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Anal sphincter tears at spontaneous delivery: a comparison of five hospitals in Norway.

https://arctichealth.org/en/permalink/ahliterature91449
Source
Acta Obstet Gynecol Scand. 2008;87(11):1176-80
Publication Type
Article
Date
2008
Author
Valbø Annelill
Gjessing Leif
Herzog Christine
Goderstad Jeanne Mette
Laine Katariina
Valset Anne Marte
Author Affiliation
Asker and Baerum Hospital, Oslo, Norway. annelill.valbo@sabhf.no
Source
Acta Obstet Gynecol Scand. 2008;87(11):1176-80
Date
2008
Language
English
Publication Type
Article
Keywords
Adult
Anal Canal - injuries
Analgesia, Epidural - methods
Birth weight
Cohort Studies
Delivery, Obstetric - adverse effects - methods
Episiotomy - methods
Female
Gestational Age
Humans
Labor Presentation
Midwifery - methods - standards - statistics & numerical data
Norway
Obstetric Labor Complications
Oxytocin - administration & dosage
Perineum - injuries
Pregnancy
Risk factors
Trauma Severity Indices
Abstract
OBJECTIVE: To analyze circumstances relating to severe anal sphincter tears occurring at spontaneous delivery, in view of reported differences in practice regarding manual perineal protection during delivery. DESIGN: Cohort study of midwife-conducted non-operative vaginal deliveries. SETTING: Five Norwegian hospitals with 12,438 consecutive deliveries during a 12-month period. METHODS: Data from 357 women sustaining third and fourth grade anal sphincter tears (2.9%) were analyzed. MAIN OUTCOME MEASURES: Different incidence of major perineal tears. RESULTS: Sphincter tear incidence varied significantly between the five hospitals, from 1.3 to 4.7% (p
PubMed ID
18972270 View in PubMed
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An evaluation of process and protocols for planned home birth attended by regulated midwives in British Columbia.

https://arctichealth.org/en/permalink/ahliterature185934
Source
J Midwifery Womens Health. 2003 Mar-Apr;48(2):138-45
Publication Type
Article
Author
Patricia A Janssen
Shoo K Lee
Elizabeth R Ryan
Lee Saxell
Author Affiliation
Department of Health Care and Epidemiology, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, Canada V6T 1Z3.
Source
J Midwifery Womens Health. 2003 Mar-Apr;48(2):138-45
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Evaluation Studies as Topic
Female
Home Childbirth - methods - statistics & numerical data
Humans
Maternal Health Services - methods
Midwifery - methods
Nurse Midwives - standards
Nursing Assessment
Outcome Assessment (Health Care)
Pregnancy
Risk factors
Abstract
Midwifery emerged as a self-regulated profession in British Columbia in the context of a 2-year demonstration project beginning in 1998. The project evaluated accountability among midwives, defined as the provision of safe and appropriate care and maintenance of standards of communication set by the College of Midwives of British Columbia. Adherence to protocols was measured by using documentation designed specifically for the Home Birth Demonstration Project. Hospital and transport records for selected clients were reviewed by an expert committee. Outcomes among Home Birth Demonstration Project clients were compared with outcomes among women eligible for home birth but planning to deliver in hospital. Adherence to clinical and communication protocols was 96% or higher. Planned home birth was not associated with an increase in risk but prevalence of adverse outcomes was too low to be studied with precision. Recommendations of an expert review committee have been implemented or are under review. Midwives have demonstrated a high degree of compliance with reporting requirements and protocols. Comparisons of birth outcomes of planned home versus hospital births, while supporting home birth as a choice for women, were limited in scope and require ongoing study. Integration of home birth has been a dynamic process with guidelines and policy continuing to evolve.
PubMed ID
12686947 View in PubMed
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Antenatal training to improve breast feeding: a randomised trial.

https://arctichealth.org/en/permalink/ahliterature130270
Source
Midwifery. 2012 Dec;28(6):784-90
Publication Type
Article
Date
Dec-2012
Author
Hanne Kronborg
Rikke Damkjær Maimburg
Michael Væth
Author Affiliation
Department of Nursing Science, School of Public Health, Aarhus University, Denmark. hk@nursingscience.au.dk
Source
Midwifery. 2012 Dec;28(6):784-90
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Adult
Breast Feeding - methods - psychology
Denmark
Female
Health Promotion - methods
Humans
Midwifery - methods
Mothers - education - psychology
Patient Acceptance of Health Care - statistics & numerical data
Pregnancy
Prenatal Care - methods
Questionnaires
Self Efficacy
Young Adult
Abstract
to assess the effect of an antenatal training programme on knowledge, self-efficacy and problems related to breast feeding and on breast-feeding duration.
a randomised controlled trial.
the Aarhus Midwifery Clinic, a large clinic connected to a Danish university hospital in an urban area of Denmark.
a total of 1193 nulliparous women were recruited before week 21+6 days of gestation, 603 were randomised to the intervention group, and 590 to the reference group.
we compared a structured antenatal training programme attended in mid-pregnancy with usual practice.
data were collected through self-reported questionnaires sent to the women's e-mail addresses and analysed according to the intention to treat principle. The primary outcomes were duration of full and any breast feeding collected 6 weeks post partum (any) and 1 year post partum (full and any).
no differences were found between groups according to duration of breast feeding, self-efficacy score, or breast-feeding problems, but after participation in the course in week 36 of gestation women in the intervention group reported a higher level of confidence (p=0.05), and 6 weeks after birth they reported to have obtained sufficient knowledge about breast feeding (p=0.02). Supplemental analysis in the intervention group revealed that women with sufficient knowledge breast fed significantly longer than women without sufficient knowledge (HR=0.74 CI: 0.58-0.97). This association was not found in the reference group (HR=1.12 CI: 0.89-1.41).
antenatal training can increase confidence of breast feeding in pregnancy and provide women with sufficient knowledge about breast feeding after birth. Antenatal training may therefore be an important low-technology health promotion tool that can be provided at low costs in most settings. The antenatal training programme needs to be followed by postnatal breast-feeding support as it is not sufficient in itself to increase the duration of breast feeding or reduce breast-feeding problems.
PubMed ID
22018394 View in PubMed
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Attitudes of midwives in Sweden toward a woman's refusal of an emergency cesarean section or a cesarean section on request.

https://arctichealth.org/en/permalink/ahliterature136907
Source
Birth. 2011 Mar;38(1):71-9
Publication Type
Article
Date
Mar-2011
Author
Margaretha Danerek
Karel Maršál
Marina Cuttini
Göran Lingman
Tore Nilstun
Anna-Karin Dykes
Author Affiliation
Department of Health Sciences, Faculty of Medicine, University Lund, Lund, Sweden.
Source
Birth. 2011 Mar;38(1):71-9
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Cesarean Section - psychology - statistics & numerical data
Cross-Sectional Studies
Decision Making
Emergencies
Female
Health Knowledge, Attitudes, Practice
Humans
Midwifery - methods
Nurse's Role - psychology
Nurse-Patient Relations
Pregnancy
Pregnancy Outcome - epidemiology
Questionnaires
Sweden - epidemiology
Treatment Refusal - psychology - statistics & numerical data
Young Adult
Abstract
A woman's refusal or request for a cesarean section can be a problem for midwives and obstetricians working in maternity units. The objective of this study was to describe the attitudes of midwives in Sweden toward the obstetrician's decision making in relation to a woman's refusal of an emergency cesarean section and to a woman's request for a cesarean section without a medical indication.
The study has a cross-sectional multicenter design and used an anonymous, structured, and standardized questionnaire for data collection. The study group comprised midwives who had experience working at a delivery ward at 13 maternity units with neonatal intensive care units in Sweden (n = 259).
In the case of a woman's refusal to undergo an emergency cesarean section for fetal reasons, most midwives (89%) thought that the obstetrician should try to persuade the woman to agree. Concerning a woman's request for a cesarean section without any medical indications, most midwives thought that the obstetrician should agree if the woman had previous maternal or fetal complications. The reason was to support the woman's decision out of respect for her autonomy; the midwives at six university hospitals were less willing to accept the woman's autonomy in this situation. If the only reason was "her own choice," 77 percent of the midwives responded that the obstetrician should not comply.
The main focus of midwives seems to be the baby's health, and therefore they do not always agree with respect to a woman's refusal or request for a cesarean section. The midwives prefer to continue to explain the situation and persuade the woman to agree with the recommendation of the obstetrician.
PubMed ID
21332777 View in PubMed
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Attitudes of Swedish midwives towards management of extremely preterm labour and birth.

https://arctichealth.org/en/permalink/ahliterature128773
Source
Midwifery. 2012 Dec;28(6):e857-64
Publication Type
Article
Date
Dec-2012
Author
Margaretha Danerek
Karel Maršál
Marina Cuttini
Göran Lingman
Tore Nilstun
Anna-Karin Dykes
Author Affiliation
Department of Health Sciences, Faculty of Medicine, University Lund, Box 157, 221 00 Lund, Sweden. margaretha.danerek@med.lu.se
Source
Midwifery. 2012 Dec;28(6):e857-64
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Adult
Female
Humans
Infant, Extremely Premature
Infant, Newborn
Intensive Care, Neonatal - methods
Interprofessional Relations
Midwifery - methods
Nurse's Role
Nurse-Patient Relations
Nursing Methodology Research
Postnatal Care - methods
Pregnancy
Pregnancy, High-Risk
Premature Birth - nursing
Questionnaires
Sweden
Young Adult
Abstract
the aim of the study was to ascertain the attitudes of Swedish midwives towards management of very preterm labour and birth and to compare the attitudes of midwives at university hospitals with those at general hospitals.
this cross-sectional descriptive and comparative study used an anonymous self-administrated questionnaire for data collection. Descriptive and analytic statistics were carried out for analysis.
the answers from midwives (n=259) were collected in a prospective SWEMID study.
the midwives had experience of working on delivery wards in maternity units with neonatal intensive care units (NICU) in Sweden.
in the management of very preterm labour and birth, midwives agreed to initiate interventions concerning steroid prophylaxis at 23 gestational weeks (GW), caesarean section for preterm labour only at 25 GW, when to give information to the neonatologist before birth at 23 GW, and when to suggest transfer to NICU at 23 GW. Midwives at university hospitals were prone to start interventions at an earlier gestational age than the midwives at general hospitals. Midwives at university hospitals seemed to be more willing to disclose information to the parents.
midwives with experience of handling very preterm births at 21-28 GW develop a positive attitude to interventions at an earlier gestational age as compared to midwives without such experience.
based on these results we suggest more communication and transfer of information about the advances in perinatal care and exchange of knowledge between the staff at general and university hospitals. Establishment of platforms for inter-professional discussions about ethically difficult situations in perinatal care, might benefit the management of very preterm labour and birth.
PubMed ID
22169524 View in PubMed
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Avoiding the first cesarean section--results of structured organizational and cultural changes.

https://arctichealth.org/en/permalink/ahliterature275550
Source
Acta Obstet Gynecol Scand. 2016 May;95(5):580-6
Publication Type
Article
Date
May-2016
Author
Marie Blomberg
Source
Acta Obstet Gynecol Scand. 2016 May;95(5):580-6
Date
May-2016
Language
English
Publication Type
Article
Keywords
Adult
Apgar score
Cesarean Section - adverse effects
Culturally Competent Care - methods - organization & administration
Female
Fetal Monitoring - methods
Gestational Age
Humans
Infant, Newborn
Midwifery - methods - standards
Natural Childbirth - methods - psychology
Organizational Innovation
Parity
Patient Care Team - standards
Pregnancy
Pregnancy Outcome - epidemiology
Quality Improvement
Sweden - epidemiology
Term Birth
Abstract
In 2006 the overall rates of instrumental deliveries (10%) and cesarean sections (CS) (20%) were high in our unit. We decided to improve quality of care by offering more women a safe and attractive normal vaginal delivery. The target group was primarily nulliparous women at term with spontaneous onset of labor and cephalic presentation.
Implementation of a "nine-item list" of structured organizational and cultural change in Linköping 2006-15. The nine items include monitoring of obstetric results, recruitment of a midwife coordinator, risk classification of women, introduction of three different midwife competence levels, improved teamwork, obstetrical morning round, fetal monitoring skills, obstetrical skills training, and public promotion of the strategy.
The CS rate in nulliparous women at term with spontaneous onset of labor decreased from 10% in 2006 to 3% in 2015. During the same period the overall CS rate dropped from 20% to 11%. The prevalence of children born at the unit with umbilical cord pH
PubMed ID
26870916 View in PubMed
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Being a bridge: Swedish antenatal care midwives' encounters with Somali-born women and questions of violence; a qualitative study.

https://arctichealth.org/en/permalink/ahliterature267056
Source
BMC Pregnancy Childbirth. 2015;15:1
Publication Type
Article
Date
2015
Author
Ulrika Byrskog
Pia Olsson
Birgitta Essén
Marie-Klingberg Allvin
Source
BMC Pregnancy Childbirth. 2015;15:1
Date
2015
Language
English
Publication Type
Article
Keywords
Communication Barriers
Culturally Competent Care - methods
Female
Humans
Midwifery - methods
Nurse's Role
Nurse-Patient Relations
Pregnancy
Pregnant Women - ethnology - psychology
Prenatal Care - methods
Qualitative Research
Refugees - psychology
Social Distance
Social Support
Somalia - ethnology
Sweden
Trust
Violence - psychology
Abstract
Violence against women is associated with serious health problems, including adverse maternal and child health. Antenatal care (ANC) midwives are increasingly expected to implement the routine of identifying exposure to violence. An increase of Somali born refugee women in Sweden, their reported adverse childbearing health and possible links to violence pose a challenge to the Swedish maternity health care system. Thus, the aim was to explore ways ANC midwives in Sweden work with Somali born women and the questions of exposure to violence.
Qualitative individual interviews with 17 midwives working with Somali-born women in nine ANC clinics in Sweden were analyzed using thematic analysis.
The midwives strived to focus on the individual woman beyond ethnicity and cultural differences. In relation to the Somali born women, they navigated between different definitions of violence, ways of handling adversities in life and social contexts, guided by experience based knowledge and collegial support. Seldom was ongoing violence encountered. The Somali-born women's' strengths and contentment were highlighted, however, language skills were considered central for a Somali-born woman's access to rights and support in the Swedish society. Shared language, trustful relationships, patience, and networking were important aspects in the work with violence among Somali-born women.
Focus on the individual woman and skills in inter-cultural communication increases possibilities of overcoming social distances. This enhances midwives' ability to identify Somali born woman's resources and needs regarding violence disclosure and support. Although routine use of professional interpretation is implemented, it might not fully provide nuances and social safety needed for violence disclosure. Thus, patience and trusting relationships are fundamental in work with violence among Somali born women. In collaboration with social networks and other health care and social work professions, the midwife can be a bridge and contribute to increased awareness of rights and support for Somali-born women in a new society.
Notes
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PubMed ID
25591791 View in PubMed
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Canada's evacuation policy for pregnant First Nations women: Resignation, resilience, and resistance.

https://arctichealth.org/en/permalink/ahliterature298294
Source
Women Birth. 2018 Dec; 31(6):479-488
Publication Type
Journal Article
Date
Dec-2018
Author
Karen M Lawford
Audrey R Giles
Ivy L Bourgeault
Author Affiliation
School of Indigenous and Canadian Studies, Carleton University, Dunton Tower 1221, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada. Electronic address: karen.lawford@carleton.ca.
Source
Women Birth. 2018 Dec; 31(6):479-488
Date
Dec-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Canada
Delivery, Obstetric
Female
Health Policy
Health Services Accessibility
Health Services, Indigenous
Humans
Indians, North American
Interviews as Topic
Inuits
Male
Midwifery - methods
Parturition - ethnology
Politics
Pregnancy
Pregnant Women - ethnology - psychology
Qualitative Research
Resilience, Psychological
Rural Population
Young Adult
Abstract
Aboriginal peoples in Canada are comprised of First Nations, Métis, and Inuit. Health care services for First Nations who live on rural and remote reserves are mostly provided by the Government of Canada through the federal department, Health Canada. One Health Canada policy, the evacuation policy, requires all First Nations women living on rural and remote reserves to leave their communities between 36 and 38 weeks gestational age and travel to urban centres to await labour and birth. Although there are a few First Nations communities in Canada that have re-established community birthing and Aboriginal midwifery is growing, most First Nations communities are still reliant on the evacuation policy for labour and birthing services. In one Canadian province, Manitoba, First Nations women are evacuated to The Pas, Thompson, or Winnipeg but most - including all women with high-risk pregnancies - go to Winnipeg.
To contribute scholarship that describes First Nations women's and community members' experiences and perspectives of Health Canada's evacuation policy in Manitoba.
Applying intersectional theory to data collected through 12 semi-structured interviews with seven women and five community members (four females, one male) in Manitoba who had experienced the evacuation policy. The data were analyzed thematically, which revealed three themes: resignation, resilience, and resistance.
The theme of resignation was epitomized by the quote, "Nobody has a choice." The ability to withstand and endure the evacuation policy despite poor or absent communication and loneliness informed of resilience. Resistance was demonstrated by women who questioned the necessity and requirement of evacuation for labour and birth. In one instance, resistance took the form of a planned homebirth with Aboriginal registered midwives.
There is a pressing need to improve the maternity care services that First Nations women receive when they are evacuated out of their communities, particularly when understood from the specific legal and constitutional position of First Nations women in Manitoba.
PubMed ID
29439924 View in PubMed
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Care for infibulated women giving birth in Norway: an anthropological analysis of health workers' management of a medically and culturally unfamiliar issue.

https://arctichealth.org/en/permalink/ahliterature79132
Source
Med Anthropol Q. 2006 Dec;20(4):516-44
Publication Type
Article
Date
Dec-2006
Author
Johansen R Elise B
Author Affiliation
Institute of General and Community Health, University of Oslo, Norway. johansene@who.int
Source
Med Anthropol Q. 2006 Dec;20(4):516-44
Date
Dec-2006
Language
English
Publication Type
Article
Keywords
Anthropology, Cultural
Circumcision, Female - adverse effects
Delivery, Obstetric - methods - psychology
Female
Humans
Midwifery - methods
Norway
Pregnancy
Somalia - ethnology
Abstract
The focus of this article is on Norwegian health care workers' experience and management of birth care of women who have undergone infibulation. Because infibulation is the most extensive form of female genital cutting, infibulated women experience a higher risk of birth complications, and health workers generally experience delivery care for this group as challenging. Infibulated women, who come from recently arrived immigrant groups, are a challenge to the predominant Norwegian birth philosophy of "natural childbirth" and the positive evaluation of everything considered natural. The challenges relate to a mixture of technical know-how and a complex set of interpretations of central cultural elements of gender, nature, health, and gender equity. The findings suggest that a combination of taboo, silence, limited knowledge, and emotional difficulty along with a wish to be culture sensitive may at times prove counterproductive to giving the best help. Health care workers often seem to impose "imagined" cultural values on infibulated women, rather than clarifying them through personal communication.
PubMed ID
17225657 View in PubMed
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Care in labor: a Swedish survey using the Bologna Score.

https://arctichealth.org/en/permalink/ahliterature91065
Source
Birth. 2008 Dec;35(4):321-8
Publication Type
Article
Date
Dec-2008
Author
Sandin-Bojö Ann-Kristin
Kvist Linda J
Author Affiliation
Division for Health and Caring Sciences, Karlstad University, Karlstad, Sweden.
Source
Birth. 2008 Dec;35(4):321-8
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Adult
Birthing Centers - organization & administration
Cross-Sectional Studies
Delivery, Obstetric - methods - nursing - standards
Evidence-Based Practice
Female
Health Knowledge, Attitudes, Practice
Humans
Labor, Obstetric
Midwifery - methods - standards - statistics & numerical data
Nurse-Patient Relations
Obstetrics and Gynecology Department, Hospital
Perinatal Care - methods - standards
Pregnancy
Prospective Studies
Quality Indicators, Health Care - standards
Questionnaires
Sweden
Abstract
BACKGROUND: An important part of midwives' area of responsibility is to strive to keep birth normal. Interventions during childbirth are costly and may disrupt the course of normal labor. The aim of this study was to describe, by use of the Bologna Score, how birth is managed in Sweden. METHODS: A prospective cross-sectional study in a national sample was performed. All (n = 51) Swedish maternity units were invited to participate and 36 (70.6%) agreed. Midwives collected data, in accordance with the Bologna Score, for all deliveries occurring during a 2-week period in 2007. RESULTS: Qualified health personnel assisted at almost all deliveries (99.9%), and a vaginal birth was planned for 84 percent of the women. A Bologna Score of 5 signifies that birth has been managed using recommended evidence-based practice, which was achieved for 22.7 percent of the planned vaginal births. Use of the supine position and some interventions were responsible for loss of points. The percentage of 5-point scores varied greatly among units (0-53.1%). CONCLUSIONS: The findings suggest that in Sweden, birth is managed according to scientific evidence to a limited degree. Large differences among units also suggest that care in childbirth is based on attitudes rather than on scientific evidence. The Bologna Score was easy to use and gave a good picture of how care was given at the participating maternity units. We suggest that the instrument is useful as a quality indicator for intrapartum care.
PubMed ID
19036045 View in PubMed
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84 records – page 1 of 9.