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  • 1.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Lindgren, H
    Pettersson, K
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women's attitudes, experiences and compliance concerning the use of Mindfetalness: A method for systematic observation of fetal movements in late pregnancy2017Konferensbidrag (Övrigt vetenskapligt)
  • 2.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Lindgren, Helena
    Pettersson, Karin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women's attitudes, experiences and compliance concerning the use of Mindfetalness- a method for systematic observation of fetal movements in late pregnancy2017Ingår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 17, nr 1, 359Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Maternal perception of decreased fetal movements and low awareness of fetal movements are associated with a negative birth outcome. Mindfetalness is a method developed for women to facilitate systematic observations of the intensity, character and frequency of fetal movements in late pregnancy. We sought to explore women's attitudes, experiences and compliance in using Mindfetalness.

    METHODS: We enrolled 104 pregnant women treated at three maternity clinics in Stockholm, Sweden, from February to July of 2016. We educated 104 women in gestational week 28-32 by providing information about fetal movements and how to practice Mindfetalness. Each was instructed to perform the assessment daily for 15 min. At each subsequent follow-up, the midwife collected information regarding their perceptions of Mindfetalness, and their compliance. Content analyses, descriptive and analytic statistics were used in the analysis of data.

    RESULTS: Of the women, 93 (89%) were positive towards Mindfetalness and compliance was high 78 (75%). Subjective responses could be binned into one of five categories: Decreased worry, relaxing, creating a relationship, more knowledge about the unborn baby and awareness of the unborn baby. Eleven (11%) women had negative perceptions of Mindfetalness, citing time, and the lack of need for a method to observe fetal movements as the most common reasons.

    CONCLUSION: Women in late pregnancy are generally positive about Mindfetalness and their compliance with daily use is high. The technique helped them to be more aware of, and create a relationship with, their unborn baby. Mindfetalness can be a useful tool in antenatal care. However, further study is necessary in order to determine whether the technique is able to reduce the incidence of negative birth outcome.

  • 3.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Linde, Anders
    Sophiahemmet Högskola.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Lindgren, H
    Pettersson, K
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Structured daily observation of fetal movements and transfer to neonatal clinic2017Konferensbidrag (Övrigt vetenskapligt)
  • 4. Avelin, Pernilla
    et al.
    Erlandsson, Kerstin
    Hildingsson, Ingegerd
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Swedish parents' experiences of parenthood and the need for support to siblings when a baby is stillborn2011Ingår i: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 38, nr 2, 150-8 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: It has been argued that having a stillborn baby in the family affects older siblings more than parents realize. The aim of this study was to describe parenthood and the needs of siblings after stillbirth from the parents' perspective.

    METHODS: Six focus groups were held with 27 parents who had experienced a stillbirth and who had had children before the loss. The discussion concerned parents' support to the siblings, and the sibling's meeting, farewell, and memories of their little sister or brother. Data were analyzed using qualitative content analysis.

    RESULTS: The overall theme of the findings was parenthood in a balance between grief and everyday life. In the analysis, three categories emerged that described the construction of the theme: support in an acute situation, sharing the experiences within the family, and adjusting to the situation.

    CONCLUSIONS: The siblings' situation is characterized by having a parent who tries to maintain a balance between grief and everyday life. Parents are present and engaged in joint activities around the stillbirth together with the siblings of the stillborn baby. Although parents are aware of the sibling's situation, they feel that they are left somewhat alone in their parenthood after stillbirth and therefore need support and guidance from others.

  • 5. Avelin, Pernilla
    et al.
    Gyllenswärd, Göran
    Erlandsson, Kerstin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Adolescents' experiences of having a stillborn half-sibling2014Ingår i: Death Studies, ISSN 0748-1187, E-ISSN 1091-7683, Vol. 38, nr 9, 557-562 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Although there is an increasing interest in siblings' experiences of loss and grief there is limited knowledge of adolescent's own perspectives, especially in a unique situation as after stillbirth in a reconstituted family. The authors interviewed 13 bereaved adolescents. They were sad that their family was not the same and expressed feelings of being inside family grief, yet outside, because they did not have full access in their reconstituted family. An implication of present findings is that it is important to include all the members of the family in the grieving process, even half-siblings of the deceased child.

  • 6. Avelin, Pernilla
    et al.
    Hildingsson, Ingegerd
    Davidsson-Bremborg, Anna
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Make the stillborn baby and the loss real for the siblings: parents' advice on how the siblings of a stillborn baby can be supported2012Ingår i: Journal of Perinatal Education, ISSN 1058-1243, EISSN 1548-8519, Vol. 21, nr 2, 90-98 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to investigate parents' advice to other parents on the basis of their own experiences of siblings' taking leave of a stillborn sister or brother. The study was a Web questionnaire study of 411 parents. The thematic content analysis resulted in two categories: "Make the stillborn baby and the loss real for the siblings" and "Take the siblings' resources and prerequisites into account." Parents' advised that siblings should see and hold the stillborn baby and, thus, be invited and included into the leave-taking process with respect to the siblings' feelings, resources, and prerequisites. Based on these findings, professional caregivers can usefully be proactive in their approach to facilitate and encourage the involvement of siblings.

  • 7. Avelin, Pernilla
    et al.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Säflund, Karin
    Wredling, Regina
    Erlandsson, Kerstin
    Parental grief and relationships after the loss of a stillborn baby2013Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 29, nr 6, 668-673 s.Artikel i tidskrift (Refereegranskat)
    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.

  • 8. Cacciatore, Joanne
    et al.
    Erlandsson, Kerstin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Fatherhood and suffering: A qualitative exploration of Swedish men's experiences of care after the death of a baby2013Ingår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, nr 5, 664-670 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: This study was designed to evaluate fathers' experiences of stillbirth and psychosocial care. METHODS: Data were collected between 27 March 2008 and 1 April 2010 via a questionnaire posted on the homepage of the Swedish National Infant Foundation. The responses to the following open-ended questions were analyzed using content analysis: "Are you grateful today for anything that health care professionals did in connection with the birth of your child?" and "Are you sad, hurt or angry today about something personnel did in connection with the birth of your baby?". RESULTS: 113/131 (86%) fathers reported feelings of being grateful. Only 22/131 (16%) fathers reported feeling sad, hurt, or angry. Fathers expressed gratitude when health care professionals treated their newborn "with respect and without fear", "with extraordinary reverence", and when their fatherhood was validated by providers. They were also grateful when providers helped them to create memories of their baby. Fathers also reported feeling sad, hurt, or angry when providers were nonchalant and indifferent and when they perceived providers to be uncaring and disrespectful toward their baby. CONCLUSION: Bereaved fathers experience overall gratitude for person-centered psychosocial care in the aftermath of stillbirth, particularly when they feel validated as a grieving father and their child is acknowledged with reverence. CLINICAL IMPLICATIONS: Health care professionals should support fathers by treating the baby who died with respect and dignity and by validating and acknowledging both his grief experiences and his fatherhood just as they would for a grieving mother.

  • 9. Davidsson-Bremborg, Anna
    et al.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Memory triggers and anniversaries of stillborn children2013Ingår i: Nordic Journal of Religion and Society, ISSN 0809-7291, E-ISSN 1890-7008, Vol. 26, nr 2, 157-174 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Care after stillbirths has changed radically within the last twenty years, not least because of research. However, less attention has been given to memorialization in the longer perspective. This is a qualitative study based on a web questionnaire with the aim to uncover memorialization practices on anniversary days. 596 bereaved mothers of stillborn children provided an answer to an open question on how they observed the anniversary. The inductive analysis resulted in six categories of memorialization: (1) internal memorialization; (2) home-based memorialization; (3) traditional grave visits; (4) extended memorialization rituals; (5) alternative activities; and (6) coincidental activities. Different memory triggers – gifts, objects, food, and places – were used to evoke memories, honour the child, and strengthen the bonds with the child and within the family.

  • 10. Erlandsson, Kerstin
    et al.
    Lindgren, Helena
    Davidsson-Bremborg, Anna
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women's premonitions prior to the death of their baby in utero and how they deal with the feeling that their baby may be unwell2012Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 91, nr 1, 28-33 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. To identify whether mothers of stillborn babies had had a premonition that their unborn child might not be well and how they dealt with that premonition. Design. A mixed method approach. Setting. One thousand and thirty-four women answered a web questionnaire. Sample. Six hundred and fourteen women fulfilled the inclusion criteria of having a stillbirth after the 22nd gestational week and answered questions about premonition. Methods. Qualitative content analysis was used for the open questions and descriptive statistics for questions with fixed alternatives. Main Outcome Measure. The premonition of an unwell unborn baby. Results. In all, 392 of 614 (64%) of the women had had a premonition that their unborn baby might be unwell; 274 of 614 (70%) contacted their clinic and were invited to come in for a check-up, but by then it was too late because the baby was already dead. A further 88 of 614 (22%) decided to wait until their next routine check-up, believing that the symptoms were part of the normal cycle of pregnancy, and that the fetus would move less towards the end of pregnancy. Thirty women (8%) contacted their clinic, but were told that everything appeared normal without an examination of the baby. Conclusions. Women need to know that a decrease in fetal movements is an important indicator of their unborn baby's health. Healthcare professionals should not delay an examination if a mother-to-be is worried about her unborn baby's wellbeing.

  • 11. Erlandsson, Kerstin
    et al.
    Lindgren, Helena
    Malm, Mari-Cristine
    Davidsson-Bremborg, Anna
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Mothers' experiences of the time after the diagnosis of an intrauterine death until the induction of the delivery: a qualitative Internet-based study2011Ingår i: Journal of obstetrics and gynaecology research, ISSN 1341-8076, E-ISSN 1447-0756, Vol. 37, nr 11, 1677-84 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: This study aims to describe how mothers spend the period of time between being diagnosed with a dead baby in utero and the induction of the delivery.

    MATERIAL AND METHODS: Data were collected using a web questionnaire. Five hundred and fifteen women who had experienced a stillbirth after the 22nd week of gestation answered the open question: 'What did you do between the diagnosis of the child's death and the beginning of the delivery?' A qualitative content analysis method was used.

    RESULTS: The results show that some mothers received help to adapt to the situation, while for others, waiting for the induction meant further stress and additional psychological trauma in an already strained situation.

    CONCLUSION: There is no reason to wait with the induction unless the parents themselves express a wish to the contrary. Health care professionals, together with the parents, should try to determine the best time for the induction of the birth after the baby's death in utero. That time may vary, depending on the parents' preferences.

  • 12. Erlandsson, Kerstin
    et al.
    Säflund, Karin
    Wredling, Regina
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Support after stillbirth and its effect on parental grief over time2011Ingår i: Journal of social work in end-of-life & palliative care, ISSN 1552-4264, Vol. 7, nr 2-3, 139-52 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this study the authors describe parents' experiences of support over a 2-year period after a stillbirth and its effect on parental grief. Data was collected by questionnaire from 33 mothers and 22 fathers at 3 months, 1 year, and 2 years after a stillbirth. Midwives, physicians, counselors, and priests--at the hospital where the stillbirth occurred--are those on the front line providing professional support. The support from family and friends was seen to be important 2 years after the stillbirth. The need for professional support after stillbirth can differ, depending on the support provided by family, friends, and social networks. They may not fully realize the value of their support and how to be supportive. Printed educational materials given to individuals in the social network or family might therefore be helpful.

  • 13. Erlandsson, Kerstin
    et al.
    Warland, Jane
    Cacciatore, Joanne
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Seeing and holding a stillborn baby: mothers' feelings in relation to how their babies were presented to them after birth-findings from an online questionnaire2013Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 29, nr 3, 246-250 s.Artikel i tidskrift (Refereegranskat)
    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.

  • 14.
    Georgsson, Susanne
    et al.
    Sophiahemmet Högskola.
    Linde, Anders
    Sophiahemmet Högskola.
    Pettersson, Karin
    Nilsson, Rebecca
    Sophiahemmet Högskola.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    To be taken seriously and receive rapid and adequate care: womens' requests when they consult health care for reduced fetal movements.2016Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 40, 102-108 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: decreased fetal movement is a reason for women to seek health care in late pregnancy.

    OBJECTIVE: to examine what pregnant women who present with decreased fetal movements want to communicate to health care professionals and to other women in the same situation.

    DESIGN: a qualitative descriptive study.

    SETTING AND PARTICIPANTS: questionnaires were distributed in all seven labour wards in Stockholm from 1 January to 31 December 2014 to women who consulted care due to decreased fetal movements. In total, 3555 questionnaires were completed of which 1 000 were included in this study. The women's responses to the open ended question: "Is there something you want to communicate to health care professionals who take care of women with decreased fetal movement or to women who experience decreased fetal movements?", were analysed with manifest content analysis.

    FINDING: three categories were revealed about requests to health care professionals: Pay attention to the woman and take her seriously, Rapid and adequate care and Improved information on fetal movements. Regarding what the women want to communicate to other pregnant women, four categories were revealed: Contact health care for check-up, Pay attention to fetal movement, Recommended source of information and Practical advice.

    CONCLUSION: pregnant women who consult health care due to decreased fetal movements want to be taken seriously and receive rapid and adequate care with the health of the infant as the primary priority. The women requested uniform information about decreased fetal movements. They wished to convey to others in the same situation the importance of consulting care once too often rather than one time too few.

  • 15. Gravensteen, Ida Kathrine
    et al.
    Helgadóttir, Linda Björk
    Jacobsen, Eva-Marie
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Sandset, Per Morten
    Ekeberg, Oivind
    Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study2013Ingår i: BMJ open, ISSN 2044-6055, Vol. 3, nr 10, e003323- s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: (1) To investigate the experiences of women with a previous stillbirth and their appraisal of the care they received at the hospital. (2) To assess the long-term level of post-traumatic stress symptoms (PTSS) in this group and identify risk factors for this outcome.

    DESIGN: A retrospective study.

    SETTING: Two university hospitals.

    PARTICIPANTS: The study population comprised 379 women with a verified diagnosis of stillbirth (≥23 gestational weeks or birth weight ≥500 g) in a singleton or twin pregnancy 5-18 years previously. 101 women completed a comprehensive questionnaire in two parts.

    PRIMARY AND SECONDARY OUTCOME MEASURES: The women's experiences and appraisal of the care provided by healthcare professionals before, during and after stillbirth. PTSS at follow-up was assessed using the Impact of Event Scale (IES).

    RESULTS: The great majority saw (98%) and held (82%) their baby. Most women felt that healthcare professionals were supportive during the delivery (85.6%) and showed respect towards their baby (94.9%). The majority (91.1%) had received some form of short-term follow-up. One-third showed clinically significant long-term PTSS (IES ≥ 20). Independent risk factors were younger age (OR 6.60, 95% CI 1.99 to 21.83), induced abortion prior to stillbirth (OR 5.78, 95% CI 1.56 to 21.38) and higher parity (OR 3.46, 95% CI 1.19 to 10.07) at the time of stillbirth. Having held the baby (OR 0.17, 95% CI 0.05 to 0.56) was associated with less PTSS.

    CONCLUSIONS: The great majority saw and held their baby and were satisfied with the support from healthcare professionals. One in three women presented with a clinically significant level of PTSS 5-18 years after stillbirth. Having held the baby was protective, whereas prior induced abortion was a risk factor for a high level of PTSS.

    TRIAL REGISTRATION: The study was registered at http://www.clinicaltrials.gov, with registration number NCT 00856076.

  • 16. Gravensteen, Ida Kathrine
    et al.
    Jacobsen, Eva-Marie
    Sandset, Per Morten
    Helgadottir, Linda Björk
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Sandvik, Leiv
    Ekeberg, Øivind
    Healthcare utilisation, induced labour and caesarean section in the pregnancy after stillbirth: a prospective study2017Ingår i: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate healthcare utilisation, induced labour and caesarean section (CS) in the pregnancy after stillbirth and assess anxiety and dread of childbirth as mediators for these outcomes.

    DESIGN: Population-based pregnancy cohort study.

    SETTING: The Norwegian Mother and Child Cohort Study.

    SAMPLE: 901 pregnant women; 174 pregnant after stillbirth, 362 pregnant after live birth and 365 previously nulliparous.

    METHODS: Data from questionnaires answered in the second and third trimesters of pregnancy and information from the Medical Birth Registry of Norway.

    MAIN OUTCOME MEASURES: Self-reported assessment of antenatal care, register-based assessment of onset and mode of delivery.

    RESULTS: Women with a previous stillbirth had more frequent antenatal visits (mean 10.0; 95% confidence interval [CI] 9.4 - 10.7) compared with women with a previous live birth (6.0; 5.8 - 6.2) and previously nulliparous women (6.3; 6.1 - 6.6). Induced labour and CS, elective and emergency, were also more prevalent in the stillbirth group. The adjusted odds ratio for elective CS was 2.5 (95% CI 1.3 - 5.0) compared with women with previous live birth and 3.7 (1.8 - 7.6) compared with previously nulliparous women. Anxiety was a minor mediator for the association between stillbirth and frequency of antenatal visits, while dread of childbirth was not a significant mediator for elective CS.

    CONCLUSIONS: Women pregnant after stillbirth were more ample users of healthcare services and had more often induced labour and CS. The higher frequency of antenatal visits and elective CS could not be accounted for by anxiety or dread of childbirth. This article is protected by copyright. All rights reserved.

  • 17. Holste, Carola
    et al.
    Pilo, Christina
    Pettersson, Karin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Papadogiannakis, Nikos
    Mothers' attitudes towards perinatal autopsy after stillbirth2011Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 90, nr 11, 1287-90 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We investigated mothers' attitudes to autopsy of their stillborn baby and their experiences concerning information and treatment in relation to their loss in an observational study. Data were collected by postal questionnaires and telephone calls. Fifty-four of 72 mothers (76%) replied. Fifty-one (94%) received information from a physician about the possibility of having an autopsy; three (6%) did not get any information. The autopsy rate was 83% (n= 45). Thirty-six of 45 (80%) received adequate information about results. Twenty-five (56%) were pleased with how results were presented. Eleven (24%) were positive about individual contact with the pathologist who performed the autopsy. Fifty-one (94%) stated that their decision concerning autopsy was right. Mothers do not regret their decision concerning perinatal autopsy but they do not always receive thorough and timely information concerning autopsy and its results. Personal contact with the perinatal pathologist might help with specific questions both before and after autopsy.

  • 18. Johansson, Margareta
    et al.
    Rubertsson, Christine
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Hildingsson, Ingegerd
    Childbirth: an emotionally demanding experience for fathers2012Ingår i: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives, ISSN 1877-5764, Vol. 3, nr 1, 11-20 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: While attending birth mostly has a positive impact on becoming a father, it has also been described as including feelings of discomfort and is more demanding than expected.

    OBJECTIVE: The objective was to explore Swedish fathers' birth experiences, and factors associated with a less-positive birth experience.

    METHODS: Mixed methods including quantitative and qualitative data were used. Two months after birth 827 fathers answered a questionnaire and 111 (13%) of these commented on the birth experience. Data were analysed with descriptive statistics, chi-square test for independence, risk ratios with a 95% confidence interval, logistic regression and content analysis.

    RESULTS: In total, 604 (74%) of the fathers had a positive or very positive birth experience. Used method identified a less-positive birth experience associated with emergency caesarean section (RR 7.5; 4.1-13.6), instrumental vaginal birth (RR 4.2; 2.3-8.0), and dissatisfaction with the partner's medical care (RR 4.6; 2.7-7.8). Healthcare professionals' competence and approach to the fathers were also related to the birth experience.

    CONCLUSIONS: As the fathers' birth experiences were associated with mode of birth and experiences of the intrapartum medical care fathers should be respectfully and empathically treated during labour and birth. It is essential to better engage fathers during the intrapartum period through involvement and support to improve the likelihood of a positive birth experience.

  • 19. Johansson, Margareta
    et al.
    Rubertsson, Christine
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Hildingsson, Ingegerd
    Improvements of postnatal care are required by Swedish fathers2013Ingår i: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 26, nr 5, 465-480 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose – This paper has two main aims: to explore fathers' postnatal care experiences with a specific focus on deficiencies and to investigate which service deficiencies remained important for fathers one year after childbirth.

    Design/methodology/approach – This is a prospective longitudinal study. Two months and one year after birth, the overall satisfaction with care were sought. A care quality index was created, based on perceived reality and subjective importance of the care given. The study excluded fathers not mastering Swedish. Total eligible fathers was consequently not known therefore pregnancies served as an estimate.

    Findings – In total, 827 fathers answered the questionnaire two months after birth and 655 returned the follow-up questionnaire after one year; 21 per cent were dissatisfied with overall postnatal-care. The most important dissatisfying factors were the way fathers were treated by staff and the women's check-up/medical care. Two months after the birth, information given about the baby's care and needs were most deficient when parents had been cared for in a hotel ward. Furthermore, information about the baby's needs and woman's check-up/medical care was most deficient when fathers had participated in emergency Caesarean section.

    Practical implications – Most fathers were satisfied with the overall postnatal care, but how fathers are treated by caregivers; the woman's check-up/medical care and information given about the baby's care and needs can be improved. Professionals should view early parenthood as a joint project and support both parents' needs.

    Originality/value – The paper provides knowledge about postnatal service quality including fathers' needs.

  • 20. Johansson, Margareta
    et al.
    Rubertsson, Christine
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Hildingsson, Ingegerd
    The Internet: one important source for pregnancy and child information among prospective fathers2010Ingår i: Journal of Men's Health, ISSN 1875-6867, E-ISSN 1875-6859, Vol. 7, nr 3, 249-258 s.Artikel i tidskrift (Refereegranskat)
  • 21.
    Linde, Anders
    et al.
    Sophiahemmet Högskola.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Pettersson, K
    Holmström, S
    Norberg, E
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Fetal movement in late pregnancy: a content analysis of women´s experiences of how their unborn baby moved less or differently2016Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Background: Pregnant women sometimes worry about their unborn baby’s health, often due to decreased fetal movements. Objectives: To examine how women, who consulted health care due to decreased fetal movements, describe how the baby had moved less or differently. Methods: Women were recruited from all seven delivery wards in Stockholm, Sweden, during 1/1 – 31/12 2014.The women completed a questionnaire after it was verified that the pregnancy was viable. A modified content analysis was used to analyse 876 questionnaires with the women’s responses to, “Try to describe how your baby has moved less or had changes in movement”. Results: Four categories and six subcategories were identified: “Frequency” (decreased frequency, absence of kicks and movement), “Intensity” (weaker fetal movements, indistinct fetal movements), “Character” (changed pattern of movements, slower movements) and “Duration”. In addition to the responses categorised in accordance with the question, the women also mentioned how they had tried to stimulate the fetus to move and that they had difficulty in distinguishing fetal movements from contractions. Further, they described worry due to incidents related to changed pattern of fetal movements. Conclusion: Women reported changes in fetal movement concerning frequency, intensity, character and duration. The challenge from a clinical perspective is to inform pregnant women about fetal movements with the goal of minimizing unnecessary consultations whilst at the same time diminishing the length of pre-hospital delay if the fetus is at risk of fetal compromise.

    Funding: The Little Child´s Foundation, Sophiahemmet Foundation, The Swedish National Infant Foundation and Capo’s Research Foundation funded this study.

     

  • 22.
    Linde, Anders
    et al.
    Sophiahemmet Högskola.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Pettersson, Karin
    Holmström, Sofia
    Norberg, Emma
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Fetal movement in late pregnancy - a content analysis of women's experiences of how their unborn baby moved less or differently2016Ingår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 16, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Pregnant women sometimes worry about their unborn baby's health, often due to decreased fetal movements. The aim of this study was to examine how women, who consulted health care due to decreased fetal movements, describe how the baby had moved less or differently.

    METHODS: Women were recruited from all seven delivery wards in Stockholm, Sweden, during 1/1 - 31/12 2014. The women completed a questionnaire after it was verified that the pregnancy was viable. A modified content analysis was used to analyse 876 questionnaires with the women's responses to, "Try to describe how your baby has moved less or had changes in movement".

    RESULTS: Four categories and six subcategories were identified: "Frequency" (decreased frequency, absence of kicks and movement), "Intensity" (weaker fetal movements, indistinct fetal movements), "Character" (changed pattern of movements, slower movements) and "Duration". In addition to the responses categorised in accordance with the question, the women also mentioned how they had tried to stimulate the fetus to move and that they had difficulty in distinguishing fetal movements from contractions. Further, they described worry due to incidents related to changed pattern of fetal movements.

    CONCLUSION: Women reported changes in fetal movement concerning frequency, intensity, character and duration. The challenge from a clinical perspective is to inform pregnant women about fetal movements with the goal of minimizing unnecessary consultations whilst at the same time diminishing the length of pre-hospital delay if the fetus is at risk of fetal compromise.

    TRIAL REGISTRATION: Not applicable.

  • 23.
    Linde, Anders
    et al.
    Sophiahemmet Högskola.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Pettersson, Karin
    Holmström, Sofia
    Norberg, Emma
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Fetal movement in late pregnancy: A content analysis of women's experiences of how their unborn baby moved less or differently2016Konferensbidrag (Övrigt vetenskapligt)
  • 24.
    Linde, Anders
    et al.
    Sophiahemmet Högskola.
    Pettersson, K
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Decreased fetal movements and perinatal outcome2016Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Background: Decreased fetal movement is associated with adverse perinatal outcome, including stillbirth. Objectives: To investigate perinatal outcome for women who seek consultation due to reduced fetal movements in late pregnancy. Methods: All women (gestational week 28+), who came to one of the seven obstetric clinics in the Stockholm region, Sweden, in 2014 due to concerns for decreased fetal movements, were asked to fill in a questionnaire and to give informed consent to follow-up of their child in the medical birth register. Preliminary results: In total 2584 women completed the questionnaire, 75 % of the women were born in Sweden and 72% were primiparas. The women were aged <19-24 (10%), 25-34 (66%) 35->40 (24%) and two-thirds had a university education. Almost one third (28%) of the women sought health care more than once due to decreased fetal movement during their pregnancy. Sixty eight percent of the women experienced decreased fetal movement for 24 hours or more before the came to the hospital for an examination of the fetus.  Data from the medical birth registry says that 90% of the women gave birth to a child after a full-term pregnancy and 72 per cent had a vaginal birth. Conclusion: The analysis is in progress, we will have more data to present in September. Funding: The Little Child´s Foundation, Sophiahemmet Foundation, The Swedish National Infant Foundation and Capo’s Research Foundation funded this study.

  • 25.
    Linde, Anders
    et al.
    Sophiahemmet Högskola.
    Pettersson, K
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women´s experiences of fetal movements before the confirmation of fetal death: contractions misinterpreted as fetal movement2016Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Background: Decreased fetal movement often precedes a stillbirth. Objectives: The objective of this study was to describe women´s experiences of fetal movement before the confirmation of fetal death. Methods: Data were collected through a Web-based questionnaire in 2009 to 2013 and women who had answered the questionnaire before September 1, 2013. Women with stillbirths after 28 gestational weeks were self-recruited. Content analysis was used to analyze the answers to one open question: “How do you remember the fetal movement during the 48 hours that preceded the diagnosis of intrauterine death?” The statements from mothers of a stillborn, born during gestational weeks 28 to 36 were compared with those of a stillborn at term. Results: The women’s 215 answers were divided into three categories: Decreased, weak, and no fetal movement at all 154 (72%); Fetal movement as normal 39 (18%) and Extremely vigorous fetal activity followed by no movement at all 22 (10%). Eight (15%) of the women with stillbirths in gestational weeks 28 to 36 interpreted contractions as fetal movement as compared to five (5%) of the women with stillbirths at term. Conclusion: Uterine contractions can be interpreted as fetal movement. A single episode of extremely vigorous fetal activity can precede fetal death. The majority of the women experienced decreased, weaker, or no fetal movement at all two days before fetal death was diagnosed. Mothers should be educated to promptly report changes in fetal movement to their health care providers. Using fetal movement information to evaluate possible fetal distress may lead to reductions in stillbirths. Funding:The Little Child´s Foundation, Sophiahemmet Foundation, The Swedish National Infant Foundation and Capo’s Research Foundation.

  • 26.
    Linde, Anders
    et al.
    Sophiahemmet Högskola.
    Pettersson, Karin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women's experiences of fetal movements before the confirmation of fetal death: Contractions misinterpreted as fetal movement2016Konferensbidrag (Övrigt vetenskapligt)
  • 27.
    Linde, Anders
    et al.
    Sophiahemmet Högskola.
    Pettersson, Karin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women's Experiences of Fetal Movements before the Confirmation of Fetal Death-Contractions Misinterpreted as Fetal Movement2015Ingår i: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 42, nr 2, 189-194 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Decreased fetal movement often precedes a stillbirth. The objective of this study was to describe women's experiences of fetal movement before the confirmation of fetal death.

    METHODS: Data were collected through a Web-based questionnaire. Women with stillbirths after 28 gestational weeks were self-recruited. Content analysis was used to analyze the answers to one open question. The statements from mothers of a stillborn, born during gestational weeks 28 to 36 were compared with those of a stillborn at term.

    RESULTS: The women's 215 answers were divided into three categories: decreased, weak, and no fetal movement at all; 154 (72%) of the descriptions were divided into three subcategories: decreased and weak movement (106; 49%), no movement at all (35; 16%), and contraction interpreted as movement (13; 6%). The category fetal movement as normal includes 39 (18%) of the descriptions. The third category, extremely vigorous fetal activity followed by no movement at all, includes 22 (10%) of the descriptions. Eight (15%) of the women with stillbirths in gestational weeks 28 to 36 interpreted contractions as fetal movement as compared to 5 (5%) of the women with stillbirths at term.

    DISCUSSION: Uterine contractions can be interpreted as fetal movement. A single episode of extremely vigorous fetal activity can precede fetal death. The majority of the women experienced decreased, weaker, or no fetal movement at all 2 days before fetal death was diagnosed. Mothers should be educated to promptly report changes in fetal movement to their health care providers. Using fetal movement information to evaluate possible fetal distress may lead to reductions in stillbirths.

  • 28.
    Linde, Anders
    et al.
    Sophiahemmet Högskola.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Pettersson, K
    Hagelberg, L
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Better safe than sorry: Reasons for consulting care due to decreased fetal movements2017Konferensbidrag (Övrigt vetenskapligt)
  • 29.
    Linde, Anders
    et al.
    Sophiahemmet Högskola.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Pettersson, Karin
    Hagelberg, Linn
    Georgsson, Susanne
    Sophiahemmet Högskola.
    "Better safe than sorry"-Reasons for consulting care due to decreased fetal movements2017Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, nr 5, 376-381 s., S1871-5192(17)30074-4Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Experience of reduced fetal movements is a common reason for consulting health care in late pregnancy. There is an association between reduced fetal movements and stillbirth.

    AIM: To explore why women decide to consult health care due to reduced fetal movements at a specific point in time and investigate reasons for delaying a consultation.

    METHODS: A questionnaire was distributed at all birth clinics in Stockholm during 2014, to women seeking care due to reduced fetal movements. In total, 3555 questionnaires were collected, 960 were included in this study. The open-ended question; "Why, specifically, do you come to the clinic today?" was analyzed using content analysis as well as the complementary question "Are there any reasons why you did not come to the clinic earlier?"

    RESULTS: Five categories were revealed: Reaching dead line, Receiving advice from health care professionals, Undergoing unmanageable worry, Contributing external factors and Not wanting to jeopardize the health of the baby. Many women stated that they decided to consult care when some time with reduced fetal movements had passed. The most common reason for not consulting care earlier was that it was a new experience. Some women stated that they did not want to feel that they were annoying, or be perceived as excessively worried. Not wanting to burden health care unnecessarily was a reason for prehospital delay.

    CONCLUSION: Worry about the baby is the crucial reason for consulting care as well as the time which has passed since the women first experienced decreased fetal movements.

  • 30. Lindgren, H
    et al.
    Malm, M.-C.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    You don't leave your baby - mother's experiences after a stillbirth2013Ingår i: Omega, ISSN 0030-2228, E-ISSN 1541-3764, Vol. 68, nr 4, 337-346 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    When a baby has died during pregnancy, the first encounter between mother and child occurs when the baby is already dead. Despair, emptiness, and grief characterize the encounter, which is also a gradual farewell to the child and the planned future for the family. This study describes mothers' experiences of the farewell of their stillborn baby at discharge from hospital. Twenty-three mothers from different parts of Sweden, who suffered stillbirth, were interviewed. Semi-structured questions were used and the replies were analyzed using content analysis. The mothers describe the separation from the child when leaving hospital as unnatural and that the separation ruins the motherhood they felt during pregnancy. Five categories were identified: unnatural to leave the baby; going home empty-handed; access to the child; security and insecurity in the separation; to let go. The overarching theme that we recognized from these responses we have formulated as: You don't leave your baby. Leaving the baby at the hospital goes against the biological instinct to care for and protect the offspring. Routines for a dignified goodbye including designating a deputy guardian into whose arms the mother can place the baby can help to facilitate the separation. The possibility of leaving the baby in the arms of someone known to the parents should be an option for parents who choose to take farewell of the child at the hospital. The place and time for the farewell should be decided on by the parents, taking the baby home for a personal farewell could be an alternative.

  • 31. Malm, Mari-Cristin
    et al.
    Hildingsson, Ingegerd
    Rubertsson, Christine
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Lindgren, Helena
    Prenatal attachment and its association with foetal movement during pregnancy - A population based survey2016Ingår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 29, nr 6, 482-486 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the association between the magnitude of foetal movements and level of prenatal attachment within a 24h 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 24h 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 24h period, while almost a fifth (18%) never or only once reported frequent foetal movement in a 24h period. Just over a quarter (26%) of respondents perceived frequent movement at least three times during a 24h period. Perceiving frequent foetal movements on three or more occasions during a 24h 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 24h 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.

  • 32. Malm, Mari-Cristin
    et al.
    Lindgren, Helena
    Rubertsson, Christine
    Hildingsson, Ingegerd
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Development of a tool to evaluate fetal movements in full-term pregnancy2014Ingår i: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives, ISSN 1877-5764, Vol. 5, nr 1, 31-5 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study women's description of fetal movements in full-term pregnancy. Further to investigate if their descriptions could be sorted with regard to intensity and type of movements, using a matrix under development to be a tool for evaluating fetal movements in clinical praxis.

    METHODS: Data were collected by distributing questionnaires including an open question: "Please describe your perception of the baby's movements during this gestational week." A matrix listed seven categories of movements divided into powerful and non-powerful movements, was used for the content analysis.

    RESULTS: 393 (78%) women responded to the open question. The movements were split into two domains: Powerful movements and Non-powerful movements. Altogether, 383 (96%) women perceived fetal movements that were sorted as powerful movement: firm, slow stretching, large and side to side. Ten (4%) women described movements exclusively, i.e. movements that did not include any of the movements in the powerful domain. Most women perceived movements that corresponded to more than one type of category, and all movements described by the women could be referred to at least one of the categories in the matrix.

    CONCLUSION: The matrix was useful for identification of the women's perceptions of fetal movements in full-term pregnancy. Further studies are needed in order to develop the tool and its potential to evaluate the well-being of the fetus before it is to be used in clinical praxis.

  • 33. Malm, Mari-Cristin
    et al.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Rubertsson, Christine
    Hildingsson, Ingegerd
    Lindgren, Helena
    Women's experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy - a crossover trial2014Ingår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 14, 349- s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Low maternal awareness of fetal movements is associated with negative birth outcomes. Knowledge regarding pregnant women's compliance with programs of systematic self-assessment of fetal movements is needed. The aim of this study was to investigate women's experiences using two different self-assessment methods for monitoring fetal movements and to determine if the women had a preference for one or the other method.

    Methods

    Data were collected by a crossover trial; 40 healthy women with an uncomplicated full-term pregnancy counted the fetal movements according to a Count-to-ten method and assessed the character of the movements according to the Mindfetalness method. Each self-assessment was observed by a midwife and followed by a questionnaire. A total of 80 self-assessments was performed; 40 with each method.

    Results

    Of the 40 women, only one did not find at least one method suitable. Twenty of the total of 39 reported a preference, 15 for the Mindfetalness method and five for the Count-to-ten method. All 39 said they felt calm, relaxed, mentally present and focused during the observations. Furthermore, the women described the observation of the movements as safe and reassuring and a moment for communication with their unborn baby.

    Conclusions

    In the 80 assessments all but one of the women found one or both methods suitable for self-assessment of fetal movements and they felt comfortable during the assessments. More women preferred the Mindfetalness method compared to the count-to-ten method, than vice versa.

  • 34. Malm, M-C
    et al.
    Lindgren, H
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Losing contact with one's unborn baby: mothers' experiences prior to receiving news that their baby has died in utero2011Ingår i: Omega, ISSN 0030-2228, E-ISSN 1541-3764, Vol. 62, nr 4, 353-367 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: A change in the pattern of movement of her unborn baby could be indicative that the baby might die. Aim: To study mothers' experiences during the time prior to receiving news that their baby has died. Method: Interviews with 26 mothers. Results: Premonition that something had happened to their baby, a sense based on a lack of movements were experienced. Six categories describe the mother's insight that the baby's life was threatened: not feeling in touch with their baby; worry' feeling something is wrong; not understanding the unbelievable; wanting information; and being certain that their baby had died. The overarching theme "There is something wrong" was formulated. Conclusion: The mother could not understand the unbelievable: that the baby had died in utero. Implications: Mother's should be cautioned to trust their insights and seek medical advice if they are concerned over the lack of movement from the unborn baby

  • 35. Malm, M-C
    et al.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Erlandsson, K
    Lindgren, H
    Waiting in no-man's-land: mothers' experiences before the induction of labour after their baby has died in utero2011Ingår i: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives, ISSN 1877-5764, Vol. 2, nr 2, 51-5 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The mother's experiences during the time after the information of their baby's death in utero until the induction of labour can be understood as a sense of being in no-man's-land, waiting without knowing for what or for how long

  • 36. Nordlund, Ewa
    et al.
    Börjesson, Astrid
    Cacciatore, Joanne
    Pappas, Carissa
    Randers, Ingrid
    Sophiahemmet Högskola.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    When a baby dies: motherhood, psychosocial care and negative affect2012Ingår i: British journal of midwifery, ISSN 0969-4900, E-ISSN 2052-4307, Vol. 20, nr 11, 780-784 s.Artikel i tidskrift (Refereegranskat)
  • 37. Omerov, Pernilla
    et al.
    Steineck, Gunnar
    Runeson, Bo
    Christensson, Anna
    Kreicbergs, Ulrika
    Sophiahemmet Högskola.
    Pettersén, Rossana
    Rubenson, Birgitta
    Skoogh, Johanna
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Nyberg, Ullakarin
    Preparatory studies to a population-based survey of suicide-bereaved parents in Sweden2013Ingår i: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 34, nr 3, 200-10 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: There is a need for evidence-based guidelines on how professionals should act following a suicide. In an effort to provide empiric knowledge, we designed a nationwide population-based study including suicide-bereaved parents.

    AIM: To describe the process from creating hypotheses through interviews to the development of a population-based questionnaire.

    METHOD: We used interviews, qualitative analysis and various means of validation to create a study-specific questionnaire to be used in a nonselected nationwide population of suicide-bereaved parents and a control population of nonbereaved (N = 2:1). The Swedish Register of Causes of Death and the Multigeneration Register were used to identify eligible individuals. All presumptive participants received a letter of invitation followed by a personal contact.

    RESULTS: We developed a questionnaire covering the participants' perception of participation, their daily living, psychological morbidity, professional actions, and other experiences in immediate connection to the time before and after the suicide. Almost three out of four parents (bereaved = 666, nonbereaved = 377) responded to the questionnaire.

    CONCLUSIONS: By involving parents early in the research process we were able to create a questionnaire that generated a high participation rate in a nationwide population-based study that might help us to answer our hypotheses about bereavement after suicide.

  • 38.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Fetal movements in the third trimester: important information about wellbeing of the fetus2010Ingår i: Sexual & Reproductive HealthCare: Official Journal of the Swedish Association of Midwives, ISSN 1877-5756, EISSN 1877-5764, Vol. 1, nr 4, 119-121 s.Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    It can be quite natural for pregnant women to believe that a decrease in the frequency of fetal movements at the end of pregnancy is normal if they have been so informed. There is also probably scope for interpretation concerning what is to be regarded as a decrease in the number of movements. Non-evidence-based information that a decrease in fetal movements is normal during the third trimester poses a threat to the unborn baby's life. If the mother does not react to a decrease in frequency and if she waits too long before contacting healthcare professionals, the window of opportunity to save the baby's life may be closed.

  • 39.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Fostrets rörelser2016Ingår i: Reproduktiv hälsa: barnmorskans kompetensområde / [ed] Helena Lindgren, Kyllike Christensson & Anna-Karin Dykes, Lund: Studentlitteratur AB, 2016, 1, 284-288 s.Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 40.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Intrauterin fosterdöd2016Ingår i: Reproduktiv hälsa: barnmorskans kompetensområde / [ed] Helena Lindgren, Kyllike Christensson & Anna-Karin Dykes, Lund: Studentlitteratur AB, 2016, 1, 417-425 s.Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 41.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Mindfetalness: det bästa för ditt ofödda barn2013Bok (Övrig (populärvetenskap, debatt, mm))
  • 42.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Mindfetalness: Structured observation of fetal movements2017Konferensbidrag (Övrigt vetenskapligt)
  • 43.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    När ett nyfött barn dör2016Ingår i: Reproduktiv hälsa: barnmorskans kompetensområde / [ed] Helena Lindgren, Kyllike Christensson & Anna-Karin Dykes, Lund: Studentlitteratur AB, 2016, 1, 740-742 s.Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 44.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Rätt information om fosterrörelser räddar liv2011Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, nr 42, 2102- s.Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 45.
    Rådestad, Ingela
    et al.
    Sophiahemmet Högskola.
    Akselsson, Anna
    Sophiahemmet Högskola.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Lindgren, H
    Pettersson, K
    Steineck, G
    Rationale, study protocol and the cluster randomization process in a controlled trial including 40,000 women investigating the effects of mindfetalness.2016Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 10, 56-61 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Shortening pre-hospital delay may decrease stillbirth rates and rates of babies born with a compromised health. Stillbirth may be preceded by a decrease in fetal movements. Mindfetalness has been developed as a response to the shortcomings of kick-counting for the monitoring of fetal movements by the pregnant woman. We do not know if practicing Mindfetalness may diminish pre-hospital delay. Nor do we know if practicing Mindfetalness may increase or decrease the percentage of women seeking health care for unfounded, from a medical perspective, worry for her fetus' well-being.

    METHODS:

    This article describes the rationale, study protocol and the randomization process for a planned study randomly allocating 40,000 pregnant women to receive, or not receive, proactive information about practicing Mindfetalness. The unit of randomization is 63 antenatal clinics in the Stockholm area. Midwives in the antenatal clinics randomized to Mindfetalness will verbally inform about practicing Mindfetalness, hand out brochures (printed in seven languages) and inform about a website giving information about Mindfetalness. Routine care will continue in the control clinics. All information for the analyses, including the main endpoint of an Apgar score below 7 (e.g., 0-6 with stillbirth giving a score of 0), measured five minutes after birth, will be retrieved from population-based registers.

    RESULTS:

    We have randomized 33 antenatal clinics to Mindfetalness and 30 to routine care. In two clinics a pilot study has been performed. One of the clinics randomly allocated to inform about Mindfetalness will not do so (but will be included in the intention-to-treat analysis). In October 2016 we started to recruit women for the main study.

    CONCLUSION:

    The work up to now follows the outlined time schedule. We expect to present the first results concerning the effects of Mindfetalness during 2018.

  • 46.
    Rådestad, Ingela
    et al.
    Sophiahemmet Högskola.
    Henley, K
    Sormunen, Taina
    Sophiahemmet Högskola.
    Perinatal palliative care after a stillbirth: Midwives experiences of using Cubitus baby2017Konferensbidrag (Övrigt vetenskapligt)
  • 47.
    Rådestad, Ingela
    et al.
    Sophiahemmet Högskola.
    Lindgren, Helena
    Women's perceptions of fetal movements in full-term pregnancy2012Ingår i: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives, ISSN 1877-5764, Vol. 3, nr 3, 113-6 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Besides the frequency of the fetal movements the woman's perceptions of the movements can give additional information about the unborn baby's wellbeing.

    OBJECTIVE: To explore women's perceptions of fetal movements in full-term pregnancy.

    METHODS: Interviews with 40 women in gestational weeks 37 + 2 to 41 + 5, all with uncomplicated pregnancies. All women were recruited from one antenatal clinic in the capital of Sweden. With an inductive approach using a content analysis the answers to the question: "Can you describe how your baby has moved this week?" was analysed.

    RESULTS: Fetal movements were categorized into seven categories: strong and powerful, large, slow, stretching, from side to side, light, and startled.

    CONCLUSIONS: Almost all the women perceived the fetal movements at the end of pregnancy as strong and powerful, and internal pressure. Including women's perceptions of fetal movements in the obstetric anamneses, gives valuable information about the fetus.

  • 48.
    Rådestad, Ingela
    et al.
    Sophiahemmet Högskola.
    Malm, Mari-Cristin
    Lindgren, Helena
    Pettersson, Karin
    Franklin Larsson, Lise-Lotte
    Sophiahemmet Högskola.
    Being alone in silence - Mothers' experiences upon confirmation of their baby's death in utero2014Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 30, nr 3, e91-e95 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: to explore mothers' experiences of the confirmation of ultrasound examination results and how they were told that their baby had died in-utero.

    DESIGN: in-depth interviews.

    SETTING: Sweden.

    PARTICIPANTS: 26 mothers of stillborn babies.

    MEASUREMENT: narratives were analysed using a qualitative content analysis with an inductive approach.

    FINDINGS: the mothers experienced that silence prevailed during the entire process of confirming the ultrasound results. Typically all present in the ultrasound room were concentrating and focusing on what they observed on the screen, no one spoke to the mother. The mothers had an instinctive feeling that their baby might be dead based on what they observed on the ultrasound screen and on their interpretation of the body language of the clinicians and midwives. Some mothers reported a time delay in receiving information about their baby's death. Experiencing uncertainty about the information received was also noticed.

    CONCLUSION: mothers emphasised an awareness of silence and feelings of being completely alone while being told of the baby's death.

    IMPLICATION FOR PRACTICE: the prevalence of silence during an ultrasound examination may in certain cases cause further psychological trauma for the mother of a stillborn baby. One way to move forward given these results may be to provide obstetric personnel sufficient training on how difficult information might be more effectively and sensitively provided in the face of an adverse pregnancy outcome.

  • 49.
    Rådestad, Ingela
    et al.
    Sophiahemmet Högskola.
    Sormunen, Taina
    Sophiahemmet Högskola.
    Rudenhed, Lisa
    Sophiahemmet Högskola.
    Pettersson, Karin
    Sleeping patterns of Swedish women experiencing a stillbirth between 2000-2014: an observational study2016Ingår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 16, nr 1, 193- s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: External (to the fetus) stressors may act together with maternal factors as well as fetal and placental factors to increase the risk of stillbirth. Data published in 2011 indicate non-left side sleeping positions, particularly the supine one, is such a stressor; we do not know, however, if this new knowledge has influenced the choice of sleeping position among pregnant women.

    METHODS: Using a web-based questionnaire made available at the home page of the Swedish national infant foundation we collected information on sleeping positions among women who gave birth to a stillborn baby between 2000 and 2014.

    RESULTS: The questionnaire was completed by 583 women. About one third of the women reporting their sleeping position stated that they lay down on their the left side when going to bed, and another third reported lying down as often on the left as on the right side. Figures for typically going to bed on the left side the 4 weeks preceding the stillbirth was as follows: 72 (30 %) of 242 between 2011 and 2014 and 86 (27 %) of 313 between 2000 and 2010. Among the 240 women who remembered their position when waking up on the day the stillbirth was diagnosed, 63 (26 %) reported a supine position.

    CONCLUSION: Our data indicate that one third of the women went to bed on the left side the month before the stillbirth. The data are consistent with the notion that efforts in Sweden to advise women to lie on their left side when going to bed may decrease the rate of stillbirth.

  • 50. Rådestad, Ingela
    et al.
    Säflund, Karin
    Wredling, Regina
    Sophiahemmet Högskola.
    Onelöv, Erik
    Steineck, Gunnar
    Holding a stillborn baby: mother's feelings of tenderness and grief2009Ingår i: British Journal of Midwifery, ISSN 0969-4900, Vol. 17, nr 3, 178-80 s.Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Actions by health professionals and the atmosphere surrounding the birth of a stillborn baby may determine the nature of the mother’s contact with her baby. A questionnaire studied mothers’ feelings when holding their stillborn baby. A total of 33 mothers of stillborn babies born after 22 weeks completed the questionnaire three months after the birth. All mothers saw their baby. Before meeting the baby, 23 women had feelings of being afraid. Thirty-one mothers held their baby. When holding their baby all mothers felt tenderness and grief, 29 warmth and 25 prides. Fifteen mothers at the same time felt insecure when holding the baby, 12 had feelings of discomfort and 11 feelings of fear. A hypothesis for future investigations is that the more that a mother can be prepared for what is to come after birth, the better the chance that feelings of fear or discomfort can be diminished.

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