Deficiency of folic acid increases the risk for neural tube defects among newborn children and megaloblastic anaemia in the mother. The aim of this study was to make a survey of how midwives working in maternity health care, family planning guidance, and specialist prenatal care in a Swedish county inform women of childbearing age about folic acid. The questionnaire study showed that 79% of the midwives informed the women about folic acid. Usually, the women received information first when they asked for it and midwifes were less prone to inform young women about folic acid. 87% of the midwives felt that they did not know enough about folic acid. CONCLUSIONS: Midwives play an important role in information about the need of folic acid intake for women in childbearing age. Changes in local routines, guidelines and further education of midwifes would subsequently provide information about the importance of folic acid to women in childbearing age.
In this study we evaluated how well maternal serum screening and abortions for Down syndrome were accepted among midwives and public health nurses, and compared how those who accepted and did not accept abortions for Down syndrome differed from each other. The questionnaire was mailed in 1998 to 400 midwives and 400 public health nurses. 79 per cent responded. The majority said that all pregnant women should be offered a screening test for Down syndrome, but less than half accepted abortion for Down syndrome. Thus, the 'informative part' of the screening (serum screening itself) is supported more often than the 'operative part' (selective abortion)-or at least the 'operative part' was found to be a more difficult question. We suggest that whereas screening may be perceived as a question of more choices, information and self-determination, abortion is more clearly a moral question. The professional background characteristics and attitudes of those accepting and not accepting abortion for Down syndrome were relatively similar, but having a midwife's education, practical involvement in serum screening and having patients with Down syndrome were associated with a somewhat higher percentage of acceptance and a lower percentage of 'don't know' responses.
The aim of the study was to identify and describe the experiences of healthcare professionals when meeting women with symptoms that might indicate endometriosis.
Semi-structured interviews were conducted with 10 gynecologists, six general practitioners and nine midwives working at one university hospital, one central hospital, one private gynecology clinic and five healthcare centers in south-east Sweden. The interviews were recorded and transcribed verbatim and analyzed using qualitative conventional content analysis.
Three clusters were identified: the corroborating encounter, the normal variation of menstruation cycles, and the suspicion of endometriosis. The healthcare professionals tried to make a corroborating encounter by acknowledging the woman, taking time to listen, and giving an explanation for the problems. Healthcare professionals had different ways to determine what was normal as regards menstrual pain, ovulation pain and dyspareunia. They also needed to have the competence to act and react when the symptoms indicated endometriosis.
Meeting women with symptoms that might indicate endometriosis is challenging and demands a certain level of competence from healthcare professionals. Sometimes the symptoms are camouflaged as "normal" menstruation pain, making it hard to satisfy the needs of this patient group.