| 1. |
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| 2. |
- Lundgren, Ingela, 1957, et al.
(author)
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Women’s experiences of childbirth, care and support – a metasynthesis
- 2009
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In: 15th Qualitative Health Research, International Institute for Qualitative Methodology's, University of Alberta, Vancouver, Canada, 4-6 October 2009.
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Conference paper (other academic/artistic)abstract
- Physical indicators have been the measure of the success of childbirth by professionals educated in a medical perspective, while the experiences of the childbearing families in different cultures have been considered of minor importance. The medicalization has the consequence of regarding every birth as potentially risky and abnormal, and requiring medical interventions. However, life changes for good, especially for women embodied through their childbirth, and the memories of the events and caring and uncaring encounters are well kept. The childbirth experiences also influence the relationships with their baby and their partner in the postpartum period, and the onset of postnatal depression, anxiety and PSTD. Several qualitative studies have described women’s experiences of childbirth, care and support in varied ways and a metasynthesis is warranted to integrate the findings. The aim is also to reflect on the findings and the theories and the methods that implicit or explicit have guided the research. The intention is to influence clinical practice, and also to push the theory and the research designs, and ask new meaningful research questions. The threefold interpretative metastudy developed by Paterson and colleagues was chosen for this collaborative metasynthesis research program in childbearing. Inclusion and exclusion criteria were developed, and seven health related databases were searched in different disciplines and findings from different cultures with the chosen keywords. Previous literature reviews were reviewed, and author and ancestry search was performed to access studies not identified through the database search. The presentation will focus on the preliminary findings from this study.
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| 3. |
- Sjöblom, Ingela, et al.
(author)
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Being a homebirth midwife in the Nordic countries – a phenomenological study
- 2015
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In: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 2015:6, s. 126-131
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Journal article (peer-reviewed)abstract
- Objective: To describe the lived experience of being a homebirth midwife in the Nordic countries. Methods: Interviews conducted with 21 homebirth midwives from the five Nordic countries were analyzed with a phenomenological approach. Results: The essential structure of being a homebirth midwife in the Nordic countries can be understood as realizing altruistic values and fulfilling one’s own desires for working life, by facilitating the desires of the women giving birth. By being “active-passive” – using all her senses and letting her intuition lead her – the midwife supports women during labor and birth. Medical skills, evidence-based knowledge and experience are important for providing the optimal care in each situation. Further this becomes the midwife’s chosen lifestyle, which alters her own self, making her available to assist the mother-to-be in fulfilling her wishes for a good birth. Finally, being able to use one’s own full potential during a home birth is experienced as the ideal way of working as a midwife, practicing the art of midwifery. Conclusion: The experience of being a homebirth midwife in the Nordic countries includes making an adaption to a lifestyle that is considered the basis for a satisfactory and rewarding way of working. A sense of fulfillment is achieved through experiencing the possibility to work according to one’s own ideals concerning the art of midwifery. The beliefs about a woman’s ability to give birth and understanding the importance of a positive birth for both the mother and the newborn baby are essential.
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| 4. |
- Aagaard Nohr, Ellen, et al.
(author)
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Evidence-based midwifery
- 2022
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In: Theories and perspectives for midwifery: a Nordic view. - Lund : Studentlitteratur. - 9789144143194 ; , s. 79-94
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Book chapter (peer-reviewed)abstract
- In this chapter, the history of evidence-based care and practice and their main principles will be presented, including a special focus on the field of obstetrics and midwifery. We will describe and discuss the main components of evidence-based midwifery and how they have been applied on important topics within maternal and newborn care. Finally, we will discuss the opportunities and challenges that midwives in the Nordic countries face when applying evidence-based care in a clinical setting that is dominated by large obstetric wards.
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| 5. |
- Ahl, Maria, et al.
(author)
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Working with home birth - Swedish midwives´experiences
- 2018
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In: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756. ; :18, s. 24-29
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Journal article (peer-reviewed)abstract
- Objective: The aim was to describe Swedish midwives’ experiences of working with home birth. Methods: Two focus group interviews were conducted with eight home birth-attending midwives. Data were analysed with qualitative content analysis. Results: Four main categories were identified: the birth as a meaningful moment; to fully focus on the birth; to practise the craft; and not to be part of the health care system. The midwives viewed childbirth as a significant moment that should be conducted on the woman’s terms. Working with home birth enabled them to work at their own pace and focus fully on the woman. During home births, they learned more about normal birth, and developed their practical skills and professional knowledge with little reliance on technology. They did, however, not feel fully accepted in the maternity care system. Conclusion: This study contributes to the discussion about midwives’ experiences of working with home birth in contexts where home birth is not covered by public health care. The study shows that the work environment influences how midwives perform their craft, how they follow and support normal birth, and how the birth setting influence valuing their work.
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| 6. |
- Ahlvik, Marie, et al.
(author)
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An important task: Midwives’ experiences of identifying children at risk of neglect
- 2022
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In: Sexual and Reproductive Healthcaare. - : Elsevier BV. - 1877-5756. ; 32:June
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Journal article (peer-reviewed)abstract
- Background: Neglect is a form of child abuse in which the child’s basic needs are not met. Early identification of the risk factors and protective factors is key to intervention strategies when a child is at risk of neglect. Few international studies describe midwives’ experiences of identifying children at risk of neglect, and no Swedish studies have been found. Objectives: The aim was to describe midwives’ experiences of identifying children at risk of neglect. Method: A qualitative method with a phenomenological reflective lifeworld approach. Interviews with ten midwives from two hospitals and six antenatal clinics in the western part of Sweden, with six from antenatal care and four from postpartum care. Results: The essential structure of midwives’ experiences is described as an important dimension of their profession that is a difficult, complex, ambiguous, and divided task. There is a fear of losing the relationship with the woman and worry about misinterpreting signals. Professional differences may arise when midwives are questioned by colleagues on decisions they have made when identifying children at risk of neglect. Midwives expressed their desire to work in a cohesive maternity healthcare system so that the women experience continuity during pregnancy, childbirth, and postpartum care. Conclusions: The study shows how midwives, during both antenatal and postpartum care, have an important but difficult task in identifying children at risk of neglect. During pregnancy and postpartum care, midwives in Sweden meet almost all women and therefore have a unique opportunity for early detection and action.
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| 7. |
- Akhavan, Sharareh, et al.
(author)
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Midwives' experiences of doula support for immigrant women in Sweden : A qualitative study
- 2012
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In: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 28:1, s. 80-85
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Journal article (peer-reviewed)abstract
- Objective: to describe and analyse midwives’ experiences of doula support for immigrant women in Sweden. Design: qualitative study, analysed using content analysis. Data were collected via interviews. Setting: interviews were conducted at the midwives’ workplaces. One midwife was interviewed at a cafe. Participants: ten midwives, who participated voluntarily and worked in maternity health care in western Sweden. Findings: the interview data generated three main categories. (1) ‘A doula is a facilitator for the midwife’ has two subcategories, ‘In relation to the midwife’ and ‘In comparison with an interpreter’, (2) ‘Confident women giving support, ’has two subcategories, ‘Personal characteristics and attitudes’ and ‘Good support,’ (3) ‘Doulas cover shortcomings’ has two subcategories, ‘In relation to maternity care’ and ‘In relation to ethnicity’. Key conclusion and implications for practice: The findings of this study show that midwives experience that doulas are a facilitator for them. Doulas provide support by enhancing the degree of peace and security and improving communication with the women in childbirth. Doulas provide increased opportunities for transcultural care. They may increase childbearing women’s confidence and satisfaction, help meet the diverse needs of childbearing women and improve care quality.
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| 8. |
- Andreasson, Ingela, 1953, et al.
(author)
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Skolans praktik – att styra mot idealet
- 2009
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In: Specialpedagoski forskning – en mångfacetterad utmaning. Red. Ann Ahlberg.. - Lund : Stundentlitteratur. - 9789144052144 ; , s. 281-298
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Book chapter (other academic/artistic)
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| 9. |
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| 10. |
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Att stödja och stärka- vårdande vid barnafödande
- 2010
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Editorial collection (other academic/artistic)abstract
- I Sverige behöver var tionde nyfött barn särskild vård under nyföddhetsperioden, s.k neonatalvård. Föräldrarna välkomnas att vara hos sitt barn dygnet runt vilket dock inte alltid är praktiskt möjligt då det kan saknas boende för dem på sjukhuset. De uppmuntras även att tilsammans med vårdpersonalen delta i sitt barns vård. Ofta är föräldrarna mycket oroliga, både för att mista sitt barn och för att barnet tar skada av behandling och undersökning. Vårdpersonalens kompetens, öppenhet och emotionella stöd är viktiga faktorer för föräldrarna. Idealt sett bör vårdandet i neonatalperioden företas av både föräldrar och professionella i samspel- ofta kallat familjeinriktad vård.
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| 11. |
- Begley, Cecily, 1954, et al.
(author)
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Evaluation of an intervention to increase vaginal birth after caesarean section through enhanced women-centred care: The OptiBIRTH randomised trial (ISRCTN10612254)
- 2017
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In: 31th ICM Triennial Congress.
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Conference paper (other academic/artistic)abstract
- Background: Vaginal birth after a previous caesarean (VBAC) is a safe alternative to repeat caesarean section (CS), is the preferred option of most women and may reduce overall CS rates.1 However, VBAC rates vary; e.g., rates in Germany, Ireland and Italy are considerably lower (29-36%) than those in the Netherlands, Sweden and Finland (45-55%). Purpose/Objective: To evaluate the effectiveness of an intervention to maximise VBAC rates. The OptiBIRTH Project was funded by a European Union Grant: FP7-HEALTH-2012-INNOVATION-1-HEALTH.2012.3.2-1. Agreement No:305208 Method: A cluster randomised trial was used. A sample size of 12 maternity units was required, each recruiting 120 consenting women, to detect an absolute 15% difference in successful VBACs (increase from 25% in control to 40% in intervention groups), using an ICC of 0.05, with power of >80% and an alpha of 0.05. To allow for loss to follow-up, 15 trial units were randomised across three countries with low VBAC rates (Germany, Ireland and Italy) and the trial commenced April 2014. An evidence-based intervention was introduced in all intervention sites. Control sites had usual care. Interim analysis by an independent Data Monitoring Committee at mid-point permitted continuation. Data were analysed using intention to treat. Key Findings: Recruitment closed October 2015, with the last babies born in December 2015, and data analysis will be completed in April 2016. The primary outcome, comparison of annual VBAC rates for each hospital before and after introduction of the intervention will be presented, and selected secondary outcomes for the recruited women including: mode of birth, perineal trauma, breastfeeding, uterine rupture, wound breakdown, perinatal mortality, Apgar scores, and admission to neonatal intensive care unit. Discussion: If the OptiBIRTH intervention increases VBAC rates safely, its introduction across Europe could prevent 160,000 unnecessary CSs every year, saving maternity services >€150 million annually and contributing to the normalisation of birth for thousands of women. References: 1 Cunningham et al (2010). National Institute of Health Consensus Development Conference Statement: Vaginal birth after caesarean. Obstet & Gynecol 115(6): 1279-1295. 2 EURO-PERISTAT 2008: CD006066.EURO-PERISTAT Project (2008). European Perinatal Health Report. (www.europeristat.com).
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| 12. |
- Berg, Marie, 1955, et al.
(author)
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A midwifery model of childbirth care - Development and implementation in Sweden and Iceland
- 2014
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In: Optimizing childbirth across Europe - an intedisciplinary maternity care conference. 9-10 April 2014, Brussels. Part of COST Action IS0907: Childbirth Cultures, Concerns & Consequences: Creating a dynamic EU framework for Optimal maternity care..
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Conference paper (other academic/artistic)abstract
- Introduction: Theoretical models are important as tools for guiding health care practice, also when optimising quality of maternity care. Aim of study: The aim was to identify and implement an evidence based woman centred midwifery model of childbirth care in the cultural context of Sweden and Iceland. Research methodology: With a qualitative hermeneutic approach a woman centred model of care was developed by a synthesis and meta-interpretation of own published qualitative studies (n=12) about women´s and midwives´ experiences of child birthing. for purposes of validity and reliability the model was assessed in six focus group interviews with practising midwives (n=30). for implementation of the model in praxis we had discussions with midwives in practice and with midwifery teachers. Ethical approval: Ethical approval was obtained in the earlier studies. Study findings: The model includes five main themes. Three central intertwined themes with sub-themes that involve interactions with each woman and family are: a reciprocal relationship; a birthing atmosphere; and grounded knowledge. The remaining two themes around the others, which likewise influence care, are the cultural context with hindering and promoting norms of a midwifery approach and the balancing act in basing work on midwifery philosophies, facilitating woman-centred maternity care in cooperation with other health professionals. Implementation and evaluation of this salutogenic woman centred midwifery model is in progress. Conclusion: In an era of rising technicality, the model with its balancing act could have positive impact on provision and outcome of childbirth care, raise normality of all birth and interdisciplinary care. This midwifery model of care could be a broad theoretical framework in maternity care and applied to other cultural contexts for the benefit of the women, babies and families.
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| 13. |
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| 14. |
- Berg, Marie, 1955, et al.
(author)
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A midwifery model of woman-centred childbirth care – In Swedish and Icelandic settings
- 2012
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In: Sexual & Reproductive Healthcare. - : Elsevier BV. - 1877-5756. ; 3:2, s. 79-87
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Journal article (peer-reviewed)abstract
- Background: Theoretical models for health care practice are important both as tools for guiding daily practice and for explaining the philosophical basis for care. Aim: The aim of this study was to define and develop an evidence-based midwifery model of womancentred care in Sweden and Iceland. Method: Using a hermeneutic approach we developed a model based on a synthesis of findings from 12 of our own published qualitative studies about women’s and/or midwives’ experiences of childbirth. For validity testing, the model was assessed in six focus group interviews with 30 practising midwives in Iceland and Sweden. Findings: The model includes five main themes. Three central intertwined themes are: a reciprocal relationship; a birthing atmosphere; and grounded knowledge. The remaining two themes, which likewise influence care, are the cultural context (with hindering and promoting norms); and the balancing act involved in facilitating woman-centred care. Conclusion: The model shows that midwifery care in this era of modern medical technology entails a balancing act for enhancing the culture of care based on midwifery philosophies. The next step will be to implement the model in midwifery programmes and in clinical practice, and to evaluate its applicability.
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| 15. |
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| 16. |
- Berg, Marie, 1955, et al.
(author)
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Att vårda vid barnafödande är att stödja och stärka
- 2004
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In: Att stödja och stärka – vårdande vid barnafödande, Berg, M. ; Lundgren, I. (red). - : Studentlitteratur. - 9789144032153 ; , s. 195-198
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Book chapter (other academic/artistic)
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| 17. |
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| 18. |
- Berg, Marie, 1955, et al.
(author)
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Evidence-based care and childbearing - A critical approach
- 2008
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In: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; :3, s. 239-247
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Journal article (peer-reviewed)abstract
- Developing the best care for clients and patients is a paramount aim of all health care practices, which therefore, should be based on best evidence. This is also crucial for care during the childbearing period here defined as pregnancy, childbirth, and infancy. However, due to dominance of the evidence-based medicine (EBM) model, health care practice has encountered problems especially regarding its relationship to qualitative research. In this article, we analyze and discuss how research based on a lifeworld perspective fits with evidence-based care (EBC), and how a circular model instead of a hierarchy is suitable when attributing value to knowledge for EBC. The article focuses on the history of EBM and EBC, the power of the evidence concept, and EBC from a narrow to a broad view. Further qualitative research and its use for developing EBC is discussed and examples are presented from the authors’ own lifeworld research in the Nordic childbearing context. Finally, an alternative circular model of knowledge for EBC is presented. In order to develop evidence-based care, there is need for multiple types of scientific knowledge with equal strength of evidence, integrated with clinical experience, setting, circumstances and health care resources, and incorporating the experiences and clinical state of the childbearing woman and her family.
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| 19. |
- Berg, Marie, 1955, et al.
(author)
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Evidensbaserat yrkesutövande : Hur mäter vi sexuell, reproduktiv och perinatal hälsa?
- 2016
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In: Reproduktiv hälsa - barnmorskans kompetensområde. Helena Lindgren et al. Del 1, 4.2, s. 60-64. - Lund : Studentlitteratur AB. - 9789144090054 ; , s. 60-64
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Book chapter (peer-reviewed)abstract
- Reproduktiv, perinatal och sexuell hälsa är ett självständigt huvudområde knutet till livets början och området för mänsklig reproduktion i ett livscykel- och genusperspektiv. Inom huvudområdet studeras och utvecklas kunskap om den normala processen och dess avvikelser i samband med graviditet, förlossning och nyföddhetsperiod samt föräldraskapets utveckling. Vidare studeras och utvecklas kunskap och teorier om kvinnors reproduktiva hälsa, sexualitet och fertilitetskontroll samt barnmorskans främjande, förebyggande, vårdande och behandlande arbete - med och för - kvinnan, barnet och familjen. Reproduktiv hälsa omfattar barnmorskans verksamhet inom reproduktiv, perinatal och sexuell hälsa. Boken är uppbyggd utifrån ICM:s (International Confederation of Midwives) beskrivning av barnmorskans kompetensområden, och den omfattar även ett webbmaterial med bland annat sammanfattningar i form av bildspel, tester och undervisningsfilmer. Boken riktar sig till barnmorskestudenter och yrkes verk samma barnmorskor samt till övriga hälsoprofessioner verksamma inom reproduktiv hälsa. Reproduktiv hälsa är framtagen i dialog med, och granskad av, vårt vetenskapliga råd. Vi rekommenderar att den används som lärobok i barnmorskeutbildningen fortsättningsvis.
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| 20. |
- Berg, Marie, 1955, et al.
(author)
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Värdegrunden för vårdandet vid barnafödande : Att stödja och stärka. Vårdande vid barnafödande
- 2010
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Book (other academic/artistic)abstract
- Många är rädda för att föda, trots att förutsättningarna i vårt land oftast är de bästa för att få en normal och lyckad förlossning. I denna bok, som är en revidering av 2004 års upplaga med tre helt nya kapitel, skriver elva författare om sin egen forskning kring möte, stöd och vårdorganisation vid barnafödande. Detta kunskapsområde lämpar sig framför allt för barnmorskor, men även för andra inom vården. Den professionella vårdaren bör tänka på att de egna grundvärderingarna påverkar både förhållningssättet och vården. Att ge tid och att möta föräldrar i en öppen dialog med förståelse och respekt är centralt för att kunna stärka dem. Det kan även innebära en balansgång mellan naturligt födande och att se till de medicinska behoven. P S-K
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| 21. |
- Bergbom, Ingegerd, 1947, et al.
(author)
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First-time pregnant women’s experiences of their body in early pregnancy
- 2017
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 31:3, s. 579-586
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Journal article (peer-reviewed)abstract
- Background: The body of first-time pregnant women is affected in many ways, and the women may not know what to expect. Conversations between women and healthcare personnel about women’s bodily experience in early pregnancy can contribute to increased body knowledge, which may have a positive impact in later stages of their pregnancy and in relation to delivery. The aim of the study was to describe first-time pregnant women’s experiences of their body in early pregnancy (pregnancy weeks 10–14). Method: Twelve women were asked to draw pictures and answer questions freely about their experiences of their first pregnant body. Hermeneutical text interpretation was used to obtain an overall view of the experiences. Findings: A main theme emerged: ‘the body is connected to the cycle of life’. This theme comprised five subthemes: ‘bodily longing and a sense of ambivalence’, ‘being 'doubtful’, ‘welcoming changes in body and mind’, ‘feeling inner strength and struggle to find strength’ and ‘accepting a different body and mind’. This main theme and the subthemes were further interpreted and were understood as an experience of ‘me and my body’. Conclusions: The body reminded the women to take care of it and gave rise to positive thoughts. When the body exhibited uncomfortable reactions and sensations, these were taken as evidence of pregnancy, which was also seen positive but it also triggered a sense of dissatisfaction with the body and a feeling of it becoming alien.
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| 22. |
- Blix, Ellen, et al.
(author)
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Midwifery in a Nordic context
- 2022
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In: Theories and perspectives for midwifery. - Lund : Studentlitteratur. - 9789144143194
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Book chapter (peer-reviewed)abstract
- In this chapter, we present the Nordic countries and people, and the Nordic welfare model. Maternity care and midwifery within the welfare state model are presented, and challenges in Nordic midwifery are discussed. Organisation of maternity care is in some aspects fairly similar in the Nordic countries but there are differences between and within countries. However, all countries have a long tradition of midwifery care with professional and licensed midwives practising autonomously and being the most central healthcare professional in maternity care.
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| 23. |
- Carin, Modh, et al.
(author)
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First time pregnant women's experiences in early pregnancy
- 2011
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In: International journal of qualitative studies on health and well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 6:2
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Journal article (peer-reviewed)abstract
- Background: There are few studies focusing on women’s experiences of early pregnancy. Medical and psychological approaches have dominated the research. Taking women’s experiences seriously during early pregnancy may prevent future suffering during childbirth. Aim: To describe and understand women’s first time experiences of early pregnancy. Method: Qualitative study using a phenomenological hermeneutic approach. Data were collected via tape-recorded interviews in two antenatal care units in Sweden. Twelve first time pregnant women in week 10-14, aged between 17 and 37 years participated. Results: To be in early pregnancy means for the women a life opening both in terms of life affirming and suffering. The central themes are: living in the present and thinking ahead, being in a change of new perspectives and values and being in change to becoming a mother. Conclusions: The results have implications for the midwife’s encounter with the women during pregnancy. Questions of more existential nature, instead of only focusing the physical aspects of the pregnancy, may lead to an improvement in health condition and a positive experience for the pregnant woman.
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| 24. |
- Carlsson, Ylva, 1975, et al.
(author)
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Parents’ experiences of the information provided at the antenatal clinic regarding foetal diagnostics – A qualitative interview study
- 2021
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In: Sexual and Reproductive Healthcare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 29
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Journal article (peer-reviewed)abstract
- Objective: This study aimed to examine the pregnant women's and their partner's experience of the information given at the antenatal clinic regarding screening methods. Methods: A qualitative interview study was conducted in the Gothenburg area in Sweden. Ten women and seven partners expecting their first child were interviewed adjacent to the second-trimester ultrasound examination. The data were analysed using qualitative content analysis. Results: The findings present an overall theme, three main categories, and ten subcategories. The overall theme showed a nonhomogeneous and individually based picture concerning the meaning and purpose of the methods, need for improvement of information, parents own information seeking, and the encounter with the midwife was also experienced as an influential encounter. The main categories show that diversity relates to the level of information given, voluntariness, the possibility of abnormal findings, and varying needs to thorough information and pre-existing knowledge. The midwifés impact was related to attitude, openness for questions, time for explanations, and the balance between providing enough information to support without worrying the parents. Conclusions: Although previous research has pointed out a decade ago that information regarding foetal diagnostics is lacking, this study shows that these shortcomings still exist and that improvement is needed. The given information should be explicit concerning the purpose, limitations, and voluntariness of prenatal testing. Sufficient time for questions and discussion is as important as considering the parents’ pre-existing knowledge, individual thoughts or questions, and a neutral attitude from the midwife is desirable.
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| 25. |
- Clarke, Mike, et al.
(author)
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OptiBIRTH: a cluster randomised trial of acomplex intervention to increase vaginalbirth after caesarean section
- 2020
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In: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393.
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Journal article (peer-reviewed)abstract
- Background: Despite evidence supporting the safety of vaginal birth after caesarean section (VBAC), rates are lowin many countries.Methods: OptiBIRTH investigated the effects of a woman-centred intervention designed to increase VBAC ratesthrough an unblinded cluster randomised trial in 15 maternity units with VBAC rates < 35% in Germany, Ireland andItaly. Sites were matched in pairs or triplets based on annual birth numbers and VBAC rate, and randomised, 1:1 or 2:1, intervention versus control, following trial registration. The intervention involved evidence-based education ofclinicians and women with one previous caesarean section (CS), appointment of opinion leaders, audit/peer review,and joint discussions by women and clinicians. Control sites provided usual care. Primary outcome was annualhospital-level VBAC rates before the trial (2012) versus final year of the trial (2016). Between April 2014 and October2015, 2002 women were recruited (intervention 1195, control 807), with mode-of-birth data available for 1940women.Results: The OptiBIRTH intervention was feasible and safe across hospital settings in three countries. There was nostatistically significant difference in the change in the proportion of women having a VBAC between interventionsites (25.6% in 2012 to 25.1% in 2016) and control sites (18.3 to 22.3%) (odds ratio adjusted for differences betweenintervention and control groups (2012) and for homogeneity in VBAC rates at sites in the countries: 0.87, 95% CI:0.67, 1.14, p = 0.32 based on 5674 women (2012) and 5284 (2016) with outcome data. Among recruited womenwith birth data, 4/1147 perinatal deaths > 24 weeks gestation occurred in the intervention group (0.34%) and 4/782in the control group (0.51%), and two uterine ruptures (one per group), a rate of 1:1000.Conclusions: Changing clinical practice takes time. As elective repeat CS is the most common reason for CS inmultiparous women, interventions that are feasible and safe and that have been shown to lead to decreasingrepeat CS, should be promoted. Continued research to refine the best way of promoting VBAC is essential. Thismay best be done using an implementation science approach that can modify evidence-based interventions inresponse to changing clinical circumstances.Trial registration: The OptiBIRTH trial was registered on 3/4/2013. Trial registration number ISRCTN10612254.
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| 26. |
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| 27. |
- Dencker, Anna, 1956, et al.
(author)
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Measuring women's experiences of decision-making and aspects of midwifery support: a confirmatory factor analysis of the revised Childbirth Experience Questionnaire
- 2020
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In: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 20:1
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Journal article (peer-reviewed)abstract
- BackgroundWomen's experiences of labour and birth can have both short- and long-term effects on their physical and psychological health. The original Swedish version of the Childbirth Experience Questionnaire (CEQ) has shown to have good psychometric quality and ability to differentiate between groups known to differ in childbirth experience. Two subscales were revised in order to include new items with more relevant content about decision-making and aspects of midwifery support. The aim of the study was to develop new items in two subscales and to test construct validity and reliability of the revised version of CEQ, called CEQ2.MethodA total of 11 new items (Professional Support and Participation) and 14 original items from the first CEQ (Own capacity and Perceived safety), were answered by 682 women with spontaneous onset of labour. Confirmatory factor analysis was used to analyse model fit.ResultsThe hypothesised four-factor model showed good fit (CMIN=2.79; RMR=0.33; GFI=0.94; CFI=0.94; TLI=0.93; RMSEA=0.054 and PCLOSE=0.12) Cronbach's alpha was good for all subscales (0.82, 0.83, 0.76 and 0.73) and for the total scale (0.91).ConclusionsCEQ2, like the first CEQ, yields four important aspects of experience during labour and birth showing good psychometric performance, including decision-making and aspects of midwifery support, in both primiparous and multiparous women.
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| 28. |
- Dencker, Anna, 1956, et al.
(author)
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Neonatal outcomes associated with mode of subsequent birth after a previous caesarean section in a first pregnancy: A Swedish population-based register study between 1999 and 2015
- 2022
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In: BMJ Paediatrics Open. - : BMJ. - 2399-9772. ; 6:1
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Journal article (peer-reviewed)abstract
- Objective To investigate neonatal outcomes within 28 days in the subsequent birth in women who gave birth to their first baby by caesarean section (CS). Design and setting National retrospective population-based register study. A cohort of 94 451 neonates who were born in Sweden between 1999 and 2015 as a second child to a mother who had her first birth by emergency or planned caesarean. Methods Data were retrieved from the national registers held by Statistics Sweden and the National Board of Health and Welfare. Logistic regression was used to calculate unadjusted and adjusted ORs (aOR) with 95% CIs for each outcome. Main outcome measures Neonatal infection, neonatal asphyxia/respiratory distress, neonatal hospital care and neonatal death within 28 days. Results Emergency CS and instrumental vaginal birth were associated with a doubled risk of neonatal infection (aOR 2.0) and planned CS with a decreased risk (aOR 0.7) compared with spontaneous vaginal birth. Compared with spontaneous vaginal birth, an increased risk of birth asphyxia and/or respiratory distress was identified with all other modes of birth (aOR 2.2-3.2). Emergency CS and instrumental vaginal birth, but not planned CS, were associated with neonatal hospital care (aOR 1.8 and 1.7) and an increased mortality rate during the neonatal period (aOR 2.9 and 3.2), compared with spontaneous vaginal birth. Conclusions In childbirth following a previous birth by CS, spontaneous vaginal birth appears to confer better neonatal outcomes within 28 days after birth overall than other modes of birth.
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| 29. |
- Dencker, Anna, 1956, et al.
(author)
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Suturing after childbirth--a randomised controlled study testing a new monofilament material.
- 2006
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In: Bjog. - 1470-0328. ; 113:1, s. 114-6
-
Journal article (peer-reviewed)abstract
- The aim of this study was to assess if a monofilament suture material (Biosyn) compared with a commonly used multifilament suture (Dexon II) would cause fewer problems and lower levels of discomfort and pain after suturing lacerations and episiotomies following vaginal delivery. Women (1139) who required suturing by a midwife were allocated for repair with either the multifilament polyglycolic acid suture (Dexon II) or with a new monofilament of glycomer 631 (Biosyn). The outcome assessment involved inspection of the sutured area and measuring levels of discomfort and pain with a Visual Analogue Scale (VAS). At follow up after 8-12 weeks, more women in the monofilament group reported problems with the sutured area.
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| 30. |
- Edqvist, Malin, 1971, et al.
(author)
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Midwives’ lived experience of a birth where the woman suffers an obstetric anal sphincter injury - a phenomenological study
- 2014
-
In: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 14:258
-
Journal article (peer-reviewed)abstract
- Background: The occurrence of obstetric anal sphincter injuries (OASIS) has increased in most high-income countries during the past twenty years. The consequences of these injuries can be devastating for women and have an impact on their daily life and quality of health. The aim of this study was to obtain a deeper understanding of midwives’ lived experiences of attending a birth in which the woman gets an obstetric anal sphincter injury. Methods: A qualitative study using phenomenological lifeworld research design. The data were collected through in-depth interviews with 13 midwives. Results: The essential meaning of the phenomenon was expressed as a deadlock difficult to resolve between a perceived truth among midwives that a skilled midwife can prevent severe perineal trauma and at the same time a coexisting more complex belief. The more complex belief is that sphincter injuries cannot always be avoided. The midwives tried to cope with their feelings of guilt and wanted to find reasons why the injury occurred. A fear of being exposed and judged by others as severely as they judged themselves hindered the midwives from sharing their experience. Ultimately the midwives accepted that the injury had occurred and moved on without any definite answers. Conclusions: Being caught between an accepted truth and a more complex belief evoked various emotions among the midwives. Feelings of guilt, shame and the midwife’s own suspicion that she is not being professionally competent were not always easy to share. This study shows the importance of creating a safe working environment in which midwives can reflect on and share their experiences to continue to develop professionally. Further research is needed to implement and evaluate the effect of reflective practices in relation to midwifery care and whether this could benefit women in childbirth.
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| 31. |
- Edqvist, Malin, 1971, et al.
(author)
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Midwives' Management during the Second Stage of Labor in Relation to Second-Degree Tears-An Experimental Study
- 2017
-
In: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 44:1, s. 86-94
-
Journal article (peer-reviewed)abstract
- INTRODUCTION: Most women who give birth for the first time experience some form of perineal trauma. Second-degree tears contribute to long-term consequences for women and are a risk factor for occult anal sphincter injuries. The objective of this study was to evaluate a multifaceted midwifery intervention designed to reduce second-degree tears among primiparous women.METHODS: An experimental cohort study where a multifaceted intervention consisting of 1) spontaneous pushing, 2) all birth positions with flexibility in the sacro-iliac joints, and 3) a two-step head-to-body delivery was compared with standard care. Crude and Adjusted OR (95% CI) were calculated between the intervention and the standard care group, for the various explanatory variables.RESULTS: A total of 597 primiparous women participated in the study, 296 in the intervention group and 301 in the standard care group. The prevalence of second-degree tears was lower in the intervention group: [Adj. OR 0.53 (95% CI 0.33-0.84)]. A low prevalence of episiotomy was found in both groups (1.7 and 3.0%). The prevalence of epidural analgesia was 61.1 percent. Despite the high use of epidural analgesia, the midwives in the intervention group managed to use the intervention.CONCLUSION: It is possible to reduce second-degree tears among primiparous women with the use of a multifaceted midwifery intervention without increasing the prevalence of episiotomy. Furthermore, the intervention is possible to employ in larger maternity wards with midwives caring for women with both low- and high-risk pregnancies.
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| 32. |
- Elden, Helen, 1959, et al.
(author)
-
Demanding and challenging: Men's experiences of living with a pregnant woman with pelvic girdle pain: An interview study
- 2014
-
In: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 2:4, s. 17-29
-
Journal article (peer-reviewed)abstract
- Background: Pelvic girdle pain (PGP) is a universally disabling condition affecting approximately 50% of pregnant women. Qualitative research describes how PGP leads to struggle in women’s daily lives, makes them question and doubt their roles and identities as professionals and mothers, and test their (marital) relationships. The purpose of this study was to describe men’s experiences of living with a pregnant woman with PGP. Methods: Participants were men whose pregnant partners participated in a project containing both qualitative and quantitative studies in 2009 to 2011. Interviews were conducted in person (n=18) or by telephone (n=8), lasting approximately 20-50 minutes. Sixteen men were interviewed during their wive’s pregnancies (M age = 30 years), eight men were re-interviewed within 12 months postpartum and two men were interviewed only postpartum (26 interviews). Results: Three major categories emerged: having no knowledge of PGP, a period of emotional and physical strain, and merging. Pregnancy in a woman with PGP caused men to alter focus from themselves to their partners and family. They expressed worry, powerlessness, inadequacy, and a need for support. They had to adapt and cope, both demanding and challenging. However, they stressed that relationships with their older children improved, and that they and their partners had succeeded in becoming a team. Conclusions: The findings indicated a need for greater focus from midwives and other health care providers on the psychological impact of PGP on the man/partner. This is important, not only for men but for their respective women as well, whereby men influence their partner’s health.
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| 33. |
- Elden, Helen, 1959, et al.
(author)
-
Effects of craniosacral therapy as experienced by pregnant women with severe pelvic girdle pain: An interview study
- 2014
-
In: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 2:3, s. 140-151
-
Journal article (peer-reviewed)abstract
- Abstract Background: Pelvic girdle pain (PGP) affects 50% of pregnant women worldwide. PGP increases with advancing pregnancy with considerable impact on quality of life, interfering with sleep, daily activities, work, motherhood and close interpersonal relationships. The use of Complementary and Alternative Medicine (CAM) is increasingly prevalent among pregnant women, particularly for pregnancy-induced back pain. Craniosacral treatment (CST) is a CAM that has shown symptom relieving effects in pregnancy-related back pain. The purpose of this study was to describe women’s experiences of the treatment. Methods: Twenty-seven women receiving CST plus standard treatment (ST) were interviewed following 3 of 5 treatments with CST by two qualified and experienced CST practitioners. Data were analysed using qualitative content analysis. Results: The experience of CST by pregnant women diagnosed with severe PGP can be described in three categories: An unfamiliar and different treatment method; description of treatment effects, and regaining a personal and social life. Women described how CST provided them with new awareness of their widespread muscle tension. They told of how they experienced increased body awareness, distraction from pain, relaxation and calm, and feelings of security and optimism. These factors may have helped them actively improve posture and lower muscle tension thereby relieving the symptoms of PGP. Conclusions: The present study reports a contextual interpretation of previously published quantitative data, as it provides a deeper understanding of total symptom relief from PGP during pregnancy. Trial registration: The trial is registered at Current Controlled Trials ISRCTN30566933. Key words Complementary and alternative medicine, Craniosacral therapy, Pregnancy, Pelvic girdle pain, Qualitative interview study
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| 34. |
- Elden, Helen, 1959, et al.
(author)
-
Life's pregnant pause of pain: Pregnant women's experiences of pelvic girdle pain related to daily life: A Swedish interview study
- 2013
-
In: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives. - : Elsevier BV. - 1877-5764. ; 4:1, s. 29-34
-
Journal article (peer-reviewed)abstract
- Introduction: Pelvic girdle pain (PGP) is a universally disabling condition affecting three of 10 pregnant women. Qualitative studies on the subject are lacking. Objective: To describe pregnant women’s experiences of PGP related to everyday life. Methods: In all, 27 women with PGP participating in a randomised controlled study were interviewed during 2010 to 2011. Qualitative content analysis was used. Results: Five main categories emerged; Pelvic girdle pain affects the ability to cope with everyday life; Coping with motherhood; Relationships between partners often reached th breaking point; Questioning one´s identity as defined by profession and work and; Lessons learned from living with PGP. The categories illustrate how women’s everyday lives were interrupted. Their ability to meet their own and others´ expectations put a strain on their lives causing disappointment, sadness, and frustration. It made them question and doubt their roles and identities as mothers, partners and professionals, and kept them from looking forward to future pregnancies, in the absence of effective treatment for PGP. Knowledge gained was that women with PGP should seek help immediately, listen to their bodies and acknowledge their limitations. Conclusion: PGP severely affects pregnant women’s everyday lives. There appears to be a lack of knowledge and awareness of PGP in general, as well as among caregivers and employers of PGP that needs to be highlighted and rectified. There is also a great need to learn how to support those suffering from it. Appropriate support during this important and rare phase in a woman’s life is warranted.
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| 35. |
- Elden, Helen, 1959, et al.
(author)
-
The pelvic ring of pain: Pregnant women’s experiences of pelvic girdle pain as related to embodied experiences and experiences of the healthcare care system: A Swedish interview study
- 2013
-
In: Nordisk jordmor kongress, 13-15 June 2013, Oslo.
-
Conference paper (other academic/artistic)abstract
- Objectives Pelvic girdle pain (PGP) is a universal disabling condition that affects three of 10 pregnant women. Qualitative studies on the subject are lacking .The aim with this study was to describe pregnant women’s experiences of PGP related to everyday life. Method In all, 27 women with PGP participating in a randomised controlled study were interviewed during 2010 to 2011. Content analysis was used. Results Five main categories emerged; Pelvic girdle pain affects ability to cope with everyday life; Coping with motherhood; Often personal relationships between partners reached breaking point; To question the identity defined by profession and work and; Lessons-learned from living with PGP. The categories illustrate that women’s everyday life stopped. Not being able to meet their own and others expectations putting a strain on their being and made them disappointed, sad and frustrated. It made them question and doubt their roles and identities as mothers, partners and professionals. They we’re not looking forward to another pregnancy, without any effective treatment for PGP at hand. Lessons learned were that women with PGP should seek help immediately, listen to their bodies and acknowledge their own limitations. Conclusion PGP severely affects pregnant women’s everyday life. There seems to be a lack of knowledge and awareness of PGP and how to support these women both general in society, among caregivers and employers that needs to be highlighted and rectified. Appropriate support during this important and rare phase in a woman’s life is warranted.
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| 36. |
- Elden, Helen, 1959, et al.
(author)
-
The pelvic ring of pain: Pregnant women’s experiences of severe pelvic girdle pain: An interview study
- 2014
-
In: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 2:2, s. 30-41
-
Journal article (peer-reviewed)abstract
- Background: Pelvic girdle pain (PGP) is a universal problem affecting approximately 50% of all pregnant women. For 25 to 30% of pregnant women the problem becomes severe. Methods: In-depth interviews were carried out with 27 pregnant women with severe PGP in 2009-2010. Qualitative content analysis was used. Results: The women’s experiences are summarized in four categories: A strange body; the body on guard; relation and support from health care and, acceptance of PGP. Conclusions: PGP completely preoccupied women with severe PGP. It influenced their self-evident trust in their bodies as well as their capabilities to guide and control them. The fear of triggering pain and unpleasant sensations made them avoid movement. They experienced anxiety and worry of not being able to manage their pregnancy and childbirth, and bind to their unborn child. They felt worse that their complaints are trivialized, and not taken seriously in health care. To be able to cope with PGP, they had to accept it and realize that they have to be aware and accept their bodies’ limitations. This means working with their bodies and not against them. PGP made the women look upon life more seriously and changed their self-perception. Increased awareness and knowledge are needed among healthcare to enable them to meet these women’s needs and provide them with adequate support. Information about PGP could be sent home with the woman at the first visit to the midwife. This would probably prevent or reduce the worry that can arise in women suffering severe PGP.
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| 37. |
- Elden, Helen, 1959, et al.
(author)
-
The pregnant pause of pain: Pregnant women’s experiences of pelvic girdle pain as related to daily life: A Swedish interview study
- 2013
-
In: BfIn (Barnafödande i Norden). March 2013, Gothenborg. ..
-
Conference paper (peer-reviewed)abstract
- Introduction Pelvic girdle pain (PGP) is a universally disabling condition affecting three of 10 pregnant women. Qualitative studies on the subject are lacking. Objective To describe pregnant women’s experiences of PGP as related to daily life. Methods In all, 27 women with PGP participating in a randomised controlled study were interviewed during 2010–2011. Qualitative content analysis was used. Results Five main categories emerged: PGP affects the ability to cope with everyday life; Coping with motherhood; Relationships between partners often reached the breaking point; Questioning one’s identity as defined by profession and work, and Lessons learned from living with PGP. The categories illustrate how women’s everyday lives were interrupted. Their inability to meet their own and others’ expectations put a strain on their lives causing disappointment, sadness and frustration. It made them question and doubt their roles and identities as mothers, partners and professionals, and kept them from looking forward to future pregnancies, in the absence of effective treatment for PGP. Knowledge gained was that women with PGP should seek help immediately, listen to their bodies, and acknowledge their limitations. Conclusion PGP severely affects pregnant women’s everyday lives. There appears to be a lack of knowledge and awareness in general, as well as among caregivers and employers of PGP that needs to be highlighted and rectified. There is also a great need to learn how to support those suffering from it. Appropriate support during this important and rare phase in a woman’s life is highly warranted.
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| 38. |
- Engnes, Kristin, et al.
(author)
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Experiences of being exposed to intimate partner violence during pregnancy
- 2012
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In: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 7:1
-
Journal article (peer-reviewed)abstract
- In this study a phenomenological approach was used in order to enter deeply into the experience of living with violence during pregnancy. The aim of the study was to gain a deeper understanding of women’s experiences of being exposed to intimate partner violence (IPV) during pregnancy. The data were collected through in-depth interviews with five Norwegian women; two during pregnancy and three after the birth. The women were between the age of 20 and 38 years. All women had received support from a professional research and treatment centre. The essential structure shows that IPV during pregnancy is characterized by difficult existential choices related to ambivalence. Existential choices mean questioning one’s existence, the meaning of life as well as one’s responsibility for oneself and others. Five constituents further explain the essential structure: Living in unpredictability, the violence is living in the body, losing oneself, feeling lonely and being pregnant leads to change. Future life with the child is experienced as a possibility for existential change. It is important for health professionals to recognize and support pregnant women who are exposed to violence as well as treating their bodies with care and respect.
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| 39. |
- Engnes, Kristin, et al.
(author)
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Women's experiences of important others in a pregnancy dominated by intimate partner violence.
- 2013
-
In: Scandinavian Journal of Caring Sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 27:3, s. 643-650
-
Journal article (peer-reviewed)abstract
- Women's experiences of important others in a pregnancy dominated by intimate partner violence Background: Being exposed to intimate partner violence (IPV) during pregnancy is a difficult and complex situation. Despite this, there are few studies describing women's own needs for help and support. Aim: The aim of this study is to gain a deeper understanding of women's experiences of important others in relation to changing their life situation in a pregnancy dominated by IPV. Methods:The study has a qualitative phenomenological design. The data were collected through in-depth interviews with seven Norwegian women, who were exposed to IPV during pregnancy. Findings:Being pregnant and exposed to violence in relation to important others means confronting present life, life history and future life. The essence implies striving for control in an uncontrolled situation, where other people might be experienced as both a rescuer and a risk. This is further described in four constitutions: the child needs protection; my mother is always present for me; an exhausted run for help; and a reduced, but important social network. Conclusions and implications for practice:For women exposed to violence, pregnancy can offer an opportunity for change. Midwives play a unique role in relation to care and continuity in this phase of life, as they can support pregnant women, help to identify their needs, possibilities for action and advise them about appropriate services. Midwives can encourage and support women to find people whom they can trust and who can offer assistance. It is vital that midwives ask about the women's relationship to the baby and their social networks, especially the relationship with their mothers. Ethical considerations: During the whole study process, guidelines for research on violence against women were followed, to respect the integrity, security and confidentiality of the participants. The study is ethically approved.
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| 40. |
- Eriksson, Monica, 1952-, et al.
(author)
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Meaning of wellness in caring science based on Rodgers's evolutionary concept analysis
- 2024
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In: Scandinavian Journal of Caring Sciences. - West Sussex : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:1, s. 185-99
-
Journal article (peer-reviewed)abstract
- Background: Wellness is a holistic, multidimensional, and process-oriented property on a continuum. It has been used interchangeably with and is undifferentiated from concepts such as health and well-being without an in-depth clarification of its theoretical foundations and a reflection on its meaning. The concept of wellness is frequently used, but its definition remains unclear. Aim: To conceptually and theoretically explore the concept of wellness to contribute to a deeper understanding in caring science. Method: Rodgers' evolutionary concept analysis was applied to the theoretical investigation of data from publications of international origins. The focus was on antecedents, attributes, consequences, surrogate and related terms, and contextual references. A literature search was performed through a manual review of reference lists and an online search in CINAHL and PubMed via EBSCO, and in ProQuest. Abstracts were examined to identify relevant studies for further review. The inclusion criteria were peer-reviewed papers in English; papers published in scientific journals using the surrogate terms ‘wellness’, ‘health’, ‘health care’, and ‘health care and wellness’; and papers discussing and/or defining the concept of wellness. Twenty-six studies met the inclusion criteria. Results: Based on the findings from this concept analysis, a definition of wellness was developed: ‘a holistic and multidimensional concept represented on a continuum of being well that goes beyond health’. Implications for nursing practice were correspondingly presented. Conclusion: Wellness is defined as a holistic and comprehensive multidimensional concept represented on a continuum of being well, that goes beyond health. It calls attention by applying the salutogenic perspective to health promotion in caring science. It is strongly related to individual lifestyle and health behaviour and is frequently used interchangeably with health and well-being without an in-depth clarification of its theoretical foundation.
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| 41. |
- Gross, Mechthild M., et al.
(author)
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Women's experiences on VBAC: results of a metasynthesis
- 2014
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In: Optimising Childbirth Across Europe, 9-10 April 2014. Brussels, Belgium..
-
Conference paper (other academic/artistic)abstract
- Background: More and more women experience a caesarean section with their first, or later, birth. During a subsequent pregnancy they experience a challenging period of decision making on the mode of birth. Vaginal birth after caesarean section (VBAC) is a relevant option for a large number of women. Despite lots of quantitative studies on VBAC there is a lack of studies that report the experiences of women. Aim of review: To report the main themes of women’s experiences of VBAC. Search strategy: The following databases were searched: CINAHL, EBSCO, Journals@ OVID, Pubmed, PSYCHINFO, using the keywords VBAC, vaginal birth after caesarean section, qualitative study, experiences, qualitative and women´s experiences in various combinations. Review methodology: In total, 1981 papers were identified; of these, 1959 had to be excluded. From the remaining 22 papers eleven were excluded at this stage, as not focusing on women´s experiences, or only focusing on experiences of CS in relation to VBAC. A metasynthesis based on the interpretative meta ethnography method was conducted. Main findings: Four final themes became obvious: ‘to be involved in decision about mode of delivery is difficult but important,’ ‘vaginal birth has several positive aspects mainly described by women,’ ‘vaginal birth after CS is a risky project,’ and ‘own strong responsibility for giving birth vaginally’. The papers discussed issues such as the women´s experience in relation to different aspects of VBAC, decision-making whether to give birth vaginally, the influence of health professionals on decision-making, reason for trying a vaginal birth, experiences when choosing VBAC, experiences of giving birth vaginally, and giving birth with CS when preferring VBAC. Conclusion: It became obvious that women may feel as though they are in a fog when preparing for a VBAC. Women need evidence-based information not only about the risks involved but also about positive aspects of VBAC.
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| 42. |
- Halldén, BM, et al.
(author)
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Ten Swedish Midwives' Lived Experiences of the Care of Teenagers' Early Induced Abortions
- 2011
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In: Health Care for Women International. - : Taylor & Francis. - 0739-9332 .- 1096-4665. ; 32:5, s. 420-440
-
Journal article (peer-reviewed)abstract
- This phenomenological hermeneutic study of 10 Swedish midwives illuminates the internal conflicts of values that arise when midwives' professional and personal belief systems clash in encounters with teenagers. Midwives may react emotionally in situations where teenagers ignore advice on contraception by rejecting the use of contraceptives and preferring early abortions as a contraceptive method. The results strengthen the suggestion that caregivers need support in reflecting on how to deal with conflicts of values that may otherwise hinder them in communicating effectively with teenagers and encounter their life-worlds and in challenging their individual assumptions on the shortcomings of using contraceptives.
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| 43. |
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| 44. |
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| 45. |
- Hansson, Malin, 1975, et al.
(author)
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Job satisfaction in midwives and its association with organisational and psychosocial factors at work : a nation-wide, cross-sectional study
- 2022
-
In: BMC Health Services Research. - London : Springer Science and Business Media LLC. - 1472-6963. ; 22:1, s. 1-10
-
Journal article (peer-reviewed)abstract
- BackgroundMidwives report a challenging work environment globally, with high levels of burnout, insufficient work resources and low job satisfaction. The primary objective of this study was to identify factors in the organisational and psychosocial work environment associated with midwives’ job satisfaction. A secondary objective was to identify differences in how midwives assess the organisational and psychosocial work environment compared to Swedish benchmarks.MethodsThis nation-wide, cross-sectional web survey study analysed midwives’ assessment of their organisational and psychosocial work environment using the COPSOQ III instrument. A multivariable, bi-directional, stepwise linear regression was used to identify association with job satisfaction (N = 1747, 99.6% women). A conventional minimal important score difference (MID ± 5 as a noticeable difference with clinical importance) were used to compare midwives’ results with Swedish benchmarks.ResultsA multivariable regression model with 13 scales explained the variance in job satisfaction (R2 = .65). Five scales, possibilities for development, quality of work, role conflict, burnout and recognition, explained most of the variance in midwives’ job satisfaction (R2 = .63) and had β values ranging from .23 to .10. Midwives had adverse MID compared to Swedish benchmarks with higher difference in mean values regarding quantitative demands (8.3), work pace (6.0) emotional demand (20.6), role conflicts (7.9) and burnout (8.3). In addition, lower organisational justice (-6.4), self-rated health (-8.8), influence (-13.2) and recognition at work (-5.8). However, variation and meaning of work showed a beneficial difference in mean values with 7.9 and 13.7 respectively.ConclusionsMidwives reported high levels of meaningfulness in their work, and meaningfulness was associated with job satisfaction. However, midwives also reported adversely high demands and a lack of influence and recognition at work and in addition, high role conflict and burnout compared to Swedish benchmarks. The lack of organisational resources are modifiable factors that can be taken into account when structural changes are made regarding organisation of care, management and resource allocation. Midwives are necessary to a high quality sexual, reproductive and perinatal health care. Future studies are needed to investigate if job satisfaction can be improved through professional recognition and development, and if this can reduce turnover in midwives.
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| 46. |
- Hansson, Malin, 1975, et al.
(author)
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Midwives marching to own drum : other professions perspective of midwifery work in labour wards
- 2018
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In: COST Action BIRTH Conference : Lisbon, Sept 17-18, 2018.
-
Conference paper (other academic/artistic)abstract
- There has been a paradigm shift in midwifery over time where different professions now work together in childbirth care. There is little research on midwives’ work from other professionals’ perspectives, which is of importance to improve midwives work situation and women-centred care. Therefore, the aim of this article was to explore other professions´ views of midwifery work during childbirth. 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. 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. The theory of veiled midwifery could be used as a theoretical basis for future studies, and could be a foundation for a dialogue of philosophical differences in the way birth is viewed in the clinical setting, to improve the work situation.
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| 47. |
- Hansson, Malin, 1975, et al.
(author)
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Professional courage to create a pathway within midwives’ fields of work : a grounded theory study
- 2021
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In: BMC Health Services Research. - London : Springer Science and Business Media LLC. - 1472-6963. ; 21:1
-
Journal article (peer-reviewed)abstract
- The theory of salutogenesis focuses on resources for health and health-promoting processes. In the context of midwives’ work, this is not well described despite the importance for occupational health and the intention to remain in the profession. In order to promote a healthy workplace, it is necessary to consider the facilitating conditions that contribute to a sustainable working life. Therefore, the aim of this study was to explore health-promoting facilitative conditions in the work situation on labour wards according to midwives.
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| 48. |
- Hansson, Malin, 1975, et al.
(author)
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Professional courage to create a pathway within midwives’ fields of work
- 2022
-
In: https://njfcongress.fi/abstracts-and-posters.
-
Conference paper (other academic/artistic)abstract
- Background: The theory of salutogenesis focuses on resources for health and health-promoting processes. In the context of midwives’ work, this is not well described despite the importance for occupational health and the intention to remain in the profession. In order to promote a healthy workplace, it is necessary to consider the facilitating conditions that contribute to a sustainable working life. Aim: To explore health-promoting facilitative conditions in the work situation on labour wards according to midwives. Methods: Face-to-face interviews with midwives constituted the empirical material in this classical grounded theory study. Results: The substantive theory of Professional courage to create a pathway within midwives’ fields of work emerged as an explanation of the health-promoting facilitative conditions in midwives’ work situation. The theory consists of a four-stage process with prerequisite contextual conditions: visualising midwifery, organisational resources and a reflective and learning environment, that were needed to fulfil the midwives’ main concern a Feasibility of working as a midwife. This meant being able to work according to best-known midwifery theory and practice in each situation. Positive consequences of a fulfilled main concern were a professional identity and grounded knowledge that enabled the development of the resistant resource professional courage. The courage made it feasible for midwives to move freely on their pathway within the different fields of work extending between normal and medicalised birth and being autonomous and regulated. Conclusions: Professional courage could be seen as a resistance resource, enabling midwives to become resilient when dealing with the unpredictable work situation. The theory can be used to foster health-promoting and sustainable work environments for midwives, which is possible if the organisational preconditions are met, visualising midwifery, having organisational resources and a reflective and learning environment. This could be a key factor in retaining midwives in the profession.
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| 49. |
- Hansson, Malin, 1975, et al.
(author)
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Veiled midwifery in the baby factory - A grounded theory study
- 2019
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In: Women and Birth. - Amsterdam : Elsevier BV. - 1871-5192 .- 1878-1799. ; 32:1, s. 80-86
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Journal article (peer-reviewed)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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- Hansson, Malin, 1975, et al.
(author)
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Veiled midwifery in the baby factory – Midwives marching to own drum - Other professions perspective of midwifery work in labour wards.
- 2019
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In: The 21st Congress of the Nordic federation of Midwives. Midwifery across borders. Reykjavik 2-4 maj 2019.
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Conference paper (other academic/artistic)abstract
- Background: There has been a paradigm shift in midwifery over time where different professions now work together in childbirth care. This demands a greater effort of interprofessional collaboration. There is little research on midwives’ work from other professionals’ perspectives, which is of importance to improve midwives work situation and women-centred care. Therefore, the aim of this article was to explore other professions´ views of midwifery work during childbirth. Method: Classical Grounded Theory, using a constant comparative analysis, was applied to focus group interviews with obstetricians, assistant nurses and managers. 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, which in turn resulted in attempts to cooperate and gain access to the midwifery world, by using three unveiling strategies: Scrutinising, Streamlining and Collaborating admittance. Conclusion: 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. The theory of veiled midwifery could be used as a theoretical basis for future studies, and could be a foundation for a dialogue of philosophical differences in the way birth is viewed in the clinical setting, to improve the work situation.
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