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  • 51.
    Ulfsdottir, Hanna
    et al.
    Sophiahemmet University.
    Saltvedt, Sissel
    Georgsson, Susanne
    Sophiahemmet University.
    Testing the waters: A cross-sectional survey of views about waterbirth among Swedish health professionals2019In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, article id S1871-5192(18)31645-7Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: For women with low risk births, waterbirth is an alternative that is requested and provided in approximately a hundred countries. However, in some countries, including Sweden, waterbirth is not generally available.

    AIM: To explore the experiences, knowledge and attitudes regarding waterbirth among midwives, obstetricians/gynaecologists and neonatologists.

    METHODS: A cross-sectional study was conducted in Sweden, using a web-based survey distributed via The Swedish Association of Midwives and the Heads of department of all Swedish maternity wards between April and June 2016. The respondents (n = 1609) answered a combination of Likert-scale and open-ended questions. The responses were analysed with descriptive statistics and quantitative content analyses.

    FINDINGS: Both midwives and physicians stated a lack of experience, knowledge and clinical guidelines related to attending and assisting waterbirths. Overall, midwives had more positive attitudes to waterbirth (38.8% vs 4.5%) as well as towards providing and implementing waterbirth, compared to physicians (71.0% vs 14.9%). Midwives stated significantly more benefits and fewer risks for women and babies, compared to physicians who requested more evidence.

    CONCLUSIONS: Opinions regarding waterbirth are to some extent based on attitudes rather than actual experience and knowledge. There are diverse interpretations of the strength of evidence and a lack of updating in the research field of waterbirth. As waterbirth is requested by women, health professionals need to update their knowledge in this topic in order to give coherent and evidence-based information and care to prospective parents.

  • 52.
    Ulfsdottir, Hanna
    et al.
    Sophiahemmet University.
    Saltvedt, Sissel
    Georgsson, Susanne
    Sophiahemmet University.
    Waterbirth in Sweden - a comparative study2018In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 97, no 3, p. 341-348Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The literature describes advantages for mothers giving birth in water, but waterbirth is controversial in Sweden and has not been offered at hospitals until recently. This study aimed to describe and compare the characteristics and outcome of waterbirths with spontaneous vaginal births at the same clinics.

    MATERIAL AND METHODS: A retrospective cohort study was conducted on all waterbirths at two maternity units in Sweden from March 2014 to November 2015 (n=306), and a consecutively selected comparison group of 306 women having conventional spontaneous vaginal births. Logistic regression was used to analyze the primary outcome; second-degree perineal tears.

    RESULTS: Women giving birth in water had a lower risk of second-degree perineal tears (adj. OR 0.6 [95% CI 0.4-0.9]). Their labor was shorter (6:03 hrs. vs 7:52 hrs.) and there were significantly less interventions than in the comparison group; amniotomy (13.7% vs. 35.3%), internal cardiotocography (11.1% vs.56.8%), and augmentation with oxytocin (5.2% vs.31.3%). There were no differences in Apgar scores or admissions to neonatal intensive care unit. The experience of childbirth, measured with a numeric rating scale, was higher in the waterbirth group indicating a more positive birth experience. Three newborns born in water had an umbilical cord avulsion.

    CONCLUSIONS: In this low-risk population, waterbirth is associated with positive effects on perineal tears, the frequency of interventions, the duration of labor and women's birth experience. Midwives handling waterbirth should be aware of the risk of umbilical cord avulsion. This article is protected by copyright. All rights reserved.

  • 53.
    Ulfsdottir, Hanna
    et al.
    Sophiahemmet University.
    Saltvedt, Sissel
    Georgsson, Susanne
    Sophiahemmet University.
    Women's experiences of waterbirth and conventional uncomplicated birthsManuscript (preprint) (Other academic)
  • 54. Wallin Lundell, Inger
    et al.
    Frans, Örjan
    Helström, Lotti
    Högberg, Ulf
    Moby, L
    Nyberg, S
    Sundström Poromaa, Inger
    Sydsjö, Gunilla
    Georgsson Öhman, Susanne
    Sophiahemmet University.
    Östlund, I
    Skoog Svanberg, Agneta
    Post-traumatic stress disorder among women requesting induced termination of pregnancy: a Swedish multi-centre study2012In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 119, no S2, p. 2-2Article in journal (Other academic)
  • 55.
    Wallin Lundell, Inger
    et al.
    Sophiahemmet University.
    Georgsson, Susanne
    Sophiahemmet University.
    Sundström Poromaa, Inger
    Högberg, Ulf
    Sydsjö, Gunilla
    Skoog Svanberg, Agneta
    How women perceive abortion care: A study focusing on healthy women and those with mental and posttraumatic stress.2016Conference paper (Other academic)
  • 56.
    Wallin Lundell, Inger
    et al.
    Sophiahemmet University.
    Georgsson, Susanne
    Sophiahemmet University.
    Sundström Poromaa, Inger
    Högberg, Ulf
    Sydsjö, Gunilla
    Skoog Svanberg, Agneta
    How women perceive abortion care: A study focusing on healthy women and those with mental and posttraumatic stress.2016Conference paper (Other academic)
  • 57.
    Wallin Lundell, Inger
    et al.
    Sophiahemmet University.
    Georgsson, Susanne
    Sophiahemmet University.
    Sundström Poromaa, Inger
    Högberg, Ulf
    Sydsjö, Gunilla
    Skoog Svanberg, Agneta
    How women perceive abortion care: A study focusing on healthy women and those with mental and posttraumatic stress2016Conference paper (Other academic)
  • 58.
    Wallin Lundell, Inger
    et al.
    Sophiahemmet University.
    Georgsson Öhman, Susanne
    Sophiahemmet University.
    Frans, Örjan
    Helström, Lotti
    Högberg, Ulf
    Nyberg, Sigrid
    Sundström Poromaa, Inger
    Sydsjö, Gunilla
    Östlund, Ingrid
    Skoog Svanberg, Agneta
    Posttraumatic stress among women after induced abortion: a Swedish multi-centre cohort study2013In: BMC women's health, ISSN 1472-6874, Vol. 13, p. 52-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Induced abortion is a common medical intervention. Whether psychological sequelae might follow induced abortion has long been a subject of concern among researchers and little is known about the relationship between posttraumatic stress disorder (PTSD) and induced abortion. Thus, the aim of the study was to assess the prevalence of PTSD and posttraumatic stress symptoms (PTSS) before and at three and six months after induced abortion, and to describe the characteristics of the women who developed PTSD or PTSS after the abortion.

    METHODS: This multi-centre cohort study included six departments of Obstetrics and Gynaecology in Sweden. The study included 1457 women who requested an induced abortion, among whom 742 women responded at the three-month follow-up and 641 women at the six-month follow-up. The Screen Questionnaire-Posttraumatic Stress Disorder (SQ-PTSD) was used for research diagnoses of PTSD and PTSS, and anxiety and depressive symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS). Measurements were made at the first visit and at three and six months after the abortion. The 95% confidence intervals for the prevalence of lifetime or ongoing PTSD and PTSS were calculated using the normal approximation. The chi-square test and the Student's t-test were used to compare data between groups.

    RESULTS: The prevalence of ongoing PTSD and PTSS before the abortion was 4.3% and 23.5%, respectively, concomitant with high levels of anxiety and depression. At three months the corresponding rates were 2.0% and 4.6%, at six months 1.9% and 6.1%, respectively. Dropouts had higher rates of PTSD and PTSS. Fifty-one women developed PTSD or PTSS during the observation period. They were young, less well educated, needed counselling, and had high levels of anxiety and depressive symptoms. During the observation period 57 women had trauma experiences, among whom 11 developed PTSD or PTSS and reported a traumatic experience in relation to the abortion.

    CONCLUSION: Few women developed PTSD or PTSS after the abortion. The majority did so because of trauma experiences unrelated to the induced abortion. Concomitant symptoms of depression and anxiety call for clinical alertness and support.

  • 59.
    Wallin Lundell, Inger
    et al.
    Sophiahemmet University.
    Georgsson Öhman, Susanne
    Sophiahemmet University.
    Sundström Poromaa, Inger
    Högberg, Ulf
    Sydsjö, Gunilla
    Skoog Svanberg, Agneta
    How women perceive abortion care: A study focusing on healthy women and those with mental and posttraumatic stress2015In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 20, no 3, p. 211-222Article in journal (Refereed)
    Abstract [en]

    Objectives To identify perceived deficiencies in the quality of abortion care among healthy women and those with mental stress. Methods This multi-centre cohort study included six obstetrics and gynaecology departments in Sweden. Posttraumatic stress (PTSD/PTSS) was assessed using the Screen Questionnaire-Posttraumatic Stress Disorder; anxiety and depressive symptoms, using the Hospital Anxiety Depression Scale; and abortion quality perceptions, using a modified version of the Quality from the Patient's Perspective questionnaire. Pain during medical abortion was assessed in a subsample using a visual analogue scale. Results Overall, 16% of the participants assessed the abortion care as being deficient, and 22% experienced intense pain during medical abortion. Women with PTSD/PTSS more often perceived the abortion care as deficient overall and differed from healthy women in reports of deficiencies in support, respectful treatment, opportunities for privacy and rest, and availability of support from a significant person during the procedure. There was a marginally significant difference between PTSD/PTSS and the comparison group for insufficient pain alleviation. Conclusions Women with PTSD/PTSS perceived abortion care to be deficient more often than did healthy women. These women do require extra support, relatively simple efforts to provide adequate pain alleviation, support and privacy during abortion may improve abortion care.

  • 60.
    Wallin Lundell, Inger
    et al.
    Sophiahemmet University.
    Sundström Poromaa, Inger
    Ekselius, Lisa
    Georgsson, Susanne
    Sophiahemmet University.
    Frans, Örjan
    Helström, Lotti
    Högberg, Ulf
    Skoog Svanberg, Agneta
    Neuroticism-related personality traits are associated with posttraumatic stress after abortion: findings from a Swedish multi-center cohort study2017In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 17, no 1, article id 96Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Most women who choose to terminate a pregnancy cope well following an abortion, although some women experience severe psychological distress. The general interpretation in the field is that the most consistent predictor of mental disorders after induced abortion is the mental health issues that women present with prior to the abortion. We have previously demonstrated that few women develop posttraumatic stress disorder (PTSD) or posttraumatic stress symptoms (PTSS) after induced abortion. Neuroticism is one predictor of importance for PTSD, and may thus be relevant as a risk factor for the development of PTSD or PTSS after abortion. We therefore compared Neuroticism-related personality trait scores of women who developed PTSD or PTSS after abortion to those of women with no evidence of PTSD or PTSS before or after the abortion.

    METHODS: A Swedish multi-center cohort study including six Obstetrics and Gynecology Departments, where 1294 abortion-seeking women were included. The Screen Questionnaire-Posttraumatic Stress Disorder (SQ-PTSD) was used to evaluate PTSD and PTSS. Measurements were made at the first visit and at three and six month after the abortion. The Swedish universities Scales of Personality (SSP) was used for assessment of Neuroticism-related personality traits. Multiple logistic regression analyses were performed to investigate the risk factors for development of PTSD or PTSS post abortion.

    RESULTS: Women who developed PTSD or PTSS after the abortion had higher scores than the comparison group on several of the personality traits associated with Neuroticism, specifically Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility and Embitterment. Women who reported high, or very high, scores on Neuroticism had adjusted odds ratios for PTSD/PTSS development of 2.6 (CI 95% 1.2-5.6) and 2.9 (CI 95% 1.3-6.6), respectively.

    CONCLUSION: High scores on Neuroticism-related personality traits influence the risk of PTSD or PTSS post abortion. This finding supports the argument that the most consistent predictor of mental disorders after abortion is pre-existing mental health status.

  • 61.
    Wallin Lundell, Inger
    et al.
    Sophiahemmet University.
    Sundström Poromaa, Inger
    Ekselius, Lisa
    Georgsson Öhman, Susanne
    Sophiahemmet University.
    Frans, Örjan
    Helström, Lotti
    Högberg, Ulf
    Sydsjö, Gunilla
    Skoog Svanberg, Agneta
    Neuroticism-related personality traits are associated with post-abortion posttraumatic stress2014In: Archives of Women's Mental Health, ISSN 1434-1816, E-ISSN 1435-1102Article in journal (Refereed)
  • 62.
    Wallin Lundell, Inger
    et al.
    Sophiahemmet University.
    Sundström Poromaa, Inger
    Frans, Örjan
    Helström, Lotti
    Högberg, Ulf
    Moby, Lena
    Nyberg, Sigrid
    Sydsjö, Gunilla
    Georgsson Öhman, Susanne
    Sophiahemmet University.
    Östlund, Ingrid
    Skoog Svanberg, Agneta
    The prevalence of posttraumatic stress among women requesting induced abortion2013In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 18, no 6, p. 480-8Article in journal (Refereed)
    Abstract [en]

    Objectives To describe the prevalence and pattern of traumatic experiences, to assess the prevalence of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS), to identify risk factors for PTSD and PTSS, and to analyse the association of PTSD and PTSS with concomitant anxiety and depressive symptoms in women requesting induced abortion. Methods A Swedish multi-centre study of women requesting an induced abortion. The Screen Questionnaire - Posttraumatic Stress Disorder was used for research diagnoses of PTSD and PTSS. Anxiety and depressive symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS). Results Of the 1514 respondents, almost half reported traumatic experiences. Lifetime- and point prevalence of PTSD were 7% (95% confidence interval [CI]: 5.8-8.5) and 4% (95% CI: 3.1-5.2), respectively. The prevalence of PTSS was 23% (95% CI: 21.1-25.4). Women who reported symptoms of anxiety or depression when requesting abortion were more likely to have ongoing PTSD or PTSS. Also single-living women and smokers displayed higher rates of ongoing PTSD. Conclusions Although PTSD is rare among women who request an induced abortion, a relatively high proportion suffers from PTSS. Abortion seeking women with trauma experiences and existing or preexisting mental disorders need more consideration and alertness when counselled for termination.

12 51 - 62 of 62
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