MCur / Department of Advanced Nursing Science / ● BACKGROUND Maternal Mortality rate is defined as the death of a woman while pregnant within 42 days of termination of pregnancy irrespective of the duration/site of the pregnancy. South Africa like any other country, has high maternal mortality rate. Most deaths are caused by factors attributed to pregnancy and childbirth in health facilities. It is the practice in all public hospitals and clinics that women are discharged ±6 hours after delivery hence most problems are not detected thus the complications they may be having such as thromboembolism or sepsis that may arise during the post-partum period. ● AIM OF THE STUDY The purpose of the study was to determine perceived factors contributing to maternal mortality among women in rural areas of Musina Municipality within Limpopo Province. ● METHODS A quantitative, descriptive, exploratory, cross- sectional research was used to conduct the study. The target population consisted of all pregnant and lactating women who attended the sampled clinics (ANC) in Musina Municipality. Self- Administered questionnaire was used to collect data from the women who met the criteria for inclusion. A total of 342 women were recruited to participate in this research from all five (5) health iv facilities. Collected data was analysed using SPSS Version 23.0 computer software with the assistance of a Statistician. ● FINDINGS Findings of this study revealed that majority of the respondents 215 (53.0%) reported late booking for Ante-Natal Care (ANC), among the late booking 120 (25.0%) commenced ANC attendance at second trimester, while 95 (12%) commenced ANC at last trimester and only attended once only. Minority of the respondents 127 (24.2%) reported that they never attended ANC because of various reasons cited such as not accessing clinic because of distance and not having transport. Majority 232 (83.5%) of the respondents revealed that professional nurses ‘attitudes and unwelcoming postures make them to report during labour than attending ANC. Of the respondents, 49 (17.6%) reported lack of knowledge on engorged breast and mastitis. Various socioeconomic and knowledge factors influenced women, (28.5%) women indicated long distance to health facility, while (12.5%) arrived in labour ward with head on perineum because labour started suddenly, lack of money and transport by (48.4%). ● RECOMMENDATION Recommendation was made on the importance of in-service training of professional midwives on interpersonal relation, proper assessment of women to detect any complications. Recommended workshops for training and different courses in order to broaden their knowledge relating to pregnancy and childbirth and management of pre and post-partum. Also awareness sessions for women about dangers signs during puerperium were recommended. ● CONCLUSION This study has identified several factors that have an important influence on maternal mortality in the study area. Among these are variables such as place of consultation/diagnosis, the person who pays the treatment costs, awareness of pregnancy complications and knowledge of the place of ANC treatment, among others. / NRF

Bakgrund: I Norden sker i stort sett alla förlossningar på sjukhus assisterade av barnmorskor. Internationellt varierar antalet hemförlossningar. Bad har historiskt sett använts för avslappning och smärtlindring i samband med en förlossning. Det finns en ökad efterfrågan hos kvinnor i Sverige som önskar sig en alternativ förlossningsmetod och det är en fråga som väcker debatt, både i Sverige och i andra länder. Syfte: Att sammanställa studier om nordiska kvinnors orsaker till och upplevelser av en alternativ förlossningsmetod. Metod: En beskrivande litteraturstudie som har utformats av kvalitativa och kvantitativa studier. Totalt ingår 19 vetenskapliga artiklar. Data har kvalitetsgranskats, analyserats och sammanställts. Resultat: Fem huvudkategorier och åtta underkategorier framkom i resultatet. Resultatet visar på att det finns en rad olika orsaker till att nordiska kvinnor väljer en alternativ förlossningsmetod. Att föda med en alternativ förlossningsmetod beskrivs som en positiv upplevelse där kvinnan själv har kontroll över förlossningsprocessen samt en möjlighet att välja förlossningsplats. Detta ingav en trygghet samt en känsla av makt och självbestämmande. Det beskrivs som en trygg miljö utan yttre störningar där kvinnorna kan fokusera och följa den naturliga förlossningsprocessen. Kvinnorna möter även en del negativa attityder kring deras val av en alternativ förlossningsmetod. Slutsats: Kvinnors orsaker till att välja en alternativ förlossningsmetod baseras på en önskan om en naturlig förlossning, bristande tro till medicinska interventioner och känslan av att få vara i kontroll. Fördelar kan ses vid dessa typer av förlossningsmetoder, framförallt rörande upplevelsen för kvinnan. Kvinnor som önskar sig en alternativ förlossningsmetod upplever att de möts av negativa attityder och ifrågasättande. Kvinnor upplever även känslor som oro och rädsla i samband med en alternativ förlossningsmetod, då i kontexten att eventuella komplikationer kan uppstå. / Background: In the Nordic countries most women give birth in hospitals, while being assisted by midwives. Internationally, the number of home deliveries varies. Bathing has historically been used for relaxation and pain relief during childbirth. There is an increased demand from women in Sweden for waterbirth, and this causes debate, both in Sweden and in other countries. Aim: To compile research concerning Nordic women ́s reasons for, as well as experiences of an alternative birth method. Method: A descriptive literature study designed by qualitative, as well as quantitative research, a total of 19 articles. Data has been interpreted, analyzed and compiled. Results: Five main categories and eight sub-categories appeared in the results. The results show that there are a variety of reasons why Nordic women choose an alternative method of delivery. Giving birth through an alternative delivery method is described as a positive experience, giving the woman a sense of control during the delivery process. Being able to choose the place of birth itself provided a sense of security as well as a sense of power and autonomy. It is described as a safe environment without external disturbances, where the women can focus and follow the natural process of childbirth. They also encounter some negative attitudes about their choices of an alternative method of delivery. Conclusion: Women's reasons for choosing an alternative birth method is based on the desire for a natural birth, a lack of faith in medical interventions, or a feeling of maintaining control. Advantages can be seen in these types of birthing methods, especially in regard to the experience for the woman. Women who wish for an alternative birth method feel that they are meeting negative attitudes and questioning. Women also experience feelings of concern and fear regarding alternative birth methods, then in the context of eventual complications that could occur.

The thesis focuses on the analysis of a dispute regarding home birth and discourses associated with it. The thesis focuses on the analysis of a dispute regarding home birth and discourses associated with it. The thesis focuses on the analysis of a dispute regarding home birth and discourses associated with it. Choice of location and proces sof giving birth in czech environment remains very limited and domestic deliveries are subject of controversy among professional medical community and state institutions on the one hand and midwives, civil movements and comitted mothers on the other hand. Theme divides laical and expert public. It's established through discourses, reflect the views and opinions of the two quarreled groups - supporters of medically controlled childbirth and supporters of natural birth. In the context of media reporting can be identified two main streams of discursive formations, scattering of concepts, thematic choices, objels and modalities of coming to the statement - medical discourse and natural discourse. The controversy both discourses in the Czech media escalated with court case with midwife Ivana Königsmarková, who in 2009 assisted at home birth that ended tragically - serious damage and subsequent death of a child. Just on the case of Ivana Königsmarková and its...

This diploma thesis deals with the psychological aspects of management focusing on the styles of leadership at the gynecological-obstetric department, specifically at the maternity hospital. The aim is to find out what kind of leadership is used by the senior and station nurses. This thesis explores how they interpret the management grid GRID and how they perceive themselves in terms of how midwives perform. For this research were choosen two hospitals, public and joint-stock company. That is why the objective was also to compare the interviews with midwives regarding their motivation, satisfaction and conflict occurance. Therefore the information was received that touched upon these topics and presented the perception of the workers in obstetrician. The theoretical part introduces the psychological aspects of leadership, so that the reader goes through chapters focusing on manager personality, management, leadership, work environment, work teams, motivation, workplace conflicts, stress, burnout syndrome, etc.. The empirical part is presented as part of the qualitative research, which presents the way of senior and station nurses with the help of the inspiration by design of the case study. Further a case study at the state hospital and a case study at joint-stock company are being developed with...

Forskning visar på att information om planerad hemförlossning är av stor betydelse för den gravida kvinnan i sitt val av födelseplats. Det finns dock inte så mycket forskning om barnmorskors, verksamma inom mödrahälsovården, upplevelser av planerad hemförlossning. Syftet med studien var att beskriva barnmorskors upplevelser av planerad hemförlossning inom mödrahälsovården. Åtta barnmorskor som arbetade inom mödrahälsovården inom region Skåne intervjuades. Intervjuerna analyserades utifrån en kvalitativ innehållsanalys med en induktiv ansats. I resultatet framkom tre huvudkategorier och nio underkategorier. Huvudkategorier består av: ”Olika förutsättningar”, ”Det ”alternativa” födandet” och ”Den professionella rollen i samtalet”. I samband med intervjuerna framkom det att barnmorskorna inte informerar om planerad hemförlossning rutinmässigt, att barnmorskorna har bristande kunskap om planerad hemförlossning, att barnmorskorna saknar nationella riktlinjer kring planerad hemförlossning samt att planerad hemförlossning finns i det dolda. De intervjuade förklarade detta med att de inte hade information eller utbildning om planerad hemförlossning under sin utbildning till barnmorskor eller på sin arbetsplats. Barnmorskorna upplevde även att det finns ett motstånd till planerad hemförlossning inom sjukhusvården samt att de ekonomiska resurserna ser olika ut i olika delar av Sverige vilket bidrar till en ojämlik förlossningsvård. Mer forskning behövs inom området för att få en ökad förståelsen för hur barnmorskors, inom mödrahälsovården, upplevelser av planerad hemförlossning, påverkar den information som ges till de gravida kvinnorna. / Research shows that information about planned home birth is of great importance for the pregnant woman in her choice of place of birth. However, there is not much research on the experiences of midwives operating within the maternal health care system about planned home birth. The purpose of the study was to elucidate midwives’ experiences of planned home birth in maternal health care. Eight midwives, operating within maternal health care in Skåne, Sweden were interviewed. The interviews were analysed using qualitative content analysis with an inductive approach. From the results emerged three main categories and nine subcategories: The main categories included: ”Different conditions”, ”The ”alternative” birth” and ”The professional role in the conversation”. It appears that the midwives do not routinely inform about planned home birth, that the midwives have deficient knowledge about planned homebirth, that the midwives lack national guidelines for planned home birth and that planned home birth is unseen. The interviewed thought a reason hereby was due to the fact that they had not received information or training about planned home birth during their training as midwives or at their workplace. The midwives experience that there is opposition to planned home birth from the healthcare system and that the financial resources look different in different parts of Sweden which contributes to an unequal maternity care. More research is needed in this area to gain an increased understanding of how midwives’ experiences in maternal health care affect the information given to pregnant women.

I initially explored historic figures of European accoucheur of the 17. and 18. century. Beyond this I focused on a period called "Pobělohorská" in Czech countries. I summarized the health conditions of the population during this period, and described medical professions, midwifery and emergency Christening ceremonies. One chapter discusses partnerships and considers women who hid their pregnancy to avoid the prospect of caring for their children in the future. For this reason I present questions relating to how women hid their pregnancy during the Early Modern period. In the next chapter I discuss aspects of the process of giving birth, the locations where women gave birth and the moments thereafter. I present the circumstances of the death of the baby and the possible causes of death. The process of investigation of the scene, an assessment of the body and the search for the mother of the baby (as a potential murderer) are all considered. The assessment of the body was in the hands of the regional physiciusurgeon and a midwife. In my work I describe how the body was assessed, how they judged the maturity of the newborn baby and if the baby was born dead or alive. Further chapters explain the treatment of the umbilical cord, the inquisition of the witnesses and the suspect, and the next steps of...

No description available.

Bakgrund: Mäns våld mot kvinnor är en ständigt aktuell fråga. Våldet består av flera former såsom fysiskt, psykiskt, ekonomiskt, materiellt, sexuellt, digitalt och hedersrelaterat våld. Barnmorskan har ett ansvar i att ställa frågor om våld till gravida kvinnor för att identifiera de som lever under våldsutsatthet och kunna erbjuda stöd och förebygga fortsatt våldsutsatthet. Syfte: Syftet var att beskriva barnmorskors upplevelse av att ställa frågan om våldsutsatthet till gravida kvinnor på mödrahälsovården.  Metod: En kvalitativ design med enskilda intervjuer har genomförts med totalt tio barnmorskor från sex olika mödrahälsovårdscentraler i sydöstra Sverige. Analysen genomfördes via en induktiv tematisk innehållsanalys. Resultat: De främsta resultaten i studien presenteras i fyra tematiska kategorier; professionellt och etiskt förhållningssätt, barnmorskans behov av att definiera våld, barnmorskans upplevelse av barriärer och barnmorskans upplevelse av brister i vårdkedjan. Barnmorskorna beskrev att rutinen kring att ställa frågan om våld till gravida kvinnor på mödrahälsovården var angelägen och självklar, där rädsla för att möta ett medgivande på frågan inte hindrade barnmorskorna från att ställa den. Slutsats: Ett av studiens fynd är att gravida kvinnor med hög socioekonomisk status ansågs utgöra en barriär för att ställa frågor om våldsutsatthet. För att överkomma de barriärer som finns för att ställa frågan om våld är det viktigt att ständigt arbeta med de frågor som utgör en barriär för barnmorskorna. / Background: Men's violence against women is an ever-present issue. Violence consists in many forms, such as physical, psychological, economic, material, sexual, digital, and honor-related violence. The midwife has a responsibility to ask questions about violence to pregnant women to identify those who are exposed to domestic violence. Aim: This study aimed to describe midwives' experience of asking the question of exposure to violence to pregnant women in maternity care. Method: A qualitative design with individual interviews has been conducted with ten midwives from six different maternity health centers in southeastern Sweden. The analysis was conducted through an inductive thematic content analysis. Results: The study´s main results are presented in four thematic categories; professional and ethical approach, the midwife's need to define violence, the midwife's experience of barriers and the midwife's experience of shortcomings in the care chain. The midwives described that the routine around asking the question of violence to pregnant women at the maternal health care was urgent and self-evident, where fear of obtaining consent to the question did not prevent the midwives from asking it. Conclusion: One of the study's finding is that pregnant women with high socioeconomicstatus were considered a barrier to asking the question. To overcome the obstacles that exist to asking the question of violence, it is important to constantly work on the issues that constitute a barrier for the midwives.

Under graviditeten sker en psykologisk utvecklingsprocess hos förstföderskan. Det är vanligt att förstföderskan har tankar om den kommande förlossningssmärtan under tredje trimestern. Förstföderskor har ett behov av att förbereda sig inför smärthanteringen, där barnmorskan är ett viktigt stöd. Att förstföderskan känner sig väl förberedd antas leda till ökad Känsla av sammanhang (KASAM) vilket i sin tur kan underlätta transitionen till föräldraskapet. För att barnmorskan ska kunna stötta förstföderskan i sin förberedelse behövs en ökad kunskap gällande hur förstföderskan förbereder sig. Syftet med studien var att belysa hur förstföderskan förbereder sig inför att hantera smärta vid kommande förlossning. Studien utfördes som en kvalitativ intervjustudie med induktiv ansats där 11 förstföderskor intervjuades. Analysen genererade en huvudkategori: Förberedelse inför det okända - en skräckblandad längtan och tre generiska kategorier: Identifiera den egna synen på smärta, Fördjupa sina kunskaper och Dela sin förberedelse. Resultatet visade att förstföderskor har ett stort behov av att förbereda sig och partnern anses vara en viktig del i detta. Förstföderskorna upplevde att det förlossningsförberedande stödet som de blivit erbjudna av vården inte var tillräckliga. Därför har flera förstföderskor i studien använt privata alternativ som de bekostat själva. Detta anses vara ett problem då alla förstföderskor inte har samma ekonomiska möjlighet att bekosta sin förberedelse. Därför är det av stor vikt att vården i Sverige strävar efter att erbjuda ett förlossningsförberedande stöd som tillmötesgår gravida förstföderskors behov för att uppnå en mer jämlik vård. Om förstföderskan är väl förberedd inför smärthanteringen leder det till ökad KASAM vilket i sin tur antas gynna föräldratransitionen. / During pregnancy, a psychological development process takes place in the expectant first-time mother. It is common for the expectant first-time mother to have thoughts about the upcoming labor pain during the third trimester. Expectant first-time mothers have a need to prepare for pain management, where the midwife is an important support. The fact that the expectant first-time mother feels well prepared is assumed to lead to increased Sense of Coherence (SOC), which in turn can facilitate the transition to parenthood. In order for the midwife to be able to support the expectant first-time mother in her preparation, an increased knowledge of how the expectant first-time mother prepares is needed. The purpose of the study was to shed light on how the first-time mother prepares to handle pain in the upcoming birth. The study was conducted as a qualitative interview study with an inductive approach where 11 expectant first-time mothers were interviewed. The analysis generated a main category: Preparation for the unknown - a longing mixed with fear and three generic categories: Identifying one's view of pain, Deepening one's knowledge and Sharing one's preparation. The results showed that expectant first-time mothers have a great need to prepare and the partner is considered to be an important part of this. The expectant first-time mothers felt that the childbirth preparation support offered to them by the health care provider were not sufficient. Therefore, several expectant first-time mothers in the study used private options that they paid for themselves. This is considered a problem as not all expectant first-time mothers have the same financial opportunity to pay for their preparation. Therefore, it is of great importance that healthcare in Sweden strives to offer childbirth preparation support that meets the needs of expectant  first-time mothers in order to achieve more equal care. If the expectant first-time mother is well prepared for pain management, it leads to increased SOC, which in turn is assumed to benefit the parenting transition.

The development ofNursing and Nursing Education in Venda is intimately related to the work of the early missionaries, Western education and medical developments. The growth of nursing and health services had a reciprocal relationship. One was not possible without the other, viz the history of missionary education, hospitals, health services, sociocultural and political development. Each stage ofthese developments was an important step in laying the foundation of modem professional nursing and nursing education. Before contact with Western medicine, health and midwifery services were provided by traditional healers, nurses and midwives. Divination was used to: diagnose disease, identify the witch, determine medicines to cure the disease. Western nursing developed through stages of: lay nursing, hospital certificated, auxiliary nurses and midwives, registered nurses and midwives, comprehensive general nurse and midwife. The history of Nursing and Nursing Education is thus part and parcel of the social developments of the country it serves. / Health Studies / M.A. (Nursing Science)