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  • 1. Abrahamsson, A
    et al.
    Springett, J
    Karlsson, L
    Ottosson, T
    Högskolan i Borås, Institutionen för Pedagogik.
    Some Lessons from Swedish Midwives' Experiences of Approaching Women Smoker in Antenatal Care2005Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 21, nr 4, s. 335-345Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: to describe the qualitatively different ways in which midwives make sense of how to approach women smokers. DESIGN, SETTING AND PARTICIPANTS: a more person-centred national project 'Smoke-free pregnancy' has been in progress in Sweden since 1992. Using a phenomenographic approach, 24 midwives who have been regularly working in antenatal care were interviewed about addressing smoking during pregnancy. FINDINGS: four different story types of how the midwives made sense of their experiences in addressing smoking in pregnancy were identified: 'avoiding', 'informing', 'friend-making', 'co-operating'. KEY CONCLUSION: the midwives' story types about how they approached women who smoke illustrated the difficulties of changing from being an expert who gives information and advice to being an expert on how to enable a woman in finding out why she smoked and how to stop smoking. IMPLICATIONS FOR PRACTICE: health education about smoking that is built on co-operation and dialogue was seen by the midwives as a productive way of working. The starting point should be the lay perspective of a woman, which means that her thoughts about smoking cessation are given the space to grow while she talks.

  • 2. Binfa, Lorena
    et al.
    Pantoja, Loreto
    Gonzalez, Hilda
    Ransjö-Arvidson, Anna-Berit
    Robertson, Eva
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Chilean midwives and midwifery students' views of women's midlife health-care needs2011Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, nr 4, s. 417-423Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective to determine Chilean midwives’ views with regard to Chilean women’s health-care needs in midlife. The aim was also to explore Chilean midwifery students’ views on the clinical care provided to women in midlife. Design a qualitative study using focus group discussions and narratives which were analysed using thematic manifest and latent content analysis. Setting 10 different primary health care (PHC) centres in Santiago, Chile. Participants 22 midwives, working in PHC clinics and 13 (n=13) midwifery students with PHC clinical experience, attending their fourth or fifth year of midwifery education at the School of Midwifery in Santiago. Findings the midwives felt that women in midlife have special health-care service needs. They also considered themselves to be the most appropriate health staff to provide health care for women in midlife, but recognised that they lacked competence in attending psychological and social health-care needs of women in midlife such as violence, abuse and sexuality issues. The midwifery students remarked that many midwives focused their attention on fulfilling the biomedical requirements. Even if the midwives had knowledge about recent research on menopause, they had difficulties in approaching this issue and including it in their counselling. Some students also questioned the sometimes disrespectful attitude shown, especially towards Peruvian immigrants and women with psychosocial problems. Conclusions and implications for practice the findings suggest that midwives need more education about women’s health-care needs in midlife, and that more focus should be placed on the psychosocial aspects of midwifery. More reflections about the quality of the client–provider relationship in clinical practice are needed. Gender issues, the structure of power relationships, and empowerment should be incorporated and critically discussed during midwifery education and training, and also in clinics.

  • 3. Nilsson, Christina
    et al.
    Lundgren, Ingela
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Women's lived experiences of fear of childbirth2009Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 25, nr 2, s. 1-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: to describe women's lived experience of fear of childbirth.

    DESIGN: a qualitative study using a phenomenological approach and a lifeworld perspective. Data were collected via tape-recorded interviews. SETTING: Sahlgrenska University Hospital, Göteborg, Sweden in 2003. PARTICIPANTS: eight pregnant women (24-37 gestational weeks) seeking help within an outpatient clinic for women with severe fear of childbirth. Two of the women were primiparous.

    FINDINGS: four constituents were identified: feeling of danger that threatens and appeals; feeling trapped; feeling like an inferior mother-to-be and on your own. The essential structure was described as 'to lose oneself as a woman into loneliness'.

    KEY CONCLUSIONS: fear of childbirth affects women in such a way that they start to doubt themselves and feel uncertain of their ability to bear and give birth to a child. Previous birth experience was central to the multiparous women. They described their experiences of suffering in relation to the care they received during childbirth. This mainly concerned pain and negative experiences with staff.

    IMPLICATIONS FOR PRACTICE: pregnant women who fear childbirth are an exposed group in need of much support during pregnancy and childbirth. The encounter between the woman and the midwife can be a way of breaking down the feeling of loneliness and restoring the woman's trust in herself as a childbearing woman.

  • 4.
    Nilsson, Christina
    et al.
    University of Gothenburg.
    Lundgren, Ingela
    University of Gothenburg.
    Smith, Valerie
    Trinity College Dublin.
    Vehvilainen-Julkunen, Katri
    Kuopio University Hospital.
    Nicoletti, Jane
    Universita Degli Studi di Genova.
    Devane, Declan
    Saolta University Healthcare Group.
    Bernloehr, Annette
    Hannover Medical School.
    van Limbeek, Evelien
    Zuyd University.
    Lalor, Joan
    University of Gothenburg.
    Begley, Cecily
    Trinity College Dublin.
    Women-centred interventions to increase vaginal birth after caesarean section (VBAC): A systematic review.2015Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 31, nr 7, s. 657-63, artikel-id S0266-6138(15)00118-7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: to evaluate the effectiveness of women-centred interventions during pregnancy and birth to increase rates of vaginal birth after caesarean.

    DESIGN: we searched bibliographic databases for randomised trials or cluster randomised trials on women-centred interventions during pregnancy and birth designed to increase VBAC rates in women with at least one previous caesarean section. Comparator groups included standard or usual care or an alternative treatment aimed at increasing VBAC rates. The methodological quality of included studies was assessed independently by two authors using the Effective Public Health Practice Project quality assessment tool. Outcome data were extracted independently from each included study by two review authors.

    FINDINGS: in total, 821 citations were identified and screened by title and abstract; 806 were excluded and full text of 15 assessed. Of these, 12 were excluded leaving three papers included in the review. Two studies evaluated the effectiveness of decision aids for mode of birth and one evaluated the effectiveness of an antenatal education programme. The findings demonstrate that neither the use of decision aids nor information/education of women have a significant effect on VBAC rates. Nevertheless, decision-aids significantly decrease women's decisional conflict about mode of birth, and information programmes significantly increase their knowledge about the risks and benefits of possible modes of birth.

    KEY CONCLUSIONS: few studies evaluated women-centred interventions designed to improve VBAC rates, and all interventions were applied in pregnancy only, none during the birth. There is an urgent need to develop and evaluate the effectiveness of all types of women-centred interventions during pregnancy and birth, designed to improve VBAC rates.

    IMPLICATIONS FOR PRACTICE: decision-aids and information programmes during pregnancy should be provided for women as, even though they do not affect the rate of VBAC, they decrease women's decisional conflict and increase their knowledge about possible modes of birth.

  • 5. Olsson, Ann
    et al.
    Robertson, Eva
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Falk, Katarina
    Nissen, Eva
    Assessing women's sexual life after childbirth: the role of the postnatal check2011Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, nr 2, s. 195-202Artikel i tidskrift (Refereegranskat)
  • 6. Premberg, Åsa
    et al.
    Carlsson, Gunilla
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Hellström, Anna-Lena
    Berg, Marie
    First-time fathers’ experiences of childbirth: A phenomenological study2011Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, nr 6, s. 848-853Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective to describe fathers' experiences during childbirth. Design qualitative method with phenomenological lifeworld approach. A re-enactment interview method, with open-ended questions analysed with a phenomenological method, was used. Participants and setting 10 first-time fathers from two hospitals were interviewed four to six weeks after childbirth in Southwest Sweden during the autumn of 2008. Findings the essential meaning of first-time fathers' lived experience of childbirth was described as an interwoven process pendulating between euphoria and agony. The four themes constituting the essence was: ‘a process into the unknown’, ‘a mutually shared experience’, ‘to guard and support the woman’ and ‘in an exposed position with hidden strong emotions’. Key conclusions childbirth was experienced as a mutually shared process for the couple. The fathers' high involvement in childbirth, in cooperation with the midwife, and being engaged in support and care for his partner in her suffering is fulfilling for both partners, although the experience of the woman's pain, fear of the unknown and the gendered preconceptions of masculine hegemony can be difficult to bear for the father-to-be. Implications for practice in order to maintain and strengthen childbirth as a mutually shared experience for the couple, the father needs to be recognised and supported as a parent-to-be. Midwives have to acknowledge fathers as valued participants and support their significant position.

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