without epidural analgesia (EDA).Method. One day during gestation weeks 37–39, urinary and salivary samples were collected to measure catecholamines and cortisol. Hourly during labor, the participants answered the Delivery Fear Scale and a pain intensity scale, and urinary and salivary samples were collected to measure stress hormones.Results. The course of fear, pain and stress hormones differed throughout labor in women with and without EDA. Pain and cortisol increased throughout labor in women without EDA. Women who received EDA had more fear, but not more pain, before the administration of the EDA than women who did not receive EDA. Pain, fear and catecholamines decreased when women received EDA, but fear and pain increased again later in labor. Fear and pain correlated, as well as levels of fear in the different phases of labor. During phase one of labor epinephrine and duration of the phase were negatively correlated.Conclusion. The course of fear, pain and concentrations of stress hormones differed, highly influenced by the administration of EDA. Fear and pain correlated more pronounced than stress hormones and fear, pain and duration of labor.
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| 6. |
- Sluijs, Anne-Marie, et al.
(författare)
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Preferred and actual mode of delivery in relation to fear of childbirth
- 2020
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : TAYLOR & FRANCIS LTD. - 0167-482X .- 1743-8942. ; 41:4, s. 266-274
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This prospective cohort study aimed to investigate the interrelation between preferred/actual mode of delivery and pre- and postpartum fear of childbirth (FOC). Material and methods: Participants from 13 midwifery practices and four hospitals in Southwest Netherlands filled out questionnaires at 30 weeks gestation (n = 561) and two months postpartum (n = 463), including questions on preferred mode of delivery, the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and Hospital Anxiety Depression Scale (HADS). Results were related to obstetric data. Results: Both severe FOC (OR 7.0, p amp;lt; .001) and previous Cesarean section (CS) (OR 16.6, p amp;lt; .001) predicted preference for CS. Severe prepartum FOC also predicted actual CS. Preferring a vaginal delivery (VD) and actually having a CS predicted higher postpartum W-DEQ scores (partial r = 0.107, p amp;lt; .05). Other significant predictors for high postpartum W-DEQ scores were high prepartum W-DEQ (partial r = 0.357) and HADS anxiety scores (partial r = 0.143) and the newborn in need of medical assistance (partial r = -0.169). Conclusions: Women preferring a VD but ending up with a CS are at risk for severe FOC postpartum, while the same risk was not demonstrated for women who preferred a CS but had a VD. Prepartum FOC is strongly associated with postpartum FOC, regardless of congruence between preferred and actual mode of delivery.
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| 7. |
- Söderquist, Johan, 1968-, et al.
(författare)
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The longitudinal course of post-traumatic stress after childbirth
- 2006
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 27:2, s. 113-119
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Tidskriftsartikel (refereegranskat)abstract
- Post-traumatic stress was assessed in early and late pregnancy, and 1, 4, 7, and 11 months postpartum by means of questionnaires among 1224 women. Thirty-seven women (3%) had post-traumatic stress (meeting criteria B, C, and D for PTSD) at least once within 1–11 months postpartum. In pregnancy, depression, severe fear of childbirth, ‘pre’-traumatic stress, previous counseling related to pregnancy/childbirth, and self-reported previous psychological problems were associated with an increased risk of having post-traumatic stress within 1–11 months postpartum. Sum-scores of post-traumatic stress did not decrease over time among women who at least once had post-traumatic stress (criteria B, C, and D) within 1–11 months postpartum. Women with post-traumatic stress also showed a decrease in perceived social support over time postpartum.
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| 8. |
- Söderquist, Johan, 1968-, et al.
(författare)
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Traumatic stress after childbirth : the role of obstetric variables
- 2002
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 23:1, s. 31-39
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Tidskriftsartikel (refereegranskat)abstract
- In a sample of 1550 recently delivered women, traumatic stress after childbirth was studied in relation to obstetric variables.A post-traumatic stress disorder (PTSD) symptom profile and traumatic stress symptoms were assessed by means of the Traumatic Event Scale (TES) Obstetric data comprised delivery mode, duration of the second stage of labor (the time from cervical dilation of 10 cm to partus) and the use of analgesia/anesthesia.Traumatic stress symptoms and having a PTSD symptom profile were both significantly related to the experience of an emergency cesarean section or an instrumental vaginal delivery It is of clinical importance, however that most women with a PTSD symptom profile were found in the normal vaginal delivery group (NVD) This implies that a normal vaginal delivery can be experienced as traumatic, lust as an emergency cesarian section is not necessarily traumatic Traumatic stress symptoms were neither substantially correlated to the duration of the second stage of labor, nor to the use of analgesia/anesthesia.
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| 9. |
- Wijma, Barbro, 1944-, et al.
(författare)
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A model for critical review of literature - With vaginismus as an example
- 2007
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 28:1, s. 21-36
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Tidskriftsartikel (refereegranskat)abstract
- In this article we present a behavioral model for the critical review of the literature within a certain research field, using vaginismus as an example. We searched the literature for the title word "vaginismus" and analyzed to what extent the articles dealt with the following seven categories: prevention, etiology, maintaining factors, consequences, object of intervention, method of intervention, and method of evaluation. In each category we scrutinized the content of the articles for biological, psychological, social, relational, and gender aspects. Quality requirements of etiological and treatment studies were then added and the results presented in a "quality-adjusted" model. There were 102 articles during 1985-2001, of which 22 were included in the review. Most of the articles deal with supposed predisposing factors of etiology and different aspects of intervention. Only a few articles discuss precipitating factors, maintaining factors, or consequences of the problem. No article had a gender analysis. Only 11 of the articles fulfilled some of the proposed quality criteria. We found the behavioral model with quality requirements useful for classifying and evaluating the literature of vaginismus. The model may also be used as a guide to design methodologically good studies. © 2007 Informa UK Ltd.
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