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  • 1.
    Bäck, Lena
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala Universitet.
    Sjöqvist, Carina
    Östersunds sjukhus.
    Karlström, Annika
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Developing competence and confidence in midwifery: focus groups with Swedish midwives2017In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, no 1, p. E32-E38Article in journal (Refereed)
    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.

  • 2.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala Univ, Dept Womens & Childrens Hlth Obstet & Gynaecol, S-75185 Uppsala, Sweden.
    Women's birth expectations, are they fulfilled?: Findings from a longitudinal Swedish cohort study2015In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 28, no 2, p. E7-E13Article in journal (Refereed)
    Abstract [en]

    Background: The importance of women's expectations on the experience of birth has shown contradictory results regarding fulfilment. The aim of this study was to describe pregnant women's expectations of birth and to investigate if these expectations were fulfilled. An additional aim was to determine if unfulfilled expectations were related to the mode of birth, use of epidural and the birth experience. Methods: This research investigated a prospective regional cohort study of 1042 Swedish-speaking women who completed a questionnaire about birth expectations in late pregnancy and were followed up with two months after birth. Five areas were under study: support from partner, support from midwife, control, participation in decision making and the midwife's presence during labour and birth. An index combining expectations and experiences was created. Results: Certain background characteristics were associated with expectations as well as experiences. Statistically significant differences were shown between expectations and experiences in support from midwife (mean 3.41 vs 3.32), support from partner (mean 3.70 vs 3.77), and midwife's presence (mean 3.00 vs 3.39). Experiences 'worse than expected' regarding decision making and control were associated with modes of birth other than vaginal and four out of five areas were associated with a less positive birth experience. Conclusion: Some women had high birth expectations of which some were fulfilled. An expectation on support from the midwife was less likely to be achieved, while support from partner and the midwives' presence were fulfilled. If the woman's expectations were not fulfilled, e.g. became 'worse than expected' this was associated with a less positive overall birth experience as well as with instrumental or surgical mode of birth. (C) 2015 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.

  • 3.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Cederlöf, Linnéa
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm.
    Widén, Sara
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm.
    Fathers' birth experience in relation to midwifery care2011In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 24, no 3, p. 129-136Article in journal (Refereed)
    Abstract [en]

    The aim was to identify the proportion of fathers having a positive experience of a normal birth and to explore factors related to midwifery care that were associated with a positive experience. Background: Research has mainly focused on the father's supportive role during childbirth rather than his personal experiences of birth. Methods: 595 new fathers living in a northern part of Sweden, whose partner had a normal birth, were included in the study. Data was collected by questionnaires. Odds Ratios with 95% confidence interval and logistic regression analysis were used. Results: The majority of fathers (82%) reported a positive birth experience. The strongest factors associated with a positive birth experience were midwife support (OR 4.0; 95 CI 2.0-8.1), the midwife's ongoing presence in the delivery room (OR 2.0; 1.1-3.9), and information about the progress of labour (OR 3.1; 1.6-5.8). Conclusion: Most fathers had a positive birth experience. Midwifery support, the midwife's presence and sufficient information about the progress of labour are important aspects in a father's positive birth experience. The role of the midwife during birth is important to the father, and his individual needs should be considered in order to enhance a positive birth experience.

  • 4.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Haines, Helen
    University of Melbourne, School of Rural Health, Australia.
    Cross, Maddalena
    University of Melbourne, School of Rural Health, Australia.
    Pallant, Julie
    University of Melbourne, School of Rural Health, Australia.
    Rubertsson, Christine
    Inst för Kvinnors och Barns hälsa, Uppsala Universitet.
    Women's satisfaction with antenatal care: Comparing women in Sweden and Australia2013In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 26, no 1, p. e9-e14Article in journal (Refereed)
    Abstract [en]

    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.

  • 5.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala University, Dept Womens & Childrens Hlth, Uppsala.
    Haines, Helen
    Uppsala University, Dept Womens & Childrens Hlth, Uppsala; Univ Melbourne, Rural Hlth Acad Ctr, Melbourne, Australia.
    Karlström, Annika
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Nystedt, Astrid
    Umeå University, Dept Nursing, Umeå.
    Presence and process of fear of birth during pregnancy - Findings from a longitudinal cohort study2017In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, no 5, p. E242-E247Article in journal (Refereed)
    Abstract [en]

    Background: The prevalence of fear of birth has been estimated between 8-30%, but there is considerable heterogeneity in research design, definitions, measurement tools used and populations. There are some inconclusive findings about the stability of childbirth fear. Aim: to assess the prevalence and characteristics of women presenting with scores >= 60 on FOBS-The Fear of Birth Scale, in mid and late pregnancy, and to study change in fear of birth and associated factors. Methods: A prospective longitudinal cohort study of a one-year cohort of 1212 pregnant women from a northern part of Sweden, recruited in mid pregnancy and followed up in late pregnancy. Fear of birth was assessed using FOBS-The fear of birth scale, with the cut off at >= 60. Findings: The prevalence of fear of birth was 22% in mid pregnancy and 19% in late pregnancy, a statistically significant decrease. Different patterns were found where some women presented with increased fear and some with decreased fear. The women who experienced more fear or less fear later in pregnancy could not be differentiated by background factors. Conclusions: More research is needed to explore factors important to reduce fear of childbirth and the optimal time to measure it.

  • 6.
    Hildingsson, Ingegerd M
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Karolinska Institutet, Kvinnors och barns hälsa.
    New parents' experiences of postnatal care in Sweden2007In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 20, no 3, p. 105-113Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim was to study new parents' satisfaction with postnatal care and to estimate the proportion of fathers who were given the option of spending the night at the postnatal ward. PROCEDURES: A questionnaire was mailed to new parents 6 months after the birth of their child in a Swedish hospital. The main outcome was overall satisfaction with postnatal care. FINDINGS: Two hundred and ninety-four new mothers and 280 new fathers completed the questionnaire. Thirty-four percent of the mothers were dissatisfied with the overall postnatal care. The strongest associated factors for new mothers' dissatisfaction were: unfriendly and unhelpful staff (RR 10.3; 3.2-32), lack of support from staff (RR 6.4; 2.3-17.5), new fathers not permitted to stay overnight (RR 5.2; 1.8-14.5), dissatisfaction with postnatal checks of the woman herself (RR 2.6; 1.1-6.3) and dissatisfaction with practical breast-feeding support (RR 1.6; 1.2-2.1). Sixty-three percent of the fathers were given the option of spending the night at the postnatal ward. The fathers who chose not to spend the night on the ward were older, had other children and were dissatisfied that they were not allowed to play a greater role in the care of their newborn baby. MAIN CONCLUSIONS: In order to increase patient satisfaction, the needs of the new family must be highlighted and more support and help provided to new parents on the postnatal ward. It is essential to have family oriented postnatal care and to give fathers the opportunity to stay overnight and involve them in the care of their newborn baby.

  • 7.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala University, Uppsala.
    Rubertsson, Christine
    Uppsala University, Uppsala; Lund University, Lund.
    Karlström, Annika
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Haines, Helen
    Uppsala University, Uppsala; University of Melbourne, Victoria, Australia.
    Exploring the Fear of Birth Scale in a mixed population of women of childbearing age-A Swedish pilot study2017In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799Article in journal (Refereed)
    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. 

  • 8.
    Johansson, Margareta
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Intrapartum care could be improved according to Swedish fathers: mode of birth matters for satisfcation2013In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 26, no 3, p. 195-201Article in journal (Refereed)
    Abstract [en]

    Background: Intrapartum care is expected to be shaped by parents' need and preferences. Aim: The aim was to explore Swedish fathers' intrapartum care quality experiences, with a specific focus on care deficiencies in relation to birth mode. A secondary aim was to explore which issues of quality that contributed most to dissatisfaction with the overall assessment of the care. Methods: Cross-sectional design, part of a prospective longitudinal survey in Sweden. A quality of care index was developed, based on perceived reality and subjective importance of given intrapartum care. Two months after birth 827 fathers answered nine questions related to quality of care. Descriptive statistics and logistic regression analysis were used. Results: Dissatisfaction with overall intrapartum care was related to deficiencies in partner's medical care (OR 5.6; 2.7-11.2), involvement in decision-making during childbirth (OR 2.6; 1.3-4.9), midwives presence in the labour room (OR 2.4; 1.2-4.7), and ability to discuss the birth afterwards (OR 2.0; 1.1-3.8). After emergency caesarean section 46% judged the partner's medical intrapartum care as most deficient (OR 1.73; 1.05-2.86), and after elective caesarean section 40% of the fathers judged involvement in decision-making as deficient (OR 4.07; 1.95-8.50). When the fathers had participated in a spontaneous vaginal birth they were dissatisfied with the presence of the midwife in the labour room (OR 1.72; 1.03-2.87). Conclusions: Deficiencies existed in the intrapartum care and were judged differently depending on mode of birth. The fathers needed to feel secure about the women's medical care, and wanted to be involved and supported.

  • 9.
    Johansson, Margareta
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Department of Clinical Science and Education, Karolinska Institutet Södersjukhuset, SE-118 83 Stockholm, Sweden.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Department of Women's and Children's Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden .
    Fenwick, Jennifer
    School of Nursing and Midwifery, Maternity and Family Unit, Griffith University.
    'As long as they are safe- birth mode does not matter' Swedish fathers' experiences of decision-making around caesarean section2014In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 27, no 3, p. 208-213Article in journal (Refereed)
    Abstract [en]

    Background: Decision-making in childbirth involves considerations about both the mother and her unborn baby's wellbeing. For men the safety of both is paramount. Aim: To explore and describe Swedish fathers' beliefs and attitudes around the decision for a caesarean section. Methods: Qualitative descriptive study. Twenty one Swedish men whose partners had experienced elective or emergency caesarean participated in a telephone interview. Thematic data analysis was used. Findings: The theme, 'Childbirth is Risky', included "Caesarean birth has lots of advantages" and "Birth mode does not matter". In the context of having experienced a caesarean section male partners considered birth mode to be irrelevant. The majority considered caesarean to be a quick and efficient way of giving birth which equated to being safer. Most men could articulate some risks associated with caesarean but these were mainly minimised. The second theme, 'Simply a matter of trust: Birth mode is not my decision', reflected men's belief that they had little to contribute to the decisions made around birth mode. The decision for a caesarean section was considered to lie with the medical practitioner. Conclusion: Mode of birth was regarded as unimportant. The recommendation for a caesarean section was readily accepted and appreciated, and shifted responsibility for birth to the medical practitioner. Involving men in the decision-making process by means of giving them information was valued. Men's limited knowledge about the risks of a caesarean may contribute to birth mode decisions. Professionals need to provide balanced and correct information within the context of individual circumstances.

  • 10.
    Karlström, Annika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Engström-Olofsson, Regina
    Thomas, Jan
    Kenyon college, Department of sociology.
    Nystedt, Astrid
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Swedish caregivers’ attitudes towards caesarean section on maternal request2009In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 22, no 2, p. 57-63Article in journal (Refereed)
    Abstract [en]

    Background Caesarean section (CS) is not an option that women in Sweden can chose themselves, although the rise in CS rate has been attributed to women. This study describes obstetricians’ and midwives’ attitudes towards CS on maternal request. Methods A qualitative descriptive study, with content analysis of 5 focus group discussions where 16 midwives and 9 obstetricians participated. Results The overarching theme was identified as “Caesarean section on maternal request—a balance between resistance and respect”. On the one hand, CS was viewed as a risky project; on the other hand, request for a CS was understood and respected when women had had a previous traumatic birth experience. Still, a CS was not really seen as a solution for childbirth related fear. Five categories were related to the theme. Overall, our findings indicate that caregivers blamed the women for the increase, they considered the management of CS on maternal request difficult, and they suggested preventive methods to reduce CS and means to strengthen their professional roles. Key conclusions and implication for practice Both midwives and obstetricians considered the management of CS on maternal request difficult, and the result showed that they balanced between resistance and respect. The result also showed that the participants stressed the importance of professionals advocating natural birth with evidence-based knowledge and methods to prevent maternal requests. Ongoing discussions among health professionals on attitudes and practice would strengthen their professional roles and lead to a decrease in CS rates in Sweden.

     

     

     

     

    Background:

     

     

    Caesarean section (CS) is not an option that women in Sweden can chose themselves,

    although the rise in CS rate has been attributed to women. This study describes

    obstetricians’ and midwives’ attitudes towards CS on maternal request.

     

    Methods:

     

     

    A qualitative descriptive study, with content analysis of 5 focus group discussions where

    16 midwives and 9 obstetricians participated.

     

    Results:

     

     

    The overarching theme was identified as ‘‘Caesarean section on maternal request–—a

    balance between resistance and respect’’. On the one hand, CS was viewed as a risky project; on the

    other hand, request for a CS was understood and respected when women had had a previous

    traumatic birth experience. Still, a CS was not really seen as a solution for childbirth related fear.

    Five categorieswere related to the theme.Overall, our findings indicate that caregivers blamed the

    women for the increase, they considered the management of CS on maternal request difficult, and

    they suggested preventive methods to reduce CS and means to strengthen their professional roles.

     

    Key conclusions and implication for practice:

     

     

    Both midwives and obstetricians considered the

     

     

  • 11.
    Larsson, Birgitta
    et al.
    Uppsala University; Sundsvall Hospital.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala University.
    Ternström, Elin
    Uppsala University.
    Rubertsson, Christine
    Uppsala University; Lund University.
    Karlström, Annika
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Women's experience of midwife-led counselling and its influence on childbirth fear: A qualitative study2018In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799Article in journal (Refereed)
    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. 

  • 12.
    Larsson, Birgitta
    et al.
    Uppsala University, Uppsala; Sundsvall Hospital.
    Karlström, Annika
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Rubertsson, Christine
    Uppsala University, Uppsala.
    Ternström, Elin
    Uppsala University, Uppsala.
    Ekdahl, Johanna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Segebladh, Birgitta
    Uppsala University, Uppsala.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala University, Uppsala.
    Birth preference in women undergoing treatment for childbirth fear: A randomised controlled trial2017In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, no 6, p. 460-467Article in journal (Refereed)
    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.

  • 13.
    Malm, Mari-Cristin
    et al.
    Dalarna University; Uppsala University.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala University.
    Rubertsson, Christine
    Uppsala University.
    Radestad, Ingela
    Sophiahemmet Univ, Stockholm.
    Lindgren, Helena
    Karolinska Inst, Stockholm.
    Prenatal attachment and its association with foetal movement during pregnancy - A population based survey2016In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 29, no 6, p. 482-486Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the association between the magnitude of foetal movements and level of prenatal attachment within a 24 h period among women in the third trimester of pregnancy. Design: a prospective population-based survey. Setting: A county in central Sweden. Participants: Low risk pregnant women from 34 to 42 weeks gestation, N = 456, 299 multiparous and 157 primiparous women. Measurements: The revised version of the Prenatal Attachment Inventory (PAI-R) and assessment of the perception of foetal movements per 24 h in the current gestational week. Findings: A total of 81 per cent of the eligible women completed the questionnaire. The overall sample of women found that the majority (96%) felt their baby move mostly in the evening. More than half of the respondents (55%) stated that they perceived frequent foetal movement on two occasions during a 24 h period, while almost a fifth (18%) never or only once reported frequent foetal movement in a 24 h period. Just over a quarter (26%) of respondents perceived frequent movement at least three times during a 24 h period. Perceiving frequent foetal movements on three or more occasions during a 24 h period, was associated with higher scores of prenatal attachment in all the three subscales. Key conclusion: Perceiving frequent foetal movements at least during three occasions per 24 h periods in late pregnancy was associated with prenatal attachment. Implications for practice: encouraging women to focus on foetal movements may positively affect prenatal attachment, especially among multiparous women > 35 years.

  • 14.
    Nilsson, Christina
    et al.
    Linnéuniversitetet.
    Lundgren, Ingela
    Sahlgrenska Akademin, Göteborgs Universitet.
    Karlström, Annika
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Self reported fear of childbirth and its association with women's birth experience and mode of delivery: A longitudinal population based study2012In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 25, no 3, p. 114-121Article in journal (Refereed)
    Abstract [en]

    Objective: To explore fear of childbirth (FOC) during pregnancy and one year after birth and its association to birth experience and mode of delivery. Design: A longitudinal population-based study. Population: Pregnant women who were listed for a routine ultrasound at three hospitals in the middle-north part of Sweden. Method: Differences between women who reported FOC and who did not were calculated using risk ratios with a 95% confidence interval. In order to explain which factors were most strongly associated to suffer from FOC during pregnancy and one year after childbirth, multivariate logistic regression analyses were used. Results: FOC during pregnancy in multiparous women was associated with a previous negative birth experience (RR 5.1, CI 2.5-10.4) and a previous emergency caesarean section (RR 2.5, CI 1.2-5.4). Associated factors for FOC one year after childbirth were: a negative birth experience (RR 10.3, CI 5.1-20.7), fear of childbirth during pregnancy (RR 7.1, CI 4.4-11.7), emergency caesarean section (RR 2.4, CI 1.2-4.5) and primiparity (RR 1.9, CI 1.2-3.1). Conclusion: FOC was associated with negative birth experiences. Women still perceived the birth experience as negative a year after the event. Women's perception of the overall birth experience as negative seems to be more important for explaining subsequent FOC than mode of delivery. Maternity care should focus on women's experiences of childbirth. Staff at antenatal clinics should ask multiparous women about their previous experience of childbirth. So that FOC is minimized, research on factors that create a positive birth experience for women is required. © 2011 Australian College of Midwives.

  • 15.
    Nystedt, Astrid
    et al.
    Department of Nursing, Umeå Universitet, Umeå.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Department of Women's and Children's Health, Uppsala University, Uppsala.
    Women's and men's negative experience of child birth-A cross-sectional survey2018In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 31, no 2, p. 103-109Article in journal (Refereed)
    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. 

  • 16.
    Sjöström, Kaisa
    et al.
    Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden .
    Welander, Sara
    Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden .
    Haines, Helen
    University of Melbourne, School of Rural Health, Shepparton, VIC, Australia .
    Andersson, Ewa
    Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden .
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden .
    Comparison of breastfeeding in rural areas of Sweden and Australia: A cohort study2013In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 26, no 4, p. 229-234Article in journal (Refereed)
    Abstract [en]

    Background

    Breastfeeding rates in Sweden and Australia appears to be decreasing in both countries. National statistics shows that 87% of infants in Sweden and 73% in Australia receive any breastfeeding two months of age.

    Aim

    To compare women's experiences of breastfeeding in Sweden and Australia and to identify factors associated with breastfeeding two months after birth.

    Methods

    A cohort study in two rural hospitals in mid Sweden (n = 300) and north-eastern Victoria in Australia (n = 91) during 2007–2009. Participants responded to questionnaires in mid pregnancy and two months after birth. Crude and adjusted odds ratios with a 95% confidence interval were used to detect differences between women in both cohorts.

    Findings

    Women in Sweden (88.3%) were more likely to report any breastfeeding of the baby two months after birth (OR 2.41; 95% CI: 1.33–4.38) compared to women in Australia (75.8%) but were less satisfied with breastfeeding support and information. The most important factor associated with breastfeeding at two months postpartum for the Swedish women was to have received sufficient information about breastfeeding on the postnatal ward (OR 2.3; 95% CI 1.41–4.76) while for the Australian women receiving the best possible help when breastfeeding for the first time was most important (OR 4.3; 95% CI 1.50–12.46).

    Conclusion

    The results indicate that Swedish women were more likely than their Australian counterparts to breastfeed the baby two months after birth. The findings demonstrated the importance of sufficient information and help when breastfeeding is initiated.

  • 17.
    Ternstrom, Elin
    et al.
    Uppsala Univ, Obstet & Gynaecol, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala Univ, Obstet & Gynaecol, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden.;Mid Sweden Univ, Dept Hlth Sci, Sundsvall, Sweden..
    Haines, Helen
    Univ Melbourne, Rural Hlth Acad Ctr, Melbourne, Vic 3010, Australia.
    Rubertsson, Christine
    Uppsala Univ, Obstet & Gynaecol, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden.
    Pregnant women's thoughts when assessing fear of birth on the Fear of Birth Scale2016In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 29, no 3, p. E44-E49Article in journal (Refereed)
    Abstract [en]

    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.

  • 18.
    Thies-Lagergren, LI
    et al.
    Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Stockholm SE-171 76, Sweden.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Stockholm SE-171 76, Sweden.
    Christensson, Kyllike
    Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Stockholm SE-171 76, Sweden.
    Kvist, Linda
    Department of Health Sciences, Lund University, Sweden .
    Who decides the position for birth? A follow-up study of a randomized controlled trial2013In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 26, no 4, p. e99-e104Article in journal (Refereed)
    Abstract [en]

    Background Physical benefits are suggested for women and their babies when women adopt an upright position of their choice at birth. Available care options during labour influence women's impressions of what intrapartum care is. This indicates that choice of birth positions may be determined more by midwives than by women's preferences.

    Question The aims of this study were to investigate factors associated with adherence to allocated birth position and also to investigate factors associated with decision-making for birth position.

    Method An invitation to answer an on-line questionnaire was mailed.

    Findings Despite being randomised, women who gave birth on the seat were statistically significantly more likely to report that they participated in decision-making and that they took the opportunity to choose their preferred birth position. They also reported statistically significantly more often than non-adherers that they felt powerful, protected and self-confident.

    Conclusions Midwives should be conscious of the potential impact that birth positions have on women's birth experiences and on maternal outcomes. Midwives should encourage women's autonomy by giving unbiased information about the birth seat. An upright birth position may lead to greater childbirth satisfaction. Women's experience of and preferences for birth positions are consistent with current evidence for best practice.

  • 19.
    Åhlund, Susanne
    et al.
    Department of Women's and Children's Health, Karolinska Institute.
    Zwedberg, Sofia
    Department of Women's and Children's Health, Karolinska Institute.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Department of Women's and Children's Health, Uppsala University, Uppsala.
    Edqvist, Malin
    The Sahlgrenska Academy, University of Gothenburg.
    Lindgren, Helena
    Department of Women's and Children's Health, Karolinska Institute.
    Midwives experiences of participating in a midwifery research project: A qualitative study2018In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 31, no 2, p. e115-e122Article in journal (Refereed)
    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. 

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