| 1. |
- Baylis, Rebecca, et al.
(författare)
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Women's experiences of internet-delivered Cognitive Behaviour Therapy (iCBT) for Fear of Birth
- 2020
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Ingår i: Women and Birth. - : ELSEVIER. - 1871-5192 .- 1878-1799. ; 33:3, s. E227-E233
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fear of Birth is common in pregnant women and associated with negative physical and mental health. There is a clear comorbidity with anxiety and depression. Internet-delivered Cognitive Behaviour Therapy has been suggested as a treatment option for Fear of Birth and a randomized controlled trial comparing internet-delivered Cognitive Behaviour Therapy with midwifery led counselling as standard care has been conducted.Objective: The aim of this study was to describe women's experiences of guided internet-delivered Cognitive Behaviour Therapy for Fear of Birth and to describe the content of their fear.Methods: The present study is a qualitative, follow-up interview study following the randomized controlled trial, the U-CARE Pregnancy Trial. In total 19 women allocated to internet-delivered Cognitive Behaviour Therapy for Fear of Birth were interviewed by telephone. A semi-structured interview guide was used and the transcripts were analyzed with thematic analysis.Results: The women's descriptions of Fear of Birth differed, however their fear was most often associated with fear of losing control, fear for the baby's life or health or own life threatening events. The experiences of internet-delivered Cognitive Behaviour Therapy for Fear of Birth varied, some women were positive to its flexibility although most women preferred a face-to face meeting. The treatment did not pin-point their fears, it was challenging to maintain motivation and to work with the treatment in solitude.Conclusions: Women's descriptions of Fear of Birth varied. Most women undergoing internet-delivered Cognitive Behaviour Therapy would have preferred a face-to-face meeting which they imagined would have soothed their fear. Internet-delivered Cognitive Behaviour Therapy for Fear of Birth may be an alternative for some women.
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| 2. |
- Blixt, Ingrid, 1968-, et al.
(författare)
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Women's advice to healthcare professionals regarding breastfeeding : "offer sensitive individualized breastfeeding support"- an interview study
- 2019
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Ingår i: International Breastfeeding Journal. - : BioMed Central. - 1746-4358. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe World Health Organization recommends exclusive breastfeeding for 6 months followed by continued breastfeeding with complementary food up to 2 years of age or beyond. Few women achieve this recommendation in Sweden, and they often stop breastfeeding earlier than they would like. Investigating women's advice to healthcare professionals is important for the provision of optimal breastfeeding support. The aim of this study was to explore women's advice to healthcare professionals regarding support for continuing to breastfeed for at least 6 months.MethodsThis investigation used an exploratory study design, and a purposive sample of women was recruited between 2015 and 2016 through social media platforms. The work is a follow-up of an earlier study exploring women's perceptions of the factors that assisted them in breastfeeding for at least 6 months. Telephone interviews were conducted with 139 Swedish women who reported that they had breastfed for at least 6 months. Women were asked the question, "Do you have any advice that you would like to give to healthcare professionals regarding breastfeeding support?". The data were analysed using content analysis.ResultsThe theme, "Professionals need to offer women sensitive, individualized breastfeeding support to promote a positive breastfeeding experience", describes the women's advice based on five categories: 1) providing evidence-based care, 2) preparing expectant parents during pregnancy, 3) creating a respectful and mutual dialogue, 4) offering individual solutions to breastfeeding problems, and 5) offering practical support.ConclusionsThis study highlights the importance of professionals providing evidence-based breastfeeding support in a sensitive and individualized manner. This consideration is an important prerequisite to strengthening women's self-confidence and assisting them in reaching their breastfeeding goals, which may enhance the positive nature of their breastfeeding experience.
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| 3. |
- Blomqvist, Ylva Thernström, 1974-, et al.
(författare)
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Initiation and extent of skin-to-skin care at two Swedish neonatal intensive care units
- 2013
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 102:1, s. 22-28
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Tidskriftsartikel (refereegranskat)abstract
- Aim To describe initiation and extent of parents application of skin-to-skin care (SSC) with their preterm infants at two Swedish neonatal intensive care units.Methods The duration of SSC was recorded in 104 infants medical charts during their hospital stay, and the parents answered a questionnaire.Results Both parents were involved in the practice of SSC. Three infants experienced SSC directly after birth, 34 within 1 h, 85 within 24 h and the remaining 19 at 2478 h postbirth. SSC commenced earlier (median age of 50 min) in infants whose first SSC was with their father instead of with their mother (median age of 649 min: p < 0.001). The earlier the SSC was initiated, the longer the infant was cared for skin-to-skin per day during his/her hospital stay (p < 0.001). The median daily duration of SSC was 403 min.Conclusion Early initiation of SSC had positive impact on the extent of parents application of SSC. Even though the infants in this study were cared for skin-to-skin to a high extent, there is a potential for extended use of SSC in this type of hospital setting for reducing separation between infants and parents.
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| 4. |
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| 5. |
- Blomqvist, Ylva Thernström, 1974-, et al.
(författare)
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Parents need support to find ways to optimise their own sleep without seeing their preterm infant's sleeping patterns as a problem
- 2017
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 106:2, s. 223-228
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This study described how parents perceived their own sleep, and their infants', during neonatal intensive care unit (NICU) admission and after discharge. It also explored the infants' sleeping location at home.METHODS: The study was conducted in the NICUs of two Swedish university hospitals. The parents of 86 infants - 86 mothers and 84 fathers - answered questionnaires during their infants' hospital stay, at discharge and at the infants' corrected ages of two, six and 12 months. The parents' own sleep was explored with the Insomnia Severity Index.RESULTS: Mothers reported more severe insomnia than fathers during their infants' hospitalisation, and these higher insomnia severity scores were associated with more severe infant sleep problems at discharge (p = 0.027) and at two months (p = 0.006) and 12 months (p = 0.002) of corrected age. During the study period, 4%-10% of the parents reported severe or very severe infant sleeping problems. The bed-sharing rate was 75% after discharge and about 60% at the corrected age of 12 months.CONCLUSION: Maternal insomnia during an infant's hospital stay was associated with later perceptions of sleep problems in their children. Parents need support to find solutions for optimal sleep without seeing their child's sleeping patterns as a problem.
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| 6. |
- Cato, Karin, 1977-, et al.
(författare)
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Antenatal depressive symptoms and early initiation of breastfeeding in association with exclusive breastfeeding six weeks postpartum : a longitudinal population-based study
- 2019
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDepressive symptoms negatively impact on breastfeeding duration, whereas early breastfeeding initiation after birth enhances the chances for a longer breastfeeding period. Our aim was to investigate the interplay between depressive symptoms during pregnancy and late initiation of the first breastfeeding session and their effect on exclusive breastfeeding at six weeks postpartum.MethodsIn a longitudinal study design, web-questionnaires including demographic data, breastfeeding information and the Edinburgh Postnatal Depression Scale (EPDS) were completed by 1217 women at pregnancy weeks 17–20, 32 and/or at six weeks postpartum. A multivariable logistic regression model was fitted to estimate the effect of depressive symptoms during pregnancy and the timing of the first breastfeeding session on exclusive breastfeeding at six weeks postpartum.ResultsExclusive breastfeeding at six weeks postpartum was reported by 77% of the women. Depressive symptoms during pregnancy (EPDS> 13); (OR:1.93 [1.28–2.91]) and not accomplishing the first breastfeeding session within two hours after birth (OR: 2.61 [1.80–3.78]), were both associated with not exclusively breastfeeding at six weeks postpartum after adjusting for identified confounders. Τhe combined exposure to depressive symptoms in pregnancy and late breastfeeding initiation was associated with an almost 4-fold increased odds of not exclusive breastfeeding at six weeks postpartum.ConclusionsWomen reporting depressive symptoms during pregnancy seem to be more vulnerable to the consequences of a postponed first breastfeeding session on exclusive breastfeeding duration. Consequently, women experiencing depressive symptoms may benefit from targeted breastfeeding support during the first hours after birth.
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| 7. |
- Cato, Karin, et al.
(författare)
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Experience of the First Breastfeeding Session in Association with the Use of the Hands-On Approach by Healthcare Professionals : A Population-Based Swedish Study
- 2014
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Ingår i: Breastfeeding Medicine. - : Mary Ann Liebert Inc. - 1556-8253 .- 1556-8342. ; 9:6, s. 294-300
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to investigate the prevalence of healthcare professionals' use of the hands-on approach during the first breastfeeding session postpartum and its possible association with the mothers' experience of their first breastfeeding session. Materials and Methods: This was a population-based longitudinal study conducted at Uppsala University Hospital, Uppsala, Sweden, of all women giving birth at the hospital from May 2006 to June 2007. Six months postpartum, a questionnaire including questions regarding breastfeeding support, caregiving routines, depressive symptoms, and the woman's experience of the first breastfeeding session was sent to the mothers. The main outcome measures were use of the hands-on approach during the first breastfeeding session and the mother's experience of the breastfeeding session. Results: In total, 879 women participated in the study. Thirty-eight percent of the women received the hands-on approach during the first breastfeeding session. High body mass index, primiparity, and having the first breastfeeding session postponed were all independently associated with the hands-on approach. Women who received the hands-on approach were more likely to report a negative experience of the first breastfeeding session (odds ratio = 4.48; 95% confidence interval, 2.57-7.82), even after adjustment for possible confounders (odds ratio = 2.37; 95% confidence interval, 1.02-5.50). Conclusions: This study indicates that the hands-on approach is commonly used during the first breastfeeding session and is associated with a more negative experience of the first breastfeeding session. Consequently, caregivers need to question the use of this method, and further research about breastfeeding support is required.
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| 8. |
- Cato, Karin, 1977-, et al.
(författare)
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Risk factors for exclusive breastfeeding lasting less than two months-Identifying women in need of targeted breastfeeding support
- 2017
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 12:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Breastfeeding rates in Sweden are declining, and it is important to identify women at risk for early cessation of exclusive breastfeeding.Objective: The aim of this study was to investigate factors associated with exclusive breastfeeding lasting less than two months postpartum.Methods: A population-based longitudinal study was conducted at Uppsala University Hospital, Sweden. Six hundred and seventy-nine women were included in this sub-study. Questionnaires were sent at five days, six weeks and six months postpartum, including questions on breastfeeding initiation and duration as well as several other background variables. The main outcome measure was exclusive breastfeeding lasting less than two months postpartum. Multivariable logistic regression analysis was used in order to calculate adjusted Odds Ratios (AOR) and 95% Confidence Intervals (95% CI).Results: Seventy-seven percent of the women reported exclusive breastfeeding at two months postpartum. The following variables in the multivariate regression analysis were independently associated with exclusive breastfeeding lasting less than two months postpartum: being a first time mother (AOR 2.15, 95% CI 1.32 +/- 3.49), reporting emotional distress during pregnancy (AOR 2.21, 95% CI 1.35 +/- 3.62) and giving birth by cesarean section (AOR 2.63, 95% CI 1.34 +/- 5.17).Conclusions: Factors associated with shorter exclusive breastfeeding duration were determined. Identification of women experiencing emotional distress during pregnancy, as well as scrutiny of caregiving routines on cesarean section need to be addressed, in order to give individual targeted breastfeeding support and promote longer breastfeeding duration.
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| 9. |
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| 10. |
- Fahlgren, Margaretha, 1952-, et al.
(författare)
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"Varför vi är där vi är idag" : Samtal med barnmorskor om abortskildringar i litteraturen
- 2019
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Ingår i: Tidskrift för Genusvetenskap. - 1654-5443 .- 2001-1377. ; 40:3/4, s. 55-76
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Tidskriftsartikel (refereegranskat)abstract
- This article explores if conversations about literary texts that thematize abortion can provide new knowledge about the clinical everyday practice of midwives. The empirical material consists of conversations with seven clinical midwives after shared reading of a sample of fictional and biographical Swedish texts from the 1930s, 1950s, 1990s and 2010s. Drawing on theories of power relations, gendered knowledge and narrative medicine, the article investigates the relationship between the texts and the midwives’ professional experiences. The study demonstrates that the participants agreed on the positive effects of reading and discussing literary texts related to their professional work. The study cannot establish that it has provided new knowledge about the midwives’ clinical practice; it concludes, however, that the shared reading and conversations generated an exchange about experiences of abortion care that subsequently could deepen knowledge about treatment and practice within the profession. The study demonstrates that the reading experience generated discussions about the clinical practice that otherwise would never have taken place, for the participants asserted that the conversations had given time for reflection about medical, social and emotional issues that did not occur in clinic. The texts brought specific professional experiences to the fore and offered new perspectives on norms, practices and the professional role. One distinct impression conveyed by the participants was that shame is still a salient feeling among the patients, signaling that abortion is still a sensitive subject. The article concludes that similar elements of reading and discussing literary texts could prove an important part of (continuous) training for professional midwives.
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| 11. |
- Haines, Helen, 1961-, et al.
(författare)
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The Role of Women's Attitudinal Profiles in Satisfaction with the Quality of their Antenatal and Intrapartum Care
- 2013
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Ingår i: Journal of Obstetric, Gynecologic and Neonatal Nursing. - : Elsevier BV. - 0884-2175 .- 1552-6909. ; 42:4, s. 428-441
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Tidskriftsartikel (refereegranskat)abstract
- Objective To compare perceptions of antenatal and intrapartum care in women categorized into three profiles based on attitudes and fear. Design Prospective longitudinal cohort study using self-report questionnaires. Profiles were constructed from responses to the Birth Attitudes Profile Scale and the Fear of Birth Scale at pregnancy weeks 18 to 20. Perception of the quality of care was measured using the Quality from Patient's Perspective index at 34 to 36 weeks pregnancy and 2 months after birth. Setting Two hospitals in Sweden and Australia. Participants Five hundred and five (505) pregnant women from one hospital in Vasternorrland, Sweden (n=386) and one in northeast Victoria, Australia (n=123). Results Women were categorized into three profiles: self-determiners, take it as it comes, and fearful. The self-determiners reported the best outcomes, whereas the fearful were most likely to perceive deficient care. Antenatally the fearful were more likely to indicate deficiencies in medical care, emotional care, support received from nurse-midwives or doctors and nurse-midwives'/doctors' understanding of the woman's situation. They also reported deficiencies in two aspects of intrapartum care: support during birth and control during birth. Conclusions Attitudinal profiling of women during pregnancy may assist clinicians to deliver the style and content of antenatal and intrapartum care to match what women value and need. An awareness of a woman's fear of birth provides an opportunity to offer comprehensive emotional support with the aim of promoting a positive birth experience.
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| 12. |
- Hauck, Yvonne, et al.
(författare)
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Australian, Irish and Swedish women's perceptions of what assisted them to breastfeed for six months: exploratory design using critical incidence technique
- 2016
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Breastfeeding initiation rates in some developed countries are high (98 % in Sweden and 96 % inAustralia) whereas in others, they are not as favourable (46 % to 55 % in Ireland). Although the World Health Organization recommends exclusively breastfeeding for six months, 15 % of Australian women, 11 % of Swedish women and less than 7 % of Irish women achieve this goal. Awareness of what women in different countries perceive as essential breastfeeding support is a gap in our knowledge.Methods: Our aim was to explore Australian, Irish and Swedish women’s perceptions of what assisted them tocontinue breastfeeding for six months. An exploratory design using critical incident techniques was used. Recruitment occurred through advertisements in local newspapers and on social networking platforms. Initial sampling was purposive, followed by snowball sampling. Telephone interviews were conducted with 64 Irish, 139 Swedish and 153 Australian women who responded to one question “what has assisted you to continue breastfeeding for at least six months?” Content analysis was conducted and common categories determined toallow comparison of frequencies and priority ranking.Results: Categories reflected the individual mother, her inner social network, her outer social network (informal support either face to face or online), and societal support (health professionals, work environment and breastfeeding being regarded as the cultural norm). Categories ranked in the top five across the three countries were ‘informal face to face support’ and ‘maternal determination’. Swedish and Australian women ranked “health professional support” higher (first and third respectively) than Irish women who ranked ‘informal online support’ as second compared to ninth and tenth for Swedish and Australian women.Conclusions: The support required to assist breastfeeding women is complex and multi-faceted. Although common international categories were revealed, the ranking of these supportive categories varied. We must recognize how the cultural context of breastfeeding support can vary for women in differing countries and acknowledge the resourcefulness of women who embrace innovations such as social media where face to face formal and informal support are not as accessible.
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| 13. |
- Hildingsson, Ingegerd, et al.
(författare)
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A known midwife can make a difference for women with fear of childbirth- birth outcome and women's experiences of intrapartum care
- 2019
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 21, s. 33-38
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is evidence that continuity of midwifery care is beneficial to women. Women with fear of childbirth in Sweden are offered counselling, but receiving care from a known midwife during labour is unusual, despite its effects in reducing interventions and increasing birth satisfaction. The aim of this study was to describe and compare birth outcome and experience of intrapartum care among women with fear of childbirth who received intrapartum care from a known midwife, versus those who did not. Methods: An experimental study of 70 women referred to counselling due to fear of birth during pregnancy wherein the counselling midwife, when possible, also assisted during labour and birth. Results: Having a known midwife during labour and birth had a positive impact on fearful women's birth experience and their perception of pain, but there was no difference in onset of labour or mode of birth. Women who received care from a known midwife experienced better care with regards to information, participation in decision making and perception of control. Conclusion: This study indicates that having access to a known midwife might have an impact on women's birth experience. This study was limited by its small sample size and further research would need to randomise fearful women to counselling or continuity of care to determine the contribution of each to reducing fear.
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| 14. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Birth outcome in a caseload study conducted in a rural area of Sweden : a register based study
- 2020
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Ingår i: Sexual & Reproductive HealthCare. - : ELSEVIER IRELAND LTD. - 1877-5756 .- 1877-5764. ; 24
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Tidskriftsartikel (refereegranskat)abstract
- Background: Continuity models of midwifery care are rare in Sweden, despite its well-known positive effects. The aim was to describe pregnancy and birth outcome in women participating in a continuity of care project in a rural area of Sweden.Method: A register-based study of 266 women recruited to the project and a control group of 125 women from the same catchment area. Midwives provided antenatal care and were on-call 7 a.m. to 11 p.m. for birth. Data were collected from the antenatal and birth records. Crude and adjusted odds ratios with 95% confidence intervals were calculated between women in the project and the control group.Results: There were more primiparous women and highly educated women recruited to the project, and fewer foreign-born and single women, compared to the control group. Women in the project met more midwives and were less likely to have a pregnancy complication. During intrapartum care, women recruited to the project were less likely to need labour augmentation and less likely to have an instrumental vaginal birth and elective caesarean section. They had fewer second degree perineal tears and were more likely to fully breastfeed at discharge. No differences were found in neonatal outcome. The continuity of a known midwife at birth was quite low.Conclusion: This study shows that women self-recruited to a continuity of care project in a rural area of Sweden had a higher rate of normal births. There were few differences if having a known midwife or not. Long distances to hospital and lack of staff affected the level of continuity.
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| 15. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Caseload midwifery for women with fear of birth is a feasible option
- 2018
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Ingår i: Sexual & Reproductive HealthCare. - : ELSEVIER IRELAND LTD. - 1877-5756 .- 1877-5764. ; 16, s. 50-55
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Continuity with a known midwife might benefit women with fear of birth, but is rare in Sweden. The aim was to test a modified caseload midwifery model of care to provide continuity of caregiver to women with fear of birth. Methods: A feasibility study where women received antenatal and intrapartum care from a known midwife who focused on women's fear during all antenatal visits. The study was performed in one antenatal clinic in central Sweden and one university hospital labor ward. Data was collected with questionnaires in mid and late pregnancy and two months after birth. The main outcome was fear of childbirth. Result Eight out of ten women received all antenatal and intrapartum care from a known midwife. The majority had a normal vaginal birth with non-pharmacological pain relief. Satisfaction was high and most women reported that their fear of birth alleviated or disappeared. Conclusion: Offering a modified caseload midwifery model of care seems to be a feasible option for women with elevated levels of childbirth fear as well as for midwives working in antenatal clinics as it reduces fear of childbirth for most women. Women were satisfied with the model of care and with the care provided.
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| 16. |
- Hildingsson, Ingegerd, et al.
(författare)
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Childbirth fear in expectant fathers : findings from a regional Swedish cohort study.
- 2014
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 30:2, s. 242-247
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:to investigate the prevalence of childbirth related fear in Swedish fathers and associated factors.DESIGN:a regional cohort study. Data was collected by a questionnaire.SETTING:three hospitals in the middle-north part of Sweden PARTICIPANTS: 1047 expectant fathers recruited in mid-pregnancy during one year (2007) who completed the Fear of Birth Scale (FOBS).MEASUREMENTS:prevalence of childbirth fear and associated factors. Crude and adjusted odds ratios were calculated between men who scored 50 and above (childbirth fear) and those that did not (no fear). Logistic regression analysis was used to assess which factors contributed most to childbirth fear in fathers.FINDINGS:the prevalence of childbirth fear in men was 13.6%. Factors associated with childbirth related fear were as follows: Less positive feelings about the approaching birth (OR 3.4; 2.2-5.2), country of birth other than Sweden (OR 2.8; 1.3-6.1), a preference for a caesarean birth (OR 2.1; 1.7-4.1), childbirth thoughts in mid-pregnancy (OR 1.9; 1.1-2.0) and expecting the first baby (OR 1.8; 1.2-2.6).KEY CONCLUSIONS:high levels of fear were associated with first time fathers and being a non-native to Sweden. Men with fear were more likely to experience pregnancy and the coming birth as a negative event. These men were also more likely to identify caesarean section as their preferred mode of birth.IMPLICATIONS FOR PRACTICE:engaging expectant fathers in antenatal conversations about their experiences of pregnancy and feelings about birth provides health-care professionals with an opportunity to address childbirth fear, share relevant information and promote birth as a normal but significant life event.
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| 17. |
- Hildingsson, Ingegerd, et al.
(författare)
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Childbirth fear in Swedish fathers is associated with parental stress as well as poor physical and mental health
- 2014
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 30:2, s. 248-254
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to compare self-rated health and perceived difficulties during pregnancy as well as antenatal attendance, birth experience and parental stress in fathers with and without childbirth related fear. Design: a longitudinal regional survey. Data were collected by three questionnaires. Setting: three hospitals in the middle-north part of Sweden. Participants: 1047 expectant fathers recruited in mid-pregnancy and followed up at two months and one year after birth. Measurements: childbirth fear was assessed using the Fear of Birth Scale (FOBS). Self-rated physical and mental health and perceived difficulties were assessed in mid pregnancy. Two months after birth antenatal attendance, mode of birth and the birth experience were investigated. Parental stress was measured using the Swedish Parental Stress Questionnaire (SPSQ). Crude and adjusted odds ratios were calculated between expectant fathers who scored 50 and above (childbirth fear) and those that did not (no fear). Findings: expectant fathers with childbirth related fear (13.6%) reported poorer physical (OR 1.8; 95% CI 1.2-2.8) and mental (OR 3.0; 1.8-5.1) health than their non-fearful counterparts. The fearful fathers were more likely to perceive difficulties in pregnancy (OR 2.1; 1.4-3.0), and the forthcoming birth (OR 4.3; 2.9-6.3) compared to fathers without childbirth fear. First-time fathers with fear attended fewer antenatal classes. Fathers with high fear reported higher mean scores in four of the five subscales of the SPSQ. Childbirth related fear was not associated with mode of birth or fathers' birth experience. Key conclusions: expectant fathers with childbirth related fear had poorer health, viewed the pregnancy, birth and the forthcoming parenthood with more difficulties. They were less often present during antenatal classes and had higher parental stress. Implications for practice: this study provides insight into the health of expectant fathers during pregnancy and highlights the importance of understanding how childbirth fear may affect expectant fathers in both the short and longer term. © 2013 Elsevier Ltd.
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| 18. |
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| 19. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Exploring the Fear of Birth Scale in a mixed population of women of childbearing age : A Swedish pilot study
- 2018
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 31:5, s. 407-413
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this pilot study was to explore the Fear of Birth Scale in a mixed sample of women of childbearing age, by investigating the levels of childbirth fear and the content of women's thoughts when completing the scale. Methods: A cross-sectional mixed method study of 179 women who completed a short questionnaire and a think aloud interview. Results: The mean score of the Fear of Birth Scale was 40.80 (SD 27.59) and 28.5% were classified as having fear of childbirth (>= 60). The internal consistency showed a Cronbach's alpha > 0.92, and a mean inter-item correlation of 0.85. The highest scores were found in women younger than 25 years (mean 60.10), foreignborn women (mean 54.30) and women who did not have any previous children (48.72). The lowest scores were found in women who had recently given birth (mean 34.82) and women older than 35 years (mean 34.85). The content analysis categorization matrix clearly accommodated all 436 statements into the five pre-existing categories. The largest categories were: the content of fear and worry with 138 statements and strategies to cope with fear or worry (122 statements). Conclusion: The Fear of Birth Scale seems to be a useful instrument for different subgroups of women. The construct of fear of childbirth may be universally understood and experienced by women of childbearing age irrespective of whether they are currently pregnant, have recently given birth or do not have children. Identifying fear of birth is important in clinical practice in order to support women's reproductive needs.
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| 20. |
- Hildingsson, Ingegerd, et al.
(författare)
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Testing the birth attitude profile scale in a Swedish sample of women with fear of birth
- 2021
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Taylor & Francis. - 0167-482X .- 1743-8942. ; 42:2, s. 132-139
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to explore the “Birth Attitude Profile Scale (BAPS)” in a selected sample of women with fear of birth. Another aim was to develop profiles of women according to their birth attitudes and levels of childbirth fear in relation to background characteristics. Methods: A secondary analysis of data collected in two different samples of women with fear of birth. Data were collected by a questionnaire in gestational week 36 and background data from mid-pregnancy. A principal component analysis and a cluster analysis were performed of the combined sample of 195 women. Results: The principal component analysis revealed four domains of the BAPS: “personal impact, birth as a natural event, freedom of choice and safety concerns”. When adding the fear of birth scale, two clusters were identified: one with strong attitudes and lower fear, labeled “self-determiners”; and one with no strong attitudes but high levels of fear, labeled “fearful.” Women in the “Fearful” cluster more often reported previous and current mental health problems, which were the main difference between the clusters. Conclusion: The BAPS instrument seems to be useful in identifying birth attitudes in women with fear of birth and could be a basis for discussions and birth planning during pregnancy. Mental health problems were the main difference in cluster membership; therefore, it is important to ask women with fear of childbirth about physical, mental and social aspects of health. In addition, a qualitative approach using techniques such as focus groups or interviews is needed to explore how women come to form their attitudes and beliefs about birth.
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| 21. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Women with fear of childbirth might benefit from having a known midwife during labour
- 2019
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 32:1, s. 58-63
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Having a known midwife at birth is valued by women across the world, however it is unusual for women with fear of childbirth to have access to this model of care. The aim of this study was to describe the prevalence and factors related to having access to a known midwife for women referred to counseling due to childbirth fear. We also wanted to explore if women's levels of childbirth fear changed over time.Methods: A pilot study of 70 women referred to counseling due to fear of birth in 3 Swedish hospitals, and where the counseling midwife, when possible, also assisted during labour and birth.Results: 34% of the women actually had a known midwife during labour and birth. Women who had a known midwife had significantly more counseling visits, they viewed the continuity of care as more important, were more satisfied with the counseling and 29% reported that their fear disappeared. Fear of birth decreased significantly over time for all women irrespective of whether they were cared for in labour by a known midwife or not.Conclusions: Although the women in the present study had limited access to a known midwife, the results indicate that having a known midwife whom the women met on several occasions made them more satisfied with the counseling and had a positive effect on their fear. Building a trustful midwife-woman relationship rather than counseling per se could be the key issue when it comes to fear of birth.
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| 22. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Women's satisfaction with antenatal care : Comparing women in Sweden and Australia
- 2013
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 26:1, s. e9-e14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Satisfaction with antenatal care could differ depending on the organisation and the context of care.AIM:To compare antenatal care in Australia and Sweden, to identify deficiencies in the content of antenatal care and what aspects contributed most in dissatisfaction with antenatal care.METHODS: A longitudinal survey of 123 Australian and 386 Swedish women recruited during one year in regional hospitals in Sweden and Australia. Data collected by three questionnaires.RESULTS:Women in Australia had more antenatal visits, less continuity of midwife caregiver but were more satisfied with antenatal education and the emotional aspects of antenatal care. Although the overall satisfaction was high, deficiencies were found in more than half of the studied variables in the content of care. Women in Sweden were more dissatisfied with information about labour and birth (OR 3.1; 1.8-5.3) and information about the time following birth (OR 3.8; 2.2-6.3), but more satisfied with the involvement of the father (OR 0.3; 0.2-0.6). Factors that contributed most to dissatisfaction with antenatal care overall were deficiency in information about pregnancy related issues (OR 3.4; 1.3-8.7) and not being taken seriously by the midwife (OR 4.1; 1.6-10.1).CONCLUSION:Satisfaction with antenatal care was high in both groups of women. Australian women were more satisfied than the Swedish women with the emotional aspects of care. Deficiencies were found in more than half of the variables measured relating to the specific aspects of care. Lack of information and not being treated seriously were important factors for not being satisfied.
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| 23. |
- Johansson, Margareta, et al.
(författare)
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Childbirth : an emotionally demanding experience for fathers
- 2012
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Ingår i: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives. - : Elsevier BV. - 1877-5764 .- 1877-5756. ; 3:1, s. 11-20
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: While attending birth mostly has a positive impact on becoming a father, it has also been described as including feelings of discomfort and is more demanding than expected.OBJECTIVE: The objective was to explore Swedish fathers' birth experiences, and factors associated with a less-positive birth experience.METHODS: Mixed methods including quantitative and qualitative data were used. Two months after birth 827 fathers answered a questionnaire and 111 (13%) of these commented on the birth experience. Data were analysed with descriptive statistics, chi-square test for independence, risk ratios with a 95% confidence interval, logistic regression and content analysis.RESULTS: In total, 604 (74%) of the fathers had a positive or very positive birth experience. Used method identified a less-positive birth experience associated with emergency caesarean section (RR 7.5; 4.1-13.6), instrumental vaginal birth (RR 4.2; 2.3-8.0), and dissatisfaction with the partner's medical care (RR 4.6; 2.7-7.8). Healthcare professionals' competence and approach to the fathers were also related to the birth experience.CONCLUSIONS: As the fathers' birth experiences were associated with mode of birth and experiences of the intrapartum medical care fathers should be respectfully and empathically treated during labour and birth. It is essential to better engage fathers during the intrapartum period through involvement and support to improve the likelihood of a positive birth experience.
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| 24. |
- Kilander, Helena, 1976-
(författare)
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Contraceptive counselling in abortion care
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Improving women’s knowledge about contraception, and their access to contraceptive methods, is central in order to strengthen their sexual and reproductive rights at the time of an abortion. Contraceptive counselling aims to support women’s reproductive control and prevent unintended pregnancies (UPs). It is unclear, however, how to provide contraceptive counselling and how to organise services at the time of an abortion, in order to achieve this.Aim: The overall aim was to study women’s choices and use of contraceptive methods post-abortion. The research also aimed to describe contraceptive counselling in the context of an abortion from women’s and health professionals’ (HP’s) perspectives. Initial studies informed subsequent improvement efforts, also evaluated in the thesis, regarding contraceptive counselling and services at the time of an abortion.Design and Methods: The studies in this thesis involve both quantitative (studies I and IV) and qualitative (studies II–IV) methods, performed at six departments in southeast Sweden. Study I had a quantitative and longitudinal design. The medical records of women (n=987) were reviewed regarding women’s choice of contraceptive method at the index abortion and the odds of repeat abortion within three to four years. Studies II and III were qualitative interview studies, in which 13 women (study II) and 21 healthcare professionals (HPs) (study III) described their experiences of contraceptive counselling at the time of an abortion. The interviews were analysed using interpretive phenomenology (study II) and conventional content analysis (study III). Study IV was a case study regarding a qualitative improvement collaborative (QIC), designed to improve contraceptive counselling and services. Three multi-professional teams involved in abortion care participated in the QIC and two women provided user-experience input. Both qualitative and quantitative data were collected and analysed.Results: The findings of the thesis are organised into three themes: I) Women and HPs described contraceptive counselling at the time of an abortion as an often - complex meeting. There was scepticism about contraceptive methods and limited receptivity to information among women. Respectful counselling facilitated women’s choice of contraceptive method even if they were sceptical and found the situation emotionally charged. II) Women’s choices, need for guidance and access to the contraceptive methods was described in the second theme. Choice of oral contraceptives (OC) dominated. Overall, 25% of the women experienced repeat abortion during followup. Women who chose long-acting reversible contraception (LARC) experienced fewer repeat abortions compared to women who chose OC. Both women and HPs reported barriers in access to LARC post-abortion. III) In a Quality Improvement Collaborative (QIC), two volunteering women provided user-experience input. HPs participating in this QIC reported strengthened skills in counselling and enhanced ability to evaluate their performance. Despite the team’s prediction that they would reach the QIC goal that ≥50% of women would start LARC within 30 days post-abortion, and the fact that a majority of the women in QIC units chose LARC, none of the teams managed to reach the goal, primarily due to insufficient capacity for timely initiation of LARC.Conclusion: The findings suggest that women need respectful counselling and guidance at the time of an abortion. Access to a range of contraceptive methods, particularly LARC, is important to prevent repeat UPs. There is room for further improvement in offering coordinated and timely access for women who choose LARC, and to evaluate counselling, in the present settings.
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| 25. |
- Larsson, Birgitta, et al.
(författare)
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Birth preference in women undergoing treatment for childbirth fear : A randomised controlled trial
- 2017
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 30:6, s. 460-467
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment. Methods: Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n = 258) were recruited at one university hospital and two regional hospitals over one year. The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n = 127) or standard care (face-to-face counselling) (n = 131). Data were collected by questionnaires in pregnancy week 20-25 (baseline), week 36 and two months after birth. Results: Caesarean section preference decreased from 34% to 12% in the ICBT group and from 24% to 20% in the counselling group. Two months after birth, the preference for caesarean increased to 20% in the ICBT group and to 29% in the counselling group, and there was no statistically significant change over time. Women in the ICBT group were less satisfied with the treatment (OR 4.5). The treatment had no impact on or worsened their childbirth fear (OR 5.5). There were no differences between the groups regarding birth experience. Conclusion: Women's birth preferences fluctuated over the course of pregnancy and after birth regardless of treatment method. Women felt their fear was reduced and were more satisfied with face-to-face counselling compared to ICBT. A higher percentage were lost to follow-up in ICBT group suggesting a need for further research.
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| 26. |
- Larsson, Birgitta, et al.
(författare)
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Women's experience of midwife-led counselling and its influence on childbirth fear : A qualitative study
- 2019
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 32:1, s. e88-e94
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women with childbirth fear have been offered counseling by experienced midwives in Sweden for decades without evidence for its effectiveness, in terms of decrease in childbirth fear. Women are usually satisfied with the counselling. However, there is a lack of qualitative data regarding women’s views about counselling for childbirth fear.Aim: To explore women’s experiences of midwife-led counselling for childbirth fear.Method: A qualitative interview study using thematic analysis. Twenty-seven women assessed for childbirth fear who had received counselling during pregnancy at three different hospitals in Sweden were interviewed by telephone one to two years after birth.Findings: The overarching theme ‘Midwife-led counselling brought positive feelings and improved confidence in birth’ was identified. This consisted of four themes describing ‘the importance of the midwife’ and ‘a mutual and strengthening dialogue’ during pregnancy. ‘Coping strategies and support enabled a positive birth’ represent women’s experiences during birth and ‘being prepared for a future birth’ were the women’s thoughts of a future birth.Conclusions: In this qualitative study, women reported that midwife-led counselling improved their confidence for birth through information and knowledge. The women experienced a greater sense of calm and preparedness, which increased the tolerance for the uncertainty related to the birthing process. This, in turn, positively affected the birth experience. Combined with a feeling of safety, which was linked to the professional support during birth, the women felt empowered. The positive birth experience strengthened the self-confidence for a future birth and the childbirth fear was described as reduced or manageable.
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| 27. |
- Malm, Mari-Cristin, et al.
(författare)
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Development of a tool to evaluate fetal movements in full-term pregnancy
- 2014
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 5:1, s. 31-35
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study women's description of fetal movements in full-term pregnancy. Further to investigate if their descriptions could be sorted with regard to intensity and type of movements, using a matrix under development to be a tool for evaluating fetal movements in clinical praxis. Methods: Data were collected by distributing questionnaires including an open question: "Please describe your perception of the baby's movements during this gestational week." A matrix listed seven categories of movements divided into powerful and non-powerful movements, was used for the content analysis. Results: 393 (78%) women responded to the open question. The movements were split into two domains: Powerful movements and Non-powerful movements. Altogether, 383 (96%) women perceived fetal movements that were sorted as powerful movement: firm, slow stretching, large and side to side. Ten (4%) women described movements exclusively, i.e. movements that did not include any of the movements in the powerful domain. Most women perceived movements that corresponded to more than one type of category, and all movements described by the women could be referred to at least one of the categories in the matrix. Conclusion: The matrix was useful for identification of the women's perceptions of fetal movements in full-term pregnancy. Further studies are needed in order to develop the tool and its potential to evaluate the well-being of the fetus before it is to be used in clinical praxis.
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| 28. |
- Noren, Josefine, et al.
(författare)
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Becoming a mother : Mothers' experience of Kangaroo Mother Care
- 2018
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Ingår i: Sexual & Reproductive HealthCare. - : ELSEVIER IRELAND LTD. - 1877-5756 .- 1877-5764. ; 16, s. 181-185
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe mothers' experiences of providing their preterm infants with Kangaroo Mother Care (KMC).Study design: A qualitative descriptive design.Setting: Two level III neonatal intensive care units (NICUs) in Sweden.Participants: Thirteen mothers of preterm infants.Methods: The mothers were interviewed when their infant had reached a corrected age of 4 months +/- 2 weeks. The interviews were recorded and transcribed and data were analyzed using qualitative content analysis.Results: The mothers described the skin-to-skin contact with, and closeness to, the preterm infant as something they valued, and involuntary physical separation as something they had to accept and adapt to. Providing the infant with breast milk by expressing and tube feeding was experienced as time-consuming and as impinging on the skin-to-skin contact.Conclusion: Mothers want to stay close to their preterm infant. The NICU environment and staff can facilitate KMC by providing a private space for parents and infants, and enable mothers to breastfeed and express breast milk by giving them support based on science and proven experience.
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| 29. |
- Pallangyo, Eunice N., et al.
(författare)
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Improved postpartum care after a participatory facilitation intervention in Dar es Salaam, Tanzania : a mixed method evaluation
- 2017
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:In order to improve the health and survival of mothers/newborns, the quality and attendance rates of postpartum care (PPC) must be increased, particularly in low-resource settings.OBJECTIVE:To describe outcomes of a collegial facilitation intervention to improve PPC in government-owned health institutions in a low-resource suburb in Dar es Salaam, Tanzania.METHODS:A before-and-after evaluation of an intervention and comparison group was conducted using mixed methods (focus group discussions, questionnaires, observations, interviews, and field-notes) at health institutions. Maternal and child health aiders, enrolled nurse midwives, registered nurse midwives, and medical and clinical officers participated. A collegial facilitation intervention was conducted and healthcare providers were organized in teams to improve PPC at their workplaces. Facilitators defined areas of improvement with colleagues and met regularly with a supervisor for support.RESULTS:The number of mothers visiting the institution for PPC increased in the intervention group. Some care actions were noted in more than 80% of the observations and mothers reported high satisfaction with care. In the comparison group, PPC continued to be next to non-existent. The healthcare providers' knowledge increased in both groups but was higher in the intervention group. The t-test showed a significant difference in knowledge between the intervention and comparison groups and between before and after the intervention in both groups. The difference of differences for knowledge was 1.3. The providers perceived the intervention outcomes to include growing professional confidence/knowledge, improved PPC quality, and mothers' positive response. The quality grading was based on the national guidelines and involved nine experts and showed that none of the providers reached the level of good quality of care.CONCLUSIONS:The participatory facilitation intervention contributed to improved quality of PPC, healthcare providers' knowledge and professional confidence, awareness of PPC among mothers, and increased PPC attendance.
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| 30. |
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| 31. |
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| 32. |
- Rondung, Elisabet, 1980-, et al.
(författare)
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Comparing Internet-Based Cognitive Behavioral Therapy With Standard Care for Women With Fear of Birth : Randomized Controlled Trial
- 2018
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Ingår i: JMIR Mental Health. - : JMIR PUBLICATIONS, INC. - 2368-7959. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although many pregnant women report fear related to the approaching birth, no consensus exists on how fear of birth should be handled in clinical care.Objective: This randomized controlled trial aimed to compare the efficacy of a guided internet-based self-help program based on cognitive behavioral therapy (guided ICBT) with standard care on the levels of fear of birth in a sample of pregnant women reporting fear of birth.Methods: This nonblinded, multicenter randomized controlled trial with a parallel design was conducted at three study centers (hospitals) in Sweden. Recruitment commenced at the ultrasound screening examination during gestational weeks 17-20. The therapist-guided ICBT intervention was inspired by the Unified protocol for transdiagnostic treatment of emotional disorders and consisted of 8 treatment modules and 1 module for postpartum follow-up. The aim was to help participants observe and understand their fear of birth and find new ways of coping with difficult thoughts and emotions Standard care was offered in the three different study regions. The primary outcome was self-assessed levels of fear of birth, measured using the Fear of Birth Scale.Results: We included 258 pregnant women reporting clinically significant levels of fear of birth (guided ICBT group, 127; standard care group, 131). Of the 127 women randomized to the guided ICBT group, 103 (81%) commenced treatment, 60 (47%) moved on to the second module, and only 13 (10%) finished >= 4 modules. The levels of fear of birth did not differ between the intervention groups postintervention. At 1-year postpartum follow-up, participants in the guided ICBT group exhibited significantly lower levels of fear of birth (U=3674.00, z=-1.97, P=.049, Cohen d=0.28, 95% CI -0.01 to 0.57). Using the linear mixed models analysis, an overall decrease in the levels of fear of birth over time was found (P <= .001), along with a significant interaction between time and intervention, showing a larger reduction in fear of birth in the guided ICBT group over time (F-1,(192).(538) =4.96, P=.03).Conclusions: Fear of birth decreased over time in both intervention groups; while the decrease was slightly larger in the guided ICBT group, the main effect of time alone, regardless of treatment allocation, was most evident. Poor treatment adherence to guided ICBT implies low feasibility and acceptance of this treatment.
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| 33. |
- Rubertsson, Christine, 1962-, et al.
(författare)
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Anxiety in early pregnancy: prevalence and contributing factors
- 2014
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Ingår i: Archives of Women's Mental Health. - : Springer Verlag (Germany). - 1434-1816 .- 1435-1102. ; 17:3, s. 221-228
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Tidskriftsartikel (refereegranskat)abstract
- Antenatal anxiety symptoms are not only a health problem for the expectant mother. Research has found that maternal anxiety may also have an impact on the developing baby. Therefore, it is important to estimate the prevalence of maternal anxiety and associated factors. The current study aims to estimate the prevalence of anxiety symptoms during the first trimester of pregnancy and to identify associated risk factors. Secondly, to investigate other factors associated with anxiety during early pregnancy including fear of childbirth and a preference for cesarean section. In a population-based community sample of 1,175 pregnant women, 916 women (78 %) were investigated in the first trimester (gestation week 8-12). The Hospital Anxiety Depression Scale (HADS-A) was used to measure anxiety symptoms. The prevalence of anxiety symptoms (HADS-A scores a parts per thousand yen8 during pregnancy) was 15.6 % in early pregnancy. Women under 25 years of age were at an increased risk of anxiety symptoms during early pregnancy (OR 2.6, CI 1.7-4.0). Women who reported a language other than Swedish as their native language (OR 4.2, CI 2.7-7.0), reported high school as their highest level of education (OR 1.6, CI 1.1-2.3), were unemployed (OR 3.5, CI 2.1-5.8), used nicotine before pregnancy (OR 1.7, CI 1.1-2.5), and had a self-reported psychiatric history of either depression (OR 3.8, CI 2.6-5.6) or anxiety (OR 5.2, CI 3.5-7.9) before their current pregnancy were all at an increased risk of anxiety symptoms during early pregnancy. Anxiety symptoms during pregnancy increased the rate of fear of birth (OR 3.0, CI 1.9-4.7) and a preference for cesarean section (OR 1.7, CI 1.0-2.8). Caregivers should pay careful attention to history of mental illness to be able to identify women with symptoms of anxiety during early pregnancy. When presenting with symptoms of anxiety, the women might need counseling and or treatment in order to decrease her anxiety.
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| 34. |
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| 35. |
- Ternström, Elin, 1982-, et al.
(författare)
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A randomized controlled study comparing internet-based cognitive behavioral therapy and counselling by standard care for fear of birth – A study protocol
- 2017
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 13, s. 75-82
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Tidskriftsartikel (refereegranskat)abstract
- Fear of birth is a concern that requires evidence based treatment. The aim of this study is to present the protocol of a randomized controlled multi-center trial to compare internet-based cognitive therapy with counseling as standard care for pregnant women reporting fear of birth. Participants will be recruited in mid-pregnancy. Women who score 60 or above on the Fear of Birth Scale will be offered to participate in this study. Data will be collected by questionnaires including validated instruments at baseline and follow-ups at gestational weeks 30 and 36, two months and one year after birth. The primary outcome will be level of fear of birth measured with the Fear of Birth Scale at 36 weeks of gestation. Secondary outcome measures are level of fear of birth at two months and one year after giving birth, preferences for mode of birth, requests for elective cesarean section, compliance and satisfaction with treatment and birth outcomes. A power calculation based on a 20% reduction of fear implies that approximately 200 will be included in the trial. The study outlined in this protocol will be the first randomized controlled trial comparing internet-based cognitive therapy with counseling for women reporting fear of birth. An effective treatment may result in better overall health for women with fear of birth and a reduction in cesarean sections for non-medical reasons. Evidence regarding treatment options of fear of birth will also provide a greater choice for women.
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| 36. |
- Ternström, Elin, et al.
(författare)
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Higher prevalence of childbirth related fear in foreign born pregnant women - Findings from a community sample in Sweden
- 2015
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 31:4, s. 445-450
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo investigate the prevalence of childbirth related fear (CBRF) in early pregnancy among both Swedish born and foreign born women living in Sweden.DesignA cross sectional prevalence study. Data was collected by a questionnaire, which was available in Swedish and eight other languages.Setting: a university hospital in the middle of Sweden.ParticipantsThe recruitment took place during a two month period where the participating women completed the Fear of Birth Scale (FOBS) in mid-pregnancy.MeasurementsPrevalence of CBRF, the cut-point of 60 and above. Odds ratios with a 95% confidence interval were calculated between women born in Sweden and women born in a foreign country. Stratified analyses were also performed separately for Swedish born and foreign born women.FindingsIn total 606 women completed the survey, 78% were born in Sweden and 22% were born in a foreign country. About 22% of the total sample scored 60 or more on the FOBS-scale. Almost 18% (n=85) of the women born in Sweden reported CBRF while 37 % (n=49) of the foreign born women reported CBRF. Being born outside Sweden (OR 2.7; CI 1.7-4.0) and expecting the first baby (OR 1.9; CI 1.3-2.8) were associated with CBRF. There were no differences in age, civil status or level of education between women with or without FOBS ≥60. However, a stratified analysis showed that primiparas born in a foreign country (OR 3.8; CI 1.8-8.0) were more likely to score 60 or more on the FOBS-scale compared to multiparas born in a foreign country.Key conclusionsChildbirth related fear was almost three times as common among foreign born women when compared to Swedish women. Foreign born childbearing women are an extremely vulnerable group who need culturally sensitive and targeted support from caregivers. Further research is needed to clearly identify the components of women's childbirth related fear in various ethnic groups.
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| 37. |
- Ternström, Elin, 1982-
(författare)
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Identification and Treatment of Women with a Fear of Birth
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Although a fear of birth affects many women during pregnancy and is associated with adverse birth outcomes, it is rarely measured in clinical practice and evidence-based treatments are lacking. The aim of this thesis was to assess the clinical utility of the Fear of Birth Scale, and to evaluate the effect of guided Internet-based cognitive behavior therapy compared with standard care on the levels of fear of birth in pregnant and postpartum women.This thesis consists of four papers originating from three studies. The Fear of Birth Scale was used to measure fear of birth among pregnant women in all three studies. In Study I, prevalence of fear of birth among Swedish-born and foreign-born pregnant women was measured, and in Study II, 31 pregnant women were interviewed about their thoughts when assessing fear of birth. In Study III, a multicenter randomized controlled trial was conducted to compare guided Internet-based cognitive behavior therapy (ICBT) with standard care for pregnant women with a fear of birth.Fear of birth was identified among 22% of the pregnant women. Prevalence was twice as high among the foreign-born women (37%) compared to the Swedish-born women (18%). When asking the participants what they thought when assessing their fear on the Fear of Birth Scale, they confirmed that they had understood the measurement intent of the scale. The randomized controlled trial showed that fear of birth decreased during pregnancy and postpartum in both groups. However, the levels of fear decreased more in the guided ICBT-group when measuring fear of birth up to one year postpartum. The changes in fear of birth over time did not differ between parity groups.Altogether, these results suggest that the Fear of Birth Scale is a suitable screening instrument for identifying pregnant women with a fear of birth in a clinical setting and that such screening would be beneficial, as it probably would increase the chance of achieving a more equitable care. As the effect of time during pregnancy and postpartum was most evident in reducing fear of birth, this can be communicated to pregnant women, along with a continuous dialogue about how the women experience fear during pregnancy.
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| 38. |
- Ternström, Elin, 1982-, et al.
(författare)
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Pregnant women's thoughts when assessing fear of birth on the Fear of Birth Scale
- 2016
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 29:3, s. E44-E49
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fear of childbirth is common during pregnancy but rarely assessed in clinical practice. The Fear of Birth Scale has been proposed as a valid measure suitable for assessing fear of birth in an antenatal clinical context. To make sure that the scale makes sense in relation to the known constructs of fear of birth, it is important to find out what women think when responding to the Fear of Birth Scale. Aim: To report what women in mid-pregnancy think when assessing fear of birth on the Fear of Birth Scale. Methods: A qualitative design using semi-structured interviews with a think aloud technique was used. Thirty-one women were recruited in gestational week 17-20. Content analysis was conducted to describe the different dimensions of fear of birth. Findings: Worry was described as unspecific feelings and thoughts, often with a negative loading. Fear was described as a strong feeling connected to something specific. Furthermore, the women thought about aspects that influence their worries and fears and explained the strategies that helped them to cope with their fear of birth. Conclusion: Women could clearly assess, describe, and discuss fear of birth using the Fear of Birth Scale. This supports the use of the Fear of Birth Scale in clinical settings as a starting point for further dialogue about women's fear of birth. The dialogue may identify women's need for information, treatment, and referral when necessary. (C) 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
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| 39. |
- Åhman, Annika, 1956-, et al.
(författare)
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Ultrasonographic fetal soft markers in a low-risk population : prevalence, association with trisomies and invasive tests
- 2014
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 93:4, s. 367-373
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo investigate the prevalence of soft markers identified at second trimester ultrasound in a low-risk population and the association of these markers with trisomies and invasive testing.DesignProspective observational study.SettingSwedish University Hospital.PopulationAll women with fetuses examined by ultrasound at 15+0–22+0 weeks gestation between July 2008 and March 2011.MethodsCases with soft markers were compared with non-cases with regard to trisomies and invasive testing.Main outcome measuresPrevalence of soft markers, likelihood ratio for trisomies and risk ratio for invasive tests after detection of soft markers.ResultsSecond trimester ultrasound was performed on 10 710 fetuses. Markers were detected in 5.9% of fetuses. 5.1% were isolated, 0.7% were multiple and 0.1% were combined with an anomaly. Presence of markers showed a positive likelihood ratio for Down syndrome, but the association (likelihood ratio = 7.1) was only statistically significant for the combined category of any marker (isolated, multiple or combined with anomaly). The risk ratio for invasive testing after the second trimester ultrasound was 24.0 in pregnancies with isolated soft markers compared with those without markers.ConclusionIn a low-risk population, soft markers were found in 5.9% of fetuses at second trimester ultrasound. The likelihood ratio for Down syndrome was significant only for any marker (isolated, multiple or combined with anomaly). The presence of soft markers increased the incidence of invasive procedures substantially. Soft markers should be noted when information on second trimester ultrasound is formulated, and all units performing fetal ultrasound examinations should have established routines concerning information management when soft markers are identified.
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