Hemförlossningar i Sverige 1992-2005. Förlossningsutfall och kvinnors erfarenheter.Detta är den första nationella undersökningen av planerade hemförlossningar i Sverige. Istudierna har vi avsett att studera kvinnor som fött eller planerat att föda barn hemma underperioden 1/1 1992 till och med 30/6 2005.Kvinnor som födde barn hemma skiljde sig från kvinnor som födde barn på sjukhus i vissaavseenden (Studie I). Data från det svenska medicinska födelseregistret för perioden 1992 till2001, för 352 kvinnor som fött utanför sjukhus jämfördes med data från 1760 kvinnor som föttpå sjukhus. Kvinnorna som fött utanför sjukhus födde fler barn, hade högre utbildningsnivåmen en lägre sammanlagd familjeinkomst och de yrkesarbetade i mindre omfattning jämförtmed kvinnor som födde barn på sjukhus. Kvinnorna som fött barn utanför sjukhus var oftarefödda i ett annat europeiskt land än Sverige men mer sällan utanför Europa. Förekomsten avhemförlossningar i Sverige baserat på registerkod ”född utanför sjukhus” var 0.38 per tusenfödslar.Genom barnmorskor som bistår hemförlossningar, annonsering och via en intresseförening fördem som vill föda hemma, identifierades 757 kvinnor med sammanlagt 1045 planeradehemförlossningar under perioden 1/1 1992 till 30/6 2005. Av de tillfrågade kvinnorna svarade99 procent att de ville delta i studien. Data insamlades genom frågeformulär. Totalt 100 av detillfrågade kvinnorna med sammanlagt 141 planerade hemförlossningar återfanns inte i detmedicinska födelseregistret. Förekomsten av planerade hemförlossningar baserat på data förkvinnor som identifierats via hemförlossningsbarnmorskor och annonsering, var 0.95 per tusenfödslar. Förekomsten av planerade hemförlossningar baserat på registerdata för dessa kvinnorvar 0.85 per tusen födslar. Överföring till sjukhus under eller direkt efter förlossningen skeddevid 12.5 procent av de planerade hemförlossningarna (studie II). De vanligaste orsakerna tillöverföringen var långsam progress (46%) samt att barnmorskan inte kunde komma närförlossningen hade startat (14%). Var fjärde förstföderska avslutade sin planeradehemförlossning på sjukhus och den vanligaste orsaken för överföring bland förstföderskor varatt en annan barnmorska än den kvinnan besökt för vård under graviditeten kom för att biståförlossningen. Faktorer som påverkade överföring hos omföderskor var att tidigare hagenomgått kejsarsnitt och för både förstföderskor och omföderskor att graviditeten varöverburen.Data från det svenska medicinska födelseregistret jämfördes för 897 förlossningar identifieradegenom datainsamlingen till studie II och 11 341 sjukhusförlossningar (kontrollgrupp). Kriterietför urval av kontrollgruppen var enkelbörd i graviditetsvecka 37 - 42 samt att förlossningenstartat spontant. Kvinnor som planerat att föda hemma födde oftare spontant vaginalt och hademer sällan allvarliga bristningar i underlivet efter förlossningen (studie III). Risker i sambandmed valet av förlossningsplats hade övervägts av tre fjärdedelar av kvinnorna (studie IV).Genom egen förberedelse, samtal främst med sin partner och hemförlossningsbarnmorskan,hanterade kvinnorna tankar om att de själva eller deras barn skulle kunna skadas eller dö vidförlossningen. Kvinnorna undvek att diskutera risker med personal inom den konventionellavården.Konklusioner: I Sverige, under åren 1992 – 2005, planerade omkring 100 kvinnor att föda barni hemmet varje år. En fjärdedel av förstföderskorna avslutade sin planerade hemförlossning påsjukhus och den totala förekomsten av överföringar var 12,5 procent. Kvinnorna hade övervägtrisker med en hemförlossning men undvek att diskutera dem med personal inom sjukvården.Den neonatala mortaliteten bland nyfödda vid planerad hemförlossning var 2,2 per tusen inomfyra veckor efter förlossningen jämfört med 0,6 per tusen i sjukhusgruppen. Kvinnor somplanerade en hemförlossning hade oftare en spontan vaginal förlossning med färre allvarligabristningar i underlivet efter förlossningen jämfört med kvinnor som födde på sjukhus.

While studying narratives in the context of its own religious tradition may uncover that religious tradition's doctrines and priorities, this study assumes that a comparative model contributes to a clearer understanding of the uniqueness of each religion's ideas. By comparing religions rather than studying them in isolation, we may understand each with greater clarity. / The narratives compared and contrasted in this study are the birth narratives of Moses and the Buddha. These two figures may be identified as the respective heroes of the Jewish and Buddhist religions. This comparative study highlights and examines the similarities and differences presented in their birth narratives and seeks to determine the significance these narratives have from within the context of their respective doctrinal traditions. Although studying one tradition alone produces important results, it is only by comparing and contrasting religious traditions, and in this case the birth narratives of different religious traditions, that the uniqueness and qualities of each come into full view. / This study begins with an examination of Moses' birth narrative, first as it has been understood by modern scholarship, and then as it has been presented in the classical literature of early Judaism. In the second part, the Buddha's birth narrative is explored, first from the perspective of modern, Western scholarship, and then as it appears in the Pali and Sanskrit literature of early Buddhism. The third part of this study is committed to a comparative analysis of the two birth narratives.

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Thesis (doctoral)--Uppsala universitet, 1994. / Includes bibliographical references (p. 267-289).

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Antepartum suicidal behaviors are a leading cause of maternal injury and death. Previous research has not investigated associations between antepartum suicidal ideation and perinatal complications. Our study objective was to evaluate the relationship of antepartum suicidal ideation with low infant birthweight, small for gestational age, and preterm birth. A cohort study was conducted among 1,108 women receiving prenatal care in Peru. Suicidal ideation was measured using the Patient Health Questionnaire-9 during pregnancy. Birth outcomes were extracted from medical records. Linear regressions and multivariable logistic regressions were used to estimate were used to investigate associations between suicidal ideation and pregnancy outcomes. The prevalence of suicidal ideation was 8.7%, preterm delivery was 5.7%, low birthweight was 4.4%, and small for gestational age was 3.4%. In an adjusted model, infant birthweight was 94.2 grams lower for mothers with antepartum suicidal ideation (95% CI: −183.0, −5.5, p = 0.037) compared with those without suicidal ideation. After adjusting for confounders including depression, participants with suicidal ideation had a nearly four-fold increased odds of delivering a small for gestational age infant (OR: 3.73; 95% CI: 1.59–8.74). These findings suggest suicidal ideation during pregnancy is associated with adverse perinatal outcomes, especially low infant birthweight. / Revisión por pares

A research report submitted to Faculty of Health Sciences, as a requirement for completion of Masters of Medicine in Paediatrics, University of the Witwatersrand, Johannesburg, 2018 / Background. Candidemia is a significant cause of morbidity and mortality in infants. The mortality rate ranges between 21% and 76%. Non-albicans candida (NAC) is increasing in incidence and resistance to azoles. Very low birth weight (VLBW) infants have numerous risk factors which predispose them as a group to invasive candidemia. Methods. A retrospective case control study of candidemia in VLBW infants admitted to the neonatal unit at Charlotte Maxeke Johannesburg Hospital (CMJAH) between 01 January 2015 to 31 December 2017 was undertaken. Clinical and demographic characteristics of VLBW infants who developed candidemia, commonest Candida species, antifungal susceptibility profiles and outcomes defined as death were identified. 71 infants with confirmed positive blood cultures for candidemia from the NHLS database were selected and each case was allocated 3 controls; the final sample comprised 284 infants. Results. Bacterial sepsis, chronic lung disease (CLD), necrotising enterocolitis (NEC) and NEC surgery, other surgery, anaemia and ventilation, all showed a strong association with development of candidemia in the infants. The most common isolate was Candida parapsilosis (59.1%), followed by Candida albicans (30.9%). The cases of candidemia overall and NAC isolates increased over the study years. Resistance to azoles by NAC was demonstrated. Mortality was 31.2% and 28.2% in controls and cases respectively. The difference in death between the two groups was not statistically significant. 7 A research report submitted to Faculty of Health Sciences WITS, as a requirement for completion of Masters of Medicine; Paediatrics. Johannesburg, South Africa 2018. Conclusions. The study demonstrated a predominance of NAC isolates, increasing rate of candidemia and increased resistance to azoles. Stricter infection control measures and medical intervention strategies should be implemented / GR 2020

This project has researched why a welfare country like Sweden has a growing number of mothers with negative and traumatic childbirth experiences and aimed to propose a conceptual solution on how design could enhance factors contributing to a positive and empowering childbirth experience.  With close contact to both midwives and mothers the research brought light on the dissonance between the physiological mechanism behind birth and the existing user journey when giving birth at Maternity Wards at hospitals. A woman in labor is treated in a generalized pathologic medical system and will encounter several blockades, which risks to prevent her from experiencing a smooth birth on her own terms, this often causing unnecessary interventions and most importantly - a disbelief in her own ability to give birth and to be a woman.   The result of the project is a couple of guidelines and visual suggestions of how a Swedish Birth Center could be established, interacted with and how a birth space could look like, with focus on providing accessibility for a positive and empowering birth experience. Enabling a woman to find her full capability to give birth requires an undisturbed and respectful environment, protecting the powerful but sensitive hormones of birth.  The concept is called Mammisi, the ancient name for birth place; birth house, referring to the findings of ancient temple complexes which were dedicated to worshipping goddesses of motherhood, fertility, birth and rebirth and where birth and fertility rituals took place. make a big difference, both for maternal health, long term economical profits and how a Birth Center implementation can be done with a low carbon footprint. The concept is easily applicable in real time, and can be used as a guide for spaces wanting to create fundations for a positive and smooth birth experience or a relaxation space.

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Thesis advisor: Joyce K. Edmonds / Background: Midwifery-led birth centers (BC) provide positive perinatal outcomes for women and birthing people at low perinatal risk that exceed national outcomes in the United States. Yet, less than 1% of all births occur in BCs. The Coxon conceptual model of birth setting decision-making provides the most comprehensive research framework about how people decide where to give birth. Research is essential for the promotion of an informed decision-making approach regarding birth setting options and the facilitation of access to high value BC care. This dissertation aims to study birth setting decision-making, specifically decision-making about BCs, in the United States. Methods: Three methods were used to address the overall dissertation aim. An integrative review was conducted to evaluate factors influencing birth setting decision-making in the United States, examining research studies from 2011-2022. A secondary data analysis of the population- based Listening to Mothers in California survey identified factors associated with interest in BC care in a future pregnancy among respondents who experienced hospital birth in California. Finally, a hermeneutic phenomenological study was conducted to explore the decision-making experiences of participants with Medicaid health insurance and who chose to give birth in a freestanding BC in Massachusetts. Results: Four themes were generated from 23 research studies included in the integrative review. The themes represented factors influencing birth setting decision-making in the United States: Birth Setting Safety Versus Risk, Influence of Media, Family, and Friends on Birth Setting Awareness, Presence or Absence of Choice and Control, and Access To Options. In the Listening to Mothers in California survey, respondents (N = 1447) were more likely to express interest in future BC care if they had experienced pressure from health professionals to have an obstetric intervention, believed childbirth is a process that should not be interfered with unless medically necessary, sought information about hospital cesarean rates, had a doula in labor, and experienced mistreatment. Finally, qualitative data from participant interviews (N = 12) generated five analytic themes that described the BC decision-making process: Desire to Step Away From “the System,” Access to Birth Center Care, Influence of Partners, Family, Friends, the Media, and Birth Workers, the Built Environment of the BC, and the Temporal Dynamics of Decision- Making. Conclusions: The findings from this dissertation extend our knowledge about BCs as a unique and necessary decision process and choice for perinatal care in the United States. Illuminating why and how people decide to seek care at BCs is vital to expanding access and supporting informed, values-based decision-making about birth settings. By making specifications and refinements to the Coxon conceptual model about birth-setting decision-making, a novel pathway is now available for further research and discovery about how people decide where to give birth in the United States and how to best support their choice. / Thesis (PhD) — Boston College, 2023. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.