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  • 1.
    Akselsson, Anna
    et al.
    Sophiahemmet University.
    Cabander, Lisa
    Thorarinsdottir, Steinunn
    Small, Rhonda
    Ternström, Elin
    Language-supported labor ward visits for pregnant migrant women: Staff experiences in a Swedish hospital2022In: European Journal of Midwifery, E-ISSN 2585-2906, Vol. 6, article id 42Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The aim of this study was to explore midwives' and assistant nurses' experiences of providing extra support to non-Swedish-speaking migrants by offering individual language-supported visits to the labor ward during pregnancy.

    METHODS: Semi-structured interviews were conducted with six guides, midwives or assistant nurses, working in the INFÖR (Individuell förlossningsförberedelse) project at Södertälje hospital in Sweden. INFOR includes a two-hour individual language-supported visit at the labor ward, for non-Swedish speaking pregnant women and their partners. An inductive thematic analysis was conducted.

    RESULTS: The guides described INFOR as being a bridge and creating safety, achieved by meeting with women and providing practical information. The guides felt that they fulfilled an important purpose, they were dedicated and adapted to the women's individual needs. Providing extra language-assisted support to migrant pregnant women was developing and enriching, but the guides highlighted some barriers. Communicating via an interpreter was a challenge and the women were in need of more and extended meetings. The guides wished that INFOR could become a standard part of antenatal care, but the model needs to be further developed, and a better system for recruitment must be introduced.

    CONCLUSIONS: The guides experienced that the INFOR model is valuable in creating safety to pregnant migrant women before birth. The model is appreciated by the expectant couples, midwives and assistant nurses, and could be implemented as standard care. However, it is important to adapt the visits to the women's and their families' needs and goals, and structure needs to be developed before implementation.

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  • 2.
    Akselsson, Anna
    et al.
    Sophiahemmet University.
    Westholm, Lena
    Small, Rhonda
    Westholm, Lena
    Midwives’ communication with non-Swedish-speaking women giving birth: A survey from a multicultural setting in Sweden2022In: European Journal of Midwifery, E-ISSN 2585-2906, Vol. 6Article in journal (Refereed)
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  • 3. Hildingsson, Ingegerd
    et al.
    Karlström, Annika
    Rubertsson, Christine
    Larsson, Birgitta
    Sophiahemmet University.
    Quality of intrapartum care assessed by women participating in a midwifery model of continuity of care2021In: European Journal of Midwifery, E-ISSN 2585-2906, Vol. 5, article id 11Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Continuity models are rare in Sweden. The aim was to compare the intrapartum care experiences between women who had or not a known midwife attending their birth.

    METHODS: A cohort study was conducted in a rural area with long distance to a labor ward in Sweden. From August 2017 to June 2019, a continuity model with a known midwife was offered between 7 a.m. and 11 p.m. daily. Questions about intrapartum care were assessed in two aspects; the perceived reality and the subjective importance.

    RESULTS: A total of 226 women recruited in early pregnancy were followed up two months after giving birth. Women who had a known midwife providing labor care reported higher overall satisfaction and were more likely to value the subjective importance and the perceived reality significantly higher than women who received intrapartum care without a known midwife assisting. When analyzing the medical aspects of intrapartum care, the most important factors for not being satisfied were deficiencies in the partner's involvement and insufficient pain relief. For the emotional aspects, deficiencies in participation in decision making was the most important aspect.

    CONCLUSIONS: Having a known midwife assisting at birth reduced discrepancies between women's subjective importance and perceived reality of intrapartum care, especially regarding support and the involvement of the partner. A known midwife generated higher overall satisfaction with the medical and emotional aspects of intrapartum care. To improve satisfaction and the quality of intrapartum care, continuity midwifery models of care should be implemented.

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  • 4. Hildingsson, Ingegerd
    et al.
    Nilsson, Johanna
    Merio, Elida
    Larsson, Birgitta
    Sophiahemmet University.
    Anxiety and depressive symptoms in women with fear of birth: A longitudinal cohort study2021In: European Journal of Midwifery, E-ISSN 2585-2906, Vol. 5, article id 32Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Anxiety and depression during pregnancy could imply difficulties in the attachment to the unborn baby. The objective of this study was to investigate the prevalence and change in anxiety and depressive symptoms in pregnant women with fear of birth. Another aim was to explore associations between symptoms of anxiety and depression on prenatal attachment.

    METHODS: This is a longitudinal cohort study of 77 pregnant women with fear of birth in three hospitals in Sweden. Data were collected by three questionnaires in mid and late pregnancy and two months after birth.

    RESULTS: Anxiety symptoms were more often reported than depressive symptoms, significantly decreasing over time in both conditions. Anxiety symptoms were associated with low education level, negative feelings towards the upcoming birth, and levels of fear of birth. Depressive symptoms were associated with levels of fear of birth. One in five women presented with fear of birth, anxiety, and depressive symptoms, suggesting that co-morbidity was quite common in this sample. Depressive symptoms and co-morbidity were negatively associated with prenatal attachment.

    CONCLUSIONS: This study shows that symptoms of anxiety and depression in women with fear of birth vary over time and that co-morbidity is quite common. Lack of emotional well-being was related to prenatal attachment. Healthcare professionals must identify and support women with anxiety and depressive symptoms and fear of birth so that difficulties in the relationship between the mother and the newborn baby might be reduced.

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  • 5.
    Larsson, Birgitta
    et al.
    Sophiahemmet University.
    Thies-Lagergren, Li
    Partners' expectations and experiences of the project 'Midwife all the way': A qualitative study2021In: European Journal of Midwifery, E-ISSN 2585-2906, Vol. 5, article id 17Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Continuity models of midwifery care are significant factors in facilitating a positive childbirth experience for birthing women. A knowledge gap exists regarding partners' experiences of continuity of midwifery care during pregnancy, birth, and after birth, although it is essential to understand the experiences of both parents in relation to continuity of care. Thus, the aim of this study was to highlight partners' expectations and experiences of having participated in a continuity of midwifery care project.

    METHODS: A qualitative interview study using thematic analysis was carried out. Thirty-six partners in a rural area in northern Sweden were recruited after the closure of the local labor ward. Interviews were conducted in October 2019 and in May 2020.

    RESULTS: An overarching theme: 'A partner-midwife relationship facilitated a sense of security'; and two themes 'The concept of availability' and 'The midwife's competence and professionalism' reflect partners' expectations and experiences after participating in a continuity of midwifery care project.

    CONCLUSIONS: Professionalism was most highly valued, but establishing a relationship with a known midwife facilitated a sense of security. When birthing women feel safe with the known midwife, the partners also feel safe. Having to travel a long-distance to a labor ward caused concern for the partners. This highlights the importance of an organization that supports families to gain access to continuity models of midwifery care and to have a possibility to give birth closer to their residence. The results of this qualitative study further strengthen the growing evidence of the positive effects of continuity models of midwifery care.

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  • 6.
    Larsson, Birgitta
    et al.
    Sophiahemmet University.
    Thies-Lagergren, Li
    Karlström, Annika
    Hildingsson, Ingegerd
    Demanding and rewarding: Midwives experiences of starting a continuity of care project in rural Sweden2021In: European Journal of Midwifery, E-ISSN 2585-2906, Vol. 5, article id 8Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The closure of a local labor ward enhanced the possibility to initiate a continuity of midwifery care model project. Continuity models of midwifery care are a cornerstone in midwifery and women-centered care, mainly accessible in metropolitan areas. Australian studies have found continuity of midwifery care to work well in rural areas. The aim of this study is to describe midwives' experiences of developing and working in a continuity of midwifery model of care in a rural setting in Sweden.

    METHODS: We used a qualitative longitudinal interview with a participatory action research approach. The project was subjected to changes over time to allow the midwives to provide the best care options and to develop a model suitable for a rural area in northern Sweden.

    RESULTS: The overarching theme, 'Developing a continuity model of midwifery care - demanding and rewarding with new insights', was based on three themes: 1) A challenging but evolving start, 2) Varying views within the midwifery group, and 3) Visions for the future. It was revealed that the midwives had to handle the grief process of the closure of the labor ward alongside their enthusiasm of being part of a continuity of midwifery care model project.

    CONCLUSIONS: The establishment of the model in light of the labor ward closure was associated with conflict within the community and this had implications for the midwives. Midwives who are attracted to work in continuity models need to understand and incorporate the prerequisites of such models. In addition, long commuting to a labor ward requires enough midwives to maintain safety and security for the women at all times.

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