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  • 1.
    Avelin, Pernilla
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Rådestad, Ingela
    Sophiahemmet Univ Coll.
    Säflund, Karin
    Karolinska Inst.
    Wredling, Regina
    Karolinska Inst.
    Erlandsson, Kerstin
    Mälardalen University, School of Health, Care and Social Welfare.
    Parental grief and relationships after the loss of a stillborn baby2013In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 29, no 6, p. 668-73Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: to describe the grief of mothers and fathers and its influence on their relationships after the loss of a stillborn baby.

    DESIGN: a postal questionnaire at three months, one year and two years after stillbirth.

    SETTING: a study of mothers and fathers of babies stillborn during a one-year period in the Stockholm region of Sweden.

    PARTICIPANTS: 55 parents, 33 mothers and 22 fathers.

    FINDINGS: mothers and fathers stated that they became closer after the loss, and that the feeling deepened over the course of the following year. The parents said that they began grieving immediately as a gradual process, both as individuals, and together as a couple. During this grieving process their expectations, expressions and personal and joint needs might have threatened their relationship as a couple, in that they individually felt alone at this time of withdrawal. While some mothers and fathers had similar grieving styles, the intensity and expression of grief varied, and the effects were profound and unique for each individual.

    KEY CONCLUSIONS: experiences following a loss are complex, with each partner attempting to come to terms with the loss and the resultant effect on the relationship with their partner.

    IMPLICATIONS FOR PRACTICE: anticipating and being able to acknowledge the different aspects of grief will enable professionals to implement more effective intervention in helping couples grieve both individually and together.

  • 2.
    Erlandsson, Kerstin
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences.
    Fagerberg, Ingegerd
    Mälardalen University, Department of Caring and Public Health Sciences.
    Mothers' lived experiences of co-care and part-care after birth, and their strong desire to be close to their baby2005In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 21, no 2, p. 131-138Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe how mothers of premature or sick mature babies, experienced the care and their own state of health after birth in postnatal care in a neonatal co-care ward. DESIGN: A Husserlian phenomenology method inspired by Giorgi was used. Six mothers were interviewed using a semi-structured, open-ended interview guide. SETTING: A neonatal ward using a concept of co-care for premature or sick mature babies and their mothers. FINDINGS: In essence, mothers felt that, whatever the circumstances, they wanted to be close to their babies. It was the mother's experience that the organisation, staff or other circumstances prolonged the separation from her baby. The mother experienced the separation from the baby intensely during the first days after birth (even for a short period of time); after returning home, they had still not come to terms with it. The mothers regarded the entire stay in hospital as one event; they did not differentiate between wards or ward staff in the delivery, maternity or neonatal wards. All mothers in the study had, therefore, also experienced part-care for shorter or longer periods when separated from their baby, being then later reunited in co-care. CONCLUSION: This study can be used as a basis for discussion on more individualised care through co-operation and organisation between delivery, maternity and neonatal wards, in order to reduce the amount of time mother and baby are separated.

  • 3.
    Erlandsson, Kerstin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Warland, J.
    School of Nursing and Midwifery, University of South Australia.
    Cacciatore, J.
    School of Social Work, Arizona State University.
    Rådestad, I.
    Sophiahemmet University College.
    Seeing and holding a stillborn baby: Mothers' feelings in relation to how their babies were presented to them after birth-Findings from an online questionnaire2013In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 29, no 3, p. 246-250Article in journal (Refereed)
    Abstract [en]

    Objective: to determine if the way caregivers offer opportunities to see and hold a stillborn baby impacts a mother's feelings about the experience of seeing and holding her newborn. Design and setting: a web questionnaire hosted by the Swedish National Infant Foundation from March 2008 to April 2010. Participants: 840 eligible participants who had experienced a stillbirth after the 22nd gestational week from 1955 to 2010 and completed an online questionnaire about their experiences. Methods: descriptive and inferential statistics. Findings: when mothers were presented the baby as a normal part of birth without being asked if they wanted to see, they more often reported that the experience was comfortable compared to mothers who were asked if they wanted to see the baby 86% vs. 76% (p=<0.01). The incitation of fear in mothers was 70% vs. 80% (p=0.02) in favour of mothers who were not asked. Furthermore the mothers who were not asked more often stated that it felt natural and good when compared to those who said staff asked if the mother wanted to see, 73% vs. 61% (p=0.07) and (78%) vs. (69%) p=0.19, respectively. A trend was seen toward more mothers feeling natural, good, comfortable, and less frightened if the provider engaged in 'assumptive bonding', that is the baby is simply and naturally presented to the mother without asking her to choose. Key conclusions: mothers of stillborn babies felt more natural, good, comfortable and less frightened if the staff supported assumptive bonding by simply offering the baby to the mother. Implications for practice: care providers should approach caring for grieving mothers with tenderness and humility, assuming that they will wish to see and hold their stillborn baby. © 2012 Elsevier Ltd.

  • 4.
    Lindberg, Inger
    et al.
    Luleå University of Technology, Sweden.
    Christensson, Kyllike
    Mälardalen University, School of Health, Care and Social Welfare.
    Öhrling, Kerstin
    Luleå University of Technology, Sweden.
    Midwives' experience of organisational and professional change2005In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 21, no 4, p. 355-364Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: to describe midwives' experiences of changes in their caring role and professional function in postpartum wards in the northern part of Sweden. In this part of the country, three out of eight maternity departments have been closed over the last 5 years. During the same period, hospital stays have reduced in length, and an early discharge model has been introduced. DESIGN: focus-group discussions. SETTING: four focus groups at two hospitals in northern Sweden. PARTICIPANTS: 21 midwives experienced in midwifery practice in maternity wards. FINDINGS: the analysis revealed four categories of comments: 'to have limited time when caring for the mother and the baby'; 'no longer being valued as the expert'; 'a wish to have responsibility for childbirth in its entirety'; 'to see future possibilities in the development of the profession'. The theme identified is 'being ahead in ideas about caring but still partly caught up in the past'. KEY CONCLUSIONS AND IMPLICATIONS: the identified theme of being ahead in ideas about caring but still partly caught up in the past can be understood as representing a transition. The midwives experienced loss and grief over their former midwifery practice, but had ideas and visions for developing and expanding their future professional role. A healthy transition requires support, participation and skilled management.

  • 5.
    Lindgren, Helena E
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Rådestad, Ingela J
    Mälardalen University, School of Health, Care and Social Welfare.
    Christensson, Kyllike
    Mälardalen University, School of Health, Care and Social Welfare.
    Wally-Byström, Kristina
    Mälardalen University, School of Health, Care and Social Welfare.
    Hildingsson, Ingegerd M
    Karolinska Institutet.
    Perceptions of risk and risk management among 735 women who opted for a home birth2010In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 26, no 10, p. 163-172Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: home birth is not included in the Swedish health-care system and the rate for planned home births is less than one in a thousand. The aim of this study was to describe women's perceptions of risk related to childbirth and the strategies for managing these perceived risks. DESIGN AND SETTING: a nationwide study including all women who had given birth at home in Sweden was conducted between 1 January 1992 and 31 July 2005. PARTICIPANTS: a total of 735 women had given birth to 1038 children. Of the 1038 questionnaires sent to the women, 1025 (99%) were returned. MEASUREMENTS: two open questions regarding risk related to childbirth and two questions answered using a scale were investigated by content analysis. FINDINGS: regarding perceived risks about hospital birth, three categories, all related to loss of autonomy, were identified: (1) being in the hands of strangers; (2) being in the hands of routines and unnecessary interventions; and (3) being in the hands of structural conditions. Perceived risks related to a home birth were associated with a sense of being beyond help: (1) worst-case scenario; and (2) distance to the hospital. The perceived risks were managed by using extrovert activities and introvert behaviour, and by avoiding discussions concerning risks with health-care professionals. CONCLUSION: women who plan for a home birth in Sweden do consider risks related to childbirth but they avoid talking about the risks with health-care professionals. IMPLICATIONS FOR PRACTICE: to understand why women choose to give birth at home, health-care professionals must learn about the perceived beneficial effect of doing so.

  • 6.
    Mbekenga, Columba K
    et al.
    Muhimbili Univ.
    Lugina, Helen I
    Muhimbili Univ.
    Christensson, Kyllike
    Karolinska Inst.
    Olsson, Pia
    Uppsala Univ.
    Postpartum experiences of first-time fathers in a Tanzanian suburb: A qualitative interview study.2010In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, no 2, p. 174-180Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: to explore postpartum experiences of first-time fathers in a multicultural, low-income, suburban Tanzanian setting. DESIGN, SETTING AND PARTICIPANTS: individual qualitative interviews with ten first-time fathers, four to ten weeks post partum in Ilala suburb, Dar es Salaam, Tanzania. FINDINGS: these first-time fathers enjoyed fatherhood and revealed a sincere concern for the well-being of the mother and infant during the postpartum period. They described themselves as active in mother and infant care and household chores; however, they were limited by breadwinning responsibilities. The families were supported by relatives or laypersons. The mothers' and infants' nutrition had high priority but poverty was an obstacle. Timing of resumption of sex after childbirth was problematic as traditions prescribed abstinence while the woman is breast feeding. The risk of contracting HIV to the family was a concern. Reproductive and child health care often excluded fathers and gave unclear information. CONCLUSION: these new fathers struggled to gain confidence and experience while engaging in family matters during post partum. Changing gender roles in the suburban Tanzanian society in general and their personal experiences of transition to fatherhood both facilitated and made the postpartum period problematic. The health sector does not respond with respect to fathers' concerns for family health and needs for support. RECOMMENDATIONS: these findings call for programmes on gender relations, which are supporting constructive masculinities and facilitate new fathers' active participation and responsibilities in parenting, family health and their relations with their partners. Such programmes should not only target people in childbearing age but also their potential support persons. Health workers should welcome fathers and discuss strategies for good family health during post partum. Counselling couples together could facilitate their support for each other in optimising health post partum.

  • 7.
    Rubertsson, Christine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Hildingsson, Ingegerd
    Mälardalen University, School of Health, Care and Social Welfare.
    Rådestad, Ingela
    Mälardalen University, School of Health, Care and Social Welfare.
    Disclosure and police reporting of intimate partner violence postpartum: a pilot study.2010In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 26, no 1, p. e1-5Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: intimate partner violence is a significant health problem. Fear of retaliation and shame may prevent women from telling anyone about the violence. This study investigated the prevalence of disclosure and police reporting of intimate partner violence during the first year postpartum. DESIGN: a prospective longitudinal Swedish cohort study based on information from 2563 women who answered a postal questionnaire in early pregnancy and 12 months postpartum. FINDINGS: of 52 women who had been exposed to violence by their partner during the first year postpartum, four (8%) had filed a police report while 19 (37%) had not told anyone about the violence. All single women in the study had disclosed the violence to a friend, a relative or filed a police report. KEY CONCLUSIONS: few women file a police report when they are being hit by their partner during the year after childbirth. Many women do not tell anyone that they have been hit. IMPLICATIONS FOR PRACTICE: these data may encourage health professionals to undertake sensitive questioning about violence, giving an opening for support.

  • 8.
    Rådestad, Ingela
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences.
    Surkan, Pamela J.
    Steineck, Gunnar
    Cnattingius, Sven
    Onelov, Erik
    Dickman, Paul W.
    Long-term outcomes for mothers who have or have not held their stillborn baby2009In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 25, no 4, p. 422-429Article in journal (Refereed)
    Abstract [en]

    Objectives: to investigate long-term outcomes of mothers who have or have not held their stillborn baby, and predictors of having held the baby. Design: postal questionnaires. Setting: a nation-wide cohort study of mothers who gave birth to a singleton stillborn baby in Sweden in 1991. Participants: 314 out of 380 women answered the questionnaire and 309 reported whether or not they had held their baby. Measurements: scales measuring anxiety, depression and well-being. Findings: 126 (68%) mothers of 185 babies stillborn after 37 gestational weeks had held their baby and 82 (68%) mothers of 120 babies stillborn at gestational weeks 28-37 had also done so. Compared with mothers who agreed completely with the statement that staff gave enough support to hold the baby, mothers who did not agree were less likely to have held their baby [relative risk (RR) 4.1; 95% confidence interval (CI) 2.7-6.1], and mothers with a low level of education were less Likely to have held their baby than mothers with a higher level of education (RR 2.2; 95% CI 1.3-3.8). Mothers who had not held their babies born after 37 gestational weeks had an increased risk of headache (RR 4.3; 95% CI 1.1-16.5), and they were less satisfied with their steep (RR 2.7; 95% CI 1.5-5.0). The increased risk of long-term outcomes associated with not holding, compared with holding, a stillborn baby were Less pronounced for women who gave birth at gestational week 28-37 compared with women who gave birth after 37 gestational weeks. Key conclusions: in this cohort, we found an overall beneficial effect of having held a stillborn baby born after 37 gestational weeks, whereas findings for having held a stillborn baby born at gestational weeks 28-37 are uncertain. The attitude of staff influenced whether or not the mother held her stillborn baby. Implications for practice: if the mother is guided by staff in a sensitive way to hold her stillborn term baby, the experience wit( possibly be beneficial for her in the long term. 

  • 9.
    Sriyasak, Atcharawadee
    et al.
    Prachomklao Coll Nursing, 203 Moo2, Thongchai 76000, Muang, Thailand..
    Almqvist, Anna-Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sridawruang, Chaweewan
    Boromarajonani Coll Nursing Udon Thani, Mueang 41330, Udon Thani, Thailand..
    Häggström-Nordin, Elisabet
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Healthcare providers' caring for Thai teenage parents: A focus group study2019In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 69, p. 172-178Article in journal (Refereed)
  • 10.
    Sriyasak, Atcharawadee
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Prachomklao College of Nursing, Phetchaburi province, Thailand .
    Almqvist, Anna-Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sridawruang, Chaweewan
    Boromarajonani College of Nursing, Udon Thani, Thailand.
    Neumsakul, Wanwadee
    Suranaree University of Technology, Thailand.
    Häggström-Nordin, Elisabet
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Struggling with motherhood and coping with fatherhood: A grounded theory study among Thai teenagers2016In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, ISSN 0266-6138, Vol. 42, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Objective to gain a deeper understanding of Thai teenage parents’ perspectives, experiences and reasoning about becoming and being a teenage parent from a gender perspective. Design an exploratory design using grounded theory methodology. Semi-structured interviews were used to collect data. An interview guide was developed, a pilot study was undertaken, and interviews were performed on two different occasions: once during the second trimester of pregnancy and again when the infant was 5–6 months old. Setting a province in the western part of Thailand. Participants the selection of a heterogeneous group of teenage parents-to-be continued until saturation was reached, as describe by Glaser and Strauss (1967), in all n=50. Inclusion criteria for participants were that they were heterosexual couples, under 20 years of age, cohabiting, and expecting their first child. Findings the core category ‘struggling with motherhood and coping with fatherhood’ comprises descriptions of the process from when the teenagers first learned about the pregnancy until the child was six months old. The teenagers had failed to use contraceptives which led to an unintended parenthood. Their parenthood became a turning point as the teenagers started to change their behaviours and lifestyle during pregnancy, and adapted their relationships to partner and family. Family commitments was a facilitator, through support given by their families. Finally, becoming a parent describes ways of dealing with the parental role, by engaging in parental activities and reestablishing goals in life. Most of the teenage parents reproduced traditional gender roles by being a caring mother or a breadwinning father respectively. Key conclusions ‘struggling with motherhood and coping with fatherhood’ referred to the parents’ stories about how they struggled and coped with life changes and their parental role when they became unintentionally pregnant, accepted their parenting, and finally became parents. After becoming parents, the main concerns of most of the teenage parents were being a caring mother and a breadwinning father. Implications for practice this study contributes a deeper understanding of Thai teenage parents’ experiences of becoming and being a parent and might improve health care professionals’ adaptation of care for teentranatanage parents and inspire them to tailor their care specifically to teenager's needs from early pregnancy to parenthood.

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