<p>By the late nineteenth century childbirth was firmly established in the domestic sphere. However, in the early years of the twentieth century different forms of maternity clinics were established where normal, as well as complicated, deliveries could take place. The aim of this dissertation is to analyse the institutionalisation of maternity care in a local urban context, the role of women in confinement in this process, and its impact on infant mortality. The geographical setting of the thesis is Sundsvall, a town in northern Sweden. The study concentrates on the period spanning from 1900 to 1930, when local communities, rather than federal agencies, were charged with creating and implementing community standards for maternity care.</p><p>In order to lower the mortality rate of illegitimate infants, and to improve delivery conditions for unmarried women, a maternity home was opened in Sundsvall in 1913. Moreover, a maternity ward was established at the local hospital in 1920. In this study it is clear, that when institutional maternity care became available, the transition was rapid and unhesitating. When analysing the local practices it is possible to highlight the central role women played as part of this process. Initially indigent women and women bearing children out of wedlock accepted the institutional alternative, but shortly thereafter married women of means turned to the newly created wards. As a result of this early acceptance, these institutions were soon filled to capacity. </p><p>During the period in question a significant reduction in infant mortality rates can be noticed in the Swedish towns. A reasonable assumption is that the institutionalisation of maternity care improved infants chances of survival. In the study it is suggested that the institutionalised maternity care made an impact on neonatal mortality, as well as on post-neonatal mortality. The study shows that local practices of care played a key role in infant survival.</p><p>This dissertation reveals the value of examining local practices in order to understand the rapid changes of maternity care. Childbirth changed from being a private matter, taking place in one’s home, to be a public concern, taking place in the institutional setting. At the 1937 Parliament (Riksdag) the responsibility for institutionalised maternity care became a public and a State concern, and maternity care became a part of the Swedish welfare system.</p>

By the late nineteenth century childbirth was firmly established in the domestic sphere. However, in the early years of the twentieth century different forms of maternity clinics were established where normal, as well as complicated, deliveries could take place. The aim of this dissertation is to analyse the institutionalisation of maternity care in a local urban context, the role of women in confinement in this process, and its impact on infant mortality. The geographical setting of the thesis is Sundsvall, a town in northern Sweden. The study concentrates on the period spanning from 1900 to 1930, when local communities, rather than federal agencies, were charged with creating and implementing community standards for maternity care. In order to lower the mortality rate of illegitimate infants, and to improve delivery conditions for unmarried women, a maternity home was opened in Sundsvall in 1913. Moreover, a maternity ward was established at the local hospital in 1920. In this study it is clear, that when institutional maternity care became available, the transition was rapid and unhesitating. When analysing the local practices it is possible to highlight the central role women played as part of this process. Initially indigent women and women bearing children out of wedlock accepted the institutional alternative, but shortly thereafter married women of means turned to the newly created wards. As a result of this early acceptance, these institutions were soon filled to capacity. During the period in question a significant reduction in infant mortality rates can be noticed in the Swedish towns. A reasonable assumption is that the institutionalisation of maternity care improved infants chances of survival. In the study it is suggested that the institutionalised maternity care made an impact on neonatal mortality, as well as on post-neonatal mortality. The study shows that local practices of care played a key role in infant survival. This dissertation reveals the value of examining local practices in order to understand the rapid changes of maternity care. Childbirth changed from being a private matter, taking place in one’s home, to be a public concern, taking place in the institutional setting. At the 1937 Parliament (Riksdag) the responsibility for institutionalised maternity care became a public and a State concern, and maternity care became a part of the Swedish welfare system.

This work proposes an approach with studies of post-structuralist side, seeking to launch other looks for questions considered naturalized in the social and cultural field on the relationship between female/maternal care and family. Thinking it was possible to establish a dialogue between gender and education, although maintaining the differences that constitute these two cultural universes, this paper aims problematize the discourses about motherhood and the crossing of the production of the female role in the family, especially with regard to the care of children with deficiency. The locus of the research was the Design of Stimulator Essential NEPES and the materiality of the study was tied to the analysis of fragments of discourse articulated by the project participants - the group of women caregivers - about their roles in the face of mothering children with deficiency and for interns of the Undergraduate Program in Special Education - Full Degree, University Federal of Santa Maria, who treated the children of the project. Seeking to make use of portions of the thought of Michel Foucault, especially about the relationship between knowledge and power and governance of conduct, it is clear the intention to understand how the discursive practices put into operation by experts in special education is a strategy government conducts female/maternal for the care of children with deficiency. From the materiality of the study was possible to see how the discourses have historically produced an immanent rationality care for female/maternal, especially in the deficiency field, and characterize a set of discourses connected to an expertise that, underpinned by an apparatus pedagogical knowledge, knowledge that articulates the governance strategies of mothers/caretakers special, thus portraying the political legitimacy of the authority of the expert. / Este trabalho que ora se apresenta propõe uma aproximação com estudos de vertente pós-estruturalista, buscando lançar outros olhares a questões consideradas naturalizadas no campo social e cultural a respeito das relações entre cuidado feminino/materno e família. Pensando ser possível estabelecer um diálogo entre gênero e educação, embora mantendo as diferenças que constituem esses dois universos culturais, este trabalho propõe problematizar os discursos sobre a maternidade e o atravessamento destes na produção do papel feminino na família, especialmente no que diz respeito ao cuidado de crianças com deficiência. O lócus da pesquisa foi o Projeto de Estimulação Essencial do NEPES e a materialidade do estudo esteve atrelada à análise dos fragmentos de falas articulados pelas participantes do projeto - mulheres do grupo de cuidadoras - acerca de seus papeis diante da maternagem de crianças com deficiência e pelas estagiárias do Curso de Graduação em Educação Especial Licenciatura Plena, da Universidade Federal de Santa Maria, que atenderam as crianças do projeto. Buscando fazer uso de parcelas do pensamento de Michel Foucault, principalmente acerca das relações de saber e poder e do governamento das condutas, evidencia-se a intenção de compreender de que forma as práticas discursivas colocadas em funcionamento pelos especialistas da educação especial se constituem em estratégias de governo das condutas femininas/maternas para o cuidado de crianças com deficiência. A partir da materialidade do estudo foi possível perceber como os discursos vêm, historicamente, produzindo uma racionalidade imanente para os cuidados femininos/maternos, especialmente no campo da deficiência, bem como caracterizar um conjunto de discursos ligado a uma expertise que, apoiada num aparato de saber pedagógico, articula esse saber às estratégias de governamento das mães/cuidadoras especiais, retratando assim a legitimação política da autoridade do especialista.

Bakgrund:Barnmorskor som arbetar på barnmorskemottagning [BMM] upplever sig ha bristande kunskap om hur professionellt stöd kan erbjudas till kvinnor med förlossningsrädsla under graviditet. Det är viktigt att gravida kvinnor med förlossningsrädsla erhåller professionellt stöd. Syfte:Syftet med studien är att belysa barnmorskor på barnmorskemottagningens erfarenheter av att erbjuda professionellt stöd till kvinnor med förlossningsrädsla under graviditet. Metod: En kvalitativ intervjustudie med induktiv ansats valdes i denna studie för att få en bredare uppfattning av barnmorskor på BMM erfarenhet. Sju barnmorskor blev intervjuade på två olika BMM i sydvästra Sverige. Resultat: I resultatet framkom det två huvudkategorier "Kvinnans förlossningsrädsla i fokus" och "Barnmorskors behov av resurser och kunskap kring förlossningsrädsla". Det tillkom även två underkategorier "Barnmorskors erfarenheter om kvinnors bristande kunskap kring förlossningsrädsla" och "Vägleda till rätt hjälpinsats för den förlossningsrädda kvinnan". Barnmorskor erbjuder professionellt stöd utifrån sina erfarenheter när kvinnan uttrycker förlossningsrädsla. Detta genom att barnmorskorna är lyhörda vid utredning av orsaker till kvinnans förlossningsrädsla. Slutsats:Barnmorskor på BMM behöver kontinuerlig utbildning om förlossningsrädsla för att kunna erbjuda gravida kvinnor professionellt stöd. Verksamhetschefer på BMM ska erbjuda dessa barnmorskor rätt förutsättningar för att de ska kunna känna sig trygga med att erbjuda professionellt stöd till förlossningsrädda kvinnor. / Background: Midwives working at maternal care center experience insufficient knowledge about how professional support can be offered to pregnant women. It´s important that pregnant women with tocophobia receive professional care from midwives during the entire pregnancy. Purpose: The aim of the study is to highlight maternal care midwives’ experiences providing professional support for pregnant women who fear of giving birth. Method: A qualitative interview study with inductive approach was chosen for this study to gain broader view of the BMM midwives' experiences. Seven midwives were interviewed at two BMM in southwestern Sweden. Results: There were two main categories "Women's fear of childbirth tokophobia". There were two subcategories "Midwife's experiences about women's lack of knowledge about fear of childbirth" and "Guide pregnant women to correct care effort". Midwives offer professional support from their own experience when women express fear of birth. This through midwives being responsive when incuayaring causes to tokophobia women. in focus" and "Midwife's need for resources and knowledge about women`s Conclusion: BMM midwives need continuous education about fear of childbirth in order to offer women prophetic support. BMM occupational managers should offer midwives right prerequisites for midwives to feel safe by providing care to women suffering from tokophobia.

In the fall of 2021 Swedish news media reported a maternity care crisis in Region Stockholm. Midwives resigned in protest against deficient working conditions and Region Stockholm appointed a special coordinator to solve the situation. The study aims to examine how Region Stockholm communicatively and strategically addresses problems in maternity care during the so-called maternity care crisis in 2021 and 2022. The questions used to fulfill the purpose of the study are: What events caused the communicative measures? What is the narrative of the communication, and does it differ from medias descriptions of the situation? Which actors are given room to speak and who is attributed responsibility? What rhetorical expressions are used? To answer these questions, previous research and theories regarding crisis communication, crisis rhetoric and message strategies for crisis management are applied. The empirical material consists of eight texts and one video, all produced and published by Region Stockholm on their own website. The nine posts are examined using a qualitative text analysis method. Our results show that mass terminations, deficient working conditions and staff shortage was the most common cause of Region Stockholm’s communicative measures. The narrative of the material was mainly about Region Stockholm presenting measures for the situation within maternity care. However, we could determine a difference between Region Stockholm’s and the media’s descriptions about the situation. The most significant result shows that Region Stockholm does not mention the word crisis in their communication. The result also shows that Region Stockholm is the actor given most room in the communication, where the coordinator is the only person that gets room to express oneself. Logos is the most common rhetorical expression that is invoked by objectively informing about the measures taken and Region Stockholm appeals to ethos by their already existing position in the society and by emphasizing positive aspects of the organization. Finally, we were not able to establish that Region Stockholm attributes crisis responsibility to themselves since they refer to different external factors that can be understood as a cause for the situation.

Background: Female genital mutilation is a harmful cultural practice that is carried out in several places around the world, despite the fact that it is a violation of women’s human rights. Worldwide, around 200 million young girls and women live with the aftermath of genital mutilation. There are several motives for implementing the practice linked to social, cultural and esthetic aspects. Aim: To describe how women who have been circumcised experience antenatal–and maternity care. Method: The study was designed as a general literature study which included nine scientific articles with a qualitative approach. Qualitative content analysis was applied. Result: Two categories and four subcategories emerged. “A confidence-building approach” and “Feeling trust in a female caregiver” went under “Good care relationship” while “Lack of knowledge about female genital mutilation” and “The feeling of being different” belonged to “Lack of empathy”. Conclusion: A confidence–building approach can demonstrably form the basis for a good care relation between a woman who has been circumcised and a healthcare professional. However, women who have been circumcised deliberately chose not to disclosure their health problems when they felt that healthcare professionals lacked knowledge about female genital mutilation. To alleviate the suffering and promote well–being of women who have circumcised, the healthcare professionals need to show respect, consideration and also provide caring care. / Bakgrund: Kvinnlig könsstympning är en skadlig kulturell sedvänja som utförs på flera håll runt om i världen trots att det är ett brott mot kvinnors mänskliga rättigheter. Globalt lever cirka 200 miljoner unga flickor och kvinnor i efterföljderna av könsstympning. Det finns flertal motiv till att genomföra kvinnlig könsstympning kopplad till sociala, kulturella samt estetiska aspekter. Syfte: Att beskriva hur kvinnor som blivit könsstympade upplever mödra–och förlossningsvården. Metod: Studien utformades som en allmän litteraturstudie med nio vetenskapliga artiklar med kvalitativ ansats. Kvalitativ innehållsanalys tillämpades. Resultat: Två kategorier och fyra subkategorier framkom. “Ett förtroendeingivande bemötande” och “Att känna tillit till en kvinnlig vårdgivare” gick under “God vårdrelation” medan “Bristande kunskaper kring kvinnlig könsstympning” och “Känslan att vara annorlunda” tillhörde “Brist på empati”. Slutsats: Ett förtroendeingivande bemötande kan bevisligen utgöra grunden för en god vårdrelation mellan kvinna som blivit könsstympad och sjukvårdspersonal. Dock valde kvinnor som blivit könsstympade avsiktligt att inte delge sina hälsoproblem när de ansåg sjukvårdspersonal sakna kunskaper om kvinnlig könsstympning. För att lindra lidandet och befrämja välbefinnandet hos kvinnor som blivit könsstympade skall hälso–och sjukvårdspersonal visa respekt, omtanke samt ge omsorgsfull vård.

Förlossningskrisen beskrivs som en kris som eskalerat under 2021. Problematiken har däremot pågått under många år. Denna studie syftade till att undersöka barnmorskors upplevelse av den psykosociala arbetsmiljön inom förlossningsvården. Kvalitativ metod tillämpades. Studien genomfördes i Sverige. En respondent valdes ut genom ett bekvämlighetsurval och resterande fem via ett snöbollsurval. Semistrukturerade intervjuer tillämpades via videosamtal och insamlad data analyserades med hjälp av tematisk analys. Resultatet visade delvis i linje med tidigare forskning, att respondenterna upplevde sin psykosociala arbetsmiljö som påfrestande men meningsfull. Underbemanningen äventyrade patientsäkerheten och respondenternas möjlighet till att ge de stöd de önskade till patienterna begränsades. De främsta negativa faktorerna utöver underbemanningen var den höga graden av stress som respondenterna upplevde på arbetsplatsen, missnöjet kring att de tvingades arbeta treskift samt känslan av att de inte blev sedda. Stöd och gemenskap kollegorna emellan samt meningsfullheten i yrket beskrevs som bidragande faktorer till att respondenterna ville arbeta kvar inom förlossningsvården. / The maternity care crisis is described as a crisis that has escalated in 2021. Although the same issue has been ongoing for many years. This study aimed to examine midwives' experience of the psychosocial work environment within maternity care. Qualitative method was applied. The study was conducted in Sweden. The first respondent was selected through a convenience sample and the other five through a snowball sample. Semi-structured interviews were applied via video calls and the data were analysed using thematic analysis. The results showed partly in line with previous research, that midwives experienced their psychosocial work environment demanding but also meaningful. Understaffing compromised patient safety and limited respondents ability to provide the support they wanted to patients. In addition to understaffing, the main negative factors identified in the study were the high levels of stress experienced by respondents in the workplace, dissatisfaction with having to work three shifts and the feeling that they were not being seen. Support and community among colleagues and the meaningfulness of the profession were described as contributing factors to respondents' desire to remain working in maternity care

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Yes / Aims and objectives.  This study was designed to complement local audit data by examining the lived experience of women who elected to attempt a vaginal birth following a previous caesarean delivery. The study sought to determine whether or not women were able to exercise informed choice and to explore how they made decisions about the method of delivery and how they interpreted their experiences following the birth. Background.  The rising operative birth rate in the UK concerns both obstetricians and midwives. Although the popular press has characterized birth by caesarean section as the socialites’ choice, in reality, maternal choice is only one factor in determining the method of birth. However, in considering the next delivery following a caesarean section, maternal choice may be a significant indicator. While accepted current UK practice favours vaginal birth after caesarean (VBAC) in line with the research evidence indicating reduced maternal morbidity, lower costs and satisfactory neonatal outcomes, Lavender et al. point out that partnership in choice has emerged as a key factor in the decision-making process over the past few decades. Chaung and Jenders explored the issue of choice in an earlier study and concluded that the best method of subsequent delivery, following a caesarean birth, is dependent on a woman's preference. Design and methodology.  Using a phenomenological approach enabled a holistic exploration of women's lived experiences of vaginal birth after the caesarean section. Results.  This was a qualitative study and, as such, the findings are not transferable to women in general. However, the results confirmed the importance of informed choice and raised some interesting issues meriting the further exploration. Conclusions.  Informed choice is the key to effective women-centred care. Women must have access to non-biased evidence-based information in order to engage in a collaborative partnership of equals with midwives and obstetricians. Relevance to clinical practice.  This study is relevant to clinical practice as it highlights the importance of informed choice and reminds practitioners that, for women, psycho-social implications may supersede their physical concerns about birth.

yes / Asylum-seeking and refugee (AS&R) women living in the UK often have complex health and social care needs, with poor underlying mental and physical health and an increased risk of negative pregnancy outcomes. Despite this, AS&R women are less likely to attend for timely maternity care and when they do, care may be poor, with staff not understanding their specific needs and displaying poor attitudes. This article discusses the Maternity Stream of the City of Sanctuary and how this charity aims to work with statutory and voluntary sector maternity-related services and groups to develop services that are inclusive for AS&R women and meet their specific needs. Volunteer AS&R women are central to the activities of the Maternity Stream and this article discusses how they engage with midwives and other maternity workers to facilitate the development of services that may ultimately improve pregnancy outcomes for AS&R women.