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- Brüggemann, Cecilia, et al.
(author)
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Labor dystocia and oxytocin augmentation before or after six centimeters cervical dilatation, in nulliparous women with spontaneous labor, in relation to mode of birth
- 2022
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In: BMC Pregnancy and Childbirth. - : BMC. - 1471-2393. ; 22:1
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Journal article (peer-reviewed)abstract
- Background The effects of diagnosing and treating labor dystocia with oxytocin infusion at different cervical dilatations have not been fully evaluated. Therefore, we aimed to examine whether cervical dilatation at diagnosis of dystocia and initiation of oxytocin infusion at different stages of cervical dilatation were associated with mode of birth, obstetric complications and womens birthing experience. Methods A retrospective cohort study, including 588 nulliparous term women with spontaneous onset of labor and dystocia requiring oxytocin augmentation. The study population was divided into three groups according to cervical dilatation at diagnosis of dystocia and initiation of oxytocin-infusion (<= 5 cm, 6-10 cm, fully dilated) with mode of birth as the primary outcome. Secondary outcomes were obstetrical and neonatal complications and women s experience of childbirth. Statistical comparison between groups using Chi-square and ANOVA was performed. The risk of operative birth (cesarean section and instrumental birth) was assessed using binary logistic regression with suitable adjustments (maternal age, body mass index and risk assessment on admission to the labor ward). Results The cesarean section rate differed between the groups (p < 0.001); 12% in the <= 5 cm group, 6% in the 6-10 cm group and 0% in the fully dilated group. There was no increased risk for operative birth in the <= 5 cm group compared to the 6-10 cm group, adjusted OR 1.28 95%CI (0.78-2.08). The fully dilated group had a decreased risk of operative birth (adjusted OR 0.48 95%CI (0.27-0.85). The rate of a negative birthing experience was high in all groups (28.5%, 19% and 18%) but was only increased among women in the <= 5 cm group compared with the 6-10 cm group, adjusted OR 1.76 95%CI (1.05-2.95). Conclusions Although no difference in the risk of operative birth was found between the <= 5 cm and 6-10 cm cervical dilatation-groups, the cesarean section rate was highest in women with dystocia requiring oxytocin augmentation at <= 5 cm cervical dilatation. This might indicate that oxytocin augmentation before 6 cm cervical dilatation could be contra-productive in preventing cesarean sections. Further, the increased risk of negative birth experience in the <= 5 cm group should be kept in mind to improve labor care.
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| 2. |
- Eldestrand, E., et al.
(author)
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Supporting young women with menstrual pain – Experiences of midwives working at youth clinics
- 2022
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In: Sexual & Reproductive HealthCare. - : Elsevier B.V.. - 1877-5756 .- 1877-5764. ; 34
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Journal article (peer-reviewed)abstract
- Background: Menstrual pain is relatively common among young girls. Many girls turn to youth clinics when seeking care for menstrual problems. Objective: The objective of the study was to describe midwives’ experiences of supporting girls with menstrual pain. Methods: This is a qualitative study with an inductive approach. Semi-structured interviews were conducted with 15 midwives working at Swedish youth clinics. Interviews were held in September 2021. The recordings were transcribed and analyzed using thematic analysis. Results: Two main themes, consisting of three subthemes each, emerged: Guiding and educating young women about menstrual pain and Striving toward pain relief. It was important to the midwives to increase young womens knowledge of menstrual pain and coping strategies, and to guide them in finding a method for menstrual pain relief. Hormonal contraceptives were often a natural choice and an effective method for pain relief, although the midwives occasionally faced resistance from young women or their mothers when recommending this. The midwives also referred to a gynecologist if needed. Conclusion: The results highlight that midwives working at youth clinics have an important role in the care of young women with menstrual pain. The midwives found it important to increase young womens knowledge about menstrual pain and coping strategies, since they had noticed knowledge gaps in these areas. The results suggest a need to improve education about menstrual pain and coping strategies for young women, preferably in school and in cooperation with healthcare professionals. © 2022 The Author(s)
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| 3. |
- Hallström, Sofia, et al.
(author)
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Fear of childbirth and mental health among lesbian, bisexual, transgender and queer people : a cross-sectional study
- 2022
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In: Journal of Psychosomatic Obstetrics and Gynaecology. - : Taylor & Francis Ltd. - 0167-482X .- 1743-8942. ; 43:4, s. 526-531
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Journal article (peer-reviewed)abstract
- Background: Most studies of fear of childbirth (FOC) are conducted on heterosexual cisgender pregnant populations of birth-giving parents. Among lesbian and bisexual women, as well as transgender and queer people (LBTQ), minority stress can add an extra layer to FOC. Gender binary and cisnormative assumptions leave it to the patient to educate and navigate healthcare providers, which can increase mental health problems. Objective: The aim of this study is to compare FOC and mental illness among expecting birth-giving parents and their partners in an LBTQ population. Materials and methods: This cross-sectional study recruited 80 self-identified pregnant LBTQ persons and their 54 non-pregnant partners at a LBTQ specialized antenatal clinic in a large Swedish city of over one million inhabitants. The survey included socio-demographic characteristics, sexual and gender orientation, obstetric history, previous mental health, previous trauma exposure and measures of FOC and mental health. Results: Levels of FOC were significantly higher for the pregnant participants (median W-DEQ 67.5) than for partners (median W-DEQ 60.0). The proportion of severe FOC was higher for pregnant participants (20.3%) than for partners (9.4%), although this difference was not statistically significant. Mental illness was significantly associated with FOC. Conclusion: The results add valuable information to our understanding of the specific needs of pregnant LBTQ people and their partners and may help us to develop healthcare in the future.
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