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  • 1.
    Bogren Jungmarker, Emily
    et al.
    Högskolan Dalarna.
    Lindgren, Helena
    Högskolan Dalarna.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Playing second fiddle is Okay-Swedish Fathers' experiences of prenatal care2010In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 55, no 5, p. 421-429Article in journal (Refereed)
    Abstract [en]

    Introduction: In Sweden, prospective fathers are encouraged and welcome to attend prenatal visits, and pregnant women assess their partners' involvement in prenatal care as very important. The aim of this study was to describe expectant fathers' experiences of and involvement in prenatal care in Sweden. Methods: Data were drawn from a 1-year cohort study of 827 Swedish-speaking fathers recruited during their partners' midpregnancy and followed up 2 months after childbirth. Results: The participants reported that the most important issues in prenatal care were the woman's physical and emotional well-being and the support she received from her midwife. However, care was identified as deficient in nearly all aspects of information, medical care, and fathers' involvement. "Excessive" care was also reported and related to how the father was treated by the midwife, mainly in terms of attention to his emotional well-being. Discussion: Although fathers prioritize the needs of their pregnant partners, it is important for caregivers to assess fathers' needs and incorporate a family-oriented approach to prenatal care.

  • 2.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Thomas, Jan
    Kenyon College, Department of Sociology.
    Maternity services from women's perspecitve in Sweden: processes, problems, and solutions.2007In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 52, no 2, p. 126-133Article in journal (Refereed)
    Abstract [en]

    Most measures of health care quality focus on medical outcomes rather than patients' assessments of quality. Drawing on data from a national survey of Swedish women, this study describes women's opinions about what is important to them during pregnancy and birth. This qualitative study is based on responses of 827 pregnant women to an open question completed in the second trimester. In total, 2061 separate statements were analyzed. Using content analysis, these statements were clustered into 4 themes: desirable characteristics of midwife, prenatal care during pregnancy, care during labor and birth, and care after birth. Within those themes, 13 categories were found. Findings suggest areas for improvement in maternity services including: the timing and length of prenatal visits, making parent education classes available to all women, prelabor visits to the maternity ward, continuous information about the progress of labor, flexibility in time of discharge, and postpartum support for families. Women also stated that characteristics of the midwife, such as being supportive, friendly, attentive, respectful, and nonjudgemental, were important. A patient-centered and individualized approach, with women and their partners as the subjects rather than the objects of care, would increase satisfaction and the overall quality of maternity services in Sweden.

  • 3.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Thomas, Jan
    Kenyon College, Gambier, Ohio, USA.
    Perinatal Outcomes and Satisfaction with Care in Women with High Body Mass Index2012In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 57, no 4, p. 336-344Article in journal (Refereed)
    Abstract [en]

    Introduction: The majority of studies on pregnant women with high body mass index (BMI) have focused on medical complications and birth outcome, rather than these women's encounters with health care providers. The aims were to identify the proportion of pregnant women with high BMIs (≥30); compare maternal characteristics and pregnancy and birth outcomes; and assess the experiences of prenatal, intrapartum, and postnatal care in women with high (≥30) and lower (<30) BMIs. Methods: Data were collected through questionnaires and antenatal records from 919 women recruited in mid-pregnancy at 3 hospitals in the north of Sweden, with a follow-up questionnaire 2 months after birth. Results: The prevalence of obesity was 15.2%. Women with high BMIs were more often aged 35 years or older and less likely to have a university education. They had more negative attitudes regarding being pregnant and reported more childbirth fear compared to women with lower BMIs, but they did not differ in regard to their feelings about the approaching birth or the first weeks with the newborn. They reported more pregnancy complications and had less continuity of caregiver. High BMI was associated with labor induction and emergency cesarean birth. No differences were found in birth complications; birth experience; or satisfaction with prenatal, intrapartum, or postnatal care. Discussion: The findings reveal that women who are obese have more complicated pregnancies and births but are generally satisfied with the care they receive. There are some differences in the way they experience care. Health care providers have a delicate task to provide sufficient information about health risks while still offering respect, encouragement, and support. © 2012 by the American College of Nurse-Midwives.

  • 4.
    Ängeby, Karin
    et al.
    City Council Värmland, Karlstad; Karlstad University, Karlstad.
    Wilde-Larsson, Bodil
    Karlstad University, Karlstad; Inland Norway University Appl Sci, Elverum, Norway.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala University, Uppsala.
    Sandin-Bojö, Ann-Kristin
    Karlstad University, Karlstad.
    Prevalence of Prolonged Latent Phase and Labor Outcomes: Review of Birth Records in a Swedish Population2018In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 63, no 1, p. 33-44Article, review/survey (Refereed)
    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.

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