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  • 1.
    Erlandsson, Kerstin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås.
    Lindgren, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Malm, Mari-Cristin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Davidsson-Bremborg, Anna
    Rådestad, Ingela
    Mothers experience of the time after the diagnosis of an intrauterine death until the induction of the delivery: a qualitative internet based study2011In: Journal of Obstetrics and Gynaecology, ISSN 0144-3615, E-ISSN 1364-6893, Vol. 37, no 11, p. 1677-1684Article in journal (Refereed)
    Abstract [en]

    Aim: This study aims to describe how mothers spend the period of time between being diagnosed with a dead baby in utero and the induction of the delivery.

    Material and Methods: Data were collected using a web questionnaire. Five hundred and fifteen women who had experienced a stillbirth after the 22nd week of gestation answered the open question: ‘What did you do between the diagnosis of the child's death and the beginning of the delivery?’ A qualitative content analysis method was used.

    Results: The results show that some mothers received help to adapt to the situation, while for others, waiting for the induction meant further stress and additional psychological trauma in an already strained situation.

    Conclusion: There is no reason to wait with the induction unless the parents themselves express a wish to the contrary. Health care professionals, together with the parents, should try to determine the best time for the induction of the birth after the baby's death in utero. That time may vary, depending on the parents' preferences.

  • 2.
    Kiruja, Jonah
    et al.
    College of Health Science and Medicine, Faculty of Nursing and Midwifery, Hargeisa University, Somaliland.
    Osman, Fatumo
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jama, Ali
    College of Health Science and Medicine, Faculty of Nursing and Midwifery, Hargeisa University, Somaliland.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Malm, Mari-Cristin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Risk factors for stillbirth and beliefs: Findings from a pilot near miss questionnaire study in Somaliland focusing the mother-baby dyad2017In: MOJ Women’s Health, ISSN 2475-5494, Vol. 5, no 3, article id 00123Article in journal (Refereed)
    Abstract [en]

    Background: Somalia is one of 13 countries in Africa with stillbirth rates of more than 30 per 1000 total birth. To our knowledge no study in Somaliland has focused on the mother-baby dyad regarding risk factors for stillbirth. The objective of this study was to identify frequency, causes and beliefs for stillbirth in mothers with life threatening conditions as a pilot for a potential nationwide near-miss study with full coverage in the Somaliland health care system.Method: A prospective cross sectional study using the WHO near-miss questionnaire in a tertiary level hospital with 1.385 deliveries during a five months period in 2015.Results: Out of 138 near miss and death events 22% (n=30) had a stillbirth. Seventy-seven percent (77%) of the mothers (n=23) with stillborn babies survived and 23% died (n=7). They were diagnosed with life threatening conditions, possible to prevent, on arrival at the tertiary hospital. None of them developed the maternal complication/s during the hospital stay. Cesarean sections (43%) were performed within three hours after arrival. Beliefs regarding the stillbirth for the near miss women were that holding the baby born death helps them cope with the loss (74%) and that religious believes helps them cope faster with the loss (91%).Conclusion and clinical implications: The near miss women, their families, TBAs and SBAs might need better information of what causes a stillbirth, how they could prevent it and about the near miss women’s beliefs surrounding stillbirth to enable them to communicate this to pregnant women and prevent delay in admission to the tertiary level hospital. Furthermore, this pilot study suggest that the “Near Miss Questionnaire” could be used in low-and middle income settings to detect a full picture of the situation with stillbirth in a country.

  • 3.
    Lindgren, Helena
    et al.
    Sahlgrenska Akademin, Göteborgs Universitet.
    Malm, Mari-Cristin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    You don't leave your baby-mother's experiences after a stillbirth2014In: Omega, ISSN 0030-2228, E-ISSN 1541-3764, Vol. 68, no 4, p. 337-46Article in journal (Refereed)
    Abstract [en]

    When a baby has died during pregnancy, the first encounter between mother and child occurs when the baby is already dead. Despair, emptiness, and grief characterize the encounter, which is also a gradual farewell to the child and the planned future for the family. This study describes mothers' experiences of the farewell of their stillborn baby at discharge from hospital. Twenty-three mothers from different parts of Sweden, who suffered stillbirth, were interviewed. Semi-structured questions were used and the replies were analyzed using content analysis. The mothers describe the separation from the child when leaving hospital as unnatural and that the separation ruins the motherhood they felt during pregnancy. Five categories were identified: unnatural to leave the baby; going home empty-handed; access to the child; security and insecurity in the separation; to let go. The overarching theme that we recognized from these responses we have formulated as: You don't leave your baby. Leaving the baby at the hospital goes against the biological instinct to care for and protect the offspring. Routines for a dignified goodbye including designating a deputy guardian into whose arms the mother can place the baby can help to facilitate the separation. The possibility of leaving the baby in the arms of someone known to the parents should be an option for parents who choose to take farewell of the child at the hospital. The place and time for the farewell should be decided on by the parents, taking the baby home for a personal farewell could be an alternative.

  • 4.
    Malm, Mari-Cristin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Kvinnors upplevelser av fosterrörelser i slutet av graviditeten2013Licentiate thesis, comprehensive summary (Other academic)
    Abstract [sv]

    Bakgrund: Det finns begränsad kunskap om hur kvinnor upplever fosterrörelser i slutet av graviditeten. Ökad kunskap om fosterrörelser kan bidra till bättre möjligheter att identifiera foster som riskerar att dö intrauterint. Syfte: Att utforska hur gravida kvinnor upplever fosterrörelser i slutet av en okomplicerad graviditet samt hur mammor som mist ett barn i livmodern upplevt kontakten med barnet tiden före beskedet att barnet hade dött. Metod: Delstudie I, djupintervjuer med 26 mammor vars barn dött före födelsen, efter 28 fullgångna graviditetsveckor. Delstudie II, frågeformulär till 393 kvinnor med okomplicerad graviditet som besvarades i graviditetsvecka 37 till 42. Svaren analyserades i båda studierna med kvalitativ innehållsanalys. Resultat: 22 mammor i delstudie I beskrev att de hade haft en föraning om att något kunde ha hänt deras barn innan de fick besked att barnet dött intrauterint. Föraningen grundades på att mammorna hade upplevt minskade eller uteblivna fosterrörelser. Det är något som inte stämmer; formulerades som ett sammanfattande tema på mammornas föraning. Processen mot insikten om att deras barn dött beskrivs i olika steg; Inte känna kontakt med barnet; Känna oro; Känna att något är fel; Inte begripa det ofattbara; Vilja få besked; Vara säker på att barnet har dött. I delstudie II beskrev 383 (96 %) kvinnor i fullgången okomplicerad graviditet olika rörelser som klassificerades som kraftfulla rörelser. De flesta kvinnorna beskrev flera typer av rörelser, tio (4 %) kvinnor beskrev fosterrörelser som inte inkluderade någon rörelse i kategorin kraftfulla rörelser. Konklusion: Mammor som mist sitt barn före födelsen hade känt en föraning om att deras väntade barn kunde må dåligt, de hade upplevt att de tappat kontakten med barnet innan de fick besked att barnet hade dött i livmodern men normaliserade känslan. De flesta kvinnor med okomplicerad, fullgången graviditet, beskriver att barnet rör sig med kraft och tryck, få kvinnor beskriver rörelser som inte kan kategoriseras som kraftfulla. Implikationer: Blivande mammor bör uppmanas att lita på sin upplevelse av att det är något som inte stämmer och kontakta sjukvården direkt om de är bekymrade över sitt ofödda barns rörelser. Bedömning av fosterrörelser i fullgången graviditet kan inkludera: förekomst, frekvens och intensitet.

    Nyckelord: Innehållsanalys, fosterdöd, fosterrörelser, fullgången graviditet, upplevelser

  • 5.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Hildingsson, Ingegerd
    Rubertsson, Christine
    Rådestad, Ingela
    Lindgren, Helena
    Prenatal attachment and its association with foetal movement during pregnancy: a population based survey2016In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 29, no 6, p. 482-486Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the association between the magnitude of foetal movements and level of prenatal attachment within a 24h period among women in the third trimester of pregnancy.

    DESIGN: a prospective population-based survey.

    SETTING: A county in central Sweden.

    PARTICIPANTS: Low risk pregnant women from 34 to 42 weeks gestation, N=456, 299 multiparous and 157 primiparous women.

    MEASUREMENTS: The revised version of the Prenatal Attachment Inventory (PAI-R) and assessment of the perception of foetal movements per 24h in the current gestational week.

    FINDINGS: A total of 81 per cent of the eligible women completed the questionnaire. The overall sample of women found that the majority (96%) felt their baby move mostly in the evening. More than half of the respondents (55%) stated that they perceived frequent foetal movement on two occasions during a 24h period, while almost a fifth (18%) never or only once reported frequent foetal movement in a 24h period. Just over a quarter (26%) of respondents perceived frequent movement at least three times during a 24h period. Perceiving frequent foetal movements on three or more occasions during a 24h period, was associated with higher scores of prenatal attachment in all the three subscales.

    KEY CONCLUSION: Perceiving frequent foetal movements at least during three occasions per 24h periods in late pregnancy was associated with prenatal attachment.

    IMPLICATIONS FOR PRACTICE: encouraging women to focus on foetal movements may positively affect prenatal attachment, especially among multiparous women >35 years.

  • 6.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ingela, Rådestad
    Lindgren, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    To lose contact with your unborn child2010In: The 18th Congress of the Nordic Federation of Midwives, Copenhagen, 2010Conference paper (Refereed)
    Abstract [en]

    Background: A dead child can not move. When a mother experiences that the movement pattern of her unborn child changes, or is absent, this can be a sign that the child has died. There is a lack of knowledge about how mothers experiences that something has happened their child intrauterine. Purpose: To study the mothers experiences of the period of time that preceded them being told that their child has died intrauterine. Method: In-depth interviews with 26 mothers whose children died prior birth, analysed with content analysis. Results: Twenty two of the 26 interviewied mothers had experienced a premonition that something might be wrong with their unborn child, prior to them being told that their child had died. The overall theme "Something is not right" emerged in the analysis. The mothers premonitions can be described as a process from a vaugh to a increasingly strong feeling that something was not wright with their child. For some mothers the feeling developed in to a realization that the life of the child might be threatened, but for most mothers it was incomprehensible that a child could die prior birth. In the analysis, six categories describing the experiences of the mothers,were identified; 1. Feeling no contact with the child; 2. Feeling anxiety; 3. Feeling that something is wrong; 4. Not comprehending the incomprehensible; 5. Wanting to know; 6. Being certain that the child is dead. Conclusion: The mothers had a feeling that something was not right, prior to being told of the death of their child. Thay felt an anxiety that they tried to control by normalazing the absence of movement by the child. The mothers anxiety was met by family and health care personnel with the explanation that expecting mothers generally feel anxious, and they should wait. The absent of fetal movement was given the explanation that the children move less, or not at all, at the end of a pregnancy. Implications: Expecting mothers should be encouraged to seek medical care when their child meves less or not at all at the end of the pregnancy. There is a lack of evidence in order to normalize the experience of mothers that feel that their child moves less at the end of the pregnancy.

  • 7.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Women’s and Children’s Health, Uppsala University, Sweden.
    Lindgren, Helena
    Sahlgrenska Akademin, Göteborgs Universitet.
    Rubertsson, Christine
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Hildingsson, Ingegerd
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Development of a tool to evaluate fetal movements in full-term pregnancy2014In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, no 1, p. 31-35Article in journal (Refereed)
    Abstract [en]

    Objective: To study women’s description of fetal movements in full-term pregnancy. Further to investigate if their descriptions could be sorted with regard to intensity and type of movements, using a matrix under development to be a tool for evaluating fetal movements in clinical praxis.

    Methods: Data were collected by distributing questionnaires including an open question: “Please describe your perception of the baby’s movements during this gestational week.” A matrix listed seven categories of movements divided into powerful and non-powerful movements, was used for the content analysis.

    Results: 393 (78%) women responded to the open question. The movements were split into two domains: Powerful movements and Non-powerful movements. Altogether, 383 (96%) women perceived fetal movements that were sorted as powerful movement: firm, slow stretchinglarge and side to side. Ten (4%) women described movements exclusively, i.e. movements that did not include any of the movements in the powerful domain. Most women perceived movements that corresponded to more than one type of category, and all movements described by the women could be referred to at least one of the categories in the matrix.

    Conclusion: The matrix was useful for identification of the women’s perceptions of fetal movements in full-term pregnancy. Further studies are needed in order to develop the tool and its potential to evaluate the well-being of the fetus before it is to be used in clinical praxis.

  • 8.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindgren, Helena
    Sahlgrenska Akademin, Göteborgs Universitet.
    Rubertsson, Christine
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Hildingsson, Ingegerd
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Quality of fetal movements in full term pregnancy: A Swedish population-based study among pregnant women within standrad antenatal care2012In: The 2012 international conference on stillbirth, SIDS ant infant survival: Helping babies survive & thrive: Conference programe book / [ed] Kelly Neal Mariotti, USA: The division of reproductive health, centers for disease control and prevention U.S Department of health and human services. Award number 200-2-12-M-50770 , 2012, p. 113-113Conference paper (Refereed)
    Abstract [en]

    Aim: To investigate the perceptions of fetal movements among women in full term pregnancy.

    Methods: A population-based study. Data were collected by distributing questionnaires including one open question: “Please describe your perception of the baby´s movements during this gestational weekto be answered in writingAll antenatal clinics in one of the counties in Sweden participated. Altogether 505 pregnant women were eligible and fulfilled the inclusion criteria for this study. A matrix, listing seven types of movements was used for the content analysis. Categorization of types of movements was performed with regard to the context described by the women.

    Results: 393 (79%) women responded to the open question. Altogether 383 (96%) women perceived fetal movements that were sorted as powerful: firm (78%), slow (24%), stretching (23%), from side to side (18 %) and large (18 %) movements. Most women described movements that corresponded to more than one type of movement. Fifty-three women (13%) also described light movements and seven (2%) startled movements, categorized as non-powerful.  Only ten (4%) women described movements that did not include any of the types of movements in the powerful category. 

    Conclusions: In full term pregnancy, fetal movements should include the following three criteria: presence, frequency and intensity.

  • 9.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindgren, Helena
    Sahlgrenska Akademin, Göteborgs Universitet.
    Rubertsson, Christine
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Hildingsson, Ingegerd
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Utveckling av ett hjälpmedel för att utvärdera kvinnors upplevelse av fostrets rörelser i fullgången graviditet2013In: Reproduktiv hälsa: Svenska barnmorskeförbundets konferens 2013 / [ed] Svenska barnmorskeförbundet, Stockholm: Svenska barnmorskeförbundet , 2013, p. 32-33Conference paper (Refereed)
    Abstract [sv]

    Bakgrund: I en tidigare genomför intervjustudie beskrev 40 kvinnor med okomplicerad graviditet hur de upplevde fostrets rörelser i slutet av graviditeten.  Starka rörelser delades in i kategorierna: kraftfulla-; stora-; långsamma-; stretchande rörelser samt rörelser då barnet rörde sig från sida till sida. Icke kraftfulla rörelser, delades in lätta och ryckiga rörelser. För att undersöka om denna kategorisering kunde användas i en större population, testades kategorierna i föreliggande studie.

    Syfte: Att studera kvinnors upplevelse av fosterrörelser i fullgången graviditet och om rörelserna som beskrevs kunde kategoriseras utifrån intensitet och typ av rörelse med hjälp av en matris som utvecklats i en förstudie.  Metod: Samtliga kvinnor i fullgången graviditet som ingick i mödrahälsovårdens basprogram under perioden 1 mars 2011 till 31 oktober 2011 i ett mellansvenskt län, inbjöds till deltagande i studien. Data samlades in genom att distribuera enkäter som innehöll en öppen fråga: " Beskriv hur du uppfattar att ditt barns rörelser vanligtvis varit under den nuvarande graviditetsveckan”. Analysen genomfördes med innehållsanalys och en matris med sju definierade kategorier av rörelser indelade i två domäner: kraftfulla rörelser och icke-kraftfulla rörelser. Resultat: 393 (78 %) kvinnor svarade på den öppna frågan. Sammanlagt 383 (96 %) kvinnor beskrev fosterrörelser som sorterades som kraftfulla, långsamma, stretching, stora och rörelser från sida till sida. Tio (4 %) kvinnor beskrev endast lätta och ryckiga rörelser det vill säga rörelser som inte kunde sorteras till någon av rörelserna i den kraftfulla domänen. De flesta kvinnor beskrev rörelser som motsvarade fler än en typ av rörelser och alla rörelser relaterade till minst en av kategorierna i matrisen. Slutsats: Matrisen var användbart för att sortera fostrets rörelser såsom de beskrevs av kvinnorna i fullgången graviditet. Ytterligare studier behövs för att utveckla hjälpmedlet och för att undersöka dess möjlighet att utvärdera fostrets välbefinnande.

  • 10.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindgren, Helena
    Sahlgrenska Akademin, Göteborgs Universitet.
    Rubertsson, Christine
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Hildingsson, Ingegerd
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women’s perceptions of fetal movements in full term pregnancy – A Swedish population-based study2013In: Book of abstracts: 19th Nordic Midwifery Congress – Nordic and Global Challenges, 2013, p. 70-70Conference paper (Refereed)
    Abstract [en]

    Background: Decreased and weak fetal movements in late pregnancy are associated with adverse neonatal outcomes. Enhanced knowledge about the women’s perception of the movement may improve the possibilities for identifying fetuses at risk.  It has previously been established that there is a risk for stillbirth if fetal movements are reduced or weak. It has also been generally understood that frequent and strong fetal movements during the last three months of pregnancy are signs of satisfactory health of the fetus.  Since observation of fetal movement depends on the mother’s perception, it is important to study these perceptions more carefully.  Objective: To investigate the perceptions of fetal movements among women in full term pregnancy. Design: A population- based study. Setting: All antenatal clinics in one of the counties in Sweden March 1, 2011 to October 31, 2011. Population: Altogether 505 pregnant women were eligible and fulfilled the inclusion criteria for this study.  Methods: Data were collected by distributing questionnaires including an open question: “Please describe your perception of the baby´s movements during this gestational week” to be answered in writing.  A protocol, listing seven types of movements was used for the content analysis. Main outcome measures: Perception of fetal movements among women in full term singleton pregnancy. Results: 393 (79%) women responded to the open question. Altogether, 383 (96%) women perceived five different types of fetal movements that were sorted as powerful: strong (78%), (24%), stretching (23%), from side to side (18%), and large (18%). Most women described movements that corresponded to more than one type of movement. Fifty three (13%) women also described light movements and seven (2%) startled movements, categorized as non-powerful. Only ten (4%) women described movements that did not include any of the movements in the powerful category. Conclusion: In full-term pregnancy, fetal movements are usually recognized as powerful. 

  • 11.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindgren, Helena
    Sahlgrenska Akademin Göteborgs Universitet.
    Rubertsson, Christine
    Kvinnors och barns hälsa, Uppsala Universitet.
    Ingegerd, Hildingsson
    Mittuniversitetet.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women's perception of fetal movements in full term pregnancy: A Swedish population-based study2012In: The 2012 International Conference on Stillbirth, SIDS and infant survival: Hosted by first candle. Helping babies survive & thrive / [ed] Rachel Y. Moon and Ruth Fretts, Baltimore, 2012, p. 113-Conference paper (Refereed)
    Abstract [en]

    Objective: To investigate the perceptions of fetal movements among women in full term pregnancy.

    Design: A population-based study.

    Setting: All antenatal clinics in one of the counties in Sweden March 1, 2011 to October 31, 2011.

    Population: Altogether 505 pregnant women were eligible and fulfilled the inclusion criteria for this study.

    Methods: Data were collected by distributing questionnaires including one open question: “Please describe your perception of the baby´s movements during this gestational weekto be answered in writingA protocol, listing seven types of movements was used for the content analysis.

    Main outcome measures: Perception of fetal movements among women in full term singleton pregnancy.

    Results: 393 (79%) women responded to the open question. Altogether 383 (96%) women perceived five different types of fetal movements that were sorted as powerful: strong (78%), slow (24%), stretching (23%), from side to side (18 %) and large (18 %) movements. Most women described movements that corresponded to more than one type of movement. Fifty three (13%) women also described light movements and seven (2%) startled movements, categorized as non-powerful.  Only ten (4%) women described movements that did not include any of the types of movements in the powerful category. 

    Conclusion: In full term pregnancy, fetal movements are usually recognized as powerful.

    Key Message box: An assessment of fetal movement should include the following three criteria: presence, frequency and intensity.

  • 12.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindgren, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rådestad, Ingela
    Att förlora kontakten med sitt ofödda barn: Mammors erfarenheter innan de får besked om att deras barn dött intrauterint2011In: Svenska Barnmorskeförbundets jubileumskonferens 2011. Reproduktiv hälsa, Stockholm, 2011Conference paper (Refereed)
    Abstract [sv]

    Bakgrund Om mamman uppplever att rörelsemönstret hos sitt väntade barn förändras eller uteblir kan det vara ett tecken på att barnet mår dåligt eller har dött i livmodern. Syfte Att studera mammors erfarenheter under den tid som föregick beskedet om att deras barn dött intrauterint. Metod Djupintervjuer med 26 mammor vars barn dött före födelsen, analyserade med innehållsanalys. Resultat Tjugotvå mammor beskrev en föraning om att något kunde ha hänt deras barn, föraningen grundades i ett uteblivet rörelsemönster hos barnet. Sex kategorier som beskriver mammornas väg mot insikten om att deras barn kunde vara hotat identifierades: Inte känna kontakt med barnet; Oro; Något är fel; Inte begripa det ofattbara; Vilja ha besked; Säker på att barnet dött. Det är något som inte stämmer; formulerades som ett sammanfattande tema på mammornas föraning och processen mot insikten skildras som steg nedåt i en trappa. Konklusion Mammorna försökte tygla sin oro genom att normalisera barnets uteblivna rörelser. Lugnande besked både från anhöriga och från sjukvården, fördröjde en undersökning av barnets hälsotillstånd. Mammorna kunde inte förstå det ofattbara; att barnet hade dött intrauterint. Implikationer: Blivande mammor bör uppmans att lita på sin instinkt och att kontakta sjukvården direkt om de är bekymrad över att barnet rör sig mindre i livmodern

  • 13.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindgren, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rådestad, Ingela
    Fosterrörelsernas kvalité i slutet av graviditeten2012In: Nationell konferens om fosterrörelser- Hur kan andelen barn som dör före födelsen minskas?, Stockholm, 2012Conference paper (Refereed)
    Abstract [sv]

    Background: Decreased fetal movements are associated with adverse outcome. Besides the frequencies of fetal movements, enhanced knowledge about the quality of fetal movements may contribute to better tools to identify fetus at risk. Aim: The aim of this study is to investigate women’s perceptions of the quality of fetal movements in full term pregnancy and within standard antenatal care. Method: 393 women with uncomplicated pregnancies participate in this study. Data were collected by questionnaires, the women answered one open question: “Describe how you perceive your child's movements usually been during the current week of pregnancy”. The answers were analyzed using content analysis. Results: 315 (78 %) of women in gestational week 37-42 describe the movements in terms of power and in equal words irrespective of parity. Conclusion: A fetal movement anamnesis can besides the frequencies also includes questions about the quality of the movements.

  • 14.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindgren, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rådestad, Ingela
    Losing contact with one’s unborn baby: mothers’ experiences prior to receiving news that their baby has died in utero2011In: Omega : Journal of Death and Dying, ISSN 1541-3764, Vol. 62, no 4, p. 353-367Article in journal (Refereed)
    Abstract [en]

    Background: A change in the pattern of movement of her unborn baby could be indicative that the baby might die.

    Aim: To study mothers' experiences during the time prior to receiving news that their baby has died.

    Method: Interviews with 26 mothers.

    Results: Premonition that something had happened to their baby, a sense based on a lack of movements were experienced. Six categories describe the mother's insight that the baby's life was threatened: not feeling in touch with their baby; worry' feeling something is wrong; not understanding the unbelievable; wanting information; and being certain that their baby had died. The overarching theme "There is something wrong" was formulated.

    Conclusion: The mother could not understand the unbelievable: that the baby had died in utero. Implications: Mother's should be cautioned to trust their insights and seek medical advice if they are concerned over the lack of movement from the unborn baby.

  • 15.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Mälardalens Högskola.
    Lindgren, Helena
    Sahlgrenska Akademin, Göteborgs Universitet.
    Waiting in no-man's-land: mother's experiences before the induction of labour after their baby has died in utero2012Conference paper (Refereed)
    Abstract [en]

    Objective: Carrying death instead of life is beyond understanding and a huge psychological challenge for a pregnant mother. The period from the time when information is received about the death of an unborn baby until labour is induced has an impact on the mother’s future well-being. The aim of this study was to investigate the mothers’ experiences of the time from the diagnosis of the death of their unborn baby until induction of labour.

    Method: In-depth interviews were conducted with 21 mothers whose babies had died prior to birth. The interviews were then analysed using content analysis.

    Results: The overall theme that emerged from the mothers’ experiences is understood as “waiting in no-man’s-land”, describing the feeling of being set aside from normality and put into an area which is unrecognized. Four categories were established. ‘Involuntary waiting’ describes the sense of being left without information about what is to come; ‘handling the unimaginable’ concerns the confusing state of finding oneself in the worst-case scenario and yet having to deal with the birth; ‘broken expectations’ is about the loss not only of the baby but also of future family life; and ‘courage to face life’ describes the determination to go on and face reality with strength.

    Conclusions The mothers’ experiences were understood as a sense of being abandoned in no-man’s-land. This time period was characterized by waiting – not knowing for what and not knowing for how long.  Information about the process and the forthcoming encounter with the baby is essential and decisions regarding time of induction should be based on the parents’ requests, not on hospital routines.  

  • 16.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rådestad, Ingela
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. School of Health, Care and Social Welfare, Mälardalen University, Västerås.
    Lindgren, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Waiting in no-man's-land: mothers´experiences before the induction of labor after their baby has died in utero2011In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 2, no 2, p. 51-55Article in journal (Refereed)
    Abstract [en]

    Objective: Carrying death instead of life is beyond understanding and a huge psychological challenge for apregnant mother. The aim of this study was to investigate the mothers’ experiences of the time from thediagnosis of the death of their unborn baby until induction of labour.

    Method: In this qualitative study, in-depth interviews were conducted with 21 mothers whose babieshad died prior to birth. The interviews were then analysed using content analysis.

    Results: The overall theme that emerged from the mothers’ experiences is understood as ‘‘waiting in noman’s-land’’, describing the feeling of being set aside from normality and put into an area which is unrecognized. Four categories were established: ‘involuntary waiting’ describes the sense of being left withoutinformation about what is to come; ‘handling the unimaginable’ concerns the confusing state of findingoneself in the worst-case scenario and yet having to deal with the birth; ‘broken expectations’ is aboutthe loss not only of the baby but also of future family life; and ‘courage to face life’ describes the determinationto go on and face reality.

    Conclusions: The mother’s experiences during the time after the information of their baby’s death in uterountil the induction of labour can be understood as a sense of being in no-man’s-land, waiting withoutknowing for what or for how long.

  • 17.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rådestad, Ingela
    Lindgren, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Losing contact with one´s unborn baby: Mothers experiences prior to receiving news that their baby has died in utero2010In: ISA aand ISPID Joint Conference, Sydney, 2010Conference paper (Refereed)
    Abstract [en]

    Introduction:If a mother experiences a change in the pattern of movement of here unborn baby, it could be indicative that the baby is unwell or has died in utero. Aim: To study mother´s experiences during the time prior to receiving news that their unborn baby has died in utero. Method: In- depth interviews ware conducted with 26 mothers whose babies died prior to birth, witch were then analysed using content analysis. Results: Twent-two mothers descriebed a premoniation that something had happened to their unborn baby, a sense based on al lack of movement from the baby. Six cathegories were constructed from the analysis of the interviews decribing the mother´s insight that the babys life was in threatened; 1. Not feelning in touch with their baby 2. Worry 3. Wanting information 4. Not understanding the unbelievable 5. Wanting information 6. being certain that their baby had died. The overarching theme- "There is something wrong" was formulated. The mother´s experiences can be illustrated as a gradually descending a staircase towards the insight that their baby´s life was threatened. Conclusion: The mothers tried to curb their worry by normalising the baby´s lack of movement. Additionally, reassurance frpm fa,ily and healt-care proefessionals delayed an investigation of the baby´s wellbeing. The mother could not understand the unbelievable; that the baby had died in utero.

  • 18.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Rubertsson, Christine
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Hildingsson, Ingegerd
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Lindgren, Helena
    Sahlgrenska Akademin, Göteborgs Universitet.
    Women's experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy: a crossover trial2014In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 14, article id 349Article in journal (Refereed)
    Abstract [en]

    Background: Low maternal awareness of fetal movements is associated with negative birth outcomes. Knowledge regarding pregnant women's compliance with programs of systematic self-assessment of fetal movements is needed. The aim of this study was to investigate women's experiences using two different self-assessment methods for monitoring fetal movements and to determine if the women had a preference for one or the other method.

    Methods: Data were collected by a crossover trial; 40 healthy women with an uncomplicated full-term pregnancy counted the fetal movements according to a Count-to-ten method and assessed the character of the movements according to the Mindfetalness method. Each self-assessment was observed by a midwife and followed by a questionnaire. A total of 80 self-assessments was performed; 40 with each method.

    Results: Of the 40 women, only one did not find at least one method suitable. Twenty of the total of 39 reported a preference, 15 for the Mindfetalness method and five for the Count-to-ten method. All 39 said they felt calm, relaxed, mentally present and focused during the observations. Furthermore, the women described the observation of the movements as safe and reassuring and a moment for communication with their unborn baby.

    Conclusions: In the 80 assessments all but one of the women found one or both methods suitable for self-assessment of fetal movements and they felt comfortable during the assessments. More women preferred the Mindfetalness method compared to the count-to-ten method, than vice versa.

  • 19.
    Malm, Mari-Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Rubertsson, Christine
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Lindgren, Helena
    Sahlgrenska Akademin, Göteborgs Universitet.
    Hildingsson, Ingegerd
    Kvinnor och Barns Hälsa, Uppsala Universitet.
    Women’s experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy: – a crossover trial2017Conference paper (Refereed)
    Abstract [en]

    Background: Low maternal awareness of fetal movements is associated with negative birth outcomes. Knowledge regarding pregnant women’s compliance with programs of systematic self-assessment of fetal movements is needed.

     

    Aim: To study women’s experiences using two different self-assessment methods for monitoring fetal movements and to determine if the women had a preference for one or the other method.

     

    Methods: Data were collected by a crossover trial. 40 healthy women with an uncomplicated full-term pregnancy counted the fetal movements according to a Count-to-ten method and assessed the character of the movements according to the Mindfetalness method. Each self-assessment was observed by a midwife and followed by a questionnaire. A total of 80 self-assessments was performed; 40 with each method.

     

    Results: One of the 40 participants did not find at least one method for monitoring fetal movements suitable. Twenty of the total of 39 reported a preference, fifteen of the 39 participants reported a preference for the Mindfetalness method and five for the Count-to-ten method. The women described the observation of the movements as a safe and reassuring moment for communication with their unborn baby. They said they felt calm, relaxed, and mentally present and focused during the observations.

    Conclusions: In the 80 assessments all but one of the women found one or both methods suitable for self-assessment of fetal movements and they felt comfortable during the assessments. More women preferred the Mindfetalness method compared to the Count-to-ten method.

     

    Clinical implications: For women who prefer systematic self-assessment methods of their unborn baby’s movements, both Count-to-ten and Mindfetalness can be presented as options. However, the methods need to be better evaluated concerning their potential to prevent pre-hospital delay when the unborn baby’s health is at stake before they can be implemented in antenatal care as a routine.

  • 20.
    Rådestad, Ingela
    et al.
    Sophiahemmet Högskola.
    Malm, Mari-Cristin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Women's and Children's Health, Uppsala University, Sweden.
    Lindgren, Helena
    Sahlgrenska Akademin, Göteborgs Universitet.
    Pettersson, Karin
    Karolinska institutet.
    Franklin Larsson, Lise-Lotte
    Ersta University .
    Being alone in silence: mothers' experiences upon confirmation of their baby´s death in utero2013In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 30, no 1, p. E91-E95Article in journal (Refereed)
    Abstract [en]

    Objective: To explore mothers' experiences of the confirmation of ultrasound examination results and how they were told that their baby had died in-utero.

    Design: In-depth interviews.SettingSweden.

    Participants: 26 mothers of stillborn babies.

    Measurement: Narratives were analysed using a qualitative content analysis with an inductive approach.

    Findings: The mothers experienced that silence prevailed during the entire process of confirming the ultrasound results. Typically all present in the ultrasound room were concentrating and focusing on what they observed on the screen, no one spoke to the mother. The mothers had an instinctive feeling that their baby might be dead based on what they observed on the ultrasound screen and on their interpretation of the body language of the clinicians and midwives. Some mothers reported a time delay in receiving information about their baby's death. Experiencing uncertainty about the information received was also noticed.

    Conclusion: Mothers emphasised an awareness of silence and feelings of being completely alone while being told of the baby's death.Implication for practicethe prevalence of silence during an ultrasound examination may in certain cases cause further psychological trauma for the mother of a stillborn baby. One way to move forward given these results may be to provide obstetric personnel sufficient training on how difficult information might be more effectively and sensitively provided in the face of an adverse pregnancy outcome.

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