Marie Berg | University of Gothenburg (original) (raw)

Papers by Marie Berg

Research paper thumbnail of Breastfeeding practices in women with type 1 diabetes: A discussion of the psychosocial factors and policies in Sweden and Australia

Women and Birth, 2014

Women with type 1 diabetes (T1DM) face many challenges during their pregnancy, birth and in the p... more Women with type 1 diabetes (T1DM) face many challenges during their pregnancy, birth and in the postnatal period, including breastfeeding initiation and continuation while maintaining stable glycaemic control. In both Sweden and Australia the rates of breastfeeding initiation are high. However, overall there is limited information about the breastfeeding practices of women with T1DM and the factors affecting them. Similarities in demographics, birth rates and health systems create bases for discussion. The aim of this paper is to discuss psychosocial factors, policies and practices that impact on the breastfeeding practices of women with T1DM. Swedish research indicates that the overall breastfeeding rate in women with T1DM remains significantly lower than in women without diabetes in the first 2 and 6 months after childbirth with no differences in exclusive breastfeeding. Breastfeeding initiation and continuation among women with T1DM in Sweden has been shown to be influenced by health services delivery, supportive breastfeeding polices and socio-economic factors, particular perceived support from social networks and health professionals. There is limited research on the impact of attitudes towards breastfeeding, emotional and social well-being and diabetes-related stress on the decision of women with T1DM to initiate and continue to breastfeed for at least 6 months. A more comprehensive understanding of the breastfeeding practices and psychosocial factors operating during the first 6 months after birth for women with T1DM will be instrumental in the future design of interventions promoting initiation and continuation of breastfeeding in Sweden, Australia and elsewhere.

Research paper thumbnail of A randomized trial of labor augmentation by oxytocin vs delayed oxytocin treatment or no oxytocin in nulliparous women with spontaneous contractions

American Journal of Obstetrics and Gynecology, 2005

Objective To study the effects of early versus delayed oxytocin augmentation on the obstetrical a... more Objective To study the effects of early versus delayed oxytocin augmentation on the obstetrical and neonatal outcome in nulliparous women with spontaneous but prolonged labour.

Research paper thumbnail of Deficiency in rest and nutrition increase the risk for prolonged labor in nulliparous women

American Journal of Obstetrics and Gynecology, 2006

Objective. The aim of this prospective study was to identify latent phase predictors of active la... more Objective. The aim of this prospective study was to identify latent phase predictors of active labor duration. Design. Prospective clinical study. Setting. Two delivery units in Sweden. Sample. Healthy nulliparous women with a normal pregnancy, spontaneous onset of active labor at term, and a cervical dilatation of 4 cm or more on admission to the delivery ward (n = 2,072). Methods. The women were asked to answer questions concerning their food and fluid intake, amount of rest and sleep during the preceding 24 hours and to assess their labor pain, sense of security and expectations of the childbirth on a visual analog scale (VAS). Duration and intervals of contractions, cervical dilatation, and position of the fetal head were noted by the midwife. A multiple regression analysis was performed with active labor duration as the outcome variable. Main outcome measure. Predictive factors of active labor duration. Results. Normal food intake during the preceding 24 hours was associated with short labor duration. A long latent phase, low levels of assessed labor pain and few hours of rest and sleep during the preceding 24 hours were significant independent predictors of extended active labor duration, when high birth weight, long contraction intervals, slight cervical dilatation, intact membranes within 2 hours of admission, high maternal age and malposition of the fetal head were controlled for. Conclusion. New findings are that latent phase duration as well as food intake and the amount of rest and sleep during the preceding 24 hours are independent predictors of labor duration.

Research paper thumbnail of Labor augmentation by means of oxytocin – women's experiences

American Journal of Obstetrics and Gynecology, 2006

Objective: The aim was to compare the childbirth experiences of primiparous women with slow labou... more Objective: The aim was to compare the childbirth experiences of primiparous women with slow labour progress who had received early versus postponed oxytocin augmentation. Methods: The population included healthy primiparous women with slow labour progress after a normal pregnancy and spontaneous onset of active labour at term who had taken part in a randomized controlled trial at two delivery units in Sweden comparing early versus postponed oxytocin augmentation. A total of 536 women were sent the Childbirth Experience Questionnaire (CEQ) one month postpartum. The 22item questionnaire assesses four domains of the childbirth experience. Main outcomes were the four domains of the CEQ: Own capacity, Professional support, Perceived safety and Participation. Results: There were no significant differences between the women in the early and expectant oxytocin treatment groups in any of the four domains; however, operative births were associated with significantly worse childbirth experiences. Almost every third woman in both groups had negative and depressing memories from the childbirth process. Conclusions: Early oxytocin augmentation for slow labour progress does not appear to be more beneficial than expectant management regarding women's perceptions of childbirth one month postpartum. Given the risks for the foetus associated with oxytocin treatment, prudent expectant management seems to be a safe and viable alternative.

Research paper thumbnail of Women’s experiences after early versus postponed oxytocin treatment of slow progress in first childbirth – a randomized controlled trial

Sexual & Reproductive Healthcare, 2012

Objective: The aim was to compare the childbirth experiences of primiparous women with slow labou... more Objective: The aim was to compare the childbirth experiences of primiparous women with slow labour progress who had received early versus postponed oxytocin augmentation. Methods: The population included healthy primiparous women with slow labour progress after a normal pregnancy and spontaneous onset of active labour at term who had taken part in a randomized controlled trial at two delivery units in Sweden comparing early versus postponed oxytocin augmentation. A total of 536 women were sent the Childbirth Experience Questionnaire (CEQ) one month postpartum. The 22item questionnaire assesses four domains of the childbirth experience. Main outcomes were the four domains of the CEQ: Own capacity, Professional support, Perceived safety and Participation. Results: There were no significant differences between the women in the early and expectant oxytocin treatment groups in any of the four domains; however, operative births were associated with significantly worse childbirth experiences. Almost every third woman in both groups had negative and depressing memories from the childbirth process. Conclusions: Early oxytocin augmentation for slow labour progress does not appear to be more beneficial than expectant management regarding women's perceptions of childbirth one month postpartum. Given the risks for the foetus associated with oxytocin treatment, prudent expectant management seems to be a safe and viable alternative.

Research paper thumbnail of Symptoms in women with Peripartum Cardiomyopathy: a mixed method study

Midwifery, 2015

Peripartum Cardiomyopathy is a form of cardiac disease often associated with cardiac failure, occ... more Peripartum Cardiomyopathy is a form of cardiac disease often associated with cardiac failure, occurring in late pregnancy or after childbirth. The anatomical and physiological changes in the mother associated with normal pregnancy are profound, and this may result in symptoms and signs that overlap with Peripartum Cardiomyopathy, leading to missed or delayed diagnosis. Women׳s experiences of Peripartum Cardiomyopathy symptoms remain poorly studied. The aim of this study was to explore and descirbe women's experiences of symptoms in Peripartum Cardiomyopathy. A triangulation of methods with individual interviews and data from medical records. Mothers with Peripartum Cardiomyopathy diagnosis were recruited from Western Sweden as a part of research project. 19 women were interviewed and medical records were reviewed by authors. All interview transcripts were analysed using qualitative inductive content analysis to identify key themes. The main theme, meaning of onset and occurrence of symptoms is captured in the metaphor: being caught in a spider web, comprising subthemes, invasion of the body by experienced symptoms and feeling of helplessness. Symptoms related to Peripartum Cardiomyopathy started for 17 women during pregnancy and in two post partum and time from symptoms to diagnosis varied between three and 190 days (median 40). The physical symptoms were:shortness of breath, excessive fatigue and swelling, bloatedness, nausea, palpitation, coughing, chest tightness, bodily pain, headache, fever, tremor, dizziness, syncope, restless and tingly body and reduced urine output. Emotionalsymptoms were: fear, anxiety, feelings of panic, and thoughts of impending death. Symptoms of Peripartum Cardiomyopathy were debilitating, exhausting and frightening for the women interviewed in this study. Health care professionals responsible for the antenatal care, especially midwives, need skills to identify initial symptoms of Peripartum Cardiomyopathy for early referral and treatment by a specialist. In order to give optimal care more research is needed to show how to improve midwives׳ knowledge of Peripartum Cardiomyopathy.

Research paper thumbnail of National medical guidelines for the use of intrapartum oxytocin (Nationella medicinska Indikationer - Indikation för värkstimulering med oxytocin under aktiv förlossning)

Målet för förlossningsvård i Sverige är en frisk mor, ett friskt barn och en positiv förlossnings... more Målet för förlossningsvård i Sverige är en frisk mor, ett friskt barn och en positiv förlossningsupplevelse, samt att ingripa så lite som möjligt i förlossningens förlopp. Under en spontan förlossning stimulerar endogen frisättning av hormonet oxytocin livmodersammandragningar som får cervix (livmoderhalsen) att vidgas. Normal förlossningsprogress brukar definieras som att cervix vidgas 1 cm per timme från det att aktiv förlossningsfas har startat. En förlångsammad progress under aktiv fas beror ofta på så kallad värksvaghet. När progressen avviker från det normala eller fördröjs med två till åtta timmar definieras det som värksvaghet (olika definitioner används i olika studier). Långsam progress kan även orsakas av mekaniska hinder, t.ex. disproportion mellan fostrets huvud och moderns bäcken, med eller utan avvikande bjudning (fosterläge). Dessa faktorer ska ha övervägts innan värkstimulering påbörjas. Värksvaghet drabbar främst förstföderskor. Risken ökar med stigande ålder. Andr...

Research paper thumbnail of Indikation för värkstimulering med oxytocin

Research paper thumbnail of A Comparison of Active Management and Expectant Management of the Third Stage of Labor

Obstetric Anesthesia Digest

Research paper thumbnail of Parental presence when their child is in neonatal intensive care

Scandinavian Journal of Caring Sciences, 2010

When a newborn baby needs care in a neonatal intensive care unit (NICU), the parents are welcome ... more When a newborn baby needs care in a neonatal intensive care unit (NICU), the parents are welcome to stay with their child whenever they wish. The aim of the present study was to investigate the time per day parents are present together with their child at the NICU and to identify factors that facilitated and obstructed their presence. In a descriptive study 67 parents of 42 children from two NICUs registered all time they spent at the NICU and then took part in a structured interview. Parental presence at NICUs varied depending on types of accommodation offered. Those who stayed in parent rooms at the units showed a significantly higher presence with their children than parents who stayed at family hotel, at home or on a maternity ward. Factors that motivated parental presence were primarily the willingness to take parental responsibility, the child's condition requiring it, and the want to have control. Good treatment by the staff, a family-friendly environment and high quality care were main facilitating factors for parents to be present at the NICU. Obstructing factors were primarily ill health by parents, a non-family-friendly environment, care of the home and of children at home. The result shows that there is a need to develop a family-friendly environment that provides optimal conditions for parents to be with their child in a NICU and to consider the parent's own reason for being or not being present.

Research paper thumbnail of Person-centred care in interventions to limit weight gain in pregnant women with obesity - a systematic review

BMC Pregnancy and Childbirth, 2015

Background: Person-centred care, asserting that individuals are partners in their care, has been ... more Background: Person-centred care, asserting that individuals are partners in their care, has been associated with care satisfaction but the value of using it to support women with obesity during pregnancy is unknown. Excessive gestational weight gain is associated with increased risks for both mother and baby and weight gain therefore is an important intervention target. The aims of this review was to 1) explore to what extent and in what manner interventions assessing weight in pregnant women with obesity use person-centred care and 2) assess if interventions including aspects of person-centred care are more effective at limiting weight gain than interventions not employing person-centred care.

Research paper thumbnail of A midwifery model of woman-centred childbirth care – In Swedish and Icelandic settings

Sexual & Reproductive Healthcare, 2012

Background: Theoretical models for health care practice are important both as tools for guiding d... more Background: Theoretical models for health care practice are important both as tools for guiding daily practice and for explaining the philosophical basis for care. Aim: The aim of this study was to define and develop an evidence-based midwifery model of womancentred care in Sweden and Iceland. Method: Using a hermeneutic approach we developed a model based on a synthesis of findings from 12 of our own published qualitative studies about women's and/or midwives' experiences of childbirth. For validity testing, the model was assessed in six focus group interviews with 30 practising midwives in Iceland and Sweden. Findings: The model includes five main themes. Three central intertwined themes are: a reciprocal relationship; a birthing atmosphere; and grounded knowledge. The remaining two themes, which likewise influence care, are the cultural context (with hindering and promoting norms); and the balancing act involved in facilitating woman-centred care. Conclusion: The model shows that midwifery care in this era of modern medical technology entails a balancing act for enhancing the culture of care based on midwifery philosophies. The next step will be to implement the model in midwifery programmes and in clinical practice, and to evaluate its applicability. j o u r n a l h o m e p a g e : w w w . s r h c j o u r n a l . o r g Please cite this article in press as: Berg M et al. A midwifery model of woman-centred childbirth care -In Swedish and Icelandic settings. Sex Reprod Healthc (2012), http://dx.

Research paper thumbnail of Waiting for permission to enter the labour ward world: First time parents’ experiences of the first encounter on a labour ward

Sexual & Reproductive Healthcare, 2011

For women and their partners, the first meeting with professional staff on the labour ward is imp... more For women and their partners, the first meeting with professional staff on the labour ward is important. This initial encounter is a short but sensitive meeting. It may be particularly crucial for first time parents, most of whom have no prior experience of the birth environment. The objective of this study was to explore the meaning of first time mothers' and their partners' first encounter with midwives and other maternity care staff when they arrive on a hospital labour ward. A hermeneutic, reflective lifeworld research approach was chosen to identify patterns of meanings, comprehension and explanations. Participants from Western Sweden were interviewed in the postnatal period; 37 individually, and 28 in focus groups. Four themes were identified: 'timing it right ', 'waiting to be informed', 'being in an inferior position', and 'facing reality with a mosaic of emotions'. The final interpretation of the phenomenon is captured as 'waiting for permission to enter the labour ward world'. The findings demonstrate the parents' efforts trying to determine the appropriateness of arrival to the labour ward. An asymmetric power relationship was expressed in the obedient acceptance of the waiting for attention in an unfamiliar situation. These findings suggest that the labour ward entry process is not parent centred. As entry to the labour ward sets the tone for the rest of the birth, this period in the labour process needs more attention in future research and practice from the maternity care professionals perspective.

Research paper thumbnail of Mothers’ experiences of skin-to-skin care of healthy full-term newborns – A phenomenology study

Sexual & Reproductive Healthcare, 2011

Objectives: Previous reports have shown that skin-to-skin contact immediately after birth is the ... more Objectives: Previous reports have shown that skin-to-skin contact immediately after birth is the optimal form of care for a full-term, healthy infant and its mother. As this is rarely researched the aim of this study was to explore experiences of skin-to-skin care in healthy mothers of healthy, full-term infants in the first days after birth. Study design: Using a lifeworld phenomenological approach, 20 women who had childbirth in hospital and were practising skin-to-skin care were interviewed 1-2 weeks after birth. Analysis of all interview texts was directed towards discovering qualitative meanings through a process of identifying meaning units. These were then clustered and analysed with the aim of describing themes of meaning and the essence of the phenomenon. Findings: The mothers wanted to give their newborn child the best possible care and the skin-to-skin care started a positive spiral. A mutual interaction developed which acted as a generator releasing energy to the mother who wanted to continue the practice which in terms increased mother-infant affinity. Happiness, peace and satisfaction were expressed by the newborns; also a child who was crying or troublesome exhibited a positive response to skin-to-skin care. Conclusion: The study provides insight and knowledge which should guide attitudes and promote practices of this simple healthcare intervention; skin-to-skin contact care to healthy infants born at term. Healthcare professionals should support affinity between a mother and her newborn through facilitation and the provision of information about its benefits.

Research paper thumbnail of Editorial

Sexual & Reproductive Healthcare, 2012

Research paper thumbnail of Mothers' experiences of having their newborn child in a neonatal intensive care unit

Scandinavian Journal of Caring Sciences, 2006

Research paper thumbnail of Experiences of the first year as father

Scandinavian Journal of Caring Sciences, 2008

Research paper thumbnail of Adolescents’ experiences of well-being when living with a long-term illness or disability

Scandinavian Journal of Caring Sciences, 2007

Research paper thumbnail of Women's experiences of childlessness 2 years after the end of in vitro fertilization treatment

Scandinavian Journal of Caring Sciences, 2005

Research paper thumbnail of Children’s experiences of attitudes and rules for going to the toilet in school

Scandinavian Journal of Caring Sciences, 2009

Children¢s experiences of attitudes and rules for going to the toilet in school Introduction: Sch... more Children¢s experiences of attitudes and rules for going to the toilet in school Introduction: School children often base their toilet habits on behavioural and social reasons. Bladder emptying problems, urinary tract infections and constipation are common health problems which are also associated with irregular toilet habits. School rules for going to the toilet have been shown to create difficulties for school children with bladder dysfunction. Aim of this study was to describe children's experiences of school rules for going to the toilet and their significance for the children. Methods: Individual open-ended questions with 19 schoolchildren aged 9-16 in elementary schools. Results: To manage the children's toilet needs, teachers used rules designed for maintaining order in the classroom. The children saw their toilets needs as a private matter and experienced it complicated to go to the toilet during recess as time was short and the risk for violation of their integrity was at its highest. The most frustrating when to comply with rules during lessons was to be forced to, in front of all their classmates, make public the need to go to the toilet: i.e the most private was exposed to the disclosure. Conclusion: The rules for going to the toilet came from the teachers' need for maintaining order in the classroom and were not adapted to the children's physical and developmental needs. To violate the integrity of children can affect their willingness to go to the school toilet which in turn affects their wellbeing during school time.

Research paper thumbnail of Breastfeeding practices in women with type 1 diabetes: A discussion of the psychosocial factors and policies in Sweden and Australia

Women and Birth, 2014

Women with type 1 diabetes (T1DM) face many challenges during their pregnancy, birth and in the p... more Women with type 1 diabetes (T1DM) face many challenges during their pregnancy, birth and in the postnatal period, including breastfeeding initiation and continuation while maintaining stable glycaemic control. In both Sweden and Australia the rates of breastfeeding initiation are high. However, overall there is limited information about the breastfeeding practices of women with T1DM and the factors affecting them. Similarities in demographics, birth rates and health systems create bases for discussion. The aim of this paper is to discuss psychosocial factors, policies and practices that impact on the breastfeeding practices of women with T1DM. Swedish research indicates that the overall breastfeeding rate in women with T1DM remains significantly lower than in women without diabetes in the first 2 and 6 months after childbirth with no differences in exclusive breastfeeding. Breastfeeding initiation and continuation among women with T1DM in Sweden has been shown to be influenced by health services delivery, supportive breastfeeding polices and socio-economic factors, particular perceived support from social networks and health professionals. There is limited research on the impact of attitudes towards breastfeeding, emotional and social well-being and diabetes-related stress on the decision of women with T1DM to initiate and continue to breastfeed for at least 6 months. A more comprehensive understanding of the breastfeeding practices and psychosocial factors operating during the first 6 months after birth for women with T1DM will be instrumental in the future design of interventions promoting initiation and continuation of breastfeeding in Sweden, Australia and elsewhere.

Research paper thumbnail of A randomized trial of labor augmentation by oxytocin vs delayed oxytocin treatment or no oxytocin in nulliparous women with spontaneous contractions

American Journal of Obstetrics and Gynecology, 2005

Objective To study the effects of early versus delayed oxytocin augmentation on the obstetrical a... more Objective To study the effects of early versus delayed oxytocin augmentation on the obstetrical and neonatal outcome in nulliparous women with spontaneous but prolonged labour.

Research paper thumbnail of Deficiency in rest and nutrition increase the risk for prolonged labor in nulliparous women

American Journal of Obstetrics and Gynecology, 2006

Objective. The aim of this prospective study was to identify latent phase predictors of active la... more Objective. The aim of this prospective study was to identify latent phase predictors of active labor duration. Design. Prospective clinical study. Setting. Two delivery units in Sweden. Sample. Healthy nulliparous women with a normal pregnancy, spontaneous onset of active labor at term, and a cervical dilatation of 4 cm or more on admission to the delivery ward (n = 2,072). Methods. The women were asked to answer questions concerning their food and fluid intake, amount of rest and sleep during the preceding 24 hours and to assess their labor pain, sense of security and expectations of the childbirth on a visual analog scale (VAS). Duration and intervals of contractions, cervical dilatation, and position of the fetal head were noted by the midwife. A multiple regression analysis was performed with active labor duration as the outcome variable. Main outcome measure. Predictive factors of active labor duration. Results. Normal food intake during the preceding 24 hours was associated with short labor duration. A long latent phase, low levels of assessed labor pain and few hours of rest and sleep during the preceding 24 hours were significant independent predictors of extended active labor duration, when high birth weight, long contraction intervals, slight cervical dilatation, intact membranes within 2 hours of admission, high maternal age and malposition of the fetal head were controlled for. Conclusion. New findings are that latent phase duration as well as food intake and the amount of rest and sleep during the preceding 24 hours are independent predictors of labor duration.

Research paper thumbnail of Labor augmentation by means of oxytocin – women's experiences

American Journal of Obstetrics and Gynecology, 2006

Objective: The aim was to compare the childbirth experiences of primiparous women with slow labou... more Objective: The aim was to compare the childbirth experiences of primiparous women with slow labour progress who had received early versus postponed oxytocin augmentation. Methods: The population included healthy primiparous women with slow labour progress after a normal pregnancy and spontaneous onset of active labour at term who had taken part in a randomized controlled trial at two delivery units in Sweden comparing early versus postponed oxytocin augmentation. A total of 536 women were sent the Childbirth Experience Questionnaire (CEQ) one month postpartum. The 22item questionnaire assesses four domains of the childbirth experience. Main outcomes were the four domains of the CEQ: Own capacity, Professional support, Perceived safety and Participation. Results: There were no significant differences between the women in the early and expectant oxytocin treatment groups in any of the four domains; however, operative births were associated with significantly worse childbirth experiences. Almost every third woman in both groups had negative and depressing memories from the childbirth process. Conclusions: Early oxytocin augmentation for slow labour progress does not appear to be more beneficial than expectant management regarding women's perceptions of childbirth one month postpartum. Given the risks for the foetus associated with oxytocin treatment, prudent expectant management seems to be a safe and viable alternative.

Research paper thumbnail of Women’s experiences after early versus postponed oxytocin treatment of slow progress in first childbirth – a randomized controlled trial

Sexual & Reproductive Healthcare, 2012

Objective: The aim was to compare the childbirth experiences of primiparous women with slow labou... more Objective: The aim was to compare the childbirth experiences of primiparous women with slow labour progress who had received early versus postponed oxytocin augmentation. Methods: The population included healthy primiparous women with slow labour progress after a normal pregnancy and spontaneous onset of active labour at term who had taken part in a randomized controlled trial at two delivery units in Sweden comparing early versus postponed oxytocin augmentation. A total of 536 women were sent the Childbirth Experience Questionnaire (CEQ) one month postpartum. The 22item questionnaire assesses four domains of the childbirth experience. Main outcomes were the four domains of the CEQ: Own capacity, Professional support, Perceived safety and Participation. Results: There were no significant differences between the women in the early and expectant oxytocin treatment groups in any of the four domains; however, operative births were associated with significantly worse childbirth experiences. Almost every third woman in both groups had negative and depressing memories from the childbirth process. Conclusions: Early oxytocin augmentation for slow labour progress does not appear to be more beneficial than expectant management regarding women's perceptions of childbirth one month postpartum. Given the risks for the foetus associated with oxytocin treatment, prudent expectant management seems to be a safe and viable alternative.

Research paper thumbnail of Symptoms in women with Peripartum Cardiomyopathy: a mixed method study

Midwifery, 2015

Peripartum Cardiomyopathy is a form of cardiac disease often associated with cardiac failure, occ... more Peripartum Cardiomyopathy is a form of cardiac disease often associated with cardiac failure, occurring in late pregnancy or after childbirth. The anatomical and physiological changes in the mother associated with normal pregnancy are profound, and this may result in symptoms and signs that overlap with Peripartum Cardiomyopathy, leading to missed or delayed diagnosis. Women׳s experiences of Peripartum Cardiomyopathy symptoms remain poorly studied. The aim of this study was to explore and descirbe women's experiences of symptoms in Peripartum Cardiomyopathy. A triangulation of methods with individual interviews and data from medical records. Mothers with Peripartum Cardiomyopathy diagnosis were recruited from Western Sweden as a part of research project. 19 women were interviewed and medical records were reviewed by authors. All interview transcripts were analysed using qualitative inductive content analysis to identify key themes. The main theme, meaning of onset and occurrence of symptoms is captured in the metaphor: being caught in a spider web, comprising subthemes, invasion of the body by experienced symptoms and feeling of helplessness. Symptoms related to Peripartum Cardiomyopathy started for 17 women during pregnancy and in two post partum and time from symptoms to diagnosis varied between three and 190 days (median 40). The physical symptoms were:shortness of breath, excessive fatigue and swelling, bloatedness, nausea, palpitation, coughing, chest tightness, bodily pain, headache, fever, tremor, dizziness, syncope, restless and tingly body and reduced urine output. Emotionalsymptoms were: fear, anxiety, feelings of panic, and thoughts of impending death. Symptoms of Peripartum Cardiomyopathy were debilitating, exhausting and frightening for the women interviewed in this study. Health care professionals responsible for the antenatal care, especially midwives, need skills to identify initial symptoms of Peripartum Cardiomyopathy for early referral and treatment by a specialist. In order to give optimal care more research is needed to show how to improve midwives׳ knowledge of Peripartum Cardiomyopathy.

Research paper thumbnail of National medical guidelines for the use of intrapartum oxytocin (Nationella medicinska Indikationer - Indikation för värkstimulering med oxytocin under aktiv förlossning)

Målet för förlossningsvård i Sverige är en frisk mor, ett friskt barn och en positiv förlossnings... more Målet för förlossningsvård i Sverige är en frisk mor, ett friskt barn och en positiv förlossningsupplevelse, samt att ingripa så lite som möjligt i förlossningens förlopp. Under en spontan förlossning stimulerar endogen frisättning av hormonet oxytocin livmodersammandragningar som får cervix (livmoderhalsen) att vidgas. Normal förlossningsprogress brukar definieras som att cervix vidgas 1 cm per timme från det att aktiv förlossningsfas har startat. En förlångsammad progress under aktiv fas beror ofta på så kallad värksvaghet. När progressen avviker från det normala eller fördröjs med två till åtta timmar definieras det som värksvaghet (olika definitioner används i olika studier). Långsam progress kan även orsakas av mekaniska hinder, t.ex. disproportion mellan fostrets huvud och moderns bäcken, med eller utan avvikande bjudning (fosterläge). Dessa faktorer ska ha övervägts innan värkstimulering påbörjas. Värksvaghet drabbar främst förstföderskor. Risken ökar med stigande ålder. Andr...

Research paper thumbnail of Indikation för värkstimulering med oxytocin

Research paper thumbnail of A Comparison of Active Management and Expectant Management of the Third Stage of Labor

Obstetric Anesthesia Digest

Research paper thumbnail of Parental presence when their child is in neonatal intensive care

Scandinavian Journal of Caring Sciences, 2010

When a newborn baby needs care in a neonatal intensive care unit (NICU), the parents are welcome ... more When a newborn baby needs care in a neonatal intensive care unit (NICU), the parents are welcome to stay with their child whenever they wish. The aim of the present study was to investigate the time per day parents are present together with their child at the NICU and to identify factors that facilitated and obstructed their presence. In a descriptive study 67 parents of 42 children from two NICUs registered all time they spent at the NICU and then took part in a structured interview. Parental presence at NICUs varied depending on types of accommodation offered. Those who stayed in parent rooms at the units showed a significantly higher presence with their children than parents who stayed at family hotel, at home or on a maternity ward. Factors that motivated parental presence were primarily the willingness to take parental responsibility, the child's condition requiring it, and the want to have control. Good treatment by the staff, a family-friendly environment and high quality care were main facilitating factors for parents to be present at the NICU. Obstructing factors were primarily ill health by parents, a non-family-friendly environment, care of the home and of children at home. The result shows that there is a need to develop a family-friendly environment that provides optimal conditions for parents to be with their child in a NICU and to consider the parent's own reason for being or not being present.

Research paper thumbnail of Person-centred care in interventions to limit weight gain in pregnant women with obesity - a systematic review

BMC Pregnancy and Childbirth, 2015

Background: Person-centred care, asserting that individuals are partners in their care, has been ... more Background: Person-centred care, asserting that individuals are partners in their care, has been associated with care satisfaction but the value of using it to support women with obesity during pregnancy is unknown. Excessive gestational weight gain is associated with increased risks for both mother and baby and weight gain therefore is an important intervention target. The aims of this review was to 1) explore to what extent and in what manner interventions assessing weight in pregnant women with obesity use person-centred care and 2) assess if interventions including aspects of person-centred care are more effective at limiting weight gain than interventions not employing person-centred care.

Research paper thumbnail of A midwifery model of woman-centred childbirth care – In Swedish and Icelandic settings

Sexual & Reproductive Healthcare, 2012

Background: Theoretical models for health care practice are important both as tools for guiding d... more Background: Theoretical models for health care practice are important both as tools for guiding daily practice and for explaining the philosophical basis for care. Aim: The aim of this study was to define and develop an evidence-based midwifery model of womancentred care in Sweden and Iceland. Method: Using a hermeneutic approach we developed a model based on a synthesis of findings from 12 of our own published qualitative studies about women's and/or midwives' experiences of childbirth. For validity testing, the model was assessed in six focus group interviews with 30 practising midwives in Iceland and Sweden. Findings: The model includes five main themes. Three central intertwined themes are: a reciprocal relationship; a birthing atmosphere; and grounded knowledge. The remaining two themes, which likewise influence care, are the cultural context (with hindering and promoting norms); and the balancing act involved in facilitating woman-centred care. Conclusion: The model shows that midwifery care in this era of modern medical technology entails a balancing act for enhancing the culture of care based on midwifery philosophies. The next step will be to implement the model in midwifery programmes and in clinical practice, and to evaluate its applicability. j o u r n a l h o m e p a g e : w w w . s r h c j o u r n a l . o r g Please cite this article in press as: Berg M et al. A midwifery model of woman-centred childbirth care -In Swedish and Icelandic settings. Sex Reprod Healthc (2012), http://dx.

Research paper thumbnail of Waiting for permission to enter the labour ward world: First time parents’ experiences of the first encounter on a labour ward

Sexual & Reproductive Healthcare, 2011

For women and their partners, the first meeting with professional staff on the labour ward is imp... more For women and their partners, the first meeting with professional staff on the labour ward is important. This initial encounter is a short but sensitive meeting. It may be particularly crucial for first time parents, most of whom have no prior experience of the birth environment. The objective of this study was to explore the meaning of first time mothers' and their partners' first encounter with midwives and other maternity care staff when they arrive on a hospital labour ward. A hermeneutic, reflective lifeworld research approach was chosen to identify patterns of meanings, comprehension and explanations. Participants from Western Sweden were interviewed in the postnatal period; 37 individually, and 28 in focus groups. Four themes were identified: 'timing it right ', 'waiting to be informed', 'being in an inferior position', and 'facing reality with a mosaic of emotions'. The final interpretation of the phenomenon is captured as 'waiting for permission to enter the labour ward world'. The findings demonstrate the parents' efforts trying to determine the appropriateness of arrival to the labour ward. An asymmetric power relationship was expressed in the obedient acceptance of the waiting for attention in an unfamiliar situation. These findings suggest that the labour ward entry process is not parent centred. As entry to the labour ward sets the tone for the rest of the birth, this period in the labour process needs more attention in future research and practice from the maternity care professionals perspective.

Research paper thumbnail of Mothers’ experiences of skin-to-skin care of healthy full-term newborns – A phenomenology study

Sexual & Reproductive Healthcare, 2011

Objectives: Previous reports have shown that skin-to-skin contact immediately after birth is the ... more Objectives: Previous reports have shown that skin-to-skin contact immediately after birth is the optimal form of care for a full-term, healthy infant and its mother. As this is rarely researched the aim of this study was to explore experiences of skin-to-skin care in healthy mothers of healthy, full-term infants in the first days after birth. Study design: Using a lifeworld phenomenological approach, 20 women who had childbirth in hospital and were practising skin-to-skin care were interviewed 1-2 weeks after birth. Analysis of all interview texts was directed towards discovering qualitative meanings through a process of identifying meaning units. These were then clustered and analysed with the aim of describing themes of meaning and the essence of the phenomenon. Findings: The mothers wanted to give their newborn child the best possible care and the skin-to-skin care started a positive spiral. A mutual interaction developed which acted as a generator releasing energy to the mother who wanted to continue the practice which in terms increased mother-infant affinity. Happiness, peace and satisfaction were expressed by the newborns; also a child who was crying or troublesome exhibited a positive response to skin-to-skin care. Conclusion: The study provides insight and knowledge which should guide attitudes and promote practices of this simple healthcare intervention; skin-to-skin contact care to healthy infants born at term. Healthcare professionals should support affinity between a mother and her newborn through facilitation and the provision of information about its benefits.

Research paper thumbnail of Editorial

Sexual & Reproductive Healthcare, 2012

Research paper thumbnail of Mothers' experiences of having their newborn child in a neonatal intensive care unit

Scandinavian Journal of Caring Sciences, 2006

Research paper thumbnail of Experiences of the first year as father

Scandinavian Journal of Caring Sciences, 2008

Research paper thumbnail of Adolescents’ experiences of well-being when living with a long-term illness or disability

Scandinavian Journal of Caring Sciences, 2007

Research paper thumbnail of Women's experiences of childlessness 2 years after the end of in vitro fertilization treatment

Scandinavian Journal of Caring Sciences, 2005

Research paper thumbnail of Children’s experiences of attitudes and rules for going to the toilet in school

Scandinavian Journal of Caring Sciences, 2009

Children¢s experiences of attitudes and rules for going to the toilet in school Introduction: Sch... more Children¢s experiences of attitudes and rules for going to the toilet in school Introduction: School children often base their toilet habits on behavioural and social reasons. Bladder emptying problems, urinary tract infections and constipation are common health problems which are also associated with irregular toilet habits. School rules for going to the toilet have been shown to create difficulties for school children with bladder dysfunction. Aim of this study was to describe children's experiences of school rules for going to the toilet and their significance for the children. Methods: Individual open-ended questions with 19 schoolchildren aged 9-16 in elementary schools. Results: To manage the children's toilet needs, teachers used rules designed for maintaining order in the classroom. The children saw their toilets needs as a private matter and experienced it complicated to go to the toilet during recess as time was short and the risk for violation of their integrity was at its highest. The most frustrating when to comply with rules during lessons was to be forced to, in front of all their classmates, make public the need to go to the toilet: i.e the most private was exposed to the disclosure. Conclusion: The rules for going to the toilet came from the teachers' need for maintaining order in the classroom and were not adapted to the children's physical and developmental needs. To violate the integrity of children can affect their willingness to go to the school toilet which in turn affects their wellbeing during school time.