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Hildingsson, Ingegerd
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Publications (10 of 156) Show all publications
Hildingsson, I., Rubertsson, C., Karlström, A. & Haines, H. (2018). Caseload midwifery for women with fear of birth is a feasible option. Sexual & Reproductive HealthCare, 16, 50-55
Open this publication in new window or tab >>Caseload midwifery for women with fear of birth is a feasible option
2018 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 16, p. 50-55Article in journal (Refereed) Published
Abstract [en]

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. 

Keywords
Caseload, Fear of birth, Intrapartum care, Midwifery, Pregnancy
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-33382 (URN)10.1016/j.srhc.2018.02.006 (DOI)2-s2.0-85043499616 (Scopus ID)
Available from: 2018-03-28 Created: 2018-03-28 Last updated: 2018-03-28Bibliographically approved
Åhlund, S., Zwedberg, S., Hildingsson, I., Edqvist, M. & Lindgren, H. (2018). Midwives experiences of participating in a midwifery research project: A qualitative study. Women and Birth, 31(2), e115-e122
Open this publication in new window or tab >>Midwives experiences of participating in a midwifery research project: A qualitative study
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2018 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 31, no 2, p. e115-e122Article in journal (Refereed) Published
Abstract [en]

Problem and background: In an earlier research project midwives were asked to perform women-centered care focusing on the assumption that the physiological process in the second stage of labour could be trusted and that the midwives role should be encouraging and supportive rather than instructing. There is no knowledge about how midwives participating in such a research project, uses their skills and experience from the study in their daily work. Aim: The aim in this study was to investigate how midwives experienced implementing woman-centered care during second stage of labour. Methods: A qualitative study was designed. Three focus groups and two interviews were conducted. The material was analysed using content analysis. Findings: The participating midwives' experiences were understood as increased awareness of their role as midwives. The overarching theme covers three categories 1) establishing a new way of working, 2) developing as midwife, 3) being affected by the prevailing culture. The intervention was experienced as an opportunity to reflect and strengthen their professional role, and made the midwives see the women and the birth in a new perspective. Conclusions: Implementing woman-centered care during second stage of labour gave the midwives an opportunity to develop in their professional role, and to enhance their confidence in the birthing women and her ability to have a physiological birth. To promote participation in, as well as conduct midwifery research, can enhance the development of the midwives professional role as well as contribute new knowledge to the field. 

Keywords
Birth, Midwives, Professional role, Qualitative research, Woman-centered care
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-32194 (URN)10.1016/j.wombi.2017.07.004 (DOI)000427813500007 ()28781066 (PubMedID)
Available from: 2017-11-29 Created: 2017-11-29 Last updated: 2018-05-07Bibliographically approved
Ängeby, K., Wilde-Larsson, B., Hildingsson, I. & Sandin-Bojö, A.-K. (2018). Prevalence of Prolonged Latent Phase and Labor Outcomes: Review of Birth Records in a Swedish Population. Journal of midwifery & women's health, 63(1), 33-44
Open this publication in new window or tab >>Prevalence of Prolonged Latent Phase and Labor Outcomes: Review of Birth Records in a Swedish Population
2018 (English)In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 63, no 1, p. 33-44Article, review/survey (Refereed) Published
Abstract [en]

IntroductionThe prevalence of a prolonged latent phase of labor has been described as ranging from 5% to 6.5% in previous research. The aim of this study was to describe the prevalence of the prolonged latent phase of 18 hours or more, based on women's report, in women intending vaginal birth and who had spontaneous onset of labor. An additional aim was to compare the incidence of obstetric interventions, and the labor and neonatal outcomes in women with and without a prolonged latent phase. MethodsA descriptive and comparative study was performed in a mid-sized hospital in western Sweden. The sample consisted of 1343 birth records of women who intended vaginal births and who had spontaneous onset of labor at 37 or more weeks' gestation during a one-year period (2013-2014). Background characteristics, obstetric interventions, and labor and neonatal outcomes were compared between women with latent phases lasting less than 18 hours and 18 hours or more, based on women's self-report. Odds ratios with 95% confidence intervals were calculated for the different exposure variables. ResultsA prolonged latent phase lasting 18 hours or more occurred in 23% of all births analyzed (n = 1343). A prolonged latent phase was more common among nulliparous women (29.2%) but also common for multiparous women (17%). Nulliparous and multiparous women who experienced a prolonged latent phase were more often exposed to amniotomy during latent phase. For nulliparous women, the adjusted odds ratio (aOR) was 11.57 (95% confidence interval [CI], 5.25-25.51) and for multiparous women the aOR was 18.73 (95% CI, 9.06-38.69). Similarly, amniotomy during active phase was more common for both nulliparous and multiparous women who experienced a prolonged latent phase (aOR, 4.05; 95% CI, 2.53-6.47 and aOR, 3.93; 95% CI, 2.43-6.37, respectively). Women with latent phases of 18 hours or more, more often experienced augmentation of labor during all phases, especially during latent phase. For nulliparous women, the aOR was 10.13 (95% CI, 2.82-36.39) and for multiparous women, aOR was11.9 (95% CI, 3.69-38.71). A prolonged latent phase was associated with more instrumental vaginal births for multiparas (aOR, 2.58; 95% CI, 1.27-5.26) and emergency cesarean regardless of parity (nulliparous women: aOR, 3.21; 95% CI, 1.08-9.50 and multiparous women: aOR, 3.93; 95% CI, 1.67-9.26). DiscussionBased on women's self-report, the prevalence of a prolonged latent phase in women at term who planned a vaginal birth and had spontaneous onset of labor was higher than previously reported. Women with a prolonged latent phase were more likely to receive obstetric interventions. Assisted vaginal birth was more common for nulliparous women with prolonged latent phase and emergency cesarean occurred more frequently for both nulliparous women and multiparous women with a prolonged latent phase.

Keywords
intrapartum care, labor, first stage; obstetric complications, quantitative research
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-33298 (URN)10.1111/jmwh.12704 (DOI)000424649100005 ()29419927 (PubMedID)
Available from: 2018-03-19 Created: 2018-03-19 Last updated: 2018-07-02Bibliographically approved
Hildingsson, I., Karlström, A., Rubertsson, C. & Haines, H. (2018). Women with fear of childbirth might benefit from having a known midwife during labour. Women and Birth
Open this publication in new window or tab >>Women with fear of childbirth might benefit from having a known midwife during labour
2018 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799Article in journal (Refereed) Epub ahead of print
Abstract [en]

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. 

Keywords
Continuity, Counseling, Fear of childbirth, Intrapartum care, Pregnancy
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-34108 (URN)10.1016/j.wombi.2018.04.014 (DOI)
Available from: 2018-07-04 Created: 2018-07-04 Last updated: 2018-07-04Bibliographically approved
Nystedt, A. & Hildingsson, I. (2018). Women's and men's negative experience of child birth-A cross-sectional survey. Women and Birth, 31(2), 103-109
Open this publication in new window or tab >>Women's and men's negative experience of child birth-A cross-sectional survey
2018 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 31, no 2, p. 103-109Article in journal (Refereed) Published
Abstract [en]

Background: A negative birth experience may influence both women and men and can limit their process of becoming a parent. Aims: This study aimed to analyze and describe women's and men's perceptions and experiences of childbirth. Design: A cross-sectional study of women and their partners living in one Swedish county were recruited in mid pregnancy and followed up two months after birth. Women (n = 928) and men (n = 818) completed the same questionnaire that investigated new parents' birth experiences in relation to socio-demographic background and birth related variables. Results: Women (6%) and men (3%) with a negative birth experiences, experienced longer labours and more often emergency caesarean section compared to women (94%) and men (97%) with a positive birth experience. The obstetric factors that contributed most strongly to a negative birth experience were emergency caesarean and was found in women (OR 4.7, 95% CI 2.0-10.8) and men (OR 4.5, Cl 95% 1.4-17.3). In addition, pain intensity and elective caesarean section were also associated with a negative birth experiences in women. Feelings during birth such as agreeing with the statement; 'It was a pain to give birth' were a strong contributing factor for both women and men. Conclusions: A negative birth experience is associated with obstetric factors such as emergency caesarean section and negative feelings. The content of negative feelings differed between women and men. It is important to take into account that their feelings differ in order to facilitate the processing of the negative birth experience for both partners. 

Keywords
Childbirth experience, Men's birth experience, Negative birth experience, Women's birth experience
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-32186 (URN)10.1016/j.wombi.2017.07.002 (DOI)000427813500016 ()28789827 (PubMedID)
Note

Available online 5 August 2017

Available from: 2017-11-29 Created: 2017-11-29 Last updated: 2018-05-07Bibliographically approved
Larsson, B., Hildingsson, I., Ternström, E., Rubertsson, C. & Karlström, A. (2018). Women's experience of midwife-led counselling and its influence on childbirth fear: A qualitative study. Women and Birth
Open this publication in new window or tab >>Women's experience of midwife-led counselling and its influence on childbirth fear: A qualitative study
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2018 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799Article in journal (Refereed) Epub ahead of print
Abstract [en]

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. 

Keywords
Childbirth fear, Counselling, Experience, Midwifery, Qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-33693 (URN)10.1016/j.wombi.2018.04.008 (DOI)
Note

Available online 27 April 2018

Available from: 2018-06-01 Created: 2018-06-01 Last updated: 2018-07-03Bibliographically approved
Ternström, E., Hildingsson, I., Haines, H., Karlström, A., Sundin, Ö., Ekdahl, J., . . . Rubertsson, C. (2017). A randomized controlled study comparing internet-based cognitive behavioral therapy and counselling by standard care for fear of birth – A study protocol. Sexual & Reproductive HealthCare, 13, 75-82
Open this publication in new window or tab >>A randomized controlled study comparing internet-based cognitive behavioral therapy and counselling by standard care for fear of birth – A study protocol
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2017 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 13, p. 75-82Article in journal (Refereed) Published
Abstract [en]

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.

National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-31379 (URN)10.1016/j.srhc.2017.06.001 (DOI)000411305800011 ()28844361 (PubMedID)2-s2.0-85021645169 (Scopus ID)
Note

Available online 15 June 2017

Available from: 2017-08-11 Created: 2017-08-11 Last updated: 2017-10-18Bibliographically approved
Larsson, B., Karlström, A., Rubertsson, C., Ternström, E., Ekdahl, J., Segebladh, B. & Hildingsson, I. (2017). Birth preference in women undergoing treatment for childbirth fear: A randomised controlled trial. Women and Birth, 30(6), 460-467
Open this publication in new window or tab >>Birth preference in women undergoing treatment for childbirth fear: A randomised controlled trial
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2017 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, no 6, p. 460-467Article in journal (Refereed) Published
Abstract [en]

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.

Keywords
Caesarean section, Childbirth fear, Counselling, Internet based cognitive behavioural therapy, Randomised controlled trial
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-31044 (URN)10.1016/j.wombi.2017.04.004 (DOI)000418296300007 ()28495462 (PubMedID)2-s2.0-85019011965 (Scopus ID)
Note

Available online 8 May 2017

Available from: 2017-06-28 Created: 2017-06-28 Last updated: 2018-03-01Bibliographically approved
Bäck, L., Hildingsson, I., Sjöqvist, C. & Karlström, A. (2017). Developing competence and confidence in midwifery: focus groups with Swedish midwives. Women and Birth, 30(1), E32-E38
Open this publication in new window or tab >>Developing competence and confidence in midwifery: focus groups with Swedish midwives
2017 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, no 1, p. E32-E38Article in journal (Refereed) Published
Abstract [en]

Background

Midwives have a significant impact on the clinical outcome and the birthing experience of women. However, there has been a lack of research focusing specifically on clinical midwives’ learning and development of professional competence.

Aim

The objective of the study was to describe how midwives reflect on learning and the development of professional competence and confidence.

Methods

A qualitative study based on focus groups with midwives employed in maternity services.

Findings

Four categories describe the results: (1) Feelings of professional safety evolve over time; (2) Personal qualities affect professional development; (3) Methods for expanding knowledge and competence; and (4) Competence as developing and demanding. The meaning of competence is to feel safe and secure in their professional role. There was a link between the amount of hands-on intrapartum experience and increasing confidence that is, assisting many births made midwives feel confident. Internal rotation was disliked because the midwives felt they had less time to deepen their knowledge and develop competence in a particular field. The midwives felt they were not seen as individuals, and this system made them feel split between different assignments.

Discussion

External factors that contribute to the development of knowledge and competence include the ability to practise hands-on skills in an organisation that is supportive and non-threatening. Internal factors include confidence, self-efficacy, and a curiosity for learning.

Conclusions

Midwives working within an organisation should be supported to develop their professional role in order to become knowledgeable, competent and confident.

Keywords
Competence, Confidence, Midwifery, Knowledge, Learning
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-29444 (URN)10.1016/j.wombi.2016.08.004 (DOI)000397042900016 ()27562606 (PubMedID)2-s2.0-84997281848 (Scopus ID)
Available from: 2016-12-07 Created: 2016-12-07 Last updated: 2018-05-04Bibliographically approved
Hildingsson, I., Rubertsson, C., Karlström, A. & Haines, H. (2017). Exploring the Fear of Birth Scale in a mixed population of women of childbearing age-A Swedish pilot study. Women and Birth
Open this publication in new window or tab >>Exploring the Fear of Birth Scale in a mixed population of women of childbearing age-A Swedish pilot study
2017 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799Article in journal (Refereed) Epub ahead of print
Abstract [en]

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 α. >. 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), foreign-born 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. 

Keywords
Childbearing, Childbirth fear, FOBS pilot study, Scale validation, Think aloud interview
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-32760 (URN)10.1016/j.wombi.2017.12.005 (DOI)
Note

Available online 14 December 2017

Available from: 2018-01-30 Created: 2018-01-30 Last updated: 2018-01-30Bibliographically approved
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