Introdução: Em Reprodução Assistida toda a equipe compartilha com o casal o árduo caminho composto pelas fases do tratamento, porém, o presente estudo deteve-se a experiência do médico. Objetivos: Investigar o Imaginário Coletivo de médicos que atuam em Reprodução Assistida sobre as situações de difícil manejo em sua prática profissional. Métodos: Foram feitas entrevistas únicas individuais, utilizando o Procedimento de Desenho-Estória com Tema como instrumento dialógico. A partir das entrevistas foi criada uma narrativa transferencial ficcional preservando elementos essenciais da dramática humana estudada. Os registros foram interpretados à luz do método psicanalítico buscando a criação/encontro de campos de sentido afetivo-emocional. Resultados: Foram encontrados os seguintes campos: \"Não deu certo!?\", que organiza-se ao redor da ideia de que não alcançar o objetivo pretendido seria o equivalente a fracassar, mesmo diante de situações incertas; \"Engole o choro!\", que organiza-se mediante a crença de que é preciso conter os sentimentos diante de determinadas situações, não deixar-se emocionar; \"Fora do comum\", que organiza-se por meio da crença de que quem está em posição de cuidador é e/ou precisa ser excepcional. Conclusões: Para a formação e à prática médica é preciso incluir, além da visão científica-tecnológica, a abordagem da subjetividade. É necessária a criação de enquadres diferenciados que auxiliem o médico a aproximar-se emocionalmente de seu trabalho, facilitem a superação de dissociações, promovam a saúde mental, contribuindo para que o exercício da profissão seja gratificante e dotado de um sentido genuíno / In Assisted Reproduction the whole team shares with the couple the hard journey through the phases of the treatment, however, this study is about the doctor\'s experience. Objectives: To investigate the Collective Imaginary of doctors working in Assisted Reproduction on some difficult situations in their professional practice. Methods: Individual interviews were conducted using the Thematic Story-Drawing Procedure as dialogical instrument. From the interviews a fictional narrative transference were created preserving essential elements of the human drama studied. The records were interpreted in light of the psychoanalytic method seeking the creation / gathering of affective-emotional sense fields. Results: The following fields were found: \"It did not work!?\", which is organized around the idea that not reaching the target would be equivalent to failing, even due to uncertain situations; \"Swallow your crying!\", Which is organized by the belief that one must contain the feelings before certain situations, not allowing themselves to get emotional; \"Out of the ordinary\", which is organized by the belief that who is in the position caregiver is and / or needs to be exceptional. Conclusions: For the training and medical practice is necessary to include, beyond the scientific-technological view, the approach of subjectivity. It is necessary to create different framings that help the doctor to approach their work emotionally, facilitate the overcoming of dissociations, promote mental health, this way contributing to the exercise of the profession so it can be rewarding and endowed with a genuine sense

A infertilidade é uma condição clínica que acomete até 15% dos casais em idade reprodutiva. Como forma de tratamento para essa parcela da população a Medicina Reprodutiva dispõe de várias técnicas de Reprodução Assistida que visam auxiliar o casal na obtenção da gestação. O primeiro passo para obtenção de sucesso na Medicina Reprodutiva é o correto diagnóstico da infertilidade e, do ponto de vista didático, as causas de infertilidade podem ser classificadas em: feminina, masculina, mista ou desconhecida. A causa feminina de infertilidade apresenta como importante fator o ovariano, representado, principalmente, por alterações no processo de maturação do oócito e/ou no processo de foliculogênese. Com relação à maturação do oócito, um dos possíveis tratamentos oferecidos pela Medicina Reprodutiva é a aplicação da técnica de maturação in vitro (MIV). Infelizmente a MIV não apresenta resultados animadores, e um dos motivos é a falta de um método adequado de seleção dos gametas de humanos que podem ser destinados à ela. No entanto, várias técnicas de seleção de oóticos já foram descritas para espécies animais; dentre elas destaca-se a coloração dos complexos cumuli-oócitos com o corante Azul Cresil Brilhante (BCB). A sua aplicação na espécie humana permanece com ressalvas, uma vez que a comunidade científica preocupa-se com os possíveis efeitos tóxicos dessa substância. Nesta Tese, conseguimos demonstrar, através da avaliação de ensaios de viabilidade e de proliferação celular, e da expressão gênica e proteica, a inocuidade dessa substância para o modelo de cultura primária de células foliculares ovarianas luteinizadas, indicando que o protocolo de coloração com BCB é seguro para a espécie humana. Adicionalmente, conseguimos caracterizar e padronizar o cultivo dessas células, que são amplamente utilizadas em estudos na área da Medicina Reprodutiva. Com relação ao outro fator ovariano de infertilidade (o processo de foliculogênese), sabe-se que a depleção acelerada dos folículos ovarianos pode provocar falência ovariana precoce (FOP), uma condição clínica que acomete até 1% das mulheres em idade reprodutiva e leva à infertilidade. Uma das causas da FOP é a alteração no gene Fragile X Mental Retardation 1 (FMR1) e consequentemente em sua proteína (FMRP). Muito do conhecimento do controle dessa proteína provem de experimentos em neurônios, onde o seu controle já foi elucidado. Nesta Tese, conseguimos demonstrar que o controle dessa proteína nas células ovarianas de humanos é similar ao controle que ocorre nos neurônios, envolvendo a via de sinalização S6K. / Infertility is a clinical condition that affects up to 15% of couples of reproductive age. Reproductive medicine applies many assisted reproductive technologies (ARTs) in order to help them to achieve pregnancy. The first step for infertility treatment success is the correct infertility diagnosis, which is divided into four categories: female, male, mixed or unknown. Female infertility is chiefly represented by ovarian dysfunctions, which are generally related to oocyte maturation and/or folliculogenesis. With regard to oocyte maturation, in vitro oocyte maturation (IVM) is one ART that can be applied but, unfortunately, nowadays it does not present suitable results, since we do not have an effective method of selecting competent human oocytes. On the other hand, in animal reproduction brilliant cresyl blue (BCB) staining has already been described as an appropriate method for oocyte selection. However its clinical applicability to humans is some away off, owing to concerns about its safety. In this thesis we have demonstrated (through many cellular viability and proliferation assays and gene and protein expression), that BCB staining, applying the correct protocol, seems to be safe for use in humans (using the primary culture of human ovarian follicular cells as an experimental model). Additionally, we have characterized and standardized the primary culture of human ovarian follicular cells, and this experimental model is widely applied in reproductive medicine experiments. With regard to folliculogenesis, it is well known that premature ovarian failure/insufficiency (POF/POI) is one condition that can be caused by follicle depletion (when folliculogenesis occurs too fast). This condition affects about 1% of females of reproductive age, causing infertility. Genetic alterations, such as in the fragile X mental retardation 1 (FMR1) gene and its protein FMRP, are considered as one cause of POF/POI. Most of our knowledge about FMRP cellular control comes from studies on neurons, and in these cells we have a clue about its control. In this thesis, we have shown that FMRP control on human granulosa cells is similar to its control on neurons, and this involves the S6K pathway.

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. / Bakgrund: Idag sker den övervägande delen av sex- och samlevnadsundervisningen i skolan och undersökningar visar på brister i denna undervisning samt att elever inte upplever sig få de kunskaper de önskar inom ämnet från skolan. Forskning har också visat att ungdomar föredrar att prata om sex och samlevnad med någon som känner sig bekväm och besitter goda kunskaper i ämnet. Barnmorskans huvudämne är sexuell och reproduktiv hälsa och rättigheter. Det finns dock begränsat med studier gjorda på hur barnmorskan involveras i skolans sex- och samlevnadsundervisning. Syfte: Syftet med den här studien var att belysa barnmorskans roll i det hälsofrämjande folkhälsoarbetet med sex och samlevnadsundervisning för ungdomar i skolan. Metod: Semistrukturerade telefonintervjuer gjordes med fyra lärare som undervisade i sex och samlevnad på högstadiet och fem barnmorskor med erfarenhet av sex och samlevnadsundervisning. Det insamlade materialet analyserades enligt Malteruds systematiska textkondensering. Resultat: Resultatet visade att barnmorskans hälsofrämjande arbete i skolan genomfördes på lite olika sätt. Dels genom föreläsningar och dels genom att elever kom på besök till ungdomsmottagningen. Hur arbetet var upplagt berodde dels på skolans efterfrågan och dels på hur tillgången till barnmorskan såg ut. Tiden som barnmorskan lade på att undervisa elever var i genomsnitt mellan 30-120 minuter som låg fördelat på ett och samma tillfälle. Barnmorskan beskrevs som kunnig och hade spetskompetens inom sitt område samt kände sig bekväm att prata om sex och samlevnad. Att barnmorskan var utomstående gjorde att eleverna också kände sig bekväma och hade lättare att ställa frågor angående känsliga ämnen. Slutsats: Slutsatsen av studien är att det finns ett behov av barnmorskans kompetens i skolan men att det inte finns någon tydlig och självklar roll för barnmorskan i skolans sexualundervisning. Klinisk tillämpbarhet: Denna studie kan användas som stöd för att främja barnmorskans insatser i skolans sex- och samlevnadsundervisning. Studien kan också användas som underlag vid upprättande av samarbetsformer mellan barnmorska och skola.

A infertilidade é uma condição clínica que acomete até 15% dos casais em idade reprodutiva. Como forma de tratamento para essa parcela da população a Medicina Reprodutiva dispõe de várias técnicas de Reprodução Assistida que visam auxiliar o casal na obtenção da gestação. O primeiro passo para obtenção de sucesso na Medicina Reprodutiva é o correto diagnóstico da infertilidade e, do ponto de vista didático, as causas de infertilidade podem ser classificadas em: feminina, masculina, mista ou desconhecida. A causa feminina de infertilidade apresenta como importante fator o ovariano, representado, principalmente, por alterações no processo de maturação do oócito e/ou no processo de foliculogênese. Com relação à maturação do oócito, um dos possíveis tratamentos oferecidos pela Medicina Reprodutiva é a aplicação da técnica de maturação in vitro (MIV). Infelizmente a MIV não apresenta resultados animadores, e um dos motivos é a falta de um método adequado de seleção dos gametas de humanos que podem ser destinados à ela. No entanto, várias técnicas de seleção de oóticos já foram descritas para espécies animais; dentre elas destaca-se a coloração dos complexos cumuli-oócitos com o corante Azul Cresil Brilhante (BCB). A sua aplicação na espécie humana permanece com ressalvas, uma vez que a comunidade científica preocupa-se com os possíveis efeitos tóxicos dessa substância. Nesta Tese, conseguimos demonstrar, através da avaliação de ensaios de viabilidade e de proliferação celular, e da expressão gênica e proteica, a inocuidade dessa substância para o modelo de cultura primária de células foliculares ovarianas luteinizadas, indicando que o protocolo de coloração com BCB é seguro para a espécie humana. Adicionalmente, conseguimos caracterizar e padronizar o cultivo dessas células, que são amplamente utilizadas em estudos na área da Medicina Reprodutiva. Com relação ao outro fator ovariano de infertilidade (o processo de foliculogênese), sabe-se que a depleção acelerada dos folículos ovarianos pode provocar falência ovariana precoce (FOP), uma condição clínica que acomete até 1% das mulheres em idade reprodutiva e leva à infertilidade. Uma das causas da FOP é a alteração no gene Fragile X Mental Retardation 1 (FMR1) e consequentemente em sua proteína (FMRP). Muito do conhecimento do controle dessa proteína provem de experimentos em neurônios, onde o seu controle já foi elucidado. Nesta Tese, conseguimos demonstrar que o controle dessa proteína nas células ovarianas de humanos é similar ao controle que ocorre nos neurônios, envolvendo a via de sinalização S6K. / Infertility is a clinical condition that affects up to 15% of couples of reproductive age. Reproductive medicine applies many assisted reproductive technologies (ARTs) in order to help them to achieve pregnancy. The first step for infertility treatment success is the correct infertility diagnosis, which is divided into four categories: female, male, mixed or unknown. Female infertility is chiefly represented by ovarian dysfunctions, which are generally related to oocyte maturation and/or folliculogenesis. With regard to oocyte maturation, in vitro oocyte maturation (IVM) is one ART that can be applied but, unfortunately, nowadays it does not present suitable results, since we do not have an effective method of selecting competent human oocytes. On the other hand, in animal reproduction brilliant cresyl blue (BCB) staining has already been described as an appropriate method for oocyte selection. However its clinical applicability to humans is some away off, owing to concerns about its safety. In this thesis we have demonstrated (through many cellular viability and proliferation assays and gene and protein expression), that BCB staining, applying the correct protocol, seems to be safe for use in humans (using the primary culture of human ovarian follicular cells as an experimental model). Additionally, we have characterized and standardized the primary culture of human ovarian follicular cells, and this experimental model is widely applied in reproductive medicine experiments. With regard to folliculogenesis, it is well known that premature ovarian failure/insufficiency (POF/POI) is one condition that can be caused by follicle depletion (when folliculogenesis occurs too fast). This condition affects about 1% of females of reproductive age, causing infertility. Genetic alterations, such as in the fragile X mental retardation 1 (FMR1) gene and its protein FMRP, are considered as one cause of POF/POI. Most of our knowledge about FMRP cellular control comes from studies on neurons, and in these cells we have a clue about its control. In this thesis, we have shown that FMRP control on human granulosa cells is similar to its control on neurons, and this involves the S6K pathway.

A infertilidade é uma condição clínica que acomete até 15% dos casais em idade reprodutiva. Como forma de tratamento para essa parcela da população a Medicina Reprodutiva dispõe de várias técnicas de Reprodução Assistida que visam auxiliar o casal na obtenção da gestação. O primeiro passo para obtenção de sucesso na Medicina Reprodutiva é o correto diagnóstico da infertilidade e, do ponto de vista didático, as causas de infertilidade podem ser classificadas em: feminina, masculina, mista ou desconhecida. A causa feminina de infertilidade apresenta como importante fator o ovariano, representado, principalmente, por alterações no processo de maturação do oócito e/ou no processo de foliculogênese. Com relação à maturação do oócito, um dos possíveis tratamentos oferecidos pela Medicina Reprodutiva é a aplicação da técnica de maturação in vitro (MIV). Infelizmente a MIV não apresenta resultados animadores, e um dos motivos é a falta de um método adequado de seleção dos gametas de humanos que podem ser destinados à ela. No entanto, várias técnicas de seleção de oóticos já foram descritas para espécies animais; dentre elas destaca-se a coloração dos complexos cumuli-oócitos com o corante Azul Cresil Brilhante (BCB). A sua aplicação na espécie humana permanece com ressalvas, uma vez que a comunidade científica preocupa-se com os possíveis efeitos tóxicos dessa substância. Nesta Tese, conseguimos demonstrar, através da avaliação de ensaios de viabilidade e de proliferação celular, e da expressão gênica e proteica, a inocuidade dessa substância para o modelo de cultura primária de células foliculares ovarianas luteinizadas, indicando que o protocolo de coloração com BCB é seguro para a espécie humana. Adicionalmente, conseguimos caracterizar e padronizar o cultivo dessas células, que são amplamente utilizadas em estudos na área da Medicina Reprodutiva. Com relação ao outro fator ovariano de infertilidade (o processo de foliculogênese), sabe-se que a depleção acelerada dos folículos ovarianos pode provocar falência ovariana precoce (FOP), uma condição clínica que acomete até 1% das mulheres em idade reprodutiva e leva à infertilidade. Uma das causas da FOP é a alteração no gene Fragile X Mental Retardation 1 (FMR1) e consequentemente em sua proteína (FMRP). Muito do conhecimento do controle dessa proteína provem de experimentos em neurônios, onde o seu controle já foi elucidado. Nesta Tese, conseguimos demonstrar que o controle dessa proteína nas células ovarianas de humanos é similar ao controle que ocorre nos neurônios, envolvendo a via de sinalização S6K. / Infertility is a clinical condition that affects up to 15% of couples of reproductive age. Reproductive medicine applies many assisted reproductive technologies (ARTs) in order to help them to achieve pregnancy. The first step for infertility treatment success is the correct infertility diagnosis, which is divided into four categories: female, male, mixed or unknown. Female infertility is chiefly represented by ovarian dysfunctions, which are generally related to oocyte maturation and/or folliculogenesis. With regard to oocyte maturation, in vitro oocyte maturation (IVM) is one ART that can be applied but, unfortunately, nowadays it does not present suitable results, since we do not have an effective method of selecting competent human oocytes. On the other hand, in animal reproduction brilliant cresyl blue (BCB) staining has already been described as an appropriate method for oocyte selection. However its clinical applicability to humans is some away off, owing to concerns about its safety. In this thesis we have demonstrated (through many cellular viability and proliferation assays and gene and protein expression), that BCB staining, applying the correct protocol, seems to be safe for use in humans (using the primary culture of human ovarian follicular cells as an experimental model). Additionally, we have characterized and standardized the primary culture of human ovarian follicular cells, and this experimental model is widely applied in reproductive medicine experiments. With regard to folliculogenesis, it is well known that premature ovarian failure/insufficiency (POF/POI) is one condition that can be caused by follicle depletion (when folliculogenesis occurs too fast). This condition affects about 1% of females of reproductive age, causing infertility. Genetic alterations, such as in the fragile X mental retardation 1 (FMR1) gene and its protein FMRP, are considered as one cause of POF/POI. Most of our knowledge about FMRP cellular control comes from studies on neurons, and in these cells we have a clue about its control. In this thesis, we have shown that FMRP control on human granulosa cells is similar to its control on neurons, and this involves the S6K pathway.

Do people’s attitudes towards female genital cutting (FGC) change after they migrate from a country where the practice is common, to one where it is not? Alongside increased levels of migration, this question is increasingly being raised. This thesis aimed to expand the understanding about attitudes towards FGC held by Somali men and women in Sweden, and thereby to identify potential factors that impede or facilitate the cessation of FGC. Cross-sectional questionnaire data were collected in four Swedish municipalities to assess attitudes to FGC. To further explore perceptions of FGC, as well as the circumcision of boys, semi-structured interviews and focus group discussions were conducted. Data were collected in 2015. The findings identified an overall widespread opposition to forms of FGC that cause anatomical change. A majority (78%) expressed an opposition to the continuation of all forms of FGC, with the odds of supporting FGC decreasing with increased years of residency in Sweden. An identified 18% reported a support for the continuation of pricking (FGC type IV). A support of pricking was linked with perceiving it as acceptable according to Islam, not a violation of children’s rights, and not causing long-term health complications. Pricking was not defined as a form of FGC by 32%. Most men described a preference to marry an uncircumcised woman (76%) or one who had had pricking (16%). How the individuals perceived the support of FGC in the Swedish Somali community corresponded well with their own approval of the practice. While there seemed to be a continuity regarding the Swedish Somalis’ core values of being a good Muslim, not inflicting harm, and upholding respectability, re-evaluation of how these are applied when it comes to circumcision of girls and boys was identified. This resulted in FGC being viewed as a practice that could be abandoned or adapted. Paradoxically, based on the same core values, the circumcision of boys was continuously perceived as an unquestionable required practice. Altogether, these results suggest that a shift in convention towards no FGC is taking place. However, the identified lack of consensus on practices regarded as FGC needs further attention.

Bakgrund: Forskning visar att valet av födelseplats har betydelse för kvinnans förlossningsupplevelse. Hemförlossning vid en lågriskgraviditet är ett säkert alternativ till att föda på sjukhus dock är intresset för hemförlossning låg i Sverige. För att kvinnor ska kunna göra ett aktivt val krävs en medvetenhet om de alternativ som finns. Författarna ställer sig frågande till om kvinnor i Sverige vet om att hemförlossning existerar. Syfte: Att belysa kvinnors kunskap och förståelse för hemförlossning i Sverige. Metod: Nitton kvinnor har fått besvara en frågeguide om hemförlossning. Svaren analyserades med en kvalitativ hermeneutisk textanalys. Resultat: Kunskapen om hemförlossning har visat sig variera. I resultatet framkommer 4 huvudteman och 8 underteman. Huvudteman består av ”Kvinnors intresse för hemförlossning varierar”, ”Informationens betydelse för beslutstagande”, ”Hinder för hemförlossning i Sverige” och ”Hemförlossning som en rättighet”. Konklusion:Studien påvisar att det finns en risk att kvinnor inte känner till att hemförlossningen existerar. Det påvisar även större hinder för möjligheten att göra ett aktivt val av födelseplats samt att genomgå en hemförlossning. / Background: Research shows that the choice of place of birth is important for the woman's birth experience. Home birth in a low-risk pregnancy is a safe alternative to giving birth in a hospital, however, interest in home birth is low in Sweden. In order for women to be able to make an active choice, an awareness of the alternatives available is required. The authors ask themselves whether women in Sweden know that home birth exists. Aim: To shed light on women's knowledge and understanding of home birth in Sweden. Aim: To shed light on women's knowledge and understanding of home birth in Sweden. Method: Questionguide analyzed with a qualitative hermeneutic text analysis. Results: Knowledge about home birth has been shown to vary. The result shows 4 main themes and 8 sub-themes. The main themes consist of "Women's interest in home birth varies", "The importance of information for decision-making", "Obstacles to home birth in Sweden" and "Home birth as a right".Conclusion: The study shows that there is risk that women do not know that homebirth exists. It also shows greater obstacles to the possibility of making an active choice of place of birth and undergoing a homebirth.

Bakgrund: Nollseparation har ingen tydlig definition och tycks vara ett relativt nytt begrepp som används inom förlossnings- och eftervården. Det framgår tydliga riktlinjer om att barnet ska ligga hud mot hud med sin moder efter förlossningen. Men i vissa fall separeras modern och barnet av olika anledningar. Barnmorskan har en central roll i vården av nyförlösta kvinnor och deras nyfödda barn.Syfte: Syftet med studien var att analysera och definiera begreppet nollseparation mellan förälder och nyfött barn ur ett barnmorskeperspektiv.Metod: En begreppsanalys baserad på en hybridmodell. Hybridmodellen är uppdelad i en teoretisk fas med litteratursökning, en fältstudiefas baserad på intervjuer av sex kliniskt verksamma barnmorskor samt en sammanfattande syntetiseringsfas.Resultat: Nollseparation är likställt med; hud mot hud-kontakt, att alltid ha en förälder närvarande, att familjen ska få vara tillsammans samt att samarbete mellan olika vårdinstanser för att bedriva samvård krävs för att upprätthålla nollseparationen. Barnmorskan får en betydelsefull nyckelfunktion i upprätthållandet av nollseparation.Slutsats: Nollseparation är ett paraplybegrepp som involverar hud mot hud-kontakt, förälders närvaro, att familjen ska få vara tillsammans, att det ska finnas en fungerande samvård mellan olika instanser samt att det ingår i barnmorskans arbetsuppgifter att främja nollseparation.Klinisk tillämpbarhet: Resultatet från detta examensarbete kan komma till nytta inom förlossnings- och eftervården, men kompetensen behöver även ökas inom andra instanser i sjukvården som kan komma i kontakt med nyfödda barn och deras föräldrar. / Background: Zero-separation has no distinct definition and appears to be a relatively new concept used in delivery- and postpartum care. There are obvious guidelines that the child should be skin-to-skin with the mother after birth. But in some cases the mother and child are separated for different reasons. The midwife has a central part in the care of emergent mothers’ and their newborn children.Aim: The aim in this study was to analyze and define the concept of zero-separation between parent and infant from a midwifes’ perspective.Method: A concept analysis based on a hybridmodel. The hybrilmodel is divided into a theoretical phase with literature search, a field study phase based on interviews with six clinically active midwives and a summary synthesis phase.Results: Zero-separation is equated with; skin-to-skin, always have a parent present, the family being together always and that couplet care is needed to maintain zero-separation. The midwife has a significant keyrole in maintaining zero-separation. Conclusion: Zero-separation is an umbrellaconcept which involves skin-to-skin, parental presence, that the family should be allowed to be together, a functioning couplet care between different instances and that maintaining zero-separation is a part of the midwifes’ assignments.Clinical application: The results from this study can be useful in delivery- and aftercare, but the competence needs to be increased in other instances in healthcare that may come in contact with newborn children and their parents.

No description available.

ABSTRACT:  Background: Women’s mental illness can have a negative impact on the woman’s relationship with both children and partners, which means that the woman is the focus when it comes to maternity care. The mental health and well-being of the woman’s partner is also affected by the woman’s mental well-being. There is not much research on how midwives can work in a professional manner to prevent negative experiences in the woman’s partner. It is the midwifes responsibility to identify which risk and health related factors can affect men’s mental health in order to timely initiate the right efforts, which in turn makes it easy to bond in the new family. Aim: To illuminate male partners mental health during complicated pregnancy and childbirth and how they experience the professional support from midwives. Method: A literature study with a qualitative design was used. Thirteen scientific articles with a descriptive method were retrieved from the databases CINAHL, PsycInfo and PubMed. Qualitative content analysis was used to analyze the results of the articles after quality review. Results: As a result of the study two themes and eight subthemes emerged. The first theme was: Witnessing trauma, this theme has five subthemes. The second theme was: Lack of support from midwives and healthcare staff and has three subthemes. Conclusion: The study’s results showed that witnessing trauma has a negative impact on men’s well-being, mental health, relationships with both children and partners as well as future pregnancy short-and long-term. Good communication between midwives and male partners can improve their relationship, limit development and effects of psychological trauma, and reduce feelings of isolation. / SAMMANFATTNING  Bakgrund: Kvinnors psykiska ohälsa kan ha en negativ inverkan på kvinnans relation till både barn och partner, vilket gjort att kvinnan är i fokus när det gäller mödravård. Kvinnans partners psykiska hälsa och välbefinnande påverkas också av kvinnans psykiska mående. Det finns inte mycket forskning om hur barnmorskan kan arbeta på ett professionellt sätt för att förebygga negativa upplevelser hos kvinnans partner. Det är barnmorskans ansvar att identifiera vilka risk-och hälsorelaterade faktorer som kan påverka mäns psykiska hälsa. För att i tid sätta in rätt insatser, vilket i sin tur underlättar anknytningen i den nya familjen. Syftet: Att belysa manliga partners psykiska hälsa vid komplicerad graviditet och förlossning samt hur de upplever det professionella stödet från barnmorska. Metod: En litteraturstudie med kvalitativ design användes. Tretton vetenskapliga artiklar med en beskrivande metod hämtades från databaserna CINAHL, PsycInfo och PubMed. Kvalitativ innehållsanalys användes för att analysera artiklarnas resultat efter kvalitetsgranskning. Resultat: I studiens resultat framkom två teman och åtta subteman. Första teman var: Att bevittna trauma, detta tema har fem subteman. Den andra temat var: Brist på stöd från barnmorska och vårdpersonal och har tre subteman. Slutsats: Studiens resultat visade att bevittnat trauma har negativ påverkan på mäns välbefinnande, psykiska hälsa, relation med både barn och partner samt framtida graviditet kort-och långsiktigt. God kommunikation mellan barnmorska och manliga partners kan förbättra deras relation, begränsa utveckling och effekter av psykiskt trauma samt minska känslan av isolering.