To investigate the association between adverse childhood experiences (ACE) and pain with onset during pregnancy.
Eighteen antenatal clinics in southern Mid-Sweden.
Of 293 women invited to participate, 232 (79%) women agreed to participate in early pregnancy and were assessed in late pregnancy.
Questionnaires were distributed in early and late pregnancy. The questionnaires sought information on socio-demography, ACE, pain location by pain drawing and pain intensity by visual analogue scales. Distribution of pain was coded in 41 predetermined areas.
Pain in third trimester with onset during present pregnancy: intensity, location and number of pain locations.
In late pregnancy, 62% of the women reported any ACE and 72% reported any pain location with onset during the present pregnancy. Among women reporting any ACE the median pain intensity was higher compared with women without such an experience (p = 0.01). The accumulated ACE displayed a positive association with the number of reported pain locations in late pregnancy (rs = 0.19, p = 0.02). This association remained significant after adjusting for background factors in multiple regression analysis (p = 0.01). When ACE was dichotomized the prevalence of pain did not differ between women with and without ACE. The subgroup of women reporting physical abuse as a child reported a higher prevalence of sacral and pelvic pain (p = 0.0003 and p = 0.02, respectively).
Adverse childhood experiences were associated with higher pain intensities and larger pain distributions in late pregnancy, which are risk factors for transition to chronic pain postpartum.
joint planning and decision-making within couples have evident effects on the well-being of the family. The purpose of this study was to investigate the level of pregnancy planning among pregnant women and their partners and to compare the coherence of pregnancy planning within the couples.
pregnant women and their partners were recruited from 18 antenatal clinics in seven Swedish counties between October 2011 and April 2012. Participants, 232 pregnant women and 144 partners, filled out a questionnaire with questions about pregnancy planning, lifestyle and relationship satisfaction. 136 couples were identified and the women?s and partners? answers were compared.
more than 75% of the pregnancies were very or rather planned and almost all participants had agreed with their partner to become pregnant. There was no significant difference in level of pregnancy planning between women and partners, and coherence within couples was strong. Level of planning was not affected by individual socio-demographic variables. Furthermore, 98 % of women and 94 % of partners had non-distressed relationships.
one of the most interesting results was the strong coherence between partners concerning their pregnancy and relationship. Approaching these results from a social constructivist perspective brings to light an importance of togetherness and how a sense and impression of unity within a couple might be constructed in different ways. As implications for practice, midwives and other professionals counselling persons in fertile age should enquire about and emphasise the benefits of equality and mutual pregnancy planning for both women and men.
Research about pregnancy-planning behaviour mostly focuses on women, even though pregnancy planning usually also concerns men. The purpose of this study was to investigate how men plan for family, and to measure their fertility knowledge after having become fathers.
Data were collected in 2014 as part of a Swedish longitudinal pregnancy-planning study. Men were recruited through their female partner one year after childbirth. Participants were asked to fill out a questionnaire about pregnancy planning, lifestyles, and fertility.
Of the 796 participants, 646 (81%) stated that the pregnancy had been very or fairly planned, and 17% (n?=?128) had made a lifestyle adjustment before pregnancy to improve health and fertility. The most common adjustments were to reduce/quit the consumption of alcohol, cigarettes, or snuff, and to exercise more. First-time fathers and those who had used assisted reproductive technology to become pregnant were more likely to have made an adjustment. Fertility knowledge varied greatly. Men with university education had better fertility knowledge than men without university education.
Our findings indicate that there is variation in how men plan and prepare for pregnancy. Most men did not adjust their lifestyle to improve health and fertility, while some made several changes. Both pregnancy-planning behaviour and fertility knowledge seem to be related to level of education and mode of conception. To gain deeper understanding of behaviour and underlying factors, more research is needed.
The aim was to explore adolescents' beliefs and awareness regarding fertility and preconception health, as well as their views and experiences of information about fertility and preconception health directed at their age group.
We performed seven semi-structured focus group interviews among upper secondary school students (n?=?47) aged 16-18 years in two Swedish counties. Data were analysed by qualitative content analysis.
One theme ('important but far away') and five categories ('starting a family far down on the list'; 'high awareness but patchy knowledge of fertility and preconception health'; 'gender roles influence beliefs about fertility and preconception health'; 'wish to preserve fertility and preconception health in order to keep the door to procreation open'; 'no panacea - early and continuous education about fertility and preconception health') emerged from the interviews. Participants recognised the importance of preconception health and were highly aware of the overall importance of a healthy lifestyle. Their knowledge, however, was patchy and they had difficulties relating to fertility and preconception health on a personal and behavioural level. Participants wanted more information but had heterogeneous beliefs about when, where and how this information should be given.
The adolescents wanted information on fertility and preconception health to be delivered repeatedly as well as through different sources.
Sexual and reproductive health and rights (SRHR) have historically been regarded as a woman's issue. It is likely that these gender norms also hinder health care providers from perceiving boys and men as health care recipients, especially within the area of SRHR. The aim of this study was to explore midwives' thoughts and experiences regarding preventive work for men's sexual and reproductive health and rights in the primary care setting.
An exploratory qualitative study. Five focus group interviews, including 4-5 participants in each group, were conducted with 22 midwives aged 31-64, who worked with reproductive, perinatal and sexual health within primary care. Data were analysed by latent content analysis.
One overall theme emerged, in everybody's interest, but no one's assigned responsibility, and three sub-themes: (i) organisational aspects create obstacles, (ii) mixed views on the midwife's role and responsibility, and (iii) beliefs about men and women: same, but different.
Midwives believed that preventive work for men's sexual and reproductive health and rights was in everybody's interest, but no one's assigned responsibility. To improve men's access to sexual and reproductive health care, actions are needed from the state, the health care system and health care providers.
Prevalence of planned pregnancies varies between countries but is often measured in a dichotomous manner. The aim of this study was to investigate to what level pregnant women had planned their pregnancies and whether pregnancy planning was associated with background characteristics and pregnancy-planning behavior.
A cross-sectional study that utilized the baseline measurements from the Swedish Pregnancy Planning study. Pregnant women (n = 3390) recruited at antenatal clinics answered a questionnaire. Data were analyzed with multinomial logistic regression, Kruskal-Wallis H and chi-squared tests.
Three of four pregnancies were very or fairly planned and 12% fairly or very unplanned. Of women with very unplanned pregnancies, 32% had considered an induced abortion. Women with planned pregnancies were more likely to have a higher level of education, higher household income, to be currently working (=50%) and to have longer relationships than women with unplanned pregnancies. The level of pregnancy planning was associated with planning behavior, such as information-seeking and intake of folic acid, but without a reduction in alcohol consumption. One-third of all women took folic acid 1 month prior to conception, 17% used tobacco daily and 11% used alcohol weekly 3 months before conception.
A majority rated their pregnancy as very or fairly planned, with socio-economic factors as explanatory variables. The level of pregnancy planning should be queried routinely to enable individualized counseling, especially for women with unplanned pregnancies. Preconception recommendations need to be established and communicated to the public to increase health promoting planning behavior.
Breastfeeding is associated with health benefits for both the mother and infant and is therefore important to support; moreover, parental leave is a beneficial factor for breastfeeding. The Swedish parental leave is generous, allowing each parent to take 90?days; additionally, a further 300?days can be taken by either parent. Generally, mothers take 70% of the parental leave days, mainly during the first year. However, breastfeeding duration has declined in the last decade, and it is not known how shared parental leave is associated with the duration of breastfeeding.
To investigate how parental leave is associated with the duration of exclusive and partial breastfeeding of the infant during the first 12?months after birth. An additional aim was to describe infants' and parents' characteristics and mode of birth in association with the duration of exclusive and partial breastfeeding.
This cross-sectional study was part of the Swedish Pregnancy Planning Study, conducted in Sweden in 2012-2015. The parents were recruited at 153 antenatal clinics in nine counties. In total, 813 couples completed a follow-up questionnaire 1 year after birth. Linear regression models were used to analyse the association between parental leave and the duration of breastfeeding.
Infants were exclusively breastfed for, on average, 2.5?months (range 0-12?months) and partially breastfed, on average, 7?months (range 0-12?months). Most of the parental leave was taken by the mother (mean?=?10.9?months) during the infant's first 12?months, while the partner took 3?months, on average. The parental leave (used and planned) during the infant's first 24?months were, on average, 21?months. In the multivariate linear regression analysis, mothers' and partners' high level of education (p?
To psychometrically test the London Measure of Unplanned Pregnancy and compare it with the Swedish Pregnancy Planning Scale.
The incidence of unplanned pregnancies is an important indicator of reproductive health. The London Measure of Unplanned Pregnancy measures pregnancy planning by taking contraceptive use, timing, intention to become pregnant, desire for pregnancy, partner agreement, and pre-conceptual preparations into account. It has, however, previously not been psychometrically evaluated using confirmatory factor analysis. The Likert-scored single-item Swedish Pregnancy Planning Scale has been developed to measure the woman's own view of pregnancy planning level.
In 2012-2013, 5493 pregnant women living in Sweden were invited to participate in the Swedish Pregnancy Planning study, of whom 3327 (61%) agreed to participate and answered a questionnaire. A test-retest pilot study was conducted in 2011-2012. Thirty-two participants responded to the questionnaire on two occasions 14 days apart. Data were analysed using confirmatory factor analysis, Cohen's weighted kappa and Spearman's correlation.
All items of the London Measure of Unplanned Pregnancy contributed to measuring pregnancy planning, but four items had low item-reliability. The London Measure of Unplanned Pregnancy and Swedish Pregnancy Planning Scale corresponded reasonably well with each other and both showed good test-retest reliability.
The London Measure of Unplanned Pregnancy may benefit from item reduction and its usefulness may be questioned. The Swedish Pregnancy Planning Scale is time-efficient and shows acceptable reliability and construct validity, which makes it more useful for measuring pregnancy planning.
Preconception care is important for the screening, prevention and management of risk factors that affect pregnancy outcomes. We aimed to investigate pre-pregnancy care policies, guidelines, recommendations and services in six European countries.
In 2013, an electronic search and investigation was undertaken of preconception policy, guidelines, recommendations and services available to healthcare professionals and the general public in six European countries: Belgium (Flanders), Denmark, Italy, the Netherlands, Sweden and the United Kingdom. Findings were compared within five categories: Governmental policy and legislation; Professional bodies and organisations; Healthcare providers; Charitable organisations; Web-based public information and internet sites.
All countries had preconception recommendations for women with chronic diseases, such as diabetes and epilepsy. Recommendations for healthy women and men were fragmented and inconsistent. Preconception guidance was often included in antenatal and pregnancy guidelines. Differences between countries were seen with regard to nutritional and lifestyle advice particularly in relation to fish, caffeine and alcohol consumption, and vitamin supplementation.
Current guidelines are heterogeneous. Collaborative research across Europe is required in order to develop evidence-based guidelines for preconception health and care. There is a need to establish a clear strategy for promoting advice and guidance within the European childbearing population.
OBJECTIVE To investigate the extent to which Danish women attending antenatal care plan their pregnancies and to determine the association between pregnancy planning and the intake of folic acid, alcohol consumption and smoking habits prior to conception and before the 16th week of gestation. METHODS A cross-sectional survey of 258 women.
intake of folic acid, alcohol consumption and smoking. Pregnancy planning was assessed by the London Measure of Unplanned Pregnancy (LMUP) and the five graded Swedish Pregnancy Planning Scale. RESULTS Most (77%) of the participants reported that their pregnancies were very or fairly well planned. Higher median LMUP scores were observed in women taking folic acid (p