Background: Pregnancy and childbirth are significant events in many women’s lives, and the prevalence of depressive symptoms increases during this vulnerable period. Apart from well documented cognitive, affective, and somatic symptoms,... more
Background: Pregnancy and childbirth are significant events in many women’s lives, and the prevalence of depressive symptoms increases during this vulnerable period. Apart from well documented cognitive, affective, and somatic symptoms, depression is associated with physiological changes, such as reduced heart-rate variability (HRV) and activation of the inflammatory response system. Mindfulness Based Interventions may potentially have an effect on both HRV, inflammatory biomarkers, and self-assessed mental health. Therefore, the aim of this study was to assess the effects of a Mindfulness Childbirth and Parenting (MBCP) intervention on HRV, serum inflammatory marker levels, through an RCT study design with an active control group. Methods: This study is a sub-study of a larger RCT, where perceived stress was the primary outcome. Participants were recruited through eight maternity health clinics in Stockholm, Sweden. The inclusion criteria were being a woman with a history of depres...
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Interview guide, translated. (DOCX 22 kb)
Research Interests: Sociology, Depression, Mindfulness, Stress, Anxiety, and 5 moreExperience, Childbirth, ANXIETY, Postpartum, and Antenatal
Abstract Incorporating systematic evidence with clinical expertise is a key element in the quest to improve quality of care and patient outcomes. The evidence supporting skin‐to‐skin contact in the first hour after birth is robust and... more
Abstract Incorporating systematic evidence with clinical expertise is a key element in the quest to improve quality of care and patient outcomes. The evidence supporting skin‐to‐skin contact in the first hour after birth is robust and includes significantly improved outcomes for both mother and infant. This paper compares available iterative data about newborn behaviour in the first hour after birth to further describe the observable behaviour pattern and to provide clinical insight for further research. Although the evidence for positive outcomes through skin‐to‐skin contact are robust, there is a dearth of research specifically focused on clinical practice. The methodology considers the four available data sets that used Widström's 9 stages, which consists of studies from Japan, Sweden, Italy and the United States, examining the parameters of each stage across settings from around the world. This research provides an expanded understanding of the timing of the newborn's progression through Widström's 9 observable stages. We found that newborns in all four data sets began with a birth cry and continued through the remaining stages of relaxation, awakening, activity, rest, crawling, familiarization, suckling and sleeping during the first hours after birth and consolidated the data into a Sign of the Stages chart to assist in further research. The evidence supports making a safe space and time for this important newborn behaviour. Clinical practices should encourage and protect this sensitive period.
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Research Interests: Psychology, Nursing, Qualitative Research, Midwifery, Medicine, and 8 moreThematic Analysis, Focus Group, Psychosocial, Skin to Skin Contact, Public health systems and services research, How to Remove Skin Tags, Guidance and Counseling Intervention Programs, and Paediatrics and reproductive medicine
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Mindfulness-based cognitive therapy (MBCT) was originally developed to prevent recurrent depression, but may also be of relevance for patient groups in the field of health psychology. The present paper gives a descriptive overview of... more
Mindfulness-based cognitive therapy (MBCT) was originally developed to prevent recurrent depression, but may also be of relevance for patient groups in the field of health psychology. The present paper gives a descriptive overview of clinical trials conducted at theUnit for Psychooncology and Health Psychology (EPoS) with the overall purpose of exemplifying research-related and clinical considerations in the field. Our studies indicate that a generic application of MBCT reduces pain intensity among women treated for breast cancer,as well as depression symptoms related to spousal bereavement in old age. Furthermore, ongoing studies will yield results on the effect of disease-specific versions of MBCT adjusted to the special needs of other populations in the field of health psychology. Finally, the importance of MBCT instructor qualification is briefly discussed and specific experiencesin relation to how these qualification criteria can be met are described.
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Objective Maternal stress and depression in pregnancy and early parenting are associated with decreased maternal sensitivity and infant social-emotional development impairments. This randomized controlled trial explored if a... more
Objective Maternal stress and depression in pregnancy and early parenting are associated with decreased maternal sensitivity and infant social-emotional development impairments. This randomized controlled trial explored if a Mindfulness-Based Childbirth and Parenting Program (MBCP) is more beneficial than a Lamaze program for infant’s social-emotional development. Infant social-emotional development was also explored in the light of maternal psychological states. Methods Pregnant women at risk of perinatal stress and depression were included and randomized to either MBCP or Lamaze. The Ages and Stages Questionnaire: Social-Emotional (ASQ:SE) regarding infant social-emotional development was filled out by the mothers (n = 88) 3 months postpartum. Data on mode of delivery, skin-to-skin care, and breastfeeding rates was collected from medical records and self-report questionnaires. The women also filled out self-report questionnaires: Perceived Stress Scale, Edinburgh Postpartum Depres...
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Objectives The aim of the present study was to investigate long-term effects of Mindfulness-Based Childbirth and Parenting (MBCP) during pregnancy on women’s perceived stress and depressive symptoms during the first year postpartum.... more
Objectives The aim of the present study was to investigate long-term effects of Mindfulness-Based Childbirth and Parenting (MBCP) during pregnancy on women’s perceived stress and depressive symptoms during the first year postpartum. Methods Women (n = 193) who were pregnant with their first child and at risk for perinatal depression were randomized to MBCP or an active control condition, which consisted of a Lamaze childbirth class. The women provided self-reported data on perceived stress, depressive symptoms, positive states of mind, and the Five Facets of Mindfulness Questionnaire at baseline, postintervention, and at 3, 9, and 12 months postpartum. Results Linear mixed model analysis showed that the intervention group had a larger decrease in stress (p = 0.04) and depression scores (p = 0.004) and larger increase in positive states of mind (p < 0.001) and mindfulness scores (p < 0.001) from baseline to postintervention (10–12 weeks later), compared with the active control ...
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Background Uninterrupted skin-to-skin contact between mothers and newborns during the first hour after birth has been reported to be 2% in Uganda. Aims To investigate if a low-cost intervention targeting the behaviors of hospital staff... more
Background Uninterrupted skin-to-skin contact between mothers and newborns during the first hour after birth has been reported to be 2% in Uganda. Aims To investigate if a low-cost intervention targeting the behaviors of hospital staff would increase skin-to-skin contact and to investigate whether skin-to-skin contact stabilised temperature in the newborn. Methods The study had a quasi-experimental, before and after design. The sample included 110 in the pre-intervention group, and 93 in the post-intervention group. Data collection included observations of skin-to-skin contact and temperature measurements. Data were also collected from medical records and interviews. Findings No infants had skin-to-skin contact before the intervention, whereas the proportion was 54.8% after the intervention. Infants who received skin-to-skin contact (n=51) and infants who did not receive skin-to-skin contact (n=146) increased in temperature; however, infants who received skin-to-skin contact were si...
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The overall aim of this thesis was to study how early breast-feeding would be influenced by pethidine given during labour and by an emergency Caesarean section. Eighteen mother-infant pairs which were exposed and 26 which were not exposed... more
The overall aim of this thesis was to study how early breast-feeding would be influenced by pethidine given during labour and by an emergency Caesarean section. Eighteen mother-infant pairs which were exposed and 26 which were not exposed to pethidine during labour were observed the first two hours after birth. The infants were put skin-to-skin on their mothers' chest. The developing breast-feeding behaviour was observed. It was found that the pethidine exposed infants had a delayed and depressed sucking and rooting behaviour. Infants with a short dose-to-delivery interval had the most depressed sucking behaviour and infants with high concentration of pethidine in the umbilical cord did not suck the breast at all during the observation. Seventeen primiparous women who had had an emergency Caesarean section and 20 women who had had a vaginal delivery were blood sampled during a breast-feeding two days after childbirth and oxytocin, prolactin and cortisol levels were measured with RIA. Women who had had vaginal delivery had a pulsatile oxytocin the first ten minutes of breast-feeding (ranging from 1-5 pulses) pattern and elevated levels of prolactin 20-30 mimltes after the onset of breast-feeding. The number of pulses was related to the amount of milk the infant ingested during the studied breast-feed and the duration of exclusive breast-feeding. Women who had had a Caesarean section had significantly fewer pulses of oxytocin (ranging from 0-3) and no elevation of prolactin. The number of pulses was related to the amount of milk the infant ingested during the studied breast-feeding in both groups. Regression analysis showed two factors to be of importance for for the differences in oxytocin patterns between the groups and that was the absence of a second stage of labour and a delayed first suckling occasion. Cortisol decreased significantly in both groups. The personality inventory, the Karolinska Scales of personality, were filled in on the second day by the mothers described above and on the day of partus by 13 primiparae and 16 multiparae and were compared with a normative group of women. The results showed that women who had had a vaginal delivery scored lower in anxiety variables and higher in socialisation than the normative group. In addition the multiparous women but not the primiparous women showed similar differences on the day of partus. The women who had had a Caesarean section did not show these differences. Basal levels of oxytocin were inversely correlated with anxiety scores in mothers with a Caesarean section and the number of pulses of oxytocin were correlated with social desirability in the women who had had a vaginal delivery. The data give further support for the importance of early breast-feeding for some maternal adaptations, such as milk production and behaviour. Furthermore, early interaction may together with labour influence maternal oxytocin secretion which may underlie some maternal adaptations. Two routines were found to disturb early suckling -pethidine given during labour and Caesarean section. Some suggestions as how to compensate for this are given. Key words: Breast-feeding, oxytocin, prolactin, cortisol, Caesarean section, newborn infant behaviour, pethidine. Stockholm, December 1996 ISBN 91-628-2269-
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Scand J Caring Sci; 2010; 24; 716–725 Fatherhood in focus, sexual activity can wait: new fathers’ experience about sexual life after childbirthBackground: Becoming a parent is overwhelming for most men and women and alters the sexual... more
Scand J Caring Sci; 2010; 24; 716–725 Fatherhood in focus, sexual activity can wait: new fathers’ experience about sexual life after childbirthBackground: Becoming a parent is overwhelming for most men and women and alters the sexual relationship for many couples.Aim: To describe fathers’ experience about sexual life after childbirth within the first 6 months after childbirth.Method: A descriptive design, using content analysis with a qualitative approach, based on focus group discussions and one-to-one interviews.Participants: Eight first-time and two subsequent fathers participated.Results: Three subthemes were identified: Struggling between stereotypes and personal perceptions of male sexuality during transition to fatherhood; new frames for negotiating sex; a need to feel safe and at ease in the new family situation. The overarching theme emerged as ‘transition to fatherhood brings sexual life to a crossroads’ and guided us to a deeper understanding of the difficulties men experience during the transition to fatherhood. To get sexual life working, a number of issues had to be resolved, such as getting involved in the care of the baby and the household and getting in tune with their partners in regard to sexual desire. The men needed to be reassured and prepared for this new situation by health care professionals.Conclusions: New fathers in our study put the baby in focus in early parenthood and were prepared to postpone sex until both parties were ready, although they needed reassurance to feel at ease with the new family situation. The fathers’ perceptions of sexual life extended to include all kinds of closeness and touching, and it deviated from the stereotype of male sexuality. This is important information for health care providers and midwives to be aware of for their encounters with men (and women) during the transition to fatherhood, and parenthood and can contribute to caring science with a gender perspective on adjustment of sexual life after childbirth.
Research Interests: Nursing, Obstetrics, Midwifery, Medicine, Caesarean Section, and 15 moreProspective studies, Pregnancy, Humans, Childbirth, Female, Amniotic Fluid, Adult, Parturition, Parity, Lactic Acid, Apgar Score, Dystocia, Prospective Cohort Study, professional patient relations, and Paediatrics and reproductive medicine
Aim: Among Swedish pregnant teenage girls it is unusual to continue pregnancy and to choose to have a baby. Swedish teenage mothers can therefore be expected to differ from adult mothers, at a group level. The aim of this study was to... more
Aim: Among Swedish pregnant teenage girls it is unusual to continue pregnancy and to choose to have a baby. Swedish teenage mothers can therefore be expected to differ from adult mothers, at a group level. The aim of this study was to describe and compare teenage mothers who were giving birth in hospital with adult mothers as to sociodemographic background, perception of health and social support. Methods: A descriptive comparative study was conducted over one year, in a county in south-western Sweden, which comprised a group of all teenage mothers aged 15—19, who gave birth at hospital (study group n=97) and the same number of adult mothers aged 25—29, matched for parity and birth of a baby closest to the index mother (reference group). Both groups answered a questionnaire regarding sociodemographic variables, lifestyle, health, self-esteem, depressive symptoms, and support. Information on the mothers' pregnancy and delivery was obtained from their maternal health and delivery ...
Research Interests: Health Behavior, Life Style, Social Support, Adolescent, Medicine, and 15 moreTeenage Pregnancy, Sweden, Pregnancy, Humans, Childbirth, Postpartum Depression, Female, Psychosocial, Mothers, Self Concept, Unplanned Pregnancy, Questionnaires, Adult, Public health systems and services research, and Socioeconomic Factors
... (I) Anxiety Proneness scales. The Psychic Anxiety scale concerns cognitive-social anxiety and insecurity, worrying and having slow recovery after stress. Psychiatric and psychosomatic patients havc consistently higher scores than... more
... (I) Anxiety Proneness scales. The Psychic Anxiety scale concerns cognitive-social anxiety and insecurity, worrying and having slow recovery after stress. Psychiatric and psychosomatic patients havc consistently higher scores than controls. ... Anxiety, Psychic Anxiety, Muscular ...
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Oxytocin and prolactin stimulate milk ejection and milk production during breastfeeding. The aim of the present study was to make a detailed analysis of maternal release of oxytocin and prolactin in response to breastfeeding during the... more
Oxytocin and prolactin stimulate milk ejection and milk production during breastfeeding. The aim of the present study was to make a detailed analysis of maternal release of oxytocin and prolactin in response to breastfeeding during the second day postpartum in mothers who had received oxytocin either intravenously for stimulation of labor or intramuscularly for prevention of postpartum hemorrhage and/or epidural analgesia or those who had received no such treatment in connection with birth. In a descriptive comparative study plasma oxytocin and prolactin concentrations were measured in response to suckling during the second day postpartum in women who had received intravenous intrapartum oxytocin (n = 8), intramuscular postpartum oxytocin (n = 13), or epidural analgesia, either with (n = 14) or without (n = 6) intrapartum oxytocin infusion, and women who received none of these interventions (n = 20). Hormone levels were analyzed by enzyme immunoassay. All mothers showed a pulsatile oxytocin pattern during the first 10 minutes of breastfeeding. Women who had received epidural analgesia with oxytocin infusion had the lowest endogenous median oxytocin levels. The more oxytocin infusion the mothers had received during labor, the lower their endogenous oxytocin levels were during a breastfeeding during the second day postpartum. A significant rise of prolactin was observed after 20 minutes in all women, but after 10 minutes in mothers having received oxytocin infusion during labor. In all women, oxytocin variability and the rise of prolactin levels between 0 and 20 minutes correlated significantly with median oxytocin and prolactin levels. Oxytocin, released in a pulsatile way, and prolactin were released by breastfeeding during the second day postpartum. Oxytocin infusion decreased endogenous oxytocin levels dose-dependently. Furthermore, oxytocin infusion facilitated the release of prolactin. Epidural analgesia in combination with oxytocin infusion influenced endogenous oxytocin levels negatively.
Research Interests: Nutrition and Dietetics, Lactation, Medicine, Sweden, Oxytocin, and 14 moreHumans, Prolactin, Female, Natural Sciences, Newborn Infant, Adult, Public health systems and services research, Breast feeding, Human Milk, Thoracic epidural analgesia, Analgesics, Epidural Analgesia, postpartum period, and Paediatrics and reproductive medicine
Research Interests: Nutrition and Dietetics, Lactation, Medicine, Sweden, Breastfeeding, and 15 moreOxytocin, Massage, Humans, Blood Pressure, Female, Natural Sciences, Newborn Infant, Adult, Public health systems and services research, Breast feeding, Cohort Studies, Mother child relations, postpartum period, Diastole, and Paediatrics and reproductive medicine
The first sexual intercourse after childbirth may be challenging for women, especially if the birth resulted in injuries in the genital area. The purpose of this study was to investigate whether or not tears in the vagina, perineum,... more
The first sexual intercourse after childbirth may be challenging for women, especially if the birth resulted in injuries in the genital area. The purpose of this study was to investigate whether or not tears in the vagina, perineum, sphincter ani, or rectum hindered sexual intercourse during the year after childbirth. We obtained information from 2,490 women in a population-based cohort identified at antenatal care. Information about first sexual intercourse was collected by means of a questionnaire sent 1 year after birth to the women and about women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s tears reported in the population-based Swedish Medical Birth Register. Adjusted relative risks with 95 percent confidence intervals for not having had sexual intercourse within 3 and 6 months, respectively, after childbirth were 1.5 (95% CI 1.2-1.8) and 1.6 (95% CI 1.2-2.3) for tears in the vagina, 1.4 (95% CI 1.1-1.6) and 1.5 (95% CI 1.1-2.1) for tears in the perineum, and 2.1 (95% CI 1.4-3.1) and 2.2 (95% CI 1.1-4.6) for tears in the sphincter ani and rectum. No statistically significant differences were found at 1-year follow-up. No associations between episiotomy and delay in resuming intercourse were found after adjusting the relative risks. Tears in the vagina, perineum, sphincter ani, or rectum are associated with a delay in women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s resumption of sexual intercourse 6 months after childbirth in Sweden.
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Aims This work aimed to study consequences of medical interventions in connection with birth on infant pre-feeding and feeding behaviors and on maternal oxytocin levels in connection with a breastfeed 2 days later.Materials and Methods... more
Aims This work aimed to study consequences of medical interventions in connection with birth on infant pre-feeding and feeding behaviors and on maternal oxytocin levels in connection with a breastfeed 2 days later.Materials and Methods Mothers and their full-term newborns (n = 41) were videotaped during a breastfeed 2 days after birth. Duration and quality of rooting [Infant Breastfeeding Assessment Tool (IBFAT)] were assessed. Maternal blood samples were collected, oxytocin levels were analyzed, and mean oxytocin level and variance were calculated. Data on medical interventions during birth, number of breastfeedings, and infant weight loss since birth were recorded. Data were analyzed using logistic regression models.Results The duration of infant rooting was significantly shorter when the mother had received epidural analgesia. The shorter the duration of infant rooting, the more often infants had breastfed and the greater was the infant weight loss since birth. Mothers with epidu...
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In this study we made a detailed analysis of the... more
In this study we made a detailed analysis of the mothers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; release pattern of adrenocorticotropic hormone (ACTH) and cortisol during a breastfeeding session during the second day postpartum and related these patterns to maternal oxytocin levels as well to the duration of sucking and the duration of skin-to-skin contact before sucking the breast. Furthermore, we investigated if epidural analgesia and oxytocin administration during and after labor influenced the release pattern of ACTH and cortisol. Sixty-three primiparae were included in the study. Fourteen received oxytocin intramuscularly postpartum, nine received oxytocin infusion, 14 received epidural analgesia combined with oxytocin infusion, and six received epidural analgesia alone. Twenty mothers did not receive any of these medical interventions. Blood samples were analyzed for ACTH and cortisol by enzyme-linked immunoassay. Both ACTH and cortisol levels fell significantly during the breastfeeding session. A significant negative relationship was found between oxytocin and ACTH levels, but not between oxytocin and cortisol levels. A positive and significant relationship was found between ACTH and cortisol levels. The duration of skin-to-skin contact before onset of sucking was significantly and negatively associated with lower cortisol levels, but not with ACTH levels. Cortisol levels differed significantly between mothers having received epidural analgesia with and without oxytocin. Breastfeeding is associated with a decrease of ACTH and cortisol levels. Skin-to-skin contact contributes to this effect. ACTH correlated negatively with the duration of sucking and with median oxytocin levels, whereas cortisol levels correlated inversely with the duration of skin-to-skin contact preceding sucking, suggesting a partial dissociation between the mechanisms regulating ACTH and cortisol release. In addition, medical interventions in connection with birth influence the activity of the hypothalamic-pituitary-adrenal axis 2 days after birth.
Research Interests: Nutrition and Dietetics, Lactation, Medicine, Oxytocin, Cortisol, and 14 morePregnancy, Humans, Female, Natural Sciences, Newborn Infant, Adult, Public health systems and services research, Adrenocorticotropic Hormone, Thoracic epidural analgesia, Analgesics, Epidural Analgesia, postpartum period, hydrocortisone, and Paediatrics and reproductive medicine
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Background/aims Uninterrupted skin-to-skin contact in the first hour after birth increases the chance of exclusive breastfeeding, a practice which improves health outcomes for both mothers and neonates. This study aimed to compare... more
Background/aims Uninterrupted skin-to-skin contact in the first hour after birth increases the chance of exclusive breastfeeding, a practice which improves health outcomes for both mothers and neonates. This study aimed to compare mother–infant pairs who had or did not have skin-to-skin contact 1 hour after birth and investigate infant behaviour and maternal adaptation as a result. Methods This study investigated the impact of skin-to-skin contact on a number of health indicators after birth of both mother and child. Two groups were included: 51 mother–infant pairs with skin-to-skin contact and 152 with no skin-to-skin contact, who were observed for 1 hour after birth. Mothers were interviewed at discharge and at 14 weeks postpartum about their sociodemographic background, ability to interpret their infant's signals and interaction with the infant, their own health and their infant's health and feeding. The Student's t-test and Chi squared test were used to assess the as...
Research Interests: Nutrition and Dietetics, Medical Sciences, Health Promotion, Midwifery, Medicine, and 14 moreHumans, Nursing Education, Female, Young Adult, Mothers, Weaning, Questionnaires, Longitudinal Studies, Adult, Public health systems and services research, Time Factors, Breast feeding, Postnatal Care, and Paediatrics and reproductive medicine
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Research Interests: Nursing, Psychometrics, Principal Component Analysis, Adolescent, Sweden, and 14 moreSelf Efficacy, Pregnancy, Humans, Female, Obstetrics and Gynaecology, Young Adult, Translating, Questionnaires, Adult, Public health systems and services research, Reproducibility of Results, Second Stage Labor, Parturition, and Paediatrics and reproductive medicine
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Continuous support during the childbirth process ultimately may strengthen the mother&amp;amp;amp;amp;amp;amp;amp;amp;#39;s self-esteem and her capacity to interact with and nurture her infant and also may improve paternal involvement... more
Continuous support during the childbirth process ultimately may strengthen the mother&amp;amp;amp;amp;amp;amp;amp;amp;#39;s self-esteem and her capacity to interact with and nurture her infant and also may improve paternal involvement in general. In the present study, we investigated whether mothers, who were attended by midwives and nurses who had had a process-oriented training program in breastfeeding counseling, perceived stronger maternal feelings for their infant than mothers who had received only routine care. In a previous study, an intervention that included a process-oriented program on breastfeeding counseling for health professionals and continuity in family classes through childbirth was conducted. The 10 largest municipalities were classified in pairs that were similar in size and had similar figures of breastfeeding duration. The municipalities were randomized pairwise to either an intervention or a control group. The present study is a follow-up study on women&amp;amp;amp;amp;amp;amp;amp;amp;#39;s feelings for their infants in relation to the kind of care that they had had and was undertaken between April 2000 and January 2003. The sampling frame was based on women who were cared for at either the intervention clinic or control clinics. The mothers at the control clinics had received standard routine care and had attended family classes through the point of birth. Data collection for control group A started before effects of the intervention could be studied. Data for control group B were collected simultaneously with data collection for the intervention group (n = 540). The mothers responded to 3 questionnaires at 3 days and at 3 and 9 months postpartum. Background data of the mothers were collected. The perception of support that was provided by the health professionals and the perception of mother-infant relationship and feelings for the infant were rated on Likert scales. At 3 days postpartum, both the intervention group and control group B versus the control group A thought that their understanding of the infant was better, they perceived more strongly that the infant as their own, and they enjoyed more breastfeeding and resting with the infant. Although there was no significant difference between the intervention group and control group B at 3 days and 3 months observation, mothers in the intervention group talked more to their infant, perceived their infant to be more beautiful than other infants, and perceived more strongly that the infant was their own than did the mothers in control group B at 9 months observation. In addition, the mothers in the intervention group felt significantly more confident with the infant and felt the infant to be closer than did the mothers in control group B. A process-oriented breastfeeding training program for antenatal midwives and postnatal nurses that included an intervention that guaranteed continuity of care strengthened the maternal relationship with the infant and the feelings for the infant.
Research Interests: Medical Sciences, Health Education, Midwifery, Counseling, Anxiety, and 15 moreHumans, Female, Infant, Patient Satisfaction, Mothers, Intervention Studies, Adult, Breast feeding, ANXIETY, Continuity of Patient Care, Cathexis, Multicenter Studies as Topic, Mother child relations, Infant Care, and Medical and Health Sciences
Little is known about the developing breastfeeding behaviour of newborn infants. This study describes infants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; pre-breastfeeding behaviour during the... more
Little is known about the developing breastfeeding behaviour of newborn infants. This study describes infants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; pre-breastfeeding behaviour during the second day of life and explores possible associations with infant characteristics. We studied 13 mothers and healthy full-term infants after normal births. At 24-48 hours of life, the newborns were placed in skin-to-skin contact with their mothers for breastfeeding and were video filmed. The order, frequency and duration of pre-defined infant pre-feeding behaviours and suckling were coded and analysed using computer-based video software. Pre-feeding behaviours occurred in the following order: rooting, hand to mouth movements, licking of the nipple and hand to breast to mouth movements. The infants started to suckle at a median of one to two minutes. Rooting was the most common behaviour, observed in 12 infants. The duration of rooting movements during the last minute before breastfeeding was inversely related to neonatal age (p≤0.001) and positively related to neonatal weight loss (p=0.02) after birth. Infants exhibited a distinct sequence of pre-feeding behaviours during the second day of life and our findings suggest that rooting movements were governed by mechanisms involved in the regulation of food intake and weight gain. This article is protected by copyright. All rights reserved.
this study aimed to examine how women׳s childbirth self-efficacy beliefs relate to aspects of well-being during the third trimester of pregnancy and whether there was any association between childbirth self-efficacy and obstetric factors.... more
this study aimed to examine how women׳s childbirth self-efficacy beliefs relate to aspects of well-being during the third trimester of pregnancy and whether there was any association between childbirth self-efficacy and obstetric factors. a cross-sectional design was used. The data was obtained through the distribution of a composite questionnaire and antenatal and birth records. data were recruited from antenatal health-care clinics in Halland, Sweden. a consecutive sample of 406 pregnant women was recruited at the end of pregnancy at gestational weeks of 35-42. five different measures were used; the Swedish version of Childbirth Self-Efficacy Inventory, the Wijma Delivery Expectancy/Experience Questionnaire, the Sense of Coherence Questionnaire, the Maternity Social Support Scale and finally the Profile of Mood States. results showed that childbirth self-efficacy was correlated with positive dimensions as vigour, sense of coherence and maternal support and negatively correlated with previous mental illness, negative mood states and fear of childbirth. Women who reported high childbirth self-efficacy had less epidural analgesia during childbirth, compared to women with low self-efficacy. this study highlights that childbirth self-efficacy is a positive dimension that interplays with other aspects and contributes to well-being during pregnancy and thereby, acts as an asset in the context of childbirth.
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Although many studies have reported negative impact of maternal depressive symptoms on family relations, few studies have explored whether or not early depressive symptoms influence interfamily relationships. The aim was to describe... more
Although many studies have reported negative impact of maternal depressive symptoms on family relations, few studies have explored whether or not early depressive symptoms influence interfamily relationships. The aim was to describe first-time mothers' feelings for their infant and partner during the first postpartum year in relation to maternal depressive symptoms. Research questions were addressed about: What is the prevalence of maternal depressive symptoms 10 days postpartum? How does maternal depressive symptoms on day 10 relate to her mood and feelings for the infant and partner at days 3 and 10, and at 6 and 12 months postpartum? A longitudinal study with first-time mothers, normal pregnancies, giving birth to healthy babies participated in the study; altogether, n = 419. Depressive symptoms were measured by Edinburgh Postnatal Depression Scale (EPDS) at 3 and 10 days. Additional questionnaires assessing the woman's mood and relationship with her infant and partner we...
Research Interests: Nursing, Depression, Humans, Female, Male, and 4 moreInterpersonal Relations, Newborn Infant, Adult, and Sexual Partners
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Adolescent sexuality is a highly charged moral issue in Kenya and Zambia. Nurse-midwives are the core health care providers of adolescent sexual and reproductive health services but public health facilities are under-utilised by... more
Adolescent sexuality is a highly charged moral issue in Kenya and Zambia. Nurse-midwives are the core health care providers of adolescent sexual and reproductive health services but public health facilities are under-utilised by adolescents. The aim of this study was to investigate attitudes among Kenyan and Zambian nurse-midwives (n=820) toward adolescent sexual and reproductive health problems, in order to improve services for adolescents. Data were collected through a questionnaire. Findings revealed that nurse-midwives disapproved of adolescent sexual activity, including masturbation, contraceptive use and abortion, but also had a pragmatic attitude to handling these issues. Those with more education and those who had received continuing education on adolescent sexuality and reproduction showed a tendency towards more youth-friendly attitudes. We suggest that critical thinking around the cultural and moral dimensions of adolescent sexuality should be emphasised in undergraduate training and continuing education, to help nurse-midwives to deal more empathetically with the reality of adolescent sexuality. Those in nursing and other leadership positions could also play an important role in encouraging wider social discussion of these matters. This would create an environment that is more tolerant of adolescent sexuality and that recognises the beneficial public health effect for adolescents of greater access to youth-friendly sexual and reproductive health services.
Research Interests: Religion, Sexual and Reproductive Health, Critical Thinking, Sexuality, Public Health, and 22 moreKenya, Adolescent, Zambia, CONTINUING EDUCATION, Staff Development, Pregnancy, Humans, Reproductive health, Unwanted pregnancy and abortion, Female, Male, Social Environment, Middle Aged, Adult, Heatlh services and reproductive health, Public health systems and services research, Sexual Activity, Health Care Provider, Service Provider, Condoms, Cross Sectional Studies, and Adolescent Behavior
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Research Interests:
To give birth and become a parent is a source of many emotions and expectations. Several studies show that women experience different problems after giving birth. It can bring many physical, emotional and social changes that may alter the... more
To give birth and become a parent is a source of many emotions and expectations. Several studies show that women experience different problems after giving birth. It can bring many physical, emotional and social changes that may alter the woman&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sexual needs and impact on her relationship. The aim of this study was to elucidate how some women experienced their sexual life with their partner after giving birth. Twenty-seven women participated in six focus group discussions (FGDs). These discussions took place 3-24 months postdelivery. The midwives at their antenatal clinics selected them. A discussion guide with broad questions related to the subject was used and an observer took notes during the FGD. Four themes were identified: body image after childbirth, how sexual patterns are altered following new stresses of family life, discordance of sexual desire with the partner and the necessity for reassurance. The women did not feel comfortable with the physical changes that had taken place and their body image. Childbirth meant less sleep and less free time; consequently, instead of having sex, women wanted to sleep or have time for themselves and that led to a changed sex pattern. Discordance of sexual desire with the partner was a problem but most of the women expressed confidence that their sexual desire would return shortly. Reassurance and confirmation that they were physically alright and back to normal was essential. New mothers are concerned with their body image and the ability to adapt to parenting. They need sensitive, professional counselling and reassurance about their body, as well as about sexual life after childbirth. This level of professional counselling is presently not widely available to new mothers, while midwives and gynaecologists should be the key persons to provide this service.
Research Interests: Nursing, Focus Groups, Sexuality, Women, Body Image, and 8 moreSweden, Humans, Female, Adult, Focus Group Discussion, Parturition, Postnatal Care, and Libido
Becoming a parent is overwhelming for most men and women and alters the sexual relationship for many couples. To describe... more
Becoming a parent is overwhelming for most men and women and alters the sexual relationship for many couples. To describe fathers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; experience about sexual life after childbirth within the first 6 months after childbirth. A descriptive design, using content analysis with a qualitative approach, based on focus group discussions and one-to-one interviews. Eight first-time and two subsequent fathers participated. Three subthemes were identified: Struggling between stereotypes and personal perceptions of male sexuality during transition to fatherhood; new frames for negotiating sex; a need to feel safe and at ease in the new family situation. The overarching theme emerged as &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;transition to fatherhood brings sexual life to a crossroads&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; and guided us to a deeper understanding of the difficulties men experience during the transition to fatherhood. To get sexual life working, a number of issues had to be resolved, such as getting involved in the care of the baby and the household and getting in tune with their partners in regard to sexual desire. The men needed to be reassured and prepared for this new situation by health care professionals. New fathers in our study put the baby in focus in early parenthood and were prepared to postpone sex until both parties were ready, although they needed reassurance to feel at ease with the new family situation. The fathers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of sexual life extended to include all kinds of closeness and touching, and it deviated from the stereotype of male sexuality. This is important information for health care providers and midwives to be aware of for their encounters with men (and women) during the transition to fatherhood, and parenthood and can contribute to caring science with a gender perspective on adjustment of sexual life after childbirth.