Motor vehicle accidents are statistically the major cause of accidental severe injuries for pregnant women and fetuses fatality. Volunteers, post mortem human surrogates, anthropomorphic crash test devices and computational occupant models are used to improve human safety in motor vehicle accidents. However, due to the ethical issues, pregnant women and their fetuses cannot be used as volunteers or post mortem human surrogates to investigate the effects of crashes on them. The only anthropomorphic test device representing pregnant women is very limited in design and lacks a fetus. There is no computational pregnant occupant model with a fetus other than 'Expecting'. This thesis focuses on understanding the risk of placental abruption for pregnant drivers involved in road accidents, hence assessing the risk to fetus fatality. An extensive review of existing models in general and pregnant women models in particular is reported. The time line of successive development of crash test dummies and their positive effect on automotive passive safety design are examined. 'Expecting', the computational pregnant occupant model with a finite element uterus and a multibody fetus, is used in this research to determine the strain levels in the uteroplacental interface. External factors, such as the effect of restraint systems and crash speeds are considered. Internal factors, such as the effect of placental location in the uterus, and the inclusion and exclusion of a fetus are investigated. The head of the multibody fetus is replaced with a deformable head model to investigate the effects of a deformable fetus head on strain levels. The computational pregnant driver model with a fetus offers a more realistic representation of the response to crash impact hence provides a useful tool to investigate fetus safety in motor vehicle accidents. Seat belt, airbag and steering wheel interact directly with the pregnant abdomen and play an important role on fetus safety in motor vehicle accidents. The results prove that the use of a three-point seat belt with the airbag offer the greatest protection to the fetus for frontal crash impacts. The model without a fetus underestimates the strain levels. The outcome of this research should assist automobile manufacturers to address the potential safety issues at the design level.

Bakgrund: Barnmorskor bör eftersträva en god vårdrelation för att överbrygga den sårbarhet och osäkerhet graviditeten skapar. Inskrivningsbesöken vid graviditet är omfattande, det är mycket information som ska hanteras, vilket försvårar möjligheten till en god vårdrelation. Syfte: Belysa hur barnmorskor vid mödrahälsovården genomför inskrivningsbesöken för att skapa en god vårdrelation. Metod: Datamaterial samlades in via intervjuer och analyserades genom kvalitativ innehållsanalys med induktiv ansats. Resultat: Barnmorskorna beskriver vikten av att skapa balans mellan graviditeten i fokus och de medicinska riktlinjerna i inskrivningsbesöken. Graviditeten är den centrala anledningen till besöken så fokus behöver ägnas åt att stärka den gravida/partnern i övergången till föräldrablivandet. Inskrivningsbesöken innebär hantering av medicinska uppgifter, vilka är centrala för vårdplaneringen men kan försvåra den gravidas/partnerns fokus på graviditeten. Den gravidas/partnerns möjlighet till delaktighet vid inskrivningsbesöken beskrivs som central. Avgörande för delaktighet är möjligheten till berättande, kroppsspråk, miljön och stöd av metoder för att främja besökens genomförande. För att främja samtalet används olika former av mallar och fraser samt strategier kring hur dokumentationen handhas. Konklusion: Barnmorskorna beskriver strategier och metoder som centrala för att främja den gravidas/partnerns delaktighet i inskrivningsbesöken. / Background: Midwives should strive for a secure care relationship to overcome the vulnerability of pregnancy. Booking interviews contains lot of information which makes it harder to accomplish a secure care relationship. Purpose: To illustrate how midwives at antenatal care conducts the booking interviews to create a secure care relationship. Method: The data was collected by interviews and analyzed by qualitative content analysis with inductive approach. Result: Midwives describe the importance to create balance between keeping the pregnancy in focus and the medical guidelines during the interviews. The pregnancy is the central reason for the interviews, thus the focus needs to be aimed strengthen the transition to parenthood. The booking interviews involve gathering medical information which is central for the care planning, but it can complicate the pregnant/partners focus on the pregnancy. It’s described as central that the pregnant/partner participates in the interviews. Crucial for participation is the possibility of narration, body language, the environment and support of methods to carrying through the visit. Various templates and phrases are used to help the conversation, and also various strategies how the documentation are handled. Conclusion: Midwives describe strategies and methods as central to promoting the pregnant/partners participation in the booking interviews.