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  • 1.
    Akhter, Nargis
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Akhter, Jasmine
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Component that make a midwife grow personally and professionally: A qualitative meta-synthesis2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Midwifery care is an essential component of providing quality maternal and child health care. Mother and new born health outcomes depends on the quality of education, license to practice, the scope of practice, sufficient resources, referral mechanisms and effective teamwork. The aim of this meta-synthesis was to describe components building midwifery professionalism for delivery of quality care. Method: This study was a meta-synthesis focusing to describe the components needed for building midwifery professionalism for delivery of quality care in high, low and middle-income countries. After assessing for relevance and quality in peer-reviewed journals, 30 qualitative studies were included from 2009 to 2018, written in English. This involved an electronic search using the following databases: PubMed, CINAHL, web of Science, Google Scholar, Summon and manually search. Result: After analysis and synthesis, the major findings can be summarized in two components; Clinical experiences make the midwives’ grow personally and professionally and an enabling environment enhances the midwives’ personal and professional development. Subcategories were; Collaboration with other health professionals and with colleges/ colleagues at the workplace, Extensive hands on clinical experience, Professional management of the workplace, Quality pre-service education and quality of the midwifery educators, In-service training, Policies and guidelines regulate the midwifery workforce, Being a member of a midwifery association. Conclusion: To ensure mothers quality midwifery care; midwives play a critical role in strengthening the midwifery workforce in high and low-middle income countries. This study highlights the benefits of building capacity for strengthening midwives and the midwifery profession. Clinical implications: There is a need to improving the educational status, improving policy and practice of health care program and facilitate the necessary resources. There is need for further research to identify how much improvements the newly deployed midwifery cadre service will bring in the field of quality midwifery care personally and professionally especially in rural setting.

  • 2.
    Akter, Rina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Parvin, Masuda
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Supportive components of care during cesarean section birth: A qualitative meta-synthesis2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    : Caesarean section is the most common surgery worldwide today. The midwives support is therefore of uttermost important for women undergoing caesarean section. Aim: The aim of the meta-synthesis was to explore the experience related to planned and unplanned cesarean sections among primipara and multipara women in hospital settings worldwide. Method: This study is a meta-synthesis with meta-ethnographic analysis on women’s experiences of caesarean section birth. This is a qualitative research based on scientific literature. The inclusion criterion was peer-review qualitative articles from different original articles about women's experiences. Results: Five categories emerged: Caring attitude and behaviour, pre-existing imagination, relational influence, the need for caring and information. The findings suggest that nurse-midwife enhance their support and increase the women’s knowledge on caesarean section birth in order to improve the experience and also for women to make good choices. Women are influenced by people near to them when choosing to have a cesarean section or not. The mothers face challenges for postoperative recovery and quality of care. Midwives have a duty to assist these mothers. Conclusion: The findings emphasize the importance of person-centered communication skills and relationships in supporting a woman during caesarian section. Organizational systems and services that facilitate continuity of care giver for example, continuity of midwifery care or peer support models, are more likely to facilitate supportive care and a trust-building relationship. Clinical implication: The findings from this study can be used for educational purposes, and to create awareness about the role of midwifery care in relation to CS.

  • 3.
    Akter, Rina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Parvin, Masuda
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Supportive components of care during cesarean section birth: A qualitative meta-synthesis2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Caesarean section is the most common surgery worldwide today. The midwives support is therefore of uttermost important for women undergoing caesarean section. Aim: The aim of the meta-synthesis was to explore the experience related to planned and unplanned cesarean sections among primipara and multipara women in hospital settings worldwide. Method: This study is a meta-synthesis with meta-ethnographic analysis on women’s experiences of caesarean section birth. This is a qualitative research based on scientific literature. The inclusion criterion was peer-review qualitative articles from different original articles about women's experiences. Results: Five categories emerged: Caring attitude and behaviour, pre-existing imagination, relational influence, the need for caring and information. The findings suggest that nurse-midwife enhance their support and increase the women’s knowledge on caesarean section birth in order to improve the experience and also for women to make good choices. Women are influenced by people near to them when choosing to have a cesarean section or not. The mothers face challenges for postoperative recovery and quality of care. Midwives have a duty to assist these mothers. Conclusion: The findings emphasize the importance of person-centered communication skills and relationships in supporting a woman during caesarian section. Organizational systems and services that facilitate continuity of care giver for example, continuity of midwifery care or peer support models, are more likely to facilitate supportive care and a trust-building relationship. Clinical implication: The findings from this study can be used for educational purposes, and to create awareness about the role of midwifery care in relation to CS.

  • 4.
    Akther, Aklima
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Naher, Kalsarun
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Parent’s perceptions experiences and attitudes about kangaroo mother care in neonatal wards: A qualitative meta-synthesis2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    The knowledge of facility-based kangaroo mother care (KMC) in Bangladesh is comparatively recent; few facilities have been taking steps towards KMC service. Each year more than a million babies die due to the complication of prematurity. To eliminate the deaths due to prematurity, it is very important to share knowledge about the implementation, experiences, challenges and barriers for KMC practice to promote KMC intervention in the developing countries. Aim: To examine parents’ perceptions, experiences and attitude towards KMC in neonatal wards. Method: This study was a meta-synthesis focusing on parents’ perceptions and experiences of KMC. The included studies used several different qualitative methodologies compiled using Meta ethnography. Result: The results comprised of three categories were identified in this study. The First category was the Barriers towards KMC. This category comprised four preliminary patterns of parent’s perceptions of barriers to have KMC: Separating due to prematurity, Fear of harming, Pain prevented closeness, and Fear prevented closeness. The second category was facilitating factors for KMC, which covered parents’ experiences of the consult support expressed in four preliminary patterns: Own wish for closeness, Having positive experience and Support from the staff. The third category Benefits for KMC included three preliminary patterns of positive perceptions of KMC made by parents: Calming, warming and bonding, connecting with the premature baby and Being able to act as a parent. Conclusion: In this meta-synthesis, the main findings were realized into three categories of KMC- Barriers towards KMC, facilitating factors of KMC, Benefits of KMC. This is a low-cost and effectiveness method of reducing infant mortality. Clinical implications: Health care professionals have opportunities to implement Kangaroo Mother Care in low resource settings. First health care professionals have to be encouraged in all postnatal wards. Secondly, parents need to be aware about KMC so that they can promote their baby’s health and eventually save their baby’s life.

  • 5.
    Andersson, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Ollas, Maja
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskors erfarenheter och strategier i mötet med nyanlända kvinnor på förlossningsavdelning, med fokus på interaktion, tillit och sammanhang: En kvalitativ intervjustudie2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Supporting the woman and her partner is a major part of the midwifery role during delivery. As the number of newly arrived women increases in Sweden, with varied backgrounds and languages, the demands on midwives’ skills increase. Both migration and childbirth can be described as transitions, which can lead to positive development but also to increased challenges. Migration can be a stressful life process for newly arrived woman and the situation of childbirth can contribute to further vulnerability and uncertainty. The midwife has to understand the needs of newly arrived women in order to support and contribute to a positive experience.

    Aim:

    The aim of this study is to describe midwives' experiences and strategies in the meeting with newly arrived women at childbirth, focusing on interaction, trust and context.

    Method

    : Semi-structured interviews with eight midwives analyzed with qualitative content analysis with deductive approach.

    Results:

    The results of the study provided information on strategies that the midwives use to create interaction, trust and context, as well as their experiences. Common to all midwives was that they experienced that good communication with the patient was very important for creating interaction. Ahead of the meeting with a newly arrived woman, the midwives made sure of that they were well prepared. Strategies used to create trust were to show consideration, be present and take time to listen to the woman. By listening to the woman's wishes, providing information and trying to make the woman feel active and making active choices during her childbirth, midwife creates a context for the woman.

    Conclusion:

    The study has shown that midwives have conscious strategies for meetings with immigrated women. There is, however, a need for clearer routines

    regarding the work of immigrated women in the delivery room, increased cultural skills of midwives and more resources to allow more time for these women.

    Clinical application:

    This study, through the strategies of midwives, can guide other midwives to support newly arrived women during childbirth. The study provides suggestions for areas of improvement and aids to improve the meeting and hence the quality of care for these women.

  • 6.
    Banu, Afroza
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Parvin, Shahanaj
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    "There Are Remaining Challenges in Bangladesh" A National Assessment Strategy Supports Reaching International Midwifery Standards Education: A focus group inquiry among midwifery faculty in Bangladesh2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Delivery by unskilled birth attendant is causing many maternal and neonatal deaths. Midwives can reduce maternal and neonatal deaths by providing skilled delivery care. To prepare skilled midwives a National Assessment Strategy for Midwifery Education Standards has been introduced.

    Aim: To describe midwifery faculty members’ perceptions of how to affirm quality midwifery education in Bangladesh using a national assessment strategy.

    Methods: A qualitative research design was chosen using a context-specific accreditation assessment tool, guided by the Global Standards for Midwifery Education. The participants were 33 midwifery teachers, and data were analyzed with content analysis.

    Results: The findings indicate that Bangladesh should be prepared to implement the Global Standards for Midwifery Education Accreditation Programmes. The assessment strategy has prepared the faculty for accreditation and paved the way through the development of standards in the tool, overcoming barriers, and using the possible facilitators.

    Conclusion: There are remaining challenges in Bangladesh regarding "moving midwifery". Midwifery teachers demand for separate faculty from nursing. Promotion system for careers development can be initiated. Updating teachers knowledge, having adequate number of teachers with competencies, and maintained collaboration between teaching and clinical practice organizations are important for "moving midwifery" in Bangladesh.

    Clinical application: The present study results can be useful for midwifery education and clinical practice improvement.

  • 7.
    Begum, Momtaj
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Sultana, Nazma
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Women’s and health care provider perceptions and experiences of bottlenecks in midwifery care: A qualitative meta-synthesis2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Women die from preventable causes during pregnancy and childbirth and often in relation to delays in midwifery care. Professional hierarchies might hamper the rights and desires of midwives in provision of normal birth in terms of the provision of quality care to all women and newborns. In health systems where decision making in normal births are influence by doctors this is particularly relevant, with women themselves subordinate to all health care professionals. Aim: The aim of this meta-synthesis was to examine women’s and health care provider’s perceptions and experiences of bottlenecks in midwifery care related to availability, accessibility, acceptability and quality of midwifery care. Method: This study was a qualitative meta-synthesis with a deductive approach, 15 article were selected for this qualitative meta-synthesis. A framework for the evaluation of quality of care and coverage of health services was used for the deductive approach. Results: Four categories emerged based on availability, accessibility, acceptability and quality of care. The delays were due to less awareness of danger signs of severe complications in the community, and delays in decision making by male family members and less empowerment of women, and lack of collaboration between health care professionals. We also identified how to overcome this situation. Conclusion: Midwifes may provide quality maternal care to all women and children and earn trust from community people to promote normal pregnancy and birth and prevent delays when complications arise. Clinical implications: Midwives can provide continuity care and through collaboration with other health care professionals advocate for women empowerment.

  • 8.
    Begum, Mst. Marium
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Nahar., Most. Nargis
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Parents’ and health care providers’ perceptions and experiences of supportive care in neonatal wards: A qualitative metasynthesis2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Four million infants die with in the first month of life and 27% of these deaths are directly related to low birth weight (LBW) or preterm birth. The main causes of infant death in premature and LBW infants is neonatal infections. It is thus crucial that the infant is taken care of in an appropriate way regarding caring and feeding and that care is provided to improve the child’s chances of survival and to lay the foundation for a healthy life. Aim: The aim of this meta-synthesiswas to examine parent`s and health care providers perceptions and experiences of supportive care in neonatal wards. Method: A qualitative meta-synthesis based on peer-reviewed scientific literature, and meta-ethnographic analysis method. In this meta-synthesis 16 articles were included. Result: The results comprised of two categories, Parents’ perspective of supportive strategies with eight corresponding preliminary patterns and Health care providers’ perspective of supportive strategies with six corresponding preliminary patterns. In the result section, each categories are presented with its corresponding preliminary patterns. The mothers experienced that the baby was unstable and therefore they wanted to be close to the baby at all times if something happened. Important was closeness to the infant is important, parental support according to needs, adequate communication and information with parents, genuine caring and continuous support to get close to the child. It also meant less light and less noise and privacy for the infant and the parent in the NICU ward.

    Conclusion

    Parents wanted to be able to be with his infant as rapidly after birth be reunited in case something happened. The importance of receiving information about their infant’s condition underpinned all communications that the parents undertook with NICU staff both in co-care when together with the child and part-care, when separated. Information for the parents was an important requirement of accepting their situation and immediately affected their anxiety. Clinical implications: The organizers of care must take in account that parents and infants will not be befitted by being cared for apart from each other. When planning for co-care enabling infants to be close to the parents, the mother-baby dyad should be prioritized. Context specific interview studies are suggested on co-care and part-care, parents and care providers perspectives.

  • 9.
    Begum, Mst. Marium
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Nahar, Most. Nargis
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Parents’ and health care providers’ perceptions and experiences of supportive care in neonatal wards: A qualitative metasynthesis2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Four million infants die with in the first month of life and 27% of these deaths are directly related to low birth weight (LBW) or preterm birth. The main causes of infant death in premature and LBW infants is neonatal infections. It is thus crucial that the infant is taken care of in an appropriate way regarding caring and feeding and that care is provided to improve the child’s chances of survival and to lay the foundation for a healthy life. Aim: The aim of this meta-synthesiswas to examine parent`s and health care providers perceptions and experiences of supportive care in neonatal wards. Method: A qualitative meta-synthesis based on peer-reviewed scientific literature, and meta-ethnographic analysis method. In this meta-synthesis 16 articles were included. Result: The results comprised of two categories, Parents’ perspective of supportive strategies with eight corresponding preliminary patterns and Health care providers’ perspective of supportive strategies with six corresponding preliminary patterns. In the result section, each categories are presented with its corresponding preliminary patterns. The mothers experienced that the baby was unstable and therefore they wanted to be close to the baby at all times if something happened. Important was closeness to the infant is important, parental support according to needs, adequate communication and information with parents, genuine caring and continuous support to get close to the child. It also meant less light and less noise and privacy for the infant and the parent in the NICU ward.Conclusion Parents wanted to be able to be with his infant as rapidly after birth be reunited in case something happened. The importance of receiving information about their infant’s condition underpinned all communications that the parents undertook with NICU staff both in co-care when together with the child and part-care, when separated. Information for the parents was an important requirement of accepting their situation and immediately affected their anxiety. Clinical implications: The organizers of care must take in account that parents and infants will not be befitted by being cared for apart from each other. When planning for co-care enabling infants to be close to the parents, the mother-baby dyad should be prioritized. Context specific interview studies are suggested on co-care and part-care, parents and care providers perspectives.

  • 10.
    Björneke, Sara
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Etnell, Ulrika
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskors upplevelser av att arbeta med yoga för gravida - en kvalitativ intervjustudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Yoga during pregnancy has become increasingly popular in Sweden and the western world in recent years. Earlier studies suggest that yoga for pregnant women may increase well-being during pregnancy, reduce fear for giving birth and increase prenatal attachment. Today, yoga for pregnant women is available at private yoga and fitness centres and at certain maternity clinics. However, there seems to be a gap of knowledge about midwifes experiences of working with yoga for pregnant women. Aim: Describe midwives experiences of working with prenatal yoga. Method: Eight semistructured interviews were conducted with midwives who have experience instructing yoga classes during pregnancy. Qualitative content analysis was used for analysis of the material. Result: Four main categories were identified. The categories were Birth Preparation, Well-being during Pregnancy, Prenatal attachment, and Contraindication or Adjustment. Furthermore, there were 11 subcategories and an overall theme: Sense of security and Trust. Conclusion: The midwives experience that yoga during pregnancy can contribute to increased well-being, both mentally and physically, establish prenatal attachment and prepare the pregnant women for childbirth. The midwives emphasize that their professional experiences in midwifery contributes to a deeper dimension in the yoga classes, enabling a safe practise during pregnancy. Clinical application: The study can inspire midwives to work with, or recommend prenatal yoga and inspire to further studies.

  • 11.
    Boberg, Kajsa
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Ismail, Mahabat
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    En jämförelse mellan den självskattadeförlossningsupplevelsen hos kvinnor med normalgraviditet och kvinnor med graviditetsdiabetes: En retrospektiv tvärsnittsstudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: How the midwife treats the women impacts her experience of childbirth. Women with GDM experience the diagnosis as stressful and worrisome, time-consuming and they wish for a pregnancy without GDM. The number of studies about their childbirth experience is low. Aim: A comparison of the self-assessed childbirth experience between women with a normal pregnancy and women with a GDM-diagnosis. To identify factors that can impact on the childbirth experience. Methods: A retrospective cross-sectional study. Data was collected thru a survey, using the VAS-scale, and registerdata from MFR. A total of 391 participated, 326 with a normal pregnancy and 65 with GDM. The material was analyzed using parametric and non-parametric statistics. Result: A total of 36,1% had a negative childbirth experience. It was more common within the GDM-group (55,4%) to have a negative experience than for women with a normal pregnancy (32,2%). Factors correlating with a negative experience was, a high BMI, born outside of Sweden, primiparous and if the women were unsatisfied with the provided pain-relief. Conclusion: Women with a GDM-diagnosis has a significantly more negative childbirth experience, factors related to pregnancy and childbirth showed a correlation with a negative childbirth experience. Clinical application: The results can be used to improve healthcare for women with GDM to contribute to a more positive childbirth experience.

  • 12.
    Crona, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Bengtsson, Johanna
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskor och undersköterskors behov av stöd vid möten med föräldrar som föder barn som inte lever: En kvalitativ intervjustudie med fokusgrupper2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    According to research health professionals are feeling grief, guilt and stress when they meet parents giving birth to stillborn babies. They are in need of support but research about what kind of support is limited.

    Aim:

    To identify midwives’ and assistant nurses’ need of support and what kind of support they need meeting parents giving birth to stillborn babies.

    Method:

    Eight midwives and five assistant nurses were interviewed and distributed in three focus groups. They were asked semi-structured questions based on a questionnaire. The analysis method was qualitative content analysis.

    Results:

    One theme and five categories were identified. The theme was: The will to do good. The categories were: Collegial support, Education, Support from the hospital management, Tutorial and Reflection and To be inexperienced.

    Conclusion:

    The need of support varied but all participants considered they were there for each other as a support and a need of continuity and education in their meetings with parents. They also wished for tutorials with regular occasions where they could meet with different professions in a group. Those participants with longer experience from childbirth care felt more secure in their meetings with parents giving birth to stillborn babies, compared with those with shorter experience.

    Clinical application:

    The study could lead to support being implemented in maternity units, which in the end could lead to better treatment for the affected parents.

  • 13.
    Domeij, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Lennström, Charlotte
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskans erfarenhet av handläggning vid uppkommen grad II-bristning: Kvalitativ intervjustudie med barnmorskor verksamma vid förlossningsavdelning2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Many women sustain a second-degree tear when giving birth vaginally. The work field of a midwife includes managing these injuries. There is limited research regarding this field and the focus tend to be on third- and fourth-degree tears, even though second-degree tears may also result in long-term complications.

    Aim:

    The aim was to investigate the midwife’s experience of managing second-degree tears.

    Method:

    Eight semi-structured individual interviews were conducted with midwives working at a medium large maternity ward located in the middle of Sweden. Qualitative content analysis was used to analyze the material.

    Results:

    Four categories and two subcategories were identified. The categories were: Information, The support of colleagues, The need for follow-ups and Physical examination and the subcategories were: Feedback strategies and Documentation.

    Conclusion:

    The result show that midwives feel insecure when managing second-degree tears, especially the midwives with less experience. The midwives also requested more feedback from the women they sutured regarding their second-degree tears and the midwives also wished for a better follow-up for the women with second-degree tears. The result also showed that the midwives give different information to women regarding their tears. No pronounced routines were found regarding what information to give and in what way.

    Clinical application:

    The results of the study aim to increase the knowledge and to develop routines regarding second-degree tears. More knowledge is needed about information given about the tear and when it is the best time to give information.

  • 14.
    Easmin, Nazma
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Khatun, Hamida
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Family members’ care of the newborn after birth, during maternal-infant separation or in the presence of the mother: A qualitative metasynthesis2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Newborn infants are sensitive and the neonatal mortality remains high in low resource settings for various reasons such as hyperthermia, hypoglycemia and infections. In both low and high income settings the bonding is important for children in the long run. Skin-to-skin care of the newborn both enhances the infant’s wellbeing and health.Aim: The aim of this meta- synthesis was to describe family members’ care of the newborn after birth, during maternal-infant separation or in the presence of the mother.Methods: Methasynthesis with metaethnography as analysis method. 15 scientific articles are included.Result: The content of the care provided is presence, emotional and practical support to the newborn. In presence, close body contact or preferably skin-to-skin contact is the main caring activity. Emotional support is provided through the presence when consoling the baby. Practical support is provided by changing diaper, through breastfeeding support etc. practical activities which in turn enhance emotions (bonding).Conclusion: The mother to the newborn should provide skin-to-skin care immediately after birth of the infant. When this is not possible the father or another family member such as grandmother, sister, or aunt could be close to the infant.Clinical implications: The results from this study can be used to foster midwives to provide evidence based care of the newborn including close contact and preferably skin-to-skin contact with the mother, father or other family member after birth. This to enhance health and wellbeing of the newborn. This thesis could be a lecture in the midwifery education.

  • 15.
    Fåhraeus, Madeleine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Saliba Persson, Chantal
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskors och fysioterapeuters erfarenheter av att möta kvinnor med ökad rectusdiastas efter graviditet: En fokusgruppstudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The abdominal muscle separation between the two rectus abdominis muscles is also known as diastasis recti (DrA) and expands during pregnancy. The duration of the natural recovery takes approximately eight weeks postpartum, but for some people the separation will remain much longer. In this paper, the diastasis will be referred as an increased DrA. According to ICM, midwives should be able to identify what deviates from normal, and if necessary, to collaborate and refer to other professionals. Aim: The aim of the study was to explore midwives and physiotherapists experiences regarding meeting women with increased diastasis recti after pregnancy.Method: A qualitative content analysis with Malteruds method systematic text condensation (STC) of focus group interviews were conducted with a total of nine physiotherapists and seven midwives around Sweden.Results: Four overall areas were identified; Increased body awareness in today's society, Views of increased DrA as a symptom of illness, The lack of knowledge about increased DrA and the acquisition of knowledge through own interest and Views on professional responsibility and the desire for cooperation and guidelines.Conclusion: Midwives and physiotherapists say they lack experience and knowledge regarding increased DrA. National guidelines and a more improved collaboration is needed for safer patient care.Clinical application: The study can inspire workplaces to invest in interprofessional training and establish guidelines based on more extensive research.

  • 16.
    Hjortsberg, Linda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Westerman, Lina
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Hur förändras tilliten till förmågan att amma hoskvinnor som deltagit i traditionellföräldraförberedande kurs via mödrahälsovården?: Ett studieprotokoll inför framtida pilotstudie med mätningav tillit till förmåga att amma med validerat mätinstrument.2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Breastfeeding is recommended by both international and national

    authorities. The breast milk contains all the nutrients the child needs during the

    first six months and has also been proven to protect against a number of diseases.

    Despite the recommendations, breastfeeding decreases. Studies that investigated

    why have shown that many factors fall under the concept of self-efficacy. Thus,

    women's breastfeeding self-efficacy is an important factor to study. Breastfeeding

    is under the midwife's area of competence and a majority of all first time parents in

    Sweden are preparing for parenting through parental prepatory course.

    Aim:

    The purpose of this study protocol was to formulate detailed project plan for

    a pilot study to investigate how breastfeeding self-efficacy change among women

    who participate in parental prepatory course through the maternity healthcare.

    Method:

    A quantitative approach with prospective longitudinal design. By

    Breastfeeding Self-Efficacy Scale Short Form (BSES-SF), a validated instrument

    for measuring breastfeeding self-efficacy, women's breastfeeding self-efficacy is

    planned to be measured before and after the course and eight weeks postpartum.

    Also socio-demographic data is planned to be collected.

    Discussion:

    A detailed method discussion was conducted to discuss the

    advantages and disadvantages of the chosen method. Also, the method discussion

    presents how other designs and plans for how future major studies may be

    conducted to investigate women's breastfeeding self-efficacy.

  • 17.
    Hultman, Elin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Skarp, Therese
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskans upplevelser och uppfattningar av professionella, sociokulturella och hälsoekonomiska barriärer som hindrar kvinnor att bestämma över sin egen kropp.: En kvalitativ intervjustudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Sexual and reproductive health is a human right and involves the right to make decisions concerning your own body and care. The midwife mostly meets and care for women and have an important role in defending and advocating women’s rights. Today there are global political influences that restricts women’s rights even though Sweden is considered to be one of the world’s most equal countries, there can be structures and factors in the Swedish society that affects women’s ability to make decisions about their own bodies in a negative way.

    The aim:

    To investigate midwives perceptions and experiences concerning professional, sociocultural and health economic barriers for women regarding decisions about their own bodies.

    Method:

    A qualitative content analysis with a deductive approach. Data from eight semi structured interviews with Swedish registered midwifes, active in different areas of the midwife profession, was analyzed based on the framework "What Prevents Quality Midwifery Care".

    Result:

    The professional barriers that the midwives perceived resulted in three subcategories: "Laws, clinical guidelines and policies", "Knowledge, education and profession" and "Caretakers personal opinions and commitment". Sociocultural barriers were categorized in: "Politics, equality and the society’s ideals", "Culture, religion and family relations", "Language" and "Personal abilities". The health economic barriers were divided in to: "Lack of time and staff" and "Costs and resources".

    Conclusion and clinical applicability:

    This study shows that there are professional, sociocultural, and health economic barriers that affects women’s autonomy in the Swedish society according to the midwives’ perceptions. The study can help caretakers increase their understanding and competence in meeting with women in care and help them strengthening their position in the society as well as on a personal level. This study can give a greater understanding for the midwife’s role when it comes to helping individuals in an exposed situation, by strengthen the women’s autonomy and sense of control. The study can also help caretakers to increase critical thinking regarding themselves in their own cultural context and preunderstanding for other individuals.

  • 18.
    Jahan, Mushrath
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Akter, Laily
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Women’s Perceptions and Experiences of Barriers and Facilities for Breast-feeding Initiation During Post-partum Period: A qualitative metasynthesis2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Delayed initiation of breastfeeding for more than one hour after birth is associated with increased neonatal morbidity and mortality. Aim: The aim of this meta-synthesis was to examine women’s perceptions and experiences of barriers and facilities for breastfeeding initiation during the postpartum period. Method: The study design was a qualitative meta-synthesis focusing on maternal perceptions and experiences of breastfeeding initiation. Eighteen qualitative articles with several methodologies were included after assessment of relevance and quality. The analysis was based on meta-ethnographic method. Result: The meta-synthesis report identified three categories and 28 sub-categories. Category I: Barriers to establishing breastfeeding described factors that had an impact on breastfeeding initiation. Category II: Facilitators to establish breast-feeding describes supportive factors as experienced by the mothers to initiate breastfeeding. In Category III: Satisfaction maternal confidence for breastfeeding support services was identified. Conclusion: This meta-synthesis study identified factors that impacted maternal confidence. Based on these, it is recommended that there is a need for evidence-based practical knowledge regarding initiation of breastfeeding, social and community awareness, husband and family support, and prenatal and antenatal breastfeeding education. These factors also showed the importance of health workers and midwives providing skilled guidance on breastfeeding initiation and help to resolve difficulties. Clinical implications and further research: The findings from this study can be used for educational purposes, and to create awareness about the evidence for midwifery care. Further country specific research is suggested with both qualitative and quantitative approaches.

  • 19.
    Jansson, Amanda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Blomström, Monica
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Beskrivning av Sensus amningskurs för blivande föräldrar och förslag på en förbättrad studiedesign för att utvärdera kursen2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    The breast milk supplies the baby with all the nutrition it needs and according to the WHO, breastfeeding is recommended as the only food during the first six months of life. Breastfeeding gives the child proximity, security and strengthening the connection. Studies have shown that women began to breastfeed as a result of breastfeeding education. Studies have also shown that there is a need and demand for breastfeeding educations.

    The aim:

    The aim was to describe what the educational Sensus breastfeeding course for becoming parents contains, how the course is ment to be evaluated and difficulties with the design. The aim was further to propose an improved design for how an evaluation of the Sensus breastfeeding course can be designed to find out how women's self-efficacy in breastfeeding is affected by a breastfeeding course during pregnancy.

    Method:

    The original plan is presented as a quantitative method and a proposal for an improved study design is presented as a qualitative method.

    Conclusion:

    According to the plan an evaluation of the Sensus breastfeeding course is planned to be conducted with a quantitative design, not going to give a fair and objective picture of parents self-efficacy in breastfeeding. Deficiencies are found in the original plan and they will be identified in the essay. A proposal for an improved design for evaluation of the Sensus breastfeeding course for becoming parents has been proposed.

    Clinical applicability:

    It is important to evaluate whether different interventions and programs can give the woman any benefit, if a breastfeeding course like in this case is recommended in the standard healthcare can give the woman an increased self-efficacy in her breastfeeding. It should also be reflected in whether the breastfeeding course should be recommended to all pregnant women enrolled in the maternal healthcare center by midwife despite the fact that the breastfeeding course not only is based on evidence.

  • 20.
    Jobs Roos, Kesti
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Roos, Kristin
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Gynekologisk undersökning vid eftervårdsbesök -barnmorskans erfarenheter av att bedöma bäckenbottensstrukturer: Kvalitativ intervjustudie med barnmorskor verksamma inommödrahälsovården2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Undergoing pregnancy and childbirth, entails great strain on a woman’s body.

    When giving birth vaginally, tears may occur, which may cause problems for the woman to a

    different extent. Through the postpartum check-up, midwives have an opportunity to identify

    problems that may have occurred and detect undiagnosed perineal injuries.

    Aim:

    The aim was to describe the midwife’s experiences of pelvic examination and to assess

    pelvic floor structures at the postpartum check-up.

    Method:

    Semi-structured interviews were conducted with eleven midwives working in

    maternal health care. Thematic analysis was used to analyze the material.

    Results:

    One global theme, three organizing themes and ten basic themes were identified.

    The global theme was:

    the woman´s needs. The organizing themes were: to support through

    the approach; to promote health

    and areas for improvement. The basic themes were: to be

    responsive; to confirm; to see individual needs; to motivate for examination; to motivate selfcare;

    education; structure; documentation; time aspect

    and follow-up.

    Conclusion:

    Midwives in maternal health care play an important role in health promotion and

    working with women's needs. They try to personalize each visit and adapt the information

    given, but their experience is that there are difficulties in motivating women to undergo a

    pelvic examination. More education, a better and clearer structure for assessing the pelvic

    floor and an improved way of addressing problems that may persist after childbirth may

    enable women getting the help and care they need.

    Clinical application:

    The study results highlight an existing need for more knowledge,

    education and structure. Attention to this can lead to discussion of further development and

    the subject can also be raised among other healthcare providers.

  • 21.
    Johansson, Isabelle
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Westin, Linn
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Att vårda kvinnor i samband med inducerad abort - Barnmorskors och sjuksköterskors erfarenheter: En kvalitativ metasyntes2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    : Midwives and nurses all over the world meet with and care for women who, for various reasons, are undergoing induced abortion. It may be a challenge that requires both knowledge and support for those working in abortion care.Objective: To describe midwives and nurses’ experiences of caring for women who undergo induced abortion. The word experience includes perceptions based on experiences. Method: The study was conducted as a qualitative metasynthesis using meta-ethnography as analysis of data. Twenty-seven (27) peer-reviewed scientific articles were included in the result. Result: Three main categories and ten different patterns highlighted the midwives and nurses' experiences of caring for women undergoing an induced abortion. These were doing a good job by being supportive, putting own values aside and with the goal to create good experiences for the woman. Barriers to qualitative abortion care included negative attitudes from the surroundings, own feelings, receiving the fetus and various issues at the abortion care clinics. The third category was the caregivers’ needs which included support and knowledge. Conclusion: The abortion-seeking woman is in need of support and non-judgmental attitudes from caregivers. Midwives and nurses need knowledge and support in the work of abortion care. Lack of support and knowledge can affect midwives and nurses’ attitudes towards induced abortion as a woman’s right, which in turn can affect the women in need of abortion care.

  • 22.
    Khatun, Baby
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Khatun, Mst. Hosneara
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Women’s and Partners’ Perceptions and Experiences of Supportive Midwifery Care during Second Stage of Labor Pain: A qualitative metasynthesis2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Childbirth is a personal and individual journey that is different for every woman. Perception of the birth experience is thought to be influenced by many factors, the most significant of which may be the type of delivery. The second stage of labor (delivery or birth stage) starts from full dilation of the cervix or when the woman feels the urge to push to complete expulsion of the fetus. The care and support provided during this phase can have strong influence both on the birth giving experience as a whole and on the pregnancy outcome. Aim: The aim of this meta-synthesis was to examine women’s and family members’ perceptions and experiences of the second stage of labor in order to illuminate components of midwifery support they deemed ’supportive’. Method: This study design is a qualitative meta-synthesis. Qualitative articles were included and analyzed by meta-ethnographic method. electronic searches were performed using the following databases: CINAHL, Web of Science, Google, Pubmed and manual searches. After assessing for relevance and quality by Johanna Briggs Institute (JBI QARI) Critical Appraisal Checklist, 15 articles were included, synthesised and categorised in the analysis. Result: This meta-synthesis describes three main categories and fifteen sub-categories. The first category “A professional midwives” includes being skilled and competent, professional planning, motivate upright position of birth process, encourage the bonding between mother and baby, establish women empowerment, and performing quality of midwifery care. The second category: “A genuine encounter” includes being trustworthy, kind, and protective with a positive attitude, being sympathetic, knowledgeable about pregnancy, encouraging breathing exercises and develop birth plans, having good relationships. The 3rd category includes active communication, enhancing power of the father, accurate and clearly messages. Conclusion: The result of this study should support midwives in providing quality care to mothers during labor, thus providing satisfaction and positive experiences of the mother’s labor. Midwives can enhance fathers’ feelings of involvement and participation by attentiveness through interaction and communicating skills. Clinical implications: This study aim women/family members’ perception and experiences second stages of labor. There is a need to improving the educational status, improving policy and practice of health care program and facilitate the necessary resources. The second stage of labour are condition which have need to extra support and encouragement of women during the delivery as well as midwifery special care.

  • 23.
    Khatun, Mst Monira
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Akter, Parvin
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Save the Children-mentors’ experiences of implementing midwifery model of care in clinical settings in Bangladesh: An interview study with qualitative approach2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The Government of Bangladesh recognizes the important role midwives play in preventing maternal and neonatal mortality and morbidity, and their integral link to improving maternal and neonatal health service provision. Thus Save the Children Mentors are created to support and introduce midwives in Bangladesh. The programs clinical mentors will play a critical role to ensuring in-service-training to midwives who provide services in midwife-led care facilities.

    Aim: The aim of this study is to describe Save the Children mentors’ experiences of implementing midwifery model of care in clinical setting in Bangladesh.

    Methods: A qualitative design was chosen. Fourteen interviews were performed with Save the Children Mentors’ in Bangladesh who were currently working in the Strengthening National Midwifery Program. Data was analyzed by inductive content analysis.

    Results: There were all kinds of gaps in the organization of care, in care practices and in community awareness regarding attitudes and knowledge of the midwifery model of care. The Save the Children Mentors learnt how to overcome the hurdles over time while motivating, educating, mentoring, sensitizing and while communicating with manages, health care providers and community members on how to manage implementation of midwifery model of care.

    Conclusion: It is important to contribute the government to improvements and fill the gap of evidence based care to implement midwifery model of care in Bangladesh. Save the Children mentors are making aware people to collaborate and support the midwives as it is a mandate of the government to implement the new cadre and gradually the situation is being changing.

  • 24.
    Linde, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Karlsson, Synnöve
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Mötet med barnmorskan - gravida kvinnors utsatthet för våld i nära relationer och barnmorskans roll i omvårdnaden av dessa kvinnor: En kvalitativ metasyntes2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Intimate partner violence is a serious threat against women's security, well-being and health. Women all over the world are subject to different kinds of violence and pregnant women are no exception. The violence can increase during pregnancy among the women that earlier has endured violence, with a risk for both the women’s and unborn baby's health. Midwives have a unique opportunity to care for and support these abused women.

    Purpose:

    To describe pregnant women’s encounter with the midwife with focus on exposure to partner violence and the role of the midwife.

    Method:

    A meta-synthesis which included both qualitative literature studies and quantitative studies with qualitative elements were used in the result. Articles were searched through databases as PubMed, CINAHL, PsycInfo and Web of Science and these were analysed through meta-ethnography.

    Results:

    The study showed that time, knowledge and confidence were important factors that could cause women in revealing to midwives about violence during pregnancy. Both women and midwives had to the most part the same patterns that they spoke about as both obstacles and help for disclosure of violence in care for women in pregnancy.

    Conclusion:

    The pattern matched well between women’s and midwive’s perceptions of the problems seen in violence during pregnancy. Trusting the midwife’s encounter and knowledge, were seen as the most important issues for women to feel safe in revealing violence during pregnancy.

    Clinical implications

    : Basic education about violence that is already under the supervision of midwives can be a way to give midwives a better prerequisite for their new role. In order to maintain and develop knowledge of violence, continuing education should be continued for legitimate midwives, which in turn provides better conditions for midwives to meet women who are pregnant with violence.

  • 25.
    Ljungkvist, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Sandén, Mariell
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Latensfasen - i samband med graviditet och förlossning: En begreppsanalys2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: A childbirth begins with a latent phase that goes into an active phase and then into the delivery stage of childbirth. The latent phase can be difficult to define clinically and can vary so much that there is no normal interval and the latent phase of labor is unclear as a concept.Aim: The aim was to increase an understanding of the concept latent phase of labor relating to pregnancy and childbirth.Methods: This study is a concept analysis and to increase the understanding of the chosen concept, latent phase of labor, the study is based on Walker Olszewski and Avant Coalson's mode. The study included both a theoretical phase and a field study phase where five midwives in obstetrics and maternity care were interviewed.Results: In order for the concept of latent phase of labor to exist, conditions are needed, for example pregnancy and symptoms of labor. And a result of the concept becomes a consequence, for example hospital care. The latent phase of labor is a phase that is diffuse and difficult for many midwives to judge, the woman must almost always come in for examination to know where in labor progress she is. Criteria for when the latent phase of labor passes to active phase varies widely internationally and women experience the latent phase of labor differently in intensity and length. Therefor it is important that the midwife is understanding and provides moral support.Conclusion: Five attributes have been found during the study, diffuse pain and distressing menstruation pain, short and irregular contractions, strength and force in the contractions, painful contractions, nothing or a small progress on the cervix, the latent phase of labor cannot exist without these attributes.Clinical applicability: With this study we wish to create comfort and reduce confusion among women by making the concept latent phase equally among midwifes.

  • 26.
    Olsson, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Tengvall, Helena
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskans roll i sex- och samlevnadsundervisningen i grundskolan: En kvalitativ intervjustudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Today, most of the sex education takes place in school. Studies shows shortcomings in this education and that students experience shortage of the knowledge wanted regarding this subject. Research has also shown that young people prefer to accomplish sex education with someone who feels comfortable and has good knowledge of the subject. The main subject of midwifery is sexual and reproductive health and rights. However, there is a limited amount of studies conducted regarding midwives involvement in sex education in schools. Purpose: The aim of this study was to highlight the role of the midwife in health-promoting public health work with sex education for adolescents in school. Method: Semi-structured telephone interviews were conducted with four teachers who taught sex education at high school and five midwives with experience of sex education. The collected material was analyzed according to Malterud's systematic text condensation. Result: The result showed that the midwife's health promotion work in school was conducted in a few different ways. Partly through lectures and partly by students visiting the youth health center (ungdomsmottagning). The way in which the work was done was due partly to the school's demand and partly to the availability of the midwife. The average time that the midwife was teaching students were between 30-120 minutes, which were distributed on one and the same occasion. The midwife's role in school was described as being proficient, competent and comfortable talking about sex. The fact that the midwife was unacquainted meant that the students felt comfortable and it was easier to ask questions about sensitive subjects. Conclusion: The conclusion of the study is that there is a need for midwifery skills at school and that, in spite of this, there is no clear and obvious role of the midwife in school education. Clinical applicability: This study can be used to support the midwife's work in sexual education in school. The study can also be used as a basis for establishing cooperation between midwife and school.

  • 27.
    Parveen, Shahanaz
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Zahan, Mauluda
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Akter, Mst. Noormahal
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Sexual and Gender Based Violence in the Midwifery Education in Bangladesh: A focus group discussion study with midwifery and nursing educators and certified midwives2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Worldwide, sexual and gender based violence is a significant problem which affects public health and human rights. Since the education for midwives is new in Bangladesh, and there are indications of widespread violence against women in the country, it is central to investigate how the topic is addressed within the midwifery education.

    Aim:

    To examine how sexual and gender based violence is addressed in the midwifery education in Bangladesh and identify potential needs for improvement, from the perspective of midwifery and nursing educators.

    Methods:

    A qualitative inductive design was used in focus group discussions (FGDs) with 29 midwifery and nursing educators. Data was analyzed by qualitative content analysis.

    Results:

    The content related to violence in the curriculum of midwifery education in Bangladesh was not considered sufficient for the students to gain sufficient knowledge or tools for practical work. Future midwives need theoretical and practical knowledge, including a broad base of basic knowledge, communication and trust building skills, skilled educators and varied learning methods. Society and community can act as both a facilitator and barrier for midwifery student's possibilities to be skilled in encountering women exposed to violence.

    Conclusion:

    To improve the midwifery education there is a need to strengthen the midwifery curriculum in line with WHO guidelines within the field of violence. Midwifery students need clinical practice to learn to identify, communicate and support women subjected to violence. Minimization of identified barriers may help to improve the confidence level of future midwives and enable them to give evidence based up-to-date care freely and independently, and to link women with available services. For this, competent midwifery educators and networking are central.

    Clinical application:

    There are needs to review the midwifery curriculum according to the WHO standard guidelines and to provide more practice opportunities to support midwifery students in their process of becoming competent midwives. Providing training for midwifery educators can upgrade their knowledge to make them more ready and skilled in guiding the students in the field of sexual and gender based violence.

  • 28.
    Parvin, Most Nargis
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Moni, Mosammat Ratna
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    "Moving" midwifery in Bangladesh: Bangladesh Midwifery Society support to its members and to the country: An interview study with members of the Bangladesh Midwifery Society2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    A midwife association is defined by ICM as a platform for developing strong, supportive, positive relationships among midwives and between the profession of midwifery and other stakeholders such as governments and health care providers. Aim: To describe Bangladesh Midwifery Society members’ perceptions of support provided by BMS, directly to its members and indirectly by ‘moving’ midwifery in the society in Bangladesh. Method: Individual interviews and content analysis. Results: Bangladesh Midwifery Society is directly and indirectly beneficial in supporting individual members and the midwifery profession. Particularly Bangladesh Midwifery Society promotes the establishment of a midwifery profession by providing quality midwifery care to women and newborn, promoting the regulatory body and quality midwifery education in Bangladesh. Conclusion: Bangladesh Midwifery Society is a key player in promoting the establishment of a midwifery profession by providing quality midwifery care to women and newborn, promoting the regulatory body and quality midwifery education in a country where midwifery is being initiated. Clinical application: This study is to be of favor to the upward existing setting of midwives in this country and in countries with the same situation of initiating the midwifery profession.

  • 29.
    Rani Biswas, Gita
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Khan, Archana
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Birth giving mothers’ experiences and perceptions about midwifery support during first stage of labour: A qualitative metasynthesis2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Pregnant women’s expectations regarding midwives’ care during first stage of labour are often positive and when these are not met, they may be dissatisfied and eventually have negative experiences of the labour and birth experiences. The care and treatment and attitudes during this phase can have strong influence both on the birth giving experience as a whole and on the pregnancy outcome. The support provided during the delivery is identified as an important factor in this regard, and midwives are central in providing this support.

    Aim:

    The aim of this is to examine mothers’ perceptions and experiences of first stage of labour in order to illuminate the supportive components of midwifery care.

    Method:

    This study is a meta-synthesis. It is based on qualitative meta-ethnography and includes 13 articles, quality assessed by the Johanna Briggs Institute for Evidence Based Nursing Quality Assessment tool and thereafter synthesized and categorized.

    Results:

    Three important components of supportive midwifery care were found, which represents the three main categories 1) A professional midwife 2) A present midwife 3) Individualized care. A professional midwife should support the woman in coping, be

    knowledgeable about labour and being able to monitor signs and symptoms, support with labour pain, provide a supportive environment, be assertive and communicative and provide emotional support through empowering words. Being supported by a present midwife meant being welcomed, having satisfying interaction and dialogue and to be given prompt attention. Individualized care included that a midwife could adjust the care according to needs and have a clear documentation.

    Conclusion and clinical implications:

    Three categories and its pattern have been discussed in this thesis. Individual care provided by professional and present midwives is central. This will help mothers to get proper services and ensure safe motherhood. It also endorse the midwives to be more benevolent in the services provided. Midwives can be guided through this thesis and the service of mother can thereby be improved. Professional midwives need to enhance their communication skill and the manner of assertiveness. Present midwives need to emphasize on their interpersonal skill. It is also recommended that midwives should have a welcoming manner, and create a friendly environment for welcoming a new born in this world.

  • 30.
    Rani Raha, Pronita
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Basri, Rabeya
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Comprehensive Sexual and Reproductive Health Care in Humanitarian Setting: A qualitative approach among midwives in Cox’sBazar, Bangladesh2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Inadequate access to Sexual and Reproductive Health (SRH) Care contributes to maternal morbidity and mortality in low resource settings and especially in humanitarian settings such as Cox Bazar in Bangladesh. More than 1.3 million Rohingya refugees are affected an estimated 316,000 women of reproductive age sheltering in Cox-Bazar after they have escaped from Myanmar. They live in spontaneous overcrowded settlements, the humanitarian needs are considerable and women are at high risk of gender-based violence. Around 64.000 women are pregnant and 2500 experience complications and their access to SRH care is limited. There is a lack of data on the quality of care women receive during early and late pregnancy in humanitarian settings and there is a need to provide scientific evidence to evaluate the effectiveness of SRH interventions delivered in humanitarian crises.

    Aim: The aim of this study will explore midwives experiences of providing Comprehensive Sexual and Reproductive Health Care in Humanitarian Settings (Cox-Bazar). More specifically to illuminate the barriers and facilitating factors for women‟s access to safe abortion and family planning in humanitarian crisis

    Methods: An inductive qualitative design was chosen. Data were collected through In-depth interview based on a topic guide and analyses by inductive content analysis. A pre-defined topic guideline was constructed for the IDI allowing the midwives to share their experiences and probe in to issues of significance for the research questions. The interviews were performed on a place and time chosen by the interviewee. Informants are midwives (n= 15) engaged in providing sexual and reproductive health care in Cox Bazar, Bangladesh and were recruited based on the inclusion criteria‟s: three years Diploma in Midwifery completed registered with the Bangladesh Nursing and Midwifery Council and have a at least 2 month working experience in health facilities in Rohingya influx areas at Cox‟s Bazar. The recorded IDIs have been transcribed along with the notes taken during the interviews. The transcripts will be analyzed using inductive Content Analysis where emerging codes will be discussed and re-evaluated to reach consensus and codes divided into categories and furthermore the identification of a theme. 3

    Results: The study findings illuminated the midwives experience to provide care in the humanitarian setting in Cox,s Bazar. Inadequate supplies, space, un-availability of medical doctors in humanitarian context, and inadequate pre-service education and training of informants were identified as structural barriers to provide quality care of comprehensive SRH care. Harmful cultural beliefs, social norms & values about modern contraceptives manipulate the women to choose and use family planning methods and receive care during early and late pregnancy were expressed by the respondent as a cultural barriers to provide quality care. Counseling on sexual and reproductive health issues by the health care providers were identified as a motivating factors of the women for seeking health care were the expressed as an opportunities for improvements in the existing health care system in humanitarian setting were highlighted in this study.

    Conclusion: Comprehensive Sexual and reproductive health is a significant public health need in all communities, including those facing emergencies. It highlights the fact that midwives and paramedics were recognize their fundamental role in detecting cultural norms and ideological opposition to family planning, abortion and other sexual and reproductive health matters often impede access to services, stigma associated with sex, unintended pregnancy, abortion, and concerns about privacy, may inhibit many from using services.

    Clinical application: Study finding will help the policy maker, to identify the professional gaps and equip them to meet the challenge of health care delivery system in humanitarian context. In addition, evaluate the readiness of health care providers to provide comprehensive sexual and reproductive health and rights. Policy expert will be benefited to finally, the finding will explore the areas need to be conduct research in future.

  • 31.
    Sandbäck, Evelina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Selin, Jonna
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    "Det väcker fler etiska funderingar när det gäller äldre personer": En kvalitativ studie om socialsekreterares upplevelser kring den etiska synen på äldre med alkoholmissbruk2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study was to investigate how social workers looked at the possibility that their ethical view of elderly with alcohol abuse affects their assessments. We used semi structured interview, where we interviewed six social workers that works with addiction. The result showed that the social workers felt that the biggest difference between people over and under the age of 65 was the needs, which meant that the assessments of contribution differed. The result showed that the social workers resonated very much about LVM, since coercion in relation to older people created many ethical dilemmas. The personal values of the social workers did not affect the assessment themselves, but they were always there, both in private and working life. In order to avoid their own values affecting their assessments, this was frequently discussed between colleagues. The result showed that ageism is both in structure and jargon, but that there was no opportunity for ageism to influence the social security assessments.

  • 32.
    Skogh, Thérése
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Todal, Kristin
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Föräldrars upplevelser och uppfattningar i samband med intrauterin fosterdöd: En kvalitativ metasyntes2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Losing a baby can be the hardest thing that happens to a parent. Every year, about 2.6 million babies die in intrauterine fetal death (IUFD). The majority occur in low-income countries, in Sweden approximately 440 children die per year. High Body Mass Index (BMI), age over 35 years and smoking are risk factors that can lead to IUFD. The cause is sometimes unclear and parents need support and confirmation from close associates and healthcare professionals. The midwife is responsible for meeting the parents' needs. Purpose: The purpose was to highlight parents’ experiences and perceptions associated with IUFD. Methods: Qualitative meta-synthesis. In total, 29 scientific studies were analyzed and compiled for this study. Data was analyzed by meta-ethnography with inductive approach. Results: Women often felt that something was wrong. Parents perceived that support from close associates and healthcare professionals as well as clear information and communication was important. This was not always experienced and sometimes it was difficult to talk about the IUFD. Making memories with their child was important and many felt alone after an IUFD. The way back was often long and complicated. Conclusion: IUFD is a traumatic experience for parents and the care they received during this time can have a lasting impact on their well-being. Clinical applicability: The study can help to develop and improve education- and work routines for midwives.

  • 33.
    Stenmark, Christel
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Johansson, Madelene
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Prenatal förberedelse och förlossningsrädsla: En metasyntes2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Fear of childbirth is not uncommon and may adversely affect the woman and her partner. Through prenatal preparation, the woman and her partner are offered the opportunity for education, information and physical and psychological training before childbirth. During pregnancy, the midwife's professional role is to provide information, counseling and call support in all aspects of sexual and reproductive health. Midwife should be able to identify women who are in need of additional support in connection with childbirth. Aim: To describe the importance of prenatal preparation in childbirths based on the perspective of women, partners and midwives. Method: The method has been inspired by qualitative metasynthesis with meta-ethography as the analytical method. Result: The women experienced a community with other participants when they participated in prenatal preparation, they perceived that they could better manage the delivery. The preparation made the women gain self-confidence and they could be more present during childbirth. The preparations also gave them a better delivery experience. The result indicates that there are pros and cons of prenatal preparation. Women can, in addition to the above-described benefits, also experience disadvantages of participating in prenatal preparation. They could experience the preparations as scary and this could strengthen their fear of childbirth. Conclusion: Prenatal preparation during pregnancy can provide support for women with fear of childbirth, but it can also enhance fear. Clinical applicability: It is important as midwife to invite all pregnant women to participate in the parental care programs offered in maternity care. It is also important that the partner is included in the prenatal preparations offered in maternity care.

  • 34.
    Tinnerholm Hultman, Liselott
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Westman, Alexandra
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Förstföderskors förlossningsupplevelse och deras uppfattning av barnmorskans stöd2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim

    The aim of this study was to describe primiparas birth experience, their perception of the midwives support and describe correlation between birth experience and midwifery support.

    Method

    The study was carried out as a quantitative cohort study where chosen variables was studied and described in relation to the aim and question formulations. The data was obtained from an earlier performed survey and was presented in charts and within the text of the study. The analysis was done in SPSS programme of statistics.

    Results

    The result showed that half of the women included in the study felt mixed feelings about their labour, closely followed by women with a positive birth experience. Almost all women (98,7%) had a positive perception of the midwife and felt support from the midwife. Within the results there is no significant correlation between primiparas positive and negative birth experience and the perception of the midwives attributes and support.

    Conclusion

    The results indicate that the midwives attributes and support contributed to a positive birth experience for primiparas. The midwives support was also important for women regardless of feelings related to their birth experience. However, no significant correlation was found between primiparas birth experience and their perception of the midwives support. Further studies are needed to explore potential association between negative birth experience and midwifery support.

  • 35.
    Wennerlund Abdelli, Céline
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Dahlström, Sara
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Upplevd förberedelse inför mötet med föräldrar som förlorat barn på grund av intrauterin fosterdöd: En kvalitativ studie med barnmorskestudenter2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Every year 440 intrauterine fetal deaths are reported in Sweden. Practicing midwives may encounter parents who have lost children due to intrauterine fetal death. Therefore, midwives need knowledge and understanding on how to, in the best way possible, work with parents who have been affected. Studies describe that student midwives are not always given adequate education to care for parents who have lost children due to intrauterine fetal death.

    Aim:

    To investigate whether student midwives perceives that they are prepared to care for parents who has lost children due to intrauterine fetal death.

    Method:

    A digital survey containing three open questions was sent to student midwives who was undergoing the final term of midwifery education in Sweden. A qualitative content analysis with inductive approach was chosen to analyze the study result.

    Results:

    After processing the data and further analyzing, five categories were identified who which answered to the purpose of the study. One overall theme emerged from the categories and its content: "It does not feel good to be unprepared".

    Conclusion:

    The student midwives did not feel prepared to meet parents affected by intrauterine fetal death. This was mainly due to the fact that they were not given the opportunity to participate in the care of parents who give birth to non-living children. There was a clear wish from the student midwives to receive practical preparation, supervision and support during the education's obstetric practice. Previous work in the field of care gave some of the student midwives some preparation to care for parents who lost children due to intrauterine fetal death.

  • 36.
    Z Ager, Emily
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Helsing, Emma
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Sexualitet, självbild och kropp: En kvalitativ metasyntes om hur kvinnor förhåller sig till det heteronormativa samhällets förväntningar2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Sexuality is important in a person's life. In our society there are norms and expectations that we all are expected to adapt to; these can affect sexuality and sexual health. To describe how women relate to their sexuality, self-image and body from a heteronormative society can give midwives a deeper understanding of women´s living conditions. Aim: To describe how women relate to their sexuality, self-image and body based on norms of society. Method: Meta-synthesis including qualitative data from 25 articles were included in the result. The analysis was done by meta-ethnography. Result: The women adapted and were flexible based on prevailing norms of society by redistributing power in the relationship, coping with lack of education and taboos, adapting to existing gender roles, and striving to fulfill ideals. These are presented as the four main categories in the result. Conclusion: Women shape their sexuality, self-image and body based on social norms and prevailing power structures. They adapt and are flexible, which affect their self-image and sexual health. The self-image and sexual health are characterized by a limited power to shape their own lives. Women need awareness of this situation in order to have the power to protect equality in their own lives and to promote equality in society. Clinical implication: Midwives as a professional group can support women of all ages to embrace their sexuality and see the beauty of their bodies. Inclusion of midwives in school sexual education; In conversation about lust, body acceptance and consent, could help improve sexual health for young women. When the midwife in her daily work meets women, who try to comply with social norms and expectations in different ways, this meta-synthesis can help in reflection on the midwifery's values about gender equality and the treatment of women in different life situations.

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