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I takt med att migrationen till Sverige har ökat har barnmorskan i mödra- och förlossningsvården behövt utöka kunskapen kring bemötandet av utrikesfödda kvinnor som genomgår graviditet och förlossning. Forskning har visat att barnmorskor har bristande kunskap i vad som kan påverka den utrikesfödda kvinnans upplevelse av mödra- och förlossningsvården i Sverige. Barnmorskan ska arbeta med en hög kulturell kompetens och ge alla kvinnor likvärdig vård oavsett etnicitet, religiös tillhörighet och kulturell bakgrund.  Denna studie har till syfte att undersöka kunskapsläget kring utrikesfödda kvinnors upplevelse av mödra- och förlossningsvården i Sverige.  Studien har genomförts som en litteraturöversikt. Sökningen genomfördes i databaserna CINAHL och PubMed, där 15 vetenskapliga artiklar inkluderades varav 13 kvalitativa och två kvantitativa, samtliga publicerade mellan 2000-06-01-2022-02-25. Genom en integrerad analys färgkodades likheter och ett resultat sammanställdes. Endast etiskt godkända artiklar inkluderades i litteraturöversikten.  Resultatet presenteras genom tre identifierade huvudkategorier med två underkategorier respektive. Första huvudkategori; vikten av ett gott bemötande med följande underkategorier; respektfullt bemötande samt bristfälligt bemötande. Huvudkategori nummer två utgörs av; att inte förstå eller bli förstådd med underkategorierna; tolkens betydelse samt kategorin; bristande information. Önskemål om att mötas halvvägs utgör huvudkategori nummer tre med underkategorierna; att känna tillhörighet och kulturtolksdoulans betydelse.  Majoriteten av utrikesfödda kvinnor ansåg att barnmorskans bemötande hade en stark påverkan på upplevelsen av mödra- och förlossningsvården i Sverige. Utöver detta upplevde flertalet utrikesfödda kvinnor att brist på respekt, okunskap hos barnmorskan och språkbarriären i mötet med barnmorskan ledde till en negativ upplevelse av mötet med mödra- och förlossningsvården i Sverige. Känslan av ensamhet, utanförskap och saknad av tillhörighet kunde motverkas genom att erhålla kontinuerligt stöd av en kulturtolksdoula. / With increasing migration to Sweden, personnel within maternity- and delivery care have been required to expand their knowledge regarding care of foreign-born women in their services. Studies show that lack of knowledge among midwifes in this area can affect foreign- born women’s experiences of maternity and childbirth care in Sweden. Midwifes need to possess a high level of cultural competence and provide all women with equal care, regardless of ethnicity, religious and cultural background.  The aim was to explore the state of knowledge regarding foreign-born women’s experience of maternity- and childbirth care in Sweden.  This study was conducted as a review of literature. Article search was carried out in the databases CINAHL and PubMed, where 15 articles were included of which 13 were qualitative and two were quantitative articles. All articles were published between 2000-06- 01-2022-02-25. Through an integrated analysis similarities were color-coded and a result was complied. Only ethically approved articles were included in the literature review.  The result was presented through identification of three main categories, each with corresponding two subcategories. The first main category was; the importance of a respectable treatment with the following subcategories; respectful treatment and inadequate treatment. The second main category was; not to understand or be understood with the following subcategories; the value of an interpreter and lack of information. The third identified main category was; desire to be met halfway with subcategories; a sense of belonging and the value of a community based doula.  The majority of foreign- born women stated that how they were treated by their midwife had a strong impact on their experience of maternity and childbirth care in Sweden. Many of these women experienced a lack of respect, knowledge gaps and a significant language barrier in their meeting with the midwife. This in turn lead to negative experiences of maternity and childbirth care in Sweden. Feelings of loneliness, exclusion and lack of belonging could be counteracted by receiving continuous support from a cultural doula interpreter.

Yes

Prenatal education is an integrative part of prenatal care. Prenatal education content and teaching methods used in prenatal classes needs to be disclosed in a comprehensive format. The purpose of this integrative research review is to describe the state of the science in prenatal education from journals dated 1990-2000, including (1) description of the prenatal education content and (2) description of the teaching methodologies. A computer search using key terms related to prenatal education was conducted. Twelve journal articles, ten of which were quantitative research studies and two qualitative studies are reviewed and synthesized. Content and teaching methodologies used in childbirth classes, prenatal classes or antenatal classes, and family training classes are the elements included in this study. Similarities and differences among studies are discussed. Results of this review indicated that prenatal education content was very similar among studies and that prenatal class' curriculum should offer a balance between topics regarding parenting skills and topics concerning pregnancy and childbirth preparation. The teaching methods most frequently identified were class and group discussions. Findings show that teaching methodologies should be selected in relation to participants' age, education level, childbirth knowledge and parenting experience. Certified childbirth educators, nurses, and nurse midwives are considered important experts in prenatal education.

Text in Afrikaans / Die politieke struktuur van antieke Egipte en ons eie politieke geskiedenis het meegebring dat aspekte rakende die vrou, vir baie jare oor die hoof gesien was, veral in die literatuur. Met antieke Egipte, waar mans hoofsaaklik verantwoordelik vir die samestelling van geskrewe materiaal was, en in Suid-Afrika waar daar in navorsing meer op onderwerpe wat mans interesseer gefokus was, het daar soveel vrae rakende die vrou onbeantwoord gebly. Die mans kon nie, het nie of wou nie, verslag doen oor wat gedurende swangerskap en baring gebeur het nie. Met behulp van ‘n uitgebreide literatuurstudie (wat bronne uit die geskiedenis, argeologie, antropologie, medisyne, wetenskap, ikonografie, kunste, argitektuur, taalkunde, astronomie, sielkunde, mitologie, tuinbou ensovoorts ingesluit het) is ontdek dat daar, in antieke Egiptiese geskrifte en uitbeeldings, baie oor swangerskap en baring gekommunikeer is. Die inligting is net nie altyd in die konteks of plekke waar ‘n mens dit sou verwag nie. Manlike skrywers het argeologiese inligting vanuit hulle manlike verwysingsraamwerk geïnterpreteer. Die meerderheid inligting oor swangerskap en baring in antieke Egipte, is dus in die verlede òf oor die hoof gesien, òf dit is vanuit ‘n manlike perspektief geïnterpreteer. Belangrike betekenisse het so verlore geraak. Hierdie studie is onderneem om lig op swangerskap en baring in antieke Egipte te werp. ‘n Grondige kennis van die vroulike fisiologie en -denkpatrone is met ‘n uitgebreide studie van die gebruike, tradisies en gelowe van antieke Egipte gekombineer om die bestaande poel van kennis op te helder. / Due to the political structure of ancient Egypt, as well as in our own political history, female matters have been overlooked for many years, especially in literature. With ancient Egypt, where mainly men were responsible for written material, and in South Africa where research, in the past, focused mainly on topics of interest to men, many questions regarding women remained unanswered. Men could not, did not, or didn’t want to report on what happens during pregnancy and birth. The research of extensive literature sources (including historical, archaeological, anthropological, medical, scientific, iconographical, art, architectural, linguistic, astronomical, physiological, mythological, horticultural and other sources) indicates that the ancient Egyptian writings and depictions contained information about pregnancy and birth. In the past most information about pregnancy and birth in ancient Egypt was either overlooked or interpreted from a male perspective. Thus important meanings and interpretations got lost. The aim of this study is to shed light on pregnancy and birth in ancient Egypt. A current thorough knowledge of female physiology and thought patterns was combined with an extensive study of practices, traditions and beliefs in ancient Egypt to elucidate the existing pool of knowledge. / Biblical Archaeology / D. Litt. et Phil. (Biblical Archaeology)

Aim: The overall aim of this study is to describe experiences of, and the association between, fear of childbirth and birth experiences of women with fear ofchildbirth. Methods: In studies I, II, and IV, a reflective lifeworld approach based on phenomenological philosophy was used to describe women’s experiences of fear of childbirth (I), previous birth experiences (II), and fear of childbirth and of birth experience in a long-term perspective (IV). In study III, differences between women who reported fear of childbirth and those who did not were calculated using risk ratios with a 95 % confidence interval and multivariate logistic regression analysis. Data were collected from interviews with eight (I) and nine (II) pregnant women with intense fear of childbirth, and with six women who had sought care for intense fear of childbirth 7 to 11 years prior to the interview (IV), and via questionnaire from a sample of 763 women during pregnancy and again one year following birth (III). Findings: Fear of childbirth was described as “to lose oneself as a woman into loneliness” (I). Previous birth experience was described as “a sense of not being present in the delivery room and an incomplete childbirth experience” (II). Fear of childbirth was associated with a previous negative birth experience and a previous emergency caesarean section (III). From a long-term perspective, fear of childbirth and birth experience was described as “an effort to make all the pieces come together” (IV). Conclusions: This thesis generates evidence on the importance of previous birth experience for women with fear of childbirth, from both qualitative and quantitative perspectives. These perspectives illustrate the complexity where women´s experiences in the delivery room are central. To avoid creating fear of childbirth, it is important that maternity care services focus on women’s birth experiences and critically evaluate care in relation to childbirth.

Text in Afrikaans / Die politieke struktuur van antieke Egipte en ons eie politieke geskiedenis het meegebring dat aspekte rakende die vrou, vir baie jare oor die hoof gesien was, veral in die literatuur. Met antieke Egipte, waar mans hoofsaaklik verantwoordelik vir die samestelling van geskrewe materiaal was, en in Suid-Afrika waar daar in navorsing meer op onderwerpe wat mans interesseer gefokus was, het daar soveel vrae rakende die vrou onbeantwoord gebly. Die mans kon nie, het nie of wou nie, verslag doen oor wat gedurende swangerskap en baring gebeur het nie. Met behulp van ‘n uitgebreide literatuurstudie (wat bronne uit die geskiedenis, argeologie, antropologie, medisyne, wetenskap, ikonografie, kunste, argitektuur, taalkunde, astronomie, sielkunde, mitologie, tuinbou ensovoorts ingesluit het) is ontdek dat daar, in antieke Egiptiese geskrifte en uitbeeldings, baie oor swangerskap en baring gekommunikeer is. Die inligting is net nie altyd in die konteks of plekke waar ‘n mens dit sou verwag nie. Manlike skrywers het argeologiese inligting vanuit hulle manlike verwysingsraamwerk geïnterpreteer. Die meerderheid inligting oor swangerskap en baring in antieke Egipte, is dus in die verlede òf oor die hoof gesien, òf dit is vanuit ‘n manlike perspektief geïnterpreteer. Belangrike betekenisse het so verlore geraak. Hierdie studie is onderneem om lig op swangerskap en baring in antieke Egipte te werp. ‘n Grondige kennis van die vroulike fisiologie en -denkpatrone is met ‘n uitgebreide studie van die gebruike, tradisies en gelowe van antieke Egipte gekombineer om die bestaande poel van kennis op te helder. / Due to the political structure of ancient Egypt, as well as in our own political history, female matters have been overlooked for many years, especially in literature. With ancient Egypt, where mainly men were responsible for written material, and in South Africa where research, in the past, focused mainly on topics of interest to men, many questions regarding women remained unanswered. Men could not, did not, or didn’t want to report on what happens during pregnancy and birth. The research of extensive literature sources (including historical, archaeological, anthropological, medical, scientific, iconographical, art, architectural, linguistic, astronomical, physiological, mythological, horticultural and other sources) indicates that the ancient Egyptian writings and depictions contained information about pregnancy and birth. In the past most information about pregnancy and birth in ancient Egypt was either overlooked or interpreted from a male perspective. Thus important meanings and interpretations got lost. The aim of this study is to shed light on pregnancy and birth in ancient Egypt. A current thorough knowledge of female physiology and thought patterns was combined with an extensive study of practices, traditions and beliefs in ancient Egypt to elucidate the existing pool of knowledge. / Biblical Archaeology / D. Litt. et Phil. (Biblical Archaeology)

Zu Beginn des 20.Jahrhunderts fanden noch nahezu alle Geburten im privaten Hause statt. In der ersten Hälfte des Jahrhunderts begann der Übergang von der traditionellen Hausgeburtshilfe zur klinischen Geburtshilfe. Nach dem 2. Weltkrieg setzte sich diese Entwicklung fort und es vollzog sich in der DDR der vollständige Übergang zur klinischen Geburtshilfe. 1970 betrug der Anteil der Klinikentbindungen 99,1 %. Von staatlicher Seite wurde die Klinikentbindung eindeutig gefördert. Im "Gesetz über den Mutter- und Kinderschutz und die Rechte der Frau" (1950) wurde die Schaffung von Entbindungsbetten und der Ausbau der Schwangerenberatungsstellen, mit Registrierung aller schwangeren Frauen angeordnet. Die Beratungsstellen und die geburtshilflichen Kliniken bilden eine Einheit. Der Schwerpunkt der Hebammenausbildung wurde auf die Ausbildung zur Anstaltshebamme gelegt. Es wurden Niederlassungsbeschränkungen für Hebammen eingeführt, sodass es ab Ende der 60er Jahre praktisch keine selbständigen Hebammen mehr gab. Ein direktes Verbot der Hausgeburtshilfe in der DDR ist nicht nachzuweisen. In den 70er Jahren wurden neue Methoden (programmierte Geburt) und neue Technik (Kardiotokographie und Ultraschall) in den geburtshilflichen Abteilungen eingeführt. In den westeuropäischen Ländern, v. a. der Bundesrepublik kam es zu einer zunehmenden Kritik der Frauen an dieser Art der Geburtshilfe. Es wurde die "familienfreundliche Geburtshilfe" propagiert und die Hausgeburt wiederentdeckt. In der DDR blieben massive Forderungen nach familienfreundlicher Geburtshilfe aus. Ein Wiederaufleben der Hausgeburt war nicht zu verzeichnen. Andere soziale, gesellschaftliche und politische Gegebenheiten in der DDR als in der BRD könnten als Gründe vermutet werden. / At the beginning of the 20th century nearly all child births took place in private homes. In the first part of this century the transition from the traditional home deliveries to childbirth hospital began. This development continued after the second world war, and in the GDR there was a complete transition to childbirth taking place practically only in hospitals. In 1970 99,1% of all deliveries took place in the obstetrical department of a hospital. This Government policy was engendered in the law of 1950 "Gesetz über den Mutter- und Kinderschutz und die Rechte der Frau" (Law concerning the Rights of Women and Protection of Mothers and Children.). This law required the creation of obstetrical departments in hospitals and extension of information and antenatal care centres for pregnant women, with the aim of registering all pregnant women. The information and antenatal care centres and the obstetrical departments were to form a joint unit. The training of midwives assumed their working place to be the hospital. Midwives were no longer allowed to be self-employed, hence by the end of the sixties there no midwives practising privately, although there is no evidence of childbirth at home being forbidden. In the seventies new methods and technology: programmed births along with sonography and cardiotokography were introduced into antenatal care. In western European countries, notably The Federal Republic of Germany, women increasingly criticised these new methods as unnatural and as not family friendly. The demand for family friendly births arose, and with it for childbirth at home and domiciliary midwives. Childbirth at home had been rediscovered. In the GDR there was no increased demand for changes in antenatal or obstetrical care. A rediscovery of childbirth at home did not take place. A different social and political environment can be assumed as the reason for this.

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